Characteristics associated with the consumption of malted drinks among Malaysian primary school children: findings from the MyBreakfast study.

BACKGROUND: The consumption of beverages contributes to diet quality and overall nutrition. Studies on malted drinks, one of the widely consumed beverage choices among children in Asia, however, have received limited attention. This study aimed to examine the prevalence of malted drink consumption and explored associations of sociodemographic characteristics, nutrient intakes, weight status and physical activity levels with malted drink consumption among primary school children in Malaysia. METHODS: Data for this analysis were from the MyBreakfast Study, a national cross-sectional study conducted from April to October 2013 throughout all regions in Malaysia. A total of 2065 primary school children aged 6 to 12 years were included in the present analysis. Data on two days 24-h dietary recall or record, anthropometry, physical activity and screen time were recorded. Associations between malted drink consumption and related factors were examined using binary logistic regression, adjusting for region, area, gender, ethnicity and household income. RESULTS: Among children aged 6 to 12 years, 73.5% reported consuming malted drinks for at least once per week. Consumption of malted drinks was significantly associated with region (χ(2) = 45.64, p < 0.001), gender (χ(2) = 4.41, p = 0.036) and ethnicity (χ(2) = 13.74, p = 0.008). Malted drink consumers had similar total energy intake but higher micronutrient intakes compared to non-consumers. High physical activity level (OR = 1.77, 95% CI = 1.06, 2.99) and lower screen time during weekends (OR = 0.93, 95% CI = 0.86, 0.99) were independently associated with malted drink consumption among 6 to 9 year-old children, but not among 10 to 12 year-old children. No association was observed between malted drink consumption and weight status. CONCLUSIONS: Malted drink consumption is prevalent among Malaysian primary school children, particularly higher among boys, indigenous children and those who lived in the East Coast region of Malaysia. Consuming malted drinks is associated with higher micronutrient intakes and higher levels of physical activity, but not with body weight status.

An easy-to-use semiquantitative food record validated for energy intake by using doubly labelled water technique.

BACKGROUND: Estimating dietary intake is important for both epidemiological and clinical studies, but often lacks accuracy. OBJECTIVE: To investigate the accuracy and validity of energy intake estimated by an easy-to-use semiquantitative food record (EI(SQFR)) compared to total energy expenditure (TEE) estimated by doubly labelled water technique (EE(DLW)). DESIGN: TEE was measured in 29 nonobese subjects using the doubly labelled water method over a period of 14 days. Within this period, subjects reported their food consumption by a newly developed semiquantitative food record for 4 consecutive days. Energy intake was calculated using the German Food Code and Nutrition Data Base BLS II.3. RESULTS: A good correlation was observed between EI(SQFR) and EE(DLW) (r = 0.685, P < 0.001). The mean difference between EI(SQFR) and EE(DLW) was -1.7+/-2.6 MJ/day (-14+/-21%, P = 0.002). An underestimation of EI(SQFR) <10% was observed in nine subjects (31%), of 10-20% in six subjects (21%), and of >20% in nine subjects (31%). In five subjects (17%), an overestimation of EI(SQFR) was observed. CONCLUSIONS: The easy-to-use semiquantitative food record provided good estimates of EI in free-living and nonobese adults without prior detailed verbal instructions. The presented food record has limitations regarding accuracy at the individual level.

Validation of a self-administered food-frequency questionnaire administered in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study: comparison of energy, protein, and macronutrient intakes estimated with the doubly labeled water, urinary nitrogen, and repeated 24-h dietary recall methods.

BACKGROUND: The validation of dietary assessment instruments is critical in the evaluation of diet as a chronic disease risk factor. OBJECTIVE: The objective was to assess the validity of a self-administered food-frequency questionnaire by comparison with dietary recall, urinary nitrogen excretion, and total energy expenditure data. DESIGN: Over a 1-y period, data from twelve 24-h dietary recalls, a food-frequency questionnaire, and four 24-h urine samples were obtained from 134 study participants of the European Prospective Investigation into Cancer and Nutrition (EPIC) Study in Potsdam, Germany. In a substudy of 28 participants, total energy expenditure from doubly labeled water measurements was assessed. RESULTS: Energy-adjusted, deattenuated correlation coefficients between the questionnaire and the recalls ranged from 0.54 for dietary fiber to 0.86 for alcohol. Cross-classification of quintiles of nutrient intakes from the questionnaire and recalls indicated severe misclassification to be <4%. Reported protein intake correlated with estimated protein excretion (r = 0.46). Energy intake and total energy expenditure were also significantly correlated (r = 0.48); however, all but one subject underreported their energy intake. The magnitude of underreporting varied considerably, by 22% on average, and increased slightly with increasing energy intake. A similar pattern of underreporting was observed when energy intakes from the 24-h dietary recalls were compared with total energy expenditure. CONCLUSIONS: These data indicate an acceptable relative validity of the food-frequency questionnaire in this study population. Compared with measurements of total energy expenditure and protein excretion, however, only moderate agreement with both the food-frequency questionnaire and the 24-h dietary recalls was observed.

Epigallocatechin-3-gallate and postprandial fat oxidation in overweight/obese male volunteers: a pilot study.

