• 期刊

Calcium Supplementation for 2 Years Improves Bone Mineral Accretion and Lean Body Mass in Chinese Adolescents

Objective: to study the effects of different doses of calcium intake on bone health and body composition in Chinese adolescents. Methods: a double-blind randomized controlled trial of calcium carbonate supplementation in 257 healthy adolescents aged 12-15 years old for 24 months. Subjects were randomly assigned to four groups receiving chewable calcium carbonate tablets providing elemental calcium at 63 mg/d, 354 mg/d, 660 mg/d, 966 mg/d, respectively. At the end of intervention, we reclassified 197 adolescents into 3 groups who had received actual doses of elemental calcium of 85 mg/d (Low dose), 230 mg/d (Medium dose) and 500 mg/d (High dose). We measured bone mineral content (BMC), bone mineral density (BMD) and body composition by dual-energy X-ray absorptiometry. Results: BMC and BMD of total body and lumbar spine were increased significantly in both males and females after intervention at all doses (p＜0.05). In males, after supplementation, total body BMC in the medium and high dose groups (2464 g and 2437 g, respectively) was significantly higher than that in the low dose group (2321 g) after adjusting for age, pubertal development, BMI, physical activity and energy intake; in addition, lean body mass in the medium and high dose groups (49.1 kg and 48.8 kg, respectively) was significantly higher than that in the low dose group (46.7 kg) (p＜0.05). There was no significant effect of calcium supplementation on bone mass or body composition in females. Conclusions: calcium supplementation more than 230 mg/d for two years can improve bone mineral accretion and lean body mass in Chinese male adolescents.

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Dairy Intake and Cognitive Health in Middle-Aged South Australians

背景：攝取低脂乳製品可能會降低肥胖、第二型糖尿病、高血壓以及所有與增加認知功能受損機會相關的心血管危險因子。目的：檢測乳製品的攝取與自述認知功能及心理安適之間的相關，並且檢定新的假說：乳製品的攝取經由它對於心血管代謝健康的正向效應可能會對認知功能有助益。方法：藉由年齡為39至65歲的432位男性與751位女性的飲食頻率問卷及自述健康狀況的資料進行回溯性橫斷分析。健康狀況的測量包括：心血管代謝健康狀況指標、認知及記憶功能、心理健康、焦慮、壓力、沮喪及自尊心等，藉由標準化的問卷來進行評估。結果：調整總熱量的攝取及其他健康干擾因子的迴歸分析結果顯示，在男性方面，攝取低脂優格與提昇記憶回想（p=0.029）以及較佳的社會功能（p=0.045）有關。在女性方面，攝取低脂乳酪與較佳的社會功能（p=0.021）及降低壓力（p=0.042）有相關。全脂乳製品的攝取，包括：冰淇淋以及鮮奶油，與增加沮喪、焦慮、壓力、認知功能受損、較差的記憶功能及整體健康有關（所有的p值皆小於0.05）。但心血管代謝健康狀況指標與乳製品的攝取則無關。結論：雖然全脂乳製品可能與較差的心理安適有關，但是低脂乳製品可能對社會功能、抗壓及記憶力是有助益的。需要飲食介入試驗來探討乳製品的攝取是否對認知功能與心理健康有直接的效應。

• 期刊

Correlates of Body Dissatisfaction among Taiwanese Adolescents

目的：本研究目的為探討臺灣青少年體型不滿意之相關因子。方法：研究參與者係來自臺灣臺北縣五所國民中學，共計883位學生，年齡介於12-16歲之間。透過自塡體重與身高計算身體質量指數（BMI），並使用外型描繪評分尺度（The Contour Drawing Rating Scale）以評估體型不滿意程度。其它測量工具尚包含多向度身體意象評價量表－外表評價分量表（The Multidimensional Body-Self Relations Questionnaire-Appearance Evaluation），Rosenberg自尊量表（The Rosenberg Self-esteem Scale），社會文化外表評價量表-內化及知覺分量表（Socio-cultural Attitudes Towards Appearance Questionnaire, [SATAQ]-Internalization and SATAQ-Awareness）以及身體活動測量。以性別分層方式，運用多元線性迴歸分析體型不滿意之相關因子。結果：女生在體型不滿意、社會文化理想外表之知覺及內化程度顯著高於男生，在多向度身體意象之外表評價得分顯著低於男生。該結果表示，相較於男生，女生對於自己的外表持較負面的態度，對於社會理想外表的認同度較高。男女生預測體型不滿意的顯著因子均為外表評價的滿意度、身體質量指數以及社會理想外表的內化程度。結論：本研究增加有關東方人體型不滿意程度的了解。在台灣及西方國家，外表評價的認知，身體質量指數以及社會理想外表的內化程度為預測體型不滿意的相關因子。然而，這些因子所能解釋男生體型不滿意的變異量並不高，有必要再深入探究男生體型不滿意的其他因子。

