Central obesity as a precursor to the metabolic syndrome in the AusDiab study and Mauritius

Evidence from epidemiologic studies that central obesity precedes future metabolic change and does not occur concurrently with the appearance of the blood pressure, glucose, and lipid abnormalities that characterize the metabolic syndrome (MetS) has been lacking. Longitudinal surveys were conducted in Mauritius in 1987, 1992, and 1998, and in Australia in 2000 and 2005 (AusDiab). This analysis included men and women (aged 25 years) in three cohorts: AusDiab 2000–2005 (n = 5,039), Mauritius 1987–1992 (n = 2,849), and Mauritius 1987–1998 (n = 1,999). MetS components included waist circumference, systolic blood pressure, fasting and 2-h postload plasma glucose, high-density lipoprotein (HDL) cholesterol, triglycerides, and homeostasis model assessment of insulin sensitivity (HOMA-S) (representing insulin sensitivity). Linear regression was used to determine which baseline components predicted deterioration in other MetS components over 5 years in AusDiab and 5 and 11 years in Mauritius, adjusted for age, sex, and ethnic group. Baseline waist circumference predicted deterioration (P < 0.01) in four of the other six MetS variables tested in AusDiab, five of six in Mauritius 1987–1992, and four of six in Mauritius 1987–1998. In contrast, an increase in waist circumference between baseline and follow-up was only predicted by insulin sensitivity (HOMA-S) at baseline, and only in one of the three cohorts. These results suggest that central obesity plays a central role in the development of the MetS and appears to precede the appearance of the other MetS components.

The metabolic syndrome as a predictor of incident diabetes mellitus in Mauritius

Aims : To assess the utility of the metabolic syndrome (MetS) and a Diabetes Predicting Model as predictors of incident diabetes.

Methods : A longitudinal survey was conducted in Mauritius in 1987 (n = 4972; response 80%) and 1992 (n = 3685; follow-up 74.2%). Diabetes status was retrospectively determined using 1999 World Health Organization (WHO) criteria. MetS was determined according to four definitions and sensitivity, positive predictive value (PPV), specificity and the association with incident diabetes before and after adjustment for MetS components calculated.

Results : Of the 3198 at risk, 297 (9.2%) developed diabetes between 1987 and 1992. The WHO MetS definition had the highest prevalence (20.3%), sensitivity (42.1%) and PPV (26.8%) for prediction of incident diabetes, the strongest association with incident diabetes after adjustment for age and sex [odds ratio 4.6 (3.5–6.0)] and was the only definition to show a significant association after adjustment for its component parts (in men only). The low prevalence and sensitivity of the International Diabetes Federation (IDF) and ATPIII MetS definitions resulted from waist circumference cut-points that were high for this population, particularly in men, and both were not superior to a diabetes predicting model on receiver operating characteristic analysis.

Conclusions : Of the MetS definitions tested, the WHO definition best identifies those who go on to develop diabetes, but is not often used in clinical practice. If cut-points or measures of obesity appropriate for this population were used, the IDF and ATPIII MetS definitions could be recommended as useful tools for prediction of diabetes, given their relative simplicity.

Gender differences in the prevalence of impaired fasting glycaemia and impaired glucose tolerance in Mauritius. Does sex matter?

Objective: To examine gender differences in the characteristics and prevalence of various categories of glucose tolerance in a population study in Mauritius.

Research design and methods: In 1998, a community-based cross-sectional survey was conducted in Mauritius. Categories of glucose metabolism were determined in 5388 adults, with an oral glucose tolerance test given to those who did not have previously diagnosed diabetes (n = 4036). Other cardiovascular risk factors were assessed among those without known diabetes.

Results: For men and women the prevalence of diabetes (22.0 vs. 21.8%, respectively) and the prevalence of coexisting impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) (3.2 vs. 2.9%) were similar. However, men were twice as likely as women to have isolated IFG [5.1% (4.2–6.0) vs. 2.9% (2.3–3.5)], despite being younger, thinner and with lower plasma insulin but higher lipids. Conversely, the prevalence of isolated IGT was lower in men [9.0% (7.9–10.2) vs. 13.9% (12.6–15.1)]. Among non-diabetic individuals, fasting glucose was higher in men than women, whereas 2-h glucose was higher in women. In people without diabetes, women had significantly higher body mass index, beta cell function (HOMA-B), fasting and 2-h insulin than men and significantly lower waist-hip ratios, waist circumference, insulin sensitivity (HOMA-S) and triglycerides.

