The Effect of Limiting Tapioca Milk Tea on Added Sugar Consumption In Taiwanese Young Male and Female Subjects.

Tapioca milk tea, the most popular beverage in Taiwan, is consumed a lot by Taiwanese which contributed to their daily sugar intake. Our study purpose is to investigate whether limiting intake of tapioca milk tea is useful for the control of sugar intake in Taiwanese. The study was conducted in questionnaires selected 38 subjects, 20-24 y, from 341 university students in Kaohsiung City, Taiwan. Subjects were match-paired by sex, age, department, and randomly divided into two groups for cross-over design in which each group had 1 week with or without tapioca milk tea. Other beverages and foods were allowed freely in both periods. Each group member recorded their own daily sugary intake for two weeks and was confirmed by researchers the next day. The average sugar intakes with or without tapioca milk tea were similar between the two treatments (p 0.05), 58.4 23.2 g/day and 56.5 22.2 g/day (glucose 25%, fructose 19%, sucrose 53%, lactose 3%). With or without tapioca milk tea, 85% of sugar intakes came from beverages. Even by limiting tapioca milk tea, the subjects took the same sugar amount from other beverages, suggesting that an established sugar intake level is hard to change. J. Med. Invest. 65:43-49, February, 2018.

Effects of Eggshell Calcium Supplementation on Bone Mass in Postmenopausal Vietnamese Women.

Bone mass decreases along with aging, especially for women after menopause because of lower estrogen secretion together with low calcium intake. This study was conducted to study the effect of eggshell calcium supplementation on bone mass in 54 postmenopausal Vietnamese women living in a farming area about 60 km from Hanoi, Vietnam. Sets of 3 subjects matched by age, bone mass, BMI and calcium intake were divided randomly into 3 groups with 18 subjects in each group. The eggshell calcium group was administered 300 mg/d calcium from eggshell, the calcium carbonate group 300 mg/d calcium from calcium carbonate and the placebo group received no calcium supplementation. Bone mass (Speed of Sound (SOS)) was measured at the beginning (the baseline), the middle (6th month) and the end of the study (12th month) by the single blind method. SOS of the eggshell group increased significantly at 12 mo (p<0.05) and was significantly higher than that of the placebo and calcium carbonate groups at 12 mo (p<0.05). The SOS of the calcium carbonate group tended to be higher than that of the placebo group but without a significant difference (p>0.05). In conclusion, eggshell calcium was more effective in increasing bone mass than calcium carbonate in postmenopausal Vietnamese women.

[A Case of Colorectal Cancer with Peritoneal Dissemination and Liver Metastasis That Responded to Comprehensive Treatment by Chemotherapy and CRS plus HIPEC].

We report a case of colorectal cancer with peritoneal dissemination and liver metastasis that achieved R0 resection by preoperative chemotherapy and CRS plus HIPEC. A 33-year-old man presented with a complaint of abdominal bloating. After further examination, he was diagnosed with transverse colon cancer with peritoneal dissemination and liver metastasis. After 9 courses of preoperative XELOX plus cetuximab and 4 courses of preoperative XELIRI plus bevacizumab, he underwent transverse colon resection, peritoneal resection, and HIPEC(MMC 20mg/4,000mL physiological saline, 40mins). There was little histological evidence of peritoneal dissemination around the region of the primary tumor. Moreover, no tumor cells were found in other peritoneal disseminations or in the liver metastasis. As a result, he was able to undergo curative resection. Colorectal cancer with peritoneal dissemination still has a poor prognosis, but combination therapy with chemotherapy and CRS plus HIPEC is expected to improve prognosis.

Rice Bran Extract Reduces the Risk of Atherosclerosis in Post-Menopausal Vietnamese Women.

