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1.
BMJ Open ; 10(2): e034598, 2020 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-32029499

RESUMO

INTRODUCTION: Folic acid (0.4 mg) taken prior to and during early pregnancy reduces the risk of neural tube defects (NTDs). Because these birth defects occur early in pregnancy, before women may know they are pregnant, many countries have mandated the addition of folic acid to food staples. In countries where fortification is not possible, and weekly iron folic acid programmes exist to reduce anaemia, the WHO recommends that 2.8 mg (7×0.4 mg) folic acid be given instead of the current weekly practice of 0.4 mg. Currently, there is a lack of evidence to support if the 2.8 mg folic acid per week dose is sufficient to raise erythrocyte folate concentrations to a level associated with a reduced risk of a NTD-affected pregnancy. We aim to conduct a three-arm randomised controlled trial to determine the effect of weekly folic acid with iron on erythrocyte folate, a biomarker of NTD risk. METHODS AND ANALYSIS: We will recruit non-pregnant women (n=300; 18-45 years) from Selangor, Malaysia. Women will be randomised to receive either 2.8, 0.4 or 0.0 (placebo) mg folic acid with 60 mg iron weekly for 16 weeks, followed by a 4-week washout period. The primary outcome will be erythrocyte folate concentration at 16 weeks and the mean concentration will be compared between randomised treatment groups (intention-to-treat) using a linear regression model adjusting for the baseline measure. ETHICS AND DISSEMINATION: Ethical approval was obtained from the University of British Columbia (H18-00768) and Universiti Putra Malaysia (JKEUPM-2018-255). The results of this trial will be presented at scientific conferences and published in peer-reviewed journals. TRIAL REGISTRATION NUMBERS: ACTRN12619000818134 and NMRR-19-119-45736.

2.
Public Health Nutr ; 23(2): 319-328, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31397262

RESUMO

OBJECTIVE: To investigate the association between dietary patterns (DP) and overweight risk in the Malaysian Adult Nutrition Surveys (MANS) of 2003 and 2014. DESIGN: DP were derived from the MANS FFQ using principal component analysis. The cross-sectional association of the derived DP with prevalence of overweight was analysed. SETTING: Malaysia. PARTICIPANTS: Nationally representative sample of Malaysian adults from MANS (2003, n 6928; 2014, n 3000). RESULTS: Three major DP were identified for both years. These were 'Traditional' (fish, eggs, local cakes), 'Western' (fast foods, meat, carbonated beverages) and 'Mixed' (ready-to-eat cereals, bread, vegetables). A fourth DP was generated in 2003, 'Flatbread & Beverages' (flatbread, creamer, malted beverages), and 2014, 'Noodles & Meat' (noodles, meat, eggs). These DP accounted for 25·6 and 26·6 % of DP variations in 2003 and 2014, respectively. For both years, Traditional DP was significantly associated with rural households, lower income, men and Malay ethnicity, while Western DP was associated with younger age and higher income. Mixed DP was positively associated with women and higher income. None of the DP showed positive association with overweight risk, except for reduced adjusted odds of overweight with adherence to Traditional DP in 2003. CONCLUSIONS: Overweight could not be attributed to adherence to a single dietary pattern among Malaysian adults. This may be due to the constantly morphing dietary landscape in Malaysia, especially in urban areas, given the ease of availability and relative affordability of multi-ethnic and international foods. Timely surveys are recommended to monitor implications of these changes.

3.
BMC Public Health ; 19(1): 1685, 2019 Dec 16.
Artigo em Inglês | MEDLINE | ID: mdl-31842826

RESUMO

The purpose of this correspondence is to express our disappointment with the coverage of the BMC Public Health supplement: Vol 19 (4) titled "Health and Nutritional Issues Among Low Income Population in Malaysia", which neglected to include the fundamental health and nutrition issues that are adversely affecting the lives and livelihood of the indigenous peoples. The Supplement comprised 21 papers. Two of these papers included indigenous peoples as study subjects. These two papers addressed peripheral, albeit important health issues, namely visual impairment and quality of life, and not the persistent and rising health concerns impacting this population. We will provide evidence from research and reports to justify our critique that the Supplement missed the opportunity to spotlight on the serious extent of the health and nutritional deprivations of the indigenous peoples of Malaysia. As researchers of the indigenous peoples, we ought to lend our voice to the "silenced minority" by highlighting their plight in the media including scientific journals.

