Background: In Thailand, cow milk allergies are the leading food allergy in infants. Rice protein is one of the hypoallergenic food ingredients used as an alternative plant-based protein in nutritional products. Sangyod rice (Oryza sativa, L., var. indica), found in southern Thailand, has been reported to contain a high content of nutrients. Isomaltooligosaccharides (IMO) are accepted as prebiotics and are applicable as food ingredients to enhance the physiochemical quality of foods as a sweetener, and can also have physiological functions including the enhancement of gut microflora. The supplementation of formulas with prebiotics will support a mature immune system and intestinal colonization of infants. Objectives: This research aimed to develop Sangyod rice protein-based infant formula for cow milk allergic infants, evaluated its nutritional composition, sensory, and anti-allergenic activity, and investigated the effects of the formula on gut microbiota modulation. Materials and methods: The development of infant formula based on Sangyod rice protein and fortified with IMO from Sangyod rice flour was studied on nutrition composition, microbiology, anti-allergenic activity, and effect on gut microbiota. These properties reflect quality and safety to meet requirements of infant and follow-up formula.Results:The energy of Sangyod rice-protein-based formula was 67 kcal per 100 ml. The results indicated that the formula met the requirements of macronutrients providing 3.03 g of protein, 4.37 g of fat, and 13.26 g of carbohydrate, and passed on total bacteria contamination. Surprisingly, the developed formulas showed higher results in an anti-allergenic activity test (86.98±5.49%) by inhibition on the release of β-hexosaminidase enzyme in RBL-2H3 cells compared to a commercial hypoallergenic formula. The addition of prebiotic (IMO) significantly increased populations of Lactobacillus (10.7 log cell/ml) within 24 hours (p<0.05) compared with commercial product. This result affected the production of shot chain fatty acids (SCFAs) by increasing the amount of acetic acid and propionic acid but had no effect on lactic acid and butyric acid production. This result may have a beneficial effect on the immune system and hopefully can help to prevent or decrease risk of cow milk allergy. The sensory evaluation of Sangyod rice protein-based formula showed the highest scores in test (6.34±1.39), odor (6.74±1.15), and overall acceptability (6.52±1.26), but had no significant differences (p<0.05) compared to commercial hypoallergenic formula.Conclusion: The Sangyod rice protein-based formula can compete and was acceptable for the hypoallergenic formula and would be an option for substituting cow milk in the treatment of cow milk protein allergy. However, this study is the first step to develop the hypoallergenic formula and still needs the preclinical testing and clinical study in the future to claim as a hypoallergenic formula. Keywords: Sangyod rice, Infant formula, rice protein-based formula, hypoallergenic formula
Background: Low serum albumin levels are one of the most common causes of morbidity and mortality in humans, particularly in older bed-ridden patients. Egg whites contains all the essential amino acids required, and it has many beneficial effects on the body. Supplementation with an egg white formula diet is expected to improve nutritional status and increase levels of serum albumin.Objective: This research aimed to investigate the effects of the egg white formula diet (EWFD) supplement on serum albumin levels in bed-ridden elderly patients with nasogastric tube feeding at home.Methods: The experiment was designed as a quasi-experimental study with one single-sample group in 25 bed-ridden elderly patients who are > 60 years old, and were purposefully selected from a district in a Province in Southern Thailand. The experiment was divided into 2 periods (the control and experimental). The control period covered the first 8 weeks where the caregivers provided the usual care and administered the commercial liquid formula to the bed-ridden elderly subjects. The experimental period covered the following 8 weeks, where the caregivers provided the usual care, commercial liquid formula, and EWFD supplementation. Demographic data was collected using a data assessment form. The effect of EWFD supplement on blood albumin levels in the bed-ridden elderly persons were measured at baseline (T0), control (T8), and experimental period (T16).Results: Serum albumin levels at T0 in subjects who received the usual care program was an average of 3.46±0.35 g/dL. The average serum albumin level at the control period (T8) was 3.56±0.44 g/dL, while after the experiment (feeding including egg white for 8 weeks) was 3.72±0.45 g/dL. The serum albumin levels significantly increased compared to the control and experimental periods (p= 0.042) Conclusion: Enhancing nutritional care through egg white supplementation improved the serum albumin levels in bed-ridden elderly patients at home. It is therefore recommended that the longitudinal study design should be implemented to monitor and maintain the serum albumin, which consequently promotes the patients’ nutritional status. Keywords: nutritional status; bed-ridden elderly; nasogastric tube feeding; bed-ridden; egg white; serum albumin; muscle mass
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