We investigated whether pre-germinated brown rice bran extract containing acylated steryl glucosides (PSG) reduces the risk of atherosclerosis in post-menopausal Vietnamese women. A total of 60 post-menopausal Vietnamese women (45-65 y old) with high LDL cholesterol levels (over 140 mg/dL) were randomly divided into PSG (n=30) and placebo (n=30) groups. The subjects in the PSG group were assigned a daily intake of 6 capsules containing 50 mg PSG, and the subjects in the placebo group were assigned a daily intake of 6 capsules containing corn oil for 6 mo. Before baseline and after month 2, month 4, and month 6 of the intervention, we conducted anthropometric measurements, blood biochemical examinations, a nutrition survey, and physical activity, flow-mediated dilation (FMD), and cardio-ankle vascular index (CAVI) measurements. Serum LDL cholesterol concentrations were significantly reduced from 163.6±25.3 (mg/dL) to 135.9±26.8 (mg/dL) compared to the placebo group (p<0.001). FMD values of the placebo group were significantly reduced from 6.6±5.1 (%) to 4.7±2.6 (%) compared to the PSG group (p<0.05). Tumor necrosis factor (TNF)-α concentrations in the PSG group were significantly reduced from 19.8±11 (pg/mL) to 10.6±5.5 (pg/mL) compared to the placebo group (p<0.05). The findings suggest that PSG may improve LDL cholesterol, TNF-α levels, and FMD values. PSG might be considered in reducing the risk of atherosclerosis in post-menopausal Vietnamese women with high LDL cholesterol.

Calcium and Vitamin D Deficiency in Vietnamese: Recommendations for an Intervention Strategy.

In recent years, reports have described various roles of vitamin D in human health. Vitamin D deficiency has emerged as a significant public health problem throughout the world. Even in the Vietnamese context, it has been reported to be present in a majority of the population in spite of the wide availability of sunlight. Vitamin D and calcium are essential nutrients for bone health. The proposed health benefits of vitamin D and calcium have attracted increased interest from health care professionals, the media, and the public. The aim of this paper is to summarize the published data on vitamin D and calcium intake as well as on the prevalence of vitamin D deficiency in the Vietnamese population, and to provide recommendations for a proper strategy to control calcium and vitamin D deficiency in this population. The national authorities should adopt policies aimed at improving vitamin D and calcium status by using measures such as dietary recommendations, food fortification, vitamin D supplementation, and judicious sun exposure.

Pre-germinated brown rice reduced both blood glucose concentration and body weight in Vietnamese women with impaired glucose tolerance.

We have reported that newly diagnosed type 2 diabetes mellitus (DM) patients in Vietnam have a low body mass index (BMI) of around 23 and that the major factor for this is high white rice (WR) intake. Brown rice (BR) is known to be beneficial in the control of blood glucose levels; however, it has the property of unpleasant palatability. Pre-germinated brown rice (PGBR) is slightly germinated by soaking BR in water as this reduces the hardness of BR and makes it easier to eat. This study was designed to evaluate the effect of a 4-mo PGBR administration on various parameters in Vietnamese women aged 45-65 y with impaired glucose tolerance (IGT). Sixty subjects were divided into a WR or PGBR group. For the first 2 wk, WR was replaced by 50% PGBR, then for 2 wk by 75% PGBR and from the second month 100%. Before the beginning of the study and at the end of the study, 1) anthropometric measurements, 2) a nutrition survey for 3 nonconsecutive days by the 24 h recall method and 3) blood biochemical examinations were conducted. Fasting plasma concentrations of glucose and lipids and the obesity-related measurements and blood pressure were favorably improved only in the PGBR diet group. The present results suggest that replacing WR with PGBR for 4 mo may be useful in controlling body weight as well as blood glucose and lipid levels in Vietnamese women with IGT.

Application of diet-derived taste active components for clinical nutrition: perspectives from ancient Ayurvedic medical science, space medicine, and modern clinical nutrition.

The principal objective of this paper is to demonstrate the role of taste and flavor in health from the ancient science of Ayurveda to modern medicine; specifically their mechanisms and roles in space medicine and their clinical relevance in modern heath care. It also describes the brief history of the use of the monosodium glutamate or flavor enhancers ("Umami substance") that improve the quality of food intake by stimulating chemosensory perception. In addition, the dietary nucleotides are known to be the components of "Umami substance" and the benefit of their use has been proposed in various types of patients with cancer, radiation therapy, organ transplantation, and for application in space medicine.

Vitamin A deficiency during pregnancy of HIV infected and non-infected women in tropical settings of Northwest Ethiopia.

