Insufficient calcium and iron intakes among general female population in Japan, with special reference to inter-regional differences

Veganism and paediatric food allergy: two increasingly prevalent dietary issues that are challenging when co-occurring

Vegan diets – defined as the exclusion of all foods of animal origin from the diet- are becoming popular. In recent years, the prevalence of food allergy has also increased, and disproportionately affects children. When vegan diets and food allergy co-occur, this combination can be challenging and pose risks of nutritional deficiencies, particularly during childhood. In this paper, we aim to summarise the major concerns regarding vegan diets and food allergy, review the literature on this topic, and provide some suggestions for healthcare providers, particularly dietitians and nutritionists, who work with food allergic, vegan patients and their family. When working with this patient population, a regular and complete medical nutrition history, including screening for any possible nutritional deficiencies, is warranted. Likewise, the routine tracking of serum markers (especially iodine, iron, zinc, calcium, Vitamins B12, D, B2, and A, selected n-3 fatty acids and protein, which are more abundant in animal vs. plant foods) and symptoms of co-morbid diseases, including asthma, is important, as comorbid diseases may increase energy and nutrient requirements. For infants and children, anthropometry ought to be tracked longitudinally at regular intervals to identify any deviations from the child’s previous growth pattern, and to accommodate any increased requirements for growth and development. Correct diagnoses, education and allergy management must be disseminated to the family in a clear and appropriate manner. Children with allergy may have increased nutritional needs due to comorbidity. This is complicated by coincident food allergy and vegan diet as both impose diet restrictions (limiting sources of important nutrients, need for dietary variety and/or increased consumption due to reduced bioavaliability).

Reduction in estimated vitamin A intake induced by new food composition tables in Japan, where vitamin A is taken mostly from plant foods

A revised edition of the standard tables of food composition was implemented in Japan in 2005; one of the major revision points is the change of retinol activity equivalents for pro-vitamin A carotenoids. This preliminary analysis was conducted to examine whether the revision affects the estimation of vitamin A intake; and if so, to what extent. Accordingly, a field survey was conducted to collect 24-h duplicates of daily foods of citizens, and 26 adult women volunteered. Application of the procedures in the new and previous standard tables of food composition gave 537 microg retinol activity equivalent and 704 microg retinol equivalence, respectively, for daily vitamin A intake. Thus, the changes in retinol activity equivalents induced substantial reduction (by 24%) in estimation of vitamin A intake among the Japanese population, for whom pro-vitamin A carotenoids in plant foods are the major sources (76%) for vitamin A, and retinol accounts for only 35% (on the retinol activity equivalent basis).

Limited acceptance of globalization in food habits among middle-aged women in Osaka, Japan

The study was initiated to identify the effects of recent changes in dietary pattern in Japan on nutrient intake. In the large city of Osaka, Japan, 24-h food duplicate samples were collected from 26 middle-aged women, and nutrients in the duplicates were estimated in reference to standard tables of food composition. The subjects took 1844 kcal (7.72 MJ) energy, 67.5 g protein, and 54.5 g lipid (37% from plants) per day. Micro-nutrient intakes were generally sufficient, but NaCl intake tended to be excessive, and the relatively high body mass index (>25 in six cases) suggested a possibility of over-eating. The food composition was rich in rice and fish, being basically of a traditional type. Consumption of bread, an acquired habit, was observed in 65% of the breakfasts but less so in lunch and none in dinner. Thus, the acceptance of bread in place of rice was limited and did not induce substantial alteration in nutrient intakes.

Effects of revision of Japanese food composition tables on estimation of nutrient intakes, with reference to age-dependent differences

OBJECTIVE

To identify effects of revision of the Japanese food composition tables from the fourth version to the fifth version on nutrient intake estimation.

DESIGN

A database on 783 samples of 24-hour food duplicate portions was re-visited. Nutrients in the duplicate portions were estimated by use of the fourth and fifth versions of the Japanese food composition tables in parallel, together with supplemental use of other databases. The two sets of estimates were subjected to comparison.

SETTING

The sample collection was conducted at 31 sites all over Japan.

SUBJECTS

The sample donors were 783 women aged 20-78 years.

RESULTS

Compared with the estimates by use of the fourth version of the tables, the estimates by the fifth version were substantially higher for intakes of energy, carbohydrate, dietary fibre, vitamin A and niacin, and lower for iron intake. The increase in carbohydrate intake estimates was more evident in older women than in young women, whereas the decrease in the intake estimation of iron and the increase in that of dietary fibre were more marked in young women than in older women.

CONCLUSION

The recent revision of food composition tables in Japan induced substantial changes in the estimation of nutrient intakes, i.e. an increase in energy, carbohydrate, dietary fibre, vitamin A and niacin, and a decrease in iron. The extent of the changes varied depending on age.

No significant effect of iron deficiency on cadmium body burden or kidney dysfunction among women in the general population in Japan

OBJECTIVE

To examine if iron-deficient conditions modify body burden or health effects of cadmium among women in the general population in Japan.

