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This study aimed to determine the phytochemical, antioxidant, and anticancer activities of the crude extract and its fractions of Cupaniopsis anacardioides. The results showed that total phenolic content (TPC), their secondary metabolites (flavonoids—TFC; proanthocyanidins—TPro), and antioxidant activity were significantly different between the crude extract and its fractions. The butanol fraction (F3) had the highest levels of TPC, TFC, and TPro, followed by the crude extract, aqueous fraction (F4), dichloromethyl fraction (F2), and hexane fraction (F1). High-Pressure Liquid Chromatography (HPLC) analysis revealed 14 major bioactive compounds were identified in the C. anacardioides extract. Further analysis showed F3 fraction contained the highest levels of the major bioactive compounds, while F1 fraction had the lowest. A similar pattern was observed for antioxidant activities. The crude extract, F3 and F4 fractions were further tested for cytotoxicity against 10 cancer cell lines, including HT29 (colon); U87, SJG2 (glioblastoma); MCF-7 (Breast); A2780 (ovarian); H460 (lung); A431 (skin); Du145 (prostate); BE2-C (neuroblastoma); MIA PaCa-2 (pancreas); and one non-tumour-derived normal breast cell line (MCF10A). Except for Du145 (prostate), the crude extract, F3 and F4 fractions inhibited the cancer cell lines at 100 µg/mL, with F3 possessing greater activity against these cancer cell lines. Future studies are recommended to isolate and identify the major bioactive compounds of the F3 fraction, and further tested their impact against cancer cell lines. This could identify the potential of anticancer agents from C. anacardioides. [ABSTRACT FROM AUTHOR]

This study applied ultrasound-assisted extraction (UAE) to effectively extract phenolic compounds and antioxidant properties from the Tuckeroo fruits using Response Surface Methodology (RSM). The results showed that ultrasonic temperature and time, sample to solvent ratio and acetone concentration significantly affected extraction yields of total phenolic compounds (TPC), flavonoids (TFC), proanthocyanidins (TPro), as well as affecting antioxidant capacity. The optimized UAE experimental conditions were recommended to be 50°C, 60 min, 2:100 g/mL, and 60% acetone for any subsequent analysis of the content of phenolic compounds in the Tuckeroo fruits. The modified optimal conditions are recommended to be 40°C, 40 min, 5:100 g/mL, and 50% acetone. [ABSTRACT FROM AUTHOR]

Aim. To review the prevalence of gestational diabetes mellitus (GDM) in Eastern and Southeastern Asia. Methods. We systematically searched for observational studies on GDM prevalence from January 2000 to December 2016. Inclusion criteria were original English papers, with full texts published in peer-reviewed journals. The quality of included studies was evaluated using the guidelines of the National Health and Medical Research Council, Australia. Fixed effects and random effects models were used to estimate the summary prevalence of GDM and the corresponding 95% confidence intervals (CI). Results. A total of 4415 papers were screened, and 48 studies with 63 GDM prevalence observations were included in the final review. The pooled prevalence of GDM was 10.1% (95% CI: 6.5%–15.7%), despite substantial variations across nations. The prevalence of GDM in lower- or upper-middle income countries was about 64% higher than in their high-income counterparts. Moreover, the one-step screening method was twice more likely to be used in diagnosing GDM when compared to the two-step screening procedure. Conclusions. The prevalence of GDM in Eastern and Southeastern Asia was high and varied among and within countries. There is a need for international uniformity in screening strategies and diagnostic criteria for GDM. [ABSTRACT FROM AUTHOR]

Aims: We estimated the prevalence of diabetes and prediabetes among Vietnamese adults, and quantitatively evaluated association with known risk factors.Methods: Subjects were 5602 men and 10,680 women in North Vietnam aged 30-69 years participating in community diabetes screening programs during 2011-2013. We calculated standardized prevalence rates and demographic projections for 2035, and used multinomial regression analysis to examine the associations of multiple risk factors with diabetes and prediabetes.Results: The age-, sex- and area of residence-standardized prevalence of diabetes was 6.0% and of prediabetes was 13.5%, with higher prevalence among men than women. Population aging is projected to raise the prevalence of diabetes to 7.0% and of prediabetes to 15.7% by 2035. Older age, obesity, large waist-to-hip ratio and hypertension were each associated with higher prevalence of diabetes, whereas the opposite direction of association was observed for underweight and minority ethnicity. In addition, diabetes was positively associated with family history of diabetes in women, but inversely related to physically heavy work among men.Conclusions: One in 17 and one in 7 adults had diabetes and prediabetes, respectively, in Vietnam. Urbanization, population aging, increased adiposity, hypertension and sedentary work are associated with the increasing prevalence of diabetes. [ABSTRACT FROM AUTHOR]

