Assessment of iron status among adolescents in the fishing villages of Tuaran, Sabah

Iron deficiency anaemia is the most common micronutrient deficiency in the world affecting the general health of millions. In Malaysia, a moderately high prevalence of anemia is often reported in infants, young children and women of childbearing age. Data on anaemia is scant for the adolescents. This study was undertaken to assess the iron status of adolescents from six fishing villages in Tuaran, Sabah. A total of 199 subjects comprising 94 male and i 05 female were included in the study. Their ages ranged from 12 to 19 years with a mean of 15.2 years. Multiple iron status indicators namely, serum ferritin (SF), transferrin saturation (TS), mean corpuscular volume (MeV) and hemoglobin concentration were used to estimate the stages of iron deficiency. The majority of the male (68.1 %) and female subjects (82.9%) had normal body mass index (BMI) values, while 25.5% and 14.3% of the males and females respectively were underweight. A small percentage of the adolescents was overweight, that is 6.4% and 2.9% of the male and female respectively. Male adolescents showed significantly higher mean values for hemoglobin concentration, hematocrit, red blood count, serum iron, transferrin saturation and serum ferritin than the female subjects. In contrast, female adolescents had a significantly higher level of total iron binding capacity

The Ninth European Congress on Clinical and Economic Aspect of Osteoporosis and Osteparthritis Athens, Greece 18 - 21 Mac 2009

The increasing life expectancy is known to be associated with a greater frailty of elderly people and with a number of chronic and degenerative diseases. Osteoporosis and its complications- especially hip fractures, represent, probably, one of the most frequent disease in western population. Given the increasing importance of the morbidity and mortality associated with hip fractures, it is fundamental to identify screening methods in order to prevent them appropriately. Op~ tim a! identification of high-risk individuals would he a simple questionnaire assessing easy-to-know information on patients, linked to hip fracture risk. The FRACTURE index is a model identifying variables that could be easily assessed in either clinical practice or by self-administration. This model was developed and validated by Black for the screening of risk factors among patients in the orthopedics clinical practice allowing important insights about patient 5-years probability of hip fracture occurrence (every 2 units of FRACTURE index there is about a two fold increase of 5-yrs hip fracture probability). The assessment tool is a set of seven key parameters that can be easily asked to a patient within the usual orthopedic practice: these parameters indude age, BMD T-score, fracture after age 50 years, maternal hip fracture after age SO, weight less than or equal to 57 kg, smoking status, and use of arms to stand up from a chair. We performed an epidemiological cohort study, evaluating the FRACTURE index among 8590 patients recruited in 145 Italian Orthopedics divisions. Among the overall patients recruited, 3497 had a recent hip fracture. About 80% of fractured patients had a FRACTURE index >8/15. Our epidemiological cohort study confirms the validity of FRACTURE score index assessment in a clinical setting to establish the hip fracture risk probability

Ethnic Differences in the Food Intake Patterns and Its Associated Factors of Adolescents in Kelantan, Malaysia

Objective: The aim of the study was to identify the ethnic differences in dietary patterns and its association with socio-economic, dietary and lifestyle practices among adolescents in Kelantan, Malaysia. Methods: A population-based study of 454 adolescents aged 12 to 19 years was included. A validated food frequency questionnaire was used to assess dietary patterns and three dietary patterns were identified based on the principal component analysis method. Results: Malay adolescents had significantly higher scores for the Western-based food pattern and local-based food pattern, whereas Chinese adolescents showed higher scores for the healthy-based food pattern. Multivariate analyses show that age and physical activity (PA) levels were positively associated with healthy-based food pattern in Malay (All, p < 0.001), whereas higher consumption of eating-out from home (EatOut) (p = 0.014) and fast food (p = 0.041) were negatively associated. High weekly breakfast skipping (p < 0.001) and EatOut (p = 0.003) were positively associated with aWestern-based pattern, whereas age (p < 0.001) and household income (p = 0.005) were negatively associated. Higher frequency of daily snacking (p = 0.013) was positively associated with local-based food pattern. For Chinese adolescents, age (p < 0.001), PA levels (p < 0.001) and maternal education level (p = 0.035) showed positive associations with the healthy-based pattern, whereas high EatOut (p = 0.001) and fast food intakes (p = 0.001) were negatively associated. Higher weekly consumption of EatOut (p = 0.007), fast food (p = 0.023) and carbonated beverages (p = 0.023), and daily snacking practice (p = 0.004) were positively associated with higher Western-based food pattern, whereas age (p = 0.004) was inversely associated. Conclusion: This study showed that there were significant differences in dietary patterns and its association factors between Malay and Chinese adolescents. More importantly, these findings suggest that unhealthy dietary and lifestyle practices could increase the risk of adherence to unhealthy Western-based food pattern that is high in fat, sugar and salt contents, and, consequently, increase the risk of developing obesity and metabolic-related disorders during these critical years of growth

Infrequent Breakfast Consumption Is Associated with Higher Body Adiposity and Abdominal Obesity in Malaysian School-Aged Adolescents

