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There is evidence in Australia that 1st generation Greek Australians (GA), despite their high prevalence of cardiovascular disease (CVD) risk factors (e.g. obesity, diabetes, hyperlipidaemia, smoking, hypertension, sedentary lifestyles) continue to display more than 35% lower mortality from CVD and overall mortality compared with the Australian-born after at least 30 years in Australia. This has been called a 'morbidity mortality paradox' or 'Greek-migrant paradox'. Retrospective data from elderly Greek migrants participating in the International Union of Nutrition Sciences Food Habits in Later Life (FHILL) study suggests that diets changed on migration due to the: (i) lack of familiar foods in the new environment; (ii) abundant and cheap animal foods (iii) memories of hunger before migration; and (iv) status ascribed to energy dense foods (animal foods, white bread and sweets) and 'plumpness' as a sign of affluence and plant foods (legumes, vegetable dishes, grainy bread) and 'thinness' as a sign of poverty. This apparently resulted in traditional foods (e.g. olive oil) being replaced with 'new' foods (e.g. butter), 'traditional' plant dishes being made more energy dense, larger serves of animal foods, sweets and fats being consumed, and increased frequency of celebratory feasts. This shift in food pattern contributed to significant weight gain in GA. Despite these potentially adverse changes, data from Greece in the 1960s (seven countries study) and from Australia in the 1990s (FHILL study) has shown that Greek migrants have continued to eat large serves of putatively protective foods (leafy vegetables, onions, garlic, tomatoes, capsicum, lemon juice, herbs, legumes, fish) prepared according to Greek cuisine (e.g. vegetables stewed in oil). Furthermore, GA were found to return to the traditional Greek food pattern with advancing years. We suspect that these factors may explain why GA have recently been found to have over double the circulating concentrations of antioxidant carotenoids, especially lutein, compared with Australians of Anglo-Celtic ancestry. This in turn may have helped to make the CVD risk factors 'benign' and reduce the risk of death. This raises the question whether specific dietary guidelines need to be developed for recent migrants to Australia, encouraging them to retain the best of their traditional cultures and include the best of the mainstream culture.
Asia Pac J Clin Nutr 2002
PMID:Morbidity mortality paradox of 1st generation Greek Australians. 1249 49

Food is fundamental to human survival, in more than just one way. First, food is basic for averting hunger and maintaining health for every human being. Secondly, food satisfies our palate and makes us happy and emotionally and socially content. Third, food constitutes a form of cultural expression. The food we eat should be safe, palatable, affordable, and of the quality that can maintain mental, emotional, physiologic and physical health. Even with globalization that has seen food movements to and from different parts of the world, for most populations in Africa, food is still very locale-specific, especially in the rural farming areas where it is produced. Many locally produced foods have both nutritional and intrinsic value. The types of foods produced in Western Africa are very different from those produced in Eastern Africa. The staple foods, vegetables and the drinks that go with these foods are different. The way food is prepared is also very different in the two parts of Africa. Cultural specificity appears to be more pronounced in Western Africa, involving more secondary processing in the home and more spicing. Data linking food to health, as something that is understood by traditional communities is not easily available. This paper will collate information that discusses people's perceptions in both Western and Eastern Africa, and try to draw comparisons between the two. The paper presents a community picture of food, nutrition and health.
Asia Pac J Clin Nutr 2003
PMID:Contemporary African food habits and their nutritional and health implications. 1450 97

Current models of the nutrition transition focus on demographic changes and economic development. A further influence may be the adoption of western-based perceptions of beauty that lead to potentially harmful eating behaviours which contribute to overweight, obesity, and eating disorders. This paper proposes a comprehensive model of the nutrition transition that includes western influences on perceived attractiveness and subsequent eating styles. An exploratory test of this model for Asian countries explores differences in intuitive eating as a function of economic development and the adoption of western standards of beauty. The intuitive eating scale (IES), a measure of food consumption that is primarily characterized by the satisfaction of physical hunger, was used to evaluate agreement with intuitive eating principles in the US and four Asian countries (Japan, Thailand, the Philippines, and China). Although intuitive eating scores in the US and Thailand failed to follow predicted patterns on two of the four IES subscales, scores for the other two IES subscales and the total IES score followed predicted patterns for Asian countries. Intuitive eating appears to be a valid, measurable concept that is correlated with economic development and levels of western influence in Asian countries. The tentative findings of this exploratory study support further evaluation of cultural influences as an important component of the nutrition transition.
Asia Pac J Clin Nutr 2004
PMID:Intuitive eating and the nutrition transition in Asia. 1522 88