Xao tam phan (Paramignya trimera(Oliv.) Guillaum) has been used as an herbal medicine for the treatment of cancer or cancer-like diseases in recent years, particularly in Vietnam. Drying is an important step for preparation of dried materials for storage and further investigation; however, the effects of drying must be taken into account when processing samples, because this can have profound effects on the stability of phytochemical compounds and the biological activity of the driedP. trimeraroot. As such, this study assessed the effects of four different drying methods (conventional, hot air, vacuum, and microwave) on phytochemical retention and antioxidant capacity ofP. trimeraroot, to identify an optimal drying method forP. trimeraroot. The results showed that the drying methods significantly affected phytochemical levels and antioxidant capacity ofP. trimeraroot and that among the four drying methods tested, microwave drying (400 W) had the highest levels of phytochemical compounds, with total phenolic, total flavonoid, proanthocyanidin, and saponin contents of 11.27 mg GAE, 19.88 mg RE, 3.98 mg CE, and 267.15 mg EE/gram of dried sample, respectively. Dried sample prepared using this method had antioxidant capacity comparable to that of other drying methods. In addition, this method had the shortest drying time (0.28 h) and consumed the least energy (0.28 kWh). Therefore, microwave drying should be considered for dryingP. trimeraroot for further investigation and utilization. [ABSTRACT FROM PUBLISHER]

Background: Leptin and ghrelin have been implicated in the pathogenesis of major depression. However, evidence is lacking among apparently healthy people. This study examined the relationship of these appetite hormones to depressive symptoms in a Japanese working population. Methods: A cross-sectional study was conducted in 2009 among 497 Japanese employees (287 men and 210 women) aged 20–68 years. Fasting serum leptin and ghrelin levels were measured using a Luminex suspension bead-based multiplexed array. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression (CES-D) scale. Logistic regression analysis was performed to estimate odds ratio (OR) and 95% confidence interval (CI) for depressive symptoms with adjustment for potential confounders. Results: The prevalence of depressive symptoms (CES-D ≥16) was 26.5% and 33.3% among men and women, respectively. Women in the middle and highest tertiles of leptin levels showed lower odds for depressive symptoms compared with those in the lowest level, although the trend association was not statistically significant (Ptrend = 0.14). Higher ghrelin levels were associated with increased odds for depressive symptoms in women (Ptrend = 0.02). The multivariable adjusted OR (95% CI) of having depressive symptoms for the lowest through highest tertiles of ghrelin levels were 1.00 (reference), 1.71 (0.76 − 3.86), and 2.69 (1.16 − 6.28), respectively. Neither leptin nor ghrelin was associated with depressive symptoms in men. Conclusions: Results suggest that lower leptin and higher ghrelin levels may be related to higher prevalence of depressive status among Japanese women. [ABSTRACT FROM AUTHOR]

ObjectiveTo examine the association between the consumption of green tea, coffee and caffeine and depressive symptoms.DesignCross-sectional study. Consumption of green tea and coffee was ascertained with a validated dietary questionnaire and the amount of caffeine intake was estimated from these beverages. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale. Multiple logistic regression analysis was performed to compute odds ratios and 95 % confidence intervals for depressive symptoms with adjustments for potential confounders.SettingTwo workplaces in north-eastern Kyushu, Japan, in 2009.SubjectsA total of 537 men and women aged 20–68 years.ResultsHigher green tea consumption was associated with a lower prevalence of depressive symptoms. Compared with participants consuming ≤1 cup/d, those consuming ≥4 cups green tea/d had a 51 % significantly lower prevalence odds of having depressive symptoms after adjustment for potential confounders, with significant trend association (P for trend = 0·01). Further adjustment for serum folate slightly attenuated the association. Coffee consumption was also inversely associated with depressive symptoms (≥2 cups/d v. <1 cup/d: OR = 0·61; 95 % CI 0·38, 0·98). Multiple-adjusted odds for depressive symptoms comparing the highest with the lowest quartile of caffeine consumption was OR = 0·57 (95 % CI 0·30, 1·05; P for trend = 0·02).ConclusionsResults suggest that higher consumption of green tea, coffee and caffeine may confer protection against depression. [ABSTRACT FROM AUTHOR]

