Publications by authors named "Mark L Wahlqvist"

157 Publications

Mapping the human gut mycobiome in middle-aged and elderly adults: multiomics insights and implications for host metabolic health.

Gut 2022 Jan 11. Epub 2022 Jan 11.

Key Laboratory of Growth Regulation and Translational Research of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou, Zhejiang, China

Objective: The human gut fungal community, known as the mycobiome, plays a fundamental role in the gut ecosystem and health. Here we aimed to investigate the determinants and long-term stability of gut mycobiome among middle-aged and elderly adults. We further explored the interplay between gut fungi and bacteria on metabolic health.

Design: The present study included 1244 participants from the Guangzhou Nutrition and Health Study. We characterised the long-term stability and determinants of the human gut mycobiome, especially long-term habitual dietary consumption. The comprehensive multiomics analyses were performed to investigate the ecological links between gut bacteria, fungi and faecal metabolome. Finally, we examined whether the interaction between gut bacteria and fungi could modulate the metabolic risk.

Results: The gut fungal composition was temporally stable and mainly determined by age, long-term habitual diet and host physiological states. Specifically, compared with middle-aged individuals, and spp were depleted, while was enriched in the elderly. Dairy consumption was positively associated with but inversely associated with . Notably, spp interacted with gut bacterial diversity to influence insulin resistance. Bidirectional mediation analyses indicated that bacterial function or faecal histidine might causally mediate an impact of on blood cholesterol.

Conclusion: We depict the sociodemographic and dietary determinants of human gut mycobiome in middle-aged and elderly individuals, and further reveal that the gut mycobiome may be closely associated with the host metabolic health through regulating gut bacterial functions and metabolites.
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http://dx.doi.org/10.1136/gutjnl-2021-326298DOI Listing
January 2022

Nutrition counseling is associated with less sarcopenia in diabetes: A cross-sectional and retrospective cohort study.

Nutrition 2021 Nov-Dec;91-92:111269. Epub 2021 Apr 7.

School of Public Health, National Defense Medical Center, Taipei, Taiwan, Republic of China. Electronic address:

Objectives: Muscle is crucial for blood glucose regulation. There is a need to prevent and treat sarcopenia in diabetes mellitus (DM). This study aimed to estimate the prevalence of sarcopenia and evaluate the association of nutritional counseling with the development of sarcopenia for people with DM.

Methods: In a cross-sectional and retrospective cohort study, people with type 2 DM were recruited from the Diabetes Shared Care Program of a teaching hospital. Muscle mass, muscle strength, and physical functional performance were evaluated using the Asian Working Group for Sarcopenia criteria. The skeletal muscle mass index was determined by dividing muscle mass by the square of the height. Clinical information, including the nutrition counseling record, was retrospectively obtained from medical records for a 2-y period.

Results: The prevalence of low skeletal muscle mass index (presarcopenia) and sarcopenia were, respectively, 20.4% and 9.6% (including 3.1% severe) among 1292 participants. Specifically, 15.3% of participants age ≥ 65 y were categorized as having sarcopenia. With more frequent nutritional counseling, there was a lesser risk of sarcopenia; the adjusted odds ratio (95% confidence interval) was 0.51 (0.27-0.94) for ≥ 3 times/2 y compared to no counseling. DM duration and age, glycemic status and medication, and body mass index and counseling frequency had no joint effects; however, these variables (except HbA1 c) were independent risk factors for low skeletal muscle mass index and sarcopenia.

Conclusions: People with type 2 DM have a high risk of sarcopenia. Increased nutrition counseling in outpatients was associated with less sarcopenia. Education about sarcopenia-associated risk factors should be encouraged early in the onset of DM.
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http://dx.doi.org/10.1016/j.nut.2021.111269DOI Listing
December 2021

Retraction: Chilinda, Z.B., et al. Optimal Household Water Access Fosters the Attainment of Minimum Dietary Diversity among Children Aged 6-23 Months in Malawi. 2021, , 178.

Nutrients 2021 Mar 26;13(4). Epub 2021 Mar 26.

Department of Nutrition, China Medical University, 91 Hsueh-Shih Road, North District, Taichung City 40402, Taiwan.

The article cited above [...].
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http://dx.doi.org/10.3390/nu13041078DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8066791PMC
March 2021

Household and schooling rather than diet offset the adverse associations of height with school competence and emotional disturbance among Taiwanese girls.

Public Health Nutr 2021 06 22;24(8):2238-2247. Epub 2021 Mar 22.

Institute of Population Health Sciences, National Health Research Institutes, 35 Keyan Road, Zhunan Town, Miaoli County, Taiwan35053, Republic of China.

Objective: Short stature may reflect health in early life and be an enduring disability. How birth weight, gender, household, elementary schooling and diet play a role in associations between stature and overall school competence (OSC) have been assessed.

Design: The 2001-2002 Nutrition and Health Survey in Taiwan (NAHSIT) for elementary schoolchildren (n 2274, 52·1 % boys) was linked to birth records. It provided sociodemographic, dietary quality, body compositional and school performance (as Scale for Assessing Emotional Disturbance, SAED; OSC as an SAED subscale) data. Lower birth weight was ≤15th percentile: 2850 g for boys and 2700 g for girls, and stature as z-scores for Taiwanese. Multivariable linear regression was used for relationships between OSC and stature. Trends in OSC by stature and school grade were assessed.

Setting: The 2001-2002 NAHSIT for elementary schoolchildren.

Participants: Totally, 2274 schoolchildren aged 6-13 years.

Results: Compared to normal height (-2< height for age z-score (HAZ) <2), shorter girls (HAZ ≤ -2) had a lower OSC (8·87 v. 10·5, P < 0·05) and taller girls (HAZ ≥ 2) had a better OSC (12·3 v. 10·5, P < 0·001). Maternal education and household income each contributed more than 5 % of OSC variance. OSC and HAZ among girls were positively associated and emotional disturbance negatively associated. Shortness-associated lower OSC underwent remediation with advancing school grade. Stature and OSC were not evidently related in boys.

Conclusions: Shorter stature can compromise OSC among school girls. The major determinants in shorter girls are less household income and limited parental education.
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http://dx.doi.org/10.1017/S136898002100121XDOI Listing
June 2021

Higher maternal autonomy is associated with reduced child stunting in Malawi.

Sci Rep 2021 02 16;11(1):3882. Epub 2021 Feb 16.

