Lactagogue effects of Torbangun, a Bataknese traditional cuisine.

Coleus amboinicus Lour (CA) has been used as a breast milk stimulant (a lactagogue) by Bataknese people in Indonesia for hundreds of years. However, the traditional use of CA is not well documented, and scientific evidence is limited to establish CA as a lactagogue. This investigation was conducted to elucidate the effect of traditional use of CA during the first month of lactation on quantity and quality of the breast milk. The results collected from the study show that CA supplementation increased breast milk production without compromising the nutritional quality of the breast milk. Lactating women receiving CA supplementation had a 65% increase in milk volume during the last two weeks of supplementation (from Day 14 to Day 28). This increase was greater than that of lactating women receiving Molocco+B12 tablets (10%) or Fenugreek seeds (20%). The residual effects of CA supplementation were seen even after the supplementation had ended for one month. Results of the present study confirmed the belief and the practice amongst the Bataknese people that CA can be used as a lactagogue in humans, and the use of CA might be suitable for lactating women in general.

Factors contributing to variation in lipoprotein (a) in Melbourne Anglo-Celtic population.

AIM: The purpose of this report is to survey the factors contributing to variation in lipoprotein(a) (Lp(a)) in a population-based sample of Anglo-Celtic Melburnians. RESULTS: The plasma Lp(a) levels were highly skewed towards low levels in this population, with a median of 156 mg/l and a mean of 262 mg/l. Approximately 33% had plasma Lp(a) above the threshold value of 300 mg/l, while 35% had Lp(a) levels below 100 mg/l. The most commonly occurring phenotype was apo(a) S3. In this phenotype, Lp(a) concentrations ranged from 10 to 596 mg/l. Lp(a) was consistently associated with diastolic blood pressure, systolic blood pressure, total protein, albumin and nitrogen excretion in the 40-60 y age group. Multiple stepwise regression analyses, in non-dietary factors, were used to explain about 13% of the variance in Lp(a) (19% in men and 23% in women). Remarkably, in the <40 y age group, non-dietary factors may account for 86% of the variance in Lp(a) and dietary factors, analysed separately, 46%. Thus, although Lp(a) is mainly genetically determined, there are clearly other factors which contribute to variations in Lp(a) concentrations.

Contemporary Minangkabau food culture in West Sumatra, Indonesia.

Diet has a strong relationship with food culture and changes in it are likely to be involved in the pathogenesis of newly emergent degenerative diseases. To obtain in-depth opinions about the food culture of Minangkabau people, focus group discussions were conducted in a Minangkabau region, represented by four villages in West Sumatra, Indonesia, from January to March 1999. The members of the discussion groups were principally women aged from 35 to 82 years old. Minangkabau culture is matriarchal and matrilineal which accounts for female gender dominants in the discussions. Rice, fish, coconut and chilli are the basic ingredients of the Minangkabau meals. Meat, especially beef and chicken, is mainly prepared for special occasions; pork is not halal and therefore not eaten by Muslim Minangkabau people; and for reasons of taste preference and availability, lamb, goat and wild game are rarely eaten. However, rendang, a popular meat dish, has been identified as one of the Minangkabau food culture characteristic dishes. Vegetables are consumed daily. Fruit is mainly seasonal, although certain kinds of fruit, such as banana, papaya and citrus, can be found all year around. Coconut has an important role in Minangkabau food culture and is the main source of dietary fat. While almost all food items consumed by the Minangkabau can be cooked with coconut milk, fried food with coconut oil is considered to be a daily basic food. Desiccated coconut is also used as a food ingredient on about a weekly basis and in snack foods almost every day. Although there have been no changes in food preparation and there is a slight difference in taste preference between the young and the old generations, there has been a dramatic shift in food preferences, which is reflected in the changing percentage of energy consumed over the past 15 years. The traditional combination of rice, fish and coconut in Minangkabau culture goes back hundreds of years, long before the emergence of the degenerative diseases of the newer economies, and is likely to offer food security and health protection to the Minangkabau for as long as the lifestyle remains traditional. Whether or not a recent increase in energy intake from fat and the quality of fat may contribute to the shift of disease pattern is fundamentally important for the Minangkabau, it seems unlikely the traditional use of coconut and its products was a health issue. Moreover, it was clear from the focus group discussions that the use of coconut encouraged the consumption of fish and vegetables.

Cardiovascular risk in the Asia-Pacific region from a nutrition and metabolic point of view: vitamin deficiencies.

