Fatty acid composition in breast milk from 4 regions of Thailand.

BACKGROUND: DHA contents in breast milk varied upon maternal dietary intakes. OBJECTIVE: To study DHA contents in breast milk in Thai lactating women from four diferent regions of Thailand. MATERIAL AND METHOD: 20 mL of hind milk from 40 lactating women from Bangkok, Chantaburi, Tak, and Surin were collected and analyzed for fatty acids contents by gas chromatography Dietary intake of lactating women after delivery until the present study was assessed by a food frequency questionnaire. Then, the average DHA intake was estimated from the diets by using the reference data. RESULTS: DHA contents in breast milk of mothers from Surin were higher than those from other areas. There were no correlations between history of DHA intake and DHA contents in breast milk. CONCLUSION: DHA contents in breast milk vary from region to region of the country. Local dietary intake and genetics might explain this contrast.

Etiology and glycemic control among Thai children and adolescents with diabetes mellitus.

BACKGROUND: There is little data on etiology and metabolic control in children and adolescents with diabetes in developing countries. OBJECTIVE: Determine the etiology of diabetes in Thai youths and to evaluate their glycemic control. MATERIAL AND METHOD: The authors retrospectively reviewed the case records of 157 patients seen at the Department of Pediatrics, Siriraj Hospital between 2003 and 2004. RESULT: Type 1 diabetes (T1D) comprised 83%, type 2 diabetes (T2D) 13%, and other types 4%. GAD65 and IA-2 antibodies were positive in 63% and 61% of T1D patients, and 0% and 9% of T2D patients, respectively. There were an increasing number of new cases, both T1D and T2D, during the study period compared with a previous study conducted at the hospital. Mean HbA1c in T1D and T2D were 8.9 +/- 2.1% and 6.2 +/- 1.80%, respectively (p < 0.001). CONCLUSION: Based on the present study, glycemic control appeared to be more satisfactory in T2D patients than those with T1D. Glycemic control among T1D patients was comparable to others in developed countries.

Dietary patterns of secondary-school students at Grade VII and Grade X

Objective: To study dietary patterns of secondary-school students at Grade VII and Grade X. Methods: Students both male and female at Grade VII and Grade X were taught about food exchange lists. Then the investigators asked them to fill their food intakes during the past 7 days by using food frequency. Also, the investigators measured their bodyweight and heights, then classified them by BMI into 3 groups which were normal weight (group I) overweight (group II) and obese (group III). Results: The male students in normal bodyweight groups at Grade VII drank more milk than the females of the same group. The energy, carbohydrate, protein and fat intakes were not different between male and female students and among the 3 groups at Grade VII. In conrast, the male students at Grade X in normal bodyweight group and overweight group had more intakes of energy, protein and fat. Also the boys of the normal bodyweight group at Grade X drank more milk. Conclusion: There were no differences in energy intakes among students of the same Grade of different BMI. Female students drank less milk than male students in the normal weight group. The male students in normal bodyweight and overweight groups at Grade X consumed more foods than the female students.

Relative risks of becoming overweight and obese in children after 6 years in secondary school.

The authors carried out a longitudinal study of bodyweights of secondary-school children from Grade VII to Grade XII. Initial data of weight for height at Grade VII showed that the prevalences of overweight boys and girls were 13.6% and 9.9% and of obesity of boys and girls 26.8% and 13.5%, respectively. However, when these children were at Grade XII the prevalences of overweight of boys and girls were 14.0% and 10.5% and of obesity of boys and girls were 15.0% and 10.8%, respectively. The relative risks of becoming overweight of boys and girls at Grade XII who were already overweight at Grade VII were 1.5 and 4.0 respectively, and the relative risks of obesity in boys and girls at Grade XII who were already obese at Grade VII were 1.4 and 4.6, respectively. The present study showed that without any nutritional intervention those children, especially girls who were overweight and obese were more likely to maintain their bodyweights throughout the 6-year period in secondary school.

High plasma branched-chain amino acids:aromatic amino acids ratio in children on the ketogenic diet: a mechanism in controlling epilepsy.

BACKGROUND: The authors proposed that ketogenic diets will produce an increase in the ratio of branched chain amino acids (BCAAs) and aromatic amino acids (BCAAs) in plasma of children who are on the diets. SUBJECTS AND METHOD: A sample of plasma amino acids sample before initiation of fasting and on day 10 of the dietary treatment was obtained in patients with refractory epilepsy who were newly admitted for initiation of ketogenic diet. Plasma amino acids were determined by high performance liquid chromatography equipment. RESULTS: There are 20 patients with refractory epilepsy participating in this study. Outcomes of ketogenic diet therapy were satisfactory. Nineteen cases out of 20 cases had a significantly higher ratio of plasma BCAAs:ARAAs during ketogenic diets than before the diet (P < 0.001). CONCLUSION: The ketogenic diets produced an increased ratio of plasma BCAAs:ARAAs. Whether the increased ratio of plasma BCAAs:ARAAs plays an important role in controlling epilepsy is yet to be elucidated.

Prevention of antibiotic-associated diarrhea in infants by probiotics.

