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This study sought to determine the prevalence of metabolic syndrome, using data collected from 4,541 adults aged 20 years and over covered in the Fifth National Nutrition Survey conducted in 1998. The metabolic variables analyzed were: total cholesterol, LDL-c, HDL-c, triglycerides and fasting blood glucose. In addition, measurements of obesity such as body mass index (BMI), waist-to-hip ratio (WHR) and waist circumference (WC) as well as blood pressure were taken. Comparing the mean metabolic characteristics of the non-obese, total obese and the android obese, results showed significant differences in almost all the variables except for the HDL-c. By gender, non-significant differences were observed between males and females in the non-obese group in terms of the BMI and glucose levels and in the android group, in terms of total cholesterol. In all three groups, the biggest difference was observed in the mean triglycerides, where males had significantly higher mean than the females. Comparing adults with >125 mg/dl fasting blood sugar (FBS) there were higher rates of hypertension, high waist-to-hip ratio (WHR), high cholesterol, high triglycerides, high LDL-c, low HDL-c, among the overweight and obese than among those with normal BMI. In general, the proportion of subjects with co-morbid factors increased with higher levels of FBS, except for high cholesterol wherein no pattern was established. The highest prevalence of high FBS was found in both males (35.8%) and females (14.5%) with the following combined characteristics: high BMI, high WHR and high WC. Males with co-existing high BMI, high WHR, and high WC were observed to have the highest prevalence rate of hypertension (66.5%). Among females, the highest prevalence rate of hypertension (37.9%) was seen among those with high fasting blood sugar. The proportion of subjects with hypertension generally increased with age irrespective of the BMI status. One of the significant correlates of high FBS is waist-hip ratio. Males with WHR of equal or greater than 1 have almost six times the risk of having high FBS, while females with WHR of equal or greater than 0.85 have five times the risk of having high FBS compared to those with normal WHR. Among females with triglyceride levels of equal or greater than 200 mg/dL, the risk of having high FBS is five times compared to those with triglyceride levels below 200 mg/dL. Univariate analysis to see the effect of the type of obesity to dyslipidaemia and hypertension revealed that females with high waist circumference generally provided greater risk compared to those who were overweight and obese as well as those with android obesity. For males, high waist circumference had greater risk of developing high triglyceride and high LDL-c. Android obese males had greater risk to high FBS. The results showed that the prevalence rate of metabolic syndrome is 0.28%, based on the number of individuals with the following characteristics: high FBS, hypertensive, android obese, with body mass index (BMI) of > or =25.0 and high WC. Females had a higher rate than males - almost twice. Considering that metabolic syndrome, with its co-morbidity factors is prevalent among some Filipino adults aged 20 years and over, it is recommended that health programs geared towards minimizing the morbid risk factors be properly developed, promoted and fully implemented.
Asia Pac J Clin Nutr 2003
PMID:Prevalence of metabolic syndrome among Filipino adults aged 20 years and over. 1450 89

The life-stage approach, which views the behaviours and exposures of an individual from the preconceptual situation of the parent through pregnancy, infancy, childhood and adolescence, and into the advancing years through adulthood, is the basis of analysis of strategies to improve long-term health. Among the behaviours of note is the dietary selection pattern, conditioning our exposure to nutrients and dietary constituents that influences growth, nutriture, cognitive and physical performance, and disease resistance and susceptibility. The African Diaspora created a population displaced from Africa to the Western Hemisphere as part of the African slave trade from the 16th to 18th centuries. It continues to manifest distinct dietary and lifestyle practices in the context of a health experience that is different both from the population in their African countries of origin and from the other ethnicities in their countries of displacement and current residence. Afro-Americans are more susceptible to a series of diseases and conditions including low birth weight, violence, and HIV/AIDS, as well as the non-communicable diseases: obesity, diabetes mellitus, cardiovascular disease, hypertension, stroke, renal failure, breast cancer, prostate cancer and lead poisoning. The differential nature of dietary practices are conditioned at times by the poverty and marginalisation of the populace, resulting in either disadvantageous or beneficial outcomes relative to others' eating habits. Serious consideration must be given to the possibility that ethnic difference give rise to different requirements and tolerances for essential nutrients and distinct protective or adverse responses to foods and dietary substances. The major challenges to health improvement for the African Diaspora is coming to grips with the policy and programmatic nuances of differential treatment and the effecting the behavioural changes that would be needed in a population skeptical of the motives of media and of the power elites of their societies.
Asia Pac J Clin Nutr 2003
PMID:Diet and long-term health: an African Diaspora perspective. 1450 96

