Community Nutrition

ObjectiveTo investigate the resource efficiency and environmental impacts of producing one kilogram of edible protein from two plant- and three animal-protein sources.DesignPrimary source data were collected and applied to commodity production statistics to calculate the indices required to compare the environmental impact of producing 1 kg of edible protein from kidney beans, almonds, eggs, chicken and beef. Inputs included land and water for raising animals and growing animal feed, total fuel, and total fertilizer and pesticide for growing the plant commodities and animal feed. Animal waste generated was computed for the animal commodities.SettingDesk-based study at the Department of Nutrition and Department of Occupational and Environmental Health, Loma Linda University.SubjectsNone.ResultsTo produce 1 kg of protein from kidney beans required approximately eighteen times less land, ten times less water, nine times less fuel, twelve times less fertilizer and ten times less pestici...

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The challenge for nutrition science is to understand strategies to enable a balance between healthy diets and sustainable food systems. This study was to quantify greenhouse gas (GHG) emission of food consumption related to different dietary preferences among Indonesian adults by body mass index (BMI). METHODS We utilized the existing food consumption survey databases. Dietary and anthropometric information were obtained from Total Diet Study (Studi Diet Total/SDT) in 2014 and Basic Health Research (Riskesdas/RKD) in 2013. The most consumed food items from 14 food groups were selected as representatives of rice, cassava, tofu, long beans, banana, chicken meat, chicken liver, mackerel tuna, chicken egg, condensed milk, palm oil, white sugar, shallot, and ground coffee. The GHGs emission factors were acquired from Thai National Life Cycle Inventory Database. Food weight (gram), energy intake (kcal), and GHGs emission (kgCO2eq) from consumption of these food items were analyzed among B...

This study presents data on consumption patterns, methods of food procurement, and adequacy of dietary intake among Burmese refugee camp households living along Thailand's border with Burma. Households established for one or more years and with children under 15 years of age were sampled. A questionnaire was used to determine economic, food-consumption, and dietary intake patterns; foods consumed were weighed and measured using a 24-hour recall for the household unit; and nutritional status was determined by a Microtoise tape and digital standing scales. In total, 182 households containing 1,159 people were surveyed. The average household energy and protein intakes were 96.6% and 111.4%, respectively, of the recommended daily allowance (RDA) for healthy Thais. Twelve percent of protein was derived from animal sources. Carbohydrate, protein, and fat accounted for 84%, 9%, and 7% of total energy, respectively. The intake of vitamins A, B1, B2, and C and of calcium ranged from 24.2...

Iron deficiency is prevalent in children and infants worldwide. Zinc deficiency may be prevalent, but data are lacking. Both iron and zinc deficiency negatively affect growth and psychomotor development. Combined iron and zinc supplementation might be beneficial, but the potential interactions need to be verified. In a randomized, placebo-controlled trial using 2 x 2 factorial design, 609 Thai infants aged 4-6 mo were supplemented daily with 10 mg of iron and/or 10 mg of zinc for 6 mo to investigate effects and interactions on micronutrient status and growth. Iron supplementation alone increased hemoglobin and ferritin concentrations more than iron and zinc combined. Anemia prevalence was significantly lower in infants receiving only iron than in infants receiving iron and zinc combined. Baseline iron deficiency was very low, and iron deficiency anemia was almost nil. After supplementation, prevalence of iron deficiency and iron deficiency anemia were significantly higher in infants...

Access to healthy food is a necessity for all people. However, there is still a lack of reviews on the assessment of respondent-based measures of neighborhood food environments (perceived food environments). The aim of this systematic review was to evaluate the measurement tools for perceived food environments by five dimensions of food access and to obtain the overview of their associations with dietary habits among people aged 18 years and older in middle- and high-income countries. Observational studies using perceived food environment measures were identified through a systematic review based on two databases for original studies published from 2010 to 2020. A total of 19 final studies were extracted from totally 2926 studies. Pertaining to the five dimensions of food access, 12 studies dealt with accessibility, 13 with availability, 6 with affordability, 10 with acceptability, 2 with accommodation, and 8 with a combination of two or more dimensions. Perceived healthy food envir...

Objectives We aimed to determine long-term effects of egg supplementation on growth, blood lipoproteins, blood proteins, nutritional status, and microbiota in primary school children. Methods A randomized controlled, cluster study was performed at 6 rural schools in Central, Eastern, and Western Thailand. 635 students (8–14 years old) were recruited into the study. Subjects were randomly assigned into 3 groups, based on weight for age: 1) Whole eggs (WE) - consume 10 additional eggs per week [n = 238] 2) Egg substitute (ES) - consume yolk-free egg substitute equivalent to 10 eggs per week [n = 200], and 3) control group (C, [n = 197]). The anthropometric, biochemical indexes, dietary intake, and microbiota were measured at week 0 (baseline), week 13–14, and week 34–35. Results At baseline, 14% were under-weighed, 9% were stunted, and 16% were wasted. At 34–35 weeks, the increases in body weight and height were higher in WE group than those in C group (3.56 ± 0.93 kg, P < 0.001 an...