4.
J Nutr ; 149(11): 1952-1959, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31318024

RESUMO

BACKGROUND: Riboflavin is required for several redox reactions. Clinical riboflavin deficiency occurs mainly in low-income countries, where it is associated with anemia. The functional significance of suboptimal riboflavin status in different populations and its role in anemia is not well understood. OBJECTIVES: We assessed the biomarker status of riboflavin and its association with hemoglobin concentration and anemia in women living in Vancouver, Canada, and Kuala Lumpur, Malaysia. METHODS: Healthy nonpregnant, nonbreastfeeding women (19-45 y) were recruited from Canada ( n = 206) and Malaysia (n = 210) via convenience sampling. Fasting blood was collected to assess riboflavin status [erythrocyte glutathione reductase activity coefficient (EGRac)], hematological indicators, soluble transferrin receptor (sTfR), ferritin, vitamin A, folate, and vitamin B-12 concentrations. Linear and logistic regression models were used to assess the association of riboflavin status with hemoglobin concentration and anemia. RESULTS: EGRac (mean ± SD) values were higher, indicating poorer riboflavin status, in Malaysian compared with Canadian women (1.49 ± 0.17 compared with 1.38 ± 0.11). Likewise, riboflavin biomarker deficiency (EGRac ≥1.40) was significantly more prevalent among Malaysians than Canadians (71% compared with 40%). More Malaysian than Canadian women were anemic (hemoglobin <120 g/L; 18% compared with 7%). With use of linear regression (pooled sample; n = 416), EGRac values were negatively associated with hemoglobin concentration (r = -0.18; P < 0.001). This relation remained significant (P = 0.029) after adjusting for age, parity, ethnicity, vitamin B-12, folate, sTfR, ferritin, and vitamin A. Women with riboflavin deficiency (EGRac ≥1.40) were twice as likely to present with anemia (adjusted OR: 2.38; 95% CI: 1.08, 5.27) compared with women with EGRac <1.40. CONCLUSIONS: Biochemical riboflavin deficiency was observed in Canadian and Malaysian women, with higher rates of deficiency among Malaysian women. Deficient biomarker status of riboflavin was a weak but significant predictor of hemoglobin and anemia, suggesting that the correction of riboflavin deficiency may potentially play a small protective role in anemia, but this requires further investigation.

5.
Am J Health Promot ; 33(3): 363-371, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30011998

RESUMO

PURPOSE: To evaluate the association between preconception care and the risk of adverse birth outcomes. DESIGN: A quasi-experimental study comparing 2 groups: (1) integrated maternal health care (MHC) program (with preconception care) and (2) standard MHC program (without preconception care). SETTING: Maternal health-care clinics in Alvand and Qazvin cities in Qazvin Province, Iran. PARTICIPANTS: A total of 152 and 247 Iranian women aged 16 to 35 years were enrolled in the integrated MHC and standard MHC program, respectively. MEASURES: The birth outcomes measured included low birth weight, preterm birth, maternal and neonatal complications, and mode of delivery (normal vaginal delivery and cesarean delivery). ANALYSIS: Multiple logistic regression was performed to determine the impact of preconception care and risk of adverse birth outcomes with adjusted odds ratios (ORs) as effect sizes. RESULTS: One hundred forty-seven women in integrated MHC and 218 women in standard MHC completed this study. Preconception care was associated with reduced risk of preterm birth (OR = 0.298; 95% confidence interval [CI] = 0.120-0.743; P = .009), low birth weight (OR = 0.406; 95% CI = 0.169-0.971; P = .043), maternal complication (OR = 0.399; 95% CI = 0.241-0.663; P < .001), and neonatal complications (OR = 0.460; 95% CI = 0.275-0.771; P = .003). CONCLUSION: The findings of the present study revealed advantages of preconception care with reduced adverse birth outcomes.

