Current status of nutrition labelling and claims in the South-East Asian region: are we in harmony?

This review includes the situation of nutrition labelling and claims in six countries in South-East Asia: Brunei, Indonesia, Malaysia, Philippines, Singapore and Thailand. With the exception of Malaysia, there is no mandatory nutrition labelling requirements for foods in these countries except for special categories of foods and when nutritional claims are made for fortified or enriched foods. Nevertheless, several food manufacturers, especially multinationals, do voluntarily label the nutritional content of a number of food products. There is, therefore, increasing interest among authorities in countries in the region to start formulating regulations for nutrition labelling for a wider variety of foods. Malaysia has proposed new regulations to make it mandatory to label a number of foodstuffs with the four core nutrients, protein, carbohydrate, fat and energy. Other countries have preferred to start with voluntary labelling by the manufacturers, but have spelt out the requirements for this voluntary labelling. The format and requirements for nutrition labelling differ widely for countries in the region. Some countries, such as Malaysia, closely follow the Codex guidelines on nutrition labelling in terms of format, components to be included and mode of expression. Other countries, such as the Philippines and Thailand, have drafted nutrition labelling regulations very similar to those of the Nutrition Labeling and Education Act (NLEA) of the United States. Nutrition and health claims are also not specifically permitted under food regulations that were enacted before 1998. However, various food products on the market have been carrying a variety of nutrition and health claims. There is concern that without proper regulations, the food industry may not be certain as to what claims can be made. Excessive and misleading claims made by irresponsible manufacturers would only serve to confuse and mislead the consumer. In recent years, there has been efforts in countries in the region to enact regulations on nutrition claims. Recently enacted regulations or amendments to existing regulations of almost all the countries reviewed have included provisions for nutrition claims. Malaysia is in the process of gazetting regulations to clearly stipulate the permitted nutrition claims and the conditions required to make these claims along the guidelines of Codex Alimentarius Commission. Only two countries in the region permit health claims to be made - Indonesia and Philippines. Other countries in the region are following developments in Codex and examining the need for allowing these claims. There are more differences than similarities in the regulations on nutrition labelling and claims among countries in the South-East Asian region as no previous efforts have been made to address these. Hopefully, through this first regional meeting, countries can initiate closer interaction, with a view to working towards greater harmonization of nutrition labelling and health claims in the region.     

Work-related accidents among the Iranian population: a time series analysis, 2000–2011

Background

Work-related accidents result in human suffering and economic losses and are considered as a major health problem worldwide, especially in the economically developing world.

Objectives

To introduce seasonal autoregressive moving average (ARIMA) models for time series analysis of work-related accident data for workers insured by the Iranian Social Security Organization (ISSO) between 2000 and 2011.

Methods

In this retrospective study, all insured people experiencing at least one work-related accident during a 10-year period were included in the analyses. We used Box–Jenkins modeling to develop a time series model of the total number of accidents.

Results

There was an average of 1476 accidents per month (1476·05±458·77, mean±SD). The final ARIMA (p,d,q) (P,D,Q)_s model for fitting to data was: ARIMA(1,1,1)×(0,1,1)₁₂ consisting of the first ordering of the autoregressive, moving average and seasonal moving average parameters with 20·942 mean absolute percentage error (MAPE).

Conclusions

The final model showed that time series analysis of ARIMA models was useful for forecasting the number of work-related accidents in Iran. In addition, the forecasted number of work-related accidents for 2011 explained the stability of occurrence of these accidents in recent years, indicating a need for preventive occupational health and safety policies such as safety inspection.     

Evaluation of the ECOHIS and the CARIES-QC among an Australian “Aboriginal” population

Quality of Life Research - An evaluation of the reliability and validity of two child oral health-related quality of life (COHRQoL) measures among Australian Aboriginal children who participated in...     

Entomophagy among the Luo of Kenya: a potential mineral source?

Primary objective To determine the iron, zinc, and calcium content in different insects commonly eaten among the Luo of Kenya.

Research design A cross-sectional design was chosen for the study in order to determine the insects eaten and their mineral content during a specific season.

Methods and procedures Five different insect species were identified and collected with the help of local informants in the Nyang'oma sublocation of the Bondo district in western Kenya, and were analysed for iron, zinc and calcium contents.