Background: Breastfeeding should begin as soon as possible after birth and continue exclusively to 6 months of age. In Vietnam, as in many other countries, breastfeeding is decreasing because of modern lifestyles and the promotion of infant formula. It is important to provide mothers, family members, and the community with the knowledge and strategies to improve breastfeeding rates. Smartphones are almost ubiquitous in Vietnam and of the potential to provide information about breastfeeding. This study aimed to document the process of designing and developing a mobile app to increase breastfeeding rates in Vietnamese women. Methods: We used a four-step mixed methods approach with a literature review, formative research (22 in-depth interviews and 49 self-administered online questionnaires), and testing of prototype apps (3 focus groups discussion and external experts). Formative research and focus group discussion involved 99 participants. Finally, the revisions of the app were tested. All of the formative research was undertaken in Hanoi in 2019–2020. Target behaviors followed by key determinants, to improve breastfeeding self-efficacy were studied and this information was then applied in developing the messages and library content. Barriers and facilitators to breastfeeding were identified from literature reviews and qualitative research. The messages were targeted at not only mothers but also included fathers, mothers-in-law, or families. Results: Mothers were mostly concerned about the initiation of breastfeeding, preventing and reducing difficulties encountered during breastfeeding, and nutrition for breastfeeding mothers. Mental health and well-being in the postnatal period are also concerns. Three key features to be included in the app were identified from the formative research: (1) notifications; (2) an information library; and (3) a searching function. The research found that the app should be installed during pregnancy rather than after delivery (81% vs 17%, respectively). Notifications that convey breastfeeding messages should be sent 2–3 times per week. Conclusion: The development of the app followed a best practice approach, including the involvement of stakeholders and grounding in behavior change theory. The next step is to evaluate the effectiveness of the BeBo mobile app in a well-conducted randomized controlled trial. Trial registration: ACTRN12619000531112. [ABSTRACT FROM AUTHOR]

Background: The association between coffee intake and circulating levels of C-reactive protein (CRP) may be modified by oxidative stress. The authors examined the relation of coffee consumption to serum CRP considering potential inter-actions of serum γ-glutamyltransferase (GGT) and bilirubin. Methods: The subjects included 4455 men and 5942 women aged 49-76 years who participated in the baseline survey of a cohort study on lifestyle-related diseases in Fukuoka, Japan. Geometric means of serum CRP and 95% confidence intervals across the category of coffee intake stratified by serum GGT and bilirubin were estimated using multiple linear regression. Results: Serum CRP concentrations were progressively lower with higher intake of coffee in men with high serum GGT (p for trend=0.009), but not in those with low serum GGT (p for trend=0.73) and GGT modified the association (p for interaction=0.03). Women showed no association between coffee intake and CRP whether serum GGT was low or high. There was no effect modification of serum bilirubin on the association between coffee intake and CRP in either men or women. Conclusions: These results support a protective effect of coffee intake against systematic inflammation in middle-aged and elderly Japanese men and imply that such an effect may be stronger in elevated oxidative stress. [ABSTRACT FROM AUTHOR]

Background: Circulating high-sensitivity C-reactive protein (CRP) is a good marker of chronic low-grade inflammation. The few studies that have addressed the relationship between coffee consumption and CRP concentrations report inconsistent findings. The authors of this study examined the relationship between coffee and green tea consumption and serum concentrations of CRP, and the interaction with alcohol consumption, smoking, and obesity in a large population of free-living Japanese men and women. Methods: Study subjects were 10,325 men and women, 49–76 years of age, living in Fukuoka City who participated in a baseline survey of a cohort study on lifestyle-related diseases. Coffee and green tea consumption and other lifestyle characteristics were assessed using a structured questionnaire. Anthropometric measurements and venous blood samples were also included. Results: CRP concentrations were progressively lower with increasing levels of coffee consumption, after adjustment for smoking and other covariates (p for trend=0.03) in men, but not in women. Stratified analysis indicated that this inverse association was primarily limited to men with a high consumption of alcohol (≥50 g/day). Green tea consumption showed no measurable relationship with CRP concentrations in either men or women. Conclusions: Coffee may be protective specifically against alcohol-induced hepatic inflammation. Further studies are warranted in different populations. Clin Chem Lab Med 2010;48:849–54. [ABSTRACT FROM AUTHOR]

Objective. Few studies have suggested an inverse relation between coffee intake and serum concentrations of uric acid (UA), but none has addressed the relation in men and women separately. We examined the relation between coffee intake and serum UA levels in free-living middle-aged and elderly men and women in Fukuoka, Japan. Methods. Study subjects were derived from the baseline survey of a cohort study on lifestyle-related diseases, and included 11.662 men and women aged 49-76 years; excluded were those with medication for gout and hyperuricemia, use of diuretic drugs, and medical care for cancer or chronic kidney disease. Statistical adjustment was made for bodymass index, alcohol use, hypertension, diabetes mellitus, and other factors. Results. There were inverse associations of coffee consumption with serum UA concentrations and hyperuricemia in men regardless of adjustment for covariates. Women showed a statistically significant, but weaker, inverse association between coffee and serum UA levels after allowance for the confounding factors. Conclusion. The findings add to evidence for a protective association between coffee intake and hyperuricemia. [ABSTRACT FROM AUTHOR]

