A cross-sectional study to examine the association between dietary patterns and risk of overweight and obesity in Hong Kong Chinese adolescents aged 10-12 years.

OBJECTIVE: To describe the dietary patterns and examine the associations of these patterns with risk of overweight and obesity in Chinese adolescents. METHODS: Baseline data collected between November 2003 and October 2004 from 171 boys and 180 girls aged 10-12 years who participated in the Hong Kong Adolescent Bone Health Cohort Study were analyzed. Dietary intake was assessed using a food frequency questionnaire and dietary pattern calculated using factor analysis. Data on demographic characteristics, weight, height, and Tanner stage were collected. Overweight and obesity were defined using The International Obesity Task Force cutoff values. Cardiovascular fitness expressed as peak oxygen consumption was predicted using the postexercise heart rate by the 3-minute step test and was used as an objective measure of physical activity. Association between dietary patterns and risk of overweight and obesity was examined using multivariate logistic regression with adjustment for demographics, puberty, and physical activity. RESULTS: The mean (SD) age of the study sample was 11.2 (0.6) years and there were 57 (16.2%) participants who were overweight/obese. Three dietary patterns were identified, namely, vegetables-fruits, snacks-beverages, and animal foods, fats, and condiments dominated. There was no significant linear association between each dietary pattern and the risk of overweight and obesity in this sample. Instead, the risk of overweight and obesity in this sample was positively associated with pubertal stage and inversely associated with physical activity. CONCLUSIONS: Pubertal stage and physical activity, but not dietary patterns, were important factors contributing to the risk of overweight and obesity in this population.

Effects of lifestyle and diet on bone health in young adult Chinese women living in Hong Kong and Beijing.

BACKGROUND: Dietary and lifestyle variations may be too small to detect possible associations with bone mineral density (BMD) within a community. Pooled data from communities with different diets and lifestyle but of the same ethnicity may help explore these associations. OBJECTIVE: To examine the effects of dietary and lifestyle factors on BMD in young Chinese women. METHODS: Baseline data were analyzed from 441 women aged 20 to 35 years in Hong Kong and Beijing who were participating in a longitudinal study evaluating the effect of milk supplementation on bone health. Data on demographic characteristics, lifestyle, use of oral contraceptives, diet, physical activity, and BMD of total hip, femoral neck, and total spine measured by dual-energy x-ray absorptiometry were pooled for analysis. RESULTS: Hong Kong subjects had significantly lower BMD and higher body-size-adjusted dietary intakes of protein, fat, fiber, vitamins, potassium, sodium, and selenium than Beijing subjects. Multivariate regression of pooled data showed that body mass index was the most important determinant of BMD at all sites. Age was negatively associated and use of oral contraceptives was positively associated with femoral neck BMD. Carbohydrate intake was positively associated with total hip BMD. Fiber intake was negatively associated with BMD at total hip and total spine. Increased vitamin E intake was associated with greater total spine BMD. None of the nutrients were associated with BMD at the femoral neck. CONCLUSIONS: Diet, lifestyle, and BMD differed greatly between young women from Hong Kong and Beijing. Body mass index was the most important determinant of BMD in young Chinese women, whereas age, use of oral contraceptives, and diet had less pronounced effects.

Very high rates of vitamin D insufficiency in women of child-bearing age living in Beijing and Hong Kong.

We aimed to describe the vitamin D status of young women living in two Chinese cities in the spring--Beijing in the north (latitude 39 degrees north) and Hong Kong (latitude 22 degrees north) in the south. We also examined the relationship between serum 25-hydroxyvitamin D and parathyroid hormone (PTH) concentrations to determine a threshold for serum 25-hydroxyvitamin D above which there is no further suppression of PTH. Finally, we examined whether dietary Ca intake influences this relationship. Non-pregnant women aged 18-40 years (n 441) were recruited between February and June. Fasting blood was collected and dietary intakes were assessed using 5 d food records. Mean serum 25-hydroxyvitamin D concentration was lower in Beijing than Hong Kong women (29 v. 34 nmol/l; P < 0.001). Vitamin D deficiency (< or = 25 nmol/l) was indicated in 40% of Beijing and 18% of Hong Kong women, and over 90% of women in both cities were insufficient (< or = 50 nmol/l). Mean Ca and vitamin D intakes were 478 mg/d and 2.0 microg/d, respectively. The relationship between 25-hydroxyvitamin D concentration and PTH was linear throughout the range with a slope of -0.36 (different from 0; P < 0.001; R 0.26), with no apparent threshold. There was no influence of Ca intake on the relationship between 25-hydroxyvitamin D and PTH concentration. Vitamin D deficiency is common and insufficiency is very common in non-pregnant women in Hong Kong and Beijing during spring. Serum 25-hydroxyvitamin D was inversely associated with PTH with no apparent threshold. Strategies such as vitamin D fortification or supplementation may be required.

