Asia Pacific Journal of Clinical Nutrition, Mar 11, 2013
Malnutrition in hospitals often goes unrecognized. At present, no nutrition screening tool provid... more Malnutrition in hospitals often goes unrecognized. At present, no nutrition screening tool provides satisfactory results in identifying nutritional risk. Most tools depend on weight and height as criteria for diagnosing malnutrition. Weight is not recorded in many patients and some tools are time-consuming. An inclusive nutrition screening form (Nutrition Alert Form, NAF) was developed and validated. NAF was modified from the original version of Subjective Global Assessment (SGA) by adding in two standard laboratory tests. The severity of the symptom and laboratory changes were scored. NAF was validated in 210 hospitalized Thai patients at Ramathibodi hospital by an experienced clinical nutritionist (physician) at Ramathibodi hospital. Cross validation was carried out between the dietitian and nurse in another 90 patients. Most of the time nurses could complete the nutrition screening in a patient within 5 minutes. One out of four patients could not be weighed on admission. The scores of 5 and 11 were selected as the cut-off scores of different malnutrition levels due to their high sensitivity, specificity and accuracy and scores of 6 to 10 were defined as moderate malnutrition. The diagnostic agreement between the dietitian and nurse for "normal to mild malnutrition", "moderate malnutrition", and "severe malnutrition" were 85%, 70% and 72%, respectively. NAF for screening of malnutrition in hospitalized Thai patients is easy to use, concise, does not require nutrition expertise and can be used whether or not body weight is taken.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet
The present study was to investigate the levels of plasma lipid peroxide products including malon... more The present study was to investigate the levels of plasma lipid peroxide products including malondialdehyde (MDA) and conjugated dienes (CD), and antioxidants including enzyme superoxide dismutase, glutathione peroxidase, catalase, plasma vitamin E and vitamin C in diabetic patients. Fifty-eight diabetic subjects; 16 males and 42 females, aged 30-75 years, were recruited. Eighteen of them had diabetes and forty of them had diabetes with hyperlipidemia. Twenty-seven healthy subjects, 8 males and 19 females, aged 30-75 years, were used as the control group. The results showed that the concentrations of plasma MDA in diabetic patients with or without hyperlipidemia tended to be increased when compared to the controls but there were no significant differences. The CD values were increased significantly in both diabetic groups when compared with control subjects. Significantly elevated levels of plasma MDA and CD were found in diabetic patients with hypertriglyceridemia (> 150 mg%). This increment did not change the antioxidant status in both enzymes and vitamins except that the plasma vitamin E levels and the ratios of tocopherol: cholesterol were increased significantly. An increase of lipid peroxide in plasma may be one important factor in the development of vascular complication and atherosclerosis seen in diabetic patients.
Hitherto, there has been no systematic evaluation of the nutritional status of HD patients in Tha... more Hitherto, there has been no systematic evaluation of the nutritional status of HD patients in Thailand. 27 patients awaiting renal transplantation, 19 M 8 F, age 47.2 +/- 8.6 y (mean +/- SD), underwent HD at Ramathibodi Hospital. Dietary assessment revealed the average daily intake of men and women to be respectively 1571 +/- 314 and 1379 +/- 403 kcal, 47 +/- 11 and 42 +/- 14 g protein. Anthropometric data showed that mean of BMI, percent ideal body weight (%IBW), percent standard triceps skinfold thickness (%TSF) and percent arm muscle circumference (%std MUAMC) to be 20.5 +/- 2.6 kg/m2, 90 +/- 12, 75 +/- 30 and 100 +/- 13, respectively. However, 37%, 56% and 70% of these patients had BMI, BW and MUAC less than the minimal cut-off levels. These data reflect the importance of energy depletion in these patients. The average serum albumin was 39 +/- 6 g/L while 52% suffered from low albumin levels. TC, LDL-C, HDL-C and TG were 4.34 +/- 1.34, 2.9 +/- 1.06, 0.89 +/- 0.33 and 1.10 +/- 0.67 mmol/L while 15% had high TC, LDL-C and 58% had low HDL-C levels. Only one patient was suffered from hypertriglyceridemia. Whereas inadequate thiamine, riboflavin, ascorbic acid and alpha-tocopherol status were present in 4-30%, toxic levels of serum retinol were seen in almost all patients. Low serum zinc and copper levels were also present. This study disclosed a wide spectrum of nutritional problems usually overlooked in CRF patients undergoing chronic hemodialysis. Whereas zinc supplementation may be needed, vitamin A supplementation in these patients should be discouraged.