OBJECTIVES: Drinking green tea is associated with many health benefits, including increased fat oxidation. We tested the hypothesis that epigallocatechin-3-gallate (EGCG), the main green tea catechin, increases fat oxidation in obese men. METHODS: Ten healthy overweight/obese males (body mass index 31.3+/-0.8 kg/m(2)) were studied in a randomized, placebo-controlled, double-blind crossover trial. Study supplements were low EGCG (300 mg), high EGCG (600 mg), caffeine (200 mg), EGCG/caffeine (300 mg/200 mg) or placebo and were taken orally for 3 days. At the third day of supplementation, O(2) consumption and CO(2) production was measured by indirect calorimetry to assess energy expenditure and fat oxidation over 4 h each after overnight fasting and after a standardized test meal. RESULTS: Energy expenditure was not affected by any supplementation, neither after overnight fasting nor after the test meal. During the first 2 h after overnight fasting, fat oxidation increased by 7.7 (not significant, NS), 15.2 (NS), 26.3 (P<0.05 vs placebo) and 35.4% (P<0.01 vs placebo and low EGCG), for low EGCG, high EGCG, caffeine and EGCG/caffeine, respectively. During the first 2 h after the meal, the mean increase in fat oxidation was 33.3 (P<0.05 vs placebo), 20.2 (NS), 34.5 (P<0.05 vs placebo) and 49.4% (P<0.05 vs placebo) for low EGCG, high EGCG, caffeine and EGCG/caffeine, respectively. CONCLUSIONS: Low EGCG increases postprandial fat oxidation in obese men and this to the same extent as 200 mg caffeine, whereas high EGCG does not exert this effect. Fasting fat oxidation is increased only by caffeine (with or without EGCG). There is no synergism of low EGCG and 200 mg caffeine. Energy expenditure is not affected by EGCG.

Validation of a simplified physical activity record by doubly labeled water technique.

INTRODUCTION: For obtaining reliable information about physical activity in epidemiological studies, validated and easy-to-use instruments are required. Therefore, a new simplified physical activity record based on 15-min recording intervals was developed and validated. SUBJECTS: Nonobese volunteers (n = 31). MEASUREMENTS: Physical activity was recorded over a 7-day period without detailed instructions. Energy expenditure was calculated (EE(sPAR)) and compared to energy expenditure measured by doubly labelled water technique (EE(DLW)). RESULTS: A good agreement between EE(sPAR) (12.1+/-3.0) and EE(DLW) (11.7+/-3.3) with a mean difference of 0.33+/-1.55 MJ (r = 0.880, P < 0.001) was observed. The absolute difference between EE(sPAR) and EE(DLW) was < 10% in 65% of the subjects. The difference between EE(sPAR) and EE(DLW) was independent of gender, age, body weight, and body mass index. A weak positive association between the difference and total body fat was observed (r = 0.618, P < 0.001), suggesting a slight tendency to overestimate EE(sPAR) with increasing total body fat. CONCLUSION: The new simplified physical activity protocol needs no detailed instructions, provides valid estimates of physical activity in nonobese free-living adults and can be used in epidemiological studies to assess total daily energy expenditure and physical activity level.

Update in the pharmaceutical therapy of the irritable bowel syndrome.

The therapeutic management of the irritable bowel syndrome (IBS) is ineffective and not satisfying either patients or practitioners. Research in functions of the enteric nervous system and its interaction with the central nervous system is the basis for the development of emerging pharmaceuticals in therapy of the IBS. These pharmaceuticals include agents such as opioid agonists, psychotropic agents and particularly serotonin receptor modulators. These novel pharmaceuticals aim to provide a more comprehensive approach in the therapy of the IBS and will serve both patients and practitioners. So far, the US Food and Drug Administration has approved two agents specifically for the treatment of the IBS, both belonging to the group of serotonin receptor modulators. However, questions remain whether a single therapy is sufficient in the management of IBS because this disease is influenced by biological and psychological as well as cultural and social factors.

Long-term high protein intake does not increase oxidative stress in rats.

The maximum dietary protein intake that does not cause adverse effects in a healthy population is uncertain. We tested whether a high protein intake enhances oxidative stress. Adult rats were adapted to different casein-based diets containing either an adequate (13.8%; AP), medium (25.7%; MP), or high (51.3%; HP) level of crude protein; a fourth group received a HP diet but no RRR-alpha-tocopherol acetate (HP-toc). After 15 wk of feeding, plasma protein carbonyl concentration, liver lipid peroxide levels [thiobarbituric acid-reacting substances (TBARS)], reduced glutathione (GSH) status and leucine kinetics ([1-(13)C]leucine) were measured. Higher concentrations of protein carbonyls and TBARS were found in rats fed the AP and the HP-toc diets compared with those fed the MP and HP diets (P: < 0.05). GSH concentrations in plasma did not differ but total blood GSH concentrations were significantly (P: < 0.05) lower in rats fed the HP-toc diet compared with those fed the AP, MP and HP diets. Liver GSH concentrations were significantly (P: < 0.01) lower in rats fed the AP diet compared with the other groups. Rates of postabsorptive leucine oxidation (LeuOX) and flux (Q(Leu)) were positively correlated with the dietary protein level (for AP, MP, and HP, respectively: LeuOX, 74.9 +/- 28.5, 109 +/- 35.2, 142.3 +/- 38.4 micromol/(kg. h); Q(Leu), 425 +/- 102, 483 +/- 82, 505 +/- 80 micromol/(kg. h). Only HP-toc resulted in a significantly greater protein breakdown (PB(Leu)) and Q(Leu). No difference was seen in nonoxidative leucine disposal. Long-term intake of high protein diets did not increase variables of oxidative stress, in contrast to our initial hypothesis. An unexpected finding was that adequate protein feeding (AP) may in fact induce oxidative stress.

Determination of total energy expenditure, resting metabolic rate and physical activity in lean and overweight people.

A new 2H/1H and 18O/16O equilibration device was tested, standardized and employed for the determination of total energy expenditure. It was shown that overweight men and women have increased resting metabolic rate as well as increased total energy expenditure when compared to their lean counterparts. The physical activity level (PAL)index was slightly decreased which possibly suggests a decreased physical activity in obese people.