Changes in Combined Lifestyle Risks and the Transition of Activities of Daily Living in the Elderly Population of Taiwan: Evidence from the Taiwan Longitudinal Study on Aging.

Functional ability decline occurs with age. This study aims to investigate the associations between the lifestyle factors-exercising, food consumption, and smoking-and the functional ability of the activities of daily living (ADL) by gender. The data were obtained from the Taiwan longitudinal study on aging, a national cohort study. The cross-sectional results demonstrated that the frequency of exercising was negatively associated with ADL in both men and women. Dairy products were positively associated with ADL in men. The longitudinal results illustrated that current and consistent exercising were negatively associated with changes in ADL scores over 4- and 8-year periods in both men and women. Seafood consumption was negatively associated with changes in the subsequent 4-year ADL scores. Past smoking was positively associated with changes in subsequent 4-year ADL scores in men, while current smoking was positively associated with changes in subsequent 8-year ADL scores in women. Therefore, consistent exercising, food consumption, and smoking were associated with ADL functional ability in elderly people, and the associations differed by gender. Elders exercising consistently had good ADL performance and maintained their ADL ability better, especially women. Seafood consumption decreased the risk of ADL decline, while smoking increased the risk of ADL decline.

Benefits of applying virtual reality in pelvic movement training through a Wii Fit: a randomized controlled trial.

BACKGROUND: Pelvic movement training has become compulsory for part of medical students. An increasing amount of research has focused on the influence of virtual reality (VR) on learning effectiveness. However, its application to pelvic floor muscles or pelvic movement training is still in its infancy. We compared the effectiveness of conventional pelvic movement training with or without VR-assisted pelvic movement training for student learning. METHODS: We recruited 44 university students (16 male and 28 female participants; average age = 19.7 ± 0.31 years) who had not previously received pelvic movement education or training. The participants were randomly assigned into traditional and experimental groups to acquire pelvic movements and relevant knowledge. The traditional group received conventional classes (about 15 min), whereas the experimental group received both conventional classes and VR-assisted teaching (additional VR session took approximately 25-45 min depending on the speed of movement of each participant). The participants were asked to control the trajectory of the centre of pressure on the Wii Fit balance board and build-in games to learn pelvic movements. We conducted evaluations before, immediately after, and 2 weeks after the experiment, based on the scores of written and practical examinations. The experimental group was also asked to complete a questionnaire during the posttest. RESULTS: We carried out two-way repeated measures ANOVA and discovered that the written examination scores indicated a significant Time × Group interaction (p=0.015). In each group, the written and practical examinations in the posttest and follow-up test exhibited significantly improved results compared with the baseline value (p <0.001, except for traditional group of written exam in follow up test vs. baseline p=0.001). The written examination in the follow-up test did not decline significantly compared with those in the posttest, but the practical examination in the follow-up test was decline significantly compared with those in the posttest (p=0.033). The experimental group had superior overall performance in the practical examinations than the traditional group (experimental group: mean = 76.27, 95% confidence level [CI] = 70.84-81.71; traditional group: mean = 64.21, 95% CI = 58.78-69.65). No significant difference in the written examination between two groups. The percentage for agreement ratio on the usefulness, ease of use, users' intention to continue using the VR-assisted teaching is high (95.5-100%). CONCLUSIONS: The results of this study suggested that conventional and conventional + VR teaching were both effective. However, the incorporation of VR stimulated learning motivation and facilitated precise performance of pelvic movements. It is recommended that pelvic floor muscles training could be supplemented with VR or games to increase students' motivation and understanding how to perform pelvic movements.

Associations of exercise, nutritional status, and smoking with cognitive decline among older adults in Taiwan: Results of a longitudinal population-based study.