Background: Previous research has demonstrated the association between maternal dietary patterns and gestational diabetes (GDM), but evidence in Asian populations remains limited and inconsistent. This study investigated the association between dietary patterns during early pregnancy and the risk of GDM among pregnant women in Western China.Methods: A prospective cohort study was conducted among 1337 pregnant women in Western China. Dietary intakes were assessed at 15-20 weeks of gestation using a validated food frequency questionnaire. GDM was diagnosed by oral glucose tolerance tests at 24-28 weeks of gestation. Exploratory factor analysis was performed to derive dietary patterns, and logistic regression models were used to examine the association between dietary patterns and GDM.Results: A total of 199 women (14.9%) developed GDM. Three dietary patterns were identified, namely, a plant-based pattern, a meat-based pattern and a high protein-low starch pattern. Notwithstanding a lack of association between dietary patterns and GDM risk in the whole cohort, there was a significant reduction in GDM risk among overweight women (BMI ≥24 kg/m2); the odds ratio being 0.29 (95% confidence interval 0.09 to 0.94) when comparing the highest versus the lowest score of the high protein-low starch pattern.Conclusions: There was no significant association between early pregnancy dietary patterns and GDM risk later in pregnancy for women in Western China, but high protein-low starch diet was associated with lower risk for GDM among women who were overweight at pre-pregnancy. [ABSTRACT FROM AUTHOR]

Malaria, together with HIV/AIDS, tuberculosis and hepatitis are the four most deadly infectious diseases globally. Progress in eliminating malaria has saved millions of lives, but also creates new challenges in detecting the 'last parasite'. Effective and accurate detection of malaria infections, both in symptomatic and asymptomatic individuals are needed. In this review, the current progress in developing new diagnostic tools to fight malaria is presented. An ideal rapid test for malaria elimination is envisioned with examples to demonstrate how innovative technologies can assist the global defeat against this disease. Diagnostic gaps where technology can bring an impact to the elimination campaign for malaria are identified. Finally, how a combination of microfluidic-based technologies and smartphone-based read-outs could potentially represent the next generation of rapid diagnostic tests is discussed. [ABSTRACT FROM AUTHOR]

This is the first study in the Asia-Pacific region to examine the criterion validity of the self-reported International Physical Activity Questionnaire-Short form (IPAQ-SF) using accelerometers, in terms of achieving the World Health Organization's (WHO) recommended physical activity guidelines for health benefits. Vietnamese adults aged 40-65 years (n = 240) wore an ActiGraph GT3X+ accelerometer for at least 5 days and completed the Vietnamese version of the IPAQ-SF. Correlations between IPAQ-SF and accelerometer-measured physical activity intensities varied from .087 to .232. Mean difference in moderate-vigorous physical activity was 0.699 min/day (95% limits: [-107, 109]). Agreement on the classification of achieving the WHO's physical activity guidelines was 69.16%. The IPAQ-SF identified 71.86% of adults who met the guidelines, whereas 56.09% of those not meeting the guidelines were classified correctly. The IPAQ-SF was found to have acceptable criterion validity and is a useful instrument to classify Vietnamese adults as achieving or not achieving the WHO's physical activity guidelines for health benefits. [ABSTRACT FROM AUTHOR]

Background: Few studies have examined the age‐standardized incidence of gestational diabetes mellitus (GDM) for comparison between populations. Information on delivery outcomes is also lacking for Chinese women with GDM. Therefore, the present study aimed to determine age‐standardized GDM incidence and assess its association with maternal and neonatal outcomes. Methods: A total of 1901 pregnant women were recruited in Chengdu, Sichuan Province. GDM was diagnosed between 24 and 28 weeks' gestation using oral glucose tolerance tests. Age‐standardized incidence rates of GDM were calculated using the direct method. Delivery outcomes were extracted from medical records and compared between the GDM and non‐GDM groups. Results: The age‐standardized GDM incidence was 18.3% (95% CI 15.6‐21.1) and increased with maternal age and prepregnancy body mass index (BMI). Women with GDM experienced longer length of stay in hospital, shorter gestation at delivery, and a higher risk of cesarean delivery. Their newborns were more likely to be macrosomic or small for gestational age, and to require neonatal intensive care. Conclusions: The incidence of GDM was high in Western China, especially among older and overweight women. Moreover, women with GDM had higher rates of adverse delivery outcomes. The findings lend further support for the screening, prevention, and management of GDM in Chinese women. [ABSTRACT FROM AUTHOR]

Covalent binding of squalene to siRNA has already been shown to be an interesting way of delivering siRNA in vivo. Whether squalene derivatives could also be used to deliver siRNA in cells without covalent binding similar to usual transfection with cationic lipids is the question addressed in this article. Accordingly, we investigated the activity of two squalene derivatives bearing a quaternary ammonium head group and a guanidinium group, respectively. The second derivative displayed interesting properties for delivering siRNA into cells in vitro. [ABSTRACT FROM AUTHOR]

