Nutritional evaluation of working Malay women in Kuala Lumpur as studied by total food duplicate method

The Importance of Sociocultural Context When Choosing to Eat Healthier

OBJECTIVE

To explore how working women in metropolitan Malaysia make food decisions.

DESIGN

A grounded theory approach and semistructured interviews.

SETTING

A large university in metropolitan Malaysia.

PARTICIPANTS

Twenty-four female employees purposively recruited to vary in ethnicity, body mass index, age, and marital status via convenience sampling.

PHENOMENON OF INTEREST

Perceptions of sociocultural influences on healthy eating behavior among working women.

ANALYSIS

Researchers audio-recorded interviews and analyzed verbatim transcripts.

RESULTS

Working women shared a desire to eat a healthier, more balanced diet by reducing processed food consumption through home-cooked meals. Participants described aspects of their living situations and cultural values about food that made it seem impossible to change their diets. Living with other people limited their ability to cook the food they wanted to eat. In addition, unspoken rules about communal eating in Malaysia, such as not refusing food and not wasting food, prevented working women from practicing healthy eating.

CONCLUSIONS AND IMPLICATIONS

In this population of working women in metropolitan Malaysia, experiences of time scarcity and limited sociocultural support for behavior change were major barriers to healthy eating. Interventions could prioritize leveraging these realities about food to facilitate environments in which women feel like they have control of their own food intake.

Antenatal calcium intake in Malaysia

AIM

To determine the adequacy of antenatal calcium intake in Malaysia, and the influencing factors.

METHODS

A cross-sectional study was conducted among postnatal women who delivered in two tertiary hospitals. Data were collected from antenatal cards, hospital documents and diet recall on daily milk and calcium intake during pregnancy. SPSS version 19.0 was used for statistical analyses.

RESULTS

A total of 150 women were studied. The total daily calcium intake was 834 ± 43 mg (mean ± standard error of the mean), but the calcium intake distribution curve was skewed to the right with a median intake of 725 mg daily. When calcium intake from milk and calcium supplements was excluded, the daily dietary calcium intake was only 478 ± 25 mg. Even with inclusion of milk and calcium supplements, more than a third (n=55 or 36.7%) of the women consumed less than 600 mg calcium in their daily diet. The adequacy of daily calcium intake was not influenced by maternal age, ethnicity, income or maternal job or educational status as well as parity.

CONCLUSION

The daily dietary calcium intake of the Malaysian antenatal population is far from adequate without the addition of calcium supplements and milk.

Nutrition, mild hyperparathyroidism, and bone mineral density in young Japanese women

BACKGROUND

The adverse effects of poor nutrition on the bones of young Asian women have not been fully elucidated.

OBJECTIVE

The purpose of this study was to investigate possible associations of vitamin D nutrition, calcium intake, and other nutrients with bone metabolism and bone mass in young Japanese women.

DESIGN

The subjects were 108 female college students aged 19-25 y. Dietary nutrients were measured by using the duplicate sampling method on 3 weekdays. Serum 25-hydroxyvitamin D [25(OH)D], intact parathyroid hormone, and bone turnover markers were also measured. Bone mineral density (BMD) of the spine and femur was measured by dual-energy X-ray absorptiometry.

RESULTS

The proportions of the subjects with low 25(OH)D (< 30 nmol/L) and high intact parathyroid hormone (> or = 6.9 pmol/L) concentrations were 32.4% and 15.7%, respectively. Serum 25(OH)D concentrations (P = 0.0265) and calcium intake (P = 0.0103) were inversely associated with serum intact parathyroid hormone. In addition to weight and physical activity, the presence of mild hyperparathyroidism was associated with a low BMD of the lumbar spine (P = 0.0062) and the femoral neck (P = 0.0250), and a low calcium intake was associated with a low BMD of the femoral neck (P = 0.0044).

CONCLUSIONS

Low calcium intake (based on low BMD of the femoral neck only) and mild hyperparathyroidism (based on low BMD of both the femoral neck and lumbar spine), partly explained by low vitamin D nutrition and a low calcium intake, are important predictors of low BMD in young Japanese women. Effects of poor nutrition and mild hyperparathyroidism on bone peak bone mass in young women should be further investigated in longitudinal studies.

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.

