Trans fatty acids in food： dietary intake and regulatory policies in China and other countries / 上海预防医学

Numerous studies have highlighted the harmful effect of trans fatty acid （TFAs） on human health. Based on a review of health hazards of TFAs， intake levels among residents in China and other countries， and current regulatory policies， this paper discusses the proposals on strengthening TFAs restriction policies in China. According to the literature review， dietary intake level of TFAs among residents in China was relatively low across the world， which remained a certain distance from the World Health Organization （WHO） recommended limit of 1% of total energy intake. However， consumption of edible oils， baked food and dairy products by Chinese residents is likely to continue to rise in the future， which might lead to an increase in TFAs intake. Therefore， it is suggested that China should strengthen the investigation and assessment of TFAs intake， adopt the WHO best policy of restricting TFAs （a national limit of 2 grams of industrially produced trans fat per 100 grams of total fat in all foods， or a national ban on the production and use of partially hydrogenated oils）， and reduce the use of edible oil.

Evaluation of Tolerable Upper Intake Levels for Vitamin D in Children and Adolescents

In 2012, the European Food Safety Authority (EFSA) suggested a tolerable upper intake level (UL) for vitamin D at 100 µg/day for adults based on the risk of hypercalcaemia. EFSA concluded that consumption of up to 50 µg/day does not lead to hypercalcaemia in children and adolescents (10-17 years). Furthermore, EFSA stated that there is no reason to assume that children and adolescents in the phase of rapid bone formation and growth have a lower tolerance for vitamin D compared to adults, and a UL of 100 µg/day for adolescents aged 11-17 years and 50 µg/day in children 1-10 years, taking the smaller body size into account, was proposed. The Norwegian Food Safety Authority (NFSA) is currently revising the national regulation of maximum limits in food supplements (not yet harmonised in the European Economic Area (EEA)), including maximum limits for vitamin D. NFSA has therefore requested the Norwegian Scientific Committee for Food Safety (VKM) to evaluate the assumption in the EFSA opinion that children and adolescents can tolerate the same amount of vitamin D as adults due to rapid bone formation and growth. In children and adolescents with lower weight than adults, this assumption actually implies that adolescents can tolerate more vitamin D per kg body weight than adults. VKM is therefore requested to evaluate if there is scientific evidence that a UL at 50 µg/day for children (1-10 years) and 100 µg/day for adolescents (11-17 years) is safe. The present statement is prepared by members of the Panel on Nutrition, Dietetic Products and Novel Food and Allergy in VKM. Three literature searches were performed to find new relevant studies investigating high intakes of vitamin D in children and adolescents and the role of vitamin D in bone formation and growth. No studies supporting a higher tolerance to vitamin D in children and adolescents due to rapid bone formation and growth were retrieved in the literature search. Moreover, there is apparently no firm association between bone formation and vitamin D levels in children during their growth period into adolescence and adulthood. No studies investigating high intakes of vitamin D in children 1-10 years were found. Furthermore, no studies that have examined safety issues and/or adverse effects of vitamin D supplementation in doses above 50 µg/day in adolescents were identified. It can therefore not be concluded that the UL at 50 µg/day in children (1-10 years) and 100 µg/day in adolescents (11-17 years) is safe. In the 2002 report from European Scientific Committee on Food (SCF), a UL was set at 25 µg/day for children aged 2-10 years, and 50 µg/day for adolescents aged 11-17 years (corresponding to the UL for adults at that time). To the best of knowledge no serious, harmful effects have been reported for these doses of vitamin D.

Relation of Nutritional Intake and Allergic Rhinitis in Infants: Using the Korea National Health and Nutrition Examination Survey (KNHANES) 2013~2016 / 대한지역사회영양학회지

OBJECTIVES: This study examined the relationship between the presence of allergic rhinitis and the nutritional intake levels of Korean infants. METHODS: The study involved a total of 1,214 infant subjects aged 1~5 months from the 2013~2016 KNHNES (Korea National Health and Nutrition Examination Survey). The Subjects were classified into two groups based on the presence of allergic rhinitis: Non-allergic rhinitis infants (NARI, n=1,088) and allergic rhinitis infants (ARI, n=126). The general characteristics and family history of allergies, nutrient intake status, nutrient supplement intake, and breast milk and baby food start period data of the two groups were compared. All statistical analyses accounted for the complex sampling design effect and sampling weights. RESULTS: The mean age was 0.5 years old in the ARI group compared to the NARI group. In the residence, the rate of urban was higher in ARI. The family history revealed a significant difference between the two groups, particularly those of mothers rather than fathers. The nutrient intake levels were high in energy, phosphorus, sodium, potassium, iron, riboflavin, niacin, and polyunsaturated fatty acids. Breastfeeding was significantly higher in the ARI group than in the NARI group. The baby food start period was 0.3 months earlier in NARI group than in ARI group. The height, body weight, and birth weight were higher in ARI group than NARI group. The result of Odds ratio analysis showed that excess energy, protein, calcium, phosphorus, iron, riboflavin, and niacin intake increases the risk of allergic rhinitis. CONCLUSIONS: These results can be used as data to develop nutrition guidelines for allergic rhinitis infants.