Background: Low vitamin D status is a global public health issue that vitamin D food fortification and biofortification may help to alleviate.Objectives: We investigated the effect of vitamin D food fortification and biofortification on circulating 25-hydroxyvitamin D (25(OH)D) concentrations. We expanded the scope of earlier reviews to include adults and children, to evaluate effects by vitamin D vitamer, and investigate linear and nonlinear dose-response relations.Methods: We conducted a systematic review and meta-analysis. We searched CINAHL, MEDLINE, PubMed, Embase, the Cochrane Library, and gray and unpublished literature sites for randomized controlled trials, including people of all ages, with the criteria: absence of illness affecting vitamin D absorption, duration ≥4 wk, equivalent placebo food control, dose quantification, dose ≥5 μg/d, baseline and endpoint or absolute change in 25(OH)D concentrations reported, random allocation, and participant blinding. Quality was assessed using the Jadad Scale.Results: Data from 34 publications (2398 adults: 1345 intervention, 1053 controls; 1532 children: 970 intervention, 562 controls) were included. Random-effects meta-analysis of all studies combined (mean dose 16.2 μg/d) indicated a pooled treatment effect of 21.2 nmol/L (95% CI: 16.2, 26.2), with a greater effect for studies using cholecalciferol than ergocalciferol. Heterogeneity was high (I2  > 75%). Metaregression analyses for all studies combined suggested positive effect differences for baseline circulating 25(OH)D concentrations <50 nmol/L, dose ≥10 μg/d and a negative effect difference when the intervention arm included a calcium dose ≥500 mg/d greater than the control arm. Dose-response rates were found to be nonlinear (Wald test for nonlinearity P < 0.001). For all studies combined, a threshold occurred at ∼26 nmol/L for a dose of ∼21 μg/d.Conclusions: These results support use of vitamin D food fortification to improve circulating 25(OH)D circulations in populations. This work was registered with PROSPERO as CRD42020145497. [ABSTRACT FROM AUTHOR]

Background and Objectives: Gestational weight gain is known to impact maternal and child health outcomes. Energy intake and energy expenditure are major components of clinical nutrition in relation to weight gain during pregnancy. The study was to determine the association of physical activity and sitting time during pregnancy with gestational weight gain in Vietnamese women.Methods and Study Design: A multicentre prospective cohort study was conducted in Vietnam from 2015 to 2017. A total of 1873 women with a singleton pregnancy were included. Physical activity and sitting exposures during pregnancy were determined using an interviewer-administered validated questionnaire. Multiple regression analysis was performed to assess physical activity and sitting time in relation to gestational weight gain, adjusting for the confounding effects of maternal characteristics and total energy intake during pregnancy.Results: The mean weight gain was 12.9 (Standard deviation 4.1) kg throughout pregnancy. Pregnant women with prolonged sitting time gained an average of 0.6 kg more weight (p=0.016 for highest versus lowest tertiles). Conversely, women who were physically active, in terms of having higher tertiles of total physical activity, moderate-to-vigorous-intensity, household/ caregiving activities, and occupational physical activity, experienced significantly less gestational weight gain (p<0.05 for highest versus lowest tertiles).Conclusions: Inverse associations were found between gestational weight gain and physical activity (i.e. intensities and several domains), whereas gestational weight gain tended to increase with longer sitting time. Therefore, being physically active and less sedentary is important to regulate weight gain during pregnancy. [ABSTRACT FROM AUTHOR]

Background and Objectives: The association between tea consumption and type 2 diabetes risk remains inconsistent in Asian populations. This case-control study investigated the association between habitual tea consumption and the risk of type 2 diabetes among Vietnamese adults.Methods and Study Design: A hospital-based case-control study was conducted during 2013-2015 in Vietnam. A total of 599 newly diagnosed diabetic cases (aged 40-65 years) and 599 hospital-based controls, frequency matched by age and sex, were recruited. Information about frequency, quantity, and duration of tea drinking, together with demographics, habitual diet and lifestyle characteristics, was obtained from direct interviews using a validated and reliable questionnaire. Unconditional logistic regression analyses were performed to assess the association between different metrics of tea consumption and the type 2 diabetes risk.Results: Control subjects reported higher tea consumption levels than the cases in terms of duration, frequency, and quantity of tea drunk. After accounting for confounding factors, increasing tea consumption was found to be associated with a reduced risk of type 2 diabetes; the adjusted odds ratio (95% confidence interval) was 0.66 (0.49, 0.89) for participants drinking >2 cups/day, relative to those drinking <1 cup/day. Significant inverse dose-response relationships were also observed for average number of cups consumed daily and years of tea drinking (p<0.01).Conclusions: Habitual tea consumption is associated with a reduced risk of type 2 diabetes among Vietnamese adults. [ABSTRACT FROM AUTHOR]

The article discusses the problem on public health and medical care in Myanmar. It tackles the challenge facing the Myanmar Ministry of Health in allocating limited health-care resources effectively, the country's average life expectancy at birth and infant mortality, and the gap in life expectancy at birth between areas with the highest and lowest values.