Department of Nutrition, China Medical University, 91 Hsueh-Shih Road, North District, Taichung City, 40402, Taiwan.

Child undernutrition is a major health problem in Malawi. We assessed the association between maternal autonomy and child stunting in Malawi. We utilized nationally representative pooled cross-sectional data from the 2010 and 2015/16 Malawi Demographic and Health Surveys (MDHS), which included 7348 mother (28.1 ± 6.8 years, range 15-49 years)-child (27.6 ± 16.7 months, range 0-59 months) pairs. Maternal autonomy composite scores captured decision-making power, tolerance of domestic violence, and financial independence. The nutritional outcome measure was stunting (height-for-age z score < - 2). Logistic regression assessed associations between maternal autonomy and stunting, and dominance analysis evaluated the relative importance of the associated factors. From the two surveys combined, 39.2% were stunted. Stunting decreased from 45.0% in 2010 to 34.6% in 2015/16; concurrently, maternal autonomy improved and was evidently associated with stunting (aOR = 0.81, 95% CI = 0.71, 0.93; p = 0.002). However, this association was probably mediated by other factors associated with improved child nutrition, including maternal education and family wealth, which, along with child age, were associated with stunting in the dominance analysis. Concurrent interventional programs may also have contributed to the decrease in stunting between the surveys, thus moderating the effect of maternal autonomy.
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http://dx.doi.org/10.1038/s41598-021-83346-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7886910PMC
February 2021

Optimal Household Water Access Fosters the Attainment of Minimum Dietary Diversity among Children Aged 6-23 Months in Malawi.

Nutrients 2021 Jan 8;13(1). Epub 2021 Jan 8.

Department of Nutrition, China Medical University, 91 Hsueh-Shih Road, North District, Taichung City 40402, Taiwan.

Along with sanitation and hygiene, water is a well-known driver of child undernutrition. However, a more direct role of household (HH) water access in shaping dietary diversity remains unexplored. We assessed the association between HH water access and achievement of minimum dietary diversity (MDD) among young children. We utilized nationally-representative cross-sectional data from the 2015/16 Malawi Demographic and Health Survey, which included 4727 mother-child dyads, respectively, (26.8 ± 6.8 years, range 15-49 years) and (13.9 ± 4.9 months, range 6-23 months). HH water access was categorized as (1) basic or no access, (2) intermediate, or (3) optimal. MDD was defined as feeding a child, during the previous day, at least four of the food groups defined by the World Health Organization. Only 27.7% of the children achieved MDD standards; most of the children who achieved MDD were from HHs with optimal water access (58.4%, < 0.001). However, only 5.9% of the mother-child dyads were from HHs with optimal water access. After adjusting for covariates, children from HHs with optimal water access had higher odds of achieving MDD than those from HHs with basic or no water access (aOR = 1.74, CI = 1.24-2.46). Our results highlight the need to incorporate water-based strategies into national nutritional policies to increase dietary diversity among Malawian infants and young children.
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http://dx.doi.org/10.3390/nu13010178DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7827850PMC
January 2021

Non-nutritional anemia: Malaria, thalassemia, G6PD deficiency and tuberculosis in Indonesia.

Asia Pac J Clin Nutr 2020 ;29(Suppl 1):S32-S40

Eijkman Institute for Molecular Biology, Ministry of Research and Technology/National Agency for Research and Innovation, Jakarta, Indonesia.

Anemia affects people worldwide and results in increased morbidity and mortality, particularly in children and reproductive-age women. Anemia is caused by an imbalance between red blood cell (RBC) loss and production (erythropoiesis), which can be caused by not only nutritional factors but also non-nutritional factors, such as inflammation and genetics. Understanding the complex and varied etiology of anemia is crucial for developing effective interventions and monitoring anemia control programs. This review focusses on two interrelated nonnutritional causes of anemia: malaria infection and RBC disorders (thalassemia and G6PD deficiency), as well as tuberculosis. According to the Haldane hypothesis, thalassemia occurs as a protective trait toward malaria infection, whereas G6PDd arises in malaria-endemic regions because of positive selection. Indonesia is a malariaendemic region; thus, the frequency of thalassemia and G6PD deficiency is high, which contributes to a greater risk for non-nutritional anemia. As Indonesia is the second global contributor to the newly diagnosed tuberculosis, and active pulmonary tuberculosis patients are more anemic, tuberculosis is also contributes to the increasing risk of anemia. Therefore, to reduce anemia rates in Indonesia, authorities must consider non-nutritional causes that might influence the local incidence of anemia, and apply co-management of endemic infectious disease such as malaria and tuberculosis, and of genetic disease i.e. thalassemia and G6PDd.
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http://dx.doi.org/10.6133/apjcn.202012_29(S1).04DOI Listing
August 2021

Intersectoral and eco-nutritional approaches to resolve persistent anemia in Indonesia.

Asia Pac J Clin Nutr 2020 ;29(Suppl 1):S1-S8

Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, Taiwan.

Anemia in Indonesia has been of concerning persistence in all age groups for some 75 years since independence. The relationships between anemia and nutrition are complex being evident with compromised general health and nutrition. Increased micronutrient intakes, especially iron and folic acid, has alleviated the problem, but encouraged nutrient-specific micronutrient interventions as attractive policy directions as if anemia were a stand-alone disease irrespective of associated disorder. Concerted action to deal with the fundamental causality has been missing. Much of the pathogenetic pathway may be nutritional, but its multifactoriality is ultimately socioecological. Given the intransigence and progression of societal and ecosystem dysfunction, it can be expected that failure to recognize their causal importance will further entrench endemic anemia. This review deliberates the practical measures taken to recognize anemia by symptomatology, food and nutrition surveys, screening (fingerpick blood), nutrition assessment, and blood loss (menstrual and faecal). It identifies vulnerable groups including premenopausal and pregnant women, children and adolescents, unwell adults, and the dependent aged. Risk settings include food insecurity, infectious disease, non-communicable disease, inheritance and epigenetics, and socioeconomic disadvantage. Underlying socio-ecological problems are livelihood, food systems, cultural habits, belief systems, and social networks and activities. With this framework, policy directions could deal more comprehensively and effectively with the socioecological complexity which underpins and limits progress towards anemia eradication at a time of intense global food and health insecurity. It will require co-operative intersectoral and eco-nutritional approaches which take into account the need for universal, sustainable livelihoods. Recommendations have been made accordingly.
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http://dx.doi.org/10.6133/apjcn.202012_29(S1).01DOI Listing
August 2021

Econutrition, brown and beige fat tissue and obesity.