Nutritionally-related health patterns in the Middle East have changed significantly during the last two decades. The main forces that have contributed to these changes are the rapid changes in the demographic characteristics of the region, speedy urbanization, and social development in the absence of steady and significant economic growth. Within these changes, the Middle East has the highest dietary energy surplus of the developing countries. The population in the region has a low poverty prevalence, at 4%. The region's child malnutrition rate is 19%, suggesting that nutrition insecurity remains a problem due mainly to poor health care and not due to inadequate dietary energy supply or poverty. The one extreme country, Afghanistan, has an extremely high dietary energy deficit of 490 kilocalories and a 40% malnutrition rate. Iran and Egypt have relatively high child malnutrition rates of 39 and 16% respectively, but belong to the dietary energy surplus group. Morocco and the United Emirates have the lowest child malnutrition rates of 6 and 8% respectively. In the Middle East, as in other parts of the world, large shifts have occurred in dietary and physical activity patterns. These changes are reflected in nutritional and health outcomes. Rising obesity rates and high levels of chronic and degenerative diseases are observed. These pressing factors that include the nature and changes in the food consumption pattern, globalization of food supply, and the inequity in health care will be discussed.
Asia Pac J Clin Nutr 2003
PMID:Nutrition-related health patterns in the Middle East. 1450 98

The present study was conducted to assess the relationship between obesity and serum levels of C-reactive protein (CRP), carotenoids, oxidized LDL (oxLDL), oxidized LDL antibodies (oLAB), and leptin in Japanese residents. The subjects were 158 males and 158 females aged 40-79 years, and living in Hokkaido, Japan, who attended a health examination screening. Serum levels of CRP, oxLDL, oLAB, and leptin were measured by enzyme-linked immunosorbent assay (ELISA) and serum carotenoid levels were measured by high-performance liquid chromatography (HPLC). Body mass index (BMI) was calculated as body weight (kg) divided by height (m) squared and obesity was defined as BMI of 25 or more (kg/m2). Serum levels of CRP and leptin were significantly higher in the obese group than in their non-obese counterparts in both genders. Serum levels of beta-carotene and beta-cryptoxanthin were lower in the obese individuals, especially in females. While values for oxLDL and oLAB did not significantly vary. BMI was positively correlated with log-transformed serum levels of CRP and leptin in both genders (males: r=0.231, p<0.05; females: r=0.305, p<0.001). In females, moreover, BMI was negatively correlated with log-transformed serum levels of beta-carotene, zeaxanthin/lutein, and beta-cryptoxanthin (r=-0.244, p<0.01; r=-0.200, p<0.05; r=-0.207, p<0.01, respectively). Significantly higher odds ratios (ORs) for high serum levels of CRP (males: OR=2.12; females: OR=3.96) and leptin (males: OR=3.83; females: OR=9.07) were observed in obese versus non-obese men and women, after adjusting for various confounding factors. Significantly lower adjusted odds ratios for high serum levels of alpha- and beta-carotenes (males: OR=0.23, 0.33; females: OR=0.35, 0.39, respectively) were also observed in the obese as compared to the non-obese group. In conclusion, obesity is highly associated with states of oxidative stress and low-grade inflammation in Japanese residents, suggesting that these latter might play an important role in the association between a high BMI and certain cancers as well as coronary heart disease (CHD).
Asian Pac J Cancer Prev
PMID:Relationship between obesity and serum markers of oxidative stress and inflammation in Japanese. 1450 48

The aim of this study was first, to investigate the prevalence of obesity, abdominal obesity, and clustering of cardiovascular (CVD) risk factors, and secondly, to identify the BMI or waist circumference (WC) level at which clustering increases in South Koreans. A population-based, cross-sectional National Health Examination Survey was carried out in 1998. A total of 8,816 subjects (4,029 men and 4,787 women) aged 15-79 y were selected by stratified multistage probability sampling design. The measurements taken of the subjects included: height, weight, waist and hip circumference, blood pressure, fasting glucose, and lipids. The prevalence of BMI > or = 25 kg/m2 was 25.3% for men and 28.3% for women. The prevalence of WC >90 cm in men, and >80 cm in women was 18.5%, and 38.5%, respectively. Clustering of 3 or more CVD risk factors was 22.7% in men ad 21.7% in women. Using <21 kg/m2; as a referent, subjects with BMI of 23 kg/m2; and 27 kg/m2; had an odds ratio of 3.5 and 10.2 in men, and 3.1 and 6.7 in women, respectively for clustering of CVD risk factors. Using <65 cm as a referent, subjects with a WC of > or = 90 cm in men and > or = 85 cm in women had an odds ratio of 13.4, and 13.6, respectively for clustering of CVD risk factors. Considering the significant associations between clustering of CVD risk factors and BMI or WC, the present study suggests that high prevalence of overweight may have important implications for the health care system, even at a lower level of BMI or WC.
Asia Pac J Clin Nutr 2003
PMID:Obesity, abdominal obesity, and clustering of cardiovascular risk factors in South Korea. 1467 64

