This paper describes body composition and dietary intakes of the three major ethnic groups residing in Singapore and how these are related to cardiovascular risk factors in these groups. When the ...relationship between body mass index (BMI, kg/m2) and body fat percentage was studied, Singaporeans were found to have higher percentage of body fat compared with Caucasians with the same BMI. At BMIs that are much lower than WHO‐recommended cut‐off values for obesity, both the absolute and relative risks of developing cardiovascular risk factors are markedly elevated for all three ethnic groups. The excessive fat accumulation and increased risks at lower BMIs signal a need to re‐examine cut‐off values for obesity among Chinese, Malays, and Indians.
In developing countries, overweight prevalence is increasing while underweight prevalence is still high. This situation is known as the double nutrition burden. Both underweight and overweight are ...related to increased risk of chronic non-communicable diseases, reduced well-being and quality of life. This study aims to compare the prevalence of overweight and underweight among Vietnamese adults in 2000 and 2005.
The study was based on two nationally representative surveys, the National Nutrition Survey 2000 (14,452 subjects) and the National Adult Obesity Survey 2005 (17,213 subjects). Adults aged 25-64 years were sampled to be nationally representative. Multiple multinomial logistic regression analysis was used to investigate the association of underweight and overweight with socio-economic indicators.
The distribution of BMI across the population and population groups indicated a shift towards higher BMI levels in 2005 as compared to 2000. The nationwide prevalence of overweight (BMI ≥ 25 kg/m2) and obesity (BMI ≥ 30 kg/m2) was 6.6% and 0.4% respectively in 2005, almost twice the rates of 2000 (3.5% and 0.2%). Using the Asian BMI cut-off of 23 kg/m2 the overweight prevalence was 16.3% in 2005 and 11.7% in 2000. In contrast, the underweight prevalence (BMI < 18.5 kg/m2) of 20.9% in 2005 was lower than the rate of 25.0% in 2000. Women were more likely to be both underweight and overweight as compared to men in both 2000 and 2005. Urban residents were more likely to be overweight and less likely to be underweight as compared to rural residents in both years. The shifts from underweight to overweight were clearer among the higher food expenditure levels.
The double nutrition burden was clearly present in Vietnam. The distribution of BMI across the population groups generally indicated a shift towards higher BMI levels in 2005 as compared to 2000. The prevalence of overweight was increased while the declined level of undernutrition was still high in 2005. The shifts of underweight to overweight were most obvious among population groups with higher food expenditure levels.
The South East Asian Nutrition Surveys (SEANUTS) were conducted in 2010/2011 in Indonesia, Malaysia, Thailand and Vietnam in country representative samples totalling 16,744 children aged 0.5 to 12 ...years. Information on socio-demographic and behavioural variables was collected using questionnaires and anthropometric variables were measured. In a sub-sample of 2016 children, serum 25-hydroxy-vitamin D (25(OH)D) was determined. Data were analysed using SPSS complex sample with weight factors to report population representative data. Children were categorized as deficient (<25 nmol/L), insufficient (<50 nmol/L), inadequate (<75 nmol/L) or desirable (>=75 nmol/L). In Malaysia and Thailand, urban children had lower 25(OH)D than rural children. In all countries, except Vietnam, boys had higher 25(OH)D levels and older children had lower 25(OH)D. Regional differences after correcting for age, sex and area of residence were seen in all countries. In Thailand and Malaysia, 25(OH)D status was associated with religion. The percentage of children with adequate 25(OH)D (>=75 nmol/L) ranged from as low as 5% (Indonesia) to 20% (Vietnam). Vitamin D insufficiency (<50 nmol/L) was noted in 40 to 50% of children in all countries. Logistic regression showed that girls, urban area, region within the country and religion significantly increased the odds for being vitamin D insufficient. The high prevalence of vitamin D insufficiency in the (sub) tropical SEANUTS countries suggests a need for tailored approach to successfully combat this problem. Promoting active outdoor livestyle with safe sunlight exposure along with food-based strategies to improve vitamin D intake can be feasible options.