Risk Assessment of Folic Acid in Food Supplements.

The Norwegian Scientific Committee for Food Safety (VKM) received a request from the Norwegian Food Safety Authority to assess whether the Tolerable Upper Intake Level (UL) of folic acid should be amended in light of new scientific evidence suggesting a possible link between high intake levels of folic acid and risk of cancer. Folic acid obtained from both food supplements and fortified foods should be assessed. Folic acid is a synthetic form of folate and is commonly used in food supplements and in food fortification because of its stability and bioavailability. Folic acid is reduced, methylated and released into the circulation. Natural folates occur in reduced forms, e.g. as tetrahydrofolate (THF), which are unstable and may thus loose biochemical activity during harvesting, storage, processing, and preparation. Folate is cofactor for enzymes in one-carbon metabolism where it provides one-carbon units for the formation of RNA and DNA. Folate is also essential for the normal functioning of the methionine cycle, which is responsible for both the conversion of homocysteine to methionine and the production of the universal methyl donor S-adenosylmethionine (SAM). SAM donates its methyl group to more than 100 methyltransferases for a wide range of substrates such as DNA, hormones, proteins, neurotransmitters and membrane phospholipids. While no Tolerable Upper Intake Level (UL) has been derived for natural dietary folates, the Scientific Committee on Food (SCF, 2000) set an UL of 1000 μg folic acid per day in 2000. The UL was set because it was found that high intakes of folic acid could correct megaloblastic anemia, which is the hallmark manifestation of vitamin B12 deficiency. In this way folic acid may mask vitamin B12 deficiency which again may cause irreversible neurological damage. The ULs for children and adolescents (1-17 years) were adjusted on the basis of body weight and range from 200 to 800 μg/day. The UL for folic acid has been reassessed by other authorities, most recently in 2009 by EFSA (EFSA, 2009), who upheld an UL of 1000 μg/day. In 2009, Ebbing et al. published results from combined analyses of two randomised, placebocontrolled trials with B-vitamin supplementation in patients with ischemic heart disease. They found an increased risk of cancer in those who were randomised to receive folic acid in combination with vitamin B12 (Ebbing et al. 2009). Folates are important for cell division. It is therefore possible that tumor growth or growth of premalignant cells may be stimulated by high concentrations of folate in the blood. Another concern with use of folic acid is circulating unmetabolised folic acid (UMFA) which is often found at intakes of more than 200 μg per day (Kelly et al. 1997). It has been argued that UMFA could affect homeostatic regulation of folate (Smith et al. 2008), and that it may reduce natural-killer cell cytotoxicity (Troen et al. 2006). In vitro studies have also demonstrated that folic acid can down-regulate tumor suppressor genes (Lubecka-Pietruszewska et al. 2013). This opinion addresses the question whether the current UL for folic acid should be amended based on new scientific evidence. Furthermore, VKM has been requested to estimate folic acid intake from food supplements and from foods that are fortified with folic acid, in all age groups in the population above 1 year. In addition, possible consequences of amending the maximum limit for folic acid in food supplements should be discussed. In the literature search for this opinion (articles published from 2009 to 15 October 2014 were obtained), we found eight meta-analyses and five single studies where the aims were to study the relation between folic acid supplementation and incidence of cancer. Meta-analyses including studies in which folic acid was used in combination with other supplements were not included in the final evaluation, as the effect of folic acid could not be distinguished from the effect of the other substances. Only one meta-analysis was therefore considered relevant for the evaluation of UL for folic acid; a meta-analysis of patients with colorectal adenomas who received 1 mg folic acid per day for 3-6 years (Figueiredo et al. 2011). No increased risk of colorectal adenomas or cancer was found in this meta-analysis. Nor did the included single studies report increased risk of colorectal cancer following folic acid supplementation (Gao et al. 2013; Wu et al. 2009). Brain tumor and childhood leukemia were investigated in two case-control studies in offspring of women using folic acid supplementation during pregnancy (Amigou et al. 2012; Milne et al. 2012). Both studies indicated no negative effects of folic acid supplementation during pregnancy. A secondary analysis of one of the single studies on colorectal adenomas found a statistically significant increased risk of prostate cancer following folic acid supplementation (Figueiredo et al. 2009). However, the small number of prostate cancer cases in this single study does not make this result robust. In six studies circulating UMFA was reported among subjects who used folic acid supplements or who were subjected to folic acid food fortification. Whether UMFA contributes to the development of cancer or other undesirable health effects is not known. These studies do not provide new evidence for amending the existing UL for folic acid. About 26% of women and 18% of men aged 18-70 years participating in the nationwide dietary survey Norkost 3, reported to take folic acid supplements. The mean intake of folic acid among users was149 μg/day among women and 172 μg/day among men. Among pregnant women participating in The Norwegian Mother and Child Cohort Study, 62% reported use of folic acid supplements in 2008. Mean folic acid intake was 388 μg/day, and the 95th percentile was 800 μg/day. Information on intake of folic acid from supplements for other age groups is not available. Intake of folic acid from fortified foods is not available in the national food consumption surveys for any age groups. However, according to a Norwegian model for food fortification from 2006 and later updates (last update in 2013), 53 μg folic acid per 100 kcal can be added to food and drinks without exceeding the UL for folic acid in any age groups. With the current levels of folic acid in food supplements and current levels in fortified products, the UL for folic acid will not be exceeded. VKM was also requested to assess the impact of any increase of the current maximum limit of 200 μg for folic acid in supplements. Increasing the maximum limits in food supplements to 400 μg will imply exceedance of UL for children younger than 6 years and an intake close to UL in children 7-10 years. An increase in the maximum limits in food supplements to 600 μg will imply exceedance of UL for children younger than 10 years and an intake close to UL in children 11-14 years. Increasing the maximum limits in food supplements to 400 μg or 600 μg will not imply exceedance of UL among adults as evaluated in the Norwegian food fortification model (VKM, 2013). No new evidence for increased risk of cancer related to folic acid was found in the reviewed literature. Studies in subjects who had a history of colorectal adenomas, a group considered particularly vulnerable to develop cancer, reported no increased risk of colon cancer or adenomas after 3-5 years of treatment with 1000 μg of folic acid per day. VKM therefore concludes that studies published after 2009 and until 15 October 2014 examining cancer do not provide support to alter the existing UL for folic acid.