The combination of immunodeficiency, inflammatory process and nutritional status that is characteristic of infective and food-borne illness is more evident in chronic diet- and environment-influenced chronic diseases such as diabetes, obesity, cardiovascular disease, cancer, arthritis and neuro-degeneration diseases. These chronic diseases tend to be oxidation-linked and may manifest in communities around the world, irrespective of income. In addressing the challenges of the above diseases, a significant role for dietary phytochemicals is emerging. Phytochemicals are required from a spectrum of food for at least their antioxidant role, if not for other properties, to protect tissues from activities that manifest themselves into what we call chronic disease. Among the diverse groups of phytochemicals, phenolic antioxidants and antimicrobials from food plants are being targeted for designed dietary intervention to manage major oxidation-linked diseases such as diabetes, cardiovascular diseases, arthritis, cognition diseases and cancer. Foods containing phenolic phytochemicals are also being targeted to manage bacterial infections associated with chronic diseases such as peptic ulcer, urinary tract infections, dental caries and food-borne bacterial infections. Plants produce phenolic metabolites as a part of growth, developmental and stress adaptation response. These stress and developmental responses are being harnessed to design consistent phytochemical profiles for safety and clinical relevancy using novel tissue culture and bioprocessing technologies. The biochemical strategy for harnessing phenolic phytochemicals for human health and wellness is based on the hypothesis that phenolic metabolites in plants are efficiently produced through an alternative mode of metabolism linking proline synthesis with pentose-phosphate pathway. In this model, stress-induced proline biosynthesis is coupled to pentose-phosphate pathway, driving the synthesis of NADPH(2) and sugar phosphates for anabolic pathways, including phenolic and antioxidant response pathways, while simultaneously providing reducing equivalents needed for mitochondrial oxidative phosphorylation in the form of proline as an alternative to NADH from Krebs/TCA cycle. Based on this model, tissue culture techniques and elicitation concepts have been used to stimulate phenolic metabolites with an antioxidant response in germinating seeds, sprouts and clonal lines of dietary plants. From our initial investigations, a model has been proposed in which the proline-linked pentose-phosphate pathway is suggested to be critical for modulating protective antioxidant response pathways in diverse biological systems, including biochemical and cellular pathways important for human health. The proposed proline-linked pentose-phosphate pathway model provides a mechanism for understanding the mode of action of phenolic phytochemicals in modulating antioxidant pathways and provides avenues by which dietary approaches may manage oxidation-linked chronic and infectious diseases. The model also has implications for the development of antimicrobial phenolic phytochemicals against bacterial pathogens in an era of increasing antibiotic resistance. Further, this model also has relevance for improving fungal and yeast-based food bioprocessing for designing functional foods and for environmental bioremediation using plant and microbial systems, as well as for improving agricultural and food systems in harsh environments.
Asia Pac J Clin Nutr 2004
PMID:A model for the role of the proline-linked pentose-phosphate pathway in phenolic phytochemical bio-synthesis and mechanism of action for human health and environmental applications. 1500 10