In the past, recommended vitamin or micronutrient intakes have often been based on levels that were adequate to prevent clinical deficiencies from developing. Once these levels were reached, clinicians and nutrition scientists generally attributed little value to higher vitamin intake from supplements or food sources. Evidence has continued to mount showing that the intake and serum concentration of certain vitamins above those necessary to prevent clinical deficiencies, might importantly influence health status. This paper discusses the association of anti-oxidant vitamins and cardiovascular disease, and the association of low intake or serum concentrations of folate, vitamin B6 and vitamin B12, and elevated serum homocysteine, resulting in an increase in vascular disease risk.

Can skin wrinkling in a site that has received limited sun exposure be used as a marker of health status and biological age?

OBJECTIVES: to determine if skin wrinkling in a site that had received limited sun exposure may be a marker of health status and biological age. DESIGN: population-based, cross-sectional study. PARTICIPANTS: we evaluated the health status of representative samples of elderly Greek-born people living in Melbourne, Greeks living in rural Greece, Anglo-Celtic Australians living in Melbourne and Swedes living in Sweden. We carried out microtopographic assessment of their skin and measured plasma dehydroepiandrosterone concentrations. METHODS: we derived activities of daily living, well-being, memory and general health status scores from a cross-cultural questionnaire. We measured skin wrinkling using cutaneous microtopographic methods and plasma dehydroepiandrosterone by enzyme immuno-assay. RESULTS: skin wrinkling was positively correlated with age (r(s)=0.27, P<0.0001) and negatively with body mass index (r(s)=-0.19, P<0.0001). Therefore, all analyses were controlled for these variables. Plasma dehydroepiandrosterone was higher in smokers than non-smokers (2.86 vs 2.08; P<0.001) and men had significantly higher plasma dehydroepiandrosterone than women (2.74 vs 1.69; P<0.0001). In the pooled data, skin wrinkling was negatively associated with general health score (r(s)=-0.13, P<0.01) and activities of daily living score (r(s)=-0.14, P<0.05) after controlling for age, body mass index and smoking. These associations were more pronounced in women. Finally, those with the least skin wrinkling had the highest dehydroepiandrosterone level (r(s)=-0.12, P=0.06) after adjusting for age, smoking and sex. CONCLUSION: skin wrinkling in a site with limited sun exposure might be used as a marker of health status and, to some extent, biological age--particularly for women.

Hypocholesterolemic effect of an enteric-coated garlic supplement.

OBJECTIVE: To evaluate the hypocholesterolemic effect of an enteric-coated garlic supplement standardized for allicin-releasing potential in mild to moderate hypercholesterolemic patients. METHODS: A double-blind randomized, placebo-controlled intervention study was conducted in 46 hypercholesterolemic subjects who had failed or were not compliant with drug therapy. Each subject was given dietary counseling to lower fat intake and enteric-coated Australian garlic powder tablets with 9.6 mg allicin-releasing potential or matching placebo tablets. RESULTS: After 12 weeks, the garlic supplement group (n=22) had a significant reduction in total cholesterol (TC, -0.36 mmol/L. -4.2%) and LDL-cholesterol (LDL-C, -0.44 mmol/L, -6.6%) while the placebo group (n=24) had a non-significant increase in TC (0.13 mmol/L, 2.0%) and LDL-C (0.18 mmol/L, 3.7%). HDL-cholesterol was significantly increased in the placebo group (0.09 mmol/L, 9.1%), compared to the garlic group (-0.02 mmol/L, -0.9%). and no significant difference in triglycerides or in LDL/HDL ratio was observed between groups. CONCLUSIONS: The study demonstrates that enteric-coated garlic powder supplements with 9.6 mg allicin-releasing potential may have value in mild to moderate hypercholesterolemic patients when combined with a low fat diet. Taken with other evidence, the efficacy of garlic for lipoprotein metabolism might require allicin bioavailability to be enhanced through the use of, for example, an enteric-coated dose form. If this is the case, the possibility remains that greater hypocholesterolemic efficacy may be evident at a higher allicin dose. Also noteworthy in this study was a small reduction in energy intake with garlic compared with placebo, attributable to reduction in fat, carbohydrate and alcohol intakes. This may also have contributed to the effects on blood lipids. This study suggests that garlic supplementation has a cholesterol-lowering effect, which may be mediated by direct action of a biologically active compound or compounds and in part through the effect on food and nutrient intake.

Skin wrinkling: can food make a difference?