Conclusion: In Mauritius, the distribution of impaired glucose metabolism differs by sex. The observation that IFG is more prevalent in men and IGT more prevalent in women raises important questions about their underlying aetiology and the ability of the current glucose thresholds to equally identify men and women at high-risk of developing diabetes. IFG should be seen as a complimentary category of abnormal glucose tolerance, rather than a replacement for IGT.

Cut-points for waist circumference in Europids and South Asians

There is little strong evidence that currently recommended higher waist circumference cut-points for Europids compared with South Asians are associated with similar risk for type 2 diabetes. This study was designed to provide such evidence. Longitudinal studies over 5 years were conducted among 5,515 Europid and 2,214 ethnically South Asian participants. Age-standardized diabetes incidence at different levels of waist circumference and incidence difference relative to a reference value were calculated. The Youden Index was used to determine waist circumference cut-points. At currently recommended cut-points, estimated annual diabetes incidence for a 50-year-old Europid was <0.6% for both sexes, and for a 50-year-old South Asian, 5.8% for men and 2.1% for women. Annual diabetes incidence of 1% was observed for a 50 year old at a waist circumference 35–40 cm greater in Europid compared to South Asian men and women. Incidence difference between recommended cut-points and a reference value (80 cm in men, 70 cm in women) was 0.3 and 4.4% per year for Europid and South Asian men, and 0.2 and 0.8% per year for Europid and South Asian women, respectively. Waist circumference cut-points chosen using the Youden Index were shown to be dependent on obesity levels in the population. The much higher observed risk of diabetes in South Asians compared to Europids at the respective recommended waist circumference cut-points suggests that differences between them should be greater. Approaches that use the Youden Index to select waist circumference cut-points are inappropriate and should not be used for this purpose.

Higher leptin levels in Asian Indians than Creoles and Europids : a potential explanation for increased metabolic risk

Background and purpose: Leptin predicts cardiovascular diseases and type 2 diabetes, diseases to which Asian Indians are highly susceptible. As a risk marker, leptin’s intra-individual and seasonal stability is unstudied and only small studies have compared leptin levels in Asian Indians with other populations. The aim of this study was to explore ethnicity related differences in leptin levels and its intra-individual and seasonal stability.

Methods: Leptin and anthropometric data from the northern Sweden MONICA (3513 Europids) and the Mauritius Non-communicable Disease (2480 Asian Indians and Creoles) studies were used. In both studies men and women, 25- to 74-year old, participated in both an initial population survey and a follow-up after 5–13 years. For the analysis of seasonal leptin variation, a subset of 1780 participants, 30- to 60-year old, in the Vasterbotten Intervention Project was used.

Results: Asian Indian men and women had higher levels of leptin, leptin per body mass index (BMI) unit (leptin/BMI) or per cm in waist circumference (WC; leptin/waist) than Creoles and Europids when adjusted for BMI (all P<0.0005) or WC (all P<0.005). In men, Creoles had higher leptin, leptin/BMI and leptin/waist than Europids when adjusted for BMI or WC (all P<0.0005). In women, Creoles had higher leptin/BMI and leptin/waist than Europids only when adjusted for WC (P<0.0005). Asian Indian ethnicity in both sexes, and Creole ethnicity in men, was independently associated with high leptin levels. The intra-class correlation for leptin was similar (0.6–0.7), independently of sex, ethnicity or follow-up time. No seasonal variation in leptin levels was seen.

Conclusion: Asian Indians have higher levels of leptin, leptin/BMI and leptin/waist than Creoles and Europids. Leptin has a high intra-individual stability and seasonal leptin variation does not appear to explain the ethnic differences observed here.

