Inong Gunanti

Low Serum Concentrations of Carotenoids and Vitamin E Are Associated with High Adiposity in Mexican-American Children

Mexican-American children have a high prevalence of overweight/obesity. Micronutrient deficiencies may be contributing to the development of greater adiposity in these children. This study investigated the relations between adiposity and serum concentrations of carotenoids, retinol, and vitamin E among Mexican-American children 8-15 y of age included in the 2001-2004 U.S. NHANES. Associations of the outcomes of childrens body mass index (BMI), truncal fat mass (TrFM), and total body fat mass (TBFM) with serum concentrations of α-carotene, cis-β-carotene, trans-β-carotene, retinol, and α-tocopherol were determined by using linear, quantile, and multinomial regression models. BMI was inversely associated with serum concentrations of α-carotene (β = -0.88, P < 0.05), trans-β-carotene (β = -2.21, P < 0.01), cis-β-carotene (β = -2.10, P < 0.01), and α-tocopherol adjusted for total cholesterol ratio (β = -3.66, P < 0.01), respectively. Similar inverse associations were found with TrFM and TBFM. Higher cis-β-carotene and α-tocopherol serum concentrations were associated with reduced probability of overweight (OR: 0.57; 95% CI: 0.37, 0.89; P < 0.05; and OR: 0.56; 95% CI: 0.37, 0.86; P < 0.05; respectively) and obesity (OR: 0.39; 95% CI: 0.26, 0.58; P < 0.01; and OR: 0.38; 95% CI: 0.24, 0.60; P < 0.01; respectively). Higher retinol serum concentrations were associated with increased probability of overweight and obesity (OR: 2.01; 95% CI: 1.26, 3.22; P < 0.01; and OR: 2.90; 95% CI: 1.65, 5.09; P < 0.01; respectively). Significant inverse associations were found between serum concentrations of carotenoids and vitamin E and adiposity among Mexican-American children, but serum retinol concentrations were positively associated with adiposity. Future research is needed to understand the causes and consequences of micronutrient status on adiposity and comorbidities.

Low Serum Vitamin B-12 and Folate Concentrations and Low Thiamin and Riboflavin Intakes Are Inversely Associated with Greater Adiposity in Mexican American Children

BACKGROUND Micronutrient status may be a contributing factor to the development of childhood obesity in many industrializing countries passing the nutritional transition. The few studies investigating associations between serum concentrations of vitamin B and intake of B vitamins with adiposity, however, have reported inconsistent findings. OBJECTIVE The aim of the study was to examine associations between serum vitamin B-12 and folate concentrations and intakes of B vitamins with body fat by using data on 1131 Mexican American children 8-15 y of age included in NHANES 2001-2004. METHODS Childrens body mass index (BMI), trunk fat mass (TrFM), and total body fat mass (TBFM) were used as body adiposity (BA) measures. Serum concentrations of folate and vitamin B-12 were measured in blood samples collected from children. Intake of B vitamins was collected according to 24-h dietary recall. Associations of BA with serum concentrations of vitamin B-12 and folate and intake of B vitamins were determined by using linear and multinomial regression models. RESULTS Serum concentrations of vitamin B-12 and folate were inversely associated with BMI (β: -2.68, P < 0.01; β = -1.33, P < 0.01), TrFM (β:-3.32, P < 0.01; β: -0.14, P < 0.05), and TBFM (β:-1.93, P < 0.01; β: -3.19; P < 0.01). Higher serum concentrations of vitamin B-12 were associated with a reduced risk of obesity (OR: 0.48; 95% CI: 0.31, 0.77; P < 0.001). Thiamin and riboflavin intakes were inversely associated with BMI (β:-1.35, P < 0.05; β: -1.11, P < 0.05) and TrFM (β:-1.26, P < 0.05; β: -1.37, P < 0.05). CONCLUSION Similar inverse associations between BA and status of both vitamin B-12 and folate and intake of thiamin and riboflavin suggest that these micronutrients may play a role in adipogenesis and risk of childhood obesity.

Secondary prevention of osteoporosis in Australia: analysis of government-dispensed prescription data.