To study the associations between nutrient intake, dairy intake and socioeconomic variables.
Food consumption data using 24 h recall were collected in 3600 children, aged 0.5 to 12 years old in ...addition to frequency of dairy use and anthropometric and sociodemographic variables.
Overall height for age Z-score (HAZ) and body mass index for age Z-score (BAZ) values (mean±SE) were -1.40±0.03 and -0.48±0.03 respectively, associated with a high prevalence of stunting and thinness in the population. The overall percentage of children not using any dairy products was 71%, and this percentage increased steadily with age. The overall energy intake from dairy was 99±3 kcal/capita/day and the overall energy intake from dairy in dairy users was 291±7 kcal/day. Dairy use did not differ between boys and girls, but was higher in urban areas, higher if the education of the mother was higher and higher if the mother had a permanent job and if the wealth status of the family was in the upper levels. Nutrient intake after the age of 3 years was inadequate for energy and all nutrients except for protein. The achievement of Recommended Dietary Allowances (RDA) for all nutrients was higher in dairy users compared to non-dairy users, also after correcting for the confounding effect of the higher energy intake (from dairy) and socio-demographic variables. The contribution increased with increasing frequency of dairy use.
Adequate dairy intake can substantially add to the achievement of RDA in Indonesian children.
Inulin-based prebiotics are non-digestible polysaccharides that influence the composition of the gut microbiota in infants and children, notably eliciting a bifidogenic effect with high short chain ...fatty acid levels. Inulin, a generic term that comprises β-(2,1)-linked linear fructans, is typically isolated from the chicory plant root, and derivatives such as oligofructose and long chain inulin appear to have different physiological properties. The first 1000 days of a child's life are increasingly recognized as a critical timeframe for health also into adulthood, whereby nutrition plays a key role. There is an ever increasing association between nutrition and gut microbiota composition and development, with life health status of an individual. This review summarizes the latest knowledge in the infant gut microbiota from preterms to healthy newborns, as well as in malnourished children in developing countries. The impact of inulin or mixtures thereof on infants, toddlers and young children with respect to intestinal function and immunity in general, is reviewed. Possible benefits of prebiotics to support the gut microbiome of malnourished infants and children, especially those with infections in the developing world, are considered, as well as for the pregnant mothers health. Importantly, novel insights in metabolic programming are covered, which are being increasing recognized for remarkable impact on long term offspring health, and eventual potential beneficial role of prebiotic inulins. Overall increasing findings prompt the potential for gut microbiota-based therapy to support health or prevent the development of certain diseases from conception to adulthood where inulin prebiotics may play a role.
Investigators have expressed interest in the associations between resting energy expenditure (REE) and body mass for over a century. Traditionally, descriptive models using regression analysis are ...applied, linking REE with metabolically active compartments such as body cell mass (BCM) and fat-free body mass (FFM). Recently developed whole body magnetic resonance imaging (MRI) and echocardiography methods now allow estimation of all major organs and tissue volumes in vivo. Because measured values are available for REE, BCM, and FFM content of individual organs and tissues, it should now be possible to develop energy expenditure-body composition estimation models based on MRI-measured organ-tissue volumes. Specifically, the present investigation tested the hypothesis that in vivo estimation of whole body REE, BCM, and FFM is possible using MRI- and echocardiography-derived organ volumes combined with previously reported organ-tissue metabolic rates and chemical composition. Thirteen subjects (5 females, 8 males) had REE, BCM, and FFM measured by indirect calorimetry, whole body 40K counting, and dual-energy X-ray absorptiometry, respectively. Models developed from estimated and measured variables were highly correlated, with no significant differences between those estimated and measured e.g., calculated vs. measured REE: r = 0.92, P < 0. 001; (mean +/- SD) 6,962 +/- 1,455 and 7,045 +/- 1,450 kJ/day, respectively (P = not significant). Strong associations were observed between REE, individual or combined organ weights, BCM, and FFM that provide new insights into earlier observed metabolic phenomona. The present approach, the first to establish an energy expenditure-body composition link with a mechanistic model in vivo, has the potential to greatly expand our knowledge of energy expenditure-body size relationships in humans.