This study evaluated the influence of socio-economic status on energy intake (EI), anthropometric characteristics and body composition (BC) of premenopausal Bangladeshi women in two socio-economic groups. This cross-sectional study measured height, weight, biceps and triceps skinfolds by standard procedures. A three-day dietary record was used to estimate EI. The biceps and triceps skinfolds were used to calculate total body fat (TBF), fat-free mass (FFM) and body fat percentage (BF%) according to Durnin and Womersley. FAO/WHO/UNU equations were used to calculate basal metabolic rates (BMR). Two locations in Bangladesh were studied; the Dhaka city area and the west region of the subdistrict Nandail (Betagair Union) in the district of Mymensingh. Study subjects were premenopausal women (N =191) aged 16(40 years. The high socio-economic group (group H, N =90) consisted of women with high income and educational level. The low socio-economic group (group L, N =101) consisted of rural, low income, illiterate women. Both groups contained three subgroups (non-pregnant, non-lactating =1, pregnant =2, lactating =3). Socio-economic status had a significant effect on body weight, height, biceps and triceps skinfolds, BMI, TBF, FFM and BF% (P<0.001). These variables were significantly higher (P<0.001) in all subgroups of group H than in the corresponding subgroups of group L. The influence of physiological status on most of these variables was not significant. EI was, however, influenced by both socio-economic (P<0.001) and physiological(P<0.05) status. The mean EI was significantly lower (P<0.001) in all subgroups of group L than in the corresponding subgroups of group H. The contributory sources were different in high and low income groups. In both groups, EI was lower than the recommended level. Based on the dietary and anthropometric results, we conclude that malnutrition is a common feature among low income rural women. This contradicts findings in western countries, where obesity is prevalent in low income groups.
Asia Pac J Clin Nutr 2004
PMID:Nutritional status of women in Bangladesh: comparison of energy intake and nutritional status of a low income rural group with a high income urban group. 1500 16

Dietary guidelines for the general population and for the management of obesity, diabetes and heart disease suggest a reduction in dietary fat, and in particular dietary saturated fatty acids (SFA). In order to achieve the recommended levels, changes in food choice patterns are required. Foods are consumed in combination with other foods, and these combinations are often recognizable as cuisine patterns. In this study we examined the food choice patterns of a group of 63 adults with existing type 2 diabetes mellitus who completed a 12 month dietary intervention trial aimed at changing dietary fat under 'free living' conditions. In both lower fat (LF, 27%) and modified fat (MF, 37%E) groups, a reduction in dietary SFA and an increase in polyunsaturated fat were required, with an additional requirement to increase dietary monounsaturated fat in the MF group. The usual diets of the study sample were on average low in total fat (27%E), but high in saturated fat (12%E). Those already consuming total fat at the level concordant with their allocation (LF or MF) achieved targets faster than those with a discordant allocation, but there was no significant effect of usual diet on time of target achievement at 12 months. At 6 months, those achieving dietary fat targets had changed to low fat dairy products and leaner meats, were having more spreads, oils, and nuts and were consuming takeaway meals less than twice a week. Contributions to dietary fat shifted from takeaway foods, meat, dairy products and cakes to spreads, oils and nuts. The modified fat and low fat groups chose more Mediterranean and South East Asian cuisines respectively. In this study sample, usual dietary patterns had an initial impact on change in the diet, but identifiable changes in food choice patterns and the adoption of certain cuisines that combined foods indicative of the dietary guidelines resulted in successful achievement of dietary fat targets.
Asia Pac J Clin Nutr 2004
PMID:The impact of usual dietary patterns, selection of significant foods and cuisine choices on changing dietary fat under 'free living' conditions. 1500 20

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

There are very few reports from the developing world on the prevalence of obesity among children even though in developed countries it has reached epidemic proportions. The objective of this study was to determine the prevalence of obesity in pre-adolescent and adolescent children in a developing country (India) using WHO guidelines for defining obesity and overweight. This cross-sectional study was carried out on 2008 school-children aged 9-15 years. Approximately half the subjects belonged to a school attended by children of well to do families while the rest belonged to two schools from middle and lower socio-economic background. Weight and height were taken for all children and the body mass index (BMI) calculated. Children whose BMI was >85th percentile for age and sex were defined as overweight. Triceps skin fold thickness (TSFT) was measured for all overweight children and those with TSFT >90th percentile for age and sex were defined as obese. The overall prevalence of obesity and overweight was 11.1% and 14.2% respectively. The prevalence of obesity as well as overweight was higher in boys as compared to girls (12.4% vs 9.9%, 15.7% vs 12.9%). Prevalence of obesity decreased significantly with age, from 18.5% at 9 years to 7.6% at 14 years, rising at 15 years to 12.1%. Significantly more children from higher socio-economic status were obese and overweight than those from lower socio-economic status groups. No significant gender difference for obesity prevalence was seen among children from a less privileged background, however, amongst children from affluent families, significantly more boys were obese as compared to girls. Pediatric obesity is an emerging problem in developing countries, especially among higher socio-economic status groups. Significant gender disparity is seen, with boys of affluent background having a higher prevalence.
Asia Pac J Clin Nutr 2004
PMID:Obesity among pre-adolescent and adolescents of a developing country (India). 1533 33


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