6.
J Nutr ; 148(6): 885-890, 2018 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-29878267

RESUMO

Background: Folic acid fortification of grains is mandated in many countries to prevent neural tube defects. Concerns regarding excessive intakes of folic acid have been raised. A synthetic analog of the circulating form of folate, l-5-methyltetrahydrofolate (l-5-MTHF), may be a potential alternative. Objective: The objective of this study was to determine the effects of folic acid or l-5-MTHF supplementation on blood folate concentrations, methyl nutrient metabolites, and DNA methylation in women living in Malaysia, where there is no mandatory fortification policy. Methods: In a 12-wk, randomized, placebo-controlled intervention trial, healthy Malaysian women (n = 142, aged 20-45 y) were randomly assigned to receive 1 of the following supplements daily: 1 mg (2.27 µmol) folic acid, 1.13 mg (2.27 µmol) l-5-MTHF, or a placebo. The primary outcomes were plasma and RBC folate and vitamin B-12 concentrations. Secondary outcomes included plasma total homocysteine, total cysteine, methionine, betaine, and choline concentrations and monocyte long interspersed nuclear element-1 (LINE-1) methylation. Results: The folic acid and l-5-MTHF groups had higher (P < 0.001) RBC folate (mean ± SD: 1498 ± 580 and 1951 ± 496 nmol/L, respectively) and plasma folate [median (25th, 75th percentiles): 40.1 nmol/L (24.9, 52.7 nmol/L) and 52.0 nmol/L (42.7, 73.1 nmol/L), respectively] concentrations compared with RBC folate (958 ± 345 nmol/L) and plasma folate [12.6 nmol/L (8.80, 17.0 nmol/L)] concentrations in the placebo group at 12 wk. The l-5-MTHF group had higher RBC folate (1951 ± 496 nmol/L; P = 0.003) and plasma folate [52.0 nmol/L (42.7, 73.1 nmol/L); P = 0.023] at 12 wk than did the folic acid group [RBC folate, 1498 ± 580 nmol/L; plasma folate, 40.1 nmol/L (24.9, 52.7 nmol/L)]. The folic acid and l-5-MTHF groups had 17% and 15%, respectively, lower (P < 0.001) plasma total homocysteine concentrations than did the placebo group at 12 wk; there were no differences between the folic acid and l-5-MTHF groups. No differences in plasma vitamin B-12, total cysteine, methionine, betaine, and choline and monocyte LINE-1 methylation were observed. Conclusion: These findings suggest differential effects of l-5-MTHF compared with folic acid supplementation on blood folate concentrations but no differences on plasma total homocysteine lowering in Malaysian women. This trial was registered at clinicaltrials.gov as NCT01584050.


Assuntos
Ácido Fólico/administração & dosagem , Ácido Fólico/sangue , Tetra-Hidrofolatos/administração & dosagem , Tetra-Hidrofolatos/farmacologia , Adulto , Suplementos Nutricionais , Método Duplo-Cego , Feminino , Ácido Fólico/farmacologia , Humanos , Malásia , Adulto Jovem
7.
Br J Nutr ; 118(10): 804-812, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29103383

RESUMO

Breast-fed infants are susceptible to vitamin D deficiency rickets. The current vitamin D 'adequate intake' (AI) for 0-6-month-old infants is 10 µg/d, corresponding with a human milk antirachitic activity (ARA) of 513 IU/l. We were particularly interested to see whether milk ARA of mothers with lifetime abundant sunlight exposure reaches the AI. We measured milk ARA of lactating mothers with different cultural backgrounds, living at different latitudes. Mature milk was derived from 181 lactating women in the Netherlands, Curaçao, Vietnam, Malaysia and Tanzania. Milk ARA and plasma 25-hydroxyvitamin D (25(OH)D) were analysed by liquid-chromatography-MS/MS; milk fatty acids were analysed by GC-flame ionisation detector (FID). None of the mothers reached the milk vitamin D AI. Milk ARA (n; median; range) were as follows: Netherlands (n 9; 46 IU/l; 3-51), Curaçao (n 10; 31 IU/l; 5-113), Vietnam: Halong Bay (n 20; 58 IU/l; 23-110), Phu Tho (n 22; 28 IU/l; 1-62), Tien Giang (n 20; 63 IU/l; 26-247), Ho-Chi-Minh-City (n 18; 49 IU/l; 24-116), Hanoi (n 21; 37 IU/l; 11-118), Malaysia-Kuala Lumpur (n 20; 14 IU/l; 1-46) and Tanzania-Ukerewe (n 21; 77 IU/l; 12-232) and Maasai (n 20; 88 IU/l; 43-189). We collected blood samples of these lactating women in Curaçao, Vietnam and from Tanzania-Ukerewe, and found that 33·3 % had plasma 25(OH)D levels between 80 and 249·9 nmol/l, 47·3 % between 50 and 79·9 nmol/l and 19·4 % between 25 and 49·9 nmol/l. Milk ARA correlated positively with maternal plasma 25(OH)D (range 27-132 nmol/l, r 0·40) and milk EPA+DHA (0·1-3·1 g%, r 0·20), and negatively with latitude (2°S-53°N, r -0·21). Milk ARA of mothers with lifetime abundant sunlight exposure is not even close to the vitamin D AI for 0-6-month-old infants. Our data may point at the importance of adequate fetal vitamin D stores.