METHODS

In 2002, 1,482 women aged 20 to 74 years in six prefectures in Japan provided informed consent to participate in this study. They offered peripheral blood and spot urine samples, and answered questionnaires on their social habits and health conditions. Never-smoking, non-pregnant and non-lactating healthy women (1,190 subjects) were selected from the volunteers. Blood samples were analyzed for serum iron, ferritin and total iron-binding capacity (TIBC) in addition to red blood cell (RBC) counts and hemoglobin (Hb) concentration as markers of anemia and iron deficiency. Urine samples were analyzed for cadmium (Cd), alpha(1)-microglobulin (alpha(1)-MG), beta(2)-microglobulin (beta(2)-MG) as markers of Cd burden and Cd-induced tubular dysfunction; the measures were expressed after being corrected for creatinine (cr) as, e.g., Cd-Ucr.

RESULTS

The subjects were classified into anemic (37 women) and iron-deficient (388 women) groups separately from healthy controls (765 women), taking ferritin (<20 ng/ml) and Hb (<10 g/100 ml) as classification indicators. Strictly matched pairs (with regard to age and prefecture) were established for 36 anemic and 280 iron-deficient cases. Comparison between the cases and the matched controls showed that serum iron was lower and TIBC was higher in accordance with lower levels of ferritin and Hb in the anemic and iron-deficient groups, although the RBC count was only slightly reduced (the anemic group) or stayed essentially unchanged (the iron-deficient group). In contrast, no significant increase in Cd-Ucr, alpha(1)-MG, or beta(2)-MG was observed in either the anemic group or the iron-deficient group compared with the matched controls. Cd-Ucr in one case of clinical anemia, however, tended to be higher than the levels among women of the same age range and from the same prefecture. Her alpha(1)-MG-Ucr and beta(2)-MG-Ucr, however, remained un-elevated.

CONCLUSIONS

The current level of iron deficiency among women in the general population in Japan may not induce significant increase in Cd body burden or Cd-induced tubular dysfunction.

Effects of iron-deficiency anemia on cadmium uptake or kidney dysfunction are essentially nil among women in general population in Japan

In the present study, 1476 adult women in 6 prefectures in Japan volunteered to offer peripheral blood and spot urine samples, and to complete questionnaires on social habits and health. Blood samples were analyzed for iron, ferritin and TIBC in serum in addition to RBC, Hb and Cd in whole blood. Urine samples were analyzed for Cd, alpha1-MG, and beta2-MG; the measures were corrected for creatinine and were expressed as e.g., Cd-Ucr. Among 1212 never-smokers, 37 women with < 25 ng ferritin/ml serum and < 10 g Hb/100 ml blood were classified as the anemics, whereas 701 women with > or = 25 ng/ml ferritin and > or = 10 g/100 ml Hb were taken as controls. Matching by age and the prefecture of residence was successful for 34 anemics. Comparison (by paired t-test) of Cd in blood, and Cd, alpha1-MG and beta2-MG in urine (as corrected for creatinine) of the anemics with that of matched controls showed no significant differences. Thus, it appeared likely that the current level of iron insufficiency among general women population in Japan may not induce substantial increase in Cd absorption or Cd-associated kidney dysfunction.

Estimation of nutrient intake by the new version of Japanese food composition tables in comparison with that by the previous version

This study was initiated to examine if the revision of the food composition tables from the 4th version to the 5th version has induced any substantial changes in nutrient intake estimation, and if so, in which nutrient item and to what extent. For this purpose, 24-hour duplicates of food samples were collected in 1996 to 1998 from 71 girl university students, together with food menus of the day. The nutrients in the duplicates were estimated by use of the 4th and the 5th version food composition tables in parallel, with supplements of other databases. The results of the estimation with the two databases were compared by Student's paired t-test. Compared with the results with the 4th version, the estimation utilizing the 5th version gave 3 to 8% increases in intakes of major nutrients including energy (except for protein), a 20% increase in vitamin A, and decreases in iron (-13%) and NaCl (-3%), whereas there were only small or essentially no changes in other minerals and vitamins. The largest increment in energy through the re-calculation came from the cereals (especially rice), and it was meats for the increment in lipid intake. The increment in vitamin A with the 5th version is primarily due to the re-evaluation of fruits and vegetables. The present observation suggests that care should be practiced in examining secular trends in nutrition when the basis of estimation is shifted from one database of the 4th version of food composition tables to another of the 5th version. Further study of a larger scale is apparently warranted to confirm the conclusions.

Exposure of women in general populations to lead via food and air in East and Southeast Asia

BACKGROUND

Despite increasing public concern of the possible health effects of lead (Pb) on general populations, reports on Pb levels in blood (Pb-B) and urine (Pb-B), as well as Pb intake via foods (Pb-F) for many Asian countries are scarce. The present study was initiated to elucidate the extent of non-occupational Pb exposure among general populations in East and Southeast Asia.

METHODS

In 1991-1997, peripheral blood, morning spot urine and 24-hour food duplicate samples were collected from 20 to 50 non-smoking adult women in each of four cities in Southeast Asia and five cities in Mainland China, and two cities each in Japan and Korea. The samples were wet-ashed and then analyzed by inductively coupled plasma mass spectrometry for Pb-B, Pb-U and Pb-F. Measures after logarithmic conversion were subjected to ANOVA and regression analysis.