The assumed "constancy" of fat-free body mass hydration is a cornerstone in the body-composition research field. Hydration, the observed ratio of total body water to fat-free body mass, is stable at ...approximately 0.73 in mammals and this constancy provides a means of estimating total body fat in vivo. This review examines both in vitro and in vivo data that support the hydration constancy hypothesis and provides a critique of applied methodology. Biological topics of interest are then examined and critical areas in need of future research are identified. These are important issues because water dilution is the only method currently available for estimating body fat in all mammals, which range in body mass by a factor of 10(4).
Water is an essential component of living organisms, and in adult mammals the fraction of fat-free body mass (FFM) as water is remarkably stable at approximately 0.73. The stability of FFM hydration ...is a cornerstone of the widely used water isotope dilution method of estimating total body fat. At present, the only suggested means of studying FFM hydration is by experimental total body water (TBW) and FFM measurements. Although deviations from the classical hydration constant are recognized, it is unknown if these are explainable physiological aberrations and/or methodological errors. Moreover, many questions related to hydration stability prevail, including body mass and age effects. These unresolved questions and the importance of the TBW-fat estimation method led us to develop a cellular level FFM hydration model. This physiological model reveals that four water-related ratios combine to produce the observed TBW-to-FFM ratio. The mean and range of FFM hydration observed in adult humans can be understood with the proposed physiological model as can variation in the TBW-to-FFM ratio over the human life span. An extension of the model to the tissue-organ body composition level confirms on a theoretical basis a small but systematic decrease in hydration observed in mammals ranging in body mass by a factor of 10(5). The present study, the first to advance a physiological hydration model, provides a conceptual framework for the TBW-fat estimation method and identifies important areas that remain to be studied.
A WHO expert consultation addressed the debate about interpretation of recommended body-mass index (BMI) cut-off points for determining overweight and obesity in Asian populations, and considered ...whether population-specific cut-off points for BMI are necessary. They reviewed scientific evidence that suggests that Asian populations have different associations between BMI, percentage of body fat, and health risks than do European populations. The consultation concluded that the proportion of Asian people with a high risk of type 2 diabetes and cardiovascular disease is substantial at BMIs lower than the existing WHO cut-off point for overweight (⩾25 kg/m2). However, available data do not necessarily indicate a clear BMI cut-off point for all Asians for overweight or obesity. The cut-off point for observed risk varies from 22kg/m2 to 25kg/m2 in different Asian populations; for high risk it varies from 26kg/m2 to 31kg/m2. No attempt was made, therefore, to redefine cut-off points for each population separately. The consultation also agreed that the WHO BMI cut-off points should be retained as international classifications. The consultation identified further potential public health action points (23·0, 27·5, 32·5, and 37·5 kg/m2) along the continuum of BMI, and proposed methods by which countries could make decisions about the definitions of increased risk for their population.
In 1229 subjects, 521 males and 708 females, with a wide range in body mass index (BMI; 13.9-40.9 kg/m2), and an age range of 7-83 years, body composition was determined by densitometry and ...anthropometry. The relationship between densitometrically-determined body fat percentage (BF%) and BMI, taking age and sex (males = 1, females = 0) into account, was analysed. For children aged 15 years and younger, the relationship differed from that in adults, due to the height-related increase in BMI in children. In children the BF% could be predicted by the formula BF% = 1.51 X BMI - 0.70 X age - 3.6 X sex + 1.4 (R2 0.38, SE of estimate (SEE) 4.4% BF%). In adults the prediction formula was: BF% = 1.20 X BMI + 0.23 X age - 10.8 X sex - 5.4 (R2 0.79, SEE = 4.1% BF%). Internal and external cross-validation of the prediction formulas showed that they gave valid estimates of body fat in males and females at all ages. In obese subjects however, the prediction formulas slightly overestimated the BF%. The prediction error is comparable to the prediction error obtained with other methods of estimating BF%, such as skinfold thickness measurements or bioelectrical impedance.
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