OBJECTIVES: This study addressed whether food and nutrient intakes were correlated with skin wrinkling in a sun-exposed site. METHODS: 177 Greek-born subjects living in Melbourne (GRM), 69 Greek subjects living in rural Greece (GRG), 48 Anglo-Celtic Australian (ACA) elderly living in Melbourne and 159 Swedish subjects living in Sweden (SWE) participating in the International Union of Nutritional Sciences IUNS "Food Habits in Later Life" study had their dietary intakes measured and their skin assessed. Food and nutrient intakes were assessed using a validated semi-quantitative food frequency questionnaire (FFQ). Skin wrinkling was measured using a cutaneous microtopographic method. RESULTS: SWE elderly had the least skin wrinkling in a sun-exposed site, followed by GRM, GRG and ACA. Correlation analyses on the pooled data and using the major food groups suggested that there may be less actinic skin damage with a higher intake of vegetables (r(s)=-0.31, p<0.0001), olive oil (r(s)=-0.29, p<0.0001), fish (r(s)=-0.24, p<0.0001) and legumes (r(s)=-0.16, p<0.0001), and lower intakes of butter (r(s)=0.46, p<0.0001) and margarine (r(s)=0.24, p<0.001), milk products (r(s)=0.16, p<0.01) and sugar products (r(s)=0.12, p<0.01). Similar findings were obtained using regression analyses, except fish was no longer significant; 32% of the variance for actinic skin damage was predicted by six out of the ten major food groups. In particular, a high intake of vegetables, legumes and olive oil appeared to be protective against cutaneous actinic damage (collectively explaining 20% of the variance); a high intake of meat, dairy and butter appeared to be adverse (explaining <5% of the variance). Prunes, apples and tea explained 34% of variance amongst ACA. CONCLUSION: This study illustrates that skin wrinkling in a sun-exposed site in older people of various ethnic backgrounds may be influenced by the types of foods consumed.

Food and nutrient intakes and overall survival of elderly Japanese.

As part of the International Union of Nutritional Sciences (IUNS) Food Habits in Later Life Project, a group of 89 free-living Japanese aged 70 years and over (43 men and 46 women) residing in semiurban Okazaki, located in the middle of Honshu Island in Japan, were studied. They were followed up in order to determine whether nutrition plays a role in Japanese longevity. Information on food and nutrient intake was collected at study entry. During 55 months follow-up, eight men and five women died. The consumption of various food groups, after adjustment for energy intake to 10.5 MJ for men and 8.4 MJ for women, was similar for survivors and deceased, but there was a greater consumption of mushrooms and fats and oils among the survivors (p<0.05). Furthermore, survivors had a higher intake of total n-3 fatty acids, especially alpha-linolenic acid, compared with the deceased (p<0.05). Subjects who were not chronically energy deficient (BMI >= 18.5 kg/m2) showed a better survival probability with a higher intake of total n-3 fatty acids (>= 2.1 g/day, 25th percentile). A similar result for total n-3 fatty acids and alpha-linolenic acid was found using Cox proportional hazards analyses adjusted for age, gender and smoking status (p<0.05). After adjustment for bodyweight, the conditionally essential amino acid tyrosine was higher in women who survived (p<0.05). These findings suggest that the intake of n-3 fatty acids and of certain amino acids might be particularly important in elderly people for living longer.

Plasma lipoprotein (a) concentrations and apolipoprotein (a) phenotypes in an Aboriginal population from Western Australia.

Factors contributing to the variation in plasma lipoprotein (a) (Lp(a)) concentration were surveyed in an Aboriginal population (175 men and 219 women), aged 24-86 years, from Western Australia. The plasma Lp(a) levels were highly skewed towards low levels in this population, with a median of 84 mg/L and a mean of 166 mg/L. Approximately 20% had plasma Lp(a) above the threshold value of 300 mg/L, while 52% had Lp(a) levels below 100 mg/L. The most commonly occurring phenotype was apolipoprotien(a) S4. In this phenotype, Lp(a) concentrations ranged from not detectable to 468 mg/L. There was a positive relationship between cigarette smoking and plasma Lp(a) concentration in men. Apolipoprotein A1 and bilirubin were positively associated with Lp(a) in the 40-60 age group and a positive relationship between weight and Lp(a) concentrations was observed in those aged 60 years or over. Thus, although Lp(a) is mainly genetically determined, there are clearly other factors which contribute to variations in Lp(a) concentrations.

The significance of eating patterns: an elderly Greek case study.