Red meat intake among employees of floating population aged 18-59 years old in China, 2012 / 中华流行病学杂志

Objective To evaluate the level of daily red meat intake and prevalence of excessive red meat intake among employees of floating population in China.Methods 48 511 employees of floating population aged 18 to 59 from 170 counties of 31 provinces (autonomous regions and municipalities) and Xinjiang Production and Construction Corps (District) were selected by stratified cluster sampling method.Information on red meat intake was collected by semiquantitative food frequency questionnaire.Average intake of 100 g/day,recommended by the World Cancer Research Fund,was used as the cut-off point to estimate the prevalence of excessive red meat intake.After performing the complex weighted analysis,level of daily red meat intake and prevalence of excessive red meat intake were calculated by demographic characteristics including age,education,industries and body mass index etc.Results 1) The mean daily red meat intake was 125.9 g(95％CI:116.5 g-132.5 g),higher in men(141.6 g,95％CI:131.3 g-148.9 g) than in women (104.7 g,95％CI:95.8 g-111.2 g) (P＜0.01).Results from the Tendency Test did not show statistically significant changes on the red meat intake related to age,education level or body mass index (P values for trend were all greater than 0.05).The standardized mean daily intake of red meat,adjusted by 2010 census data of China,was 121.0 g(95％ CI:113.4 g-128.7 g).2) The prevalence of excessive red meat intake was 36.2％ (95％ CI:33.0％-39.3％) significantly higher in males (42.4％,95％ CI:38.9％-45.8％) than in females (27.8％,95％CI:27.1％-31.0％) (P＜0.01).The prevalence was estimated to be the highest among the population aged 30-39,with 43.5％ (95％CI:39.7％-47.4％) in males and 30.1％(95％CI:26.5％-33.9％) in females.The standardized prevalence,adjusted by 2010 census data of China,appeared to be 34.6％ (95％CI:31.9％-38.0％).Conclusion The level of daily red meat intake was higher than 1 00 g/d,the standard recommended by the World Cancer Foundation,among floating population of China.Both the mean daily red meat intake and prevalence of excessive red meat intake were higher in floating population than that in the local residents in China.

