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Fulltext Parental body mass index is associated with adolescent overweight and obesity in Mashhad, Iran

Shafaghi K, Shariff ZM, Taib MN, Rahman HA, Mobarhan MG, Jabbari H

Asia Pac J Clin Nutr, 2014;23(2):225-31.
PMID: 24901091 DOI: 10.6133/apjcn.2014.23.2.11

OBJECTIVE: This cross-sectional study was carried out to determine the prevalence of overweight and obesity among secondary school children aged 12 to 14 years in the city of Mashhad, Iran and its association with parental body mass index.
METHODS: A total of 1189 secondary school children (579 males and 610 females) aged 12- 14 years old were selected through a stratified multistage random sampling. All adolescents were measured for weight and height. Household socio-demographic information and parental weight and height were self-reported by parents. Adolescents were classified as overweight or obese based on BMI-for age Z-score. Multivariable logistic Regression (MLR) determined the relationship between parental BMI and adolescent overweight and obesity.
RESULTS: The overall prevalence of overweight and obesity among secondary school children in Mashhad was 17.2% and 11.9%, respectively. A higher proportion of male (30.7%) than female (27.4%) children were overweight or obese. BMI of the children was significantly related to parental BMI (p<0.001), gender (p= 0.02), birth order (p<0.01), parents' education level (p<0.001), father's employment status (p<0.001), and family income (p<0.001). MLR showed that the father's BMI was significantly associated with male BMI (OR: 2.02) and female BMI (OR: 1.59), whereas the mother's BMI was significantly associated with female BMI only (OR: 0.514).
CONCLUSION: The high prevalence of overweight/obesity among the research population compared with previous studies in Iran could be related to the changing lifestyle of the population. The strong relationship with parental BMI was probably related to a combination of genetic and lifestyle factors. Strategies to address childhood obesity should consider the interaction of these factors.
Palm vitamin E and the healing of ethanol-induced gastric lesions

Ismail NM, Jaarin K, Ahmad A, Marzuki A, Ng WK, Gapor MT

Asia Pac J Clin Nutr, 1999 Dec;8(4):258-62.
PMID: 24394225

The main focus of the study was to examine the effect of palm vitamin E (a tocotrienol-enriched fraction of palm oil) on the healing of ethanol-induced gastric mucosal lesions. The study was divided into three sections.Study 1 determined the gastric content of vitamin E after dietary supplementation with palm vitamin E for 3 weeks. Seven rats were fed a normal diet and another 7 were fed a palm vitamin E-enriched diet (150 mg/kg food). The gastric content of vitamin E levels were higher in rats fed with a palm vitamin E-enriched diet (p<0.01). Study 2 determined the time-dependent effects of palm vitamin E on gastric lesions and gastric acidity postethanol administration. Two groups of rats were fed either a normal rat diet or a palm vitamin E-enriched diet (150 mg/kg food). After 3 weeks, the control and a treated group received a single intragastric dose of 100% ethanol. Assessment of gastric lesions after 1 week showed a lower gastric lesion index in the palm vitamin E group compared with the controls (p<0.05) but there was no difference in the gastric acid content after 1 week between the two groups. Study 3 determined the effects of palm vitamin E on the gastric tissue content of malondialdehyde (MDA), PGE2 and gastric acidity without ethanol administration. The MDA content was lower in the palm vitamin E-treated group (p<0.05). However, the gastric acid and PGE2 content in both groups did not differ. The findings suggest that feeding with a palm vitamin E-enriched diet (150 mg/kg food) for 3 weeks resulted in a significant concentration of vitamin E in the gastric tissue. It was concluded that palm vitamin E may promote the healing of ethanol-induced gastric lesions through minimizing the lipid preoccupation process in the gastric mucous.
Fulltext Palm olein oil produces less lipid peroxidation products than soya bean oil

