Consumption of Lutein and Zeaxanthin and Its Relation to the Level of Macular Pigment Optical Density in Thai Subjects.

The aim of the study is to determine dietary lutein and zeaxanthin (L/Z) consumption and to evaluate its association with macular pigment optical density (MPOD) in Thai subjects. Methods. This study was a cross-sectional study. A total of 120 ophthalmologically healthy subjects aged between 40 and 72 years were recruited from Bangkok and the vicinity area. Demographic data were collected using a questionnaire, while a semiquantitative food frequency questionnaire assessed the L/Z intake. MPOD was determined using the reflectometry method (VISUCAM 500®, Carl Zeiss Meditec AG). Pearson's correlation coefficient analyzed the relationship between L/Z consumption and MPOD. Results. The mean age of the participants was 50.7 ± 7.5 years. The mean consumption of L/Z was 3.03 ± 2.65 mg per day. The mean MPOD was 0.102 ± 0.023 density units. Consumption of foods rich in L/Z, including ivy gourd (r = 0.217, p < 0.05), Chinese flowering cabbage (r = 0.194, p < 0.05), balsam pear (r = 0.193, p < 0.05), lettuce (r = 0.182, p < 0.05), sweet corn (r = 0.181, p < 0.05), and pumpkin (r = 0.181, p < 0.05), was positively associated with the mean optical density (mean MPOD). Consumption of green onion (r = 0.212, p < 0.05) was positively associated with the sum of optical densities (MPOD volume). In contrast, chilli pepper consumption showed a negative association with mean MPOD (r = -0.220, p < 0.05) and amaranth showed a negative association with MPOD volume (r = -0.283, p < 0.05). No association was found between total L/Z consumption and MPOD. Conclusion. L/Z consumption is low among Thais living in Bangkok and the vicinity area, which may not be sufficient to ensure eye health, and total L/Z consumption is not associated with MPOD.

Vitamin D Status Is Positively Associated with Calcium Absorption among Postmenopausal Thai Women with Low Calcium Intakes.

BACKGROUND: Few data exist on the ability of postmenopausal women to absorb calcium from diets habitually low in calcium. OBJECTIVE: The objective of this study was to evaluate fractional calcium absorption from a green leafy vegetable vs. milk in relation to vitamin D status. METHODS: We measured fractional calcium absorption from both a dairy- and plant-based source in 19 postmenopausal Thai women (aged 52-63 y) with low calcium consumption (350 ± 207 mg/d) in relation to serum parathyroid hormone (PTH) and serum 25-hydroxyvitamin D [25(OH)D]. Fractional calcium absorption was measured using a triple stable calcium isotope method based on isotope recovery in a 28-h urine collection. Two extrinsically labeled test meals were ingested in random order: a green leafy vegetable (cassia) ingested along with 4³Ca or a glass of milk containing 44Ca. Women received intravenous 4²Ca with the first test meal. RESULTS: In 19 postmenopausal women studied (mean age, 56.9 ± 3.4 y), ~95% were 25(OH)D sufficient (≥20 µg/L). Serum 25(OH)D status was positively correlated with fractional absorption from both cassia (P = 0.05, R² = 0.21) and milk (P = 0.03, R² = 0.26). Fractional calcium absorption from cassia was significantly lower than that measured from milk (42.6% ± 12.3% vs. 47.8% ± 12.8%, P = 0.03), but true calcium absorption did not significantly differ (120 ± 35 mg/d vs. 135 ± 36 mg/d). Serum PTH was significantly inversely associated with serum 25(OH)D (P = 0.006, R² = 0.37) even though PTH was not elevated (>65 pg/mL). CONCLUSIONS: These findings suggest that vitamin D status is an important determinant of calcium absorption among Thai women with low calcium intakes, and cassia may be a readily available source of calcium in this population. Furthermore, these data indicate that serum 25(OH)D concentrations may affect PTH elevation in postmenopausal women with low calcium intakes.

Food based dietary guidelines (FBDGs) development and promotion in Thailand.