Assuntos
Aleitamento Materno , Leite Humano/metabolismo , Necessidades Nutricionais , Luz Solar , Deficiência de Vitamina D , Vitamina D/administração & dosagem , Adulto , Curaçao , Dieta , Feminino , Humanos , Lactente , Fenômenos Fisiológicos da Nutrição do Lactente , Recém-Nascido , Lactação/metabolismo , Malásia , Masculino , Países Baixos , Política Nutricional , Raquitismo/sangue , Raquitismo/etiologia , Tanzânia , Vietnã , Vitamina D/análogos & derivados , Vitamina D/sangue , Vitamina D/metabolismo , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/epidemiologia , Deficiência de Vitamina D/metabolismo , Vitaminas/administração & dosagem , Vitaminas/metabolismo , Adulto Jovem
8.
Nutrients ; 8(12)2016 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-27916932

RESUMO

BACKGROUND: The 2010 World Health Organisation (WHO) Infant and Young Child Feeding (IYCF) indicators are useful for monitoring feeding practices. METHODS: A total sample of 300 subjects aged 6 to 23 months was recruited from urban suburbs of Kuala Lumpur and Putrajaya. Compliance with each IYCF indicator was computed according to WHO recommendations. Dietary intake based on two-day weighed food records was obtained from a sub-group (N = 119) of the total sample. The mean adequacy ratio (MAR) value was computed as an overall measure of dietary intake adequacy. Contributions of core IYCF indicators to MAR were determined by multinomial logistic regression. RESULTS: Generally, the subjects showed high compliance for (i) timely introduction of complementary foods at 6 to 8 months (97.9%); (ii) minimum meal frequency among non-breastfed children aged 6 to 23 months (95.2%); (iii) consumption of iron-rich foods at 6 to 23 months (92.3%); and minimum dietary diversity (78.0%). While relatively high proportions achieved the recommended intake levels for protein (87.4%) and iron (71.4%), lower proportions attained the recommendations for calcium (56.3%) and energy (56.3%). The intake of micronutrients was generally poor. The minimum dietary diversity had the greatest contribution to MAR (95% CI: 3.09, 39.87) (p = 0.000) among the core IYCF indicators. CONCLUSION: Malaysian urban infants and toddlers showed moderate to high compliance with WHO IYCF indicators. The robustness of the analytical approach in this study in quantifying contributions of IYCF indicators to MAR should be further investigated.


Assuntos
Dieta/efeitos adversos , Métodos de Alimentação/efeitos adversos , Fenômenos Fisiológicos da Nutrição do Lactente , Política Nutricional , Cooperação do Paciente , Saúde Suburbana , Aleitamento Materno/etnologia , Cuidadores , Creches , Desenvolvimento Infantil , Estudos Transversais , Dieta/etnologia , Registros de Dieta , Feminino , Indicadores Básicos de Saúde , Humanos , Lactente , Fenômenos Fisiológicos da Nutrição do Lactente/etnologia , Malásia , Masculino , Inquéritos Nutricionais , Pais , Cooperação do Paciente/etnologia , Saúde Suburbana/etnologia , Organização Mundial da Saúde
9.
J Agric Food Chem ; 64(32): 6295-305, 2016 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-27436425

RESUMO

Gangliosides (GA) are found in animal tissues and fluids, such as blood and milk. These sialo-glycosphingolipids have bioactivities in neural development, the gastrointestinal tract, and the immune system. In this study, a high-performance liquid chromatography-mass spectrometry (HPLC-MS) method was validated to characterize and quantitate the GA in beef, chicken, pork, and fish species (turbot, snapper, king salmon, and island mackerel). For the first time, we report the concentration of GM3, the dominant GA in these foods, as ranging from 0.35 to 1.1 mg/100 g and 0.70 to 5.86 mg/100 g of meat and fish, respectively. The minor GAs measured were GD3, GD1a, GD1b, and GT1b. Molecular species distribution revealed that the GA contained long- to very-long-chain acyl fatty acids attached to the ceramide moiety. Fish GA contained only N-acetylneuraminic acid (NeuAc) sialic acid, while beef, chicken, and pork contained GD1a/b species that incorporated both NeuAc and N-glycolylneuraminic acid (NeuGc) and hydroxylated fatty acids.


Assuntos
Cromatografia Líquida de Alta Pressão/métodos , Gangliosídeos/química , Espectrometria de Massas/métodos , Carne/análise , Animais , Bovinos , Galinhas , Peixes , Suínos
10.
Artigo em Inglês | MEDLINE | ID: mdl-27244965

