Plasma NOx concentrations in glucose intolerance and type 2 diabetes. A case-control study in a Vietnamese population.

AIM: The Vietnamese develop type 2 diabetes (T2D) and metabolic syndrome (MS) at a lower BMI than other ethnicities. Thus, biomarkers that identify subjects at an increased risk of T2D independently of obesity are being sought. Recent studies show that circulating NO metabolites (NOx) are increased in T2D. We investigated whether plasma NOx levels predict insulin resistance and glucose intolerance before the development of T2D, independently of obesity. METHODS: The current study was derived from a population-based study in HCMC, Vietnam, which was designed to investigate the prevalence of MS and T2D in a population aged 30-69 years. Four hundred and twenty-two subjects were recruited from the study and were stratified into 4 age- and gender-matched groups according to a glucose tolerance test {normal glucose tolerance (NGT), impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and T2D}. RESULTS: Plasma NOx concentrations were significantly increased in T2D but not in IFG or IGT compared with NGT. Multiregression analysis showed that plasma NOx levels were inversely correlated with BMI in T2D whereas no association was found between plasma NOx levels and BMI in non-diabetic subjects. Moreover, there was no correlation between plasma NOx levels and homeostasis model assessment-insulin resistance (HOMA-IR) in both diabetic and non-diabetic subjects. CONCLUSION: Plasma NOx levels did not predict glucose intolerance or insulin resistance before the development of T2D and the increase in plasma NOx levels in T2D was not caused by adiposity. Thus, plasma NOx is not a useful marker for the prediction of high-risk subjects for T2D among Vietnamese.

Trends in overweight and obesity in pre-school children in urban areas of Ho Chi Minh City, Vietnam, from 2002 to 2005.

OBJECTIVE: To assess the trends in overweight and obesity in pre-school children in urban areas of Ho Chi Minh City (HCMC), Vietnam, over the period 2002 to 2005. DESIGN: Two cross-sectional studies were conducted in 2002 and 2005. Multistage cluster sampling was used in both surveys to select the subjects. Sociodemographic information was collected using a self-administered questionnaire given to parents in 2002 and using an interview-administered questionnaire to parents in 2005. Weight and height were measured using the same standard methods in both surveys. BMI (kg/m2) was calculated and overweight/obesity was defined using the age- and sex-specific BMI cut-off points proposed by the International Obesity Taskforce. SUBJECTS AND SETTING: Children aged 4 to 5 years, attending pre-schools in urban areas of HCMC, Vietnam, in 2002 (n 492) and 2005 (n 670). RESULTS: The prevalence of overweight and obesity almost doubled from 2002 to 2005 (21.4 % and 36.8 %, respectively). The increase was more evident in less wealthy districts than in wealthy districts. The proportion of boys classified as obese in 2005 (22.5 %) was three times that in 2002 (6.9 %). CONCLUSION: The prevalence of overweight and obesity has increased rapidly in children aged 4 to 5 years in urban areas, and especially in less wealthy districts, over a 3-year period. These results signal an urgent need for prevention programmes to control and reverse this rapid upward trend in overweight and obesity in young children in HCMC.

Prevalence of overweight and obesity in preschool children and associated socio-demographic factors in Ho Chi Minh City, Vietnam.

OBJECTIVE: To evaluate the magnitude of overweight and obesity and its relationship with socio-demographic factors among preschool children in urban areas of Ho Chi Minh City (HCMC), Vietnam. METHODS: This is the baseline measurement from a one-year follow-up study on obesity in children attending kindergartens in HCMC with a sample of 670 children. Socio-demographic information was collected using an interview-administered, pre-coded questionnaire. Weight and height were measured. Body mass index (BMI: kg/m(2)) was calculated and overweight/obesity was defined using age- and sex-specific BMI cut-off points proposed by the International Obesity Task Force. RESULTS: The prevalence of overweight and obesity was 20.5% (95% CI: 17.5, 24.3) and 16.3% (95% CI: 13.2, 20.4), respectively. The level of overweight/obesity was similar in both less wealthy and wealthy urban areas: 35.9% (95% CI: 29.4, 42.9) and 38.9% (95% CI: 32.3, 45.0), respectively. A multivariate model showed that gender, parental overweight, paternal education, high birth weight, duration of breast-feeding and sleep hours at night were all significantly associated with overweight/obesity (p < 0.05). The prevalence ratio of overweight/obesity and obesity in children where both parents were overweight were 1.87 (95% CI: 1.37, 2.54) and 2.59 (95% CI: 1.46, 4.61) times, respectively, higher than for children whose parents were of normal weight. The prevalence ratio of being obese significantly decreased by 5% (PR: 0.95; 95% CI: 0.93, 0.98) for each additional month of breast-feeding. CONCLUSIONS: Overweight and obesity is a public health problem in preschool children and apparently becoming widespread in urban areas of HCMC. Overweight and obesity in children were strongly associated with parental overweight status, but longer duration of breast-feeding and longer sleep duration at night appear to protect against overweight and obesity in young children.