Objective Experimental studies have shown that some nutrients are involved in initiating and maintaining sleep, but epidemiological evidence on overall dietary patterns and insomnia is scarce. We investigated the relationship between dietary patterns and sleep symptoms in a Japanese working population. Methods The participants were 2025 workers, aged 18–70 years, who participated in a health survey during a periodic checkup in 2012 and 2013. Dietary intake was assessed with a self-administered diet history questionnaire. Dietary patterns were extracted by principal component analysis on the basis of the energy-adjusted intake of 52 food and beverage items. Sleep duration, difficulty initiating and maintaining sleep, and poor quality of sleep were self-reported. Logistic regression was used to estimate the odds ratios of each sleep symptom according to quartile categories of each dietary pattern with adjustment for potential confounding variables. Results We identified three major dietary patterns. A healthy pattern, characterized by a high intake of vegetables, mushrooms, potatoes, seaweeds, soy products, and eggs, was associated with a decreased prevalence of difficulty initiating sleep once or more a week (P for trend = 0.03); the multivariate adjusted odds ratio in the highest quartile of this score compared with the lowest was 0.75 (95% CI: 0.57–0.99). This association persisted after the exclusion of individuals with severe depressive symptoms. However, there was no significant association with difficulty initiating sleep at least three times a week. Conclusions Our findings suggest that a healthy dietary pattern may be associated with difficulty initiating sleep at least once a week. [ABSTRACT FROM AUTHOR]

This study was aimed to examine the cross-sectional association of protein, carbohydrate, and fat intake with depressive symptoms among 1794 Japanese male workers aged 18–69 years who participated in a health survey. Dietary intake was assessed with a validated self-administered diet history questionnaire. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression (CES-D) scale. Odds ratio of depressive symptoms (CES-D scale of ≥16) was estimated by using multiple logistic regression with adjustment for covariates including folate, vitamin B6, vitamin B12, polyunsaturated fatty acid, magnesium, and iron intake. Multivariable-adjusted odds ratio of depressive symptoms for the highest quartile of protein intake was 26%, albeit not statistically significant, lower compared with the lowest. The inverse association was more evident when a cutoff value of CES-D score ≥19 was used. The multivariable-adjusted odds ratios (95% confidence intervals) for the highest through lowest quartile of protein intake were 1.00 (reference), 0.69 (0.47–1.01), 0.69 (0.44–1.09), and 0.58 (0.31–1.06) ( P for trend=0.096). Neither carbohydrate nor fat intake was associated with depressive symptoms. Our findings suggest that low protein intake may be associated with higher prevalence of depressive symptoms in Japanese male workers. [ABSTRACT FROM AUTHOR]

Long working hours have been associated with an increased risk of cardiovascular disease, but its relationship with hypertension remains unclear. The objective of this study is to examine the relationship between overtime and presence of hypertension using data from a large-scale multi-company study in Japan. Participants were 52 365 workers of four companies that provided both health-checkup data and self-reported data on overtime worked. Hypertension was defined as systolic blood pressure ≥140 mmHg, diastolic blood pressure ≥90 mmHg, and/or the use of antihypertensive drug. Logistic regression analysis was performed to determine the odds ratio for hypertension for each category of overtime work (<45, 45-79, 80-99 or ≥100 h/month) with adjustments for age, sex, company, smoking status and body mass index. The prevalence of hypertension tended to decrease with increasing overtime work: 17.5, 12.0, 11.1 and 9.1% for the shortest (<45 h/month) through the longest overtime category (≥100 h/month). The age-, sex- and company-adjusted odds ratios (95% confidence interval) were 1.00 (reference), 0.81 (0.75-0.86), 0.73 (0.62-0.86), 0.58 (0.44-0.76), respectively ( p for linear trend <0.001). In a sub-cohort, the inverse association remained statistically significant after an additional adjustment for other potential confounders. Results of the present large-scale study among Japanese workers suggest an inverse association between overtime work and presence of hypertension. [ABSTRACT FROM AUTHOR]

