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There has been rapid development in the Asia-Pacific region, leading to improvements in the food supply and nutrition. The high prevalence of low birth weight has been a problem in many countries and continues to be a problem in some parts of the region. In the past few years an epidemic of obesity and chronic disease has emerged. The fetal origins hypothesis links the high prevalence of low birth weight and recent increasing obesity to explain the emerging epidemic of chronic disease. One public health strategy to challenge this epidemic is the promotion of breastfeeding of all infants. Breastfeeding has been shown to protect against childhood obesity, and is "dose related", that is, the longer an infant is breastfed, the lower the risk of obesity.
Asia Pac J Public Health 2001
PMID:The fetal origins of disease hypothesis: public health implications for the Asia-Pacific region. 1259 1

To study the association between the changes of weight, family history and hypertension at different ages, a pair-matched case-control study was conducted in the outpatient service of department of internal medicine in Binjiang Hospital of Tianjin from 1994 to 1996. The cases were selected from 312 patients with hypertension diagnosed during 1994-1996 and identified newly in the survey. The controls were selected from other outpatients of no cardiovascular disease histories matched by age and sex. The conditional logistic regression model was used. The cases and controls were divided into two age groups under 59 years old, 60 and older. History of hypertension in the first degree-relatives was linked to hypertension, but family history of hypertension of groups under age 59, and at 60 and older was mainly hypertension history of parents and siblings, respectively. Other risk factors of developing hypertension were higher weight or body mass index (kg/m2) in the survey, higher degree of weight gain in comparison with the basic weight and early age at beginning weight gain in all two groups. However, the risk of developing hypertension for increasing weight and obesity increased with advancing age groups. The study further indicates that controlling body weight, decreasing the degree of weight gain, and delaying the beginning age of weight gain all contribute to the lower risk of suffering from hypertension and were effective measures of hypertension of the prevention and cure.
Asia Pac J Public Health 2001
PMID:A case-control for the association between change in weight, family history and hypertension at different ages. 1259 6

WHO's Declaration of the "Health for All" (HFA) goal was pronounced in 1978 in Alma Ata, and it was planned that HFA would be achieved through primary health care programmes and approaches by 2000. However, it is now 2002 and despite the technological advancements in medicine, science, and ICT, Health for All is far from reality. Instead, more and more conflicts are emerging with lethal consequences, such as, bioterrorism, biological agent abuse, global-terrorism, and environmental destruction is occurring at a greater scale that we have witnessed before. We may have the latest technology and knowledge today, but ironically, we are using them to inflict more suffering and pain in the world. In the Asia-Pacific, the past 30 years has seen dramatic advancement and lifestyle changes. We are now paying a high price for such progress in terms of risk factors to the health of the population, such as, ageing diseases, obesity, smoking, diabetes, hypertension, and related conditions. The social, political, economic and environmental factors appeared to have deterred and negated WHO's HFA goal to attain basic human rights and health care for all. The HFA will not be achieved in the future if we do not learn from history and start taking measures now.
Asia Pac J Public Health 2002
PMID:Future health: coping with change. 1259 18

By international standards New Zealand (population 3.8 x 10(6)) has a high rate of colorectal cancer, with approximately 2000 new cases occurring and approximately 1000 deaths each year. But within the New Zealand population, a lower incidence of colorectal cancer is reported for Maori than for non-Maori New Zealanders (22.2 and 43.7 per 100,000 respectively). Information from the New Zealand National Nutrition Survey 1997 shows that in comparison to non-Maori, Maori eat more in total, eat more red meat, drink more alcohol, consume more saturated fat, have a higher prevalence of obesity and have a lower proportion of individuals consuming a given level of fruit and vegetables per day. All these factors would be expected to increase colorectal cancer risk. Puha (sow thistle; Sonchus sp.) and watercress (Nasturtium officinale, N.aquaticum) are foods with plausible cancer protective properties which are components of the Maori, but not the non-Maori diet.
Asian Pac J Cancer Prev 2002
PMID:A Comparison of Risk and Protective Factors for Colorectal Cancer in the Diet of New Zealand Maori and non-Maori. 1271 90

