Associations of Plasma BDNF and BDNF Gene Polymorphism with Cardiometabolic Parameters in Thai Children: A Pilot Study.

Background: Childhood obesity is an important public health crisis worldwide. The brain-derived neurotrophic factor (BDNF) has been demonstrated to play a role in controlling energy homeostasis and cardiovascular regulation. Objectives: To examine brain-derived neurotrophic factor (BDNF) levels and anthropometric-cardiometabolic and hematological parameters in obese and nonobese children and to determine whether two BDNF gene polymorphisms (G196A and C270T) are linked to BDNF levels, obesity, and anthropometric-cardiometabolic and hematological parameters among Thai children. Methods: This case-control study included an analysis of 469 Thai children: 279 healthy nonobese and 190 obese children. Anthropometric-cardiometabolic and hematological variables and BDNF levels were measured. Genotyping of BDNF G196A and C270T was performed using the polymerase chain reaction-restriction fragment length polymorphism technique. Results: Children in the obese group had significantly higher white blood cell counts and some cardiometabolic parameters. Although the difference in BDNF level between the nonobese and obese groups was not significant, BDNF level was significantly positively correlated with hematological and cardiometabolic parameters, including blood pressure, triglycerides, and triglycerides and the glucose index. The BDNF G196A polymorphism in children was only associated with decreased systolic blood pressure (p < 0.05), while the BDNF C270T polymorphism was found not to be related to BDNF levels, obesity, or other parameters after adjusting for potential covariates. Conclusions: These findings in Thai children suggest that obesity is associated with increased cardiometabolic risk factors, but not with BDNF levels or the two BDNF polymorphisms studied, while the BDNF G196A polymorphism is a beneficial marker for controlling blood pressure among Thai children.

Changing trends of obesity and lipid profiles among Bangkok school children after comprehensive management of the bright and healthy Thai kid project.

BACKGROUND: Cardiovascular diseases are the world's leading cause of death. Children in Thailand are currently facing obesity, hyperlipidemia, and high atherogenic indices. This study aimed to assess the success of the Bright and Healthy Thai Kid project in reducing obesity and high lipid profiles among Bangkok school children. METHODS: A community-based, intervention (participatory action) with pre-post comparison of anthropometric and lipid profile data was conducted in five randomly selected Bangkok primary schools. The participatory action involved teachers, students, and parents. Data collection on anthropometric measurements, dietary intake, physical activity, and fasting blood samples of three generations of students was carried out during July-August (midterm months in Thailand) in the years 2004, 2017, and 2019. SPSS for Windows, version 16 was used for data analysis. RESULTS: Comparing the data from 2004, 2017, and 2019, obesity rates of 19.3 in 2004 gradually declined to 16.9 and 15.6 in 2017 and 2019 (P <  0.001). High serum total cholesterol, triglyceride, LDL-C, and atherogenic indices decreased significantly (p <  0.001). CONCLUSIONS: We believe that the great time and effort expended for a campaign to reduce rates of obesity and hyperlipidemia in school children does work to prevent future cardiovascular diseases. Long-term investment in national programs is required to achieve whole societal involvement in improving knowledge and skills related to health, nutrition, and healthy food choices.

Effectiveness Of A School-Based Multicomponent Intervention On Nutritional Status Among Primary School Children In Bangkok, Thailand.

BACKGROUND: Childhood obesity has become a major public health issue today. The prevalence of obesity and overweight is increasing in both adults and children. Childhood obesity in Thailand has more than doubled since the 1960s and a recent study reported that overweight and obesity in Thais is the 5th highest in Asia. The present study objective was to evaluate the effectiveness of a life-skills, multicomponent, school-based intervention on child nutritional status. METHODS: A quasi-experimental design was conducted in two-groups (control and intervention schools) on 453 students attending grade levels 4-5 in Bangkok. Two schools were selected for control, and two schools for intervention groups. The interventions included education, diet, physical activity (PA), food-environment, school builtenvironment, and life-skills components. Subjects were measured at baseline and at 6 months post-treatment. RESULTS: The intervention group had significant differences in overall healthy practices (+1.5 mean difference, p=0.048), dietary habits, physical activity, lower total cholesterol (TC) levels (-2.43 mean, p=0.019) and higher high density lipoprotein cholesterol (HDL-C) levels (+4.06 p=0.028) as compared to the control. A higher reduction of overweight individuals among the intervention group over the intervention period was observed. Physical activity and consumption of vegetables increased while consumption of high-caloric snacks and fast foods decreased in children after the intervention. CONCLUSIONS: This study indicated that a multidisciplinary approach in school-based interventions is most likely to be effective in preventing children from becoming overweight in the long term. More research should be conducted on school-based interventions with longer intervention periods and higher sustainability.

Implementation of a Nutrition Program Reduced Post-Discharge Growth Restriction in Thai Very Low Birth Weight Preterm Infants.