LGI) dietary advice emphasized on consuming brown-rice variety 313-19-1 or Sinlek (GI = 58) which... more LGI) dietary advice emphasized on consuming brown-rice variety 313-19-1 or Sinlek (GI = 58) which contains high dietary fiber and many types of antioxidant, is beneficial for plasma glucose and lipid control in type 2 diabetes mellitus (T2DM). Therefore, rice bran of brown rice Sinlek may have potential application as functional food.
This study's aim was to test the low-density lipoprotein cholesterol-(LDL-c-) lowering efficacy o... more This study's aim was to test the low-density lipoprotein cholesterol-(LDL-c-) lowering efficacy of biscuits containing 2 g of plant stanols, which corresponded to 3.4 g of plant stanol esters. The biscuit is a new food format that can be consumed as a snack. In a double-blind, placebo-controlled parallel design study, 119 mildly to moderately hypercholesterolemic volunteers were randomized to plant stanol or control groups. Subjects were comparable in age, gender, lipid profiles, and body mass index. They consumed a control biscuit once a day for a two-week period, followed by a four-week intervention period that either had a plant stanol ester biscuit or a control. During the habitual diet, one biscuit per day was consumed at any time that subjects wished. Serum lipid profiles were measured at the first day of run-in, at baseline, and at the study's end. Compared to the control, the total cholesterol (TC), LDLc, and the LDL-to-high-density lipoprotein (LDL/HDL) ratio had serum reductions of 4.9%, 6.1%, and 4.3%, respectively, and were observed after 4 weeks of biscuit consumption with added plant stanols (P < 0.05). A significantly higher reduction in LDL-c (8.9%) and LDL/HDL ratio (11.4%) was measured in those taking a plant stanol biscuit with a meal compared to those who consumed a plant stanol biscuit without other food. In conclusion, incorporating plant stanols into a biscuit is an attractive, convenient, and acceptable way to modestly lower elevated cholesterol concentrations. For optimal efficacy, biscuits should be consumed with a meal as part of a healthy diet.
Malnutrition in hospitals often goes unrecognized. At present, no nutrition screening tool provid... more Malnutrition in hospitals often goes unrecognized. At present, no nutrition screening tool provides satisfactory re-sults in identifying nutritional risk. Most tools depend on weight and height as criteria for diagnosing malnutrition. Weight is not recorded in many patients and some tools are time-consuming. An inclusive nutrition screening form (Nutrition Alert Form, NAF) was developed and validated. NAF was modified from the original version of Subjective Global Assessment (SGA) by adding in two standard laboratory tests. The severity of the symptom and laboratory changes were scored. NAF was validated in 210 hospitalized Thai patients at Ramathibodi hospital by an experienced clinical nutritionist (physician) at Ramathibodi hospital. Cross validation was carried out between the dietitian and nurse in another 90 patients. Most of the time nurses could complete the nutrition screening in a patient within 5 minutes. One out of four patients could not be weighed on admission. The sco...
Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2006
Morbid obesity is a growing problem in Thailand. Several surgical procedures are available for we... more Morbid obesity is a growing problem in Thailand. Several surgical procedures are available for weight reduction. The laparoscopic gastric banding has been shown to be an effective weight loss with a low post or perioperative complication. The aim of this report was to evaluate the early preliminary outcome of the laparoscopic Swedish adjustable gastric banding operation in Thai cohort patients. From November 2003 until March 2005, ten patients with a median age of 31 (range, 18-61) underwent laparoscopic Swedish adjustable gastric banding for morbid obesity at Ramathibodi Hospital. Demography, clinical course and outcome including excess weight loss and peri-operative complications were reviewed and studied. Descriptive statistics were used for data summary. There were 3 men and 7 women with a median preoperative body weight of 142.5 kg (range, 98-164 kg), and median body mass index (BMI) of 49.2 kg/m2 (range, 40.3-62.4 kg/m2). The operations were successful in 9 out of 10 patients ...
Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2005
The low incidence of coronary heart disease in Greenland Eskimos and Japanese fishermen who have ... more The low incidence of coronary heart disease in Greenland Eskimos and Japanese fishermen who have high consumption of fish and seafood has called the attention in the role of eicosapentaenoic (EPA = 20:5n-3) and docosahexaenoic (DHA = 22: 6n-3) acids, the major n-3 polyunsaturated fatty acids (PUFAs) in fish oils, in reducing cardiovascular risk. N-3 PUFAs may reduce serum lipids by promoting fatty acid oxidation and decrease VLDL producing from the liver, depress tissue arachidonate synthesis and alter the composition and tissue PUFAs. Plasma lipoprotein and fatty acid composition of total serum and erythrocyte lipids in 9 hypertriglyceridemic patients consisting of 4 males and 5 females aged 39-72 yr who attended the Nutrition Clinic, Ramathibodi Hospital were investigated. The study period consisted of 4 wks of dietary advice only followed by 48 wks of dietary advice with a daily intake of 6 g of fish oil capsules (FOC). Six grams of FOC provided 1080 mg of 2:5n-3 and 720 mg of 22...
Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2004
The amount of phytate and total dietary fiber of 6 popular tropical fruits eaten by diabetic pati... more The amount of phytate and total dietary fiber of 6 popular tropical fruits eaten by diabetic patient residing in Bangkok were studied. They were dragon fruit, durian, guava, longan, mango, and pineapple. Fruit containing the highest content of total dietary fiber was guava which had about 2.7%. Longan contained the lowest fiber content equal to 0.19%. The highest content of phytate was found in pineapple about 0.09% and the lowest content was in longan about 0.037%. It was noticed that longan contained the lowest total dietary fiber and the lowest phytate content.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2003
To evaluate the effect of 5 g fresh chili pepper (CAP) on glucose response after a glucose drink ... more To evaluate the effect of 5 g fresh chili pepper (CAP) on glucose response after a glucose drink and metabolic rate (MR) in Thai women. The glucose response after a glucose drink was evaluated in 10 healthy women. The plasma glucose levels at 0, 15, 30 and 60 min after glucose load with and without 5 g fresh CAP were compared. Evaluation of MR was performed in an additional 12 subjects. MR was measured by the ventilated-hood indirect calorimetry system before and for 60 min after CAP ingestion. The rise of plasma glucose at 30 min after CAP ingestion was significantly lower than the rise of plasma glucose after a plain glucose drink by 20.6 per cent (p < 0.01). On the other hand, the CAP ingestion significantly increased MR above resting MR. Moreover, MR immediately increased by 20 per cent within a few minutes after CAP ingestion and showed a remarkable increase of 7.2-17.4 per cent from baseline for 11 min. The significance of thermogenic change was present up to 30 min (p <...
Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2001
Decreased bone mineral density (BMD) with age is an increasing health problem, especially for pos... more Decreased bone mineral density (BMD) with age is an increasing health problem, especially for postmenopausal women. Multiple factors have been reported to affect BMD including both genetic and environmental factors such as calcium intake and physical activity. For Thailand, people residing in different regions may differ in BMD due to these factors. However, there is a paucity of data concerning this issue. The objectives of this study were to identify the lifestyle factors which may influence BMD and to investigate the association between BMD and these factors in postmenopausal women who have been living in Bangkok and other provinces in Thailand. Subjects consisted of 466 postmenopausal women aged 46-90 years including 236 Bangkokians (116 early postmenopausals and 120 late postmenopausals) and 230 non-Bangkokians (134 early postmenopausals and 96 late postmenopausals). All were healthy and ambulatory. BMD was measured by dual energy X-ray absorptiometry (DEXA, Expert XL). Calcium...