This study aimed to explore the long-term effects of exercise, smoking, and nutritional status on cognitive reserve and changes in cognitive function among Taiwanese adults aged ≥65 years. Data were obtained from the Taiwan Longitudinal Study of Aging, a national representative population-based cohort study. Results showed that the average baseline scores on the Short Portable Mental Status Questionnaire (SPMSQ) and Mini-Nutritional Assessment (MNA) were 9.07 and 26.01, respectively. The proportions of smoking and exercising at baseline were 24.12% and 58.67%, respectively. A linear regression analysis indicated that old adults who were current and consistent exercisers had better subsequent 4-year SPMSQ scores than those who were not exercisers (P < 0.05). The MNA score was positively associated with subsequent 4- and 8-year SPMSQ scores for the 65-74-year-old adults (P < 0.05). The logistic regression analysis showed that current and consistent exercise was negatively associated with subsequent 4-year cognitive decline (P < 0.05). Previous exercise experience was positively associated with subsequent 8-year cognitive decline for the ≥75-year-old adults (P < 0.05). The MNA score was negatively correlated with subsequent 4- and 8-year cognitive decline among the 65-74-year-old adults. Among the adults aged ≥75 years, consistent smoking was positively associated with cognitive decline over 4 years (P < 0.05). Therefore, current and consistent exercise and good nutritional status benefit cognitive function and reserve, and have protective effects on cognitive decline among old adults, whereas discontinued exercise, poor nutrition, and cigarette smoking are likely to raise the risk of cognitive decline.

Urinary Concentrations of Triclosan, Benzophenone-3, and Bisphenol A in Taiwanese Children and Adolescents.

The purpose of this study was to determine the levels of urinary triclosan (TCS), benzophenone-3 (BP-3), and bisphenol A (BPA) in 52 children and 71 adolescents. The effects of age and sex on the levels of urinary TCS, BP-3, and BPA were explored, respectively. Results demonstrated the overall detection rates of urinary TCS, BP-3, and BPA were 18.7%, 8.1%, and 49.6%, respectively. The females had higher TCS concentrations than males (p = 0.051). The detection rate of urinary BP-3 in females (12.3%) was higher than that in males (0%) (p = 0.015). Moreover, the detection rate of urinary BP-3 in adolescents (14.1%) was higher than that in children (0%) (p = 0.005). For children, no urinary BP-3 was found. There were no differences in detection rates and concentrations of urinary TCS, BP-3, and BPA between males and females, respectively. For adolescents, urinary BP-3 was only found in the females. Urinary TCS levels in females were higher than those in males (p = 0.047). The present study showed that urinary TCS concentrations in females were significantly higher than those in males, respectively. In addition, BP-3 was only detected in urine samples of female adolescents. Sex and age were the important factors influencing urinary TCS and BP-3 concentrations.

Associations between body mass index, mid-arm circumference, calf circumference, and functional ability over time in an elderly Taiwanese population.

BACKGROUND: Anthropometric measurements such as body mass index (BMI), mid-arm circumference (MAC), and calf-circumference (CC) are assessed with ease during regular health visits, but the associations between these anthropometric parameters and functional ability in elderly population over time has not been studied in detail. This study aimed to examine the associations between functional ability and the anthropometric parameters BMI, MAC, and CC in Taiwanese adults ≥ 65 years old. METHODS: Data were obtained from the Taiwan Longitudinal Study of Aging and analyzed retrospectively. RESULTS: Functional decline over a 4- and 8-year period was noted in approximately 14% and 21% of study participants, respectively. BMI was negatively associated with participants' current Activities of Daily Living (ADL) scores, and was positively associated with 4-year ADL scores in adults ≥ 65 years old (ß = -1.19 and 1.14, P = 0.0010 and 0.0420, respectively). MAC and CC were negatively associated with current ADL scores (ß = -1.46, P < 0.0001 and ß = -4.68, P < 0.0001, respectively). The association between CC and current ADL score was stronger than the association between current ADL score and either BMI or MAC. For adults ≥ 65 years old, a high BMI increased the risk of ADL decline over 4 and 8 years by 4-fold and 3-fold (adjusted odds ratio = 4.23 and 2.64, 95% confidential interval = 1.95-9.19 and 1.22-5.71, P = 0.0003 and 0.0141, respectively). CONCLUSIONS: BMI is a significant predictor of decline of functional ability in Taiwanese adults ≥ 65 years old. CC is an important anthropometric indicator of current functional ability among older adults.

Associations of various perceived-stress situations with depressive symptoms in ≥50-year old Taiwanese men and women: Results from the Taiwan Longitudinal Study on Aging.

