Pulani Lanerolle

Portion size estimation aids for Asian foods.

BACKGROUND Portion size estimation is fundamental to the accuracy of dietary recall, as well as interventions in obesity. Data on portion size estimation aids (PSEA) for Asian foods are limited. PSEA for Asian foods were developed and their accuracy and precision were tested for inclusion in a food atlas. METHODS Sixteen food items were selected to represent all food groups. Small and life size photographs were developed, and line diagrams were drawn. These, together with household utensils, were tested among a random sample of 80 schoolchildren (aged 10-16 years). A total of 3180 estimations were made: 876 for small photographs (n = 11 foods), 558 for life size photographs (n = 7 foods), 1271 for line diagrams (n = 16 foods) and 475 for household utensils (n = 6 foods). RESULTS Line diagrams had a high percentage (63.9%) of correct estimations and a low percentage of over estimations (18.0%) and under estimations (18.1%), whereas household utensils performed poorly with 0.6% correct estimations. Greater accuracy and precision were obtained for amorphous foods with small photographs and for non-amorphous foods with line diagrams. The combination of small photographs (for vegetables) and line diagrams (for other foods) achieved a high correlation (r = 0.959, P ≤ 0.001), percentage correct estimations (68.3%) and low under estimations (19.9%) and over estimations (11.8%). Food texture, but not age or sex, was associated with correct estimations in all of the PSEA, except household utensils. CONCLUSIONS Accuracy and precision of a combination PSEA is convincing, enabling inclusion into an Asian food atlas for dietary assessment and intervention.

Sedentary Behaviour and Physical Activity in South Asian Women: Time to Review Current Recommendations?

Objective Our aims were to describe activity and sedentary behaviours in urban Asian women, with dysglycaemia (diagnosed at recruitment), and without dysglycaemia and examine the relative contribution of these parameters to their glycaemic status. Methods 2800 urban women (30–45 years) were selected by random cluster sampling and screened for dysglycaemia for a final sample of 272 newly diagnosed, drug naive dysglycaemic and 345 normoglycaemic women. Physical activity and sedentary behaviours were assessed by the International Physical Activity Questionnaire (IPAQ). Demographic data, diet and anthropometry were recorded. Logistic regression analysis assessed contribution of all parameters to dysglycaemia and exposure attributable fractions were calculated. Results The mean energy expenditure on walking (2648.5±1023.7 MET-min/week) and on moderate and vigorous physical activity (4342.3±1768.1 MET-min/week) for normoglycemic women and dysglycaemic women (walking;1046.4±728.4 MET-min/week, moderate and vigorous physical activity; 1086.7±1184.4 MET-min/week) was above the recommended amount of physical activity per week. 94.3% of women spent >1000 MET-minutes/week on activity. Mean sitting and TV time for normoglycaemic and dysglycaemic women were 154.3±62.8, 38.4±31.9, 312.6±116.7 and 140.2±56.5 minutes per day respectively. Physical activity and sedentary behaviour contributed to dysglycaemia after adjustment for family history, diet, systolic blood pressure and Body Mass Index. Exposure attributable fractions for dysglycaemia were; lower physical activity: 78%, higher waist circumference: 94%, and TV viewing time: 85%. Conclusions Urban South Asian women are at risk of dysglycaemia at lower levels of sedentary behaviour and greater physical activity than western populations, indicating the need for re-visiting current physical activity guidelines for South Asians.

Nutraceuticals: concepts and controversies

Sponsored by unicef. DOI: http://dx.doi.org/10.4038/cmj.v56i4.3901 Ceylon Medical Journal 2011; 56 : 171-173

Body fat assessment in Sri Lankan adolescent girls; development of a simple field tool

Background: Development of accurate, simple measures of body fat is essential in developing countries due to the rising prevalence of overweight and obesity. Application of skin-fold thickness (SFT) to body fat prediction equations is an inexpensive method suitable for field settings. Aim: To determine percentage fat mass (%FM) of Sri Lankan adolescent girls using Fourier Transform Infrared spectrometry (FTIR) as a reference method and develop a SFT-prediction equation to estimate %FM. Methods: Weight, height and SFT were measured and %FM determined by FTIR in 131 adolescent, post-menarcheal girls (15–19 years). SFT-measurements were applied to available body composition equations for validation in the population. A new equation for %FM was derived and validated. Results: Mean %FM (FTIR) was 19.13 ± 8.2.Selected body composition prediction equations over-estimated %FM. The multiple regression procedure yielded a final equation consisting of two anthropometric and one demographic variable, %FM = 9.701 − (0.460)* age+(0.640)*TricepsSFT+(0.583)*Supra-iliacSFT. Conclusions: Existing SFT prediction-equations are unsuitable for predicting %FM in this population. The new equation utilizing one peripheral and one truncal skin-fold, is appropriate for prediction of %FM in this population and may be applicable to other South Asian/Asian-Indian adolescents following validation.

Lifestyle patterns and dysglycaemic risk in urban Sri Lankan women.