Very low birth weight (VLBW) preterm infants are vulnerable to growth restriction after discharge due to cumulative protein and energy deficits during their hospital stay and early post-discharge period. The current study evaluated the effectiveness of the preterm infant, post-discharge nutrition (PIN) program to reduce post-discharge growth restriction in Thai VLBW preterm infants. A prospective, non-randomized interventional cohort study was undertaken to assess the growth of 22 VLBW preterm infants who received the PIN program and compared them with 22 VLBW preterm infants who received conventional nutrition services. Infant's growth was recorded monthly until the infants reached six months' corrected age (6-moCA). Intervention infants had significantly greater body weights (p = 0.013) and head circumferences (p = 0.009). Also, a greater proportion of the intervention group recovered their weight to the standard weight at 4-moCA (p = 0.027) and at 6-moCA (p = 0.007) and their head circumference to the standard head circumference at 6-moCA (p = 0.004) compared to their historical comparison counterparts. Enlistment in the PIN program thus resulted in significantly reduced post-discharge growth restriction in VLBW preterm infants. Further research on longer term effects of the program on infant's growth and development is warranted.

The association between obesity and blood pressure in Thai public school children.

BACKGROUND: The prevalence of obesity has substantially increased in the past 3 decades in both developed and developing countries and may lead to an increase in high blood pressure (BP) at an early age. This study aimed to determine the prevalence of obesity and its association with blood pressure among primary school children in central Thailand. METHODS: A cross-sectional study was conducted in two public schools in Bangkok in 2012. A total of 693 students (317 boys and 376 girls) aged 8-12 years participated voluntarily. Anthropometric measurements of weight, height, waist circumference (WC) and BP were collected. Fasting venous blood samples were obtained for biochemical analysis of fasting plasma glucose (FPG) and lipid parameters. Child nutritional status was defined by body mass index (BMI) for age based on the 2000 Center for Diseases Control and Prevention growth charts. The cutoff for abdominal obesity was WC at the 75 percentile or greater. Hypertension was defined according to the 2004 Pediatrics US blood pressure reference. Multinomial logistic regression was used to examine the relationship between high BP and obesity after controlling for other covariates. RESULTS: The prevalence of obese children was 30.6% for boys and 12.8% for girls (mean prevalence 20.9%). Pre-hypertension (Pre-HT) was 5.7% and 2.7% for boys and girls and hypertension (HT) was 4.7% for boys and 3.2% for girls, respectively. Children with pre-HT and HT had significantly higher body weight, height, WC, BMI, SBP, DBP, TG, and TC/HDL-C levels but lower HDL-C levels than those children with normotension. After controlling for age, sex, glucose and lipid parameters, child obesity was significantly associated with pre-HT and HT (odds rations (ORs) = 9.00, 95% CI: 3.20-25.31 for pre-HT and ORs = 10.60, 95% CI: 3.75-30.00 for HT). So also was WC (abdominal obesity) when considered alone (ORs = 6.20, 95% CI: 2.60-14.81 for pre-HT and ORs = 13.73, 95% CI: 4.85-38.83 for HT) (p-value < 0.001). CONCLUSIONS: Obesity among school children was positively associated with higher BP. Prevention of childhood obesity should be strengthened to prevent the risk of early high BP including cardiovascular risk factors.

Self discipline and obesity in Bangkok school children.

BACKGROUND: Childhood obesity has become an important public health problem in Thailand. This study aimed to determine the relationship between self discipline and obesity in Bangkok school children. METHODS: A case control study was conducted. 140 cases (obese children) and 140 controls (normal weight children) were randomly chosen from grades 4-6 students in 4 Bangkok public schools. Questionnaire responses regarding general characteristics and child self-discipline were obtained from children and their parents. RESULTS: Self discipline in eating habits, money management and time management were reported at significantly lower levels among the obese group (p < 0.05). After controlling all other variables, it was revealed that the ranking of factors associated with obesity by adjusted odds ratio (OR) were low self-discipline in managing expenses (3.1), poor home environment (3.0,), moderate self-discipline in time management (2.9), television viewing time ≥2 hours/day (2.6), an obese father (2.2), and an obese mother (1.9). CONCLUSIONS: It was recommended that parents and teachers participate in child self-discipline guidance, particularly with regard to eating habits, money management and time management in a supportive environment that both facilitates prevention of obesity and simultaneously develops a child's personal control.

Participatory action project in reducing childhood obesity in Thai primary schools.

UNLABELLED: The project aimed to improve nutrition and activity among primary schoolchildren via targeted activities. A preliminary nutritional survey was carried out involving 5126 children in 4 Bangkok public schools. Participatory action research involving students, teachers, and parents was conducted. After a 2-day training course, teachers integrated project concepts into their course curriculum. Seminars on weight management were given separately to parents and students. After 8 months, postnutritional survey was conducted. Preprogram and postprogram evaluation of obese and normal groups was done using questionnaires on dietary intake and exercise. RESULTS: showed that high caloric dietary intake significantly decreased for the obese group (P < .001). Aerobic exercise activity also increased in both groups (P < .001) and prevalence of obesity declined from 19.3% to 16.8%. Thus, a long-term, participatory effort to promote healthy diets and physical exercise could be effective with primary school students and may establish habits that last to later life.