Dietary maximum exposure assessment of vitamins and minerals from various sources in Korean adolescents / 한국영양학회지

Dietary supplement use is prevalent and represents an important source of nutrition. This study was conducted in order to assess the dietary maximum exposure of vitamins and minerals from various sources including regular diet, vitamin.mineral supplements for non-prescription drug (VMS-NPD), vitamin.mineral supplements for health functional foods (VMS-HFF), and fortified foods (FF). A total of 1,407 adolescent boys and girls attending middle or high schools were chosen from various cities and rural communities in Korea. Users of vitamin and mineral supplements (n = 60, 15-18 years of age) were chosen from the above 1,407 students. Intake of vitamins and minerals from a regular diet and FF was assessed by both food record method and direct interview for three days of two weekdays and one weekend, and those from VMS-NPD and VMS-HFF were assessed by both questionnaire and direct interview, and compared with the recommended nutrient intake (RNI) and the tolerable upper intake level (UL) for Korean adolescents. Daily average exposure range of vitamins and minerals from a regular diet was 0.3 to 4.4 times of the RNI. Some subjects had an excessive exposure to the UL in the following areas: from regular diets, vitamin A (1.7%) and niacin (5.0%); from only VMS-NPD, vitamin C (9.1%) and iron (5.6%); and from only VMS-HFF, niacin (8.6%) > vitamin B6 (7.5%) > folic acid (2.9%) > vitamin C (2.3%). Nutrients of daily total intake from regular diet, VMS-NPD, VMS-HFF, and FF higher than the UL included nicotinic acid for 33.3% of subjects, and, then, in order, vitamin C (26.6%) > vitamin A (13.3%), iron (13.3%) > zinc (11.7%) > calcium (5.0%) > vitamin E (1.7%), vitamin B6 (1.7%). Thus, findings of this study showed that subjects may potentially be at risk due to overuse of supplements, even though most of them took enough vitamins and minerals from their regular diet. Therefore, we should encourage adolescents to have sound health care habits through systematic and educational aspects.

The estimated daily manganese intake of Korean children aged 11-12

The purpose of this study was to estimate the daily manganese (Mn) intake of Korean children. This study was done using a three-day dietary intake survey of 257 Korean children (boys 123; girls 134). The Mn intake values were calculated based on a database that provides the Mn content of the frequently consumed Korean foods, alongside the food composition table provided by the Korean National Rural Living Science Institute. The average age, height, weight and body mass index of our subjects were 11.9 years, 155.4 cm, 48.9 kg and 20.2 kg/m2 in boys and 11.9 years, 154.1 cm, 43.5 kg and 18.3 kg/m2 in girls. The average daily energy intakes were 2,249.2 kcal in boys and 2,044.5 kcal in girls. Boys consumed significantly more Mn than girls, based on intake estimates of 4,585.3 microg (117.6% of adequate intake) and 4,029.3 microg (117.1% of adequate intake), respectively (P < 0.001). Boys had a Mn intake of 2,041.1 microg per 1,000 kcal of energy consumption, whereas for girls this was at 1,983.9 microg per 1,000 kcal. Neither group exceeded the tolerable upper intake level for Mn. The major food groups which contributed to Mn intake in our subjects were cereals (50.8%), vegetables (21.0%), seasonings (8.9%), and pulses (7.7%). Notably, boys derived a higher Mn intake through cereals and vegetable than did girls (P < 0.001, P < 0.05). The key food sources of Mn, in descending order, were rice, soybean curd, kimchi, black rice and cereals. We propose that the results of our study may be used as a basis for follow-up studies that examine the Mn intake of children.

Urgent need to increase current dietary reference intakes of vitamin D / 中华临床营养杂志

level and recommended nutrient intake)in China has been out-of-date.Therefore,it has became an urgent problem for Chinese Nutrition Society to re-evaluate the DRIs of vitamin D and make corresponding modifications.

Estimation of manganese daily intake among adults in Korea

The purpose of this study was to estimate daily intake of manganese in Korean adults. Manganese intake was estimated through the use of the database of manganese content in frequently consumed Korean foods after first conducting anthropometric measurement and a survey on dietary intake with 354 Korean adults. Average age, height, weight and body mass index were 54.6 years, 165.7 cm, 67.2 kg and 24.5 kg/m2 in males and 53.8 years, 153.7 cm, 59.1 kg and 24.9 kg/m2 in females. The daily energy intakes of subjects were 1740.1 kcal in males and 1432.6 kcal in females. Male and female subjects recorded, respectively, 5.2 mg and 4.1 mg in manganese intake indicating that the male subjects consume more manganese (p<0.001). And they posted, respectively, 3.0 mg and 2.9 mg in manganese intake per 1000 kcal of energy consumption; it turned out that there was no significant difference. Daily manganese intake of both males and females posted, respectively, 148.8% and 135.2% of the adequate intake, and 8 males and 3 females surpassed the tolerable upper intake level. It is suggested that the study for accurate determination of manganese consumption needs to be more diversified based on the database of manganese content in Korean foods.