Specific dietary patterns are associated with the risk of chronic disease. An in-depth understanding more reflective of lifestyle would be possible when assessing the synergistic effects of both diet and physical activity in pattern analysis. In the present study, we examined the biochemical markers of dysglycaemia and cardiometabolic risk in relation to lifestyle patterns using principal component analysis (PCA). Urban women (n 2800) aged 30-45 years were screened for dysglycaemia using cluster sampling from the Colombo Municipal Council area. All the 272 dysglycaemic women detected through screening and 345 randomly selected normoglycaemic women were enrolled. The International Physical Activity Questionnaire and a quantitative FFQ were used to assess physical activity and diet, respectively. Anthropometric measurements, bioelectrical impedance analysis and biochemical estimations were carried out. Lifestyle patterns were identified based on dietary and physical activity data using exploratory factor analysis. PCA was used for the extraction of factors. A total of three lifestyle patterns were identified. Women who were predominantly physically inactive and consumed snacks and dairy products had the greatest cardiometabolic risk, with a higher likelihood of having unfavourable obesity indices (increased waist circumference, fat mass percentage and BMI and decreased fat-free mass percentage), glycaemic indices (increased glycosylated Hb (HbA1c) and fasting blood sugar concentrations) and lipid profile (increased total cholesterol/TAG and decreased HDL-cholesterol concentrations) and increased high-sensitivity C-reactive protein concentrations. For the first time, we report lifestyle patterns and demonstrate the synergistic effects of physical activity/inactivity and diet and their relative association with cardiometabolic risk in urban women. Lifestyle pattern analysis greatly increases our understanding of high-risk behaviours occurring within real-life complexities.

Evaluation of Nutrition Education for Improving Iron Status in Combination with Daily Iron Supplementation

1. UNICEF. State of the world’s children 2000. New York: UNICEF, 2000. 2. Gross R, Lopez de Romaña G, Tomaro J. A life-cycle approach to multi-micronutrient supplementation: rationale and programme concept. Food Nutr Bull 2000;21:270–274. 3. UNICEF. The progress of nations 1999. New York: UNICEF, 1999. 4. UNICEF. Composition of a multi-micronutrient supplement for women in developing countries. Report of a UNICEF/WHO/UNU workshop. New York: UNICEF, 2000. References

Body composition in urban South Asian women; development of a bioelectrical impedance analysis prediction equation.

Abstract Background: Assessment of body composition plays a significant role in combating chronic disease among South Asians. Accurate assessment of body composition by bioelectrical impedance analysis (BIA) requires population-specific equations which are currently unavailable for urban South Asian women. Aim: To assess validity of direct BIA assessment and selected equations for prediction of total body water (TBW), against Deuterium (2H2O) dilution and develop and validate a population-specific TBW equation for urban South Asian women. Subjects and method: Data of 80 urban Sri Lankan women (30–45 years) were used for this analysis. Body composition was assessed by 2H2O dilution (reference) and BIA. Available BIA equations were assessed for validity. A new TBW equation was generated and validated. Results: Direct BIA measurements and other equations did not meet validation criteria in predicting TBW. TBW by the new equation (TBW = 3.443 + 0.342 × (height2/impedance) + 0.176 × weight) correlated (p < 0.001) with TBW by reference method. TBW using the new equation was not significantly different (25.30 ± 2.4 kg) from the reference (25.32 ± 2.7 kg). Conclusion: Direct use of TBW by instrument and existing equations are less suitable for this population. The new TBW equation is suitable for body composition assessment in urban South Asian women.

Urbanisation, dietary patterns and body composition changes in adolescent girls: a descriptive cross sectional study

BackgroundUrbanisation has been reported to have negative effects on lifestyle and possibly on body composition. The aim of this study was to assess the effect of urbanization on dietary patterns and measures of body composition in Sri Lankan adolescent girls.MethodsBody Mass Index was calculated in 552 adolescent school dropouts. Percentage body fat was calculated using a population specific skin fold thickness equation. Dietary patterns were identified based on information obtained from a food frequency questionnaire. Extraction of factors of the dietary patterns was by principal component analysis. The sum of hours / week spent on physical activity was calculated. Focus group discussions were held to gather supportive qualitative data on food related behaviors. Multivariate linear regression models were used to assess the association between independent variables and dietary patterns.ResultsTwo dietary patterns were identified; a convenience-based dietary pattern with higher factor loadings for starchy foods other than rice, animal foods, dairy products, fruits, sweetened food and fried food, and a traditional pattern with higher factor loadings for rice, tubers and potatoes, vegetables and dark green leafy vegetables. An urban girl had greater than three times the risk of having a higher percentage body-fat than a rural girl (P = 0.01, OR = 3.2). Time spent on physical activity was significantly (P = 0.003) higher among the rural girls. Focus group discussions indicate that urban girls preferred food from vendors due to convenience while rural girls preferred home cooked meals.ConclusionsUrban adolescents in this study followed a convenience based dietary pattern and this dietary pattern and lower physical activity was associated with overweight and higher body fat.