Objectives We aimed to study the effect of an Asian ketogenic diet with increased egg consumption on anthropometries, glucose, and cholesterol homeostasis in people with metabolic syndrome. Methods We compared changes in metabolic parameters between a ketogenic diet (carbohydrate < 10% of total calories) with increased whole egg intakes (Yolk KD) or yolk-free ketogenic diet with egg white supplementation (White KD) and a balanced diet with controlled energy (C). This study included a 4-week run in phase, a 12-week intervention phase, and a follow up phase at week-36. Subjects were monitored for changes in anthropometries, biochemistries including oral glucose tolerance testing, and physical activities. Results When compared week-0 (baseline) with week-12, average body weight (Wt), waist circumference (WC), triglyceride (TG), and blood pressure in Yolk-KD and White-KD groups significantly reduced from week-0 (P < 0.05). No difference of these parameters in C group between week-...

Background: Lifestyle intervention is effective in preventing type 2 diabetes mellitus (T2DM). The efficacy of intervention components across different sociocultural settings is relevant for real world implementation. Thus, this study aimed to evaluate the effectiveness of a culturally tailored diabetes prevention program (CTDPP) for at-risk Muslim people in Thailand. Methods: The CTDPP was developed and culturally adapted based on formative research. Participants at risk for diabetes were recruited and randomly assigned to either the intervention group (n ¼ 60) or the control group (n ¼ 59). Study group subjects participated in the CTDPP for 3 months. Control group subjects received only routine self-care recommendations for preventing diabetes. All participants were assessed for diabetes prevention knowledge and health outcomes at baseline and follow-up. Results: At the 12th week, the intervention group and control group showed that diabetes prevention knowledge improved from baseline (p < 0.05). The score for knowledge was significantly higher in the intervention group than in control group. Other health outcomes demonstrated significant within-group improvements only in the intervention group, but not in the control group. Changes in participants' HbA 1 c levels were not significant for within-group and between-group comparisons at baseline and 12 weeks. Adjusting for covariates at baseline, our ANCOVA analysis showed that differences in weight, body mass index, and waist circumference between the intervention and control groups were significant (p < 0.01). Conclusion: This diabetes prevention program integrating Thai-Muslim culture and driven by community health leaders was successful. Our program empowered at-risk people with diabetes prevention knowledge.

Background Food frequency questionnaires (FFQ) are a useful dietary assessment tool to determine relationships between diet and non-communicable diseases (NCDs). Our purpose was to validate a semiquantitative FFQ (semi-FFQ) for Thais at risk of metabolic syndrome (MS). Methods The study identified 345 men and women aged 30 to 65 years were enrolled and invited to participate in data collection for 4 weeks. They were asked to maintain a 4-day food record and partook in a semi-FFQ interview during week 4. Urine samples and biochemical results related to MS were collected. Validation results were associated with 3 primary nutrients for MS (sugar, fat, and sodium) and biochemical results (blood glucose, lipid profiles, blood pressure, and 24-hour urine sodium). Results Ninety-four participants were enrolled (54 in a “urine-collection not-required” group and 40 in a “urine collection” group). The level of each key MS nutrient significantly increased commensurate with rises in semi- FFQ e...

Over-nutrition, sedentary lifestyles and leading causes to Type 2 diabetes mellitus (T2D) have been increasing over time in Thailand (1). Although age, gender, ethnicity and family history are non-modifiable risk factor of diabetes, other risk factors, such as overweight and obesity could be improved by increasing adequate physical activity (2). The objective of this study is to develop and validate physical activity questionnaire (PAQ) for Thai at-risk people for T2D. The criterion validity of total physical activity was estimated from the International Physical Activity Questionnaire (IPAQ) using the ActiGraph accelerometer as an objective reference measure. Development and validation of questionnaire, a total of 95 at-risk people for T2D were recruited (Figure 1). The PAQ was developed based on IPAQ. The developed PAQ was evaluated by three experts to ensure content validity. The at-risk people were interviewed by using the developed PAQ for the previous seven-day activities. Spearman's correlation was used to compare accelerometer and the developed PAQ for concurrent validity. Interclass correlation was used to evaluate reliability of the developed PAQ separated by 3 days. Chi-square test was used for representing significant differences (p-value < 0.05) of the proportion of participants meeting current physical activity guidelines. The experts ensured the content validity of the developed PAQ with total CVI's score of 0.91. Table 1 presented the concurrent validity and reliability results of the developed PAQ. The total physical activity from the developed PAQ (MET-min week −1), which included part-time occupation domain and excluded part-time occupation domain was significantly correlated with the total physical activity (counts week −1) from ActiGraph accelerometer (r = 0.57 and 0.54, p < 0.01, respectively). The 3-days test-retest reliability of the total physical activity from the developed PAQ was 0.86 (p < 0.05) when including part-time occupation domain and was 0.85 (p < 0.05) when excluded part-time occupation domain.