Search

Geriatric community centers often offer nutrition lectures to older adults. In order to make learning more interesting and pragmatic, we developed group activity sessions. This undertaking was tested for its efficacy in changes of frailty status and several other geriatric health parameters. A cluster-randomized controlled trial was conducted between September 2018 and December 2019 at 13 luncheon-providing community strongholds in Taipei, Taiwan. During the 3-month intervention period, 6 experimental strongholds received a weekly 1 h exercise workout and 1 h nutrition activities aiming at achieving the recommendations of the Taiwanese Daily Food Guide for elderlies; the other 7 received a weekly 1 h exercise workout and 1 h other activities. Dietary intakes and frailty status were the primary outcomes. Secondary outcomes included working memory and depression. The measurements were performed at baseline, 3 months, and 6 months. The nutrition intervention significantly reduced the intake of refined grains and roots (p = 0.003) and increased that of non-refined grains and roots (p = 0.008), dairy products (p < 0.0001), and seeds and nuts (at borderline, p = 0.080) at 3 months. Some, but not all, of these changes were maintained at 6 months. Performance improvements included the frailty status score (p = 0.036) and forward digit span (p = 0.004), a working memory parameter, at 3 months. Only the forward digit span remained improved (p = 0.007) at 6 months. The 3-month nutrition group activities combined with exercise sessions improved the frailty status and working memory more than exercise alone. The dietary and frailty improvements were accompanied by improved dietary intakes and advanced behavioral stages. However, the improved frailty status backslid after intervention ceased, suggesting that boosting activities are needed for maintaining the intervention effect.

It is unclear whether low dietary intake accompanied with multiple nutrient deficiencies or specific nutrient inadequacy is associated with geriatric syndrome. This study aimed to examine the nutrition inadequacy profiles associated with frailty and cognitive impairment (CI). With information from the Nutrition and Health Survey in Taiwan, 2014–2017, sex-specific nutrient intakes and intake per kg of body weight (BW) were estimated from 24-hour recall data for two age groups (65–74 years; ≥75 years) regarding the three frailty and three CI subgroups. Total energy intakes were significantly lower with the severity of both frailty and CI in analysis combining both gender and age groups, and in both the 65-to-74-year-old women or the over-75-year-old women. These trends were observed but not significant in either of the two age groups in men. Significantly lower levels of energy intake have been observed when age, sex, and sampling strata were adjusted. Intake levels of multiple nutrients also decreased with the severity of frailty and CI. A greater number of nutrient inadequacies for the frail and the CI was found in the 65-to-74-year-old group than the over-75-year-old age group. However, most of the associations between micronutrients and the two geriatric syndromes disappeared after energy adjustment. The remaining few did not show consistency across age–sex subgroups. In conclusion, frailty or CI was associated with low amounts of food consumption accompanied by multiple nutrient insufficiencies. Dietary intervention to ensure adequate total energy and multiple nutrient intakes should be trialed in the geriatric population to address both the causal and efficacy issues.

Background Emerging evidence suggests that a dietary protein intake higher than the current recommended dietary allowance of 0.8 g/kg body weight (BW)/d may be needed to maintain optimal muscle mass, strength, and function in older adults. However, defining optimal protein intake in this age group remains a challenge. Objective In this study we sought to describe the dietary protein intake in frail, prefrail, and robust older Taiwanese adults. Methods Data for 1920 older adults were collected from the Nutrition and Health Survey in Taiwan from 2014 to 2017. Dietary intake was assessed using the 24-h recall method. Frailty was determined using the modified Fried's criteria. Body composition was assessed using DXA. Sex-specific dietary protein intakes, measured as values/kg of BW, fat-free mass (FFM), and lean mass (LM), were estimated for the 3 age groups (65-69, 70-79, and ≥80y) and the 3 frailty levels. Results In both males (P for trend = 0.034) and females (P for trend = 0.015), there were significant downward trends for protein intake/kg of BW with the severity of frailty. The age-adjusted protein intake/kg of BW was still significant in males (P for trend = 0.009), but no longer in females. This phenomenon was also seen for protein intake at lunch and dinner but not at breakfast. Age-adjusted trends for protein intake/kg FFM or LM were not significant in either sex. The median protein intake in robust older males and females was 1.21 and 1.19 g/kg BW/d, respectively, and the mean intakes were even higher. Conclusion Median protein intake in robust Taiwanese older adults was approximately 1.2 g/kg BW/d, with higher mean values. The protein adequate intake in Taiwanese older adults was higher than the current recommended daily allowance (RDA) level but within the RDA range derived from the state-of art indicator amino acid oxidation technique.