RESUMO

The objective of this study was to investigate the relationship between metabolic syndrome and its individual components with socio-economic factors among 14-18 year-old adolescents in Shiraz, Iran. Using a multistage random sampling, a total of 538 (289 males and 249 females) adolescents consented to the study. Socio-economic status was obtained using a self-administered questionnaire while presence of metabolic syndrome and its individual components was ascertained using NCEP-ATP III criteria. The relationships between the participants' socio-economic status and metabolic syndrome and its components were determined using bivariate and multivariate statistical analyses. Approximately 6% of the adolescents had metabolic syndrome, with significantly more males than females (9.3% vs 2.4%, p < 0.001). The most commonly found abnormality was low high-density lipoprotein cholesterol (42.4%), followed by hypertensive (16.3%). The prevalence rates of elevated triglycerides, abdominal obesity and high fasting plasma glucose were 15.6%, 8.6% and 3.1%, respectively. Metabolic syndrome was significantly more prevalent in obese participants (44.4%) than those with normal body weight (2.0%) or overweight (9.3%). There were positive associations between the components of metabolic syndrome and parental education, school location and household monthly income. Having a family history of obesity was associated with metabolic syndrome after controlling for other variables (OR = 2.1; 95% CI: 0.9-5.2, p = 0.042). Overweight and obese subjects were approximately 8 times and 15 times more likely to develop metabolic syndrome, respectively (overweight: OR = 8.2; 95% CI: 3.6-17.2; obese: OR = 15.4; 95% CI: 4.8-43.7). In conclusion, a positive association exists between socio-economic status and metabolic syndrome and its individual components among the studied participants. An intervention program to prevent metabolic syndrome needs to be developed for this young generation, especially among those who are overweight or obese and those with a family history of obesity. Keywords: adolescents, metabolic syndrome, components of metabolic syndrome, socio-economic status, Iran


Assuntos
Síndrome Metabólica/epidemiologia , Síndrome Metabólica/psicologia , Classe Social , Adolescente , Glicemia/metabolismo , Escolaridade , Feminino , Humanos , Hipertensão/epidemiologia , Renda , Irã (Geográfico)/epidemiologia , Lipoproteínas HDL/sangue , Masculino , Obesidade/epidemiologia , Obesidade/psicologia , Sobrepeso/epidemiologia , Sobrepeso/psicologia , Pais , Prevalência , Distribuição por Sexo , Triglicerídeos/sangue
11.
Asia Pac J Clin Nutr ; 25(2): 227-40, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27222405

RESUMO

The term 'added sugars' refers to sugars and syrup added to foods during processing or preparation, and sugars and syrups added at the table. Calls to limit the daily intakes of added sugars and its sources arose from evidence analysed by WHO, the American Heart Association and other organizations. The present review examined the best available evidence regarding levels of added sugar consumption among different age and sex groups in Malaysia and sources of added sugars. Information was extracted from food balance sheets, household expenditure surveys, nutrition surveys and published studies. Varying results emerged, as nationwide information on intake of sugar and foods with added sugar were obtained at different times and used different assessment methods. Data from the 2003 Malaysian Adult Nutrition Survey (MANS) using food frequency questionnaires suggested that on average, Malaysian adults consumed 30 grams of sweetened condensed milk (equivalent to 16 grams sugar) and 21 grams of table sugar per day, which together are below the WHO recommendation of 50 grams sugar for every 2000 kcal/day to reduce risk of chronic disease. Published studies suggested that, for both adults and the elderly, frequently consumed sweetened foods were beverages (tea or coffee) with sweetened condensed milk and added sugar. More accurate data should be obtained by conducting population-wide studies using biomarkers of sugar intake (e.g. 24-hour urinary sucrose and fructose excretion or serum abundance of the stable isotope 13C) to determine intake levels, and multiple 24 hour recalls to identify major food sources of added sugar.


Assuntos
Sacarose na Dieta/administração & dosagem , Adolescente , Adulto , Distribuição por Idade , Criança , Pré-Escolar , Culinária/estatística & dados numéricos , Ingestão de Energia , Manipulação de Alimentos/estatística & dados numéricos , Humanos , Malásia , Pessoa de Meia-Idade , Inquéritos Nutricionais/estatística & dados numéricos , Distribuição por Sexo , Inquéritos e Questionários , Organização Mundial da Saúde , Adulto Jovem
12.
Asia Pac J Clin Nutr ; 21(4): 476-86, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-23017305

RESUMO

It is estimated that more than 200 million young children worldwide fail to reach their potential in cognitive development owing to undernutrition. Numerous studies have assessed the effects of micronutrient supplementation on growth and cognitive development in infants, toddlers and preschoolers. However, micronutrient interventions on the cognitive performance of older children are limited. This article seeks to provide an update on micronutrient interventions and cognitive outcomes among children aged 5-15 years in developing countries. A total of 13 randomized controlled trials published since 2000 were identified. Majority of these studies assessed the effects of micronutrient-fortified foods on various domains of cognitive function. Among key micronutrients assessed were iron, zinc, iodine and vitamin A. This review found a lack of consistency in the impact of micronutrient supplementation on intelligence, long term mental functions and school examination grades of the children. A beneficial effect of micronutrient supplementation on short term memory was more consistently reported. Overall, the evidence from this review for the impact of micronutrients on cognitive performance in older children remains equivocal. In light of the growing interest on the influence of nutrition on cognition, it is important that culturally-appropriate and sufficiently sensitive assessment tools be used for measuring the desired cognitive outcomes that are most likely to be affected by the nutrients under study.