RESULTS

Geometric mean values in cities in East and Southeast Asia were in ranges of 32-65 microg/L for Pb-B, 2.1-7.5 microg/g cr for Pb-Ucr, and 7-32 microg/day for Pb-F. The values for a combination of two cities of Tokyo and Kyoto, Japan (38 microg/L for Pb-B and 9.3 microg/day for Pb-F) appeared to be lower than the values for other Asian cities, and the values for all Japan (thus including both urban and rural areas) were even lower (19 microg/L for Pb-B and 7.7 microg/day for Pb-F). Comparison of Pb uptake via respiratory and dietary routes showed that Pb via dietary route accounted for 15% of the total in Manila where Pb in air was high (ca. 650 ng/m(3)), whereas it was 54% in Tokyo+Kyoto where Pb in air was low (ca. 75 ng/m(3)).

CONCLUSIONS

When compared internationally, Pb-F and Pb-B in Asia in general are similar to or somewhat higher than the levels in Europe and USA, whereas the levels in Japan are probably lower than the two latter areas. In Asia, Pb-F accounted for 15-54% of all Pb sources, the percentage being variable depending on local conditions especially Pb in atmospheric air.

Correlation between concentration in urine and in blood of cadmium and lead among women in Asia

The objectives of the present study are to examine if there exists a quantitative relationship between lead in urine (Pb-U) and that in blood (Pb-B), and also between cadmium in urine (Cd-U) and that in blood (Cd-B) among the general populations who are environmentally (and not occupationally) exposed to these elements at various levels. For this purpose, peripheral blood and morning spot urine samples were collected in 1991-1998 from approximately 50 non-smoking adult women each in four cities in south-east Asia and five cities in mainland China, and two cities each in Japan and Korea. The samples were wet-ashed and then analyzed by inductively-coupled plasma mass spectrometry for Pb-B, Cd-B, Pb-U and Cd-U. Measured values were subjected to analysis to detect possible correlation between the pairs of parameters. A significant correlation between Pb-B and Pb-U was observed when the intensity of Pb exposure (as expressed by Pb-B) was relatively high so that the correlation was significant in all cases studied when Pb-B level was, e.g. 50 microg/l or above. It was also observed that the correlation between Cd-B and Cd-U was significant when Cd-B was, e.g. > 1 microg/l. Thus, it is possible to deduce that, in environmental health, Pb-B and Cd-U levels can be estimated on a group basis from Pb-U and Cd-B, respectively, when Pb and Cd exposure levels are relatively high, e.g. with Pb-B and Cd-B of > 50 microg/l and > 1 microg/l.

Total food duplicate study on nutrient intake of working women in Manila, the Philippines

Intakes of various nutrients by working women in Manila, the Philippines, was surveyed by the total food duplicate method, with foci to elucidate relative weight of three meals and snack in addition to quantitative evaluation of nutrient intakes. In practice, 45 women (average age; 37.2 years) volunteered, who were all nonsmokers and nonhabitual drinkers, and mostly married. In parallel, hematology, serum biochemistry, anthropometry and clinical examinations were conducted. On average, the women took 1787 kcal energy, 57 g protein, and 54 g lipid daily. Comparison with the Recommended Dietary Allowances (RDA) for Filipinos showed that intakes of energy and major nutrients were adequate, whereas that of minerals (e.g., 15 mg Fe/day vs. 26 mg Fe/day as RDA) and vitamins (e.g., 0.65 mg vitamin B1/day vs. 1 mg/day as RDA) were generally insufficient. Prevalence of anemia was however rather low with an average hemoglobin concentration of 12.9 g/100 ml blood. Rice was the staple source of energy for daily life, and beef rather than fish and shellfish was the leading source of protein. Lunch was the richest meal of a day (with the largest intake of energy, protein and lipid), and snacks rather than dinner appeared to be next substantial.

Determination of lead and cadmium in food and blood by inductively coupled plasma mass spectrometry: a comparison with graphite furnace atomic absorption spectrometry

To compare inductively coupled plasma mass spectrometry (ICP-MS) and graphite furnace atomic absorption spectometry (GF-AAS) as the method for determining lead and cadmium in the human diet and blood, 418 diet homogenate samples and the same number of blood samples were collected from Chinese and Japanese women and were analyzed by the two methods. The results showed that our ICP-MS method is precise and accurate, being comparable to the GF-AAS method established previously. The ICP-MS method is simple and fast spending only one-tenth of the time necessary for GF-AAS and allows simultaneous analyses of lead and cadmium with low detection limits. When applied to actual sample analysis, however, ICP-MS results tend to be 10-20% lower than GF-AAS results in the analysis of lead in the diet and blood and cadmium in blood. This is possibly due to some interference in ICP-MS and matrix of samples. As the ICP-MS results could be mathematically corrected to be equivalent to the GF-AAS results, we conclude that this ICP-MS method can be used as a routine analytical method for the determination of lead and cadmium in human diet and blood samples.