Zaiton Z, Merican Z, Khalid BA, Mohamed JB, Baharom S

Asia Pac J Clin Nutr, 1997 Jun;6(2):116-8.
PMID: 24394713

The soleus muscles of hyperthyroid rats were used to investigate the effect of palm olein oil and soya bean oil on the production of lipid peroxidation products. It was found that palm olein oil but not soya bean oil significantly decreased malonaldehyde and conjugated diene levels of the soleus muscles of hyperthyroid rats. These findings suggest that palm olein per se produces less lipid peroxidation products than soya bean oil. Such an assay method gives a composite net picture of the propensity of an oil to produce lipid peroxidation products.
Palm oil tocotrienols and plant flavonoids act synergistically with each other and with Tamoxifen in inhibiting proliferation and growth of estrogen receptor-negative MDA-MB-435 and -positive MCF-7 human breast cancer cells in culture

Guthrie N, Gapor A, Chambers AF, Carroll KK

Asia Pac J Clin Nutr, 1997 Mar;6(1):41-5.
PMID: 24394652

Palm oil, unlike many other dietary oils, does not increase the yield of chemically-induced mammary tumors in rats when fed at high levels in the diet. This difference appears to be due to the vitamin E fraction of palm oil, which is rich in tocotrienols, since palm oil stripped of this fraction does increase tumor yields. Experiments in our laboratory have shown that tocotrienols inhibit proliferation and growth of both MDA-MB-435 and MCF-7 cells in culture much more effectively than a-tocopherol. In addition, it was found that combinations of tocotrienols with Tamoxifen, a drug widely used for treatment of breast cancer, inhibit these cells more effectively than either tocotrienols or Tamoxifen alone. The present studies have now shown synergistic effects between tocotrienols and a number of other flavonoids from various plant sources, including citrus fruits, in the inhibition of both MDA-MB-435 and MCF-7 cells (IC50s 0.05-25 and 0.02-5 μg/mL respectively). In the MCF-7 cells, 1:1:1 combinations of tocotrienols, flavonoids and Tamoxifen were even more effective, with the best combination being d-tocotrienol, hesperetin and Tamoxifen (IC50 0.0005 μg/mL). These results suggest that diets containing palm oil may reduce the risk of breast cancer, particularly when eaten with other plant foods containing flavonoids, and may also enhance the effectiveness of Tamoxifen for treatment of breast cancer.
Fulltext Palm oil and palm olein frying applications

Ismail R

Asia Pac J Clin Nutr, 2005;14(4):414-9.
PMID: 16326649

Several million tones of palm oil and palm olein are used annually in the world for frying. This paper will discuss their frying performances in three major applications - industrial production of potato chips/crisps, industrial production of pre-fried frozen French fries and in fast food outlets. In the first study, about four tones of potato chips were continuously fried 8 hours a day and five days a week. The palm olein used (with proper management) performed well and was still in excellent condition and usable at the end of the trial. This was reflected in its low free fatty acid (FFA) content of around 0.23%, peroxide value of 4 meq/kg, anisidine value of 16, low polar and polymer contents of 10% and 2%, respectively, induction period (OSI) of 21 hours and high content of tocopehrols and tocotrienols of 530 ppm even after >1900 hours. In the second study in which an average 12 tones pre-fried frozen French fries were continuously fried a day for 5 days a week, palm oil performed excellently as reflected by its low FFA of 0.34%, food oil sensor reading of 1.1, low polar and polymer contents of 17% and 2.8%, respectively, over the 12 days of trial. In the third study in which palm shortening, palm oil and palm olein were simultaneously used to intermittently fry chicken parts in the laboratory simulating the conditions in fast food outlets, the three frying oils also performed very satisfactorily as reflected by their reasonably low FFA of <1%, smoke points of >180 degrees C, and polar and polymer contents of <25% and <6%, respectively, after 5 days of consecutive frying. All the quality indicators did not exceed the maximum discard points for frying oils/fats in the three applications, while the fried food product was well accepted by the in-house train sensory panel using a-nine point hedonic score.
Palm fruit chemistry and nutrition