Objective: Existing evidence is limited on what extent fitness can counterbalance type 2 diabetes mellitus (T2DM) risk associated with obesity. We investigated the joint association of weight status and estimated VO2max, a marker of fitness, with the risk of developing T2DM among Japanese men using haemoglobin A1c and fasting glucose criterion. Methods: The present study included 3,523 male employees aged 18–61 years without diabetes who provided health check-up and fitness data in Japan in 2003–2005. We calculated hazard ratios and 95% confidence intervals for incident diabetes using the Cox regression model. Results: During a mean follow-up of 6.0 years, 199 men developed diabetes. Multivariable-adjusted hazard ratios (95% confidence interval) of diabetes were 1.00 (reference), 1.44 (1.01–2.07), and 1.48 (1.03–2.13) for the highest through the lowest tertile of fitness (P for trend  = 0.04). Additional adjustment for body mass index largely attenuated the association of fitness with diabetes. Joint analysis showed that adjusted hazard ratios of diabetes were 1.00, 1.32, 2.94, and 1.83 in normal weight high-fit men, normal weight low-fit men, overweight high-fit men, and overweight low-fit men, respectively. Conclusion: The results suggest that weight control is more important than fitness in prevention of type 2 diabetes in Japanese men. [ABSTRACT FROM AUTHOR]

Objective: Epidemiologic evidence on long working hour and diabetes has been conflicting. We examined the association between overtime work and prevalence of diabetes among Japanese workers. Methods: The subjects were 40,861 employees (35,170 men and 5,691 women), aged 16 to 83 years, of 4 companies in Japan. Hours of overtime were assessed using self-reported questionnaires. Diabetes was defined as a fasting plasma glucose ≥126 mg/dl (7.0 mmol/l), hemoglobin A1c ≥6.5% (48 mmol/mol), or current use of anti-diabetic drug. Multiple logistic regression analysis was used to calculate odds ratio of diabetes for each category of overtime. Results: After adjustment for age, sex, company, smoking, and BMI, there was a suggestion of U-shaped relationship between overtime work and prevalence of diabetes (P for quadratic trend = 0.07). Compared with those who worked <45 hours of overtime per month, the adjusted odds ratios (95% confidence interval) of diabetes were 0.86 (0.77–0.94), 0.69 (0.53–0.89), and 1.03 (0.72–1.46) for those who worked 45–79, 80–99, and ≥100 hours of overtime per month, respectively. In one company (n = 33,807), where other potential confounders including shift work, job position, type of department, alcohol consumption, sleep duration, leisure time physical activity, and family history of diabetes was additionally adjusted for, similar result was obtained (P for quadratic trend = 0.05). Conclusions: Long hours of overtime work may not be associated with increased prevalence of diabetes among Japanese workers. [ABSTRACT FROM AUTHOR]

Background Influences of alcohol use on glucose metabolism may depend on alcohol flushing response. We investigated the effect of alcohol flushing response on the associations between alcohol consumption and markers of glucose metabolism in Japanese men and women. Methods The subjects were 979 employees (885 men and 94 women), aged 18 to 69 years, of a manufacturing company in Japan. Flushing response and alcohol consumption were determined using a self-administered questionnaire. Homeostasis model assessment-insulin resistance ( HOMA- IR) and homeostasis model assessment for β-cell function ( HOMA- β) were computed using fasting plasma glucose and insulin. For each group of flushers and nonflushers, multiple regression analysis was used to estimate means of fasting plasma glucose, hemoglobin A1c ( Hb A1c), and HOMAs for each category of alcohol consumption, with adjustments for potential confounders. Results In flushers, alcohol consumption was associated with Hb A1c levels in a U-shaped manner, with the lowest Hb A1c levels being observed at an alcohol consumption level of 23.0 to <34.5 g ethanol/d ( p for quadratic trend = 0.002). In nonflushers, alcohol consumption was linearly and inversely associated with HbA1c levels ( p for linear trend = 0.001). Decreases in HbA1c were more evident among flushers compared with nonflushers at moderate alcohol consumption levels ( p for interaction = 0.049). An increase of fasting glucose associated with highest alcohol consumption was observed in both flushers and nonflushers. A statistically significant decrease in HOMA- IR with increasing alcohol consumption was observed in flushers ( p for trend = 0.007), whereas HOMA- IR levels slightly decreased at higher alcohol consumption in nonflushers. HOMA- β similarly decreased with increasing alcohol consumption in both flushers and nonflushers (both p for trend < 0.001). Conclusions The results suggest that the alcohol flushing response may improve glucose metabolism and insulin resistance at moderate alcohol use levels in apparently healthy Japanese adults. [ABSTRACT FROM AUTHOR]