Asia Pacific Journal of Clinical Nutrition, Mar 11, 2013
Malnutrition in hospitals often goes unrecognized. At present, no nutrition screening tool provid... more Malnutrition in hospitals often goes unrecognized. At present, no nutrition screening tool provides satisfactory results in identifying nutritional risk. Most tools depend on weight and height as criteria for diagnosing malnutrition. Weight is not recorded in many patients and some tools are time-consuming. An inclusive nutrition screening form (Nutrition Alert Form, NAF) was developed and validated. NAF was modified from the original version of Subjective Global Assessment (SGA) by adding in two standard laboratory tests. The severity of the symptom and laboratory changes were scored. NAF was validated in 210 hospitalized Thai patients at Ramathibodi hospital by an experienced clinical nutritionist (physician) at Ramathibodi hospital. Cross validation was carried out between the dietitian and nurse in another 90 patients. Most of the time nurses could complete the nutrition screening in a patient within 5 minutes. One out of four patients could not be weighed on admission. The scores of 5 and 11 were selected as the cut-off scores of different malnutrition levels due to their high sensitivity, specificity and accuracy and scores of 6 to 10 were defined as moderate malnutrition. The diagnostic agreement between the dietitian and nurse for "normal to mild malnutrition", "moderate malnutrition", and "severe malnutrition" were 85%, 70% and 72%, respectively. NAF for screening of malnutrition in hospitalized Thai patients is easy to use, concise, does not require nutrition expertise and can be used whether or not body weight is taken.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet
The present study was to investigate the levels of plasma lipid peroxide products including malon... more The present study was to investigate the levels of plasma lipid peroxide products including malondialdehyde (MDA) and conjugated dienes (CD), and antioxidants including enzyme superoxide dismutase, glutathione peroxidase, catalase, plasma vitamin E and vitamin C in diabetic patients. Fifty-eight diabetic subjects; 16 males and 42 females, aged 30-75 years, were recruited. Eighteen of them had diabetes and forty of them had diabetes with hyperlipidemia. Twenty-seven healthy subjects, 8 males and 19 females, aged 30-75 years, were used as the control group. The results showed that the concentrations of plasma MDA in diabetic patients with or without hyperlipidemia tended to be increased when compared to the controls but there were no significant differences. The CD values were increased significantly in both diabetic groups when compared with control subjects. Significantly elevated levels of plasma MDA and CD were found in diabetic patients with hypertriglyceridemia (&gt; 150 mg%). This increment did not change the antioxidant status in both enzymes and vitamins except that the plasma vitamin E levels and the ratios of tocopherol: cholesterol were increased significantly. An increase of lipid peroxide in plasma may be one important factor in the development of vascular complication and atherosclerosis seen in diabetic patients.
Hitherto, there has been no systematic evaluation of the nutritional status of HD patients in Tha... more Hitherto, there has been no systematic evaluation of the nutritional status of HD patients in Thailand. 27 patients awaiting renal transplantation, 19 M 8 F, age 47.2 +/- 8.6 y (mean +/- SD), underwent HD at Ramathibodi Hospital. Dietary assessment revealed the average daily intake of men and women to be respectively 1571 +/- 314 and 1379 +/- 403 kcal, 47 +/- 11 and 42 +/- 14 g protein. Anthropometric data showed that mean of BMI, percent ideal body weight (%IBW), percent standard triceps skinfold thickness (%TSF) and percent arm muscle circumference (%std MUAMC) to be 20.5 +/- 2.6 kg/m2, 90 +/- 12, 75 +/- 30 and 100 +/- 13, respectively. However, 37%, 56% and 70% of these patients had BMI, BW and MUAC less than the minimal cut-off levels. These data reflect the importance of energy depletion in these patients. The average serum albumin was 39 +/- 6 g/L while 52% suffered from low albumin levels. TC, LDL-C, HDL-C and TG were 4.34 +/- 1.34, 2.9 +/- 1.06, 0.89 +/- 0.33 and 1.10 +/- 0.67 mmol/L while 15% had high TC, LDL-C and 58% had low HDL-C levels. Only one patient was suffered from hypertriglyceridemia. Whereas inadequate thiamine, riboflavin, ascorbic acid and alpha-tocopherol status were present in 4-30%, toxic levels of serum retinol were seen in almost all patients. Low serum zinc and copper levels were also present. This study disclosed a wide spectrum of nutritional problems usually overlooked in CRF patients undergoing chronic hemodialysis. Whereas zinc supplementation may be needed, vitamin A supplementation in these patients should be discouraged.