Assuntos
Desenvolvimento do Adolescente , Desenvolvimento Infantil , Transtornos Cognitivos/prevenção & controle , Países em Desenvolvimento , Micronutrientes/uso terapêutico , Adolescente , Criança , Pré-Escolar , Suplementos Nutricionais , Avaliação Educacional , Feminino , Alimentos Fortificados , Humanos , Inteligência , Masculino , Memória de Curto Prazo , Micronutrientes/administração & dosagem , Ensaios Clínicos Controlados Aleatórios como Assunto , Análise e Desempenho de Tarefas
13.
J Nutr Sci Vitaminol (Tokyo) ; 57(2): 150-5, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21697634

RESUMO

Folate is of prime interest among investigators in nutrition due to its multiple roles in maintaining health, especially in preventing neural tube defects and reducing the risk of cardiovascular diseases. We investigated the effect of dietary folate intake on blood folate, vitamin B(12), vitamin B(6), and homocysteine status. One hundred subjects consisting of Chinese and Malay subjects volunteered to participate in this cross-sectional study. Dietary folate intake was assessed by 24-h dietary recall and a food-frequency questionnaire (FFQ). Serum and red blood cell folate were analyzed using a microbiological assay, while serum vitamin B(12) was determined by electrochemiluminescence immunoassay (ECLIA), and high-performance liquid chromatography (HPLC) was used for the determination of serum vitamin B(6) and homocysteine. The mean folate intake, serum folate, RBC folate, serum vitamin B(12), and B(6), were higher in female subjects, with the exception of serum homocysteine. The Chinese tended to have higher folate intake, serum folate, RBC folate, and vitamin B(12). A positive association was found between folate intake and serum folate while a negative association was found between folate intake and serum homocysteine. Stepwise linear regression of serum folate showed a significant positive coefficient for folate intake whilst a significant negative coefficient was found for serum homocysteine when controlling for age, gender, and ethnicity. In conclusion, high dietary folate intake helps to increase serum folate and to lower the homocysteine levels.


Assuntos
Dieta , Ácido Fólico/farmacologia , Homocisteína/sangue , Estado Nutricional , Vitamina B 12/sangue , Vitamina B 6/sangue , Complexo Vitamínico B/farmacologia , Adulto , Grupo com Ancestrais do Continente Asiático , Doenças Cardiovasculares/prevenção & controle , Estudos Transversais , Registros de Dieta , Inquéritos sobre Dietas , Eritrócitos/metabolismo , Feminino , Ácido Fólico/sangue , Humanos , Modelos Lineares , Malásia , Masculino , Pessoa de Meia-Idade , Defeitos do Tubo Neural/prevenção & controle , Fatores Sexuais , Inquéritos e Questionários , Complexo Vitamínico B/sangue , Adulto Jovem
14.
Lancet ; 377(9764): 516-25, 2011 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-21269675

RESUMO

Although maternal and child mortality are on the decline in southeast Asia, there are still major disparities, and greater equity is key to achieve the Millennium Development Goals. We used comparable cross-national data sources to document mortality trends from 1990 to 2008 and to assess major causes of maternal and child deaths. We present inequalities in intervention coverage by two common measures of wealth quintiles and rural or urban status. Case studies of reduction in mortality in Thailand and Indonesia indicate the varying extents of success and point to some factors that accelerate progress. We developed a Lives Saved Tool analysis for the region and for country subgroups to estimate deaths averted by cause and intervention. We identified three major patterns of maternal and child mortality reduction: early, rapid downward trends (Brunei, Singapore, Malaysia, and Thailand); initially high declines (sustained by Vietnam but faltering in the Philippines and Indonesia); and high initial rates with a downward trend (Laos, Cambodia, and Myanmar). Economic development seems to provide an important context that should be coupled with broader health-system interventions. Increasing coverage and consideration of the health-system context is needed, and regional support from the Association of Southeast Asian Nations can provide increased policy support to achieve maternal, neonatal, and child health goals.