This study was aimed to evaluate the cross-sectional and longitudinal associations between various perceived-stress and depressive symptoms in old Taiwanese men and women aged 50 years and over. Data were derived from the Taiwan Longitudinal Study on Aging. Stress for health, finance, and family members' related issues were all cross-sectionally associated with concurrent depressive symptoms for men and women (all P<0.05). Increased/constant-high health stress was positively associated with subsequent depressive symptoms in both genders (all P<0.05). Constantly high job stress and increased stress over family members' problems were associated with higher likelihood of subsequent depressive symptoms in men (P<0.05). Constantly high/increased financial stress and relationship strain with family members were positively associated with subsequent depressive symptoms in women (all P<0.05). The results suggest that stress for health, job, finance, and family members-related issues are unequally associated with depressive symptoms among Taiwanese men and women aged 50 years and over. Changes of health stress even reduced are significantly associated with subsequent depressive symptoms. Long-term job stress and increased stress over family members' problems increase occurrences of men's depressive symptoms, while increased/long-term financial stress and relationship-strain with family members increase occurrences of women's depressive symptoms. Long-term high health stress has more impacts on men's depressive symptoms than women's, while long-term high relationship strain with family members has more impacts on women's depressive symptoms than men's.

Dietary patterns and depressive symptoms in a Taiwanese population aged 53 years and over: Results from the Taiwan Longitudinal Study of Aging.

AIM: The present study aimed to examine the associations between dietary patterns and depressive symptoms in a Taiwanese population aged 53 years and over, and evaluate the longitudinal impacts of dietary patterns on depressive symptoms. METHODS: Data were from the Taiwan Longitudinal Study of Aging. RESULT: Depressive symptoms were identified in 23% of adults aged ≥53 years. Multivariate logistic regression analysis showed that a Western dietary pattern, which was characterized by frequent consumption of meat/poultry and eggs, with infrequent consumption of fish, beans/legumes, vegetables and fruit, was cross-sectionally associated with a high risk of depressive symptoms (P < 0.05). A traditional dietary pattern, which was characterized by frequent consumption of meat/poultry and eggs with infrequent consumption of fish, increased by 60% the risk of depressive symptoms during the subsequent 8 years (P < 0.05). A healthy dietary pattern, which was characterized by frequent consumption of fish, vegetables and fruits, was not significantly associated with subsequent depressive symptoms. CONCLUSIONS: Dietary patterns correlate with depressive symptoms in a Taiwanese population aged 53 years and over. The Western and traditional dietary patterns, characterized by frequent consumption of meat/poultry and eggs, and infrequent consumption of fish, increased the risk of current and subsequent depressive symptoms. Geriatr Gerontol Int 2016; 16: 1289-1295.

Occurrence of triclosan in the tropical rivers receiving the effluents from the hospital wastewater treatment plant.

The objective of this study was to determine the occurrence of triclosan in the tropical rivers where received the effluents from a hospital wastewater treatment plant (HWWTP) in southern Taiwan. Three and ten sampling sites were selected at the Jiaosu River (S0-S2) and Dian-Bao River (S3-S12), respectively. The samples of the HWWTP influent, effluent and receiving river water and sediment were collected and analyzed using ultrahigh-performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/ MS). Results showed that the triclosan level in surface water of the Jiaosu River and Dian-Bao River ranged from 3 to 68 ng/L and ranged from <2.7 to 51 ng/L, respectively. The hospital did contribute a loading of triclosan to the neighboring river. The mean value of triclosan concentration in the downstream surface water of the Jiaosu River (S1 20.2 ng/L) was approximately three times higher than that of the background level (S0 6.0 ng/L) (p = 0.011). The concentrations of triclosan in two surface water samples were over the predicted no effect concentration (PNEC) of 50 ng/L for algae. In addition, significant seasonal differences of triclosan in surface water of Jiaosu River (p = 0.020) and the HWWTP effluents (p = 0.302) were also observed. The concentrations of triclosan in sediments of these two rivers seemed stable. On average, triclosan was detected in 86 % of the sediment samples with a range from <1.1 to 13 ng/g. Triclosan in surface water and sediments of the tropical rivers might be rapidly photolyzed due to plenty of sunshine. It is worth to further investigate the occurrence and fate of triclosan photoproduct in the aquatic environment of the tropics.

Dietary patterns and cognitive decline in Taiwanese aged 65 years and older.