Sundram K, Sambanthamurthi R, Tan YA

Asia Pac J Clin Nutr, 2003;12(3):355-62.
PMID: 14506001

The palm fruit (Elaies guineensis) yields palm oil, a palmitic-oleic rich semi solid fat and the fat-soluble minor components, vitamin E (tocopherols, tocotrienols), carotenoids and phytosterols. A recent innovation has led to the recovery and concentration of water-soluble antioxidants from palm oil milling waste, characterized by its high content of phenolic acids and flavonoids. These natural ingredients pose both challenges and opportunities for the food and nutraceutical industries. Palm oil's rich content of saturated and monounsaturated fatty acids has actually been turned into an asset in view of current dietary recommendations aimed at zero trans content in solid fats such as margarine, shortenings and frying fats. Using palm oil in combination with other oils and fats facilitates the development of a new generation of fat products that can be tailored to meet most current dietary recommendations. The wide range of natural palm oil fractions, differing in their physico-chemical characteristics, the most notable of which is the carotenoid-rich red palm oil further assists this. Palm vitamin E (30% tocopherols, 70% tocotrienols) has been extensively researched for its nutritional and health properties, including antioxidant activities, cholesterol lowering, anti-cancer effects and protection against atherosclerosis. These are attributed largely to its tocotrienol content. A relatively new output from the oil palm fruit is the water-soluble phenolic-flavonoid-rich antioxidant complex. This has potent antioxidant properties coupled with beneficial effects against skin, breast and other cancers. Enabled by its water solubility, this is currently being tested for use as nutraceuticals and in cosmetics with potential benefits against skin aging. A further challenge would be to package all these palm ingredients into a single functional food for better nutrition and health.
Fulltext Overweight among primary school-age children in Malaysia

Naidu BM, Mahmud SZ, Ambak R, Sallehuddin SM, Mutalip HA, Saari R, et al.

Asia Pac J Clin Nutr, 2013;22(3):408-15.
PMID: 23945411 DOI: 10.6133/apjcn.2013.22.3.18

This study is a secondary data analysis from the National Health Morbidity Survey III, a population-based study conducted in 2006. A total of 7,749 children between 7 and 12 years old were recruited into the study. This study seeks to report the prevalence of overweight (including obesity) children in Malaysia using international cut-off point and identify its associated key social determinants. The results show that the overall prevalence of overweight children in Malaysia was 19.9%. The urban residents, males, Chinese, those who are wealthy, have overweight or educated guardians showed higher prevalence of overweight. In multivariable analysis, higher likelihood of being overweight was observed among those with advancing age (OR=1.15), urban residents (OR=1.16, 95% CI: 1.01-1.36), the Chinese (OR=1.45, 95% CI: 1.19-1.77), boys (OR=1.23, 95% CI: 1.08-1.41), and those who came from higher income family. In conclusion, one out of five of 7-12 year-old-children in Malaysia were overweight. Locality of residence, ethnicity, gender, guardian education, and overweight guardian were likely to be the predictors of this alarming issue. Societal and public health efforts are needed in order to reduce the burden of disease associated with obesity.
Study name: National Health and Morbidity Survey (NHMS-2006)
Fulltext Optimal nutrition therapy in paediatric critical care in the Asia-Pacific and Middle East: a consensus

Lee JH, Rogers E, Chor YK, Samransamruajkit R, Koh PL, Miqdady M, et al.

