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.

The function and respiratory muscle strength in Thai obese children.

Objective: This study was to compare the pulmonary function, respiratory muscle strength, and physical activity level between obese and non-obese children and to determine the correlation between pulmonary function, respiratory muscle strength and physical activity level in both child groups. Methods: Thai healthy children aged between 10-12 years participated in this study. They were classified into an obese group with body weight > +3 standard deviations and a non-obese group with body weight between+ 1.5 standard deviations of children who have the same height. Children in both groups were measured for pulmonary function, forced vital capacity (FVC), and forced expiratory volume in one second (FEV1), FEV1/FVC ratio, vital capacity (VC), inspiratory muscle strength (MIP), expiratory muscle strength (MEP), and physical activity level. Results: The results showed that FVC, FEV1 and VC of the obese group were statistically higher than the non-obese group (p<0.05). FEV1/FVC ratio of the obese group was statistically lower than the non-obese group (p<0.05). MIP and MEP were not significantly different between the groups (p>0.05). Physical activity levels were not significantly different between the groups (p>0.05). Moreover, the results demonstrated that physical activity level in the obese group had no correlation with FVC, FEV1, FEV1/FVC ratio and VC (r = 0.203, 0.170, -0.067 and 0.133 respectively; p > 0.05) and similarly the non-obese group showed no correlation with FVC, FEV1, FEV1/FVC ratio and VC (r = 0.225, 0.168, -0.207 and 0.168 respectively; p > 0.05). Additionally, the results demonstrated that physical activity level in the obese group had no correlation with MIP and MEP (r = 0.151 and 0.355 respectively; p > 0.05) and similarly the non-obese group showed no correlation with MIP and MEP (r = 0.202 and 0.006 respectively; p > 0.05). Conclusion: This study provides information about the pulmonary function and respiratory muscle strength in Thai obese children. FVC, FEV1 and VC of the obese group were higher than the non-obese group. In addition, FEV1/FVC ratio of the obese group was lower than the non-obese group. Although, all parameters including pulmonary function of both groups were in the normal range. However, obese children tend to observe airway obstruction higher than non-obese children. Moreover, respiratory muscle strength and physical activity level were not different between groups. Additionally, physical activity level had no correlation with pulmonary function and respiratory muscle strength in both groups.

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.

Identification of known mutation in LDL receptor gene underlying severe FH phenotype in Thai patient: A case report.

Objective: Familial hypercholesterolemia (FH) is associated with atherosclerosis coronary artery disease (CAD). The aim of this study is to identify a mutation in the LDL receptor gene that underlined the FH phenotype in a female patient and her family. Methods: The LDL receptor gene was screened by Polymerase Chain Reaction-Single Strand Conformation Polymorphism (PCR-SSCP), direct DNA sequencing and was subsequently confirmed by PCR-RFLP. Results: The screening of the entire LDL receptor gene revealed a 5’ donor splice site mutation of the first base of intron 3, i.e., 313+1G T mutation in one allele. This mutation was previously reported in a Danish patient with severe hypercholesterolemia. Conclusions: This case report illustrates the use of DNA diagnosis of a female heterozygous FH case and her family members, which is more accurate than clinical diagnosis especially when clinical phenotype is variable or when the individual who is at high risk is still a normolipidemic at his/ her young age. DNA diagnosis is now used as a tool to find or diagnose FH. Accurate and/or early diagnosis is important for prevention and treatment of FH patients in order to avoid the development of CAD in these patients.

Increasing risks of becoming obese after 6 years in primary school: comparing the relative risks among some schools in Bangkok, Saraburi and Sakolnakorn.

The authors carried out a retrospectively study of bodyweights of primary-school children from Grade I to Grade VI in 4 schools from Bangkok, one school from Saraburi and data of school children from a district in Sakolnakorn with a six year follow-up period. In the cohort there were 437 children from Bangkok, 225 children from Saraburi and 633 children from Sakolnakorn. Initial data show that prevalence of obesity at grade I in schools from Bangkok, Saraburi and Sakolnakorn were 16%, 23% and 4%, respectively. However, when these children were in grade VI, the prevalence of obesity increased to 31%, 30% and 9%, respectively. Relative risks of becoming obese at grade VI in children who were overweight and obese at grade I are 3 and 5 fold in Bangkok, 2 and 3 fold in Saraburi, 6 and 12 fold in Sakolnakorn, respectively. The present study shows that prevalence of obesity increased at quite dramatic rates during the primary school period in these study groups.

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.

Lactose intolerance in Thai adults.

Lactose intolerance is common in Thai adults who ingest cow's milk but its incidence has not been clearly defined The authors evaluated 45 volunteers (15 males, 35 females), aged 21-31 yrs old, who drank one 240-ml box of milk daily. A Lactose tolerance test was performed using a breath-hydrogen test (BHT) after oral intake of 25 g of lactose dissolved in 250 ml of water The presence of gastrointestinal symptoms of lactose intolerance, flatulence, abdominal pain and diarrhea, were recorded Twenty-one subjects (47%) were categorized as lactose malabsorbers and intolerant, two subjects (4%) were malabsorbers but tolerant, and 22 of 45 (49%) were absorbers and tolerant. The incidence of lactose malabsorption was, thus, 51%; symptoms of intolerance were found in 21 of the 23 malabsorbers, making the incidence of lactose intolerance 47%. In the lactose malabsorbant and intolerant group, the more breath-hydrogen (H) the more symptoms observed All subjects who had a negative breath-H2 test had no symptoms. The breath-H2 test should be used as a standard method to evaluate lactose absorption and lactose tolerance. The incidence of lactose intolerance has decreased from the past and the symptoms are not so severe that the people limit the consumption of milk since it is a major source of food containing good quality of protein and calcium.

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.

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.

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.

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.

Early atherosclerosis in children in familial hypercholesterolemia: A 2 case report.

Familial hypercholesterolemia (FH) is inherited as an autosomal dominant. It is an important clinical condition leading to hypertension, atherosclerosis, and premature coronary artery disease. Atherosclerosis is rarely reported in children. We report here 2 children with familial hypercholesterolemia and early atherosclerosis. The first case is a 4 year-old Thai boy who presented with yellowish papules in the skin creases which had been present for 2 years. His grandfather and father had been diagnosed with diabetes mellitus and hypercholesterolemia, respectively. Physical examination revealed his weight for height to be 125% and planar xanthomas. The remaining examination was unremarkable. Plasma lipid profiles showed a total cholesterol level of 674 mg/dl, a triglyceride level of 261 mg/dl, a high-density lipoprotein cholesterol (HDL-C) level of 39 mg/dl, and a low-density lipoprotein cholesterol (LDL-C) level of 583 mg/dl. The results of a carotid duplex scan showed atherosclerotic plaques in both carotid arteries. The second case is a 10 year-old Thai boy who had no symptoms, but hismother and uncle had been diagnosed with coronary heart disease and diabetes mellitus,respectively. Physical examination revealed a weight for height of 112%, but the remaining examination was unremarkable. Plasma lipid profiles showed a total cholesterol level of 328 mg/dl, a triglyceride level of 59 mg/dl, an HDL-C level of 54 mg/dl, and an LDL-C level of 262 mg/dl. A carotid duplex scan showed atherosclerotic plaques in both carotid arteries. Atherosclerosis is rarely reported in children and it usually correlates with ischemic heart disease. The finding of atherosclerotic plaques in the large arteries may reflect deposition of atheroma in their coronary arteries. We suggest that this investigation is an important procedure in the screening of early atherosclerosis in order to primarily and secondarily.