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171 Iron status and dietary intake of Chinese pregnant women with anaemia in the third
trimester
Aiguo Ma, Xuecun Chen, Mingci Zheng, Yu Wang, Rongxian Xu, Juesheng Li
Anaemia in pregnancy is a major public health problem in China.
Anaemia in pregnant women may be related to dietary intake of nutrients.
To examine the relationship between iron status and dietary nutrients, a
cross-sectional study in pregnant women was carried out. The intake of
foods and food ingredients were surveyed by using 24-h dietary recall.
Blood haemoglobin, haematocrit, serum iron, serum ferritin, transferrin
and soluble transferrin receptor were measured in 1189 clinically normal
pregnant women in the third trimester of pregnancy. The results showed
that the average daily intake of rice and wheat was 504.2 g in the
anaemia group and 468.6 g in the normal group. Carbohydrates
accounted for 63.69% and 63.09% of energy in the anaemia and normal
groups, respectively. Intake of fat was very low; 18.38% of energy in
anaemia group and 19.23% of energy in normal group. Soybean intake
was 109.4 g/day and 63.6 g/day in the anaemia and normal groups,
respectively (P < 0.001). There were lower intakes of green vegetables
(172.1 g/day) and fruits (154.9 g/day) in the anaemia group than in the
normal group (246.2 g/day green vegetables (P < 0.001) and 196.4 g/day
fruit (P < 0.001)). Intakes of retinol and ascorbic acid were much lower in
the anaemia than in the normal group (P < 0.001). In the anaemia group,
vitamin A intake was only 54.76% of the Chinese recommended daily
allowance (RDA) and ascorbic acid intake was 53.35% of the Chinese
RDA. Intake of total vitamin E was 14.55 mg/day in the anaemia group
compared with 17.35 mg/day in the normal group (P < 0.016). Moreover,
intake of iron in pregnant women with anaemia was slightly lower than
that in the normal group. Comparison of iron status between the anaemia
and normal groups found serum iron in women with anaemia at
0.89 µg/L, which was significantly lower than 1.09 µg/L in the normal
group (P < 0.001). There were lower average values of ferritin
(14.70 µg/L) and transferrin (3.34 g/L) in the anaemia group than in the
normal group (20.40 µg/L ferritin (P < 0.001) and 3.44 g/L transferrin
(P < 0.001)). Soluble transferrin receptor was significantly higher
(32.90 nmol/L) in the anaemia than in the normal group (23.58 nmol/L;
P < 0.001). The results of this study indicate that anaemia might be
attributed to a low iron intake, a low intake of enhancers of iron absorption
and a high intake of inhibitors of iron absorption from a traditional Chinese
diet rich in grains.
176
Faecal bulking efficacy of Australasian breakfast cereals
John A Monro
Faecal bulk may play an important role in preventing a range of disorders of the large
bowel, but as yet there is little information available on the relative faecal bulking
capacities of various foods. Breakfast cereals are often promoted as a good source of
potential bulk for 'inner health' because they provide dietary fibre, but their relative abilities
to provide faecal bulk per se have not been described. The faecal bulking efficacy of 28
representative Australasian breakfast cereals was therefore measured. A rat model
developed for the purpose, and shown to give similar responses as humans to cereal
fibres, was used to measure faecal bulking efficacy as increases in fully hydrated faecal
weight/100 g diet, based on precise measurements of food intake, faecal dry matter output
and faecal water-holding capacity (g water held without stress/g faecal dry matter).