Assuntos
Mortalidade da Criança , Bem-Estar da Criança , Mortalidade Materna , Bem-Estar Materno , Ásia Sudeste , Criança , Serviços de Saúde da Criança , Mortalidade da Criança/tendências , Feminino , Pessoal de Saúde/educação , Política de Saúde , Mão de Obra em Saúde , Disparidades em Assistência à Saúde , Humanos , Recém-Nascido , Serviços de Saúde Materna , Mortalidade Materna/tendências , Pobreza , Serviços de Saúde Rural , Cobertura Universal do Seguro de Saúde , Serviços Urbanos de Saúde , Vacinação
16.
Artigo em Inglês | MEDLINE | ID: mdl-19842450

RESUMO

Metabolic syndrome is a cluster of interconnected cardiovascular risk factors. This research determined the prevalence of metabolic syndrome by body mass index, sociodemography, and lifestyle habits of women 30-50 years old in Babol Iran. A systematic random sampling was used to select 984 middle aged women from an urban area in Babol, Mazandaran, Iran. Screening was used to select eligible women who fulfilled selection criteria. The Adult Treatment Panel III (ATP III) criteria were used to classify participants as having metabolic syndrome. The overall prevalence of metabolic syndrome was 31.0%. Abdominal obesity was observed in about 76.6% (n = 273) of subjects. The prevalences of hypertension, high fasting blood glucose, high triglycerides and low HDL-cholesterol were 12.1, 12.1, 41.5 and 48.6%, respectively. Older age (OR = 2.07; CI = 1.56-2.75), higher waist circumference (OR = 6.46; 95% CI = 3.48-11.96), higher systolic (OR = 3.84; 95% CI = 2.37-6.22) and diastolic blood pressure (OR = 1.89; 95% CI =1.17-3.05), low education level (OR = 2.780; CI = 1.80-4.31), housekeeping (OR = 3.92; CI = 1.24-12.44) and farming occupation (OR = 20.54; 95% CI = 3.54-119.06) were associated with increased risk for metabolic syndrome. The odds ratio (OR) showed no significant associations between metabolic syndrome and smoking or exposure to smoking. This study showed high prevalence of metabolic syndrome in Iranian middle aged women. A larger area and population study is needed to enable broader recommendations for the prevention of metabolic syndrome.


Assuntos
Síndrome Metabólica/epidemiologia , Adulto , Estudos Transversais , Feminino , Humanos , Irã (Geográfico)/epidemiologia , Pessoa de Meia-Idade , Prevalência
17.
Asia Pac J Clin Nutr ; 18(3): 433-40, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19786392

RESUMO

Mongolia is experiencing changes in its unique nomadic lifestyle and dietary habits in the last two decades with accompanying increase in obesity rate. The dietary pattern approach, which investigates the overall diet in relation to obesity risks, has become appealing in nutrition epidemiology. The aim of this study was to identify major dietary patterns of the Mongolian adults in relation to the risk of having obesity. Dietary intake of a total 418 adults aged ? 25 years was assessed by using a food frequency questionnaire with 68 items. An exploratory factor analysis resulted in three dietary patterns: transitional high in processed meat and potato, traditional rich in whole milk, fats and oils and healthy with greater intake of whole grains, mixed vegetables and fruits. Individuals in the upper quintile of the transitional pattern had significantly greater risk of obesity (BMI > or =25 kg/m2: OR=2.47; 95% CI=1.04-5.86) while subjects in the highest quintile of the healthy dietary pattern were found to have significantly decreased risk of obesity (OR: 0.49; 95% CI=0.25-0.95). Men in the highest quintile of the transitional pattern had greater risk of abdominal obesity WC > or =90 cm: OR= 4.08; 95% CI=1.11-14.97) than those in the lowest quintile. Women in the top quintile of the traditional pattern had a greater odds of having abdominal obesity (WC > or =80 cm: OR=4.59; 95% CI=1.58-13.30) than those in the lowest quintile. The study suggests that public health efforts be targeted at adults in Mongolia to address the undesirable aspects of the transitional and the traditional dietary patterns.


Assuntos
Doenças Cardiovasculares/etiologia , Dieta , Preferências Alimentares/etnologia , Alimentos/classificação , Obesidade/etiologia , Adulto , Doenças Cardiovasculares/etnologia , Dieta/etnologia , Inquéritos sobre Dietas , Feminino , Alimentos/efeitos adversos , Promoção da Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Mongólia , Obesidade/etnologia , Fatores de Risco
18.
Asia Pac J Clin Nutr ; 18(2): 285-92, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19713190

