Influence of Micronutrient Status during Infancy and Middle Childhood on Cognition at Middle Childhood.

Objectives: To evaluate the relationship between micronutrient status during infancy and middle childhood on cognition at middle childhood. Methods: A longitudinal study was conducted in apparent healthy children in the northeast of Thailand. Intelligence Quotient (IQ) was measured using the Wechsler Intelligence Scale for Children, III (Thai) at 9 y. Hemoglobin, serum ferritin, and serum zinc (sZn) were assessed at early infancy (4 mo), late infancy (1 y), and middle childhood (9 y). Serum transferrin receptor and urine iodine (UI) were assessed at 9 y. Using multiple regression, the relationship between micronutrient status during infancy and middle childhood and cognition at middle childhood was ascertained. Results: Full scale IQ and performance IQ at 9 y was influenced by sZn at 1 y (β = 0.4 μmol/L, p = 0.011 and β = 0.6 μmol/L, p = 0.001). The influence of UI at 9 y on Verbal IQ at 9 was small but significant (β = 0.02 μg/L, p = 0.024). None of the iron status at 4 mo, 1 y, and 9 y were associated with IQ. Conclusions: In apparent healthy children, zinc status at late infancy and iodine status at middle childhood were associated with IQ at middle childhood. Further analyses are needed to understand this relationship.

Study on different sites of waist circumference and its relationship to weight-for-height index in Thai adolescents.

OBJECTIVE: To compare waist circumference (WC) measured at different sites of trunk region and to determine predictive WC values that were corresponding to weight-for-height index in Thai adolescents. MATERIAL AND METHOD: The authors conducted the cross-sectional study in 509 adolescents, aged 10-18 years old WC was measured at four different sites of trunk region, WC1; at midway between the lowest rib and the iliac crest, WC2; at the narrowest waist, WC3; at immediately above the iliac crest and WC4; at the umbilicus level. Receiver operating characteristic analysis was also performed to determine WC cutoffs to maximize the sensitivity and specificity. RESULTS: WC measured at all four sites provided small different powerful value in prediction of trunk fat and total body fat (TBF) in adolescents and that WC4 provided slightly better predictive value than other WC. In boys, WC provided better prediction of trunk fat than the prediction of TBF, whereas in girls, the prediction of trunk fat and TBF from WC were of similar magnitude. By receiver operating characteristic analysis, WC risk threshold for predicting the overweight adolescents using Thai weight-for-height Z score > or = 1.5 SD as reference was 73.5 cm for boys (sensitivity 96.8%, specificity 85.7%) and 72.3 cm for girls (sensitivity 96.1%, sensitivity 80.5%). WC threshold was increased to 75.8 cm. (sensitivity 96.3.%, specificity 86.4%) for boys and 74.6 cm for girls (sensitivity 95.1%, specificity 85.7%) in order to detect the obese children. CONCLUSION: Waist circumference has been proposed as the simple tool for screening the overweight adolescents and when measured at the umbilicus level, it is considered the feasible site for self-evaluation. Further study is needed to investigate the relationship between the increased WC and metabolic risk factors for obesity in adolescents.

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.

Effect of nutrition education model on weight control in obese school children.

A study on the effect of nutrition education on weight control in obese children was conducted on 139 primary school children, grades 4 to 6. Their ages ranged between 9 and 12 years and initially the mean body mass index ranged between 24.4 and 24.9. Subjects were divided into three groups. Group 1, Sainamthip pupils (n=41) and their parents, received a weight control guideline booklet (WCGB); a nutrition session which included nutrition counseling and a food demonstration was provided to the parents once a month. Group 2 from Wat Plubplachai (n=46) received the same WCGB, whereas group 3 from Wat Amarindraram (n=52) served as a control group and did not receive the booklet. Prior to the beginning of the study, there was no difference in the mean nutrition knowledge score among the three groups. School visits and nutrition education were also provided for groups 1 and 2 every two weeks for three months by nutritionists. Results showed that energy, protein and fat intakes at weeks 12 in Group 1 significantly decreased compared to those of week 1, whereas significant change in protein and cholesterol were observed in Group 2. No change was seen in main nutrients in group 3. Fat intakes among the three groups at week 12 was relatively high when compared to dietary recommendations. Changes in body mass index of subjects were also affected by physiological maturation. However, nutrition education during the 12-week weight control programme did not affect changes in serum cholesterol and HDL-cholesterol of group 1 and 2. Lack of parents’ participation seemed to be one determining factor leading to insufficient weight reduction in obese pupils and this.

Nutrition knowledge and nutrient consumption of working women in Bangkok metropolis: A case study of silom area and government enterprises.

The study was conducted to evaluate nutrition knowledge and nutrient intakes of adult women, aged 20-50 years, working in the Bangkok Metropolitan Area. 308 subjects from the Silom business area and 178 subjects from government enterprises were randomly selected. Nutrition knowledge was evaluated in all subjects using food questionnaires. Average scores of the two groups were quite acceptable and no mean significant difference was found. Based on a 24-hour food record, the energy intakes of the two groups, were quite satisfactory, at around 75-79% of Thai RDA. However, the percentage of energy obtained from fat in the food they consumed was relatively high with regard to their energy intakes. Average vitamin A, iron and phosphorus intakes were adequate for the subjects but the calcium intake was only 50% of the recommended level. No significant correlation was detected between the body mass index of subjects and various nutrient variables. To promote nutrition education, proper food practices need to be emphasized.

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.