Eating patterns are a relatively neglected area of nutrition assessment with considerable potential health importance. Cross-cultural and socio-anthropological studies provide insight into the great range of food patterns which are related to health, biochemical measurements and anthropometry. The International Union of Nutritional Sciences (IUNS) study of aged folk in food-culturally disparate communities has provided opportunities to explore these issues. This paper uses cross-sectional data from the Greek arms of the IUNS study to explore associations between eating pattern variables (number of meals, time of meals, main meal for lunch and/or dinner, meal plus alcohol) and with the prevalence of self-reported heart disease and diabetes, body fatness, blood lipids, blood glucose and the overall variety of foods consumed. The eating pattern variables were not associated with blood lipids, self-reported heart disease or diabetes. Body fatness was negatively associated with the consumption of a greater number of meals/snacks daily (p<0.01), with the consumption of two cooked meals daily (p<0. 05) or when the main meal was consumed at lunch time (p<0.05) and when breakfast was consumed earlier rather than later in the morning (p<0.01). Later dinner times were positively correlated with a higher fasting blood glucose in non-diabetic elderly Greeks (p<0. 0005). A more varied diet was positively associated with the consumption of alcohol with dinner (p<0.0001) and with a greater number of meals/snacks daily (p<0.0001). These findings suggest that adherence to the traditional Greek eating pattern may be protective against obesity and appears to promote greater food variety.

Food intake and eating patterns of Indonesian elderly before the 1998 economic crisis.

The Nutrient and Metabolic Study of Indonesian Elderly (NUMSIE) was conducted in part to identify differences in eating patterns and in food and energy intakes between elderly people residing in urban metropolitan Jakarta (JAK) and in urban non-metropolitan Semarang (SEM) in order to investigate the prevalence of food and energy deficiencies. Data on food intake were collected from 212 JAK elderly and 238 SEM elderly aged 60 years and over using a quantitative food frequency questionnaire (FFQ). Although most of the elderly lived with their families or extended families, a large proportion of the subjects were eating alone, especially in the SEM sample. Jakartan elderly had significantly higher intakes of most food groups, except for added sugar and cow's milk. Total food intake of JAK subjects was also significantly higher (p<0.0001) than that of SEM subjects. The ratio of plant to animal food was lower among SEM elderly due principally to their higher intake of milk. Thirty percent of both JAK and SEM elderly consumed less than the recommended amounts of cereals, followed by vegetables and fruits (10%, 47% JAK; 22%, 75% SEM, respectively). Finally, it was found that the range of daily energy intakes was higher in JAK (1251-2079 kcal) than in SEM (939-1579 kcal). This suggests that SEM elderly were more likely to be energy deficient than were JAK elderly. While the results of this study indicate that food and energy intakes may be inadequate in Indonesian elderly, especially in non-metropolitan areas, more analyses are required to ascertain the true prevalence of malnutrition in this age group using anthropometric and blood measurements.

Agreement of skinfold measurement and bioelectrical impedance analysis (BIA) methods with dual energy X-ray absorptiometry (DEXA) in estimating total body fat in Anglo-Celtic Australians.

OBJECTIVE: To compare percentage total body fat (%BF) estimated by the four skinfold thickness measurement (SKF) and single-frequency bioelectrical impedance analysis (BIA) methods using three different sets of equations, to that assessed by the dual energy X-ray absorptiometric (DEXA) method using a Lunar DPX densitometer. DESIGN: Cross-sectional study. SUBJECTS: An Anglo-Celtic Australian population of 66 males and 130 females (age: 26-86 y). MEASUREMENTS: %BF by anthropometry, BIA using three different sets of equations and DEXA. RESULTS: Mean %BF assessed by DEXA (%BF(DEXA)) was similar to that estimated by SKF (%BF(SKF)) in males, while %BF(DEXA) was slightly higher in females. %BF estimated by BIA (%BF(BIA)) was significantly lower than %BF(DEXA) in females, regardless of equations used for calculation, while the level of agreement between BIA and DEXA in estimating %BF in males was dependent on prediction equations used for calculation of %BF(BIA). A better agreement was obtained from the use on the prediction equations of Segal et al (1988), compared to other two sets of equations. The agreement between SKF or BIA and DEXA declined with increasing %BF. CONCLUSIONS: There was a good agreement between DEXA and SKF, and slightly less so between DEXA and BIA, in estimating %BF in an Anglo-Celtic adult population. The agreement in most cases, however, was dependent on the degree of body fatness. In comparison to DEXA, both SKF and BIA, with the use of the equations of Segal et al (1988), are applicable to estimate %BF in an Anglo-Celtic Australian population.

Platelet fatty acids and peripheral blood lymphocyte subsets in an institutionalized elderly population.