Probiotics administration has been claimed to prevent antibiotic-associated diarrhea. The investigators thus conducted a double blind, placebo controlled study of providing probiotics to infants and children with severe bacterial infections and receiving broad spechum antibiotics. The results of the study showed that the group receiving probiotics had fewer diarrheal episodes (37.5%) than the control group (80%), although the numbers were too small for statistical analysis. In conclusion, probiotics administration to patients receiving high doses of broad spectrum antibiotics may prevent the occurrence of antibiotic-associated diarrhea. A further study with a larger number is required.

Comparison of the nutrient content of fresh fruit juices vs commercial fruit juices.

OBJECTIVE: To compare the types and quantities of carbohydrate, electrolytes, pH and osmolarity of fresh fruit juices and commercial fruit juices. MATERIAL AND METHOD: Forty kinds of fresh fruits available in Thai markets were analyzed for types and quantities of carbohydrate, electrolyte, pH and osmolarity and compared with previously obtained data for commercial fruit juices. RESULTS: Most fresh fruit juices did not contain sucrose, whereas, commercial fruit juices mostly have sucrose in the range of 3-112 g/L. Although both fruit juices were acidic (pH varied from 3.6-6.7 and 3.2-5.8 of fresh juice and commercial juice), fresh fruit juices had a more neutral pH than commercial fruit juices. Apple, guava, orange, pear, and pineapple juices from commercial fruit juices had a high osmolarity compared with fresh fruit juices. All types of fresh fruit juices contained less sodium than commercial ones, whereas, most fresh fruit juices contained more potassium, phosphorus, and magnesium than commercial fluids. CONCLUSION: The nutrient content of fresh fruit juices and commercial fruit juices from the same kinds of fruits are not the same, possibly due to the manufacturing process. Therefore, physicians should know the composition of fruit juices in order to advise patients properly.

Intensive diabetes education program and multidisciplinary team approach in management of newly diagnosed type 1 diabetes mellitus: a greater patient benefit, experience at Siriraj Hospital.

It is accepted worldwide that an effective multidisciplinary management team is essential for providing comprehensive self-management training to type I diabetics and their families. Therefore, the authors developed an intensive multidisciplinary education team that included pediatric endocrinologists, a dietitian, a psychologist, nurses, scientists and volunteers in the Department of Pediatrics, Siriraj Hospital in August 1996. This study aimed to analyze twenty-four newly diagnosed diabetics who underwent this specified program and multidisciplinary team approach in comparison to twenty-eight diabetic patients who were diagnosed before the program and team were established in order to see whether the length of hospitalization had been reduced and to compare the readmission rates of recurrent DKA with previous patients. The results demonstrated that by using the intensive program and multidisciplinary team the average length of admission was reduced from 36.04 days to 17.63 days (p value = 0.03). The readmission rate in the first year after diagnosis was also reduced from 17.8 per cent to 4 per cent. Concerning diabetes control, the average HbA1c level showed significantly better control. Therefore, this study demonstrated a successful team and program for newly diagnosed Thai childhood and adolescent diabetics and also emphasized that a multidisciplinary team approach with an effectively intensive education program is important in helping diabetics and families cope with their emerging problems and receive the long-term benefits of effective self-care.

The effects of participation in an obesity summer camp on perceived self-efficacy and weight control in obese Thai children.

Obesity is a condition that can play a very significant role on the health of children who are growing up into maturity. The effects of obesity include increased risk of heart disease, diabetes, and hypertension. Its major causes are excessive eating, lack of restraint, and easily gratifying their desire for tasty food. If an adjustment can be made to their perception and behavior so that they can define the volume of food consumed then these obese children are capable of monitoring their weight and are able to reduce the risk of illness as a consequence of obesity without needing weight control pills which can be detrimental to their health. The most important factor that can help to change obese children's behavior is their perceived self-efficiency in monitoring their weight by self-control practiced by dieting and balanced excercise using the support of other members of the obese children group. Participation in the summer camp for obese children has the following objectives to promote their perceived self-efficacy; to make an adjustment to their consumption and exercise behavior, and to make them aware of the effects of obesity. The activities of the project comprised of education relating to obese children and their parents, restriction of energy intake to 800 Kcal/d, participation in group activities and exercise e.g. swimming, aerobics, and visual education without administration of weight control tablets for 4 weeks, 5 days/week. After completing of the summer camp, group meetings were held occasionally to assess their perceived self-efficacy. The results of monitoring the behavior of 20 obese children participating in project with BMI ranging from 26-41 Kg/m2, with age range of 10-15 years, were assessed by data collection by questionnaires concerning perceived self-efficacy, a BMI Assessment Form, and the data analysed using paired t-test. The results of the assessment on the last day of the summer camp and 12 weeks after the late day found that obese children had an increased perceived self-efficacy at a statistically significant level of P<.001 on both occasions. It can be concluded therefore that participation in a summer camp by obese children made them have aware of their ability to control their weight and that they could decrease their weight without needing weight control pills.

Learning of nutritional values of foods of childhood obesity during a summer camp.

During a summer camp held between March 30, 1992 - April 24, 1992, 21 obese children, 8 males and 13 females were taught about nutritional requirements, values and food exchange lists. After 3-weeks of instruction, the obese children were evaluated about these topics. Caloric values of fruits were easily remembered. Carbohydrate category ranked second after fruits. Meats category was the last to be remembered; however, eight percent of the participants could pass the test in meat category. The evaluation showed successful teaching about nutritional values of food to these children. This teaching could be the base for the next summer course.