OBJECTIVE: This study examines the association between dietary patterns and cognitive decline in Taiwanese aged 65 years and older. METHODS: Data were from a population-based longitudinal study, the Taiwan Longitudinal Study of Aging, with a nationally representative sample. RESULTS: Nearly 2%, 8%, and 3% of participants had a western, traditional, and healthy dietary pattern, respectively. Western and traditional dietary patterns were negatively associated with subsequent short portable mental state questionnaire score over 4 and/or 8 years (all p < 0.05), whereas a healthy dietary pattern was not. Western dietary patterns significantly increased, by nearly threefold, the risk of subsequent cognitive decline over 8 years (adjusted odds ratio = 4.35, 95% confidence interval = 1.52-12.50, p < 0.05). For elders aged 65-74 years, a western dietary pattern was positively associated with increased, by eightfold, risk of cognitive decline over 8 years (adjusted odds ratio = 9.35, 95% confidence interval = 2.38-36.67, p < 0.05), whereas traditional and healthy dietary patterns were not. For elders aged ≥ 75 years, none of western, traditional, or healthy dietary patterns were associated with cognitive decline over 4 and 8 years. CONCLUSIONS: Dietary patterns correlate with cognitive function in Taiwanese aged 65 years and older and can predict the occurrence of subsequent cognitive decline. Western dietary pattern increases the risk of cognitive decline over 8 years. This study suggests that a diet that involves frequent consumption of meat/poultry and eggs and infrequent consumption of fish, beans/legumes, and vegetables and fruits may adversely affect cognitive function in older Taiwanese.

Nutrition risk, functional dependence, and co-morbidities affect depressive symptoms in Taiwanese aged 53 years and over: a population-based longitudinal study.

OBJECTIVE: This study examined cross-sectional and longitudinal associations of nutritional risk, functional dependence and co-morbidities with depressive symptoms in people aged 53 years and over in Taiwan. METHODS: Study data were obtained from a population-based longitudinal study, the Taiwan Longitudinal Study of Aging (TLSA), with a nationally representative sample of nearly-old and old Taiwanese. RESULTS: The prevalence of having depressive symptoms and being at risk of malnutrition/malnourishment in 1999 was 23% and 21%. Mini-Nutritional Assessment (MNA) score, being at risk of malnutrition/malnourishment, number of self-reported co-morbidities, and activities of daily living (ADL) score were all cross-sectionally correlated with depressive symptoms (all p<.05). Being at risk of malnutrition/malnourishment and number of co-morbidities were also longitudinally associated with increased risk of subsequent depressive symptoms over four and eight years (all p<.05). The relationship between nutritional risk and subsequent depressive symptoms was stronger than the relationship between co-morbidities and ADL score and subsequent depressive symptoms. CONCLUSIONS: These results suggested that nutritional risk, co-morbidities and functional dependence are all associated with increased risks of depressive symptoms in people aged 53 years and above. Nutritional risk contributes significantly to subsequent depressive symptoms and is a strong and consistent predictor of subsequent depressive symptoms in nearly-old and old Taiwanese.

Need-based intervention is an effective strategy for improving the nutritional status of older people living in a nursing home: a randomized controlled trial.

BACKGROUND: Nutrition is a key element in geriatric health. Protein-energy malnutrition is common in institutionalized persons. OBJECTIVE: This study examined the effectiveness of a need-based "routine screening and timely intervention" strategy in improving the nutritional status of persons living in nursing homes. DESIGN: A 24-week randomized, double-blind, controlled trial. SETTING: A privately managed geriatric nursing home in Taiwan. PARTICIPANTS: Ninety-two ≥65-year old persons who were ≤25kg/m(2), >1 month residence, able to self-feed or receive oral feeding, without acute infection and non-bed-ridden. METHODS: Prospective participants were stratified by gender and then randomly assigned to either the control group (n=45) or the intervention group (n=47). Each subject in the intervention group was given a 50g/day soy-protein-based nutritional supplement if he/she was rated as undernourished according to the Mini Nutritional Assessment (MNA, score ≤24) and BMI ≤24kg/m(2). The supplement contained 9.5g protein, 250kcal energy and all essential micro-nutrients. The supplementation would be suspended once either one of the "at risk" condition was corrected. Nutritional rating with the MNA took place at baseline and every 4 weeks during the trial. Biochemical indicators were measured at baseline, mid-point (week-12) and end-point (week-24). Results were analyzed with the two-sample t-test, and the generalized estimating equations (GEE) controlled for demographic and health-related variables. RESULTS: Of the 92 subjects, 82 completed the trial; 7 withdrew and 3 died during the trial. Results showed that the need-based intervention was an effective and appropriate strategy for improving the nutritional status of persons at risk of undernourishment. The intervention significantly improved body weight, BMI, mid-arm circumference, calf circumference, and serum albumin and cholesterol concentrations at all intervals (all p<0.05). However, the intervention did not significantly improve hematocrit, hemoglobin or lymphocyte count status. CONCLUSIONS: Results suggest that the need-based nutritional intervention can be a practical and useful strategy for improving the nutritional status of persons living in nursing homes and save on healthcare cost. The potential application of this strategy deserves the attention of health planners.