BACKGROUND: Vitamin A deficiency (VAD) is known to be a major public health problem among women of reproductive age in South East Asia and Africa. In Ethiopia, there are no studies conducted on serum vitamin A status of HIV-infected pregnant women. Therefore, the present study was aimed at determining the level of serum vitamin A and VAD among pregnant women with and without HIV infection in tropical settings of Northwest Ethiopia. METHODS: In this cross-sectional study, blood samples were collected from 423 pregnant women and from 55 healthy volunteers who visited the University of Gondar Hospital. Serum concentration of vitamin A was measured by high performance liquid chromatography. RESULTS: After controlling for total serum protein, albumin and demographic variables, the mean ± SD serum vitamin A in HIV seropositive pregnant women (0.96 ± 0.42 µmol/L) was significantly lower than that in pregnant women without HIV infection (1.10 ± 0.45 µmol/L, P < 0.05). Likewise, the level of serum vitamin A in HIV seropositive non-pregnant women (0.74 ± 0.39) was significantly lower than that in HIV negative non-pregnant women (1.18 ± 0.59 µmol/L, P < 0.004). VAD (serum retinol < 0.7 µmol/L) was observed in 18.4% and 17.7% of HIV infected and uninfected pregnant women, respectively. Forty six percent of non-pregnant women with HIV infection had VAD while only 28% controls were deficient for vitamin A (P = 0.002). CONCLUSION: The present study shows that VAD is a major public health problem among pregnant women in the tropical settings of Northwest Ethiopia. Considering the possible implications of VAD during pregnancy, we recommend multivitamin (which has a lower level of vitamin A) supplementation in the care and management of pregnant women with or without HIV infection.

Difructose anhydride III enhances bioavailability of water-insoluble iron in anemic Vietnamese women.

Difructose anhydride III (DFAIII) is an indigestible disaccharide and has been shown to enhance iron absorption in animal studies; however, the effect has not been investigated in anemic subjects. We investigated the efficacy of co-administration of DFAIII with water-insoluble iron in the treatment of iron deficiency anemia in Vietnamese women. One hundred sixty-eight moderately anemic women (80 g/L

Effects of zinc supplementation on serum zinc concentration and ratio of apo/holo-activities of angiotensin converting enzyme in patients with taste impairment.

OBJECTIVE: The aim of the present study was to evaluate the effects of zinc supplementation on hypogeusia, serum zinc concentration and the ratio of apo/holo-activities of angiotensin converting enzyme (ACE ratio) in patients with taste impairment. ACE ratio was used as an index of zinc nutritional status. METHODS: Forty patients complaining of taste impairment were divided into two groups: zinc deficiency taste impairment (n=12) and idiopathic taste impairment (n=28). Patients with zincemia values of less than 63 microg/dl with no history of other disorder or medication known to cause dysgeusia were diagnosed as zinc deficiency group, while those with the same condition and values more than 64 microg/dl were considered to belong to the idiopathic group. Patients orally received 150 mg of polaprezinc containing 33 mg of zinc every day. Subjective symptom was scored according to visual analogue scale (VAS). RESULTS: Zinc supplementation improved hypogeusia in both idiopathic and zinc deficiency groups. The mean improvements of VAS were 3.02+/-3.03 in the idiopathic group and 3.13+/-2.53 in the zinc deficiency group. Thus, there were no significant differences in idiopathic and zinc deficiency groups. Significant correlations were found between the improvement of VAS score and the ACE ratio after zinc supplementation in both idiopathic and zinc deficiency groups. On the contrary, significant correlations were not found between the improvement of VAS score and the zinc concentration in the serum after zinc supplementation in both groups. CONCLUSION: The results of the present study indicated that zinc deficiency is a predominant factor underlying taste impairment and ACE ratio may be a predictor of the prognosis for taste impairment after zinc supplementation, in addition to a more sensitive indicator of zinc nutrition than zinc concentration in the serum.

Clinical trial of glutamate for the improvement of nutrition and health in the elderly.