Asia Pac J Clin Nutr, 2016 Dec;25(4):676-696.
PMID: 27702711 DOI: 10.6133/apjcn.012016.07

Current practices and available resources for nutrition therapy in paediatric intensive care units (PICUs) in the Asia Pacific-Middle East region are expected to differ from western countries. Existing guidelines for nutrition management in critically ill children may not be directly applicable in this region. This paper outlines consensus statements developed by the Asia Pacific-Middle East Consensus Working Group on Nutrition Therapy in the Paediatric Critical Care Environment. Challenges and recommendations unique to the region are described.
Fulltext Optimal cut-off levels to define obesity: body mass index and waist circumference, and their relationship to cardiovascular disease, dyslipidaemia, hypertension and diabetes in Malaysia

Mohd Zaher ZM, Zambari R, Chan SP, Muruga V, Ng B, Appannah G, et al.

Asia Pac J Clin Nutr, 2009;18(2):209-16.
PMID: 19713180

Many studies in Asia have demonstrated that Asian populations may require lower cut-off levels for body mass index (BMI) and waist circumference to define obesity and abdominal obesity respectively, compared to western populations. Optimal cut-off levels for body mass index and waist circumference were determined to assess the relationship between the two anthropometric- and cardiovascular indices. Receiver operating characteristics analysis was used to determine the optimal cut-off levels. The study sample included 1833 subjects (mean age of 44+/-14 years) from 93 primary care clinics in Malaysia. Eight hundred and seventy two of the subjects were men and 960 were women. The optimal body mass index cut-off values predicting dyslipidaemia, hypertension, diabetes mellitus, or at least one cardiovascular risk factor varied from 23.5 to 25.5 kg/m2 in men and 24.9 to 27.4 kg/m2 in women. As for waist circumference, the optimal cut-off values varied from 83 to 92 cm in men and from 83 to 88 cm in women. The optimal cut-off values from our study showed that body mass index of 23.5 kg/m2 in men and 24.9 kg/m2 in women and waist circumference of 83 cm in men and women may be more suitable for defining the criteria for overweight or obesity among adults in Malaysia. Waist circumference may be a better indicator for the prediction of obesity-related cardiovascular risk factors in men and women compared to BMI. Further investigation using a bigger sample size in Asia needs to be done to confirm our findings.
Study site: 93 primary care clinics (klinik kesihatan and general practice clinics) in Malaysia
Fulltext Ocular manifestation of vitamin A deficiency among Orang asli (Aborigine) children in Malaysia

Ngah NF, Moktar N, Isa NH, Selvara S, Yusof MS, Sani HA, et al.

Asia Pac J Clin Nutr, 2002;11(2):88-91.
PMID: 12074186

This study determined the prevalence of ocular manifestation of vitamin A deficiency in Orang Asli (Aborigine) children. Night blindness was found in 16.0% of the children, conjunctiva xerosis in 57.3%, Bitot's spot in 2.8%, corneal xerosis in 0.5% and corneal scars in 5.6%. These findings show that history of night blindness had sensitivity, specificity and predictive value (positive) of 47.2, 98.1 and 96.2%, respectively, compared with the standard diagnosis procedure using luxometer readings.
Fulltext Nutritional status of women and children in Malaysian rural populations

Ali O, Isa ZM

Asia Pac J Clin Nutr, 1995 Sep;4(3):319-24.
PMID: 24394359

This study was conducted to investigate the nutritional status of the rural population in Malaysia, especially women and children. A total of 262 women aged 18 and over and 183 children aged 2-6 years were selected using multistage cluster sampling from four locations in rural areas. It was found that the prevalence of malnutrition among children 2-6 years old ranged between 25.5% in the Malays Felda settlement scheme to 80% in the Orang Asli settlement. Malnutrition was associated with worm infestations, bottle feeding and early weaning. More than 30% of Orang Asli women were malnourished compared to less than 15% of Malay Felda settlement women. On the other hand, Malay women in the land settlement scheme had a higher risk of developing overweight and diabetes. Goitre was found among 11.5% of children; however, no cretinism was found. Breast feeding was still a common practice among rural mothers, but inadequate health education tended to reduce the duration of breast feeding and increased early weaning. Upgrading women's status in the rural areas will ultimately improve the nutritional and health status of the children and community as a whole.
Nutritional assessment of rural villages and estates in peninsular Malaysia: Total blood cholesterol values in children, adolescents and adults