Main outcomes and results The iron content ranged from 18 to 1562 mg/100 g dry matter, the zinc content from 8 to 25 mg/100 g, and the calcium content from 33 to 341 mg/100 g in five different insects, onyoso mammon (ant), oyala (termite), ogawo (termite), agaor (termite), onjiri mammon (cricket).

Conclusions Insect eating could prove to be a valuable measure to combat, especially, iron and zinc deficiency in developing countries.     

Entomophagy among the Luo of Kenya: a potential mineral source?

Primary objective To determine the iron, zinc, and calcium content in different insects commonly eaten among the Luo of Kenya.Research design A cross-sectional design was chosen for the study in order to determine the insects eaten and their mineral content during a specific season.Methods and procedures Five different insect species were identified and collected with the help of local informants in the Nyang'oma sublocation of the Bondo district in western Kenya, and were analysed for iron, zinc and calcium contents.Main outcomes and results The iron content ranged from 18 to 1562 mg/100 g dry matter, the zinc content from 8 to 25 mg/100 g, and the calcium content from 33 to 341 mg/100 g in five different insects, onyoso mammon (ant), oyala (termite), ogawo (termite), agaor (termite), onjiri mammon (cricket).Conclusions Insect eating could prove to be a valuable measure to combat, especially, iron and zinc deficiency in developing countries.     

Cumulative incidence of rheumatic fever in an endemic region: a guide to the susceptibility of the population?

Aboriginal Australians in northern Australia are subject to endemic infection with group A streptococci, with correspondingly high rates of acute rheumatic fever and rheumatic heart disease. For 12 communities with good ascertainment, the estimated lifetime cumulative incidence of acute rheumatic fever was approximately 5.7%, whereas over the whole population, with less adequate ascertainment, the cumulative incidence was only 2.7%. The corresponding prevalences of established rheumatic heart disease were substantially less than the cumulative incidences of acute rheumatic fever, at least in part because of poor ascertainment. The cumulative incidence of acute rheumatic fever estimates the proportion of susceptible individuals in endemically exposed populations. Our figures of 2.7-5.7% susceptible are consistent with others in the literature. Such comparisons suggest that the major part of the variation in rheumatic fever incidence between populations is due to differences in streptococcal exposure and treatment, rather than to any difference in (genetic) susceptibility.     

Cancer registry of French Polynesia: Results for the 1990–1995 period among native and immigrant population

We present the data of the Cancer Registry of French Polynesia (FP) for the 1990–1995 period, highlighting the difference between the incidences among inhabitants born in FP and in immigrants. A total of 1606 incident cases of cancer were registered during the 6-year period from 1990 to 1995, about 90% of which were histologically confirmed. Among these incident cases, 1361 occurred in native French Polynesians (FPs) and 245 in immigrants. Overall cancer incidence was found to be very slightly higher among women in the native population (209/10⁵) than among immigrants (191/10⁵), and lower among men in the native population (186/10⁵) than in the immigrants (241/10⁵). Cervix, corpus uteri, and thyroid cancer incidence rates were higher among women born in FP than among immigrant women. In contrast, colorectal cancer and melanoma incidences rates were lower, and colorectal cancer was similar. Laryngeal cancer incidence was higher among men born in FP than among immigrant men. In contrast, cancers of the oral cavity, colon and rectum, prostate gland, bladder and melanoma were less frequent. This first report, based on the data from the Cancer Registry of French Polynesia, shows high cancer incidence rates in females and low incidence in males born in FP, as compared to those recorded in France; and low cancer incidence rates, as compared to New Zealand Maoris and Hawaiians. For certain cancers, for example colorectal cancer, the incidence in the immigrant population seems to be between that of the native FP population and that of the population living in France, and lower than in New Zealand Maoris and Hawaiians.     