A healthy dietary pattern review for Asian countries is scarce, which is crucial for guiding healthy eating. We reviewed Taiwanese dietary pattern discovery studies. Included were 19 studies, the majority of which employed dimension reduction methods to find dietary patterns associated with various health conditions. To show what is a high or low intake of foods in Taiwan, we also report the average dietary content and the 25th and 75th percentile values of the adult population for six food groups gathered by the Nutrition and Health Survey in Taiwan, 2017–2020. The healthy Taiwanese dietary approach is cohesive across multiple health outcomes occurring at different ages. It is featured with higher intakes of plant-based foods, aquatic foods, and some beneficial ethnic foods (soy products), drinks (tea), and cooking methods (boiling and steaming); lower intakes of fast foods, fatty and processed meats, sugar, salt rich foods/drinks, and fried foods; but with mixed findings for dairy and egg. Yet, the average Taiwanese person consumed many refined staple foods and livestock, but not sufficient vegetables, fruits, whole grains and roots, beans, and nuts. Dairy consumption remains low. In conclusion, Taiwanese discovery studies point to a mortality-lowering total wellbeing dietary pattern consistent with the current knowledge, which discloses potential benefits of soy product, tea, and boiling and steaming.

Phytonutrients may play important roles in human health and yet only recently a few studies have described phytonutrient consumption patterns, using data obtained from daily consumption methods. We aimed to estimate the phytonutrient content in Taiwanese diets and analyzed main food sources of 10 major phytonutrients. In this study, food items and dietary data gathered with the 24-hour dietary recall from 2908 participants in the 2005–2008 Nutrition and Health Survey in Taiwan were used to create a food phytonutrient database with 933 plant-based foods through integrating database, literature search, and chemical analysis and to appraise phytonutrient consumption status of participants. SUDAAN (Survey Data Analysis) was used for generating weighted phytonutrient intake estimates and for statistical testing. In Taiwanese adults, ∼20% met the recommended number of servings for fruits and 30% met that for vegetables from the Taiwan Food-Guide recommendations. However, only 7.4% consumed the recommended numbers for both fruits and vegetables. Those meeting the recommendations tended to be older and with more females compared with those who did not. Phytonutrient intake levels were higher in meeters than nonmeeters. More than 60% of α-carotene, lycopene, hesperetin, epigallocatechin 3-gallate, and isoflavones came from a single phytonutrient-specific food source. In addition, sweet potato leaf, spinach, and water spinach were among the top three sources of multiple phytonutrients. Cross-comparison between this study and two previous studies with similar methodology showed higher mean levels of lycopene and quercetin in the United States, anthocyanidins in Korea, and lutein and zeaxanthin in Taiwan. The Taiwanese phytonutrient pattern is different from that of the Korean and American. It would be interesting to relate phytonutrient patterns to health profiles in the future.

In this short review, an electroorganic synthesis approach to the construction of addressable, complex molecular surfaces is described along with the parameters that guided the development of that synthetic approach. The result of the work is a synthetic toolbox that will allow microelectrode arrays to be used for the "real-time" monitoring of small molecule interactions with biological targets.

Microelectrode arrays are potentially powerful tools for monitoring molecular interactions between small molecules and biological targets in "real-time". Yet while the potential for the arrays is coming into focus, there are still barriers that prevent us from taking full advantage of the devices. Chief among these is the need to construct and characterize molecules on the arrays so that they are specifically located by individually addressable electrodes or groups of electrodes in the array. Currently, we are working on methods to construct larger molecular libraries directly on the arrays, an effort that seeks to avoid transferring the libraries to the array one member at a time. To do so, we need to expand the synthetic toolbox available on the arrays. In that context, olefin functionalization is one of the most powerful strategies in modern organic chemistry because it converts readily available double bonds into a wide array of functional groups. For this reason, we are initially examining the role of cis-dihydroxylation, epoxidation, and diazidation reactions which can play in a site-selective array-based synthesis. The chemistry is already paying dividends. In one application, we have shown that a site-selective cis-hydroxylation reaction can enable a new “safety-catch" linker strategy that is completely orthogonal to the typical deprotection strategies used for diversity of oriented syntheses. The result provides a foundation for future synthetic efforts because it enables full characterization of molecules synthesized by any electrode in an array. In this poster, we will discuss progress towards additional array-based olefin functionalization reactions as well as detail the safety-catch linker strategy mentioned above. Figure 1