We conducted a review of previous cohort studies on the association between a history of diabetes mellitus (DM) and the occurrence of cancer. We limited the papers to those concerning cohort studies on 9 cancer sites, i.e. the kidney, liver, biliary tract, pancreas, colon or rectum, prostate, breast, endometrium, and ovary, in addition to all cancers. With regard to kidney, liver, biliary tract, pancreatic, colorectal, breast, and endometrial cancers, the risk of cancer development has been consistently reported to be positively associated with DM by two or more cohort studies. In contrast, DM was shown to relate negatively to the risk of prostate cancer by two cohort studies. However, there were no cohort studies which showed an either significantly positive or negative association of DM with ovarian cancer. Elevated levels of insulin or IGFs among DM patients have been proposed as a causal mechanism of increased risk for most of the reviewed cancers. In addition, increased estrogen levels in DM patients have been suggested to explain the casual mechanism of increased risk for kidney, breast and endometrial cancers, and decreased risk for prostate cancer. On the other hand, the possibility of detection bias has been suggested in the association of DM with the risk of most of these cancers. Obesity and heavy consumption of alcohol have been indicated as confounding factors in the relationship of DM to the risk for some of them. Thus, further studies are necessary for firm conclusions regarding the association of DM with cancer risk.
Asian Pac J Cancer Prev 2000
PMID:A Review of Cohort Studies on the Association Between History of Diabetes Mellitus and Occurrence of Cancer. 1271 99

Breast cancer is among the commonest malignant diseases in women. Over the past two decades tamoxifen has been generally accepted as an endocrine therapy of choice for prevention of breast cancer recurrence. Although tamoxifen was thought to have only a few adverse effects, several reports indicate that it is associated with an increase incidence of proliferative and neoplastic changes in the endometrium, with a 1.3 to 7.5 relative risk of developing endometrial carcinoma. The increased risk of endometrial cancer following the use of tamoxifen has stimulated studies on endometrial diagnostic screening methods. During the past ten years several reports have shown the benefits of transvaginal ultrasonography in detecting endometrial pathologies in patients receiving tamoxifen. Sonohysterography has been claimed to be a useful diagnostic tool on differentiating space-occupying lesion, eg. endometrial polyp, from abnormal endometrial-myometrial junction while the contribution of pulsed flow velocity in diagnosis of endometrial pathologies seems to be inconclusive. More recently a few factors have been identified as risk of developing endometrial cancer after tamoxifen use. These include pre-existing endometrial pathologies, obesity, and prior ERT use. This information provides us a more sensible way in following breast cancer patients receiving tamoxifen. It is proposed here that postmenopausal breast cancer patients intend to have tamoxifen treatment should receive a "two - step evaluation". The pretreatment evaluation is aimed to classify patients at risk of later development of endometrial pathologies after being exposed to tamoxifen while the ongoing evaluation is designed to closely follow the patents after the initiation of tamoxifen in hope that this will provide a tool for early diagnosis or hopefully a protective measure against endometrial carcinoma associated with tamoxifen therapy.
Asian Pac J Cancer Prev 2002
PMID:Prevention of Endometrial Cancer in Breast Cancer Patients Taking Tamoxifen : The Gynecologists' Role. 1271 83

With the change of nutrient intake after the Second World War, obesity is becoming one of the most serious health problems in Japan. From a practical viewpoint for prevention of lifestyle related diseases, we planned an intervention trial of weight control for obese women. After obtaining informed consent, we recruited patients over 30 years old with a BMI of 24 or more for the present program. Forty patients were randomly assigned into study groups A (28) and B (12). Group A started the prevention program at the entry and group B started three months thereafter, according to the protocol. This trial was designed to evaluate effectiveness of intervention trial during the first 3 months by comparing values with those for the non- intervention subjects. At the baseline and after three and six months, participants were checked for body size, dietary intake and serum chemistry. They were stressed to make a record not only of food intake but also physical activity over the 3 months. Every weekend they returned their record diaries by mail and we provided appropriate comments by telephone and/or mail after reviewing them. After follow up for 3 months, we observed significant improvement in BMI, waist and hip size. There was a 4.2 % decrease of initial body weight on average after intervention but a 0.3 % increase in the group without intervention, the difference between the two groups being statistically significant. With regard to change in key biomarkers in group A, decreased serum triglycerides appeared related to the reduction of BMI, but no link was apparent for total cholesterol.
Asian Pac J Cancer Prev 2002
PMID:A Model Obesity Control Program Focusing on a Healthy Diet and Gentle Exercise in Aichi Cancer Center Hospital. 1271 94

