Lower birth weight and diet in Taiwanese girls more than boys predicts learning impediments.

Possible links between lower birth weight, childhood diet, and learning in Taiwan are evaluated. The population representative Elementary School Children's Nutrition and Health Survey in Taiwan 2001-2002 and the national birth registry were used to examine school and social performance using the modified Scale for Assessing Emotional Disturbance questionnaires in relation to diet quality by the Youth Healthy Eating Index-Taiwan and birth weight of children aged 6-13 years (n=2283). Lower birth weight (≤15th percentile: ≤2850 g for boys and ≤2700 g for girls) children were mostly from mountainous areas and of indigenous descent. Compared to normal birth weight, lower birth weight girls experienced greater inability to learn and weaker overall competence. Better diet quality predicted more favorable emotional and behavioral outcomes in lower birth weight girls, and this persisted with adjustment for covariates. None of these findings were evident among boys. Girls' cognitive and social development appears to be susceptible to diet quality and birth weight, such that the adverse risk of lower birth weight on school performance may be offset by improved diet.

A global overall dietary index: ODI-R revised to emphasize quality over quantity.

Incorporating the Healthy Eating Index concept, we have developed a global dietary quality index, the Overall Dietary Index (ODI). We have evaluated the relationships between ODI and chronic disease in a 1998 Taiwanese Health Screening program with over 46,000 members (51.2% females) aged 19-84. However, it could not predict health status adequately. Therefore, we revised this ODI which became ODI-R (Revised). The revision added a quality evaluation for staples (whole grains) and protein-rich foods (fish and soy) and reduced the impact of dietary fat quantity. ODI-R comprises nine items with a maximal score of 100. It has 5 food categories: dairy products, protein rich foods (eggs/legumes/fish/meats), vegetables, fruits and cereals; 2 dietary fat qualities (P/S ratio and cholesterol); and 2 descriptors: dietary moderation (alcohol, salt and sugar as one item) and dietary variety. The mean ODI-R was lower than ODI (64.4 vs. 68.1 in men and 65.5 vs. 69.0 in women) and the distribution. The correlations between macronutrients and ODI-R were weaker than for ODI, especially for fat (from +/-0.52 to +/-0.07) as well as for cholesterol and all fatty acid types by degree of saturation. For dietary fiber and micronutrients, the correlations became either less negative or more positive, signaling that the ODI-R reflects food quality more appropriately than ODI in regard to micronutrients. Empirically, a subtraction scoring approach for the overeating of protein rich foods, did not meaningfully decrease ODI-R in Taiwanese elderly or children. ODI-R provides an effective measure of dietary quality over quantity.

Hyperuricemia and metabolic syndrome in Taiwanese children.

Metabolic fitness in childhood is of increasing concern in transitional and advanced economies as the metabolic syndrome (MS) is recognized more often in this age group. As the MS appears, so also does hyperuricemia. Studies in Taiwan have identified both indigenous and Chinese with high prevalence of hyperuricemia. Data (1227 boys and 1057 girls, aged 6-12) from the Nutrition and Health Survey in Taiwan Elementary School Children (NAHSIT Children 2001-2002) were used to appraise the association between uric acid (UA) and MS in children. Mean serum urate increases by age, ranging from 5.69 mg/dL to 7.11 mg/dL for boys and 5.61 mg/dL to 6.13 md/dL for girls. Boys have higher UA concentrations (6.07 mg/dL vs. 5.74 mg/dL) and hyperuricemia (UA > or = 7 mg/dL) rate (26.5% vs. 18.8%) than girls. Children of Mountain areas have higher rates of hyperuricemia (boys: 39.2%, girls: 30.1%). 5.56% of boys and 6.39% of girls were classified as having the MS by ATP III criteria. Serum urate was closely correlated with the MS parameters, and waist circumference (WC) in particular (r=0.387). WC alone accounted for 18% of variance of serum urate concentration. Both serum urate and hyperuricemia are significant risk factors for the MS (serum urate in mg/dL, OR: 1.54, 95% CI: 1.36-1.74; hyperuricemia, OR: 3.73, 95% CI: 2.47-5.62). Adjustment for age and region accentuate these relationships. Not only abdominal fatness, but also uric acid status, or both together may be of interest to public health workers and clinicians in regard to the transitional health problem of MS.