• 期刊

Health Ratings for Underweight, Overweight and Obese Adolescents: Disparities between Adolescent's Own Report and the Parent's Report

In many Asian countries, overweight and obese children are sometimes considered healthier than their underweight or normal weight counterparts. Using Taiwan as an example, this research aims to examine the relationship between inappropriate weight and self-rated health (SRH) for adolescents, and inappropriate weight and the parent's impression of their adolescent's general health. We analyzed data from 1,879 adolescents (933 boys and 946 girls) from the third year (2003) of a panel survey conducted by the Academia Sinica of Taiwan. Adolescents were identified as underweight, normal weight, overweight and obese using body mass index (BMI). Kappa statistic was used to determine agreements between adolescent's own report and their health as reported by their parent. Logistic regression was used to determine odds of reporting reduced health by adolescents with inappropriate weight. A separate regression was carried out using the parent's reports for these adolescents. We found that underweight boys were more likely to report reduced health (OR=2.15, p＜0.01). Overweight girls had lower odds of reporting reduced health compared with normal weight girls (OR=0.42, p＜0.01). Parents were more likely to report reduced health for underweight girls (OR=2.10, p＜0.01). For boys, parents were less likely to report reduced health for overweight boys compared with reports for normal weight subjects (OR=0.51, p＜0.01). Being underweight is associated with poor perceived health by both the adolescents and their parents. This contrasts with overweight and obesity, which are not. Health educational programs could help in adjusting perceptions concerning the health consequences associated with overweight and obesity.

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Rising Methods and Leavening Agents Used in the Production of Bread Do Not Impact the Glycaemic Index

本篇研究的目的是比較使用不同發酵方法及不同發酵劑所做出的麵包其升糖指數。依照不同生產方法選出11種麵包，並分配給3個試驗組，每組各10人；平均年齡為30.0 ± 10.7歲，平均BMI為22.9 ± 2.8。執行標準升糖指數的試驗，即隔夜禁食，以葡萄糖為參考食物，蒐集給食後兩個小時內的血液樣本。升糖指數的計算使用的是一般慣用的方法。此外，增加的曲線下面積以對數轉換，而升糖指數使用回歸分析來計算。各式麵包的平均升糖指數，以遞增方式的排序如下：瑞士黑麥™ 60、長燕麥68、酸麵糰加燕麥71、長黑麥76、短燕麥77、短全麥78、長全麥80、酸麵糰82、短黑麥82、酵母88、全麥發酵92。平均升糖指數有顯著差異的麵包如下：瑞士黑麥與酵母（p = 0.010）、瑞士黑麥與全麥發酵（p = 0.007）及酸麵糰加燕麥與全麥發酵（p = 0.043）。本篇研究所使用的發酵方法和發酵劑對於測試用麵包的升糖指數並沒有影響。其他的因素，如增加麵包的密度、添加全穀類，可能對於要生產低升糖指數的麵包來說是必需的。

• 期刊

Milk Fortified with the Current Adequate Intake for Vitamin D (5μg) Increases Serum 25-Hydroxyvitamin D Compared to Control Milk but Is Not Sufficient to Prevent a Seasonal Decline in Young Women

Low vitamin D status in women of childbearing age may have implications for health. Vitamin D status of New Zealanders (NZ), based on low serum 25-hydroxyvitamin D (25OHD) is suboptimal. Vitamin D status may be improved with supplements and/or fortified foods. Recently an Adequate Intake (AI) for Australia and NZ was set at 5 μg/d vitamin D. We aimed to determine the effect of daily consumption of milk powder fortified with 5 μg vitamin D3 on serum 25OHD concentration over 12 wks. 73 non-pregnant women (18 - 47 y) living in Dunedin, NZ (46°S) were randomised to receive either unfortified (control) or fortified (5 μg vitamin D3) milk for 12 wks from January to April. Mean 25OHD was similar between groups at week 0 (control 74 vs 76 nmol/L) and fell significantly in both groups over the 12 weeks (control 53 nmol/L, fortified 65 nmol/L; p ＜ 0.001). After 12 wks the fortified milk group had a serum 25OHD 19% (95% CI; 7, 32%) higher (10 nmol/L) than the control group after adjusting for baseline levels (p ＜ 0.001). Daily consumption of fortified milk providing the current AI of 5 μg per day vitamin D3 for 12 weeks resulted in higher 25OHD concentrations than control milk. This dose was not sufficient to prevent the seasonal decline in 25OHD. This study suggests an AI of 5 μg may be inadequate for New Zealanders to allow for seasonal changes in sunlight exposure, and is unlikely sufficient for other populations with low sunlight exposure.