It is often stated, "the faster you lose weight, the faster it is regained ". A review of existing literature does not support such a statement--indeed if anything the reverse is true. The origins of this erroneous view are the misconceptions that weight regain is a simple matter of bad dietary and social habits and that it takes time to change these, that physiological adaptations to rapid weight loss are different to those of gradual weight loss and that weight regain is simply due to a return to old habits. Indeed there are many advantages to rapid weight loss achieved with the use of a modern very low energy diet, including the fact that rapid weight loss is a motivating factor, that the mild ketosis that occurs not only suppresses hunger, but also slows protein loss and that adherence is easier with a structured dietary regime. VLEDs are dietary preparations that provide all nutritional requirements together with between 1845 and 3280 KJ (450 and 800 Kcal) per day. An individual takes this meal replacement three times daily as a substitute for breakfast, lunch and dinner. In addition, a bowl of non-starchy vegetables once daily provides some fibre and helps to satisfy the social aspect of eating. A teaspoon of oil on the vegetables contracts the gall bladder to minimise the risk of gall stone formation. Since weight loss, at whatever rate, results in physiological adaptations leading to weight regain, careful attention must be paid to the period after the VLED regime is completed. Lifestyle modification, diet and exercise are instituted optimally with behaviour modification. If, despite the subject's best efforts, weight regain occurs, an appetite suppressant is advisable to help control the drive to eat.
Asia Pac J Clin Nutr 2006
PMID:State of the science: VLED (Very Low Energy Diet) for obesity. 1692 61

The food security assessment used by the United State's Food Security/Hunger Survey Module (US- FSSM) was used in five studies: these were in two urban and four rural areas in Indonesia between February 2004- August 2005. The number of households assessed was 3,704 and consisted of 45% urban and 55% rural. All households had children below five years. This paper aims to assess the applicability of US-FSSM for measuring household food-insecurity in Indonesia. Common coping-strategies discussed are to borrow money from the family, get an additional job, to lessen portion size of food, and to sell small assets. Although households in urban and rural areas were similar in size/number of children and male headed; the urban households were more income-secure, educated, and had better access to electrical appliances. A majority of the households was food-insecure (77% and 84% in urban and rural consecutively). More food-insecure households without and with hunger were found in rural areas. The number of affirmative responses to 17 out of 18 questions in the USFSSM was more in the rural households, showing less fortunate cases of food-insecurity. For a given coping strategy, as food-security status becomes more severe, the higher the percentage of households employing it. For a given food-security status, percentage of households was higher among lower-degree and less among higher-degree coping. Combining food-security and coping-strategy indicators may help to identify transient-food-secure households. Observing both indicators throughout different time of the year continuously may further identify adaptive mechanism by chronic-food-insecure households. Information on household food diversity could enrich findings on dietary intake modification, hence moving from food-security to nutrition-security.
Asia Pac J Clin Nutr 2007
PMID:Household food security status measured by the US-Household Food Security/Hunger Survey Module (US-FSSM) is in line with coping strategy indicators found in urban and rural Indonesia. 1746 96

This study reports on findings from the ex post evaluation of the Maewo Capacity Building project in Vanuatu which was funded by World Vision Australia. The objective of the evaluation was to examine the extent to which the infrastructure and systems left behind by the project contributed to the improvement of household food security, and health and nutritional outcomes in Maewo island, using Ambae island as a comparator The household food security of 817 households selected by a two stage cluster sampling method was assessed using a modified version of the Radimer-Comell hunger scale and the US National Measure of food security. Anthropometric measurement in children (6-59 months) and mortality data were also obtained. The prevalence of food insecurity without hunger was estimated at 15.3% (95%CI: 12.1% to 19.2%) in Maewo versus 38.2% (95%CI: 33.6% to 43.0%) in Ambae while food insecurity with hunger in children did not vary by location. After controlling for age, gender and household food security status, children aged 6-59 months in Maewo were less likely to be underweight than children of the same age in Ambae (OR: 0.66, 95%CI 0.38 to 0.99). No difference was detected between the two locations in terms of stunting and wasting prevalence. The crude mortality rate (CMR) was lower in Maewo (CTvIIR=0.47/10,000/day, 95%CI: 0.39 to 0.55) than Ambae (CMR= 0.59/10,000/day, 95%CI: 0.51 to 0.67) but no difference existed in mortality in children under five years old. The major causes of death were similar in both locations and the causes frequently reported were malaria, acute respiratory infection and dianheal diseases. The evaluation found that Maewo had better health and nutrition outcomes but the infrastructure left behind by the project and the livelihood system may have been weakened by cyclone Ivy that devastated the region from 25 to 27 February 2004.
Pac Health Dialog 2004 Mar
PMID:Food insecurity, malnutrition and mortality in Maewo and Ambae islands, Vanuatu. 2045 95

