HIV-infected patients receiving antiretroviral therapy have increased risk of metabolic syndrome, including dyslipidemia. In this study, we determined whether individual nutritional counseling reduced dyslipidemia, particularly LDL cholesterol, among HIV-infected patients with dyslipidemia not currently taking lipid-lowering medication. We conducted a randomized 24-week trial among HIV-infected patients with dyslipidemia who were on ART and were eligible to initiate therapeutic lifestyle changes according to the Thai National Cholesterol Education Program. Participants were randomly assigned to an intervention group that received individual counseling with a nutritionist for 7 sessions (baseline, weeks 2, 4, 8, 12, 18 and 24) and a control group that received standard verbal diet information at baseline and nutritional counseling only at week 24. A 24-hr recall technique was used to assess dietary intake for both groups at baseline and week 24. Lipid profile (total cholesterol, LDL, HDL and triglyceride) was measured at baseline and after 12 and 24 weeks of therapy. An intention-to-treat and linear mixed model were used. Seventy-two patients were randomly assigned, and 62 (86%) participants completed their lipid profile test. After 12 weeks of follow-up, there were significant reductions in the intervention group for total cholesterol (−14.4 ± 4.6 mg/dL, P=0.002), LDL cholesterol (−13.7 ± 4.1 mg/dL, P=0.001), and triglyceride (−30.4 ± 13.8 mg/dL, P=0.03). A significant reduction in LDL cholesterol was also observed in the control group (−7.7 ± 3.8 mg/dL, P=0.04), but there were no significant differences in change of mean lipid levels between groups at 12 weeks of follow-up. After 24 weeks, participants assigned to the intervention group demonstrated significantly greater decreases in serum total cholesterol (−19.0 ± 4.6 vs 0.2 ± 4.3 mg/dL, P=0.003) and LDL cholesterol (−21.5 ± 4.1 vs −6.8 ± 3.8 mg/dL, P=0.009). There were no significant changes in HDL cholesterol or triglycerides levels in either group.

One current initiative to assist rural Thai families to increase home food production and security is the implementation of home gardens that produce fish, small animals, and vegetables. This paper presents the results of an investigation comparing seasonal dietary intake and nutritional status among northeastern Thai children in mixed-gardening and nongardening families (n = 30 for each group). Assignment to the gardening group was based on the presence of a mixed garden, whereas nongardening subjects were randomly selected and matched for comparison. Statistical analysis (paired t-test) indicated that there was no significant difference in the observed biochemical variables (serum retinol, ferritin, hemoglobin) between groups at the p < or = .05 level. Nutritional status in regard to height-for-weight, weight-for-age, and weight-for-height Z scores was better among children of gardening families, although the differences were not significant. The small sample size and reported results indicate that the relationship between the practice of mixed home gardening and dietary intake and nutritional status needs further investigation.

Abstract

Iodization of food grade salt has been mandated in Thailand since 1994. Currently, processed food consumption is increasing, triggered by higher income, urbanization, and lifestyle changes, which affects the source of salt and potentially iodized salt among the population. However, adequate information about the use of iodized salt in processed foods in Thailand is still lacking. Therefore, this study aimed to assess iodine intake through salt-containing processed foods and condiments which were identified using national survey data. Potential iodine intake from iodized salt in food products was modelled using consumption data and product salt content from food labelling and laboratory analysis. Fish sauce, soy sauce and seasoning sauces (salty condiments) have alternative regulation allowing for direct iodization of the final product, therefore modelling was conducted including and excluding these products. Daily salt intake from household salt and food industry salt (including salty condiments) was estimated to be 2.4 g for children 0–5 years of age, 4.6 g for children 6–12 years of age, and 11.5 g for adults. The use of iodized salt in processed foods (excluding salty condiments) met approximately 100% of the estimated average requirement (EAR) for iodine for non-pregnant adults and for children 6 to 12 years of age, and 50% of the EAR for iodine for children aged 0 to 5 years of age. In all cases, iodine intake from processed food consumption was greater than from estimated household iodized salt consumption. Findings suggest that iodized salt from processed foods is an important source of iodine intake, especially in adults. The use of iodized salt by the food industry should be enforced along with population monitoring to ensure sustainability of optimal iodine intake. Currently, the addition of iodine into fish sauce, soy sauce and seasoning sauces has an important role in achieving and sustaining optimal iodine intake.

This study aims to describe the current practice on growth monitoring and promotion (GMP) system in Thailand, identify its constraints and recommend appropriate solutions. In the four provinces studied, 80 health centres were systematically selected. A total of 80 health officers, 183 health volunteers and 1,200 caretakers were interviewed and tested for GMP knowledge and practices. One-fourth of the health officers and half of the volunteers did not understand the objectives of the GMP. More than half of the health officers and volunteers did not have the skill to weigh properly. About half of the volunteers could not plot and explain the growth chart correctly. Only 40% of the caretakers understand the growth chart. Documentation of weight on child health card is lacking. We recommend adequate trainings and supervisions for health officers and volunteers, revised GMP guidelines to enhance integration with other programmes, and a study to identify the effectiveness of the GMP.

No abstract

Probiotics are living microorganism that can be employed as a new approach to promote human health. These organisms are found to have attractive means for health due to their probiotic properties particularly in generating antimicrobial activity. Lactobacillus spp. is one of the main genera commonly used for probiotic purpose. Human milk is a potential source of Lactobacillus spp. and one of the criteria that found beneficial is that it is of human origin, which could be more reliable sources to be used in human. Lack of studies on isolation of probiotic bacteria from human milk was reported and some probiotic properties show a variation between strains from different regions and population. Therefore, it is important to carry out the isolation of Lactobacillus spp. from a large number of species in the genera to facilitate the finding of the most competent strain to be incorporated as probiotic agent. Moreover, to ensure suitability and compatibility for human use, the probiotic agent originated from human milk should not be an exception. In addition, certain probiotics show a great correlation with prebiotic existed in human milk to boost their function and may suggest an added value to be a suitable candidate as probiotic. This review provides an overview of studies related to human milk as the promising sources for isolation of probiotic microorganisms.

Abstract. In Thailand, iodine deficiency disorders (IDD) are endemic in 57 out of 75 provinces with an estimated 15 million people at risk of IDD. A three pronged control program with iodized salt, iodized water and iodized oil capsules is being implemented. The water iodization program is both school based and household based. In the household, the residents are given iodine solution, two drops of which is to be added to 10 l of drinking water. In the schools, in addition to this method, an iodinator is used. This releases a fixed amount of iodine into the drinking water. This study examines the cost of the water iodization program in Thailand for the year 1996 in terms of cost per beneficiary, cost per µg iodine consumed daily and cost per goiter person years averted. We used a discount rate of 5%. Field visit and interviews of health personnel from Ministry to village level were conducted to gather primary data. Review of existing papers and reports of the Department of Health, Government of Thailand was done for secondary data. The costs included the capital cost of equipments, initial training and the recurrent costs of potassium iodate, proportional salaries of personnel involved, monitoring and communication activities. The cost per beneficiary of school based iodinator method (US$ 0.72) and school based drop method (US$ 0.64) were similar and much higher than the household based approach (US$ 0.12). The cost per µg of iodine consumed daily was ten times higher in the school based approach (US$ 0.01) compared to the household approach (US$ 0.001). The cost per goiter case averted for the whole strategy of water iodization was US$ 194.50. Water iodization appears to be a low cost intervention. However, the need for behavioral modification raises the issue of long term sustainability.