Milk supplementation and bone health in young adult chinese women.

BACKGROUND: Milk is potentially beneficial for bone health, particularly for Chinese populations where consumption of dairy products is low. There are few data about milk consumption by Chinese women aged 20-35 years. This study examines whether milk supplement over 2 years caused increased bone mineral density (BMD) in Chinese women aged 20-35 years. METHODS: Four hundred forty-one community-living women living in Hong Kong SAR (221) and Beijing (220) China were randomized to receive milk supplement or nothing. The supplement consisted of two sachets of milk powder (1000 mg calcium, 80 microg vitamin K(1)), for 24 months. BMD at total hip, total spine, and whole body was measured at baseline and at 6, 12, 18, and 24 months; blood specimens were analyzed at baseline and at 3 and 24 months for biochemical indices of bone turnover and vitamin K. Urine samples also were collected. Analysis was by intention to treat as well as per protocol. Differences in change from baseline between the milk and control groups were analyzed using the mixed models approach to repeated measures, including the baseline value as a covariate. RESULTS: Both groups had an increase in BMD and a decrease in bone turnover markers over time, as an indicator of the process of attainment of peak bone mass during this period. Apart from a higher total spine BMD at 6 months in the milk group using per protocol analysis, there was little significant difference observed between the milk group and the control group. CONCLUSIONS: Age-related bone metabolism and lack of compliance most likely explain the lack of consistent changes in BMD or bone biochemical measures in response to milk supplementation for 2 years in Chinese women aged 20-35 years.

The association between isoflavone and lower urinary tract symptoms in elderly men.

The objective of the present study is to explore the association between lower urinary tract symptoms (LUTS) and dietary isoflavone in elderly men. In a large prospective cohort of 2000 Chinese men, the association between dietary isoflavone and LUTS were studied using standardized structured questionnaires. Dietary intake was assessed by a modified version of the Block FFQ. LUTS were assessed by the Chinese version of the International Prostatic Symptoms Score. Demographic, lifestyle and other medical information were also collected and were adjusted for in the analysis. After excluding 299 men with history of bladder surgery, bladder or prostate cancer or who were current users of medication for urinary problems, the association between LUTS and dietary isoflavone was explored. A total of 96.2 % of subjects reported some consumption of genistein, glycitein or daidzein. In ordinal multinominal logistic regression, subjects with dietary total isoflavone of more than 5.1 mg were significantly less likely to suffer from more severe LUTS (dietary intake from 5.1 to 9.5 mg: OR 0.59; 95 % CI 0.44, 0.80; from 9.6 to 14.3 mg: OR 0.81; 95 % CI 0.61, 1.09; from 14.4 to 21.7 mg: OR 0.68; 95 % CI 0.51, 0.92; 21.8 mg and above: OR 0.73; 95 % CI 0.54, 0.98) after adjustment for covariates. In this cross-sectional study, we showed a strong inverse association between dietary intake of isoflavone and the risk of LUTS.

A community model for care of elderly people with diabetes via telemedicine.

A primary care group diabetes care program using telemedicine was developed and its feasibility and acceptability were tested in 22 subjects with Type 2 diabetes mellitus using a one-group, pretest-posttest quasi-experimental design. Compliance with the program was 100%. Significant reductions in total calorie intake as well as body mass index were achieved, with an increase in the percentage of subjects achieving better diabetes control as measured by the 2-hr hemastix. Improvements in diabetes knowledge and disease-specific and generic measures of quality of life were also observed. Most subjects evaluated this mode of service delivery favorably in the questionnaire and focus group discussions. There is potential for the integration of this mode of service delivery into current health services.