Compared to a baseline diet containing 50% sucrose, increments in hydrated faecal
weight due to 50% breakfast cereal ranged from slightly negative (Cornflakes, -2 g/100 g
diet) to about 80 g/100 g diet (San Bran). Most breakfast cereals increased hydrated
faecal weight by between 10 and 20 g/100 g diet from a baseline of 21 ± 1.5 g/100 g diet,
but four products containing high levels of wheat bran had an exceptionally large impact
on hydrated faecal weight (increment >20 g/100 g diet), and the changes resulted more
from relative changes in dry matter output than in faecal water retention/gram. However,
as faecal water retention was about 2.5 g water/g faecal dry matter on average, increases
in dry matter represented large increases in faecal water load. Faecal bulking indices (FBI)
for most of the breakfast cereals were less than 20 (wheat bran = 100). The content of
wheat bran equivalents for faecal bulk (WBEfb)) in the breakfast cereals was calculated
from FBI. Most breakfast cereals contributed, per serve, less than 10% of a theoretical
daily reference value for faecal bulk (DRVfb = 63 WBEfb/day), which was based on data
from human clinical trials and dietary fibre recommendations. Based on the WBE fb
contribution/serving that would be required to meet the DRVfb from the number of servings
of dietary fibre sources in the CSIRO 12345+ food and nutrition plan, the results suggest
that although some high bran breakfast cereals may contribute substantially to, and many
are reasonable sources of, faecal bulk, for most of them, one or two servings at breakfast
cannot be relied on to effectively redress shortfalls in faecal bulk elsewhere in the diet.
186
Zinc and iron status during pregnancy of Filipino women
Nynke de Jong, Aurora B Ampong Romano, Rosalind S Gibson
Low birthweight is associated with maternal anaemia and, in some
circumstances, with low iron and zinc status, but this relationship has
not been investigated in the Philippines. In this study, we assessed the
prevalence of anaemia and suboptimal iron and zinc status in pregnant
women from three geographical regions (mountain, coast, city) of
Zamboanga del Sur province at 24 weeks (n = 305), and again at 36
weeks (n = 127), gestation. At 24 weeks, 34% were anaemic (i.e.,
haemoglobin < 105 g/L) from all causes, of whom only 14% had
concomitant low serum ferritin values (i.e., < 12 g/L). The presence of
infection was low, based on both elevated white blood cell count (> 11
109/L; 19%) and serum C-reactive protein (> 15 mg/L; 3%). Of the
women surveyed, 20% were iron depleted but not anaemic, and 15%
were zinc deficient (i.e., serum zinc < 7.1 mol/L). The mean (± SD)
birthweight of the infants (n = 250) was 3074 g ± 408 g, of whom 5%
were of low birthweight (< 2500 g). No differences existed for
biochemical indices or birthweight among the three regions, or
between women consuming maize or rice-based diets. Women with
low haemoglobin (P = 0.05) and low serum zinc (P = 0.14) values at 24
weeks gestation had infants with lower birthweights than those with
values 105 g/L and 7.1 mol/L, respectively. However, in the
multivariate model, the contribution of maternal haemoglobin to the
variance in birthweight at 24 weeks gestation was non-significant,
although modest for serum zinc. Anaemia and/or suboptimal zinc
status during pregnancy may be related to low birthweight in the
Philippines, and their aetiology deserves further study.
194
Tocotrienols are needed for normal bone calcification in growing
female rats
Mohamed Norazlina, Soelaiman Ima-Nirwana, Mohd. Top Abdul Gapor, B.
Abdul Kadir Khalid
In this study the effects of vitamin E deficiency and supplementation on bone
calcification were determined using 4-month-old female Sprague-Dawley rats. The rats
weighed between 180 and 200 g. The study was divided in three parts. In experiment 1
the rats were given normal rat chow (RC, control group), a vitamin E deficient (VED)
diet or a 50% vitamin E deficient (50%VED) diet. In experiment 2 the rats were given
VED supplemented with 30 mg/kg palm vitamin E (PVE30), 60 mg/kg palm vitamin E
(PVE60) or 30 mg/kg pure -tocopherol (ATF). In experiment 3 the rats were fed RC
and given the same supplements as in experiment 2. The treatment lasted 8 months.