To promote a cancer prevention program at hospital, we started the hospital-based epidemiologic research program at Aichi Cancer Center (HERPACC) in 1988. Because patients visiting hospitals are very concerned not only about their own health condition but also practical way of disease prevention, we consider outpatients, especially those free of cancer, as ideal targets to make a model program and a practical cancer prevention strategy for general people. To confirm risk and protective effects of lifestyle factors like dietary habits, smoking and drinking, and exercise on cancer in Japanese, we have been undertaking large-scale case-referent comparative studies of main cancer sites (stomach, colorectal, lung, breast and uterine cancers) using the data generated by HERPACC. The risk of respiratory tract cancer was definitely elevated by habitual smoking and that of upper digestive tract cancer by combined habitual smoking and drinking. Frequent intake of raw vegetables and/or fruit in contrast reduced the risk of lung cancer among smokers. Current obesity was positively associated with risk of post-menopausal breast cancer, recently on the increase in Japan. However, all sites of cancer were linearly decreased with frequency of exercise in both males and females. Based on these pieces of evidence and other main results obtained from the HERPACC studies, prevention trials with provision of information about protective and risk factors for main sites of cancers to outpatients have been planned in parallel to continuation of HERPACC.
Asian Pac J Cancer Prev 2000
PMID:A Model of Practical Cancer Prevention for Out-patients Visiting a Hospital: the Hospital-based Epidemiologic Research Program at Aichi Cancer Center (HERPACC). 1271 87

Childhood obesity is a serious public health problem because of its strong association with adulthood obesity and the related adverse health consequences. The published literature indicates a rising prevalence of childhood obesity in both developed and developing countries. However no data exists on the prevalence in Northeast Thailand, one of the poorest regions of the country and one that has experienced a recent economic transition. The objective of this study was to estimate the prevalence of obesity in seven to nine year old children in urban Khon Kaen, Northeast Thailand. A cross-sectional school based survey was conducted to determine the prevalence of obesity in children of urban Khon Kaen, Thailand. Multi-staged cluster sampling was used to select 12 school clusters of 72 children each between the ages of 7 and 9 years, in primary school grades 1, 2 and 3 from government, private and demonstration schools. A total of 864 seven to nine year old school children were studied. Anthropometric measurements of standing height and weight were taken for all subjects to the nearest tenth of a centimetre and tenth of a kilogram respectively, Childhood obesity was defined as a weight-for-height Z-score above 2.0 standard deviations of the National Center for Health Statistics/World Health Organisation reference population median. The prevalence of childhood obesity was 10.8% (95% CI: 7.6, 13.9). Obesity was significantly more prevalent in boys than girls. The biggest difference was observed between the three school types, with the highest prevalence of obesity found at teacher training demonstration schools and the lowest at the government schools. This study provides the first data on childhood obesity prevalence in Northeast Thailand. The prevalence of 10.8 per cent is lower than that found in two other urban areas of Thailand but slightly higher than expected for this relatively poor region. If this prevalence rate increases, as observed in other countries in economic transition, the incidence of non-communicable diseases associated with obesity is also likely to increase, thus raising cause for concern and reason for intervention to both control and prevent obesity during childhood.
Asia Pac J Clin Nutr 2003
PMID:The prevalence of childhood obesity in primary school children in urban Khon Kaen, northeast Thailand. 1273 13

The association of central obesity measures and food patterns with metabolic risk factors for coronary heart disease (CHD) were studied among middle aged (>or =30 years) Bengalee Hindu men of Calcutta, India. CHD risk factors included total cholesterol (TC), fasting triglyceride (FTG), fasting plasma glucose (FPG), high density lipoprotein cholesterol (HDL-c), low density lipoprotein cholesterol (LDL-c) and very low density lipoprotein cholesterol (VLDL-c). The total sample size in the study was 212 male individuals. Anthropometric measurements, metabolic and food pattern variables were collected from each participant. The relative role of central obesity measures and food pattern variables in explaining metabolic risk factors of CHD were also made in this study. The results revealed that body mass index (BMI) had no significant relation with any of the metabolic risk factors of CHD. Whereas almost all-central obesity measures, namely waist circumference (WC), waist-hip ratio (WHR), and conicity index (CI) were significantly and positively related with TC, FTG, FPG and VLDL-c. Of the food pattern variables, only the frequency of egg, fried snacks and Bengalee sweets consumption were positively and significantly related with all central obesity measures. In contrast, frequency of chicken and fish consumption was negatively associated with central obesity measures. Conicity index (CI) was found to be the most consistent in explaining metabolic variables of CHD. Percent of variance explained by central obesity measures and food patterns were TC (10%), FPG (16%), FTG (6.6%) and VLDL-c (6.7%). Significant negative association of chicken and fish consumption with central obesity measures indicates the beneficial effect of both these items in this population.
Asia Pac J Clin Nutr 2003
PMID:Association of food patterns, central obesity measures and metabolic risk factors for coronary heart disease (CHD) in middle aged Bengalee Hindu men, Calcutta, India. 1281 Apr 6


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