Food composition table-based estimation of energy and major nutrient intake in comparison with chemical analysis: a validation study in Korea

This study was initiated to examine the accuracy of conventional food composition table-based estimation of intakes of energy, protein, lipid and carbohydrate, in comparison with chemical analysis. For this purpose, 66 women (at the ages of 29 to 54 years) in three locations in Jeju Island, Republic of Korea, volunteered to offer 24-hour food duplicate samples. A half of them were house-wives, and the remaining half were farmers or fishers. The duplicate samples were subjected 1) to the chemical analysis for daily intake of energy, protein, lipid and carbohydrate after official methods in Korea (measured values), and 2) to the estimation of intakes of the same items taking advantage of Korean Food Composition Tables (estimated values). The two sets of the results, i.e., the measured and estimated values, were compared by paired and unpaired t-test, and linear regression analysis. The estimated values correlated closely with the measured values, irrespective of energy or the three major nutrients. A close agreement was observed for energy intake (the estimated/measured ratio of > 98%), and it was also the case for protein intake (101%). Under- and over-estimation was observed, however, in regard to carbohydrate (by - 8%) and lipid intake (by + 24%), respectively. It was concluded that the Korean Food Composition Tables are sufficiently accurate when applied for estimation of total energy intake as well as protein intake. Cares should be taken, however, in applying the tables for estimation of lipid and carbohydrate intake, because there may be the risk of over- and under-estimation for the former and the latter, respectively.

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.

Background lead and cadmium exposure of adult women in Xian City and two farming villages in Shaanxi Province, China

The objectives of the present study are: (a) to clarify the current levels of environmental exposure to lead (Pb) and cadmium (Cd) in Shaanxi Province in China in comparison with levels in other parts of mainland China; (b) to examine if there is any urban-rural difference in Pb and Cd exposure; and (c) to quantify the role of cereals as the dietary source of environmental exposure to these metals. For this purpose, triplet surveys on lead and cadmium exposure were conducted in the provincial capital of Xian and two farming villages A and B in Shaanxi Province, China in 1997. The grand geometric mean for lead (Pb) intake via foods (Pb-F), Pb in blood (Pb-B) and Pb in urine as corrected for creatinine concentration (Pb-Ucr) were 30 micrograms/day, 33 micrograms/l and 5 micrograms/g creatinine, respectively, with significant differences among the survey sites, e.g. Pb-B being higher in Xian (43 micrograms/l) than in the two villages (38 and 22 micrograms/l). The counterpart values for cadmium (Cd) intake via foods (Cd-F), Cd in blood (Cd-B) and Cd in urine (Cd-Ucr) were 6.1 micrograms/day, 0.46 microgram/l and 2.8 micrograms/g creatinine, respectively, with no substantial inter-survey site difference. Thus, it was possible to conclude that, from comparison with the values reported in 1990s literature, the exposure of Shaanxi people to Pb and Cd is no higher than, and even possibly lower than, the levels reported for people in other parts of mainland China. The exposure to Cd was almost exclusively from foods, whereas the exposure to air-borne Pb was large enough in Xian to explain higher Pb-B and Pb-Ucr than the level in Village B despite lower Pb-F in Xian than in Village B. Cereals (wheat, rice, maize and foxtail millet) contributed 26 and 84% of dietary Pb and Cd intake, respectively.

Non-occupational lead and cadmium exposure of adult women in Bangkok, Thailand

This survey was conducted to examine the extent of the exposure of Bangkok citizens to lead (Pb) and cadmium (Cd), and to evaluate the role of rice as the source of these heavy metals. In practice, 52 non-smoking adult women in an institution in the vicinity of Bangkok, volunteered to offer blood, spot urine, boiled rice and 24-h total food duplicate samples. Samples were wet-ashed, and then analyzed for Pb and Cd by ICP-MS. Geometric means for the levels in blood (Pb-B and Cd-B) and urine (Pb-U and Cd-U as corrected for creatinine concentration), and also for dietary intake (Pb-F and Cd-F) were 32.3 micrograms/l for Pb-B, 0.41 microgram/l for Cd-B, 2.06 micrograms/g creatinine for Pb-U, 1.40 micrograms/g creatinine for Cd-U, 15.1 micrograms/day for Pb-F and 7.1 micrograms/day for Cd-F. Rice contributed 30% and 4% of dietary Cd and Pb burden, respectively. When compared with the counterpart values obtained in four neighboring cities in southeast Asia (i.e. Nanning, Tainan, Manila, and Kuala Lumpur), dietary Pb burden of the women in Bangkok was middle in the order among the values for the five cities. Pb level in the blood was the lowest of the levels among the five cities and Pb in urine was also among the low group. This apparent discrepancy in the order between Pb-B (i.e. the fifth) and Pb-F (the third) might be attributable to recent reduction of Pb levels in the atmosphere in Bangkok. Regarding Cd exposure, Cd levels in blood and urine as well as dietary Cd burden of Bangkok women were either the lowest or the next lowest among those in the five cities.