Asia Pac J Clin Nutr 2020 ;29(4):668-680

Institute of Nutrition and Health, Qingdao University, Qingdao, China. Email:

Background And Objectives: Obesity is caused by excessive fat accumulation or abnormal fat distribution and has become one of the biggest health challenges worldwide. Considering the high thermogenic ability of brown fat tissue (BAT) and the plasticity of fat tissue, to induce the browning of white fat tissue (WAT), so increasing BAT activity provides an attractive option for the prevention and resolution of obesity. The aim of the present narrative review was to understand the relationship between diet, BAT, and obesity.

Methods And Study Design: PubMed and Embase databases were searched to identify eligible studies.

Results: Although cold exposure has long been known to be effective in the browning of WAT and activation of BAT, it is societally impractical for everyday body weight management aside from the tolerance of ambient temperature. An alternative is to identify specific dietary components with similar effects to cold exposure on BAT. Current evidence indicates that capsaicin and capsinoids, catechins, curcumin, quercetin, berberine, lipoic acid, polyunsaturated fatty acids, royal jelly, and some natural sweeteners are effective promoters of WAT browning, increase BAT activity and improve obesity related traits. However, only capsaicin, capsinoids, and catechins have demonstrated efficacy in clinical trials. Evidence for effects of curcumin, quercetin, berberine, lipoic acid, polyunsaturated fatty acids, royal jelly and natural sweeteners on BAT have only been observed in animal or in vitro studies, with clinical trials awaited for verification.

Conclusions: Several dietary components can induce WAT browning and activate BAT, offering potential targets for obesity prevention and management.
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http://dx.doi.org/10.6133/apjcn.202012_29(4).0001DOI Listing
November 2021

Dietary patterns and anemia morphology in young men and women in Shandong province, China.

Asia Pac J Clin Nutr 2020 ;29(3):513-522

Institute of Nutrition and Health, Qingdao University, Qingdao, China. Email:

Background And Objectives: The association between diet and macrocytic and hypochromic anemia in young Chinese men and women remains unclear. The present study aimed to investigate the relationship between dietary pattern and macrocytic and hypochromic microcytic anemia in young Chinese men and women.

Methods And Study Design: Some 4,840 first-year students (2,385 men and 2,455 women) were recruited for this study from Qingdao University, China. Biochemical and hematological parameters, and food frequency questionnaires were obtained from the subjects. Based on dietary intake, participants were divided into three dietary patterns: seafood dietary pattern (SDP), vegan dietary pattern (VDP) and omnivorous dietary pattern (ODP). The risks for macrocytic and microcytic hypochromic anemia in three dietary patterns were assessed.

Results: Macrocytic and hypochromic anemia were less common in participants who adhered to the omnivorous dietary pattern than to the vegan or seafood dietary patterns (p<0.05). Adhering to an omnivorous dietary pattern was negatively associated with macrocytic anemia in men [odds ratio (95% CI): 0.74 (0.62, 0.89), p<0.001] and microcytic, hypochromic anemia in both genders [men: odds ratio (95% CI): 0.64 (0.45, 0.92), p=0.01; women: odds ratio (95% CI): 0.71 (0.51, 0.99), p=0.04].

Conclusions: Adhering to an omnivorous dietary pattern was associated with less common macrocytic anemia in young men and microcytic, hypochromic anemia. Dietary diversity is important in preventing macrocytic anemia in men and also microcytic, hypochromic anemia in young men and women. Excessive alcohol intake is the most plausible explanation for macrocytosis in the young men.
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http://dx.doi.org/10.6133/apjcn.202009_29(3).0010DOI Listing
July 2021

Self-monitoring networks for personal and societal health: Dietary patterns, activities, blood pressure and Covid-19.

Authors:
Mark L Wahlqvist

Asia Pac J Clin Nutr 2020 ;29(3):446-449

Monash Asia institute, Monash University, Melbourne, Australia. Email:

The contributors to and consequences of disordered health are increasingly complex with sociodemographic, ecological, economic and food system change. But there are opportunities for any adversity to be mitigated by advances in the understanding of human, especially nutritional, ecobiology and in its more accessible and affordable evaluation and monitoring. Viral pandemics are on the rise with climate change and loss of ecosystems. They threaten human civilisation and planetary habitability. Human security is dependent on sustainable livelihoods of which food and water systems are a vital part. We are socioecological beings and depend for our health on biodiversity and the food diversity that ensures; and on connectedness and communication, made more difficult in pandemics. Rapid and accessible point-of-care (POC) tools are now becoming available to compliment other selfmonitoring network approaches, whether checklist or questionnaire, physical, chemical, or biological, for healthcare and nutritional health. They can provide information as several complimentary and interdependent health indices to facilitate personal, group and community action and management plans. This applies to indices of both communicable and non-communicable disease which problems separately and together are compromising health prospects. These indices include ones of physical and mental activities, dietary patterns, metabolites, blood pressure and now the presence and severity of viruses like Covid-19.Of imminent relevance and promise are optically- readable biosensor based strips for nasal, pharyngeal or salivary samples to check viral presence or finger prick blood for immunoglobulins and interleukins. These should allow less socially prohibitive measures to curb viral transmission and promote personal and societal wellbeing.
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http://dx.doi.org/10.6133/apjcn.202009_29(3).0001DOI Listing
October 2020

Covid-19 and dietary socioecology: Risk minimisation.

Asia Pac J Clin Nutr 2020 ;29(2):207-219

Monash Asia institute, Monash University, Melbourne, Australia. Email:

Pandemics have shaped humanity over and over again, but the coronavirus outbreak of 2019-2020 is in a world at the tipping point of catastrophic climate change. Its origins and distinction derive from over-population with inequity and an industrial revolution since the 17th century which has exploited fossil fuels as a globalised energy source, a period now described as the anthropocene. Asymptotic ecosystem loss and dysfunction, for people whose being is socioecological, makes ultimate survival tenuous. Microbial forms of life jump species when habitats are destroyed, or their host misused. Our innate immunity depends on our general health and fitness- social, mental, physical, and nutritional, in step with nature and its rhythms through walking in it, enjoying sunlight and sleep. Biodiversity and the associated benefit of food variety, after being breast-fed, is the key descriptor of a healthful, sustainable, accessible, and acceptable way of eating. How this pattern might contribute to our resilience in the face of a highly transmissible and biologically evasive virus is becoming clear. It may also be possible to compliment usefully preventive vaccination and therapeutic healthcare and rehabilitation through a greater understanding of our nutritional biology.
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http://dx.doi.org/10.6133/apjcn.202007_29(2).0001DOI Listing
July 2020

Imagining a habitable planet through food and health.

