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PURPOSE OF THE PAPER: To summarize the current health status of Kanaka Maoli (indigenous Hawaiians) with historical background, underlying factors responsible for the Kanaka Maoli health plight and recommendations. METHODS: The author reviewed the available literature and some not readily available, unpublished information. PRINCIPAL FINDINGS: Kanaka Maoli continue to have the worst health and socio­economic indicators of the various ethnic groups in their home islands of Ka Pae'aina (Hawai'i). Cardiovascular disorders, cancer, diabetes, obstructive lung disease, maternal and infant health and mental distress are the prominent maladies. Tobacco smoking, high­fat diet, alcohol drinking, hyperlipidemia and obesity are the major lifestyle risk factors. Societal factors, such as depopulation, foreign transmigration, colonial exploitation, coercive assimilation, cultural conflict and racism persist. Since 1990, Kanaka Maoli communities have established five island­wide Native Hawaiian Health Care Systems to improve availability, accessibility, and acceptability of health services to their people, but with inadequate resources. CONCLUSIONS: Under present conditions, while the future may bring some amelioration of Kanaka Maoli ill health, the price will be progressive acculturation and loss of Kanaka Maoli identity. Accordingly, recommendations include augmented revitalization of the traditional culture, effective recontrol by the Kanaka Maoli of their lives and natural resources and thus, improved total health. KEY WORDS: Pacific Islander Americans, Kanaka Maoli, Hawaiians, Indigenous Health, Culture, Ethnicity, Racism, Colonialism, Sovereignty
Asian Am Pac Isl J Health 1993
PMID:Health Status of Kanaka Maoli (Indigenous Hawaiians). 1156 47

Hypercholesterolemia. especially low-density lipoprotein cholesterol, is well-known as a risk factor for coronary heart disease. The prevalence of hyperlipidemia in the Asia-Pacific regions, although not as high as in the North American and European regions, in adults and children varied from country to country. The 'Cardiovascular Risk Factor of Chiang Mai children (CARFACC)' study has shown the small 'n' and capital 'N' phenomenons, where in some individuals, blood lipid levels were tracked from childhood to adulthood. The new concept of programming by early nutrition on later adult health has now been accepted. The prevention of dyslipidemia during childhood should receive more attention.
Asia Pac J Clin Nutr 2001
PMID:Cardiovascular risk in the Asia-Pacific region from a nutrition and metabolic point of view: lipid. 1171 Mar 48

Chinese tea and the major health effects include: antimicrobial, anti-ultraviolet radiation, anticancer, lowering blood lipid and glucose, and protecting against coronary heart diseases. In contrast to the extensive studies on the protective effects of tea on cancer, fewer studies on the health effects of tea on cardiovascular diseases (CVD) have been published. This paper summarises the research results on the possible protective effects of tea on CVD available in China. The results from animal studies clearly demonstrated that tea pigments are effective in lowering blood lipid levels and preventing plaque formation in the aorta. However, the evidence of tea pigments in protecting ischemia heart disease (IHD) in humans is less convincing. One large well-designed ecological study reported an inverse correlation between tea drinking and IHD mortality; but the inverse correlation disappeared after controlling possible confounding factors. However, the effects in improving blood lipid levels and rheology biomarkers in hyperlipidemia subjects or CVD patients by tea pigments seem promising. However, these studies were not well-designed, controlled randomized clinical trials. This made the assessment difficult and inconclusive.
Asia Pac J Clin Nutr 2001
PMID:Candidate foods in the Asia-Pacific region for cardiovascular protection: Oriental tea. 1171 Mar 54