Fatty acid has been suggested to be involved in development of diabetes. However, its association is unclear among Japanese populations, which consume large amounts of fish rich in n-3 polyunsaturated fatty acids. The present cross-sectional study examined the association of individual dietary fatty acids and dietary fatty acid patterns with abnormal glucose metabolism among 1065 Japanese employees, aged 18–69 years. Impaired glucose metabolism is defined if a person has a history of diabetes, current use of anti-diabetic drug, fasting plasma glucose of 110 mg/dl (≥6.1 mmol/L) or greater, or hemoglobin A1C of 6.0% (≥42 mmol/mol) or greater. Dietary intake was assessed with a self-administered diet history questionnaire. Dietary fatty acid patterns were extracted by principal component analysis. Odds ratios of impaired glucose metabolism according to tertile categories of each fatty acids and dietary fatty acid patterns were estimated using logistic regression with adjustment for potential confounding variables. A higher intake of polyunsaturated fatty acid, n-6 fatty acid, linoleic acid, and oleic acid were significantly associated with a decreased prevalence of impaired glucose metabolism (P for trend = 0.03, 0.01, 0.02, and 0.04, respectively). Alpha-linolenic acid was marginally significantly associated with a decreased prevalence of impaired glucose metabolism (P for trend = 0.12). Of three fatty acid patterns identified, a higher plant oil pattern score, which characterized by high intake of alpha-linolenic acid, linoleic acid, and oleic acid, was associated with a decreased prevalence of impaired glucose metabolism (P for trend = 0.03). No association was observed for other patterns. In conclusion, plant source fatty acids might be protectively associated with development of diabetes in Japanese adults. [ABSTRACT FROM AUTHOR]

Abstract: The association of fatty acid composition with insulin resistance and type 2 diabetes has been reported in Western populations, but there is limited evidence of this association among the Japanese, whose populace consume large amounts of fish. To test the hypothesis that high palmitic, palmitoleic, and dihomo-γ-linolenic acids and low levels of linoleic and n-3 fatty acids are associated with higher insulin resistance among the Japanese, the authors investigated the relationship between serum fatty acid composition and serum C-peptide concentrations in 437 Japanese employees aged 21 to 67 years who participated in a workplace health examination. Serum cholesterol ester and phospholipid fatty acid compositions were measured by gas-liquid chromatography. Desaturase activity was estimated by fatty acid product-to-precursor ratios. A multiple regression was used to assess the association between fatty acid and C-peptide concentrations. C-peptide concentrations were associated inversely with linoleic acid levels in cholesterol ester and phospholipid (P for trend = .01 and .02, respectively) and positively with stearic and palmitoleic acids in cholesterol ester (P for trend =.02 and .006, respectively) and dihomo-γ-linolenic acid in cholesterol ester and phospholipid (P for trend < .0001 for both). C-peptide concentrations were not associated with n-3 polyunsaturated fatty acids. C-peptide concentrations significantly increased as δ-9-desaturase (16:1 n-7/16:0) and δ-6-desaturase (18:3 n-6/18:2 n-6) increased (P for trend = .01 and .03, respectively) and δ-5-desaturase (20:4 n-6/20:3 n-6) decreased (P for trend = .004). In conclusion, a fatty acid pattern with high levels of serum stearic, palmitoleic, or dihomo-γ-linolenic acids; δ-9-desaturase (16:1 n-7/16:0) or δ-6-desaturase (18:3 n-6/18:2 n-6) activities; and low levels of serum linoleic acid or δ-5-desaturase (20:4 n-6/20:3 n-6) activity might be associated with higher insulin resistance in Japanese adults. [Copyright &y& Elsevier]

Abstract: Objective: It remains unsettled whether dietary patterns play a role in insulin resistance. We assessed the association of major dietary patterns with C-peptide concentrations in a Japanese working population. Methods: A cross-sectional study was conducted in 456 municipal employees (270 men and 186 women) 21 to 67 y old who participated in a health survey at the time of their periodic checkup. The dietary patterns were derived by using the principal component analysis of the consumption of 52 food and beverage items, which was assessed by a validated brief dietary history questionnaire. Multiple regression analysis was used to estimate the means of C-peptide concentrations across tertiles of each dietary pattern score with the adjustment of potential confounders, including age, body mass index, physical activity, smoking, alcohol drinking, and energy intake. Results: We identified three dietary patterns: healthy, animal food, and Westernized breakfast patterns. The Westernized breakfast pattern was characterized by high intakes of bread, confectionaries, and milk and yogurt but low intakes of rice and alcohol and was inversely associated with C-peptide concentrations in women but not in men. The multivariable-adjusted means of C-peptide concentrations were 1.03 ng/mL (95% confidence interval 0.95–1.12), 0.95 ng/mL (95% confidence interval 0.88–1.03), and 0.89 ng/mL (95% confidence interval 0.82–0.97) for the lowest through the highest tertiles of the Westernized breakfast pattern score (P for trend = 0.015) in women. Other dietary patterns were not appreciably associated with C-peptide concentrations. In a subgroup, similar associations were observed between dietary patterns and the homeostasis model assessment of insulin resistance. Conclusion: The Westernized breakfast pattern may be associated with a lower insulin resistance in Japanese women. [Copyright &y& Elsevier]