Evaluation of the direct detection of group a β-hemolytic streptococcal antigen in a pediatric population: Comparison with the traditional culture technique

An evaluation of the Directigen Group A Strep Test (DGAST) in comparison witht the traditional culture technique, was carried out on 1907 throat specimens, obtained from pediatric patients suspected of having a group A -hemolytic streptococcal pharyngitis.Of the 344 specimens positive by culture, 277 were DGAST positive (sensitivity, 81%). Of the 1563 specimens negative by culture, 1511 were DGAST negative (specificity, 97%).Nineteen isolates of non-group A 3-hemolytic streptococci were recovered, primarily group G, B and G.The DGAST is easy to perform, rapid and very specific, but a lower sensitivity indicates that a back up traditional culture is still necessary, especially in pediatric patients.Corresponding author     

Dyslipidemia and the risk of incident hypertension in a population of community-dwelling Brazilian elderly: the Bambuí Cohort Study of Aging

This study aimed to examine the prognostic value of lipid parameters for incident hypertension in elderly living in a community. The study included 306 (81% from total) persons aged > 60 years who were free of hypertension and of cardiovascular diseases at the baseline survey of the Bambuí Cohort Study of Aging. The cumulative incidence of hypertension over three years was 37.3%. The relative risk (RR) of incident hypertension decreased 0.92 for each unit of HDL-cholesterol (95%CI: 0.86-0.99) independent of several potential confounding factors. Individuals with HDL-cholesterol in the top tercile (> 55 mg/dL) had a risk of hypertension halve that those in the bottom tercile (RR = 0.54; 95%CI: 0.33-0.90). Other lipid parameters had no significant effect on the outcome. High HDL-cholesterol showed an independent protective effect on subsequent development of hypertension in the elderly.     

COVID-19 – Impact of the lockdown on the weight variation among the Lebanese population

The aim of this study is to assess lifestyle changes along with weight fluctuations during the COVID-19 lockdown in Lebanon. This cross-sectional study was conducted using a web-survey disseminated through social media platforms to a large sample of the Lebanese population between May 25th and June 8th, 2020, during the lockdown in Lebanon. Behavioral changes and weight variation during the confinement were assessed. Two thousand one hundred sixty-one participants (64.9% female) aged 18 to 78 years old were included in this study. On average, no net weight variation was reported by the participants. 59.3% of the smokers changed their smoking habits, 40.7% of the drinkers reported a decrease in alcohol consumption, 43.5% of the participants exercised less than one time weekly and 35.8% changed their diet. Increased frequency of physical activity, following a diet during lockdown, decreased weight dissatisfaction (P < 0.0001 for the three variables) were retained as significant factors associated with weight loss. Planning to engage in physical activity post lockdown was associated with weight gain (P = 0.021). In the Lebanese population, no net weight variation was reported during the lockdown. Increasing physical activity and initiating diet were associated with weight loss. Healthcare authorities should be alerted about the importance of these factors during the follow-up of the confined population.     

Outbreak of mumps in a vaccinated child population: a question of vaccine failure?

In Belgium, children are immunized against measles-mumps-rubella (MMR) in a two-dose schedule at the age of 15 months and 11 years. Despite these recommendations, epidemics of mumps still occur. During an outbreak of mumps in Bruges (Belgium), 105 cases were registered in seven schools (age group 3-12 years). Lower than optimal vaccination coverage, inadequate vaccination schedule and a combination of primary and/or secondary vaccine failure are considered as possible reasons for the outbreak as described in the article. The role of secondary vaccine failure is highlighted.     

Health check-ups for the French under-consuming agricultural population: A pilot evaluation of the Instants santé MSA program

BackgroundThe social protection scheme in charge of farmers and agricultural employees (MSA) in France has developed a two-step health promotion program with a nurse appointment followed by a consultation with a doctor of the participant's choosing to reach its under-consuming beneficiaries and enroll them back into a care pathway. Our objective was to carry out a pilot evaluation of this program.MethodsThe evaluation was carried out on the population invited during the second semester of 2017 using data from the program's service providers (date of invitation, of nurse appointment…), regional MSA bodies (consultation voucher), and reimbursement data (other care consumption). Participation rates were calculated overall and by participant characteristics. Medical needs were identified during the nurse appointment and new care pathways were assessed using reimbursement data. Multivariable regression models identified factors associated with participation.Results2366 beneficiaries were included in the analysis. 1559 (65.89%) were men and mean age was 52.41 (standard deviation = 14.86). 409 (17.29%) attended the nurse appointment. There was a significant increase in participation with age, in farmers vs. employees (odds ratio = 1.905, 95% confidence interval = 1.393–2.604), and in people living in the most disadvantaged areas (odds ratio = 1.579, 95% confidence interval=1.079–2.312). Participation to the consultation following the nurse appointment was high (62.35%–73.11%). 87.53% of participants had at least one medical need, and new care pathways were more frequent among those who had attended the nurse appointment (55.50% vs. 34.80%, p < 0.0001).ConclusionsThis pilot evaluation shows promising results which need to be confirmed with a national evaluation of the program and longer-term evidence.     