Unhealthy dietary pattern increases the risk of obesity and metabolic disorders in growing children and adolescents. However, the way the habitual pattern of breakfast consumption influences body composition and risk of obesity in adolescents is not well defined. Thus, the aim of the present study was to assess any associations between breakfast consumption practices and body composition profiles in 236 apparently healthy adolescents aged 12 to 19 years. A selfadministered questionnaire on dietary behaviour and lifestyle practices and a dietary food frequency questionnaire were used. Body composition and adiposity indices were determined using standard anthropometric measurement protocols and dual energy x-ray absorptiometry (DXA). Mean age of the participants was 15.361.9 years. The majority of participants (71.2%) fell in the normal body mass index (BMI) ranges. Breakfast consumption patterns showed that only half of the participants (50%) were consuming breakfast daily. Gender-specific multivariate analyses (ANCOVA) showed that in both boys and girls, those eating breakfast at least 5 times a week had significantly lower body weight, body mass index (BMI), BMI z-scores, waist circumference, body fat mass and percent body fat (%BF) compared to infrequent breakfast eaters, after adjustment for age, household income, pubertal status, eating-out and snacking practices, daily energy intakes, and daily physical activity levels. The present findings indicate that infrequent breakfast consumption is associated with higher body adiposity and abdominal obesity. Therefore, daily breakfast consumption with healthy food choices should be encouraged in growing children and adolescents to prevent adiposity during these critical years of growth

Perceived Barriers and Needs of Dietary Macro Nutrient Intake in Adolescent Schoolgirls in Small Island

Adolescence is an important period of rapid change in biological, psychosocial and cognitive growth and development marked by significant increases in nutrition and energy needs. The study aimed to explore perceived barriers and needs regarding dietary macronutrient intake in adolescent girls in Barrang Lompo Island in Makassar City, South Sulawesi Province, Indonesia. The qualitative design drew on constructs from social cognitive theory. The sample consisted of 18 adolescent girls and their mothers from grades 8 to 11 whose dietary macronutrient intake was less than the recommended dietary allowance. A semi-structured interview protocol was used to explore perceived barriers and needs regarding dietary macronutrient intake, and the data were subjected to thematic analysis and analytic generalization. To ensure adequate dietary intake, adolescent girls need support from family and friends and access to preferred foods. Barriers include laziness about eating key foods, feelings of fullness due to snacking, addiction to cellphones, and lack of raw foodstuffs for making their favorite dishes. Social cognitive theory used to identify needs and barriers showed environmental and individual factors from adolescents play important role in appropriate food consumption in teenage girls. The findings may help to improve future interventions to enhance dietary patterns in adolescent girls who live in small island

Influence of body composition, muscle strength, diet and physical activity on total body and forearm bone mass in Chinese adolescent girls

The aim of the present study was to determine association between body composition, muscle strength, diet and physical exercise with bone mineral content (BMC) and bone area (BA) in 283 Chinese adolescent girls aged 15 years in Beijing, China. Body composition, pubertal stage, physical activity and dietary intakes were assessed using standard validated protocols. Total body and forearm bone, lean body mass (LBM) and fat body mass (FBM) were determined by dual X-ray absorptiometry. Multivariate linear regression analyses were carried out to examine the predictors of BMC and BA, after controlling for potential confounders. The subjects had a mean age of 15·0 (SD 0·9) years and 99·6% of them had reached menarche. Multivariate analyses showed that LBM, FBM, handgrip muscle strength and milk intake were significant independent determinants of BMC and BA of the total body and/or forearm sites. LBM was found to be a stronger independent determinant than FBM of BMC and BA, whereas handgrip muscle strength was only found as significant determinant of BMC and BA at the forearm sites than in total body BMC and BA. Further, total physical activity level had a significant positive association with handgrip and LBM. This suggested that greater muscle strength and higher LBM may reflect higher levels of physical activity. Therefore, continuous healthy lifestyle practices such as adequate intake of milk and continuous participation in physical activity should be encouraged throughout adolescence to optimise bone growth during this period

Lifestyle Practices and Obesity in Malaysian Adolescents

Aim: To determine the influence of physical activity (PA) and sedentary behavior (SB) on obesity profiles of 454 Malaysian adolescents aged 12 to 19. Methods: Validated PA and SB questionnaires were used and body composition assessed using anthropometry and dual-energy X-ray absorptiometry (DXA). Results: Gender-specific multivariate analyses showed boys with high levels of total PA and moderate-to-vigorous physical activity (MVPA) exhibited significantly lower levels of total body fat, percent body fat and android fat mass compared with low PA and MVPA groups, after adjusting for potential confounders. Girls with high SB levels showed significantly higher BMI, waist circumference and DXA-derived body fat indices than those at lower SB level. Multiple logistic analyses indicated that boys with low levels of total PA and MVPA had significantly greater obesity risk, 3.0 (OR 3.0; 95% CI, 1.1–8.1; p < 0.05) and 3.8-fold (OR 3.8; 95% CI, 1.4–10.1; p < 0.01), respectively, than more active boys. Only in girls with high SB level was there a significantly increased risk of obesity, 2.9 times higher than girls at low SP levels (OR 2.8; 95% CI, 1.0–7.5; p < 0.05). Conclusions: The present findings indicate that higher PA duration and intensity reduced body fat and obesity risk while high screen-based sedentary behaviors significantly adversely influenced body fat mass, particularly amongst girls when the PA level was low