Authors:
Mark L Wahlqvist

Eur J Clin Nutr 2021 02 17;75(2):219-229. Epub 2020 Jun 17.

Monash Asia Institute, Monash University, Melbourne, VIC, Australia.

Background And Objectives: Whether and how it might be possible to imagine a habitable planet through food and health.

Methods: Reflection on childhood happenstances, sociodemographic circumstances, educational opportunities, persons of influence and lifetime experiences insofar as they might have shaped a view of the past, present and future world as the sole rational home of us all. Confirmation of these notions by personal, kindred, and other contemporary records and publications.

Results: The need to live with uncertainty and an appreciation of connectedness with things animate and inanimate; and for this to be belief, identity, reason and professional imprimatur. That these things have unwittingly informed a near lifetime of interest and enthusiasm for how food and health systems are best served by socioecological approaches.

Conclusions: That we are socioecological beings with a destiny dependent on reconciling ourselves, as earthlings, as to how well we keep our place in the cosmos habitable. To that end we must dream and work.
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http://dx.doi.org/10.1038/s41430-020-0672-xDOI Listing
February 2021

Regulobiosis: A regulatory and food system-sensitive role for fungal symbionts in human evolution and ecobiology.

Asia Pac J Clin Nutr 2020 ;29(1):9-15

Institute of Nutrition and Health, Qingdao University, Qingdao, China.

The role of microbiomes in human biology and health are being extensively investigated, yet how the fungal community or mycobiome contributes to an integral microbiome is unclear and probably underestimated. We review the roles of fungi from the perspectives of their functionality in human biology, their cross-kingdom talk with other human microbial organisms, their dependence on diet and their involvement in human health and diseases. We hypothesize that members of the fungal community may interact as necessary symbionts with members of other human microbiome communities, and play a key role in human biology, yet to be fully understood. We propose further that "regulobiosis", whereby fungi play a regulatory role in human ecobiology, is operative in humans as probably obtains in other forms of life. Fungally-dependent regulobiosis would characterise, at first, microbiomes which include, but are not limited to, bacteria, archaea, and viruses; then, their human host; and, next, provide ecological connectedness.
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http://dx.doi.org/10.6133/apjcn.202003_29(1).0002DOI Listing
January 2021

Benefit risk and cost ratios in sustainable food and health policy: Changing and challenging trajectories.

Authors:
Mark L Wahlqvist

Asia Pac J Clin Nutr 2020 ;29(1):1-8

Monash Asia institute, Monash University, Melbourne, Australia. Email:

There is benefit, risk and cost in all that we do, but when it comes to food, we expect that it will benefit our health, be available, safe to eat and affordable. But as climate change and demographic shifts through displacement and ageing gather momentum, the emphases on each of benefit, risk and cost will alter. That we are ecological beings whose health and wellbeing are ecosystem-dependent, must now be the underpinning framework for risk management. Loss of natural environment and biodiversity represents reduced nutritional and health resilience, which will need to be factored in to risk assessment and management with climate change. This is proving a problematic risk communication challenge. Previously desirable food and food pattern recommendations will be tempered by substantial sustainability, availability, safety, affordability, equity and ethical considerations. Future workforces will need to ensure basic livelihoods (food, water, shelter, clothing, healthcare, education, communication, essential transport, resource management and effective governance) and with risk minimisation. Cost appraisal will have less to do with monetisation and more to do with resource management in accordance with equity and ethical principles. Communities could adopt Liveability Units (LU) for traceability and community-based transactions, as a currency for a more sustainable future, encouraging and enabling food and health system viability. Open source food and health systems, supported by LU matrix (bar code or QR) scanning with smartphones could be widely available for individual, household and community benefit, risk and cost management. The risk is remoteness from food's origins and megadata commercialisation.
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http://dx.doi.org/10.6133/apjcn.202003_29(1).0001DOI Listing
January 2021

Dietary diversity offsets the adverse mortality risk among older indigenous Taiwanese.

Asia Pac J Clin Nutr 2019 ;28(3):593-600

School of Public Health, National Defense Medical Center, Taipei, Taiwan, ROC.

Background And Objectives: The extent to which health and survival inequality between indigenous and nonindigenous older Taiwanese is associated with diet is uncertain.

Methods And Study Design: Participants from the Elderly Nutrition and Health Survey in Taiwan (1999-2000) formed this cohort. Dietary information was collected by 24-hr recall and simplified food frequency questionnaire. Dietary quality was assessed by dietary diversity score (DDS, 0-6). Annual medical service utilization and expenditure were derived from National Health Insurance claims until 2006. Survivorship was ascertained from the National Death Registry until 2008. Cox proportional- hazards models were used to determine the association between aboriginality and mortality in conjunction with dietary diversity.

Results: Indigenes (n=156) compared with nonindigenes (n=1182) significantly differed in socio-demography, behaviors and chronic disease prevalences. For up to 8 years, indigenes had a higher mortality rate (46.2% vs 33.6%, p=0.003). Indigenes' nutrient intakes were less for polyunsaturated fat, dietary fiber, vitamins and minerals (but more sodium); food intakes more for meat, with less cooking oil, dairy products and fruits; and a lower DDS, (3.61 vs 4.54). They had a 41% higher mortality risk (HR: 1.41, 95% CI: 1.09-1.81, p=0.008). Control for demographic variables did not change the findings. However, the increase in HR was substantially attenuated by the inclusion of DDS (HR: 1.15, 95% CI: 0.88-1.49, p=0.316). There was no significant interaction between aboriginality and DDS on mortality (p=0.673).

Conclusions: Older indigenous Taiwanese have a higher mortality risk than their majority counterparts. Irrespective of aboriginality, the more diverse diet is associated with a lower risk of mortality.
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http://dx.doi.org/10.6133/apjcn.201909_28(3).0019DOI Listing
February 2020

Addressing nutritional requirements of ageing consumers in Asia-recommendations from an expert workshop.

