Nutrition and the global risk for chronic diseases: the INTERHEALTH nutrition initiative. The INTERHEALTH Steering Committee

The influence of yoga-based programs on risk profiles in adults with type 2 diabetes mellitus: a systematic review

There is growing evidence that yoga may offer a safe and cost-effective intervention for Type 2 Diabetes mellitus (DM 2). However, systematic reviews are lacking. This article critically reviews the published literature regarding the effects of yoga-based programs on physiologic and anthropometric risk profiles and related clinical outcomes in adults with DM 2. We performed a comprehensive literature search using four computerized English and Indian scientific databases. The search was restricted to original studies (1970-2006) that evaluated the metabolic and clinical effects of yoga in adults with DM 2. Studies targeting clinical populations with cardiovascular disorders that included adults with comorbid DM were also evaluated. Data were extracted regarding study design, setting, target population, intervention, comparison group or condition, outcome assessment, data analysis and presentation, follow-up, and key results, and the quality of each study was evaluated according to specific predetermined criteria. We identified 25 eligible studies, including 15 uncontrolled trials, 6 non-randomized controlled trials and 4 randomized controlled trials (RCTs). Overall, these studies suggest beneficial changes in several risk indices, including glucose tolerance and insulin sensitivity, lipid profiles, anthropometric characteristics, blood pressure, oxidative stress, coagulation profiles, sympathetic activation and pulmonary function, as well as improvement in specific clinical outcomes. Yoga may improve risk profiles in adults with DM 2, and may have promise for the prevention and management of cardiovascular complications in this population. However, the limitations characterizing most studies preclude drawing firm conclusions. Additional high-quality RCTs are needed to confirm and further elucidate the effects of standardized yoga programs in populations with DM 2.

Predicting under- and overnutrition among women of reproductive age: a population-based study in central Java, Indonesia

OBJECTIVES

To evaluate changes over 1 year in weight and body mass index (BMI) among a population-based sample of non-pregnant women in Indonesia and to identify risk factors for developing under- and overnutrition.

DESIGN

Cross-sectional studies in 1996 and 1997 in the same population.

SETTING

Purworejo District, central Java, Indonesia.

SUBJECTS

Non-pregnant women (n = 4132) aged 15-49 years of age who participated in both 1996 and 1997. Based on BMI, women were classified as having chronic energy deficiency (CED), and as being either of normal weight or obese.

RESULTS

The mean height of the women was below the fifth percentile of international standards. In 1996, 16.2% had CED, 72.2% were normal and 11.6% were obese. In 1997, the corresponding figures were 14.4%, 71.2% and 14.3%, respectively, revealing a significant mean increase in weight and BMI. Among women classified as normal in 1996, 3.0% developed CED in 1997. Significant risk factors for developing CED were experiences of child deaths and non-use of contraceptives. Among women classified as normal in 1996, 5.3% developed obesity in 1997. Here, significant risk factors included most indicators of wealth as well as occupation.

CONCLUSIONS

The results should be important for future efforts to prevent CED and obesity in the general population; conditions which are both associated with health risks.

The use of cyclic voltammetry for the evaluation of antioxidant capacity

Low-molecular weight antioxidants (LMWAs) play a major role in protecting biological systems against reactive oxygen-derived species and reflect the antioxidant capacity of the system. Cyclic voltammetry (CV), shown to be convenient methodology, has been validated for quantitation of the LMWA capacity of blood plasma, tissue homogenates, and plant extracts. Analysis of the CV tracing yields the values of (i) the biological oxidation potential, E and E(1/2), which relate to the nature of the specific molecule(s); (ii) the intensity (Ia) of the anodic current; and (iii) the area of the anodic wave (S). Both Ia and S relate to the concentration of the molecule(s). LMWA components of human plasma and animal tissues were identified and further validated by reconstruction of the CV tracing and by high-performance liquid chromatography-electrochemical detection. To reflect the oxidative stress status, the use of an additional parameter, R, has been proposed. R represents the level (%) of oxidized ascorbate (compared with total ascorbate) and is measured by high-performance liquid chromatography-electrochemical detection. All these parameters were monitored in healthy human subjects as well as in chronic (diabetes mellitus) and acute care patients (subjected to total body irradiation before bone marrow transplantation). The electroanalytical methodologies presented here could be widely employed for rapid evaluation of the status of subjects (in health and disease) for monitoring of their response to treatment and/or nutritional supplementation as well as for screening of specific populations.

