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Protein-energy malnutrition still impacts children’s growth and development. We investigated the prolonged effects of egg supplementation on growth and microbiota in primary school children. For this study, 8–14-year-old students (51.5% F) in six rural schools in Thailand were randomly assigned into three groups: (1) whole egg (WE), consuming 10 additional eggs/week (n = 238) (n = 238); (2) protein substitute (PS), consuming yolk-free egg substitutes equivalent to 10 eggs/week (n = 200); and (3) control group (C, (n = 197)). The outcomes were measured at week 0, 14, and 35. At the baseline, 17% of the students were underweight, 18% were stunted, and 13% were wasted. At week 35, compared to the C group the weight and height difference increased significantly in the WE group (3.6 ± 23.5 kg, p < 0.001; 5.1 ± 23.2 cm, p < 0.001). No significant differences in weight or height were observed between the PS and C groups. Significant decreases in atherogenic lipoproteins were observed in the WE, but not in PS group. HDL-cholesterol tended to increase in the WE group (0.02 ± 0.59 mmol/L, ns). The bacterial diversity was similar among the groups. The relative abundance of Bifidobacterium increased by 1.28-fold in the WE group compared to the baseline and differential abundance analysis which indicated that Lachnospira increased and Varibaculum decreased significantly. In conclusion, prolonged whole egg supplementation is an effective intervention to improve growth, nutritional biomarkers, and gut microbiota with unaltered adverse effects on blood lipoproteins.

BACKGROUND In a number of patients, post-acute COVID syndrome develops after acute infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Long COVID [LC]). Here, we examined the immune responses and clinical characteristics of individuals with LC compared to age- and gender-matched healthy recovered COVID individuals (HC) during the Omicron pandemic. Immune responses following BNT162b2 (Pfizer) booster are also determined. METHODS This retrospective cohort study included 292 patients (LC, 158; HC, 134) confirmed to have SARS-CoV-2 infection from January to August 2022. We determined anti-SARS-CoV-2 receptor-binding domain immunoglobulin G (anti-RBD IgG), surrogate virus neutralization test (sVNT), T-cell subsets, and neutralization of wild-type, BA.1 and BA.5. A subset of patients was voluntarily recruited for booster vaccination with BNT162b2 vaccine and immunogenicity was assessed 4weeks after vaccination. RESULTS Cycle thresholds were higher in the HC group than in the LC group (20.7 vs. 19.7; P<0.039). Anti-RBD IgG was higher at ≤56 days after COVID-19 onset (PC) in 3-dose vaccines compared with 2-dose vaccines in the LC group (P=0.02) and after 57-84 days PC in 3-dose vaccines in the HC group (P<0.001). The sVNT in LC was significantly high against Wuhan and sVNT was 30% lower against the Omicron than the Wuhan. sVNT was relatively sustained in 3-dose vaccines than ≤ 2-dose vaccines. sVNT in the HC group reached its peak at 57-84 days PC as compared with the LC group. CONCLUSIONS These findings imply that LC produced increased neutralizing antibody responses than those with HC. During the Omicron pandemic, immunity after LC has still waned; therefore, a booster vaccine may be needed after 2-3 months from last infection. (ClinicalTrials.gov number, NCT05484700)

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 estimated intakes. Correlation coefficients (r) were as follows: fasting blood glucose, r = 0.293 (fruits) and r = 0.285 (desserts); triglycerides, r = 0.252 (a la carte-dishes); LDL-cholesterol, r = 0.205 (rice-with-topping dishes); systolic blood pressure, r = 0.272 (snacks) and r = 0.190 (a la carte dishes). Conclusions The semi-FFQ helps assess dietary patterns of Thai populations at risk of NCDs.

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 researchers identified 345 men and women aged 30–65 years who were eligible for the study. Ninety-four participants were finally enrolled (54 in a “urine-collection not-required” group and 40 in a “urine collection” group). They were asked to maintain a 4-day food record for 4 weeks 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 three primary nutrients for MS (sugar, fat, and sodium) and biochemical results (blood glucose, lipid profiles, blood pressure, and 24-h urine sodium). Results The biomarker level of each key MS nutrient significantly increased commensurate with rises in semi-FFQ estimated intakes. Correlation coefficients (r) were as follows: fasting blood glucose, r = 0.221 (fruits) and r = 0.229 (desserts); triglycerides, r = 0.112 (a la carte-dishes); low-density lipoprotein cholesterol, r = 0.205 (rice-with-topping dishes); systolic blood pressure, r = 0.272 (snacks) and r = 0.190 (a la carte dishes). Fasting blood glucose was a significant biomarker associated with the development of metabolic syndrome (OR 1.42, 95% CI 1.12–1.81). We also found that fat (OR 1.28, 95% CI 1.09–1.89), sodium (OR 1.98, 95% CI 1.05–1.95) and energy (OR 1.09, 95% CI 1.01–1.17) from an a la carte meal were significantly associated with the development of metabolic syndrome. Conclusions Thai food has a unique characteristic since it often pairs various ingredients and seasoning in one menu. This semi-FFQ is a tool that offers relatively valid ranking for intake of energy, nutrients, single foods, and mixed dishes based on Thai menus associated with a risk for developing metabolic syndrome and NCDs. Using this tool could help identify unhealthy dietary patterns and help develop recommendations for people at risk with the goal of preventing NCDs.

