The relationship between smoking, BMI, physical activity, and dietary intake among Thai adults in central Thailand.

OBJECTIVE: Evaluate dietary intake, physical activity, and BMI in adult Thais stratified by smoking status, living in the central region of Thailand. MATERIAL AND METHOD: Participants (n = 1,027) were administered a health questionnaires, 24-h dietary recall, and anthropometric measurements were obtained. RESULTS: Compared to ex-smokers (24.5 +/- 4.3 kg/m2) and non-smokers (24.8 +/- 4.0 kg/m2), current smokers (22.6 +/- 3.8 kg/m2) had significantly lower BMIs, regardless of gender (p < 0.001). In addition, male smokers had smaller waist circumferences than non-smokers. There were no statistically significant differences in nutrient intake or physical activity based on smoking status. Results from this study are consistent with others reports showing that smoking is associated with lower weights and BMI when compared to non-smokers. The mechanism for this association may be related to the potential for nicotine to increase metabolic rate rather than appetite suppression in smokers. CONCLUSION: Because the substantial negative health consequences of smoking are far stronger than those associated with modest weight differences, smoking cannot be viewed as an appropriate weight management strategy.

The association of dietary calcium, bone mineral density and biochemical bone turnover markers in rural Thai women.

OBJECTIVE: To investigate the relative contribution of dietary calcium intake on bone mineral density (BMD) and biochemical bone turnover markers in rural Thai women. MATERIAL AND METHOD: A cross-sectional investigation was designed in 255 rural Thai women. Usual dietary calcium intake was determined by 3-day food records and quantitative food-frequency questionnaire. BMD was measured by DXA. The three markers for bone turnover event: serum total alkaline phosphatase, serum N-mid osteocalcin and type I collagen C-telopeptide, including serum calcium and were determined in 125 women in the present study. RESULTS: An average daily calcium intake in the present study was 265 mg/day. Two hundred and thirty three out of 255 women (87%) consumed dietary calcium less than half of the recommended value and only 3% of women (n = 7) had calcium intake > 800 mg/day. After controlling certain parameters: age and body mass index, women who consumed higher amount of dietary calcium had significantly higher BMD at all sites. Moreover highly increased bone turnover markers were observed in those with lowest quartile calcium intake. Women with osteopenia and osteoporosis were older, lower BMI, consumed less calcium and had significantly higher values of all biochemical bone turnover markers than those who had normal BMD. CONCLUSION: The present study showed that a habitual diet of the rural Thai population might not provide enough calcium as needed for bone retention and for prevention of bone loss in the following years. Modification of eating pattern by promotion of increased consumption of locally available calcium rich food may be beneficial for prevention of osteoporosis among this population.

Dietary calcium intake among rural Thais in Northeastern Thailand.

OBJECTIVES: The present study examined the amount and relative contribution of calcium from the habitual diet among rural Thais. MATERIAL AND METHOD: Calcium intake was assessed using 3-day food records and interviewer-administered quantitative food-frequency questionnaire, containing 73 food items. RESULTS: The authors recruited 436 healthy participants (181 men and 255 women), between 20 and 85 years of age. Averaged daily calcium intake among men and women were 378.6 and 265.6 mg, respectively. Sixty-seven percent of men and eighty seven percent of women had less dietary calcium intake than half of the recommended level (< 400 mg/day) whereas only 6 and 3% had an intake more than 800 mg/day. The major food sources of dietary calcium was glutinous rice (32 percent) followed by small animals with edible bones (31 percent) and fresh and fermented fish (20 percent). Dairy products and vegetables constituted only 8 and 5% of dietary calcium, respectively. CONCLUSION: The habitual diet among rural Northeast Thais does not meet the recommended calcium intake level. To promote more consumption of dairy products and locally-available calcium-rich foods would be beneficial to prevent osteoporosis among this population.

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.

Bone mineral density in rural Thai adults living in Khon Kaen province.

OBJECTIVES: To define the bone status and pattern of bone loss in a normal adult population living in a rural area of Khon Kaen province. STUDY DESIGN: A descriptive study. SETTINGS: Department of Medicine, Faculty of Medicine, Khon Kaen University, Thailand. Subjects 436 subjects (181 men and 255 women), aged 20-80 years. MAIN OUTCOME MEASURES: Bone parameter including total bone mineral density (BMD), the bone mineral density at different sites such as forearm, lumbar spine and hip, bone mineral content (BMC) were measured by dual energy X-ray absorptiometry (DEXA). RESULTS: The result revealed that women had lower bone mass at various bone sites than men. The peak bone mass in women was observed between 30-39 years of age except at the distal radius which occurred between 20-29 years of age while the peak bone mass in men was observed between 20-29 years of age. It was also shown that bone loss occurred in both men and women with advancing age. The rate of decline at all sites in women was greater than men especially when they were over 60 years old. When comparisons were made between pre and post-menopausal women, the mean of bone mineral density in pre-menopausal women was 1.18 +/- 0.08, 0.69 +/- 0.06, 0.69 +/- 0.06, 1.0 +/- 0.13, 1.15 +/- 0.13 g/cm2 at total body, mid-shaft radius, ultra distal radius, femoral neck and lumbar spine, respectively while the mean of bone mineral density in post-menopausal women was 1.02 +/- 0.12, 0.54 +/- 0.11, 0.54 +/- 0.11, 0.75 +/- 0.16, 0.88 +/- 0.2 g/cm2 at total body, mid-shaft radius, ultra distal radius, femoral neck and lumbar spine, respectively which were lower than BMD in pre-menopausal women (p<0.05). The mean bone mineral content (BMC) in pre-menopausal women was 2401+318.3 g while in post-menopausal women it was 1915.4+421.7 g (p<0.05). The rate of bone loss correlated with the duration after menopause. In this study, using World Health Organization criteria for diagnosis of osteopenia and osteoporosis and a reference value obtained from Khon Kaen young adults, the prevalence of osteopenia in Khon Kaen women subjects was 37.4 per cent at femoral neck, 30.2 per cent at lumbar spine, 44.5 per cent at ultra distal radius, 31.5 per cent at mid-shaft radius and the prevalence of was osteoporosis 19.3 per cent at femoral neck, 24.7 per cent at lumbar spine, 18.5 per cent at ultra distal radius and 26.4 per cent at mid-shaft radius. CONCLUSION: The result of this study demonstrated the bone parameters in rural Thai adults living in Khon Kaen province, the pattern of bone loss, the difference between men and women and finally the prevalence of osteopenia and osteoporosis.