[Preventive nutritional services for the elderly]

Population aging is a global. These demographic transitions have brought about dramatic changes in the world's health needs and status. Chronic diseases of aging account for nearly half of population morbidity and mortality in the developing regions of the world 85% of deaths and disability in developed regions. Chronic diseases in the elderly is, in over 60%, associated with malnutrition. Malnutrition is one of the few preventable risk factors for chronic diseases. Carefully planned population-based nutrition interventions can lower risk malnutrition and thus for chronic diseases and as well as for their adverse outcomes. Nutrition interventions can also be used to reach particularly vulnerable segments of the population, such as extremely frail elders, to reduce the prevalence of nutrient deficiencies. Clearly, the prevention of nutrition-related problems in the population, including older persons, has important global health implications.

Place of birth and dietary intake in Ontario. I. Energy, fat, cholesterol, carbohydrate, fiber, and alcohol

BACKGROUND

The importance of dietary intake in the prevention of major health problems is acknowledged. Because of the impact of culture on food intake, this study investigated the relationship between place of birth and nutrient intake in Ontario, using data from the 1990 Ontario Health Survey.

METHODS

Adults (age = 18) were categorized as non-immigrants (born in Canada; n = 29,458) or immigrants (born outside of Canada, classified by countries of birth; n = 7,158). Energy, fat, cholesterol, carbohydrate, and fiber intakes were examined, as well as alcohol consumption during the previous week. A companion article describes results for protein and selected micronutrients. Multiple linear and logistic regression analyses investigated the association of place of birth with nutrient intakes, adjusting for sociodemographic factors and ethnicity.

RESULTS

Fat and carbohydrate intakes were strongly associated with place of birth, but cholesterol and fiber intakes were not. Immigrants, overall, were less likely than nonimmigrants to consume more fat (OR = 0.45, P < 0.0001), less carbohydrate (OR = 0.55, P < 0.0001), or more alcohol (OR = 0.64, P = 0.0004) than recommended. However, variations existed by country of birth.

CONCLUSIONS

Immigrants were generally more likely to meet recommendation for fat and carbohydrate intakes than were nonimmigrants. These healthy eating behaviors need to be reinforced as part of health promotion.

Why do we like fat?

Dietary choices are strongly influenced by the taste and texture of foods. Fats are responsible for the sensory properties of many foods and greatly contribute to eating pleasure. Although diets rich in fats tend to be more flavorful and varied, they also are high in energy. Because excessive fat consumption has been associated with higher rates of obesity and coronary heart disease, nutrition education efforts have focused on replacing dietary fats with grains, vegetables, and fruit. However, preference for high-fat foods appear to be a universal human trait, and in the absence of efficient physiologic mechanisms regulating fat intake, fat consumption appears to be determined simply by the amount of fat available in the food supply. Fat consumption at national levels is determined largely by economic variables such as urbanization or income. The question is whether these barriers can be surmounted by appropriate nutrition education and intervention programs.

The nutrition transition: new trends in the global diet

Analyses of economic and food availability data for 1962-1994 reveal a major shift in the structure of the global diet marked by an uncoupling of the classic relationship between incomes and fat intakes. Global availability of cheap vegetable oils and fats has resulted in greatly increased fat consumption among low-income nations. Consequently, the nutrition transition now occurs at lower levels of the gross national product than previously, and is accelerated further by high urbanization rates. Data from Asian nations, where diet structure is rapidly changing, suggest that diets higher in fats and sweeteners are also more diverse and more varied. Given that preferences for palatable diets are a universal human trait, fat consumption may be governed not by physiological mechanisms but by the amount of fat available in the food supply. Whereas economic development has led to improved food security and better health, adverse health effects of the nutrition transition include growing rates of childhood obesity. The implications of these trends are explored.