Kallaya Kijboonchoo

SEANUTS: the nutritional status and dietary intakes of 0.5–12-year-old Thai children

In the present study, we investigated nutritional status and health-related factors in a multistage cluster sample of 3119 Thai urban and rural children aged 0·5-12·9 years. In a subsample, blood samples were collected for the measurement of Hb, transferrin receptor, vitamin A and vitamin D concentrations. The prevalence of stunting and underweight was higher in rural children than in urban children, whereas the wasting rate was similar in both rural and urban areas. Among children aged 3·0-5·9 years, the prevalence of overweight was significantly higher in urban areas than in rural areas and so was the obesity rate in children aged 6·0-12·9 years. Protein intakes of all age groups were relatively high in both the areas. Intakes of Ca, Fe, Zn and vitamin C were significantly higher in urban areas than in rural areas. The prevalence of anaemia in rural areas was twice as high as that in urban areas, particularly in infants and young children. However, the prevalence of Fe-deficiency anaemia was similar in both urban and rural areas. While the prevalence of vitamin A deficiency (by serum retinol cut-off < 0·7 μmol/l) seemed to be very low, vitamin A insufficiency (by serum retinol cut-off < 1·05 μmol/l) was more prevalent (29·4-31·7%) in both the areas. The prevalence of vitamin D insufficiency ranged between 27·7 and 45·6% among the children. The present study indicates that the double burden of malnutrition is still a major public health problem in Thailand. Further studies need to explore the associated risk factors for these nutrient deficiencies. Effective strategies and actions are needed to tackle the nutritional problems in Thai children.

Validation of bioelectrical impedance analysis for total body water assessment against the deuterium dilution technique in Asian children

Background/Objectives:To develop and cross-validate bioelectrical impedance analysis (BIA) prediction equations of total body water (TBW) and fat-free mass (FFM) for Asian pre-pubertal children from China, Lebanon, Malaysia, Philippines and Thailand.Subjects/Methods:Height, weight, age, gender, resistance and reactance measured by BIA were collected from 948 Asian children (492 boys and 456 girls) aged 8–10 years from the five countries. The deuterium dilution technique was used as the criterion method for the estimation of TBW and FFM. The BIA equations were developed using stepwise multiple regression analysis and cross-validated using the Bland–Altman approach.Results:The BIA prediction equation for the estimation of TBW was as follows: TBW=0.231 × height2/resistance+0.066 × height+0.188 × weight+0.128 × age+0.500 × sex−0.316 × Thais−4.574 (R 2=88.0%, root mean square error (RMSE)=1.3 kg), and for the estimation of FFM was as follows: FFM=0.299 × height2/resistance+0.086 × height+0.245 × weight+0.260 × age+0.901 × sex−0.415 × ethnicity (Thai ethnicity =1, others = 0)−6.952 (R 2=88.3%, RMSE=1.7 kg). No significant difference between measured and predicted values for the whole cross-validation sample was found. However, the prediction equation for estimation of TBW/FFM tended to overestimate TBW/FFM at lower levels whereas underestimate at higher levels of TBW/FFM. Accuracy of the general equation for TBW and FFM was also valid at each body mass index category.Conclusions:Ethnicity influences the relationship between BIA and body composition in Asian pre-pubertal children. The newly developed BIA prediction equations are valid for use in Asian pre-pubertal children.

Bone status measured by quantitative ultrasound: a comparison with DXA in Thai children

Background/Objectives:Quantitative ultrasound (QUS) is used to measure bone quality and is known to be safe, radiation free and relatively inexpensive compared with dual-energy X-ray absorptiometry (DXA) that is considered the gold standard for bone status assessments. However, there is no consensus regarding the validity of QUS for measuring bone status. The aim of this study was to compare QUS and DXA in assessing bone status in Thai children.Subjects/Methods:A total of 181 Thai children (90 boys and 91 girls) aged 6 to 12 years were recruited. Bone status was measured by two different techniques in terms of the speed of sound (SOS) using QUS and bone mineral density (BMD) using DXA. Calcium intake was assessed by 24 h diet recall. Pearson’s correlation, κ-statistic and Bland and Altman analysis were used to assess the agreement between the methods.Results:There was no correlation between the two different techniques. Mean difference (s.d.) of the Z-scores of BMD and SOS was −0.61 (1.27) that was different from zero (P<0.05). Tertiles of Z-scores of BMD and QUS showed low agreement (κ 0.022, P=0.677) and the limits of agreement in Bland and Altman statistics were wide.Conclusions:Although QUS is easy and convenient to use, the SOS measurements at the radius seem not appropriate for assessing bone quality status.