Asia Pac J Clin Nutr 2019 ;28(2):204-213

Division of Human Nutrition and Health, Wageningen University, The Netherlands.

The number of older persons in Asia is expected to triple by 2050. Ageing is associated with non-communicable chronic diseases, malnutrition, and geriatric syndromes, which influences the burden on the cost related to healthcare, health outcomes, and the quality of life. Experts in the field of older adult nutrition from Asia, Australia, and Europe were invited to participate in a two-day workshop to review the available data, current policies and programs for the ageing population in different countries of Asia to identify the gaps in knowledge and to develop recommendations for action. In Asia, most of the data pertaining to health status, nutritional status, and nutrient intake of the older persons were mainly obtained by conducting studies in nursing homes or hospitals and small cohort studies. There were limited country-specific data on this population. Moreover, the available data pertaining to different countries were difficult to compare due to differences in the reporting format and reference values used. Although nutrition initiatives and policies were realized and public education was conducted to support the older persons, most of these efforts targeted the general population rather than the older persons population segment. In healthcare management, a higher amount of education is required pertaining to the knowledge of nutritional requirements and appropriate feeding of the older persons to reduce underfeeding and its consequences. The expert group recommended the use of a systematic approach for reviewing data pertaining to different countries, initiatives, and programs to further evaluate the available data to underpin future research.
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http://dx.doi.org/10.6133/apjcn.201906_28(2).0001DOI Listing
January 2020

Advances in n-3 polyunsaturated fatty acid nutrition.

Asia Pac J Clin Nutr 2019 ;28(1):1-5

Department of Nutrition, Dietetics and Food, Monash University, Melbourne, Australia.

There is conclusive evidence to demonstrate the role of omega-3 polyunsaturated fatty acids (n-3 PUFA) in human development and growth, vision, and cell membrane fluidity (membrane order). N-3 PUFA also contribute to human health maintenance through correction of arrhythmias, inhibition of platelet aggregation and prolongation of clotting time, lowering blood pressure, lowering serum triglycerides and plasma homocysteine, being antiinflammatory and immunomodulatory, being cardio-protective, increasing insulin sensitivity in Asians, and decreasing the risk of breast and colorectal cancers. This understanding of a wide spectrum of biological effects attributable to n-3 PUFA has been unsettled by a systematic review of randomized clinical intervention trials (RCTs) which has reported that n-3 PUFA have negligible or no effect on all-cause or cardiovascular mortality. Here, possible reasons for the inconsistencies in regard to n-3 PUFA and cardiovascular diseases, along with the implications for their broader biology, are considered.
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http://dx.doi.org/10.6133/apjcn.201903_28(1).0001DOI Listing
August 2019

Maternal contributors to intergenerational nutrition, health, and well-being: revisiting the Tanjungsari Cohort Study for effective policy and action in Indonesia.

Asia Pac J Clin Nutr 2019;28(Suppl 1):S1-S16

Monash Asia Institute, Monash University, Melbourne, Australia.

Perinatal and maternal mortalities in Java became of concern in the 1980s. Since some 90% of births took place at home, the Tanjungsari (TS) district of West Java was identfied as a locality where community-based risk management strategy might reduce this health burden. In 1987, traditional birth attendants (TBA) were trained to identify risk factors for unfavourable birth outcomes. From January 1st 1988 to December 1989, some 4,000 pregnant women in TS were followed and assigned either a trained or untrained TBA. In the first year, early neonatal, and maternal mortality rates (MMR) (32.9 per 1000 and 170 per 100,000 deliveries respectively) were reduced, but not sustained in the second year. Nationally, MMR was 446 in 2009 and 126 in 2015. Although possible to improve health worker performance, and community engagement, the most likely explanation for benefit attrition is that people and material resources 'downstream' of the TBA services were inadequate. Three decades later, Indonesian neonatal and maternal mortality rates of 14 per 1000 and 126 per 100,000 live births in 2015 (globally 16.2 in 2009 and 216 in 2015) according to UNICEF, still demanded improvement, despite more hospital-based births. The original 1988 cohort of women, their children and grandchildren, can now be interrogated for medium to long term health outcomes of nutritional, such as birth weight and growth, and other risk factors. The evolving TS cohort health and nutrition intermediates and endpoints are instructive. Maternal and early life factors predict adult energy metabolism and cognitive function.
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http://dx.doi.org/10.6133/apjcn.201901_28(S1).0001DOI Listing
November 2019

Characterization of polyphenols in Australian sweet lupin (Lupinus angustifolius) seed coat by HPLC-DAD-ESI-MS/MS.

Food Res Int 2019 02 28;116:1153-1162. Epub 2018 Sep 28.

School of Molecular and Life Sciences, Faculty of Science and Engineering, Curtin Health Innovation Research Institute, Curtin University, Bentley, Western Australia 6102, Australia. Electronic address:

Seeds of the legume lupin (Lupinus spp.) are becoming increasingly important as human food. The seed coat, at ~25% of the whole seed of Lupinus angustifolius (Australian sweet lupin, ASL), is the main by-product of lupin kernel flour production. The primary market for lupin seed coat is low value feed with very limited use in foods. In this study, seed coats of six ASL commercial varieties from two growing sites were sampled for identification and quantification of polyphenols using a high-performance liquid chromatography (HPLC) with diode array detector (DAD) and coupled with a triple quadrupole mass spectrometer which equipped with electrospray ionization source (ESI-MS/MS). Three flavones (apigenin-7-O-β-apiofuranosyl-6,8-di-C-β-glucopyranoside, vicenin 2, and apigenin-7-O-β-glucopyranoside), one isoflavone (genistein) and one dihydroflavonol derivative (aromadendrin-6-C-β-d-glucopyranosyl-7-O-[β-D-apiofuranosyl-(1 → 2)]-O-β-D-glucopyranoside), and several hydroxybenzoic and hydroxycinnamic acid derivatives were identified. Considerable variations in levels of individual polyphenols were found but apigenin-7-O-β-apiofuranosyl-6,8-di-C-β-glucopyranoside was the predominant polyphenol in all samples accounting for 73.08-82.89% of the total free polyphenols. These results suggest that ASL seed coat could be valuable dietary source of polyphenols.
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http://dx.doi.org/10.1016/j.foodres.2018.09.061DOI Listing
February 2019

Secular trend towards ultra-processed food consumption and expenditure compromises dietary quality among Taiwanese adolescents.