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Effect of β-hydroxy-β-methylbutyrate on Protein Metabolism in Bed-ridden Elderly Receiving Tube Feeding

營養不良與肌肉流失是護理之家老年臥床住民常見的情況。過去研究顯示，補充β-羥基-β-甲基丁酸鹽（HMB）可以避免數種代謝分解狀態下的肌肉流失。本研究目的為探討補充HMB對接受管灌飲食的護理之家老年臥床住民，身體組成與蛋白質代謝的影響。受試者隨機分為HMB組（39位，每天補充2 g）或控制組（40位），於補充14天前後進行人體測量，並收集血液與24小時尿液樣本；其中部分受試者（HMB組19位，控制組20位）繼續補充14天。控制身體質量指數（BMI）基準值後，14天或28天後體重與BMI改變量，在兩組間並無顯著差異；HMB組血液尿素氮14天後顯著降低，在控制組則無顯著改變；HMB組尿液尿素氮在14與28天後顯著降低，控制組則呈現增加的趨勢。控制BMI基準值後，血液尿素氮與尿液尿素氮的變化量在兩組間有顯著差異。本研究顯示，補充HMB 2至4週，可以減緩接受管灌飲食的護理之家老年臥床住民的肌肉損耗。

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Initiating BMI Prevalence Studies in Vietnamese Children: Changes in a Transitional Economy

背景：越南飲食型態與生活型態的快速改變，使得有必要注意越南孩童的體重、身高、身體質量指數的變化趨勢。目的：測定1992-2000年間的越南6-15歲學童的體重、身高及身體質量指數分層趨勢，參照其社經水平及城鄉差異。方法：使用越南居住標準調查（1992-1993）及全面營養調查（2000）的資料，為越南孩童的代表性樣本。身體質量指數的分層是使用國際肥胖特別工作組的準則，計算各資料庫及兩個資料庫匯總分析的孩童肥胖盛行率及趨勢。結果：在兩個調查間，孩童的平均體重、身高、身體質量指數有顯著的增加（各為2.1 kg、4 cm及0.28 kg/m^2）。身高增加的程度，鄉村的孩童大於都市的孩童；且身體質量指數的增加程度，鄉村的孩童小於都市孩童。結論：越南都市孩童過重的盛行率上升是個需要關注的問題，並需要經由政策上的改變來監控；而鄉村男孩體重過低的盛行率未改變也值得關注。需要一個整體國家的小學營養計畫來處理孩童的體重過低及過重的問題。

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Whole Blood Citrulline Concentrations in Newborns with Non-syndromic Oral Clefts-A Preliminary Report

瓜胺酸是食物中少量存在的胺基酸，只有葫蘆科的水果（例如西瓜等）以及樺樹的樹液除外，而這些都已被用來治療生殖系統失調數個世紀了。最近發表了一項關於瓜胺酸可能做為胚胎發育異常的生物標記的觀察，受到注意。我們的研究是調查新生兒的瓜胺酸濃度是否為顏面唇顎裂的潛在風險因子。由一項新生兒篩檢計劃中取得瓜胺酸濃度來進行回溯性分析。研究族群中包括52位有單純性唇裂伴隨有或無顎裂的小孩，107位無先天性異常的健康小孩作為對照組。全血瓜胺酸濃度是利用串聯式質譜儀進行測量。以瓜胺酸濃度的兩個切點，分成下列三個組別進行分析：（1）低濃度（小於8 μmol/L）（2）中等濃度（8－16 μmol/L）（3）高濃度（大於16 μmol/L）。低瓜胺酸濃度在先天性唇顎裂的小孩，比無異常的小孩更常見。對照組小孩具有高瓜胺酸濃度的比例為病例組的兩倍。本文研究結果，證實新生兒瓜胺酸濃度的狀態與先天性唇顎裂的危險性之間的可能關聯。呼籲需要此領域的進一步研究以及育齡婦女增加富含瓜胺酸的食物（或補充劑）攝取。

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Nutritional Status of the Iranian Children with Physical Disability: A Cross-Sectional Study

Background: Malnutrition can potentially prone a disabled child to further morbidities thus imposing further suffering to the affected child and his/her family. This is the first report on the nutritional status of physically disabled children from Iran. Methods: A total of 290 physically disabled children aged 6-12 years old, of both sexes, and from all specialized schools in Tehran, Meshed and Rasht were enrolled in a descriptive cross-sectional study. Dietary assessment was performed for disabled children using 24hr and food-frequency questionnaires. Weight and height were assessed and body mass index (BMI) was calculated for all subjects. Results: In disabled children, while the mean energy intake was more than 90% of the amount required, mean calcium and iron intakes were 75.8% and 58.7% of the corresponding required amounts. Despite absence of significant difference in energy and fat intake, the intakes of protein, calcium and riboflavin were significantly lower in girls than in boys. Z score of weight showed that over 40% of disabled girls and boys were underweight. Comparison with anthropometric data from other studies showed that low weight was more prevalent in disabled than in non-disabled children (p＜0.001). Moreover, both disabled boys and girls had significantly shorter statures than their nondisabled counterparts. Conclusions: Malnutrition (low weight and stunting) is quite prevalent among Iranian children with motor disabilities and it is more prevalent in girls than in boys. It seems that poor food composition is a more important contributing factor than total low calorie intake. These data warrants further studies.