Community based nutrition programmes (CBNP) are increasingly being seen as a key turning point in implementation strategies leading to food and nutrition improvement as a sound basis for socio-economic development. In order to be effective and successful, CBNP require a constellation of methods and services planned from the community along with policy support for effective implementation, reaching the unreachable and empowering those at the grass roots. These also need to be guided and monitored using a set of indicators such as essential minimum needs indicators specific to the community's needs. The community based approach has also been embraced at the global level with the Millennium Development Goals, advocating achieving a set of eight goals ranging from reducing poverty and hunger to improving educational opportunities for all children and forming stronger global partnerships for development. Lessons learned from CBNP in Asia show that in order to be effective, the programmes must be adopted at national level and implemented at community level. National level leadership and commitment to sound nutrition improvement policies and goals, must be combined with basic services, mass mobilization, people empowerment and actions at community level.
Asia Pac J Clin Nutr 2008
PMID:Community based approaches to prevent and control malnutrition. 1829 14

Food for humans is one of the most important of all global issues. It is a critical determinant of planetary and individual health, of economic development, of how sustainable energy and water supplies are, and its security a powerful determinant of peace or conflict. Those who assume leadership for the integrity of food and health systems have great responsibility. The IUNS (International Union of Nutritional Sciences), regional and national nutrition science and food technology organizations have concern about the leadership capacity available and required in what are rapidly changing and increasingly demanding circumstances. These include persistent poverty and hunger, climate change which threatens the sustainability of food production and fragile financial systems which are making food less affordable for many. North East Asia (NEA) is a major region for its population size, its economic wealth and disparities, its food production, its life expectancies among the best and its global reach. In 2008, for those of Chinese ancestry and of wider Asian origin, Nutrition Leadership training has been conducted in Hangzhou, Shanghai, Seoul and Taiwan (Hsinchu and Zhunan). Ninety prospective young leaders participated in all. Several successful early career Asian nutrition scientists and professionals served as role models. Senior colleagues acted as mentors for groups of 2 or 3. With mentors, the concept of leadership has been examined, careers and roles explored, knowledge and skills honed for a different future, and plans made to network in mutual support. Early feedback indicates that new opportunities have been created and seized.
Asia Pac J Clin Nutr 2008
PMID:Nutrition leadership training in North-East Asia: an IUNS initiative in conjunction with nutrition societies in the region. 1911 8

This study was designed to review the food security of the country and to study the household food insecurity of poor households in relation to the poverty level. Cross-sectional survey design was used to assess the perceptions of socio-economic changes, food insecurity in national and household levels, and their health impact. A total of 731 poor households were involved in our study. One third of the total households were in a status of severe food insecurity with hunger. Analysis on the risk factors of household food insecurity showed that the household income was significantly inversely associated with household food insecurity (RR = -0.489; 95% CI -0.540, -0.398; P < .001). Food insecurity with hunger in the households is significantly related to poverty of the households.
Asia Pac J Public Health 2008 Oct
PMID:Poverty and household food insecurity in Mongolia. 1953 61

Health is intrinsic to human security (HumS) although it is somewhat anthropocentric and about our own psychosocial and biomedical status more than various external threats. The 1994 United Nations Development Program definition of HumS includes economic, food, environmental, personal, community and political security with freedom from fear and want. Environmental factors are critical for health security (HealS), especially with widespread socio-economic difficulty, and health systems less affordable or accessible. The nexus between nutritionally-related disorders and infectious disease is the most pervasive world health problem. Most if not all of the Millennium Development Goals are food-linked. Maternal nutrition has life-long health effects on the yet-to-be born child. The mix of essential nutrient deprivation and energy imbalance is rife across many societies. Food systems require deeper understanding and governance to overcome these food-related health risks which are matters of food security (FoodS). Nutritionally-related Disability Adjusted Life Years (DALYS) are improving markedly in many parts of the world, along with poverty and hunger reduction and health system advances. But recent economic, energy, food, water, climate change and health crises along with conflict are limiting. It is time for international and regional understanding of how households and communities can collectively manage these threats in affordable and sustainable ways. There is untapped problem-solving capacity at the international local level if supported by combined food--health systems expertise, innovation, infrastructure and governance. Principles of equity and ethics must apply. The Food in Health Security (FIHS) roundtable aims to develop a Network to facilitate this process.
Asia Pac J Clin Nutr 2009
PMID:Why food in health security (FIHS)? 1996 35


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