Cross-sectional and longitudinal associations of functional and health status with institutional care use: results from the Survey of Health and Living Status of the Elderly in Taiwan.

AIM: This study evaluated the cross-sectional and longitudinal associations of functional and health status with institutional care, and examined determinants of institutional care use over time. METHODS: Data of this study were obtained from the Survey of Health and Living Status of the Elderly in Taiwan (SHLSET), which was launched in 1989 and involved a nationally representative sample of nearly-old and old Taiwanese. The baseline data in this present study were collected in 1999, and followed in 2003 and 2007. RESULTS: Participants with institutional care use had a higher activities of daily living (ADL) score, more self-reported diseases and poorer self-reported health status than participants without institutional care use (all P<0.05). Cross-sectional analysis showed that a higher ADL score, having heart diseases and having a stroke were positively associated with institutional care use (P<0.05); whereas the number of self-reported diseases and poor self-reported health status were not associated with institutional care use. Longitudinal analysis showed that increased ADL scores and the number of self-reported diseases over 4- and 8 years were associated with an increased likelihood of subsequent institutional care use (all P<0.05). Worsening health status over 4 years was associated with an increased likelihood of subsequent institutional care use, but this association did not exist over 8 years. CONCLUSIONS: Only ADL and ADL deterioration over time are cross-sectionally and longitudinally associated with increased institutional care use. Declining functional status is a major determinant of institutional care use for Taiwanese aged over 53 years.

Predictors of smoking cessation in 50-66-year-old male Taiwanese smokers: a 7-year national cohort study.

The study was aimed to determine the predictors of smoking cessation in 50-66-year-old male Taiwanese smokers. The study analyzed datasets of the "Survey of Health and Living Status of the Elderly in Taiwan" (SHLSET), a population-based longitudinal cohort study conducted by the Bureau of Health Promotion of Taiwan. Binary logistic regression analysis was performed to determine the association of demographic, socioeconomic, lifestyle and health-related variables with changes in smoking status at baseline, or with subsequent changes in smoking status in 50-66-year-old male Taiwanese. Functional impairment was the strongest predictor of quitting smoking for 50-66-year-old Taiwanese men. Other factors including a first hospitalization, emergency visit, or diagnosis of heart disease, quitting drinking, living with a spouse and older age were associated with increased likelihood of quitting smoking. Men with long smoking history, heavy daily cigarette consumption and more formal education were less likely to quit. Results suggest that functional decline is the major cause for quitting smoking for older Taiwanese men. Physical impairment and traumatic diseases that cause physical impairment have the most impact whereas "silent diseases" such as hypertension or diabetes have little impact. These findings should be useful for designing target-specific intervention strategies for older male Taiwanese smokers.

Comparing the predictive ability of population-specific Mini-Nutritional Assessment with Subjective Global Assessment for Taiwanese patients with hemodialysis: a cross-sectional study.