Vitamin E derived from palm oil contained a mixture of ATF and tocotrienols. Rats on
the VED and 50%VED diets had lower bone calcium content in the left femur compared
to the RC group (91.6 ± 13.3 mg and 118.3 ± 26.0 mg cf. 165.7 ± 15.2 mg; P < 0.05)
and L5 vertebra (28.3 ± 4.0 mg and 39.5 ± 6.2 mg compared with 51.4 ± 5.8 mg;
P < 0.05). Supplementing the VED group with PVE60 improved bone calcification in the
left femur (133.6 ± 5.0 mg compared with 91.6 ± 13.3 mg; P < 0.05) and L5 vertebra
(41.3 ± 3.3 mg compared with 28.3 ± 4.0 mg; P< 0.05) while supplementation with
PVE30 improved bone calcium content in the L5 vertebra (35.6 ± 3.1 mg compared with
28.3 ± 4.0 mg; P < 0.05). However, supplementation with ATF did not change the
lumbar and femoral bone calcium content compared to the VED group. Supplementing
the RC group with PVE30, PVE60 or ATF did not cause any significant changes in
bone calcium content. In conclusion, vitamin E deficiency impaired bone calcification.
Supplementation with the higher dose of palm vitamin E improved bone calcium
content, but supplementation with pure ATF alone did not. This effect may be attributed
to the tocotrienol content of palm vitamin E. Therefore, tocotrienols play an important
role in bone calcification.
200
Association between overweight or obesity and household income and
parental body mass index in Australian youth: analysis of the
Australian National Nutrition Survey, 1995
Zaimin Wang, Carla M Patterson, Andrew P Hills
This study is a secondary data analysis based on the 1995 Australian National Nutrition
Survey (NNS). A random subsample of 1581 school children aged 7 15 years old from
the NNS was studied. The results show the prevalence of overweight, obesity and
combined overweight and obesity was 10.6 20.9%, 3.7 7.2% and 15.6 25.7%,
respectively. The odds ratio of overweight or obese boys with highest household
income was significantly smaller than those with the lowest household income. The
proportion of combined overweight and obesity in children whose parents were
overweight or obese was significantly greater compared with those whose parents were
not. The trend of increasing prevalence of overweight or obesity among children with
increasing parental body mass index (BMI) was significant after adjusting for age
except the trend of father's BMI for boys. This study provided baseline data on the
recent prevalence of overweight or obesity of Australian school children using new
international absolute BMI cut-off points. It indicated that young school girls (7 9 years)
were more likely to be overweight or obese compared with boys, the prevalence rates
of overweight or obesity in older boys (13 15 year) was significantly greater than in
other age groups while in girls it was the opposite. The boys with lowest household
income ($0 17 500) were more likely to be overweight or obese compared with those
with the highest household income (greater than $67 500). Having parents especially
mothers who were overweight or obese may increase the risk of children being
overweight or obese.
206
Antioxidant effect of Phaseolus vulgaris in streptozotocin-induced
diabetic rats
Subramanian Venkateswaran, Leelavinothan Pari
The antioxidant effect of an aqueous extract of Phaseolus vulgaris pods, an indigenous
plant used in Ayurvedic medicine in India, was studied in rats with streptozotocininduced diabetes. Oral administration of Phaseolus vulgaris pod extract (PPEt;
200 mg/kg body weight) for 45 days resulted in a significant reduction in thiobarbituric
acid reactive substances and hydroperoxides. The extract also causes a significant
increase in reduced glutathione, superoxide dismutase, catalase, glutathione
peroxidase and glutathione-S-transferase in the liver and kidneys of rats with
streptozotocin-induced diabetes. These results clearly show the antioxidant property of
PPEt. The effect of PPEt at 200 mg/kg body weight was more effective than
glibenclamide.
210
Cross-sectional study of diet and risk factors for metabolic diseases in
a Ghanaian population in Sydney, Australia
Ashraf Saleh, Soumela Amanatidis, Samir Samman
Ethnic groups in affluent environments experience higher rates of metabolic diseases
than their native counterparts. Our objective was to determine the prevalence of
metabolic risk factors in Ghanaians in Sydney, and to investigate the relationship with
dietary and lifestyle factors. Cross-sectional design with anthropometry, blood pressure,
plasma lipids, glucose and insulin concentrations were measured on two occasions on
each subject. Dietary information was obtained by three 24-h dietary recalls. Adults (45
male, 35 female) were recruited from a local association in Sydney, Australia.
Overweight was observed in a large proportion of subjects (71% and 66% of men and
women, respectively), with 18% of men and 26% of women classified as obese.