Dietary guidelines based on 5 food groups was used as a main nutrition education tool until 1996 when food based dietary guidelines (FBDGs) were promoted after 2 years of formulation and development. These FBDGs for the general population were designed to promote desirable and culturally acceptable eating behavior. The nine qualitative guidelines of Thai FBDGs include: 1. eat a variety of foods from each of the five food groups and maintain proper weight, 2. eat adequate rice, or alternate carbohydrate, 3. eat plenty of vegetables and fruits regularly, 4. eat fish, lean meats, eggs, legumes and pulses regularly, 5. drink sufficient amount of milk every day, 6. take moderate amounts of fat, 7. avoid excessive intake of sweet and salty foods, 8. eat clean and uncontaminated foods, and 9. avoid or reduce consumption of alcoholic beverages. In 1998, the quantitative part of Thai FBDGs or food guide model was established as "Nutrition Flag" after rigorous test for understanding and acceptability among consumers. Promotion and dissemination of the Thai FBDGs have been carried out at national and community levels through basic health, agricultural and educational services and training activities, as well as periodic campaigning via multiple communication channels and media. Recently in 2009, the FBDGs for infant and preschool children were introduced to replace the previous infant and young child feeding guidelines. There has been no formal evaluation on the impact of promotion of the Thai FBDGs but some periodic testing of knowledge and practices have shown positive results.

Process and outcome evaluation of a diabetes prevention education program for community healthcare workers in Thailand.

OBJECTIVE: To describe the development, process and outcome evaluation of a culturally tailored diabetes prevention education program for community healthcare workers (CHCWs) in Thailand. METHODS: A tailored diabetes prevention education program was designed based on formative research and implemented with 35 CHCWs in semi-urban areas in Chiang Mai province, Thailand. Modules were delivered over eight group classes and eight self-directed E-learning sessions (www.FitThai.org). The program incorporated problem-based learning, discussion, reflection, community-based application, self-evaluation and on-line support. The frequency that students accessed on-line materials, including videotaped lectures, readings, monthly newsletters and community resources, was documented. Participant satisfaction was assessed through three questionnaires. Knowledge was assessed through pre-post testing. RESULTS: Three-quarters of participants attended all eight classes and no participant attended fewer than six. On-line support and materials were accessed 3 to 38 times (median 13). Participants reported that program information and activities were fun, useful, culturally-relevant and applicable to diabetes prevention in their specific communities. Participants also appreciated the innovative technology support for their work. Comfort with E-learning varied among participants. Scores on pre-post knowledge test increased from a mean (sd) of 56.5% (6.26) to 75.5% (6.01) (p < .001). CONCLUSIONS: An innovative diabetes prevention education program was developed for CHCWs in Thailand. Interactive classroom modules and self-directed E-learning were generally well-received and supported better knowledge scores. Ongoing access to web-based materials and expert support may help sustain learning.

Practical experience in development and promotion of food-based dietary guidelines in Thailand.

Although under-nutrition problems have been decreasing in Thailand, non-communicable diseases have become leading causes of death and disability. Food-Based Dietary Guidelines (FBDGs) is a key strategy to promote healthy daily food consumption and appropriate lifestyles. The development consists of qualitative and quantitative parts. The purposes were 1) to assist consumers in making healthy dietary choices and disease prevention; 2) to guide governmental agencies in nutrition implementations, promotion of healthy food products and education programs; 3) to assist national and local agencies in policy formulations and implementations; 4) to assist healthcare providers in primary diseases prevention efforts. The procedures to develop FBDGs specifically were to 1) set nutritional goals based on Thai DRI and RDI; 2) assign the units used for one portion of each food group; 3) quantify the size and number of servings of the major food groups, using the nutritive value calculated by the popularity vote method from secondary data; 4) evaluate the nutritive value of recommended amounts from combinations; 5) develop and test several food guide models based on Thai people's understanding and cultures; 6) implement through educational tools for the nationwide public units; 7) offer training programs, monitoring and evaluation in various populations to be performed by Ministry of Public Health (MOPH) and other academic sections. In long run successful FBDGs, there must not only be support from policy makers and cooperation between nutritionists from universities and the MOPH, but also application of ongoing activities such as "Sweet Enough Campaign Network" or "School Lunch Program"