BACKGROUND: The Mini-Nutritional Assessment (MNA) and Subjective Global Assessment (SGA) are two frequently used tools in nutritional assessment. OBJECTIVES: This study aimed to evaluate the feasibility of applying the MNA with population-specific anthropometric modifications and to compare the predictive ability of MNA with that of the SGA in patients with hemodialysis. DESIGN: Purposive sampling. METHODS: This study was conducted in the Hemodialysis Unit of E-Da Hospital in Kaohsiung, Taiwan. A total of 192 patients with hemodialysis were evaluated their nutritional status concomitantly with the SGA and the MNA in two versions-MNA Taiwan version-I adopted population-specific anthropometric cut points, and MNA Taiwan version-II had body mass index (BMI) omitted. RESULTS: The SGA graded 1% malnourished and 51% at risk of malnutrition for patients with hemodialysis; MNA Taiwan version-I graded 3% and 41%, respectively, whereas MNA Taiwan version-II graded 5% and 36%, respectively. There were significant differences between patterns of nutritional status predicted with the SGA and the MNA versions (P<0.05). The scores predicted with both tools correlated positively with appetite, serum albumin and creatinine levels, BMI, and mid-arm and calf circumferences, and negatively with number of emergency visits. However, only MNA versions negatively correlated with length of hospital stay (all P<0.05). Linear regression analysis revealed that the MNA Taiwan version-I, -II and SGA scores were positively associated with BMI and serum albumin level, and negatively associated with number of emergency visits after adjusting for confounders (all P<0.05). However, only MNA Taiwan version-I and -II were negatively associated with C-reactive protein (CRP) level (P<0.05). The associations of MNA Taiwan version-II with albumin and CRP levels were stronger than those obtained using MNA Taiwan version-I and SGA. CONCLUSIONS: The present study suggests that both the modified MNA versions can evaluate nutritional risk of patients with hemodialysis in Taiwan. The MNA Taiwan version-II which adopted population-specific anthropometric cut values without BMI is better able to assess nutritional status and reflect health status of patients with hemodialysis than MNA Taiwan version-I and SGA.

The association of BMI and sedentary time with respiratory symptoms and asthma in 5th grade schoolchildren in Kaohsiung, Taiwan.

This study aimed to evaluate the association of body fatness and sedentary status with asthma and respiratory symptoms in schoolchildren in Kaohsiung, Taiwan. A questionnaire study elicited episodes of respiratory symptoms and data on lifestyle and anthropometric parameters in 1329 5th grade schoolchildren. Results showed that 12.4% of boys and 9.5% of girls had physician-diagnosed asthma, whereas 15.1% of boys and 12.4% of girls had suspected asthma. Significantly greater proportions of boys had non-exercise-induced respiratory symptoms than girls (p < 0.05). The number of respiratory symptoms was positively correlated with TV-watching time per day and self-reported sedentary time per weekend-day in girls (p < 0.05). Underweight was positively associated with one of the seven respiratory symptoms in girls (p < 0.05). At risk of overweight was positively associated with two of the seven respiratory symptoms in boys and one of the seven respiratory symptoms in girls (all p < 0.05). The risk of having physician-diagnosed asthma and suspected asthma increased 93% and 72%, respectively, in schoolchildren at risk of overweight (p < 0.05). Overweight was associated with a 78% increase in physician-diagnosed asthma (adjusted odd ratio (aOR) = 1.78, 95% CI = 1.08-2.91, p < 0.05). Higher sedentary time was significantly associated with more occurrences of one of the seven respiratory symptoms in girls (aOR = 1.05, 95% CI = 1.00-1.11, p < 0.05). Higher body mass index (BMI) was significantly correlated with longer TV-watching time per day in girls and longer self-reported sedentary time per weekday in boys (p < 0.05). In summary, schoolchildren who are at risk of overweight or overweight and/or have more sedentary time have increased risk of respiratory symptoms and asthma. Weight and sedentary statuses of schoolchildren can affect their respiratory health.

The association of plasma C-reactive protein levels with anthropometric and lipid parameters in elderly Taiwanese.

C-reactive protein (CRP), a plasma inflammation marker, has been known to play a role in the development of cardiovascular diseases. This study aims to evaluate the association of CRP with anthropometric and plasma lipid parameters in elderly Taiwanese 65 years or older. Data from the Elderly Nutrition and Health Survey in Taiwan (1999-2000), a national probability sampling study conducted to gain an understanding of the dietary pattern, and nutritional and health status of elderly Taiwanese were analyzed. Results showed that in men, CRP was positively correlated with age and waist-to-hip ratio (WHR) (both p<0.05) whereas in women, CRP was positively correlated with waist and WHR but negatively correlated with HDL-C (all p<0.05). Linear regression analysis showed that log CRP was positively associated with WHR in both genders (p<0.05) after adjusting for confounders. The correlation of CRP with WHR was stronger than that with both waist circumference and body mass index (BMI). Log CRP was inversely associated with HDL-C in women, but not men. The study suggests that among the anthropometric parameters examined, WHR is a stronger predictor for elevated CRP in elderly Taiwanese men and women. Whereas low HDL-C is a predictor among the plasma lipid parameters for elevated plasma CRP, at least in women. Gender differences exist in the association of CRP with anthropometric and lipid parameters.

The association of diet with respiratory symptoms and asthma in schoolchildren in Taipei, Taiwan.