Wai TN, Lin KG, Siong TE, Hashim N

Asia Pac J Clin Nutr, 2000 Jun;9(2):115-21.
PMID: 24394397

The present study is unique in the Malaysian context on two counts; first, it employs for the first time a functional group approach (groups based on occupational or economic activity) in the assessment of community nutritional status. Second, the study provides on a nationwide-sampling basis, information on total blood cholesterol (TC) levels in rural children (7.0-12.9 years; n = 1921) and adolescents (13.0-17.9 years; n = 753) which were hitherto unavailable. Total blood cholesterol measurements were performed on 7184 subjects ranging from 7 to 75-years-old (males = 3151; females = 4033) from households in 69 rural villages and seven estates in peninsular Malaysia, which were based on selected multistage random sampling according to the household's involvement in the following economic activities: rice farming, rubber smallholding, coconut smallholding, fishing and employment in estates. In all functional groups, TC values increased with age and there was a distinct gender effect, namely females had higher TC values than males throughout the age spectrum analyzed. Mean TC levels for children and adolescents were in the range 3.85-4.37 mmol/L, rising markedly during adulthood to an overall mean of 4.91 ± 1.13 mmol/L for men and 5.17 ± 1.11 mmol/L for women. In adults (>= 18.0 years), there was marked disparity in mean TC values among the functional groups; males and females from rice households had the lowest mean TC values (4.58 and 4.99 mmol/L, respectively). Individuals at 'high risk' (TC > 6.20 mmol/L) averaged 16.0% in women and 11.6% in men, with women from the fishing, rubber and coconut households particularly affected (17.1-21.1%). When compared to earlier rural TC data reported for closely similar rural communities in the peninsula, the present findings suggest a 'hypercholesterolemic shift' approximating 0.39 mmol/L (15 mg/dL) in the adult population; however, this was not apparent in the children and adolescents from these rural communities.
Fulltext Nutrition and the Malaysian Healthy Lifestyle Programme: challenges in implementation

Suleiman AB, Tee ES

Asia Pac J Clin Nutr, 1998 Dec;7(3/4):230-7.
PMID: 24393676

There are significant differences in the food consumption patterns of countries. In the lower income countries, most of the energy intake is derived from cereals and starchy roots. On the other hand, the intake of these carbohydrate foods is much lower in the economically developed countries and more of the energy is derived from added fats, alcohol, meat, dairy products and sweeteners. The contribution of energy from various food groups has changed markedly over the past three decades. With increasing national wealth there is a general tendency for the consumption of cereal foods to decline, whereas the consumption of added fats, alcohol, meat and dairy products has increased over the years. Similar changes have also been observed for Malaysia. These dietary alterations, as well as other lifestyle changes, have brought about a new nutrition scenario in many developing countries. These countries are now faced with the twin problems of malnutrition, that is, undernutrition among some segments of the population and diet-related chronic diseases in other groups; for example, obesity, hypertension, coronary heart disease, diabetes and various cancers. In Malaysia, deaths due to diseases of the circulatory system and neoplasms have been on the rise since the 1960s. The former has been the most important cause of death in the country for more than 15 years, with cancer ranking third for almost 10 years. Epidemiological data collected from different community groups showed increased prevalences of various risk factors amongst Malaysians. In view of the changed nutrition scenario in the country, intervention programmes have been reviewed accordingly. The Healthy Lifestyle (HLS) Programme was launched in 1991 as a comprehensive, long-term approach to combating the emerging diet-related chronic diseases. For six consecutive years one thematic campaign per year was carried out; namely, coronary heart disease (1991), sexually transmitted diseases (1992), food safety (1993), childhood diseases (1994), cancers (1995) and diabetes mellitus (1996). To further strengthen health promotion among the community, another series of activities to be carried out under the second phase of the HLS programme from 1997 to 2002 was launched within the framework of the National Plan of Action on Nutrition (NPAN) for Malaysia. In view of the importance of diet and nutrition in the causation and prevention of chronic diseases, the theme for the first year of this phase was Healthy Eating. It is clear that nutrition education for the community in order to inculcate a culture of healthy eating is the long-term solution. A series of guidelines have been prepared for dissemination to the public via a variety of media and approaches, and with the collaboration of various government and non-governmental organisations. The implementation of the programme is, however, a challenge to health and nutrition workers. There is a need to examine the strategies for nutrition education to ensure more effective dissemination of information. The challenge is to determine how best to promote healthy eating within the present scenerio of rapid urbanisation, 'western' dietary pattern influence, a whole barrage of convenience and 'health' foods, and nutrition misinformation. We would like to share our experiences in the approaches taken and our concerns with other countries in the region given that various opportunities exist for collaboration.
Fulltext Nutrition and physical activity interventions to ameliorate postpartum depression: A scoping review