Responsible aquaculture and trophic level implications to global fish supply

Hunger and malnutrition remain among the most devastating problems facing the world’s poor and needy, and continue to dominate the health and well-being of the world’s poorest nations. Moreover, there are growing doubts as to the long-term sustainability of many existing food production systems, including capture fisheries and aquaculture, to meet the future increasing global demands.Of the different agricultural food production systems, aquaculture (the farming of aquatic animals and plants) is widely viewed as an important weapon in the global fight against malnutrition and poverty, particularly within developing countries where over 93% of global production is currently produced, providing in most instances an affordable and a much needed source of high quality animal protein, lipids, and other essential nutrients. The current article compares for the first time the development and growth of the aquaculture sector and capture fisheries by analyzing production by mean trophic level. Whereas marine capture fisheries have been feeding the world on high trophic level carnivorous fish species since mankind has been fishing the oceans, aquaculture production within developing countries has focused, by and large, on the production of lower trophic level species. However, like capture fisheries, aquaculture focus within economically developed countries has been essentially on the culture of high value-, high trophic level-carnivorous species. The long term sustainability of these production systems is questionable unless the industry can reduce its dependence upon capture fisheries for sourcing raw materials for feed formulation and seed inputs. In line with above, the article calls for the urgent need for all countries to adopt and adhere to the principles and guidelines for responsible aquaculture of the FAO Code of Conduct for Responsible Fisheries.

Can dietary lipid source circadian alternation improve omega-3 deposition in rainbow trout?

With the salmonid industry currently exploiting the vast majority of globally available fish oil, there is the need to optimise fish oil utilisation by increasing its efficiency in terms of transferring the health-promoting long chain omega-3 fatty acids (n−3 LC-PUFA) into farmed fish flesh. The aim of this study was to evaluate if dietary fatty acid deposition is affected by the time of feeding, and hence identify possible innovative feeding strategies towardsmore efficient use of dietary fish oil. Over a period of 12 weeks, three diets with different lipid sources, canola oil (CO), fish oil (FO) or a 50/50 blend of the two oils (Mix), were alternated daily and fed to rainbow trout (Oncorhynchus mykiss). Six treatments were administered to fish, reference treatment (REF, continuously fed FO), control treatment (CT, continuously fed Mix), am canola oil ration (amCOR), pm canola oil ration (pmCOR), am canola oil satiation (amCOS) and pm canola oil satiation (pmCOS). Fish received either the CO diet in the am or pm feeds and received the FO diet at the opposite time. A significant increase in growth and feed consumption was noted in the pmCOS treatment. Fillet fatty acid profile was modified by associated feeding schedules and was generally reflective of dietary fatty acid profile. No significant increases in n−3 LCPUFA deposition were observed. However, both linoleic acid (18:2n−6) and α-linolenic acid (18:3n−3) contents were significantly higher in pmCOR compared to amCOR and CT. The results of the present study suggest the existence of cyclical circadian patterns in fatty acid deposition in rainbow trout.

Use of wild fish and other aquatic organisms as feed in aquaculture; a review of practices and implications in the Asia Pacific