Abdominal overweight was seen in 63% and 74% of men and women, respectively.
Abdominal obesity was seen in 20% of men and 49% of women. Hypertension was
detected in 40% of men and 17% of women, 16% of men and 6% of women were
diagnosed with definite hypertension. Seventy-one per cent of men and 29% of women
were classified as hypercholesterolaemic and 67% of men and 23% of women had
elevated low-density lipoprotein cholesterol. In men, low high-density lipoprotein
cholesterol and hypertriacylglycerolaemia affected 18% and 13%, respectively. Fasting
hyperinsulinaemia was observed in 14% and 9% of men and women, respectively. The
majority of subjects (73%) sustained one or more metabolic risk factors. Dietary fat
contributed 33% and 35% of total energy intake in men and women, respectively,
saturated fat contributing 11% in both sexes. A high prevalence of overweight,
diabetes, hypertension and dyslipidaemia exists in this population, particularly in men,
highlighting the need for intervention.
217
Glycaemic glucose equivalent: combining carbohydrate content,
quantity and glycaemic index of foods for precision in glycaemia
management
John A Monro
The glycaemic index (GI) is the blood glucose response to carbohydrate in a food as a
percentage of the response to an equal weight of glucose. Because GI is a percentage,
it is not related quantitatively to food intakes, and because it is based on equicarbohydrate comparisons, GI-based exchanges for control of glycaemia should be
restricted to foods providing equal carbohydrate doses. To overcome these limitations
of GI, the glycaemic glucose equivalent (GGE), the weight of glucose having the same
glycaemic impact as a given weight of food, is proposed as a practical measure of
relative glycaemic impact. To illustrate the differences between GGE and GI in
quantitative management of postprandial glycaemia, published values for carbohydrate
content, GI and serving size of foods in the food groupings, breads, breakfast cereals,
pulses, fruit and vegetables, were used to determine the GGE content per equal weight
and per serving of foods. Food rankings and classifications for exchanges based on
GGE content were compared with those based on GI. In all of the food groupings
analysed, values for relative glycaemic impact (as GGE per 100 g food and per serving)
within each of the categories, low, medium and high GI, were too scattered for GI to be
a reliable indicator of the glycaemic impact of any given food. Correlations between GI
and GGE content per serving were highest in food groupings of similar carbohydrate
content and serving size, including breads (r = 0.73) and breakfast cereals (r = 0.8), but
low in more varied groups including pulses (r = 0.66), fruit (r = 0.48) and vegetables
(r = 0.28). Because of the non-correspondence of GI and GGE content, food rankings
by GI did not agree with rankings by GGE content, and placement of foods in GI-based
food exchange categories was often not appropriate for managing glycaemia. Effects of
meal composition and food intake on relative glycaemic impact could be represented by
GGE content, but not by GI. Because GGE is not restricted to equicarbohydrate
comparisons, and is a function of food quantity, GGE may be applied, irrespective of
food or meal composition and weight, and in a number of approaches to the
management of glycaemia. Accurate control of postprandial glycaemia should therefore
be achievable using GGE because they address the need to combine GI with
carbohydrate dose in diets of varying composition and intake, to obtain a realistic
indication of relative glycaemic impact.