Yahya NFS, Teng NIMF, Das S, Juliana N

Asia Pac J Clin Nutr, 2021 Dec;30(4):662-674.
PMID: 34967195 DOI: 10.6133/apjcn.202112_30(4).0013

BACKGROUND AND OBJECTIVES: Globally, there is a high prevalence of postpartum depression (17.7%) reported in a recent study among mothers during the postpartum period. It contributes to poor health and well-being among newly delivered women. We reviewed the published effect of nutrition and physical activity interventions on improving and treating postpartum depression.
METHODS AND STUDY DESIGN: The scoping review was performed using Arksey and O'Malley's methodological framework. The systematic search was conducted using Scopus, Pubmed, EBSCOHost and Google Scholar in April 2020, updated in March 2021. Only literature published between January 2010 until February 2021 was searched.
RESULTS: A total of 25 articles were included, of which 23 were randomised controlled trials , and 2 were quasi-experimental studies. Some of studies found improvements in depression (76% out of all studies). On this basis, nutrition or physical activity intervention probably improves postpartum depression. Moreover, the integration of nutrition and physical activity appears to improve depression in the more thorough follow-up of participants . Active involvement of the participant in the interventions was contributory to effectiveness.
CONCLUSIONS: Nutrition and physical activity interventions with appropriate strategy and delivery are promising options for the management of postpartum maternal mental health. More definitive investigation of non-pharmacological interventions to ameliorate depression among postpartum women is warranted.
Fulltext Nutrition and educational achievement of urban primary schoolchildren in Malaysia

Shariff ZM, Bond JT, Johnson NE

Asia Pac J Clin Nutr, 2000 Dec;9(4):264-73.
PMID: 24394502

The relationship between nutrition, health and educational achievement of school-age population in less developed countries has been of interest to many researchers due to the frequent observation that many children did not complete primary school and those who completed, did not do as well as children in the developed countries. Nevertheless, nutritional and health status by itself is not the only variable affecting educational achievement, since biological, psychological, socioeconomic and cultural factors could directly or indirectly affect both nutrition, health status and educational achievement. The mechanism by which health and nutrition influence educational achievement is not well established, but poor health and malnutrition in early childhood may affect cognitive abilities, necessary for learning process and consequently educational achievement. A study was conducted in Kuala Lumpur, Malaysia, to investigate the relationship between nutritional status and educational achievement among primary schoolchildren from low income households (n = 399). A high percentage of them were mild-significantly underweight (52%), stunted (47%) and wasted (36%) and increasingly overweight (6%). In general, more boys than girls were found to experience some form of malnutrition. While weight-for-height did not differ significantly according to family, child and school factors, weight-for-age and height-for-age differed significantly by gender. Also, height-for-age was significantly related to household income. This indicates that stunting may be a consequence of prolonged socioeconomic deprivation. Educational achievement was measured based on test scores for Malay language (ML), English language (EL) and mathematics (MT). While a majority of the schoolchildren obtained optimum scores (>75) for ML and MT, the majority of them had insufficient scores (<50) for EL. Children's total score (TS) for the three subjects was significantly associated with household socioeconomic status, gender, birth order and heightfor- age. Even after controlling for household socioeconomic status, significant association between TS and height-for-age persisted. In this sample of schoolchildren, household income, gender, birth order and height-forage were significant predictors of TS. The finding that height-for-age is related to educational achievement agrees with other studies, which have reported that height-for-age, compared to weight-for-height or weight-forage is linked to educational achievement. Height-for-age reflects the accumulation of nutritional deprivation throughout the years, which may consequently affect the cognitive development of the children.
Fulltext Nutrition and ecosystems in Sarawak: The role of the areca nut