Iron status and dietary iron intake of adolescents from a rural community in Sabah, Malaysia

Iron deficiency anaemia (IDA) is the most prevalent micronutrient deficiency in the world affecting the general health and wellbeing of millions. In Malaysia, moderately high prevalences of anaemia have been reported amongst infants, young children and women of childbearing age. Data is scant for the adolescents. This study was undertaken to assess the iron status and dietary intake of 165 adolescents, comprising 74 male and 91 female subjects, aged 12 to 19 years, from the rural communities in Tuaran District of Sabah, Malaysia. Convenience sampling was used for the selection of study subjects. Multiple iron status indicators namely, serum ferritin (SF), transferrin saturation (TS), mean corpuscular volume (MCV) and haemoglobin (Hb) were determined for the study. The mean age of the subjects was 15.2 ± 2.1 years. While the majority of the subjects (77.6%) had normal body mass index (BMI) values, 17.6% were underweight and 4.8% overweight. About 35% to 40% of the subjects showed deficient values for haematocrit, serum ferritin, serum iron, mean corpuscular haemoglobin (MCH), mean corpuscular volume (MCV) and transferrin saturation (TS), and 20% were anaemic (Hb &lt;12 g/L). Using the multiple criteria of iron status indicators, the prevalence of iron depletion, iron deficiency and IDA in the male and female adolescents were 5.4% vs. 6.6%, 18.9% vs. 26.4% and 5.4% vs. 26.4%, respectively. Iron deficiency anaemia (85.0%) contributed largely to the prevalence of anaemia. The dietary iron intake of the adolescents was unsatisfactory, with approximately 98% of subjects failing to meet the Malaysian RDA level. Almost all the female subjects (91%) had dietary iron intake below two-thirds of the RDA level compared with a much smaller proportion for the male adolescents (68%). The prevalence of IDA in the present study population, especially in the female adolescents, appears to be a significant public health problem. Priority should therefore be given to the eradication of iron deficiency in adolescents from low-income areas by dietary modification and micronutrient supplementation amongst female adolescents

Serum 25-Hydroxyvitamin D Concentrations and Season-Specific Correlates in Japanese Adults

Background: Several lines of evidence indicate an important role for vitamin D in the prevention of a range of diseases. Blood vitamin D levels show clear seasonal variation; however, data on the determinants of vitamin D status for each season are limited. We investigated the association between lifestyle and serum vitamin D concentration by season in Japanese workers. Methods: Subjects were 312 men and 217 women aged 21 to 67 years who worked in municipal offices in Northern Kyushu, Japan and participated in a periodic checkup in July or November. Multiple linear regression analysis was used to examine the association between serum 25-hydroxivitamin D concentrations and lifestyle factors for each season. Results: Mean serum 25-hydroxyvitamin D concentration was 27.4 ng/ml (68.4 nmol/L) and 21.4 ng/ml (53.4 nmol/L) for workers surveyed in July and November, respectively (P < 0.001); the prevalence of vitamin D deficiency (<20 ng/ml) was 9.3% and 46.7%, respectively (P < 0.001). In November, dietary vitamin D intake (in both sexes) and nonsmoking and physical activity (in men) were significantly associated with higher concentrations of serum 25-hydroxyvitamin D. In summer, fish/shellfish intake was associated with higher serum 25- hydroxyvitamin D concentrations in women. Conclusions: Vitamin D deficiency is common in Japanese workers during seasons with limited sunlight. The lifestyle correlates of favorable vitamin D status in November were physical activity, dietary vitamin D intake, and nonsmoking

The association between dietary protein intake and bone mass accretion in pubertal girls with low calcium intakes

To assess the association between protein intakes and bone mass accrual in girls, data were analysed for 757 pre-pubertal girls (mean age 10·1 years) in urban Beijing, China, who participated in a 5-year study including 2 years of milk supplementation (intervention groups only) and 3 years of follow-up study. At 0, 12, 24, 48 and 60 months from the baseline, bone mass of the proximal or distal forearm (PF or DF) and total body (TB) was measured with dual energy X-ray absorptiometry; dietary intakes were assessed by a 3-d food record (including two weekdays and one weekend day). Linear mixed models were used and continuous variables were logarithm transformed. The mean longitudinal Ca intake (432–675 mg/d on average) positively influenced bone mineral content (BMC) at TB, PF and DF after controlling for baseline bone mass and other possible confounders. However, negative associations were observed between protein intake (55·9–61·0 g/d on average) and BMC accrual at TB, PF or DF (b ¼ 21·92, 210·2 or 24·82, respectively, P,0·01) after adjustment. When protein intake was considered according to animal or plant food sources, protein from animal foods, particularly meat, had significant negative effects on BMC accrual at DF or PF after adjustment. It was concluded that higher protein intake, especially from animal foods, appeared to have a negative effect on bone mass accrual in Chinese pubertal girls with low Ca intakes