The associations between platelet fatty acids and peripheral blood lymphocyte subsets were studied in 78 institutionalized elderly individuals (27 men and 51 women), aged 67 to 100. Platelet fatty acids were assessed by gas chromatography, and peripheral blood lymphocyte subsets were quantitated by immunophenotyping using flow cytometry. It was found that women had a higher number of total T-cells (CD3), T-helper (CD3+4+) cells, and B-cells (CD19). However, no gender differences were observed in the percentages of lymphocyte subsets. In elderly men, after adjusting for age and fatty acid intake, the platelet concentration of omega-3 polyunsaturated fatty acids was positively related to the percentage of CD3 and CD3+4+ bearing lymphocytes (rs = 0.59, P < 0.05; and rs = 0.55, P < 0.05, respectively), and the concentration of total saturated fatty acids was also positively associated with the percentage of B (CD19) cells (rs = 0.50, P < 0.05). However, similar relationships were not observed in elderly women. No significant associations were found between trans fatty acids and any of the lymphocyte subsets in the study population. These findings suggest that fatty acids may be related to immune function. Any effects may be important in the host immune defence, especially in elderly individuals.

Cross-cultural comparison of Lp(a) profiles.

Lipoprotein(a) (Lp(a)) and apolipoprotein(a) (apo(a)) phenotypes as genetic markers for coronary heart disease (CHD) have been the focus of great interest in recent times. Included in this study were four Australian populations comprising 348 Anglo-Celtic Melburnians (157 men and 191 women), 339 Chinese Melburnians (169 men and 170 women), 402 South Asian Melburnians (216 men and 186 women) and 394 Aboriginal Australians from Western Australia (175 men and 219 women). Plasma Lp(a) concentrations were more highly skewed towards the lower range in the Chinese and Aboriginal groups than in the Anglo-Celtics and South Asians. Approximately 33% of Anglo-Celtics, 20% Aboriginals, 13% Chinese and 44% South Asians had plasma Lp(a) levels above the generally accepted risk threshold values of 300 mg/L. In Aboriginals and Chinese, the S4 apo(a) phenotype predominated while in Anglo-Celtics and South Asians, the highest frequency occurred in the S3 phenotype. In the S4 phenotype, Lp(a) values varied between the four populations but there was no significant difference in concentration between gender.

Bioavailability of two different formulations of coenzyme Q10 in healthy subjects.

The bioavailability of coenzyme Q10 (ubiquinone) formulated as an emulsion in a soft gelatin capsule (Ensorb(TM), NDS Pty Ltd, Sydney, Australia) was compared with a hard gelatin powder-filled capsule. The study design was a randomized cross-over trial with a 3-week wash-out period. The study population comprised 23 apparently healthy adults (12 men and 11 women), aged 20-43 years. Each participant took two 50 mg capsules, and blood samples were taken over a period of 36 h. The plasma concentration of coenzyme Q10 peaked between 3 and 4 h after administration of both preparations. The area under the curve (AUC) of Ensorb™ was 927% higher than that observed with the powder-filled capsule (P < 0.0001), suggesting that this emulsion preparation has a higher bioavailability.

Changes in serum carotenoids in subjects with colorectal adenomas after 24 mo of beta-carotene supplementation. Australian Polyp Prevention Project Investigators.

The effect of beta-carotene supplementation on major serum carotenoid fractions (lutein/zeaxanthin, beta-cryptoxanthin, lycopene, alpha-carotene, and beta-carotene) was investigated in 224 people with colorectal adenomas (139 men, 85 women) recruited for the Australian Polyp Prevention Project (APPP). Each subject was randomly assigned to take either 20 mg beta-carotene/d or placebo over 24 mo. Besides the expected increase in serum concentration of beta-carotene (1073% in men, 839% in women), lycopene (176% in men) and alpha-carotene (211% in men and 166% in women) concentrations were also increased after body mass index, baseline concentration, change in respective carotenoid intake, and other confounding factors were adjusted for. The increase in serum concentrations of these carotenoids after beta-carotene supplementation suggests that beta-carotene may interact biologically with other carotenoids and such interaction would need to be taken into consideration when the protective effect of beta-carotene supplementation for cancer or other diseases is examined.

Determination of tocotrienol and tocopherol isomers at physiological concentration by HPLC in Caucasian and Japanese women.

A sensitive, specific and simple method for simultaneous evaluation of tocopherol and tocotrienol isomers in human serum by normal phase HPLC with a fluorescence detector has been developed. Tocopherol and tocotrienol isomers are measurable in physiological concentration in human serum by this method. There is no significant difference in serum alpha- and beta-tocopherols and alpha-, gamma-, and delta-tocotrienols between Caucasian and Japanese subjects. However, serum gamma- and delta-tocopherol concentrations in Japanese women are significantly higher than in Caucasian women.