Strickland SS, Duffield AE

Asia Pac J Clin Nutr, 1998 Dec;7(3/4):300-6.
PMID: 24393688

The effects of population pressure on agricultural sustainability in the delicate tropical and subtropical ecosystems have often been thought to explain high prevalence rates of malnutrition in rural South-East Asia. However, recent studies in rural Sarawak suggest that processes of modernisation have resulted in increased variations in energy nutritional status in adults. A contributory factor may be consumption of the areca nut (Malay pinang, of the palm Areca catechu). This is thought to influence energy balance through effects on appetite and resting metabolic rate. Body mass index (BMI, kg/m2) data for 325 Iban men and 438 non-pregnant Iban women, measured in 1990 and again in 1996, have been analysed in relation to areca use, smoking behaviour, socio-economic status, and reported morbidity. Body composition derived from skinfold thickness measurements for 313 men and 382 women was also analysed. The results suggest that use of areca nut is associated with significantly lower age-related increments in BMI and percentage body fat in women after allowing for age, smoking, reported morbidity, and confounding socio-economic factors. Therefore, the impact of recent economic and social development seen in rising prevalences of 'over-nutrition' may be modulated by use of the areca nut.
Fulltext Nutrition and cardiovascular disease: an Asia Pacific perspective

Khor GL

Asia Pac J Clin Nutr, 1997 Jun;6(2):122-42.
PMID: 24394715

Changes in the dietary intake patterns of countries in the Asia Pacific region are considered in relation to trends of cardiovascular disease mortality. Cardiovascular disease now constitutes the major cause of mortality in many of the countries of the region. The mortality rate for coronary heart disease (CHD) has been on the decline since the mid-1960s in countries such as Australia, New Zealand and Japan, while a decline in other countries, including Singapore and Hong Kong, appears to be occurring about two decades later after a delayed increase. In contrast, countries like Malaysia and China have had and continue an upward trend for CHD mortality. Nonetheless, the mortality rates due to CHD in New Zealand, Australia, Singapore followed by Hong Kong rank among the highest in the region. In China, Taiwan and Japan, death due to cerebrovascular disease remains a major cause of death, although the latter two countries have undergone a significant decline in stroke death rates since 1970. The intakes of fat from land animal products, fish and vegetable oils, depending on fatty acid patterns and, possibly other constituents, are candidate contributors to the different atherogenic and thrombotic effects. Countries which have a higher mortality from CHD tend to have a higher intake of energy from fat and proportion of fat from animal products. These fat intakes may operate to increase hypercholesterolemia and overweight in various countries. Again, intakes of other food items and constituents used in the region such as soybeans, dietary antioxidants in fruits, vegetables, seeds, cereals, nuts and tea and alcohol consumption are candidate cardio-protectants. The wide dietary scope of Asia Pacific populations, from diverse socio-cultural backgrounds, and at different levels of economic and technological development poses several analytic challenges and opportunities. Future research should improve the datasets and think laterally about pathogenesis and intervention.
Modulation of human lipids and lipoproteins by dietary palm oil and palm olein: a review