Dietary free-glutamate (Glu) improves taste and palatability. In our previous study, we found that Glu intake by hospitalized elderly was low and supplementation of monosodium L-glutamate (MSG) to their staple diet improved their behavior. To confirm such findings, we conducted a double-blind and placebo-controlled trial in hospitalized elderly. The study consisted of a 1-month lead-in period, a 3-month intervention period, and a 1-month follow-up period. In the intervention group, 0.5% (w/w) MSG was added to every staple diet, 150 g of rice gruel (the MSG group). Fourteen subjects in the MSG group (average age 83.0 +/- 8.9 years) and 15 in the control group (average age 84.3 +/- 9.6 years) completed the study. The subjects of both groups took most of the given foods based on the energy requirement of each subject's metabolic rate, body weight, and activity. In the last week of each period, nurses assessed the dementia score and daily performance of both groups. The daily performance was improved by dietary MSG. Behavior during mealtime was video-recorded for 5 min in the lead-in period and after 3 months in the intervention period. Significant improvement in the mealtime behavior was observed only in the MSG group. Furthermore, although serum albumin itself did not increase, the ratio of reduced-form albumin to total albumin increased only in the MSG group. In conclusion, supplementation of 0.5% MSG to rice gruel three times a day for 3 months improved behaviors and the nutritional status of hospitalized elderly.

Can dietary supplementation of monosodium glutamate improve the health of the elderly?

Dietary free l-glutamate has been known for a century to improve taste and palatability. Recent evidence suggests that this effect is mediated through specific l-glutamate receptors located on the taste buds. However, l-glutamate receptors are also present elsewhere in the gastrointestinal tract, such as the stomach. Here, l-glutamate exerts physiologic actions beneficial to gut function by stimulating l-glutamate receptors linked to the gastric vagus nerve. In addition, dietary l-glutamate also appears to be an important energy substrate for gut tissue. Can such l-glutamate effects on taste and gut function be clinically useful? Elderly people often develop health problems related to their nutritional status that can be linked to insufficient energy and nutrient intake. A number of studies have examined the potential usefulness of l-glutamate, added to food in the form of monosodium glutamate (MSG), in promoting better nutrition in the elderly and in patients with poor nutrition. Some positive effects have been observed. This article reviews the physiologic roles of dietary l-glutamate in relation to alimentation and examines the evidence linking the utility of MSG supplementation to the improvement of nutrition in elderly and hospitalized patients.

Awa (Tokushima) lactate-fermented tea as well as green tea enhance the effect of diet restriction on obesity in rats.

Drinking tea is recommended for promoting health due to its bioactive nutrients, such as catechins and caffeine. In Tokushima area, we have a unique traditional tea, named Awa tea, which are fermented with Lactobacillus pentosus and Lactobacillus plantarum. The present study was designed to investigate anti-obesity effects of the Awa tea and compare with those of non-fermented green tea. Obese male Wistar rats (19 weeks of age) were given by low energy diets containing 3% of Awa and green tea extracts, respectively, or without any tea extracts (control), for 4 weeks. Awa tea contained smaller amount of catechins than green tea, although they contained similar amounts of polyphenols. This finding indicates that there are distinct kinds of polyphenols from catechins. The diets containing Awa and green tea extracts further decreased whole body weight, fat tissue mass and plasma leptin level, compared with control diet. In addition, their diets increased the daily amount of lipid excreted to feces and total 24-h-energy consumption, compared with the control group. However, there is no significant difference in these anti-obesity effects between Awa tea and green tea. Our results indicate that Awa lactate-fermented tea as well as green tea similarly enhance the effect of diet restriction on obesity, at least in part, through the increase in fat energy consumption and the decrease in fat absorption in rats.

Effects of two-month consumption of 30 g a day of soy protein isolate or skimmed curd protein on blood lipid concentration in Russian adults with hyperlipidemia.