Food Nutr Res 2018 17;62. Epub 2018 Sep 17.

School of Public Health, National Defense Medical Center, Taipei, Taiwan.

Objective: To compare two Nutrition and Health Surveys in Taiwan (NAHSITs) 15-18 years apart to evaluate secular changes in ultra-processed food (UPF) consumption and expenditure among Taiwanese adolescents aged 16-18 years and the influences of such changes on dietary quality.

Design: This cross-sectional study was based on two representative surveys (NAHSIT 1993-1996, = 788; NAHSIT 2011, = 1,274) of senior high school students. Dietary information and food expenditure were based on 24-h dietary recall. All food items were classified into original foods, processed culinary ingredients, processed foods, and UPFs based on NOVA criteria. Dietary quality was categorized as poor or good based on the mean of the Youth Healthy Eating Index-Taiwan Revised.

Results: Compared to 1993-1996, adolescents consumed less energy from original foods (55 vs. 39%) but more from processed foods (12 vs. 18%) and UPFs (21 vs. 25%) in 2011, with no apparent gender differences. Those who consumed more UPFs had the lowest proportions of protein energy intake in both surveys (13.7 and 13.1%). Those who consumed more UPFs had higher levels of saturated fat and lower levels of monounsaturated and polyunsaturated fat, dietary fiber, and micronutrient intakes. The participants who consumed more UPFs and fewer original foods exhibited poorer dietary quality. Boys and girls exhibited equal UPF expenditure in both surveys despite an increase in UPF energy consumption. The adjusted odds ratios (95% confidence interval) were 1.33 (1.16-1.52) and 1.36 (1.10-1.69) for the risk of poor dietary quality with 10% increases in UPF energy intake and expenditure, respectively, in 2011.

Conclusions: UPF energy consumption among Taiwanese adolescents increased between 1993-1996 and 2011. Observed trends in expenditure suggest that lower UPF costs influenced food choices during this period. Increasing UPF intake and expenditure was associated with poor dietary quality.
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http://dx.doi.org/10.29219/fnr.v62.1565DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6150927PMC
September 2018

A non-invasive modifiable Healthy Ageing Nutrition Index (HANI) predicts longevity in free-living older Taiwanese.

Sci Rep 2018 05 8;8(1):7113. Epub 2018 May 8.

Graduate Institute of Life Sciences, National Defense Medical Center, 161 Minchuan East Road, Sec. 6, Taipei, 11490, Taiwan, ROC.

Nutritional factors contributing to disability and mortality are modifiable in later life. Indices would add utility. We developed a gender-specific Healthy Ageing Nutrition Index (HANI) for all-cause mortality in free-living elderly. We stratified 1898 participants aged ≥65 y from the 1999-2000 Nutrition and Health Survey in Taiwan by region and randomly allocated them into development and validation sets. Linkage to the National Death Registry database until December 31, 2008 enabled mortality prediction using Cox proportional-hazards models. Four factors (appetite, eating with others, dietary diversity score, and BMI) with best total of 25 HANI points for men; and 3 factors (cooking frequency, dietary diversity score, and BMI) with best total of 27 HANI points for women, were developed. In the validation set, the highest HANI group exhibited a greater intake of plant-derived food and associated nutrients, a favourable quality of life, and more muscle mass, compared with the lowest group. The highest HANI group predicts mortality risk lower by 44 percent in men and 61 percent in women. Adjusted mortality HRs were comparable between sets. HANI is a simple, non-invasive, inexpensive, and potentially modifiable tool for nutrition monitoring and survival prediction for older adults, superior to its individual components.
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http://dx.doi.org/10.1038/s41598-018-24625-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5940774PMC
May 2018

Dietary quality linkage to overall competence at school and emotional disturbance in representative Taiwanese young adolescents: dependence on gender, parental characteristics and personal behaviors.

Nutr J 2018 02 22;17(1):29. Epub 2018 Feb 22.

Division of Preventive Medicine and Health Services Research, Institute of Population Health Sciences, National Health Research Institutes, 35 Keyan Road, Zhunan Town, Miaoli County, 350, Taiwan, Republic of China.

Background: Child school performance during puberty may be at increased risk through emotional disturbance. It is hypothesized that this may be mitigated by dietary quality.

Methods: In a nationally representative sample (Nutrition and Health Survey in Taiwan, NAHSIT), 1371 Taiwanese aged 11-16 years, overall competence at school, (OCS) and emotional status have been assessed by teachers with the SAED (Scale for Assessing Emotional Disturbance). Parents provided family socio-demographics and students completed a behavioral and dietary questionnaire (Youth Healthy Eating Index - Taiwan, YHEI-TW). Associations between emotional disturbance (ED), OCS and dietary quality (YHEI-TW) were assessed in multiple linear regression models with adjustments for covariates including parental characteristics, personal behaviors, body fatness and puberty.

Results: Boys or girls with ED had a less favorable OCS (p < 0.001), minimally dependent on YHEI-TW. On multivariable analysis there was a more positive association between OCS and YHEI-TW among boys (β = 0.05, p < 0.01) and girls (β = 0.07, p < 0.001). Poor dietary quality was associated with ED, especially in girls (β =  - 0.06, p < 0.001). Additionally, parental characteristics, body fatness, and personal behaviors are associated with OCS. Puberty is associated with ED and may be indirectly linked to OCS.

Conclusions: Unsatisfactory food intake is associated with the link between emotional disturbance and impaired school performance, as assessed by OCS, especially among girls. For both genders, socio-economic and behavioral factors including parenteral income, reading, screen viewing and smoking are modulators of this association. Puberty was a modifying factor in girls. Dietary quality is a relevant factor for health (ED) as well as education (OCS) during early adolescence.
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http://dx.doi.org/10.1186/s12937-018-0333-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5822521PMC
February 2018

Cardiometabolic disorder reduces survival prospects more than suboptimal body mass index irrespective of age or gender: a longitudinal study of 377,929 adults in Taiwan.

BMC Public Health 2018 02 14;18(1):142. Epub 2018 Feb 14.

Institute of Population Health Sciences, National Health Research Institutes, 35 Keyan Road, Zhunan, Miaoli County, Taiwan.

Background: The effect of cardio-metabolic profile on the relationship of body mass index (BMI) with mortality is unclear. The aim of this study was to explore association between BMI and mortality at all ages, taking account of cardio-metabolic disorders.