This study aimed to evaluate the association of diet with respiratory symptoms and asthma in schoolchildren in Taipei, Taiwan. An in-class interview survey elicited experiences of asthma and respiratory symptoms and consumption frequencies of the major food categories in 2290 fifth graders. Respiratory symptoms surveyed included persistent cough, chest tightness, wheezing with cold, wheezing without cold, dyspnea-associated wheezing, and exercise-induced cough or wheezing. Results showed that the consumption of sweetened beverages had the strongest association with respiratory symptoms and was positively associated with six of the seven respiratory symptoms (all p < 0.05). The adjusted odds ratios (aOR) ranged from 1.05 (95% confidence interval (CI = 1.01-1.09) for exercise-induced cough to 1.09 (95% CI = 1.03-1.16) for wheezing without cold. Egg consumption was associated with 5 of the 7 respiratory symptoms. Consumptions of seafood, soy products, and fruits were each negatively associated with one of the seven respiratory symptoms (all p < 0.05). Consumption of seafood was negatively associated with physician-diagnosed asthma and consumptions of sweetened beverages and eggs were positively associated with suspected asthma (p < 0.05). In conclusion, the study suggests that diet is associated with the respiratory symptoms in schoolchildren in Taipei. Consumptions of sweetened beverages and eggs are associated with increased risk of respiratory symptoms and asthma whereas consumptions of soy products and fruits are associated with reduced risk of respiratory symptoms.

Associations of BMI, TV-watching time, and physical activity on respiratory symptoms and asthma in 5th grade schoolchildren in Taipei, Taiwan.

The study evaluated the associations of body fatness, TV-watching time, and physical activity with the occurrences of asthma and respiratory symptoms in schoolchildren in Taipei, Taiwan. A questionnaire survey was conducted to elicit episodes of respiratory symptoms and data on lifestyle and anthropometric factors in 2290 5th-grade schoolchildren. Results show that overweight was positively associated with 5 of the 7 respiratory symptoms. The risk of having respiratory symptoms increased 47%-94% in overweight schoolchildren. Watching TV > or = 3 hrs/day was associated with more occurrences of respiratory symptoms (aOR = 1.42-1.90). Physical activity > or =3 times/week was associated with fewer occurrences of respiratory symptoms (aOR = 0.66-0.73). Overweight was positively associated with an increased risk of suspected asthma in boys (aOR = 1.56, 95% CI = 1.07-2.29), but not in girls. In summary, overweight and greater TV-watching time increase the risk of respiratory symptoms, while habitual physical activity decreases the risk of respiratory symptoms. Weight status, sedentary life, and frequency of physical exercise are the factors that can impact on the respiratory health of schoolchildren.

Risk factors for respiratory symptoms and asthma in the residential environment of 5th grade schoolchildren in Taipei, Taiwan.

This study examined the association of residential environmental factors with respiratory symptoms and asthma in 2,290 fifth graders in Taipei, Taiwan. A self-report survey questionnaire elicited experiences of respiratory symptoms, disease history, and characteristics of residential environmental factors from schoolchildren. The proportion of schoolchildren having physician-diagnosed asthma was 9.8% and suspected asthma was 16.1%. The proportions of having respiratory symptoms in the past 12 months ranged from 9.8% for wheezing without a cold to 40.5% for exercise-induced cough. Higher proportions of boys had non-exercise-induced respiratory symptoms, physician-diagnosed asthma, and suspected asthma than girls (p < 0.05). Exposure to odoriferous chemical vapor was significantly associated with all seven respiratory symptoms considered in the study (p < 0.05). After adjusting for confounding factors including residential districts, gender, diagnosed allergy, and parental history of respiratory symptoms, odoriferous chemical vapors, gas leaks, dehumidifier use, presence of cockroaches at home, and leaky water/water puddle at home were significantly associated with the proportions of physician-diagnosed asthma or suspected asthma of the schoolchildren. The adjusted odds ratio (aOR) of physician-diagnosed asthma was 2.35 (95% confidential interval = 1.45-3.82) for odoriferous chemical vapor. The aOR of suspected asthma measure was 2.14 (95% CI = 1.40-3.26) for odoriferous chemical vapor. Odoriferous chemical vapor was the major risk factor of respiratory illness in the residential environment of schoolchildren in Taipei. Other household risk factors included gas leaks, dampness, and cockroaches at home.