An evaluation of the impact of a school nutrition programme in Vietnam.

OBJECTIVE: To evaluate the effectiveness of a school nutrition programme on the weight gain and growth of Vietnamese schoolchildren. DESIGN: A proximate cluster evaluation of children in seven schools, in which fortified milk and biscuits supplying 300 kcal of energy were being given on school days, compared with children in 14 nearby schools with no feeding. All children were dewormed. SETTING: Twenty-one primary schools in Dong Thap Province, Vietnam. SUBJECTS: A cohort of 1080 children in grade 1 of 21 primary schools, and a cross-sectional interview of 400 children in grade 3. RESULTS: The programme gave children the equivalent of 90 kcal day- 1 over 17 months. t-Tests showed a small but statistically significant difference between groups in their average gain in weight and height: 3.19 versus 2.95 kg (P < 0.001) and 8.15 versus 7.88 cm (P = 0.008). A multiple-level model showed that the programme was statistically significant after controlling for clustering of children in schools, sex, age and initial underweight (P = 0.024). A significant impact on height was also seen in a regression model, but not when controlling for school. The most undernourished children tended to gain the least weight. There was no evidence of substitution. CONCLUSION: The programme had a small but significant effect on weight gain, but the most undernourished children benefited the least. Methods need to be developed to target them. This design may offer a means of estimating the impact of school feeding on growth in other programme settings.

Reproducibility and validity of a food frequency questionnaire among Vietnamese in Ho Chi Minh City.

OBJECTIVE: Our objective was to assess the reproducibility and validity of a food frequency questionnaire (FFQ) among individuals living in Ho Chi Minh City, Vietnam. METHODS: A total of 116 food items in our FFQ were selected by ranking food items according to their contribution to the population intake of nutrients, based on multiple 24-hour recalls (24HRs) from 144 participants in July 2001. The FFQ was validated by using three 24HRs for 118 men and women in Ho Chi Minh City, Vietnam in August 2002. The reproducibility of the FFQ was assessed by repeated administration at 7 +/- 3.4 days. RESULTS: The reproducibility study showed that Spearman correlation coefficients, adjusted for energy intake, ranged from 0.47 to 0.72, and that weighted kappa values ranged from 0.42 for lipid to 0.65 for potassium. In the validation study, correlation coefficients, adjusted for energy intake, between the FFQ and the 24HRs ranged from 0.16 (calcium) to 0.45 (retinol). The proportion of subjects classified by the FFQ into the same third as determined by the 24HRs was between 42% and 62%. CONCLUSIONS: This food frequency questionnaire measured the usual intake of major nutrients for Vietnamese adults living in Ho Chi Minh City and its urban area, where dietary patterns are similar to those of the Vietnamese population.

Anthropometric characteristics, dietary patterns and risk of type 2 diabetes mellitus in Vietnam.

OBJECTIVE: To determine the impact of anthropometric characteristics and dietary patterns on Type 2 diabetes mellitus in Vietnam. METHODS: Data from 144 subjects (9m/39f newly diagnosed diabetics; 18m/78f control subjects) were analyzed in this case-control study. Height, weight, waist and hip circumferences and percent body fat were measured. Dietary intakes were assessed by 24-hour recall on three non-consecutive weekdays. Fasting blood samples were collected for the analysis of plasma glucose, fructosamine, protein and lipid concentrations. RESULTS: Although the body mass index (BMI, kg/m(2)) was similar between diabetic and control subjects, diabetic subjects had significantly greater percent body fat (31.1 +/- 5.8% vs. 27.7 +/- 6.2%) and waist-hip ratios (WHR, 0.91 +/- 0.07 vs. 0.86 +/- 0.08). Diabetic subjects had higher intakes of protein (p < 0.01), especially animal protein (p < 0.001), and consumed more meat (p < 0.01) than control subjects. Percent body fat and WHR were positively associated with diabetes (odds ratios [OR] 1.53 [95%CI 1.29-1.79] and 1.09 [95% CI 0.89-1.58], respectively) as were protein intake (OR 1.21 [95% CI 1.12-1.31]) and animal protein intake (OR 1.18 [95% CI 1.10-1.26]). CONCLUSIONS: This study indicates that percent body fat and WHR are risk factors associated with diabetes even when the BMI is normal. Evolving dietary patterns with increasingly more protein and meat consumption may also contribute to the deterioration of glucose metabolism among Vietnamese people.