RESUMO

It is important to elucidate the dietary factors contributing to the development of metabolic syndrome among middle-aged women to better prevent and manage the syndrome. The objective was to determine the relationship between dietary intake and metabolic syndrome in urban Babolian middle-aged women. Systematic random sampling was used to select 984 women 30-50 years of age from urban area of Babol, Mazandaran, Iran. Dietary patterns were evaluated using a food frequency questionnaire. The ATP III criteria were used to classify study participants as having the metabolic syndrome. Correlations of component foods with indices of the metabolic syndrome were assessed using Spearman's rank correlation coefficient (rho). The adjusted odds ratios (OR) and their 95% confidence intervals were obtained for the nutrient groups. Mean total kilocalories consumed per day were 2965. The study suggests that a good dietary pattern that is rich in fruits, legumes, vegetables, cereals, and fish (component 1), as well as high intake of dairy products and eggs (components 4) decrease the likelihood of having metabolic syndrome. The adjusted OR for the metabolic syndrome in women with low fat intake was higher than in women with high and moderate fat (OR=2.92; 95% CI=1.36, 6.28). It is necessary to emphasize the benefits of lifestyle modification, including losing weight, and consumption of more fruits, legumes, vegetables, cereals, fish, dairy products in reducing the risk of the metabolic syndrome in middle aged women.


Assuntos
Dieta , Síndrome Metabólica/epidemiologia , Adulto , Animais , Índice de Massa Corporal , Laticínios , Registros de Dieta , Gorduras na Dieta/administração & dosagem , Grão Comestível , Ingestão de Energia , Fabaceae , Feminino , Peixes , Frutas , Índice Glicêmico , Humanos , Irã (Geográfico)/epidemiologia , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/prevenção & controle , Pessoa de Meia-Idade , Razão de Chances , Fatores de Risco , Inquéritos e Questionários , Verduras
19.
Asia Pac J Clin Nutr ; 17 Suppl 1: 111-5, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-18296315

RESUMO

Estimates of FAO indicate that 14% of the population worldwide or 864 million in 2002-2004 were undernourished in not having enough food to meet basic daily energy needs. Asia has the highest number of undernourished people, with 163 million in East Asia and 300 million in South Asia. Meanwhile obesity and diet-related non-communicable diseases continue to escalate in the region. The double burden of malnutrition also affects the poor, which is a serious problem in Asia, as it has the largest number of poor subsisting on less than $1/day. As poverty in the region is predominantly rural, agriculture-based strategies are important for improving household food security and nutritional status. These measures include shifting toward production of high-value products for boosting income, enhancing agricultural biodiversity, increasing consumption of indigenous food plants and biofortified crops. Urban poor faces additional nutritional problems being more sensitive to rising costs of living, lack of space for home and school gardening, and trade-offs between convenience and affordability versus poor diet quality and risk of contamination. Time constraints faced by working couples in food preparation and child care are also important considerations. Combating the double burden among the poor requires a comprehensive approach including adequate public health services, and access to education and employment skills, besides nutrition interventions.


Assuntos
Agricultura/métodos , Fome , Desnutrição/prevenção & controle , Obesidade/prevenção & controle , Pobreza , Agricultura/normas , Ásia/epidemiologia , Países em Desenvolvimento , Abastecimento de Alimentos , Humanos , Desnutrição/epidemiologia , Estado Nutricional , Obesidade/epidemiologia
20.
Nutr Res Pract ; 2(1): 26-34, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-20126362

RESUMO

This cross-sectional study assessed household food insecurity among low-income rural communities and examined its association with demographic and socioeconomic factors as well as coping strategies to minimize food insecurity. Demographic, socioeconomic, expenditure and coping strategy data were collected from 200 women of poor households in a rural community in Malaysia. Households were categorized as either food secure (n=84) or food insecure (n=116) using the Radimer/Cornell Hunger and Food Insecurity instrument. T-test, Chi-square and logistic regression were utilized for comparison of factors between food secure and food insecure households and determination of factors associated with household food insecurity, respectively. More of the food insecure households were living below the poverty line, had a larger household size, more children and school-going children and mothers as housewives. As food insecure households had more school-going children, reducing expenditures on the children's education is an important strategy to reduce household expenditures. Borrowing money to buy foods, receiving foods from family members, relatives and neighbors and reducing the number of meals seemed to cushion the food insecure households from experiencing food insufficiency. Most of the food insecure households adopted the strategy on cooking whatever is available at home for their meals. The logistic regression model indicates that food insecure households were likely to have more children (OR=1.71; p<0.05) and non-working mothers (OR=6.15; p<0.05), did not own any land (OR=3.18; p<0.05) and adopted the strategy of food preparation based on whatever is available at their homes (OR=4.33; p<0.05). However, mothers who reported to borrow money to purchase food (OR=0.84; p<0.05) and households with higher incomes of fathers (OR=0.99; p<0.05) were more likely to be food secure. Understanding the factors that contribute to household food insecurity is imperative so that effective strategies could be developed and implemented.

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