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.

Nutritional evaluation of women in urban areas in continental China

In 1993-1995, a nutritional survey was conducted in China, in which 50 women each in three cities of Beijing, Shanghai and Nanning (thus 150 in total) volunteered to offer 24-hr total food duplicates and peripheral blood samples. People daily took 1,776 kcal (7,431 kJ) energy, 57 g protein, 75 g lipid, 218 g carbohydrate, 439 mg calcium, 24 mg iron, 3,398 mg sodium and 1,521 mg potassium. When compared with the recommended dietary allowance for Chinese, intakes of energy, iron and possibly vitamin C were sufficient in a majority of the participants, but not so in cases of calcium, and several vitamins. The lipid energy ratio was 38% on an average and was higher than 30% in a majority (73%) of the people. BMI, but not the lipid energy ratio, correlated with the serum triglyceride level. In accordance with high iron intake, the prevalence of anemia was low. Inter-city differences were evident in nutrient sources. Thus, Beijing people took more amounts of protein and lipid from meats (including eggs and milk), whereas plant-based foods were important sources of lipid in Shanghai and that of protein in Nanning. Furthermore, consumption of rice was significantly lower in Beijing than in Shanghai and Nanning, whereas wheat consumption was higher in Beijing than in Shanghai and Nanning.

Nutritional evaluation of Chinese working women in the city of Tainan, Taiwan

Nutritional survey was conducted in 1994 in Tainan City, southern Taiwan. Total food duplicate samples were collected from 52 women volunteers. Clinical examinations, anthropometry, hematology and serum biochemistry were also conducted. The intakes of nutrients were estimated from the weights of food items in reference to the standard food composition tables for Taiwanese. On average, the participants took 1,973 kcal energy, 69 g protein, 73 g lipid and 269 g carbohydrate per day. Animal-based foods accounted for 49% and 36% of protein and lipid sources, respectively, but fish and shellfish contributed only 11% for protein and essentially nil for lipid. Lunch was the most substantial meal of the day. When classified by age (i.e., 22-29, 30-39 and 40-66 year-old groups), no age-related difference was detected among the three groups in all nutrients except for crude fiber. Comparison with recommended dietary allowance (RDA) for Taiwanese, the insufficiency ratios were more than 50% for minerals (i.e., Fe and Ca) and vitamins (except for vitamin C). Excess in the lipid energy ratio (> 30%) was observed in 60% of the study population. In agreement with this high lipid intake, 17% of the participants had BMI of > 25, and triglyceride levels were elevated (> 150 mg/100 ml) in 27%. There were no anemic case despite the low Fe intake (14 mg/day).

Nutritional evaluation of women in urban and rural areas in Korea as studied by total food duplicate method

Nutrient intake was studied by the total food duplicate method in 141 adult working women (at the ages of 21 to 56 years) in four regions (Seoul, Pusan, Chunan and Haman) in Korea. Clinical, hematological and anthropometrical examinations were conducted in parallel. The nutrient intakes were estimated in reference to the weight of each food item and the national standard food composition tables for Korean population, and evaluated in comparison with the nationally recommended dietary allowances (RDA). The intakes were essentially sufficient when evaluated on a group basis. Plant-based foods were major sources of both protein (67%) and lipid (72%). Dinner was the most substantial sources of all nutrients. Further evaluation on an individual basis taking 80-120% RDA as acceptable showed that young people (at the ages of 20-29 years) and those in Seoul had highest prevalence of insufficient intake of nutrients, especially energy, protein and iron. Consumption of rice, the traditional staple food, was the lowest in Seoul and in the youngest groups as compared with others. The prevalence of overweight cases was also the lowest in the Seoul participants. The two observations when combined apparently suggest the difficulties in public nutrition.