Recently the American Heart Association has reported that favorable effects of soy protein on blood lipids were characteristic only for high amounts of soy protein and not observed for an intake less than 30 g/d. However, the period of the studies with the smaller amount was 4-6 wk and we thought a longer study was necessary for the conclusion. The death rate by heart disease is very high in Russia; therefore, we have done this study in Russian subjects with hyperlipidemia. Prior to the study we tried to find a favorable method for subjects to take 30 g protein a day from soybean protein isolate (SPI) or skimmed curd protein (SMP) and decided to use Russian style cookies. Thirty subjects with hyperlipidemia were recruited; however, due to the 5-mo long study 28 of them (19 females and 9 males aged 50+/-2 y) could complete the trial. They were randomly assigned to two groups and were given either cookie for 2 mo separated by a month-long washout interval in a cross-over design. Fasting blood samples were drawn before and after the dietary treatments. Fasting blood samples at 1 mo were also measured as a health check and to observe the trends of the blood parameters in the middle of the study period. Serum samples were used for the lipid and other biochemical measurements. Every month for 3 non-consecutive days, energy and nutrient intakes were assessed and physical activity was estimated by pedometer. With the consumption of SPI for 2 mo, concentrations of total-cholesterol changed from 280+/-7 to 263+/-8 mg/dL (-6.5%, p=0.0099), HDL-cholesterol from 57.4+/-2.5 to 62.6+/-2.9 mg/dL (+9%, p=0.0047), non-HDL-cholesterol (total-cholesterol-HDL-cholesterol) from 223+/-7 to 201+/-8 mg/dL (-11%, p=0.0023) and triglycerides from 204+/-23 to 173+/- 19 mg/dL (-18%, p=0.022). There were no significant changes with SMP (p>0.05). Thus, administration of 30 g SPI a day for 2 mo confirmed its favorable effects on serum lipids in Russians with hyperlipidemia.

High-dose dietary supplementation of vitamin A induces brain-derived neurotrophic factor and nerve growth factor production in mice with simultaneous deficiency of vitamin A and zinc.

Marginal vitamin A and zinc (Zn) deficiency often co-exist in many populations. Vitamin A plays a trophic role in brain and is important for its development. We investigated effects of dietary supplementation of vitamin A on brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) production in mice depleted for vitamin A and Zn. After 3 months' feeding with a low vitamin A and Zn (LVA-LZ) diet, mice were divided into two groups and replenished with either normal or high vitamin A with low Zn diet for an additional 2 months. Levels of BDNF and NGF were measured from extracts of hippocampus, cortex and cerebellum at the end of the third and fifth months. The LVA-LZ group tended to show decreased amounts of the BDNF and NGF, while animals supplemented with high vitamin A along with Zn deficiency had high BDNF and NGF concentrations. From these results, we conclude that vitamin A may increase BDNF and NGF levels.

Vitamin A deficiency in patients with diarrhea and HIV infection in Ethiopia.

Diarrhea, micronutrient deficiencies and HIV/AIDS are major public health problems in developing countries, especially in sub-Saharan Africa. This study was aimed to investigate serum levels of vitamin A in diarrheic patients with and without HIV co-infection compared to healthy controls. Two hundred eleven diarrheic patients (110 HIV infected), 87 apparently healthy controls and 41 asymptomatic HIV seropositive blood donors who visited the University of Gondar Hospital, in Gondar, Ethiopia were included. Stool samples were examined for enteropathogens following the standard procedures. Serum vitamin A levels were measured by high performance liquid chromatography. Shigella species were isolated from 8.5% of the patients while intestinal parasites were detected in 32.2% without significant difference by HIV serostatus. The mean+/-SD serum vitamin A in diarrheic patients with (0.82+/-0.59 micromol/L) and without (0.84+/-0.54 micromol/L) HIV co-infection and in asymptomatic HIV infected blood donors (0.96+/-0.52 micromol/L) was significantly lower than that in healthy controls (1.52+/-0.71 micromol/L), p<0.001. Vitamin A deficiency (VAD, serum retinol < 0.70 micromol/L) was observed in 52.7% and 45.5% of diarrheic patients with and without HIV co-infection, respectively. About 13% of healthy controls and 29.3% of asymptomatic HIV infected blood donors were deficient in vitamin A. The levels of serum vitamin A were not associated with the presence of intestinal parasites or Shigella species. The findings demonstrate that VAD is a severe public health problem among diarrheic patients in Gondar, Ethiopia. Intervention programmes involving health and nutrition education and supplementation of vitamin A might help in reducing morbidity in such patients.

Favorable effects of tea on reducing the cognitive deficits and brain morphological changes in senescence-accelerated mice.