Assessment of the health status of a population living in the catchment area of the Kuĭbyshev water reservoir

An analysis of trends in primary morbidity in the regions belonging to the catchment area of the Kuibyshev water reservoir within the Republic of Tatarstan has shown its rise in the examined classes of diseases. There is the highest increase in morbidity in the areas located in the river basins of Kama, Sviyaga, Kazanka, Mesha, which are the main tributaries of the Kuibyshev water reservoir in the Republic of Tatarstan. The cumulative hazard index in the assessment of a noncancer risk to the health of the population consuming the portable water and fish from the Kuibyshev reservoir is 0.34, which suggests that there is no serious hazard to human health. With oral intake of lead and cadmium, the cancer risk corresponds to the maximum acceptable value.     

Exploration of a cultural-adaptation of the EQ-5D for Thai population: A “bolt-on” experiment

Quality of Life Research - As the EQ-5D was developed in western countries with only five dimensions, it might be insensitive to non-western populations including Thai. This study examined the...     

Predictors of 10-year mortality in a population of community-dwelling Brazilian elderly: the Bambuí Cohort Study of Aging

We used data on 1,399 participants aged 60 and over from the Bambuí Cohort Study of Aging to examine predictors of mortality in a socioeconomically disadvantaged population. From 1997 to 2007, 599 participants died and 6.2% were lost to follow-up, leading to 12,415 person-years (pyrs) of observation. The death rate was 48.3 per 1,000 pyrs. Age (adjusted hazard ratio [HR] = 1.40), male gender (HR = 1.80), never married (HR = 1.78) or a widow (HR = 1.26), poor self-rated health (HR = 1.31), inability to perform four or more activities of daily living (HR = 3.29), number of cardiovascular risk factors (HR = 1.51 for two and HR = 1.91 for three or more), Trypanosoma cruzi infection (HR = 1.27), and number of medications (HR = 1.06) were each significantly (p < 0.05) and independently associated with mortality. The Mini-Mental State Examination score showed a protective effect (HR = 0.96). Except T. cruzi infection, other predictors of mortality were highly consistent with those found in more affluent elderly populations.     

Assessment of fruit and vegetable intake among the population of junior high school students from Oleśnica

The aim of this study was to assess fruit and vegetable intake among the population of junior high school students. 113 students from Junior High School No. 2 in Ole?nica participated in the research. In order to assess the intake of fruit and vegetables, the method of food frequency questionnaire was used. It was stated that vegetables appearing most frequently in the diet of girls were: tomatoes, carrots, cucumbers and fresh vegetable salads, and in the meals of boys were: tomatoes, fresh vegetable salads, cucumbers and vegetable salads. Boys and girls declared that the most often consumed fruits were: apples, oranges, mandarins and bananas. The mean daily total consumption of fruit and vegetables by the junior high school students was 358.5 g/day. Compared with current dietary recommendations, intakes of fruit and vegetables were too low.     

Predictors of 10-year hospital use in a community-dwelling population of Brazilian elderly: the Bambuí Cohort Study of Aging

We use data from a population-based cohort of elderly Brazilians to assess predictors of hospitalizations during ten years of follow-up. Participants were 1,448 persons aged 60 years and over at baseline (1997). The outcome was self-reported number of hospitalizations per year. Slightly more than a fifth (23%) experienced no hospitalizations during the 10 year follow-up. About 30% had 1-2 events, 31% had between 3 and 7 events, and about 18% had 8 or more events during this time. Results of multivariable hurdle and Cox proportional hazards models showed that the risk of hospitalization was positively associated with male sex, increased age, chronic conditions, and visits to the doctors in the previous 12 months. Underweight was a predictor of any hospitalization, while obesity was an inconsistent predictor of hospitalization.