Identification of leptin gene variants in school children with early onset obesity.

OBJECTIVE: To investigate leptin gene variations in Thai primary school children. MATERIAL AND METHOD: Direct DNA sequencing was performed following polymerase chain reaction (PCR) amplification of the leptin gene in 30 obese children aged 10-12 years old. RESULTS: A heterozygous variant 19 (G > A), located in the non-coding region of exon 1 was detected in 13 subjects (43.3%, A: 0.22). Only 2 subjects (6.7%, G: 0.03) harbored a heterozygous (CAA > CAG) polymorphism in codon 25 of exon 2. CONCLUSION: The 25 (CAA > CAG) polymorphism appeared to be a new leptin gene variant in Thai people. This study provides basic information concerning the prevalence of leptin gene polymorphisms in Thai children with early onset obesity. It might be useful as genetic marker for screening for obesity potential in large populations.

A descriptive study of 36 cases of solitary soft tissue cysticercosis at Ramathibodi Hospital from surgical specimens during 1990-2006.

We present a study of 36 cases of solitary soft tissue cysticercosis retrieved from pathological reports and medical records during 1990-2006. The soft tissue was the most common organ affected by cysticercosis in our study accounting for 75% of all affected cases. The brain was the second most common, and accounted for 15%. The most common location for the soft tissue lesions was upper extremities which accounted for 33% of cases, and the least common sites were the back, eyelid, buttock and cheek, which accounted for 3% each. Preoperative diagnoses of the lesions were as follows: lipoma, masses of undetermined nature, cysts, abscesses, fat necrosis and lymphadenitis. The mean size of lesions was 1.5 cm; the minimum and maximum sizes were 0.3 and 3 cm, respectively. The mean age of the patients was 33.5 years and the range was 9 to 68 years. The ratio of males to females was 1 to 5, which may reflect differences in eating habits and social life between males and females in our society. Our findings indicated that none of the cases in our study were diagnosed as cysticercosis preoperatively. Therefore, clinicians should include cysticercosis in the differential diagnosis of soft tissue cystic nodules or masses. Data regarding the sizes of lesions should be helpful in differentiating this entity from other soft tissue lesions in clinical practice and on magnetic resonance imaging.

Do Thai women of child bearing age need pre-conceptional supplementation of dietary folate?

Recent studies in western countries have indicated that women with low serum folate before pregnancy have greater risk of giving birth to babies with neural tube defects, and preconceptional folate supplementation has been recommended to prevent such defects. To determine whether Thai women needed folate supplementation before pregnancy, we carried out a cross-sectional study from September 2001 to January 2002. The objectives were to determine serum folate levels among women of child-bearing age and their relationship to dietary folate intake. One hundred and sixty-five apparently healthy, volunteer women aged 15 - 45 years were recruited from the Family Planning Clinic, Mother and Child Hospital, Health Promotion Centre, Region I, Bangkok. Data on general characteristics, nutritional status and dietary folate intake were recorded while venous blood was drawn for serum folate analysis. Results showed that 65.5% of the study group had low dietary folate intake, that 18% had low serum folate, and that there was a significant correlation between dietary intake and serum level (r = 0.68, P<0.001). There were also significant correlations between serum level and body mass index, (r =0.13, P<0.001). However, there were no significant associations between serum level and age, educational level, occupation, family income, or duration vegetables were stored in the refrigerator before consumption. In conclusion, there is preliminary evidence that some pregnant Thai women may have sufficiently low serum folate levels to put their babies at risk. We recommend further study on a larger scale to confirm whether folate supplementation is needed for Thai women at child bearing age. In the interim, it may be wise for obstetricians to measure serum folate in pregnant women to determine whether folate supplementation is required.

Birth weight doubling time of Thai infants.

BACKGROUND: For decades, birth weight doubling time (BWDT) has been used as an indicator for the assessment of physical growth of infants. However, the relevant data in the literature were obtained mainly from western subjects and no similar studies have been carried out for South EastAsian or otherAsian countries. OBJECTIVE: To determine BWDT and related variables forThai infants. METHODS: A study was conducted from January to August 1999 at the well baby clinic of Bamrasnaradura Hospital. Apparently normal infants (335) with birth weight between 2,500 and 4,000 grams were recruited and followed up until they had doubled their birth weights. Data on infant birth weight, sex, mother education, occupation, income and feeding practices were collected. RESULTS: The mean BWDT was 114 days which was slightly less than that given in previous reports. Male infants doubled their birth weights in less time (104 days) than females (123 days) and the difference was statistically significant (p < 0.001). Infants with lower birth weights doubled their birth weights earlier than those with higher birth weights (p < 0.001). Infants who were not given complementary food had shorter BWDT than those who were (p < 0.001), but we could not demonstrate any significant association between BWDT and type of food, mother's education or family income (p > 0.05). Factors that did affect BWDT were birth weight, sex, daily weight gain and use of complementary food. However, by multivariate analysis only birth weight and daily weight gain showed significant association with BWDT (p < 0.001). CONCLUSION: Both prenatal and postnatal factors may affect BWDT significantly.