BackgroundOsteoporosis is a common cause of disability and death in elderly men and women. Until 2007, Australian Government-subsidized use of oral bisphosphonates, raloxifene and calcitriol (1α,25-dihydroxycholecalciferol) was limited to secondary prevention (requiring x-ray evidence of previous low-trauma fracture). The cost to the Pharmaceutical Benefits Scheme was substantial (164 million Australian dollars in 2005/6).ObjectiveTo examine the dispensed prescriptions for oral bisphosphonates, raloxifene, calcitriol and two calcium products for the secondary prevention of osteoporosis (after previous low-trauma fracture) in the Australian population.MethodsWe analysed government data on prescriptions for oral bisphosphonates, raloxifene, calcitriol and two calcium products from 1995 to 2006, and by sex and age from 2002 to 2006. Prescription counts were converted to defined daily doses (DDD)/1000 population/day. This standardized drug utilization method used census population data, and adjusts for the effects of aging in the Australian population.ResultsTotal bisphosphonate use increased 460% from 2.19 to 12.26 DDD/1000 population/day between June 2000 and June 2006. The proportion of total bisphosphonate use in June 2006 was 75.1% alendronate, 24.6% risedronate and 0.3% etidronate. Raloxifene use in June 2006 was 1.32 DDD/1000 population/day. The weekly forms of alendronate and risedronate, introduced in 2001 and 2003, respectively, were quickly adopted. Bisphosphonate use peaked at age 80–89 years in females and 85–94 years in males, with 3-fold higher use in females than in males.ConclusionsPharmaceutical intervention for osteoporosis in Australia is increasing with most use in the elderly, the population at greatest risk of fracture. However, fracture prevalence in this population is considerably higher than prescribing of effective anti-osteoporosis medications, representing a missed opportunity for the quality use of medicines.

The effect of zinc supplementation on body composition and hormone levels related to adiposity among children: a systematic review.

OBJECTIVE To provide a comprehensive synthesis of the effects of Zn supplementation on childhood body composition and adiposity-related hormone levels. DESIGN Five electronic databases were searched for randomized controlled trials of Zn supplementation studies published before 28 February 2015. No statistical pooling of results was carried out due to diversity in study designs. SETTING Community- or hospital-based, from fourteen developing and developed countries. SUBJECTS Children and adolescents aged 0 to 10 years. RESULTS Seven of the fourteen studies reported an overall or subgroup effect of Zn supplementation on at least one parameter of body composition, when determined by anthropometric measurements (increased mid upper-arm circumference, triceps skinfold, subscapular skinfold and mid upper-arm muscle area, and decreased BMI). Three out of the fourteen studies reported increased mean value of total body water estimated by bio-impedance analysis and increased fat-free mass estimated by dual energy X-ray absorptiometry and by total body water. Zn supplementation was associated with increased fat-free mass among stunted children. One study found supplementation decreased leptin and insulin concentrations. CONCLUSIONS Due to the use of anthropometry when determining body composition, a majority of the studies could not accurately address whether alterations in the fat and/or fat-free mass components of the body were responsible for the observed changes in body composition. The effect of Zn supplementation on body composition is not consistent but may modify fat-free mass among children with pre-existing growth failure.

Low Vitamin B12 and Folate Serum Concentrations, and B-Vitamin Intake Are Associated with Greater Adiposity in Mexican American Children

Abstract of paper that presented at 20th International Congress of Nutrition, Granada, September 2013.Background and Objectives: Indonesia is one of the countries facing nutrition transition with an increased proportion of the middle-class population. Few studies explored young child feeding practice amongst middle class families in developing countries. This study aims to assess child feeding practices and their associations with child nutritional status in urban area of Indonesia. Methods: The study was designed as a mixed-method study in an urban middle-class community, comprising of a qualitative study amongst 26 families of young children and a case-control study involving 288 (109 cases and 179 controls) children aged 12-36 months. Cases were mild to moderately underweight children, while controls were normal weight children. The data collection methods consisted of in-depth interview for the qualitative phase and anthropometry measurements, structured interviews pertaining to child feeding practices and 24-hours recall for the quantitative phase. Results: The qualitative study suggested that mothers appeared to have positive attitude and were familiar with many brands of toddler formula milk. Mothers reported challenges in encouraging their children to eat and relied on formula milk to increase child’s food intake.The results of the case-control study showed that only 10.4% children received six-month exclusive breastfeeding and there was a significantly higher proportion of control than case children who were offered formula milk within their first month of life. Almost all children (91.7%, CI = 87.7 – 94.5) had low dietary diversity (consumed 1-3 food groups) in the last 24 hours. Formula milk was the largest contributor to child’s energy intake amongst the control children. Conclusions: The low dietary diversity warn potential problems for the health of Indonesian children. A large government strategy on complementary feeding practices including controlling the marketing activities of formula milk need to be enhanced.