Global and Asian aquaculture have witnessed a ten-fold increase in production from 1980 to 2004. However, the relative percent contribution to production of each of the major commodities has remained almost unchanged. For example, the contribution of freshwater finfish has declined from 71 to 66 percent in Asia but has remained unchanged globally over the last 20 to 30 years. This fact has dictated trends in the use of fish as a feed for cultured stocks. The growth in the sector has gone hand in hand with an increasing dependence on fish as feed, either directly or indirectly. In a number of countries in the Asia-Pacific region, the aquaculture sector has surpassed the capture fisheries sector in its respective contributions to the gross domestic product (GDP). Aquaculture’s increased contribution to national GDPs can be taken as a clear indication of the contribution of the sector to food security and poverty alleviation. The use of finfish and other aquatic organisms as a feed source can be through direct utilization of whole or chopped raw fish in wet form, through fishmeal and fish oil in formulated feeds, and/or as live fish, although the latter is uncommon and the overall amounts used are relatively small. In the first two categories, the fish used are often termed “trash fish/low-value fish”. Although attempts have been made to define this term, all definitions have a certain degree of ambiguity and/or subjectivity. In this regional review, the amount of fish used as feed sources based on the above categories was estimated primarily from the production data, supported by assumptions on the inclusion levels of fishmeal in formulated feeds and observed feed conversion efficiencies for both formulated feeds and for stock fed trash fish/low-value fish directly. A scenario for the use of fish as feed was developed by starting from the levels of aquaculture production recorded in 2004 and assuming increases in production volumes of 10, 15 and 20 percent by 2010, respectively, for the three trajectories. In parallel, the pattern of wild fish use as feed was projected to change as fish and shrimp farmers increasingly replace farmmade feeds by incorporating trash fish/low-value fish with manufactured feeds that include fishmeal. Also, the fishmeal inclusion rates in manufactured feeds are falling slowly, and this has been incorporated into the projections. The regional review also deals with the production of fishmeal using trash fish/low-value fish in the Asia-Pacific region. Regional fishmeal production as a whole is relatively low when compared with that of major fishmeal-producing countries such as Chile, Iceland and Norway, amounting to approximately 1 million tonnes per year. However, there is a trend towards increasing the use of fish industry waste, such as from the tuna canning industry in Thailand. The fishmeal produced in the region is priced considerably lower than globally traded fishmeal, but its quality is poorer. Total fishmeal use in Asian aquaculture in 2004 was estimated as 2 388 million tonnes, the highest proportion of this being used for crustacean aquaculture (1 418 million tonnes). Based on growth predictions (to year 2010) in the sector and improvements to feed quality and management, it is expected that the quantity of fishmeal used in Asian aquaculture will be slightly less than at present. An estimated 240 000 tonnes of fish oil is used in Asian aquaculture, principally in shrimp feeds. Based on production estimates of commodities in 2004 that rely on trash fish/low-value fish as the main feed source, this regional review suggests that Asian aquaculture currently uses between 2 465 and 3 882 million tonnes, an amount that is predicted to decrease to between 1.890 and 2 795 million tonnes by 2010. The use of trash fish/low-value fish and fishmeal by the aquaculture sector has been repeatedly adjudicated as a non-sustainable practice, and globally the sector is seeking to reduce its dependence on fish as feed through improved feed management practices and development of better quality feeds and feed formulations using alternative ingredients. Over the next few years, decreases in the use of trash fish/low-value fish are also expected to be achieved through better conversion of raw materials into fishmeal and fish oil during the reduction processes. The “way forward” in addressing the issue of the use of fish as feed in aquaculture in the Asia-Pacific region includes the need for a concerted regional research thrust to reduce the use of fish as feed sources in aquaculture, as has been achieved in the animal husbandry sector. Secondly, there is a need to increase farmer awareness on the use of trash fish as feed. This is achievable, considering the similar progress that has been made by the region’s shrimp farming sector, which almost exclusively involves small-scale practitioners who are often clustered in a given locality. The analysis also suggests that the use of trash fish/low-value fish in aquaculture may be compatible with improving food security and alleviating poverty. In Asia, trash fish/low-value fish is mostly landed in areas where there are other suitable fish commodities for human consumption. To make the trash fish/low-value fish suitable and available for human consumption would involve some degree of value-adding and transportation costs, which are likely to increase the price to beyond the means of the consumer, particularly in remote rural areas. Under such a scenario, the direct or indirect use of this perishable resource as a feed source to produce a consumable commodity appears to make economic sense and appears to be the most logical use for overall human benefit. In this manner, trash fish/low-value fish contributes to food security by increasing income generation opportunities and hence contributes to poverty alleviation. Another factor that needs to be taken into account is the large numbers of artisanal fishers who harvest this raw material. The continued use of trash fish/low-value fish, therefore, allows these fishers to maintain their livelihoods¹. Admittedly, this is an area that warrants more detailed investigation, from resource use, livelihoods and economic viewpoints.

Estimation of nitrogen and phosphorus in effluent from the striped catfish farming sector in the Mekong Delta, Vietnam

In this study an attempt is made to estimate nitrogen and phosphorus discharged to the environment from the striped catfish (Pangasianodon hypophthalmus) farming sector in the Mekong Delta (8°33̕–10°55̕ N, 104°30̕–106°50̕ E), South Vietnam. The sector accounted for 687,000 t production in 2007 and 1,094,879 t in 2008, with over 95% of the produce destined for export to over 100 countries. Commercial and farm-made feeds are used in catfish farming, currently the former being more predominant. Nitrogen discharge levels were similar for commercial feeds (median 46.0 kg/t fish) and farm-made feeds (median 46.8 kg/t fish); whilst, phosphorus discharge levels for commercial feeds (median 14.4 kg/t fish) were considerably lower than for farm-made feeds (median 18.4 kg/t fish). Based on the median nutrient discharge levels for commercial feeds, striped catfish production in the Mekong Delta discharged 31,602 t N and 9,893 t P, and 50,364 t N and 15,766 t P in 2007 and 2008, respectively. However, the amount of nutrients returned directly to the Mekong River may be substantially less than this as a significant proportion of the water used for catfish farming as well as the sludge is diverted to other agricultural farming systems. Striped catfish farming in the Mekong Delta compared favourably with other cultured species, irrespective of the type of feed used, when the total amounts of N and P discharged in the production of a tonne of production was estimated.