The present study was carried out to explore the effects of oolong and green teas on improving the memory deficits and brain pathological changes in senescence accelerated-prone mice P8 (SAMP8). Six-month-old mice were supplied with oolong tea, green tea or water as the sole drinking fluid for 16 wk. The memory ability of mice was evaluated by passive and active avoidance tests, while the extent of the brain degeneration was measured by the spongiosis grades and the lipofuscin percentage in the hippocampus. The total grading score and serum biochemical levels were also measured. The results indicated that the mice supplemented with the oolong and green tea drinks reversed the cognitive impairment, lessened the spongy degeneration and lipofuscin, and increased the serum Trolox equivalent antioxidant capacity more than the control group. The total grading score of the oolong tea group was lower than that of the control group in male mice, whereas it did not differ among female groups. No differentiations in the concentrations of total cholesterol. triglyceride, glucose, iron or hemoglobin were observed among three drink groups. In conclusion, oolong and green teas could reduce the deteriorations of cognitive ability, brain degenerative changes and aging process in SAMP8, probably through the potent antioxidative activity of the tea.

Increased nerve growth factor by zinc supplementation with concurrent vitamin A deficiency does not improve memory performance in mice.

We investigated the effects of dietary supplementation of zinc (Zn) with or without vitamin A (Vit. A), to elucidate any cross activity between the two micronutrients, on memory and nerve growth factor (NGF) production in ddY male mice depleted for the two elements. After 3 mo-feeding with a Zn and Vit. A deficient (VAD) diet, mice were divided into three groups and replenished with normal Zn with VAD diet (NZ-VAD), high Zn with VAD diet (HZ-VAD) or normal Zn + normal Vit. A (NZ-NVA) for additional 2 mo. One more group was made and given the normal diet for the same period (Control group). Levels of NGF were measured from extracts of hippocampus, cerebellum and cortex at the end of the 3rd and 5th month. In addition, a radial arm maze task was performed at the end of the 5th month. The two Zn supplemented groups (NZ-VAD and HZ-VAD) tended to show high NGF concentration but memory was not improved. However, improved memory was observed in the NZ-NVA group. From these results we concluded that Zn may increase NGF; however, memory was improved only when Vit. A was sufficient.

[Evaluation of host immunity and side effects in breast cancer patients treated with adjuvant chemotherapy (FEC therapy)].

BACKGROUND: FEC (5-FU+epirubicin+cyclophosphamide) therapy has been used as adjuvant chemotherapy for breast cancer patients with nodes positive. The aim of this study was to evaluate host immunity and side effects of the FEC therapy. The effect of oral administration of Lentinus edodes mycelia (LEM) was also observed. METHODS: Ten patients were enrolled in this study. The treatment with 5-FU (500 mg/m2), epirubicin (75 mg/m2) and cyclophosphamide (500 mg/m2) was administered every 21 days for 2 cycles, and LEM (9 g/day po) was administered during the 2nd cycle. RESULTS: NK cell activity and the number of white blood cells decreased on the 7th day after the therapy, and they recovered on the 21st day. However, this NK cell activity and the number of white blood cells didn't decrease when the FEC therapy was used with LEM po. CONCLUSIONS: FEC 75 therapy has made some impacts on host immunity, and LEM with the FEC 75 therapy might have prevented host immunity.

Japanese citrus fruit (sudachi) juice is associated with increased bioavailability of calcium from whole small fish and suppressed bone resorption in rats.

Shirasuboshi (boiled and semi-dried whitebait) is a processed fish food that contains abundant calcium. It is eaten whole and commonly consumed in Japan. In this study, the effect of sudachi (Citrus sudachi) juice on calcium, magnesium and phosphorus bioavailability, and bone metabolism in rats was examined. After 14 d of diets low in calcium and phosphorus, male Sprague-Dawley rats were fed shirasuboshi diets containing dried shirasuboshi powder treated with 20% (S20) or 40% (S40) sudachi juice, or distilled water (C) (0.5% Ca; 0.3% P) for 14 d. The apparent absorptions and retentions of calcium, magnesium and phosphorus from shirasuboshi were determined. Bone formation was calculated by measuring serum osteocalcin, and bone resorption by measuring urinary pyridinoline and deoxypyridinoline. The apparent absorption and retention of calcium and magnesium in the S20 group were significantly higher than in the C and S40 groups. Although serum osteocalcin was not affected by the addition of sudachi juice, the urinary pyridinoline and deoxypyridinoline concentrations in the S40 group were significantly lower than in the C and S20 groups. Our results indicate that sudachi juice added to shirasuboshi was associated with increased calcium bioavailability and suppressed bone resorption in rats.