Lactose-free milk prolonged endurance capacity in lactose intolerant Asian males.

BackgroundSeveral studies on Caucasian volunteers have proven that milk is an effective recovery drink for athletes. Such benefit, however, cannot be directly applied to the lactose-intolerant Asian population. This study investigated the effects of ingesting water (WT), sports drink (SPD) and lactose-free milk (LFM) on cycling capacity.MethodsTen healthy young men completed 3 randomized experimental trials. Each trial consisted of an intermittent glycogen depleting session, a 2 h recovery period during which they ingested the test drink, followed by cycling at 70% of their maximum oxygen consumption (VO2max) to volitional exhaustion. Each trial was separated by at least one week.ResultsThere were no complaints or symptoms of lactose intolerance during any of the trials. The cycling periods were different (p < 0.05) amongst the 3 trials, namely, lactose-free milk (LFM; 69.6 ± 14.0 min), sports drink (SPD; 52.1!±11.6 min), and water (WT; 36.0±11.1 min), respectively. The VO2 and VCO2 of LFM (30±4 and 29±4 ml/kg/min) were lower (p < 0.05) than that of SPD (34±4 and 34±4 ml/kg/min) and WT (35±4 and 33±5 ml/kg/min). There were no differences (p = 0.45) in VO2 and VCO2 between SPD and WT. Mean rating of perceived exertion was lowest in LFM (14±5; p < 0.05), while no difference was found between the other two trials (SPD: 16±4 and WT: 16±4; p = 0.18).ConclusionLactose-free milk is likely to be an effective recovery drink for enhancing subsequent cycling capacity in lactose intolerant Asian males.

Nutrifit programme to improve health-related fitness among young Thai schoolchildren.

A Nutrifit programme, consisting of a nutrition education and physical training model, was developed by modifying an established Fitnessgram as a tool. the programme was tested among 514 schoolchildren aged eight to nine years who were enrolled in two provincial government schools (A and B) and two private schools (C and D) in the Bangkok Metropolitan Area. Health-related fitness tests using the Fitnessgram were administered in all four schools, followed by the Nutrifit programme intervention in schools B and D. the intervention included 10 nutrition and physical training education sessions during the regular physical education classes. During the seven-month programme period, though the nutritional status of children did not show a significant change, improvement in health-related fitness tests was noted in both non-intervened and intervened schools. It is recommended that the Nutrifit programme be incorporated into the school curriculum as a measure of nutrition and fitness aimed at health promotion and disease prevention.

Waist Circumference Measures and Application to Thai Children and Adolescents

The prevalence of childhood obesity has been increasing worldwide. Assessment of changing trends in nutritional and health status of the child population could be achieved using accurate and reliable body composition techniques. Waist circumference is a simple anthropometric measure that is useful for the detection of abdominal obesity which reflects the sum of subcutaneous and visceral adipose tissues in the trunk region. Research evidence shows that waist circumference is highly correlated with weight-for-height and body mass index. Waist circumference is also a good predictor of cardiovascular risk factors. Measurement of waist circumference can be performed at different sites of the trunk region and the measurement technique requires a standardized procedure. Reference data of percentile distributions of waist circumference among children and adolescents are now available in many countries, including Thailand. Waist circumference cut-off can be an advantageous tool for a large-scale screening of children who are at risk for overnutrition and for tracking child growth. Future studies need to address the universal waist circumference benchmark and the application of waist circumference as well as weight-to-height ratio for growth monitoring and public health intervention program towards promoting a healthy child population.