Methods: We followed 377,929 individuals (≥ 20 years), who registered for health checkups in 1996-2007, until 2008 and found 9490 deaths. From multivariable Cox proportional hazards models we estimated mortality hazard ratios (HR) for those in high blood pressure, hyperglycemia, high waist circumference, dyslipidemia, and different BMIs categories (the underweight [< 18.5 kg/m], low normal weight [18.5-21.9 kg/m], normal weight [22-23.9 kg/m, the referent], overweight [24-26.9 kg/m], obese1 [27-29.9 kg/m], and obese2 [≥ 30 kg/m]). Population attributable risk (PAR) provided estimates of the population mortality burden attributable to high blood pressure, hyperglycemia, high waist circumference, dyslipidemia, and deviant BMIs.

Results: Higher blood pressure, hyperglycemia, high waist circumference, and dyslipidemia were significantly predictive of higher mortality for nearly all ages. Compared with the referent BMI, underweight (HR = 1.69, 95% confidence interval = 1.51-1.90) and low normal weight (HR = 1.19, 1.11-1.28) were significant mortality risks, while overweight (HR = 0.82, 0.76-0.89) and obese1 (HR = 0.88, 0.79-0.97) were protective against premature death. The mortality impact of obesity was largely attributable to cardio-metabolic profile and attenuated by age. The population mortality burden with high blood pressure (PAR = 7.29%), hyperglycemia (PAR = 5.15%), high waist circumference (PAR = 4.24%), and dyslipidemia (PAR = 5.66%) was similar to that in the underweight (PAR = 5.50%) or low normal weight (PAR = 6.04%) groups. Findings for non-smokers and by gender were similar.

Conclusions: The effect of BMI on mortality varies with age and is affected by cardio-metabolic status. Compared to any deviant BMI, abnormal cardio-metabolic status has a similar or even greater health impact at both the individual and population levels.
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http://dx.doi.org/10.1186/s12889-018-5038-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5812051PMC
February 2018

Gender differences in longevity in free-living older adults who eat-with-others: a prospective study in Taiwan.

BMJ Open 2017 09 18;7(9):e016575. Epub 2017 Sep 18.

Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan.

Objectives: Social activities such as 'eating-with-others' can positively affect the ageing process. We investigated the gender-specific association between eating arrangements and risk of all-cause mortality among free-living older adults.

Setting: A representative sample from the Elderly Nutrition and Health Survey in Taiwan during 1999-2000.

Participants: Some 1894 participants (955 men and 939 women) who aged ≥65 and completed eating arrangement question as well as confirmed survivorship information.

Primary And Secondary Outcome Measures: Eating arrangements, health condition and 24-hour dietary recall information were collected at baseline. We classified eating arrangements as the daily frequency of eating-with-others (0-3). Survivorship was determined by the National Death Registry until the end of 2008. Cox proportional-hazards regression was used to assess the association between eating-with-others and mortality risk.

Results: Overall, 63.1% of men and 56.4% of women ate with others three times a day. Both men and women who ate with others were more likely to have higher meat and vegetable intakes and greater dietary quality than those who ate alone. The HRs (95% CI) for all-cause mortality when eating-with-others two and three times per day were 0.42 (0.28 to 0.61), 0.67 (0.52 to 0.88) in men and 0.68 (0.42 to 1.11), 0.86 (0.64 to 1.16) in women, compared with those who ate alone. Multivariable HRs (95% CI) adjusted for sociodemographic, nutritional and 'activities of daily living' covariates were 0.43 (0.25 to 0.73), 0.63 (0.41 to 0.98) in men and 0.68 (0.35 to 1.30), 0.69 (0.39 to 1.21) in women. With further adjustment for financial status, HR was reduced by 54% in men who ate with others two times a day. Pathway analysis shows this to be dependent on improved dietary quality by eating-with-others.

Conclusions: Eating-with-others is an independent survival factor in older men. Providing a social environment which encourages eating-with-others may benefit survival of older people, especially for men.
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http://dx.doi.org/10.1136/bmjopen-2017-016575DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5623554PMC
September 2017

Fitness and food environments around junior high schools in Taiwan and their association with body composition: Gender differences for recreational, reading, food and beverage exposures.

PLoS One 2017 3;12(8):e0182517. Epub 2017 Aug 3.

Division of Preventive Medicine and Health Services Research, Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan, ROC.

School environments may contribute to adolescent behavior, reproductive physiology and body composition (BC). The Nutritional and Health Survey in Taiwan (2010) for 1458 junior high school students was geo-mapped for 30 school environs. Facilities for physical activity (fitness centers, gymnasia and sports stadiums, activity centers and parks), sedentary activities (reading material rental shops (RMRS), internet cafes) and food and beverage outlets (FBOs) were calculated as weighted numbers within 1000m of schools. Multiple linear regressions were used to predict BC variable z-scores. For boys, higher fitness center densities and, for girls, gymnasia and sports stadiums were associated with less abdominal fatness. For girls, body mass index, waist circumference (WC) and triceps skinfold thickness (TSF) were greater when RMRS density was higher as was TSF with internet café density. Where there were no FBOs, boys' WC and TSF were less with more parks, but girls were shorter and WC more adverse. With greater RMRS density and no FBOs, girls still had increased WC/Hip ratio, and less mid-arm muscle circumference. Boys' findings were more evident after considering puberty. Physical activity facilities (differently by gender), food and beverage outlets absence for boys and low reading material rental shop density for girls increase the likelihood of healthier body composition.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0182517PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5728346PMC
August 2017

The Clinical Nutrition Research Agenda in Indonesia and beyond: ecological strategy for food in health care delivery.

Asia Pac J Clin Nutr 2017 Jun;26(Suppl 1):S1-S8

Monash Asia Institute, Monash University, Melbourne, Australia.