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

Several nutrition and non-nutritional pathways are recognised in the development and occurrence of cardiovascular disease. In many populations, high intakes of saturated fat are associated with elevated serum cholesterol concentrations and increased coronary heart disease (CHD) mortality. However, several studies report that hyperlipidaemia and heart diseases are not common among populations who consume coconut, a source of saturated fat. A case-control study was conducted among the Minangkabau known to be high coconut consumers to examine the difference in food patterns and risk of coronary heart disease (CHD) between the coronary cases and their gender- and age-matched apparently healthy counterparts serving as controls. Eligible subjects with CHD were identified through the co-operation of five participating hospitals located in Padang and Bukittinggi in West Sumatra, Indonesia. A total of 93 eligible cases (62 men and 31 women) in the Case group and 189 subjects (113 men and 76 women) in the Control group were recruited. Information on the intakes of individual foods and dishes over the preceding 12 months was obtained using a semi-quantitative food frequency questionnaire. The Case groups had significantly higher intakes of meats, eggs, sugar, tea, coffee and fruits, but lower intakes of soy products, rice and cereals compared to the controls. Coconut consumption as flesh or milk was not different between cases and controls. The cases had significantly higher intakes of protein and cholesterol, but lower intake of carbohydrate. Similar intakes of saturated and unsaturated fatty acids between the cases and controls indicated that the consumption of total fat or saturated fat, including that from coconut, was not a predictor for CHD in this food culture. However, the intakes of animal foods, total protein, dietary cholesterol and less plant derived carbohydrates were predictors of CHD.
Asia Pac J Clin Nutr 2004
PMID:Dietary intake and the risk of coronary heart disease among the coconut-consuming Minangkabau in West Sumatra, Indonesia. 1556 44

As a preliminary study, we determined the serum lipid profiles among primary school children from four Bangkok schools and identified the risk factors and their association with child lipid profiles. We conducted a cross-sectional study using fasting blood samples and food frequency questionnaires. Overall, there were 40% that had hypercholesterolemia with total cholesterol (TC) at > or = 200 mg/dl and high low density lipoprotein cholesterol (LDL-C) at > or = 130 mg/dl. Overall, 5.4% had high triglyceride (TG) levels at > or = 150 mg/dl. There was no association between lipid profiles and age, gender or nutritional status, except that higher TG levels were found among obese children than others (p < 0.001). The most popular high fat foods were fried chicken, sausages and cakes, in order of preference. Results from this study indicate that Bangkok public primary school children are facing a problem with hyperlipidemia. Build up discipline in healthy eating habits, healthy food choices and physical exercise should pave the way to healthy Thai kids and growing adults with better quality of life.
Asia Pac J Public Health 2006
PMID:A preliminary study of hyperlipidemia in Bangkok school children. 1715 77

Stroke is one of the leading causes of death and certainly the major cause of disability in the world. WHO has estimated that between 1990 to 2020 the world will witness an increase in stroke mortality of 78% in woman and 106% in man. Much of this increase will be in developing countries which are witnessing rapid change in lifestyle and nutrition, hypertension, diabetes mellitus, smoking, atrial fibrillation, hyperlipidemia, Homocysteinemia, and alcohol are the most significant modifiable risk factors of stroke. Of these, hypertension, diabetes, smoking, hyperlipidemia, homocysteinemia and alcoholism are obviously affected by lifestyle and nutrition. However, whilst epidemiology studies have noted an association of nutritional practice with stroke risk, further research is needed to show how nutritional interventions can be effective in stroke prevention.
Asia Pac J Clin Nutr 2007
PMID:Nutrition and stroke. 1739 17

