To what Extent Can Food-based Approaches Ensure Dietary Adequacy for Women and Young Children in SE Asia.

Objectives: To predict whether food-based approaches can ensure dietary adequacy for 6-23 month old children and women of reproductive age in SE Asia and to identify problem nutrients. Methods: Linear programming was used to determine whether nutritionally adequate diets based on locally available non-fortified foods (11 micronutrients ≥ WHO/FAO RNI, assuming moderate iron and zinc bioavailability) could be formulated for women and young children in 5 countries. Model parameters were defined using nationally representative (Indonesia, Thailand, Vietnam, Cambodia) or locally representative (Laos, Cambodian children<12 months) 24-hour recall dietary data. Problem nutrients were defined as those <100% RNI in a diet where intakes were maximised. Nutrient adequacies, for food-based recommendations (FBR), were defined as those >65% RNI, when intakes were minimised, in diets achieving the FBR. Results: Numbers of problem nutrients ranged from 2-9, 1-8 and 0-5, for 6-8 mo, 9-11 mo and 12- 23 mo old children; and from 3-7, 2-4 and 1-4 for pregnant, lactating and non-pregnant- nonlactating women, respectively, depending on the country. In most countries, modeled FBRs ensured adequacy for ≥7 (children) and ≥5 (women) nutrients. In all countries, FBRs did not ensure adequate iron (all groups) and folate (women) intakes. Conclusions: Interventions, such as food fortification or the promotion of unutilized nutrient dense foods, are likely required to ensure dietary adequacy, for women and young children, in SE Asia. Funding: The European Commission, FP7, GA-2896-16.

Factors associated with dual form of malnutrition in school children in Nakhon Pathom and Bangkok.

OBJECTIVE: The present study examined the influence of family characteristics and maternal feeding practices on eating behaviors, food consumption and nutritional status of children living in 6 districts of Nakhon Pathom province and 3 surrounding districts of Bangkok. MATERIAL AND METHOD: One hundred and ninety nine families were enrolled in the present study. Four specific mother-child pair groups were purposively selected: 62 obese child/overweight mother pairs, 49 obese child/ normal weight mother pairs, 37 wasted child/overweight mother pairs, and 51 normal weight child/normal weight mother pairs. Anthropometric measurements were performed on all subjects. Biological data, socioeconomic status, maternal feeding practices, as well as eating and lifestyle behaviors of the children were obtained from mothers and children using structured questionnaires and interviews. RESULT: Most mothers from all groups, 40.8%-62.2%, had a primary education, were non-manual workers, with families containing 4-6 persons per household, and a family income of < or = 20,000 baht per month. Multivariate logistic regression analysis showed that maternal overweight prior to pregnancy (OR11.85, 95%CI 2.16-64.99) child's high birth weight (OR 4.53, 95%CI 1.09-18.73) as well as maternal control over the consumption of high caloric food (OR13.07, 95%CI 4.08-41.86) and large amounts of food consumed by the children (OR12.58, 95%CI 4.30-36.80) were significant factors associated with childhood obesity. Compared to normal weight children, a higher proportion of obese children were not breast-fed and a higher proportion of normal weight mothers controlled the consumption of high caloric food in their obese children. Overweight mothers with wasted children also controlled their children's food intake. Higher proportion of wasted children had a higher snack consumption frequency but lower energy food intake than the normal weight children. CONCLUSION: Understanding the underlying causes of dual form of malnutrition in the households would have implication for policy makers to address and implement a nutrition action plan. It is suggested that a malnutrition, (under and over-nutrition) prevention program must involve strategies within families that focus on providing nutrition education and the powerful guidance to help parents foster appropriate patterns of food choice and eating in their children. Promotion of increased physical activity in children is also essential. These strategies are aimed to promote the optimal child's weight and health.

Factors influencing obesity in school children in Bangkok metropolitan area.

A study of factors related to child obesity was conducted on 521 Thai school children. They were randomly selected ad nutritionally assessed by weight for age, weight for height, and triceps skin fold thickness. The 24-hour dietary recall forms were sent to 267 sub sample subjects in order to determine nutrient intakes. Food questionnaires were also sent to subjects and their parents. Data of nutrient intakes of students were analyzed by the N-Squared Nutritionist III and food questionnaires by SPSS/PC+ program. The results showed that heredity was one factor that could influence child obesity. Regarding food habits, obese students preferred high fat foods and carbonated beverages. Both obese and normal weight students frequently consumed snacks or fruits during the time they spent watching television on the weekend. Food intake data revealed no significant difference in energy, fat and carbohydrate intakes between the 2 groups, except for the significantly lower distribution of energy from protein in obese students (p<0.05). However, obese students with parents whose BMI of more than 25 kg/m2, tended to consume both significantly higher caloric and fat intakes than the normal students. With respect to familial environment, it was found that mother was that main person who prepared food. The students nutritional statuses were not significantly correlated with parental education or occupation. For the obese students, good nutrition knowledge contradicted their food practices. To prevent obesity in students, nutrition education with proper food practices should be emphasized for school children and both parents and teachers should be considered as key persons.