Sundram K

Asia Pac J Clin Nutr, 1997 Mar;6(1):12-6.
PMID: 24394646

Several human clinical trials have now evaluated palm oil's effects on blood lipids and lipoproteins. These studies suggest that palm oil and palm olein diets do not raise plasma TC and LDL-cholesterol levels to the extent expected from its fatty acid composition. With maximum substitution of palm oil in a Western type diet some coronary heart disease risk factors were beneficially modulated: HDL2-cholesterol was significantly increased while the apolipoprotein B/A1 ratio was beneficially lowered by palm oil. Comparison of palm olein with a variety of monounsaturated edible oils including rapeseed, canola, and olive oils has shown that plasma and LDL-cholesterol were not elevated by palm olein. To focus these findings, specific fatty acid effects have been evaluated. Myristic acid may be the most potent cholesterol raising saturated fatty acid. Palmitic acid effects were largely comparable to the monounsaturated oleic acid in normolipidaemic subjects while trans fatty acids detrimentally increased plasma cholesterol, LDL-cholesterol, lipoprotein Lp(a) and lowered the beneficial HDL-cholesterol. Apart from these fatty acids there is evidence that the tocotrienols in palm oil products may have a hypocholesterolaemic effect. This is mediated by the ability of the tocotrienols to suppress HMG-CoA reductase. These new findings on palm oil merit a scientific reexamination of the classical saturated fat-lipid hypothesis and its role in lipoprotein regulation.
Fulltext Modulation of NFκB signalling pathway by tocotrienol: A systematic review

Nasir NAA, Sadikan MZ, Agarwal R

Asia Pac J Clin Nutr, 2021 Sep;30(3):537-555.
PMID: 34587713 DOI: 10.6133/apjcn.202109_30(3).0020

Tocotrienols have been reported to exert anticancer, anti-inflammatory, antioxidant, cardio-protective and boneprotective effects through modulation of NFκB signalling pathway. The objective of this systematic review is to evaluate available literature showing the effect of tocotrienols on NFκB signalling pathway and identify the potential mechanisms involved. A comprehensive search was conducted using PubMed and SCOPUS databases using the keywords "tocotrienol" and "NFκB" or "nuclear factor kappa b". Main inclusion criteria were English language original articles showing the effect of tocotrienol on NFκB signalling pathway. Fifty-nine articles were selected from the total of 117 articles initially retrieved from the literature search. Modulation of regulatory proteins and genes such as inhibition of farnesyl prenyl transferase were found to be the mechanisms underlying the tocotrienol-induced suppression of NFκB activation.
Fulltext Micronutrient interventions on cognitive performance of children aged 5-15 years in developing countries

Khor GL, Misra S

Asia Pac J Clin Nutr, 2012;21(4):476-86.
PMID: 23017305

It is estimated that more than 200 million young children worldwide fail to reach their potential in cognitive development owing to undernutrition. Numerous studies have assessed the effects of micronutrient supplementation on growth and cognitive development in infants, toddlers and preschoolers. However, micronutrient interventions on the cognitive performance of older children are limited. This article seeks to provide an update on micronutrient interventions and cognitive outcomes among children aged 5-15 years in developing countries. A total of 13 randomized controlled trials published since 2000 were identified. Majority of these studies assessed the effects of micronutrient-fortified foods on various domains of cognitive function. Among key micronutrients assessed were iron, zinc, iodine and vitamin A. This review found a lack of consistency in the impact of micronutrient supplementation on intelligence, long term mental functions and school examination grades of the children. A beneficial effect of micronutrient supplementation on short term memory was more consistently reported. Overall, the evidence from this review for the impact of micronutrients on cognitive performance in older children remains equivocal. In light of the growing interest on the influence of nutrition on cognition, it is important that culturally-appropriate and sufficiently sensitive assessment tools be used for measuring the desired cognitive outcomes that are most likely to be affected by the nutrients under study.

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