Cu(I)-catalyzed "click" reactions cannot be performed on a borate ester derived polymer coating on a microelectrode array because the Cu(II) precursor for the catalyst triggers background reactions between both acetylene and azide groups with the polymer surface. Fortunately, the Cu(II)-background reaction can itself be used to site-selectively add the acetylene and azide nucleophiles to the surface of the array. In this way, molecules previously functionalized for use in "click" reactions can be added directly to the array. In a similar fashion, activated esters can be added site-selectively to a borate ester coated array. The new chemistry can be used to explore new biological interactions on the arrays. Specifically, the binding of a v107 derived peptide with both human and murine VEGF was probed using a functionalized microelectrode array.

Diblock copolymers are excellent coatings for microelectrode arrays because they provide a stable surface that can support both synthetic and analytical electrochemistry. However, the surfaces that are optimal for synthetic studies are not the same as the surfaces that are optimal for analytical studies. Hence, no one surface provides an ideal platform for both building and analyzing a molecular library. Fortunately, the synthetic chemistry available on a microelectrode array allows a surface that is ideal for synthesis can be converted into one that is ideal for signaling studies; a scenario that allows for the use of an optimized synthetic and analytical surface on a single microelectrode array.

Alanine aminotransferase (ALT) is generally used for evaluating liver function, and its concentrations are closely associated with sex and nutritional status. This study investigates the relationships between dietary components and serum ALT activity in Taiwanese adolescents.Data were collected from 1,941 adolescents aged 13-18 years who participated in the fourth National Nutrition and Health Survey in Taiwan (2010-2011, adolescents).The mean age was 15.3±0.1 y (15.3±0.1 y for boys and 15.2±0.1 y for girls). Mean serum ALT was 14.8±13.3 U/L (17.7±16.3 U/L for boys and 12.1±8.7 U/L for girls; p0.001). Multivariate analysis revealed that, among girls, a single-unit increase in dietary zinc was associated with 1.12- and 1.11-fold increases in risk for increased serum ALT tertile 2 (T2) and T3, respectively, compared with T1; and a single-unit increase in vitamin B-2 intake increased risk by 1.71- and 1.54-fold, respectively. Further analysis revealed that the risk increase for boys and girls who consumed the highest amounts of dietary zinc and vitamin B-2 (T3) was 1.97- and 2.62-fold, respectively; they were also more likely to have higher serum ALT (11 U/L for boys and9 U/L for girls) than those of the reference (presented as zinc T1 and vitamin B-1 T1).Increased dietary zinc and vitamin B-2 intake is associated with higher serum ALT in adolescents.

OBJECTIVES: Indicator of Amino Acid Oxidation (IAAO) method is a state-of-art method to determine protein requirement. A recent review summarized the estimated average requirement (EAR) derived from IAAO plus two standard deviations as around 1.15–1.29 g/Kg body weight (BW) for elderlies. However, emerging evidence shows that providing protein beyond nitrogen balance point (as high as 1.5 g/Kg BW) to frail or pre-frail elderlies seems to provide additional benefit on muscle mass and performance, compared to 1.2 g/Kg BW. It is not clear whether community-dwelling elders require higher than 1.2–1.3 g/Kg BW to maintain adequate muscle mass and quality. This study intends to derive dietary protein Adequate Intake (AI) from a group of representative community-dwelling non-frail elderlies in Taiwan. METHODS: Using the 24-hour recall data of 1430 elderly adults (65y) from the Nutrition and Health Survey in Taiwan, 2014–2016, protein intake by age groups (65–69; 70–79; 80+) and by frailty levels (robust; pre-frail; frail) in both genders was estimated. Frailty phenotypes were determined using Linda Fried criteria. SUDAAN was used for statistical analysis. RESULTS: Mean levels of protein intake were 1.2, 1.4, and 1.3 g per Kg body weight (BW) per day (d) for men aged 65–69, 70–79, and 80+; and 1.2, 1.3, and 0.9 g/Kg BW/d for women at the same age groups. The mean protein intakes were 1.4, 1.3, and 1.2 g/kg BW/d for elderly men at robust, pre-frail, and frail states, respectively; and they were 1.3, 1.2, and 1.0 for women. The median were 1.3, 1.2, and 1.1 for men and 1.3, 1.1, and 1.1 for women. CONCLUSIONS: Adequate intake of the community-dwelling elderly Taiwanese men and women is estimated around 1.3 g/Kg BW/d, taking into consideration the frailty issue. This information may be considered complementary to IAAO data in establishing protein requirement. FUNDING SOURCES: Health Promotion Agency; International Life Science Institutes; Academia Sinica.