Summary Background Protein-energy malnutrition is still problematic worldwide. It directly impacts growth and development, especially in children. We investigated the long–term effects of egg supplementation on the growth, biochemical indices, and microbiota of primary school children. Methods A randomized controlled cluster study was carried out in six rural schools in Thailand. Participants were randomly assigned into three groups: 1) whole egg (WE) – consuming 10 additional eggs/week [n = 238], 2) protein substitute (PS) – consuming yolk–free egg substitute equivalent to 10 eggs/week [n = 200], and 3) control group (n= 197]). Demographic and biochemical indices, and microbiota composition were measured at weeks 0, 14, and 35. Findings 635 students (8 to 14 years old) were recruited (51·5% female). At baseline, 17% of the participants were underweight, 18% were stunted, and 13% were wasted. At week 35, compared to the control group, body weight and height increased significantly in WE (3·6 ± 23·5 kg, P<0·001 and 5·1 ± 23·2 cm, P<0·001). No significant differences in weight or height were observed between PS and Control. Prealbumin levels were higher (1·5 ± 8·4 mg/dL, P<0·001) in WE, but not in PS, compared to control. Significant decreases in total cholesterol, triglycerides, and LDL cholesterol were observed in the WE, but not in the PS groups. HDL cholesterol tended to increase in WE (0·7 ± 25·2 mg/dL, ns). Neither the alpha nor beta diversity of the bacterial diversity was significantly different among all groups. After WE supplementation, the overall relative abundance of Bifidobacterium increased by 1·28-fold as compared to baseline and the differential abundance analysis also indicated that Lachnospira increased significantly and Varibaculum decreased. Interpretation Long-term whole egg supplementation is an effective, feasible and low-cost intervention to reduce protein-energy malnutrition, particularly in low-middle-income countries. Whole egg supplementation improves growth and nutritional biomarkers, and positively impacts gut microbiota without adverse effects on blood cholesterol levels. Funding Agricultural Research Development Agency (ARDA) of Thailand (PRP6105022310, PRP6505030460).

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 &lt; 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 &lt; 0.05). No difference of these parameters in C group between week-0 and week-12 was observed (ns). When comparing Yolk-KD vs. White-KD groups, there was no difference of anthropometric and metabolic changes between week-0 vs. week-12 (ns). Wt, WC, TG, and diastolic blood pressure (DBP) in Yolk-KD group decreased 4 kg, 3.8 cm, 14.9 mg/dl, and 7.4 mmHg, respectively (P &lt; 0.05). Wt, WC, TG, systolic blood pressure (SBP), and DBP in White-KD group decreased 3.9 kg, 3.3 cm, 18.1 mg/dl, 3.7 mmHg, and 4.7 mmHg, respectively (P &lt; 0.05). Fasting blood sugar and high-density lipoprotein cholesterol at week-12 were not significantly different from baseline (ns). At week-36 weight reduction in Yolk-KD and White-KD groups still maintained better than that in C group (P &lt; 0.05). The physical activity of all subjects was not change throughout study (ns). Conclusions Behavior modification through dietary changes plays a vital role in controlling metabolic syndrome. Implementation on ketogenic diet was easier than balanced diet with controlled energy. Therefore, an Asian ketogenic diet regardless of amounts of dietary cholesterol helps lose weight without negative impacts on physical and biochemical indices. Funding Sources Mahidol University.

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 &lt; 0.001 and 5.11 ± 0.92 cm, P &lt; 0.001). No significant differences in weight and height were observed between the ES and C groups. Prealbumin levels were higher (1.53 ± 0.33 mg/dL, P &lt; 0.001) in WE but not ES as compared with C. There were significant decreases in total cholesterol, triglycerides, and LDL cholesterol in WE but not ES as compared with C. Additionally, HDL cholesterol tended to increase in WE (0.66 ± 0.99 mg/dL, ns) as compared with C. Bacterial diversity in WE, ES and C group was not significantly change neither alpha nor beta diversity. After whole egg supplementation, the overall relative abundance of the Bifidobacterium was increased up to 1.28-fold. The differential abundance analysis also indicated that Lachnospira significantly increased and Varibaculum significantly decreased after whole egg supplementation. Conclusions Long-term whole egg supplementation significantly enhanced growth in young children with no adverse effect on blood cholesterol levels. The result coincided with promoting health-benefit gut bacteria. However, further insight into the mechanistic effect of egg consumption on gut microbiota and growth is needed. Funding Sources Agricultural Research Development Agency (ARDA), Thailand.