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We have previously reported an interaction between -514C>T polymorphism at the hepatic lipase (HL) gene and dietary fat on high-density lipoprotein-cholesterol (HDL-C) metabolism in a representative sample of white subjects participating in the Framingham Heart Study. Replication of these findings in other populations will provide proof for the relevance and consistency of this marker as a tool for risk assessment and more personalized cardiovascular disease prevention. Therefore, we examined this gene-nutrient interaction in a representative sample of Singaporeans (1324 Chinese, 471 Malays and 375 Asian Indians) whose dietary fat intake was recorded by a validated questionnaire. When no stratification by fat intake was considered, the T allele was associated with higher plasma HDL-C concentrations (P = 0.001), higher triglyceride (TG) concentrations (P = 0.001) and higher HDL-C/TG ratios (P = 0.041). We found a highly significant interaction (P = 0.001) between polymorphism and fat intake in determining TG concentration and the HDL-C/TG ratio (P = 0.001) in the overall sample even after adjustment for potential confounders. Thus, TT subjects showed higher TG concentrations only when fat intake supplied >30% of total energy. This interaction was also found when fat intake was considered as continuous (P = 0.035). Moreover, in the upper tertile of fat intake, TT subjects had 45% more TG than CC individuals (P < 0.01). For HDL-C concentration, the gene-diet interaction was significant (P = 0.015) only in subjects of Indian origin. In conclusion, our results indicate that there are differences in the association of -514C>T polymorphism with plasma lipids according to dietary intake and ethnic background. Specifically, the TT genotype is associated with a more atherogenic lipid profile when subjects consume diets with a fat content > 30%. KEY WORDS: * Dietary fat * hepatic lipase * gene x nutrient interaction * cardiovascular risk.

This paper describes body composition and dietary intakes of the three major ethnic groups residing in Singapore and how these are related to cardiovascular risk factors in these groups. When the relationship between body mass index (BMI, kg/[m.sup.2]) and body fat percentage was studied, Singaporeans were found to have higher percentage of body fat compared with Caucasians with the same BMI. At BMIs that are much lower than WHO-recommended cut-off values for obesity, both the absolute and relative risks of developing cardiovascular risk factors are markedly elevated for all three ethnic groups. The excessive fat accumulation and increased risks at lower BMIs signal a need to re-examine cut-off values for obesity among Chinese, Malays, and Indians. Key words: body mass index, Asian, WHO

Body composition was measured in 205 male and female Beijing Chinese and in 148 male and female Singaporean Chinese, age 34 (mean) (range 18–68) years and body mass index (BMI) 22.3 (15.9–38.5) kg/m. In Beijing Siri’s two-compartment model based on densitometry was used as a reference technique and in Singapore Siri’s three-compartment model based on densitometry and deuterium oxide dilution was used. In addition, body composition was predicted using equations based on anthropometry and bioelectrical impedance developed in Caucasian populations. Percentage body fat (BF%) predicted from BMI was systematically underestimated by about 1% in Beijing Chinese and by about 3.5% in Singaporean Chinese. The difference in bias (measured minus predicted BF%) between the two population groups could be explained by differences in frame size. The Durnin and Womersley equations for BF% based on skinfold thickness predicted BF% in the male and female Chinese groups adequately, with only a slight (less than 1% body fat) and not significant bias. The prediction of BF% based on the waist circumference (Lean’s formula) resulted in an unbiased estimate of BF% in females (bias about 1% body fat), whereas in males the formula systematically underestimated BF% by 3.5–5%. Bioelectrical impedance underestimated BF% systematically by 3%, in males and females to about the same extent. The bias of all prediction formulas was positively correlated with the level of body fatness and, except for impedance, also negatively correlated with age. The negative association of the bias with age indicates that the age-related increase in body fatness is lower in Chinese than in Caucasians. It can be concluded of the studied prediction techniques that only the skinfold methodology using the equations of Durnin and Womersley give valid mean estimates for both Chinese males and females. The other techniques require the development of population-specific... [ABSTRACT FROM AUTHOR]

This article addresses the need for appropriate definition of obesity in China using body mass index (BMI). In addition to publications documenting the high body fat percentage and increased diseases risks at lower BMI levels among Singaporean Chinese, Malays and Indians, a number of publications from Asia have indicated similar findings using different methodologies. In the recent studies, the same trend is confirmed among children, adolescents and elderly Singaporeans. There are considerabe public health implications accompanying these findings.

Editorial. Discusses issues concerning the definition of obesity among Asians. Appropriateness of definitions based on body mass index (BMI); Differences in the relationship between BMI and body fat percentage across population groups; Occurrence of cardiovascular disease in Asian populations considered normal under the World Health Organization BMI classification.

Mental disorders are both common and costly. The mental health system in Singapore lacks co-ordination as well as being underdeveloped in certain areas. To address these gaps as well to face emerging challenges like an ageing population, and other socioeconomic changes, the Ministry of Health of Singapore has commissioned a Committee to formulate a 5-year Mental Health Policy and Blueprint. A task group has been formed to implement this blueprint and evaluation of these various initiatives with performance measures are inevitable. The choice of these measures, however, can be a daunting task with the various and diverse interests of multiple stakeholders. This paper describes the process of choosing the relevant measures with the appropriate attributes, and suggests a framework, which can serve as a guide for selecting mental health performance measures.

Body composition methods can be classified into direct, indirect and doubly indirect methods. In vivo direct methods use neutron activation analysis to get information on body composition. Indirect methods rely on rules and constants derived from direct methods. Most basic research, especially the development of rules and models has been done in Caucasian subjects in Europe or USA. The critical use of more advanced body composition methodologies in various ethnic groups has shown that assumptions may differ between ethnic groups, an example being the assumption of constant density of the fat free mass. Indirect or predictive methods rely on statistical relationships between body parameters and components of body composition. Subcutaneous fat patterning differs among ethnic groups, and this may have consequences for the validity of body fat predicted from skinfold thickness. Relative leg length and relative arm length also differ between ethnic groups. As a result the body mass index (weight/height squared, BMI), often used as surrogate for body fat percent, and formulas based on bioelectrical impedance measurement show different validity among ethnic groups. Less information is available about the validity of indicators for body fat distribution. There are indications that the relationship between the amount of visceral adipose tissue and waist circumference or waist-hip circumference ratio also differs among ethnic groups. Ethnic differences in body composition rules and constants are important and challenging to investigate, especially in relation to overweight and obesity.