Microelectrode arrays can be ideal tools for probing a host of biological interactions. Yet in spite of their general utility, their use is still limited by our ability to construct complex molecular surfaces that can spatially isolate molecules in specific locations proximal to specific electrodes. With this in mind, we have been developing electrochemically based tools that allow for the placement of molecules by specific electrodes in an array and then probe the binding of those molecules with biological targets in “real-time”. Yet while those methods are very useful, they have limits. They enable the analysis of smaller libraries, but are not as effective if one wants to probe a receptor with even a medium size library. The problem is that the tools developed to date require a library to be synthesized at a remote site and then transfer that library to the array one molecule at a time. For larger libraries, this is time consuming and cumbersome. A better strategy would be to build the library directly on the array. The approach to building a molecular library typically involves a diversification strategy like the one shown in Scheme 1. In the Scheme, P1-P4 represent protecting groups that can be orthogonally removed. But what are the orthogonal protecting groups that can be removed site-selectively on a microelectrode array so that such a strategy can be used to synthesize more complex molecular surfaces? Furthermore, are the current surfaces used on the arrays compatible with such an intensive synthetic effort? In the talk to be given, we will describe initial findings that begin to address these questions as we push for the development of new methods that will allow for the greater community to take full advantage of what microelectrode arrays can offer. Figure 1

Microelectrode arrays have great potential as a platform for monitoring the interactions between small molecules and biological receptors in “real-time”. For this reason, we have developed new polymer coatings for the arrays, new site-selective methods for building or placing molecules by electrodes in the arrays, new methods for characterizing molecules build on the arrays, and new approaches to detecting molecular interactions that occur on the array.1 With these tools in place, attention is now being turned toward using the arrays to gather biological data on molecules of interest. That effort has at times been successful, and at times raised new challenges for controlling the surface of the arrays. The talk to be presented will focus on two such problems. One of the reasons the arrays were developed was so that we could examine “weaker” interactions without the washing steps required by many immunological studies. One such challenge involved the binding of the v107 peptide to its VEGF target (Scheme 2). In particular, we were interested in comparing the binding of peptide analogs to both the human and murine VEGF proteins. While homology studies suggested that the binding should be similar, we hoped to experimentally verify that suggestion and develop a cheap easy way to probe such interactions. V107 is known to bind the human VEGF with micromolar affinity (Scheme 2). The suitability of the arrays for this study will be highlighted with both receptors leading to very similar binding curves with the surface bound v107 peptide. While interactions with stronger affinity can be seen very well, there are challenges associated with the arrays amplifying the signals. For example, our interest in using the arrays to probe interactions between small molecules and their G-protein targets has been hampered by the signal being amplified to a point that cannot be observed on the arrays. In this talk, an approach to solving this problem will be presented. 1. For an instructional review see: Graaf, M. D.; Moeller, K. D. Langmuir 2015, 31, 7697. Figure 1

Functional gastrointestinal disorders (FGID) are a group of disorders of the digestive system in which the chronic or recurrent symptoms cannot be explained by the presence of structural or tissue abnormality. This survey used a modified Rome III questionnaire on the health and nutrition status of a general population in Taiwan during 2005-2008. A total of 4,275 responders completed the questionnaire. The sample was evenly distributed for men (n=2,137) and women (n=2,138). The prevalence of FGID was 26.2%. Unspecified functional bowel disorder was the most prevalent (8.9%). The second was functional dyspepsia (5.3%), and the third were irritable bowel syndrome (4.4%) and functional constipation (4.4%). Women had a greater prevalence than males (33.2% compared to 22.4%, p0.05) with regards to total FGID. Most categories of FGID were significantly prominent in women, except functional diarrhea. The FGID groups took fewer servings of vegetables and fruits than the non-FGID group each day (vegetables 2.51 vs 2.70, p0.001; fruits 0.82 vs 0.91, p0.001). Smoking, alcohol consumption, and betel nut chewing had no significant impaction on prevalence of FGID. The mean BSRS (brief-symptom rating scale) for screening depression and suicide ideation was higher in the FGID group (2.86 vs 1.63, p0.001). In conclusion, FGID diagnosed with Rome III criteria are not uncommon in Taiwan's general population. Subjects who met the Rome III criteria for FGID in Taiwan were younger, had less vegetables and fruits intake, higher BSRS scores and were of greater female predominance.