Despite progress with the food-associated health agenda in the public health and clinical domains, much remains to be done in Indonesia. There are reasons to be optimistic which include economic development, increasing literacy, progress towards universal health coverage and community organizational arrangements across the archipelago which focus on health through some 10,000 puskesmas. These community health centres are variably staffed with voluntary cadres from the community, bidans (nurses) and general medical practitioners. For more effective prevention and management of nutritionally-related health problems, innovative community and clinical nutrition research and expertise is required. With rapid urbanisation, the growth of the digital economy, increasing socio-economic inequity and climate change, there are imperatives for ecologically sustainable, nonemployment dependent livelihoods which provide energy, food, water, education and health care security. A relevant health care workforce will include those who research and practice clinical nutrition. Here we gather together an account of an extensive body of published and emerging literature which makes a case collectively for a more ecological approach to nutrition and health and how it might revitalise the Indonesian and other health care systems.
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http://dx.doi.org/10.6133/apjcn.062017.s12DOI Listing
June 2017

High Ratios of C20:4n-6/C20:5n-3 and Thromboxane B /6-Keto-Prostaglandin F in Placenta Are Potential Risk Contributors for Neural Tube Defects: A Case-Control Study in Shanxi Province, China.

Birth Defects Res 2017 May 24;109(8):550-563. Epub 2017 Mar 24.

Department of Food Science and Nutrition, Zhejiang University, Hangzhou, China.

Background: Neural tube defects (NTDs) are severe congenital malformations. Folate supplementation can reduce the risk, but cannot prevent all NTDs, suggesting other reasons for folate-resistant NTDs. The present study assesses placental fatty acid composition, eicosanoids, and cytokines as risk factors for NTDs in a Chinese population with highly incident NTDs.

Methods: Seventy-seven aborted fetuses with NTDs during the third trimester were cases and 142 healthy newborns were controls. Placental fatty acid composition, eicosanoids, and cytokines were determined by standard methods.

Results: The placental C20:4n-6/C20:5n-3 and thromboxane B (TXB )/6-keto-prostaglandin F (6-keto-PGF ) ratios were significantly higher for cases than controls (p < 0.001 and 0.05, respectively). For the top versus the lowest tertiles of placental C20:4n-6/C20:5n-3 and TXB /6-keto-PGF , odds ratios for NTD occurrence were 3.79 (95% confidence interval, 1.60-8.96) (p for trend < 0.01) and 5.52 (95% confidence interval, 2.07-14.74) (p for trend < 0.001), respectively, adjusted for fetal sex as well as maternal age, occupation, parity, smoking, passive smoking, periconceptional folate supplementation, conception season, and tea drinking. The C20:4n-6/C20:5n-3 and TXB /6-keto-PGF ratios were positively correlated (r = 0.14; p < 0.05). The proportions of C18:2n-6, C18:3n-6, C20:3n-6, C18:3n-3, C20:3n-3, C20:5n-3, and C22:5n-3 were significantly lower in cases than controls, and all negatively associated with NTD occurrence (tertile-specific odds ratios); after adjustment for the potential confounders, these associations remained significant (p for trend < 0.05) except for C20:3n-3.

Conclusion: High placental ratios of C20:4n-6/C20:5n-3 and TXB /6-keto-PGF are risk factors for neural tube defects.Birth Defects Research 109:550-563, 2017.© 2017 Wiley Periodicals, Inc.
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http://dx.doi.org/10.1002/bdr2.1003DOI Listing
May 2017

Medical costs of a low skeletal muscle mass are modulated by dietary diversity and physical activity in community-dwelling older Taiwanese: a longitudinal study.

Int J Behav Nutr Phys Act 2017 03 14;14(1):31. Epub 2017 Mar 14.

School of Public Health, National Defense Medical Center, 161 Minchuan East Road, Sec. 6, Taipei, 11490, Taiwan, Republic of China.

Background: Age-related loss of skeletal muscle mass (SMM) and function (sarcopenia) are associated with poor health outcomes and an economic burden on health care services. An appropriate diet and physical activity have been proposed for prevention and treatment of sarcopenia. Nevertheless, the effects on medical service utilization and costs remain unclear. This study determined the effects of SMM in conjunction with diet quality and physical activity on medical service utilization and expenditure in community-dwelling older Taiwanese.

Methods: In total, 1337 participants from the Elderly Nutrition and Health Survey in Taiwan (1999-2000) were enrolled. An SMM index [SMMI, calculated by dividing SMM (kg) by height (m)] was used as the marker of sarcopenia. Participants with the lowest SMMI quartiles (<11.4 kg/m for men and 8.50 kg/m for women) comprised the high-risk group, and the remainder comprised the low-risk group. Dietary information (dietary diversity: low and high) and physical activity (low and moderate) were obtained at baseline. Annual medical service utilization and expenditure were calculated from National Health Insurance claims until December 31, 2006. Generalized linear models were used to determine the association between the SMMI and annual medical service utilization and costs in conjunction with dietary diversity or physical activity.

Results: After 8 follow-up years, regardless of gender, participants in the high-risk group reported significantly more hospitalization (days and expenditure) and total medical expenditure. Participants in the high-risk group who had low dietary diversity made fewer annual outpatient (14%), preventive care (19%), and dental (40%) visits, but exhibited longer hospitalization (102%) than did those who had a low SMMI and high dietary diversity. Similar patterns were observed in the corresponding medical expenditures. The findings were similar when considering physical activity. Being in the low-risk group in conjunction with having high dietary diversity or more physical activity was associated with the lowest annual adjusted mean hospitalization days with expenditure, and also total expenditure.

Conclusions: A lower SMMI was associated with more hospitalization days and costs. However, high dietary diversity and more physical activity can attenuate the effects of lower SMMI on medical service utilization and expenditure.
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http://dx.doi.org/10.1186/s12966-017-0487-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5348879PMC
March 2017

Neglecting legumes has compromised human health and sustainable food production.

Nat Plants 2016 08 2;2:16112. Epub 2016 Aug 2.

School of Plant Biology, Faculty of Science, The University of Western Australia, Perth, Western Australia 6009, Australia.

The United Nations declared 2016 as the International Year of Pulses (grain legumes) under the banner 'nutritious seeds for a sustainable future'. A second green revolution is required to ensure food and nutritional security in the face of global climate change. Grain legumes provide an unparalleled solution to this problem because of their inherent capacity for symbiotic atmospheric nitrogen fixation, which provides economically sustainable advantages for farming. In addition, a legume-rich diet has health benefits for humans and livestock alike. However, grain legumes form only a minor part of most current human diets, and legume crops are greatly under-used. Food security and soil fertility could be significantly improved by greater grain legume usage and increased improvement of a range of grain legumes. The current lack of coordinated focus on grain legumes has compromised human health, nutritional security and sustainable food production.
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http://dx.doi.org/10.1038/nplants.2016.112DOI Listing
August 2016
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