Obesity resides upstream of the constituents of metabolic syndromes such as diabetes, hypertension, hyperlipidemia, and arteriosclerosis. Postprandial hyperlipidemia is also implicated in atherogenesis. Therefore, factors that influence the body adiposity and the magnitude of postprandial hyperlipidemia have been intensively investigated. Diacylglycerol (DAG) oil, which is defined to contain DAG 80% (w/w) or greater in the present presentation, is an edible oil with similar taste and usability compared with conventional edible oil rich in TAG. Safety of DAG has been widely evaluated and listed as a GRAS (Generally Recognized as Safe) substance by US FDA. The aim of this review was to summarize the metabolism and nutritional functions of DAG based on the data from scientific journals and conference publications. Effect of DAG ingestion on postprandial elevations of serum lipids was investigated in several dosages, food formula, and in subjects in various conditions. Postprandial triglyceride in serum and the chylomicron fraction are significantly smaller after DAG consumption compared with TAG with a similar fatty acid composition in healthy subjects, and was remarkably reduced in subjects with insulin resistance. Long-term DAG ingestion in controlled diet or free-living condition significantly decreased body adiposity and improved type II diabetic complications. A single dose DAG consumption significantly increased fat oxidation as compared to eucaloric TAG ingestion. DAG oil consumption might be beneficial in reducing the risk factors for lifestyle-related diseases such as obesity, visceral obesity, postprandial hyperlipidemia, insulin resistance, and atherosclerosis.
Asia Pac J Clin Nutr 2007
PMID:Metabolism of diacylglycerol in humans. 1739 38

India has been recognized all over the world for spices and medicinal plants. Both exhibit a wide range of physiological and pharmacological properties. Current biomedical efforts are focused on their scientific merits, to provide science-based evidence for the traditional uses and to develop either functional foods or nutraceuticals. The Indian traditional medical systems use turmeric for wound healing, rheumatic disorders, gastrointestinal symptoms, deworming, rhinitis and as a cosmetic. Studies in India have explored its anti-inflammatory, cholekinetic and anti-oxidant potentials with the recent investigations focusing on its preventive effect on precarcinogenic, anti-inflammatory and anti atherosclerotic effects in biological systems both under in vitro and in vivo conditions in animals and humans. Both turmeric and curcumin were found to increase detoxifying enzymes, prevent DNA damage, improve DNA repair, decrease mutations and tumour formation and exhibit antioxidative potential in animals. Limited clinical studies suggest that turmeric can significantly impact excretion of mutagens in urine in smokers and regress precancerous palatal lesions. It reduces DNA adducts and micronuclei in oral epithelial cells. It prevents formation of nitroso compounds both in vivo and in vitro. It delays induced cataract in diabetes and reduces hyperlipidemia in obese rats. Recently several molecular targets have been identified for therapeutic / preventive effects of turmeric. Fenugreek seeds, a rich source of soluble fiber used in Indian cuisine reduces blood glucose and lipids and can be used as a food adjuvant in diabetes. Similarly garlic, onions, and ginger have been found to modulate favourably the process of carcinogenesis.
Asia Pac J Clin Nutr 2008
PMID:Traditional Indian spices and their health significance. 1829 52

Some drugs affect secretion of secreted proteins (e.g. cytokines) released from target cells, but it remains unclear whether these proteins act in an autocrine manner and directly effect the cells on which the drugs act. In this study, we propose a computational method for testing a biological hypothesis: there exist autocrine signaling pathways that are dynamically regulated by drug response transcriptome networks and control them simultaneously. If such pathways are identified, they could be useful for revealing drug mode-of-action and identifying novel drug targets. By the node-set separation method proposed, dynamic structural changes can be embedded in transcriptome networks that enable us to find master-regulator genes or critical paths at each observed time. We then combine the protein-protein interaction network with the estimated dynamic transcriptome network to discover drug-affected autocrine pathways if they exist. The statistical significance (p-values) of the pathways are evaluated by the meta-analysis technique. The dynamics of the interactions between the transcriptome networks and the signaling pathways will be shown in this framework. We illustrate our strategy by an application using anti-hyperlipidemia drug, Fenofibrate. From over one million protein-protein interaction pathways, we extracted significant 23 autocrine-like pathways with the Bonferroni correction, including VEGF-NRP1-GIPC1-PRKCA-PPARalpha, that is one of the most significant ones and contains PPARalpha, a target of Fenofibrate.
Pac Symp Biocomput 2009
PMID:Unraveling dynamic activities of autocrine pathways that control drug-response transcriptome networks. 1920 6


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