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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 receiving placebo and zinc than in those receiving iron or iron and zinc. Serum zinc was higher in infants receiving zinc (16.7 [+ or -] 5.2 [micro]mol/L), iron and zinc (12.1 [+ or -] 3.8 [micro]mol/L) or iron alone (11.5 [+ or -] 2.5 [micro]mol/L) than in the placebo group (9.8 [+ or -] 1.9 [micro]mol/L). Iron and zinc interacted to affect iron and zinc status, but not hemoglobin. Iron supplementation had a small but significant effect on ponderal growth, whereas zinc supplementation did not. To conclude, in Thai infants, iron supplementation improved hemoglobin, iron status, and ponderal growth, whereas zinc supplementation improved zinc status. Overall, for infants, combined iron and zinc supplementation is preferable to iron or zinc supplementation alone.

Aim: To examine the innovative nutrition educational tool that improves knowledge, blood pressure level, and urine sodium excretion in at-risk Thai people with hypertension. Subjects and methods: Sixty-seven at-risk hypertensive subjects in semi-urban areas were randomized and divided into control and intervention groups. Anthropometry, blood pressure level, knowledge score, urine sodium excretion, and 24-h recall from the same day as 24-h urine collection were measured in both groups. The control group (n = 35) participated in a general healthcare counseling program. The intervention group (n = 32) participated in a sodium reduction counseling program using an innovative nutrition educational tool (LINE). During 8 weeks of the intervention program, interactive sodium reduction key messages were sent to the intervention group. All measurements were collected and compared after the end of the program. Results: The baseline characteristics were not different between the two groups. The knowledge score increased significantly in both groups (intervention: p = 0.000; control: p = 0.001). The intervention group had a significant decrease of the systolic blood pressure (p = 0.041) and the diastolic blood pressure (p = 0.001). There was no significant difference in the blood pressure level, knowledge score, and urine sodium excretion between the two groups. Conclusion: Although the knowledge score increased in both groups, the innovative nutritional education tool was more effective than the general healthcare counseling program regarding the blood pressure level reduction. Therefore, the innovative nutrition educational tool should be beneficial as a supportive approach for health promotion. [ABSTRACT FROM AUTHOR]

The objective of this study was to evaluate the greenhouse gas emissions (GHGEs) generated by the production of tofu. A partial life cycle assessment (LCA) was performed using SimaPro 8 software with a functional unit of 1 kg of packaged tofu and a farm to factory gate boundary. Original production data for the period of 1 year were obtained from a tofu manufacturer based in the United States and used with soybean production data from SimaPro 8 Ecoinvent 3.1 and U.S. Life Cycle Inventory databases to calculate the associated GHGEs as carbon dioxide equivalents (CO2e). The LCA calculations included resource inputs required to produce and package tofu: soybeans, water, electricity, natural gas, transportation, and packaging materials. The LCA boundary was from the cradle (i.e., soybean farm) to the factory exit gate (i.e., postpackaging). Uncertainty analyses were performed using Monte Carlo simulations. Total CO2e from packaged tofu were 982 g/kg, 9820 g/kg of protein, 1150 g/1000 calories, and 336 g/retail packet of 396 g. For 1 kg of packaged tofu, 16% of CO2e resulted from soybean production, 52%fromtofu manufacturing, 23% from packaging, and 9% from transportation. Tofu, a protein- rich plant food, generates relatively low GHGEs. [ABSTRACT FROM AUTHOR]

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 pesticide in comparison to producing 1 kg of protein from beef. Compared with producing 1 kg of protein from chicken and eggs, beef generated five to six times more waste (manure) to produce 1 kg of protein.ConclusionsThe substitution of beef with beans in meal patterns will significantly reduce the environmental footprint worldwide and should also be encouraged to reduce the prevalence of non-communicable chronic diseases. Societies must work together to change the perception that red meat (e.g. beef) is the mainstay of an affluent and healthy diet. [ABSTRACT FROM PUBLISHER]

Although under-nutrition problems have been decreasing in Thailand, non-communicable diseases have become leading causes of death and disability. Food-Based Dietary Guidelines (FBDGs) is a key strategy to promote healthy daily food consumption and appropriate lifestyles. The development consists of qualitative and quantitative parts. The purposes were 1) to assist consumers in making healthy dietary choices and disease prevention; 2) to guide governmental agencies in nutrition implementations, promotion of healthy food products and education programs; 3) to assist national and local agencies in policy formulations and implementations; 4) to assist healthcare providers in primary diseases prevention efforts. The procedures to develop FBDGs specifically were to 1) set nutritional goals based on Thai DRI and RDI; 2) assign the units used for one portion of each food group; 3) quantify the size and number of servings of the major food groups, using the nutritive value calculated by the popularity vote method from secondary data; 4) evaluate the nutritive value of recommended amounts from combinations; 5) develop and test several food guide models based on Thai people's understanding and cultures; 6) implement through educational tools for the nationwide public units; 7) offer training programs, monitoring and evaluation in various populations to be performed by Ministry of Public Health (MOPH) and other academic sections. In long run successful FBDGs, there must not only be support from policy makers and cooperation between nutritionists from universities and the MOPH, but also application of ongoing activities such as "Sweet Enough Campaign Network" or "School Lunch Program". [ABSTRACT FROM AUTHOR]

Objective: To investigate the resource efficiency and environmental impacts of producing one kilogram of edible protein from two plant- and three animal-protein sources., Design: Primary 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., Setting: Desk-based study at the Department of Nutrition and Department of Occupational and Environmental Health, Loma Linda University., Subjects: None., Results: To 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 pesticide in comparison to producing 1 kg of protein from beef. Compared with producing 1 kg of protein from chicken and eggs, beef generated five to six times more waste (manure) to produce 1 kg of protein., Conclusions: The substitution of beef with beans in meal patterns will significantly reduce the environmental footprint worldwide and should also be encouraged to reduce the prevalence of non-communicable chronic diseases. Societies must work together to change the perception that red meat (e.g. beef) is the mainstay of an affluent and healthy diet.

Objective: To describe the development, process and outcome evaluation of a culturally tailored diabetes prevention education program for community healthcare workers (CHCWs) in Thailand., Methods: A tailored diabetes prevention education program was designed based on formative research and implemented with 35 CHCWs in semi-urban areas in Chiang Mai province, Thailand. Modules were delivered over eight group classes and eight self-directed E-learning sessions (www.FitThai.org). The program incorporated problem-based learning, discussion, reflection, community-based application, self-evaluation and on-line support. The frequency that students accessed on-line materials, including videotaped lectures, readings, monthly newsletters and community resources, was documented. Participant satisfaction was assessed through three questionnaires. Knowledge was assessed through pre-post testing., Results: Three-quarters of participants attended all eight classes and no participant attended fewer than six. On-line support and materials were accessed 3 to 38 times (median 13). Participants reported that program information and activities were fun, useful, culturally-relevant and applicable to diabetes prevention in their specific communities. Participants also appreciated the innovative technology support for their work. Comfort with E-learning varied among participants. Scores on pre-post knowledge test increased from a mean (sd) of 56.5% (6.26) to 75.5% (6.01) (p < .001)., Conclusions: An innovative diabetes prevention education program was developed for CHCWs in Thailand. Interactive classroom modules and self-directed E-learning were generally well-received and supported better knowledge scores. Ongoing access to web-based materials and expert support may help sustain learning.