LGI) dietary advice emphasized on consuming brown-rice variety 313-19-1 or Sinlek (GI = 58) which... more LGI) dietary advice emphasized on consuming brown-rice variety 313-19-1 or Sinlek (GI = 58) which contains high dietary fiber and many types of antioxidant, is beneficial for plasma glucose and lipid control in type 2 diabetes mellitus (T2DM). Therefore, rice bran of brown rice Sinlek may have potential application as functional food.
This study's aim was to test the low-density lipoprotein cholesterol-(LDL-c-) lowering efficacy o... more This study's aim was to test the low-density lipoprotein cholesterol-(LDL-c-) lowering efficacy of biscuits containing 2 g of plant stanols, which corresponded to 3.4 g of plant stanol esters. The biscuit is a new food format that can be consumed as a snack. In a double-blind, placebo-controlled parallel design study, 119 mildly to moderately hypercholesterolemic volunteers were randomized to plant stanol or control groups. Subjects were comparable in age, gender, lipid profiles, and body mass index. They consumed a control biscuit once a day for a two-week period, followed by a four-week intervention period that either had a plant stanol ester biscuit or a control. During the habitual diet, one biscuit per day was consumed at any time that subjects wished. Serum lipid profiles were measured at the first day of run-in, at baseline, and at the study's end. Compared to the control, the total cholesterol (TC), LDLc, and the LDL-to-high-density lipoprotein (LDL/HDL) ratio had serum reductions of 4.9%, 6.1%, and 4.3%, respectively, and were observed after 4 weeks of biscuit consumption with added plant stanols (P < 0.05). A significantly higher reduction in LDL-c (8.9%) and LDL/HDL ratio (11.4%) was measured in those taking a plant stanol biscuit with a meal compared to those who consumed a plant stanol biscuit without other food. In conclusion, incorporating plant stanols into a biscuit is an attractive, convenient, and acceptable way to modestly lower elevated cholesterol concentrations. For optimal efficacy, biscuits should be consumed with a meal as part of a healthy diet.
Malnutrition in hospitals often goes unrecognized. At present, no nutrition screening tool provid... more Malnutrition in hospitals often goes unrecognized. At present, no nutrition screening tool provides satisfactory re-sults in identifying nutritional risk. Most tools depend on weight and height as criteria for diagnosing malnutrition. Weight is not recorded in many patients and some tools are time-consuming. An inclusive nutrition screening form (Nutrition Alert Form, NAF) was developed and validated. NAF was modified from the original version of Subjective Global Assessment (SGA) by adding in two standard laboratory tests. The severity of the symptom and laboratory changes were scored. NAF was validated in 210 hospitalized Thai patients at Ramathibodi hospital by an experienced clinical nutritionist (physician) at Ramathibodi hospital. Cross validation was carried out between the dietitian and nurse in another 90 patients. Most of the time nurses could complete the nutrition screening in a patient within 5 minutes. One out of four patients could not be weighed on admission. The sco...
Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2006
Morbid obesity is a growing problem in Thailand. Several surgical procedures are available for we... more Morbid obesity is a growing problem in Thailand. Several surgical procedures are available for weight reduction. The laparoscopic gastric banding has been shown to be an effective weight loss with a low post or perioperative complication. The aim of this report was to evaluate the early preliminary outcome of the laparoscopic Swedish adjustable gastric banding operation in Thai cohort patients. From November 2003 until March 2005, ten patients with a median age of 31 (range, 18-61) underwent laparoscopic Swedish adjustable gastric banding for morbid obesity at Ramathibodi Hospital. Demography, clinical course and outcome including excess weight loss and peri-operative complications were reviewed and studied. Descriptive statistics were used for data summary. There were 3 men and 7 women with a median preoperative body weight of 142.5 kg (range, 98-164 kg), and median body mass index (BMI) of 49.2 kg/m2 (range, 40.3-62.4 kg/m2). The operations were successful in 9 out of 10 patients ...
Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2005
The low incidence of coronary heart disease in Greenland Eskimos and Japanese fishermen who have ... more The low incidence of coronary heart disease in Greenland Eskimos and Japanese fishermen who have high consumption of fish and seafood has called the attention in the role of eicosapentaenoic (EPA = 20:5n-3) and docosahexaenoic (DHA = 22: 6n-3) acids, the major n-3 polyunsaturated fatty acids (PUFAs) in fish oils, in reducing cardiovascular risk. N-3 PUFAs may reduce serum lipids by promoting fatty acid oxidation and decrease VLDL producing from the liver, depress tissue arachidonate synthesis and alter the composition and tissue PUFAs. Plasma lipoprotein and fatty acid composition of total serum and erythrocyte lipids in 9 hypertriglyceridemic patients consisting of 4 males and 5 females aged 39-72 yr who attended the Nutrition Clinic, Ramathibodi Hospital were investigated. The study period consisted of 4 wks of dietary advice only followed by 48 wks of dietary advice with a daily intake of 6 g of fish oil capsules (FOC). Six grams of FOC provided 1080 mg of 2:5n-3 and 720 mg of 22...
Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2004
The amount of phytate and total dietary fiber of 6 popular tropical fruits eaten by diabetic pati... more The amount of phytate and total dietary fiber of 6 popular tropical fruits eaten by diabetic patient residing in Bangkok were studied. They were dragon fruit, durian, guava, longan, mango, and pineapple. Fruit containing the highest content of total dietary fiber was guava which had about 2.7%. Longan contained the lowest fiber content equal to 0.19%. The highest content of phytate was found in pineapple about 0.09% and the lowest content was in longan about 0.037%. It was noticed that longan contained the lowest total dietary fiber and the lowest phytate content.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2003
To evaluate the effect of 5 g fresh chili pepper (CAP) on glucose response after a glucose drink ... more To evaluate the effect of 5 g fresh chili pepper (CAP) on glucose response after a glucose drink and metabolic rate (MR) in Thai women. The glucose response after a glucose drink was evaluated in 10 healthy women. The plasma glucose levels at 0, 15, 30 and 60 min after glucose load with and without 5 g fresh CAP were compared. Evaluation of MR was performed in an additional 12 subjects. MR was measured by the ventilated-hood indirect calorimetry system before and for 60 min after CAP ingestion. The rise of plasma glucose at 30 min after CAP ingestion was significantly lower than the rise of plasma glucose after a plain glucose drink by 20.6 per cent (p < 0.01). On the other hand, the CAP ingestion significantly increased MR above resting MR. Moreover, MR immediately increased by 20 per cent within a few minutes after CAP ingestion and showed a remarkable increase of 7.2-17.4 per cent from baseline for 11 min. The significance of thermogenic change was present up to 30 min (p <...
Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2001
Decreased bone mineral density (BMD) with age is an increasing health problem, especially for pos... more Decreased bone mineral density (BMD) with age is an increasing health problem, especially for postmenopausal women. Multiple factors have been reported to affect BMD including both genetic and environmental factors such as calcium intake and physical activity. For Thailand, people residing in different regions may differ in BMD due to these factors. However, there is a paucity of data concerning this issue. The objectives of this study were to identify the lifestyle factors which may influence BMD and to investigate the association between BMD and these factors in postmenopausal women who have been living in Bangkok and other provinces in Thailand. Subjects consisted of 466 postmenopausal women aged 46-90 years including 236 Bangkokians (116 early postmenopausals and 120 late postmenopausals) and 230 non-Bangkokians (134 early postmenopausals and 96 late postmenopausals). All were healthy and ambulatory. BMD was measured by dual energy X-ray absorptiometry (DEXA, Expert XL). Calcium...
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