The Effects of Isoflavones Intake Level on Bone Markers and Bone Related Hormones in Growing Female Rats

The overall purpose of this study was to investigate the effects of level of isoflavones supplementation on bone metabolism in growing female rats. Forty-five rats divided into three groups; Control, 1/2IF, and 1IF. Serum osteocalcin and alkaline phosphatase (ALP) activity, urinary deoxypyridinoline (DPD) crosslinks value were measured to monitor bone formation and resorption at the ninth week after feeding. Hormones related to bone metabolism were determined, included parathyroid hormone (PTH), calcitonin, estradiol, growth hormone and insulin-like growth factor I (IGF-I). The results of this study were as follows: the isoflavones intake level did not affect weight gain, mean food intake and food efficiency ratio. The serum concentration of osteocalcin and the activity of ALP were not significantly different by different levels of isoflavones supplementation. The urinary DPD crosslinks value was not significantly different by different levels of isoflavones supplementation. There were no significant differences in serum PTH, estradiol and IGFI among all groups. However, calcitonin was shown significantly higher in the groups of 1IF and 1/2IF than control group. And growth hormone was shown significantly higher in the groups of 1IF than control group.

Ready-to-eat Cereal Consumption Enhances Milk and Calcium Intake in Korean Population from 2001 Korean National Health and Nutrition Survey

The purpose of this study was to establish an association between the consumption of ready-to-eat cereal (RTEC), milk, and calcium within the context of the most current population dietary practice in Korea. Inadequate calcium intake among Korean children and adults is one of the important public health concern. Milk is one of the best calcium sources because of its bioavailability, and RTEC is one of the foods commonly consumed with milk. The most recent Korean National Health and Nutrition Survey, 2001 dataset was used as the source of data for this research. Subjects excluding pregnant women, were categorized according to gender and age (1~5, 6~11, 12~19, 20~49, 50 + years) and then by consumption of RTEC and milk. SAS and SUDAAN were used for statistical analyses. Sample weighted means, standard errors, and population percentages were calculated, and multiple regression model with adjustment for covariates were used to determine the predictability of total daily calcium intake from inclusion of RTEC and milk compared to the meal without RTEC and milk. RTEC was consumed by 2.4% of Korean people. Average calcium intake was 17 times greater when RTEC was consumed with milk than when RTEC was consumed without milk. Respondents who consumed RTEC with milk had significantly higher mean daily calcium and other nutrient intakes than respondents who consumed neither. In the multiple regression analysis, milk consumption with or without RTEC predicted total daily calcium intake after adjusting for age, income, and alcohol consumption (p < 0.0001). The percentage of respondents below the estimated average requirement (EAR) level for calcium was lower for RTEC consumers than for RTEC non-consumers in all age-gender groups, especially significant differences were in children aged 1~5, boys and girls aged 12~19, men aged 20~49, and women older than 50 years of age. RTEC consumption was not associated with intake in excess of the tolerable upper intake level (UL) for calcium. In conclusion, RTEC consumption was positively associated with both milk and calcium intakes in all age and gender groups in Korean population.

EFFECT OF DIFFERENT INTAKE LEVELS OF PROTEIN AND ZINC ON ZINC ABSORPTION AND RETENTION IN RATS / 营养学报

Thirty male weanling WAK strain rats were divided rondomly into 6 groups. All of the diets were pure synthetics according to AOAC. The 1st, 2nd and 3rd group were given diets containing 6, 15 and 24 ppm of zinc respectively, and 10% protein for all three groups, on the other hand, the 4th, 5th and 6th group were given diets containing 5% 10% and 20% of protein respectively, and 15 ppm of zinc.After feeding in stainless steel cage singly for 50 days rats were given intubately solution of 65Zn containing 1.5 ?Ci per 100g of body weight. Then the faeces and urine of rats were collected on 5 consecutive days, and the zinc absorption and retention of all of the tested rats were determined with method of 65Zn as tracer. The results indicated that. (1) The zinc absorption and retention of rats fed on the lowest zinc level were increased significantly. (2) The zinc absorption and retention of rats fed the lowest protein level were decreased significantly, and were improved clearly by increasing protein intake level. (3) The urine excretion of zinc is very low and can not be used as an index in zinc metabolism research. The methodology for determining zinc absorption and retention in organism with method of 65Zn and total zinc is discussed.