226
Green tea catechin improves microsomal phospholipase A2 activity
and the arachidonic acid cascade system in the kidney of diabetic rats
Soon-Jae Rhee, Jeong-Hwa Choi, Mo Ra Park
The purpose of this study was to investigate the effects of green tea catechin on the
microsomal phospholipase A2 activity and arachidonic acid cascade in the kidneys of
streptozotocin-induced diabetic rats. Sprague-Dawley male rats weighing 100 ± 10 g
were assigned randomly to one normal and three streptozotocin-induced diabetic
groups. The diabetic groups were the DM-0C group (n = 10), fed a catechin-free diet,
the DM-0.25C group (n = 10), fed a 0.25 g catechin per 100 g diet, and the DM-0.5C
group (n = 10), fed a 0.5 g catechin per 100 g diet. The kidney microsomal
phospholipase A2 activity was higher in the diabetic groups than in the normal group,
while it was lower in the DM-0.25C and DM-0.5C groups than in the DM-0C group. The
percentage of phosphatidylcholine hydrolysed in the kidney microsomes was not
significantly different between any of the four groups. The percentage of
phosphatidylethanolamine hydrolysed in the kidney microsomes was progressively
higher in the DM-0.5C, DM-0.25C and DM-0C groups, respectively, compared to the
normal group. The formation of thromboxane A2 was significantly higher while the
formation of prostacyclin was lower in kidney microsomes of the streptozotocin-induced
diabetic groups compared with the normal group, but this condition was improved by
catechin supplementation. Kidney microsomal vitamin E concentrations were
progressively lower in the DM-0.5C, DM-0.25C, and DM-0C groups, respectively,
compared to the normal group. The kidney thiobarbituric acid reactive substance
(TBARS) contents became higher in the DM-0C and DM-0.25C groups as compared
with the normal group, whereas the DM-0.5C group did not differ from the normal
group. Kidney function appears to be improved by green tea catechin supplementation
due to its antithrombus action, which in turn controls the arachidonic acid cascade
system.
232
Effects of green tea catechin on prostaglandin synthesis of renal
glomerular and renal dysfunction in streptozotocin-induced diabetic
rats
Soon-Jae Rhee, Mi-Ji Kim, Oh-Gye Kwag
The purpose of the present study was to investigate the effects of green tea catechin on
prostaglandin synthesis of renal glomerular and renal dysfunction in rats with
streptozotocin induced diabetes. Sprague-Dawley rats weighing 100 ± 10 g were
randomly assigned to one normal group and three groups with streptozotocin-induced
diabetes. The diabetic groups were classified to a catechin-free diet (DM group), a
0.25% catechin diet (DM-0.25C group) and a 0.5% catechin diet (DM-0.5C group)
according to the levels of catechin supplement in their diet. The animals were
maintained on an experimental diet for 4 weeks. At this point, they were injected with
streptozotocin to induce diabetes. They were killed on the sixth day. The catechin
supplementation groups (DM-0.25C, DM-0.5C groups) showed a decrease in
thromboxane A2 synthesis but an increase in prostacyclin synthesis, compared to the
DM group. The ratio of prostacyclin/thromboxane A 2 was 53.3% and 38.1% lower in the
DM and DM-0.25C groups, respectively, than in the normal group. The ratio in the DM0.5C group did not differ from that in the normal group. The glomerular filtration rate in
catechin feeding groups (DM-0.25C and DM-0.5C groups) was maintained at the
normal level. The urinary 2-microglobulin content in the DM-0.5C group was
significantly lower than that in the normal group. On the sixth day after induction of
diabetes, the urinary microalbumin content in the DM, DM-0.25C and DM-0.5C groups
had increased 5.40, 4.02, 3.87 times, respectively, compared with the normal group. In
conclusion, kidney function appears to be improved by green tea catechin
supplementation due to its antithrombotic action, which in turn controls the arachidonic
acid cascade system.
237
Selective feeding centres in refugee settings: evaluation framework
protocol
Andre MN Renzaho
Selective feeding programs are centres for the treatment of persons suffering from
acute malnutrition. Unlike chronic malnutrition, acute malnutrition reflects recent
problems. In a crisis situation, wasting is preferred above other indicators because it is
sensitive to rapid change, indicates present change, can be used to monitor the impact
of interventions and is a good predictor of immediate mortality risk. This paper reviews
the current approach being used in the field to evaluate the effectiveness of feeding
programs. There is no comprehensive evaluation framework in place to assess the
impact of feeding programs on mortality due to malnutrition. Some loose outcome
measures, such as the number of children enrolled in a feeding centre, are being used
to determine if a feeding centre should continue. In addition, malnutrition prevalence
and crude mortality rates determined through nutritional and mortality surveys are used
to assess the impact of feeding programs. This procedure does not take into account
potential confounding factors that impact on malnutrition prevalence, including access
to non-relief foods and the general food ration. Therefore, one could not confidently say
that the reduction of malnutrition prevalence is a result of feeding programs. This paper
presents an alternative approach to evaluating feeding centres.