Choline and betaine are involved in several similar health-relevant metabolic pathways, but the foods sources are different. We have assessed their intakes (individual, sums and ratios) from a dominantly Chinese food cultural point of view. A representative free-living Taiwanese population aged 13-64 years was drawn from the Nutrition and Health Survey in Taiwan (NAHSIT) 1993-1996. Food intake was derived from interviews as 24-hour recalls. The USDA database, with adaptations for Taiwan, provided choline and betaine food compositions. Major food contributors of these nutrients were identified and compared with data from the US Framingham offspring study. Mean and variance reduced median nutrient intakes were calculated. Top ten major food contributors of choline in Taiwan were eggs, pork, chicken, fish, soybean and its products, dark leafy vegetables, dairy, fruit, wheat products and light leafy vegetables in sequence. For betaine, the top ten were dark leafy vegetables, wheat products, fish, pork, bread, chicken, cake/cookies, grain-based alcoholic beverages, rice and its products and sauces. The main contributors of choline in Taiwan and the USA were, respectively, eggs and red meat; and for betaine, greens were similarly best contributor. The rankings of the main food contributors of choline and betaine differed substantially between Taiwan and the USA. The total daily intakes (mean±SE, mg) in Taiwan for choline were 372±19 (median=348) in men and 265±9 (median 261) for women; for betaine, values were 101±3 (median 93) in men and 78±8 (median 76) for women. These allow for health outcome considerations.

The aim of this study was to investigate trends in nutrients and sources of dietary intake for Taiwanese people from the Nutrition and Health Survey in Taiwan (NAHSIT) 1993-1996 to 2005-2008. Twenty-four hour dietary recall data were obtained from the 2005-2008 NAHSIT. The results showed that intake of cereals and grains, and dietary fiber has decreased, whereas intake of carbohydrate rich convenience foods has increased. As a result, 10-20 g of dietary fat is now obtained from carbohydrate rich foods. A greater proportion of Taiwanese are choosing low-fat meat products, however, excessive intake of meat by men and women aged 19 to 64 years is resulting in excessive intakes of protein, cholesterol and saturated fat. Men and women aged 19 to 30 years had insufficient intakes of fruit and vegetables. Consumption of fruit, dairy/products, and nuts was low in all age groups. We recommend strengthening public nutrition education and changing diet related environment to improve dietary quality and food group distributions. Issues of concern include excessive intakes of energy and the soybean/fish/meat/eggs food group in all subjects, high amount of processed foods and refined-carbohydrate rich foods in men aged 19 to 64 years and women aged 19-30 years, as well as intakes below the DRI for a variety of nutrients in elderly persons.

The availability of new food choices has increased dramatically in recent times, whilst increasingly sedentary lifestyles have reduced calorie intake requirements. The present study uses 24 hour dietary recall data, and biochemical and anthropometric measurements from the 1993-1996 and 2005-2008 Nutrition and Health Surveys in Taiwan (NAHSIT) to investigate trends in dietary habits, and cardiovascular and metabolic disease markers in Taiwanese persons aged 19 years and above. We found that dietary habits in Taiwan are changing, particularly in regards to intakes of cakes and sweets, and sugary drinks. Energy intakes in young people have increased, and combined with an increasingly sedentary lifestyle, this may have led to the increase in obesity and associated metabolic diseases. Large increases in the prevalence of the metabolic syndrome, diabetes, hypertriglyceridemia and gout have been observed. Fortunately, some positive dietary and behavioral changes have also been observed; including an increased avoidance of products made from animal fats and oils' and a concomitant increase in the use of vegetable oil. Intakes of fruit and vegetables, soy products, fish, whole grains, nuts and seeds have also increased; and intakes of red meat, carbohydrates and sodium containing foods have decreased. These positive dietary changes could explain the lack of large changes in the prevalence of hypertension and hypercholesterolemia, and the decrease in prevalence of hyperuricemia. Intake of dairy products remains low, and continues to be an important dietary issue in Taiwan.