Association Between Pretreatment Dietary Preference and Weight Loss after Radiation Therapy in Head and Neck Cancer Patients: A Pilot Study.

Weight loss is common in cancer patients underwent radiation therapy. However, the impact of pretreatment behavior on postradiation nutritional status was unknown. This prospective observational study was conducted in 31 Thai head and neck cancer patients to investigate the association between pretreatment dietary preference and weight change after radiotherapy. Pretreatment preferences on sweet, salty, sour, bitter, umami, spicy, and fatty food were evaluated using a validated questionnaire, TASTE26. Body weights were monitored at baseline, 1,000-2,000, 2,800-3,400, 4,000-4,400, and 5,000-7,000 cGy of radiations and 2 month-follow up after radiotherapy. The energy intakes were analyzed by using 3 day-dietary record and INMUCAL software. Spicy food preference was the only factor found positively correlated with weight loss after radiation (r = 0.64, P = 0.007). Consistently, strong spicy lovers had more pronounced reduction of energy intake and body weight, and higher needs of tube feeding than those of mild or moderate lovers (P < 0.05). This study suggested that stronger preference on spicy food may be associated with less energy intake and more severe weight loss after radiation therapy. A large-scale study is warranted to confirm such findings. Then, preradiation screening for spicy preference may be useful to predict weight loss during radiation therapy.

Iron bioavailability in 8-24-month-old Thai children from a micronutrient-fortified quick-cooking rice containing ferric ammonium citrate or a mixture of ferrous sulphate and ferric sodium ethylenediaminetetraacetic acid.

A quick-cooking rice, produced from broken rice, is a convenient ingredient for complementary foods in Thailand. The rice is fortified with micronutrients including iron during the processing procedure, which can cause unacceptable sensory changes. A quick-cooking rice fortified with ferric ammonium citrate (FAC) or a mixture of ferrous sulphate (FeSO4 ) and ferric sodium ethylenediaminetetraacetic acid (NaFeEDTA), with a 2:1 molar ratio of iron from FeSO4 : iron from NaFeEDTA (FeSO4 + NaFeEDTA), gave a product that was organoleptically acceptable. The study compared iron absorption by infants and young children fed with micronutrient-fortified quick-cooking rice containing the test iron compounds or FeSO4 . Micronutrient-fortified quick-cooking rice prepared as a traditional Thai dessert was fed to two groups of 15 8-24-month healthy Thai children. The iron fortificants were isotopically labelled with (57) Fe for the reference FeSO4 or (58) Fe for the tested fortificants, and iron absorption was quantified based on erythrocyte incorporation of the iron isotopes 14 days after feeding. The relative bioavailability of FAC and of the FeSO4 + NaFeEDTA was obtained by comparing their iron absorption with that of FeSO4 . Mean fractional iron absorption was 5.8% [±standard error (SE) 1.9] from FAC and 10.3% (±SE 1.9) from FeSO4 + NaFeEDTA. The relative bioavailability of FAC was 83% (P = 0.02). The relative bioavailability of FeSO4 + NaFeEDTA was 145% (P = 0.001). Iron absorption from the rice containing FAC or FeSO4 + NaFeEDTA was sufficiently high to be used in its formulation, although iron absorption from FeSO4 + NaFeEDTA was significantly higher (P < 0.00001).

Shelf stability, sensory qualities, and bioavailability of iron-fortified Nepalese curry powder.

BACKGROUND: The prevalence of iron-deficiency anemia in Nepal is almost 50% of the whole population. Curry powder is a promising vehicle for fortification due to its use in various meals. OBJECTIVE: To evaluate the bioavailability of different iron fortificants in curry powder and their effects on the qualities of curry powder. METHODS: The serving size of curry powder was evaluated in 40 Nepalese households and 10 restaurants. The powders were fortified with iron sources of different bioavailability. Sources with good bioavailability of iron--ferrous sulfate (FS), ferrous fumarate (FF), and sodium ferric ethylenediaminetetraacetic acid (NaFeEDTA)--were added to provide one-third of the recommended daily intake (RDI) of iron per serving. Elemental iron (H-reduced [HRI] and electrolytic [EEI]), which has poor bioavailability, was added to provide two-thirds of the RDI per serving. Both fortified and unfortified products were packed in either commercial packs or low-density polyethylene bags and stored at 40 +/- 2 degrees C under fluorescent light for 3 months. The stored products were analyzed for CIE color, peroxide value, thiobarbituric acid reactive substances, moisture, water activity, iron, and sensory qualities. The contents of phenolic compounds and phytate were analyzed, and iron bioavailability was determined by the Caco-2 cell technique. RESULTS: The serving size of curry powder was 4 g. Iron fortificants did not have adverse effects on the physical, chemical, and sensory qualities of curry powder packed in commercial packaging. After 3 months storage, HRI significantly affected darker colors of curry powder and the cooked dishes prepared with curry powder. The relative bioavailabilities of NaFeEDTA and EEI were 1.05 and 1.28 times that of FS, respectively. The cost of fortification with EEI was similar to that with FS and 4.6 times less than that with NaFeEDTA. CONCLUSIONS: It is feasible and economical to fortify Nepalese curry powder packed in commercial packaging with EEI.

Evolution of Trans-fatty acid consumption in Thailand and strategies for its reduction.

Eliminating industrially produced trans-fatty acids (TFAs) from the food supply is one of the World Health Organization's (WHO's) priority targets to control and prevent non-communicable diseases. This review paper describes the strategies used to reduce TFA consumption in Thailand based on a situation analysis consisting of an assessment of TFA content in the national food supply, its intake, and stakeholder-based analysis of Strengths, Weaknesses, Opportunities, and Threats (SWOT). The analysis resulted in the drafting of a regulatory approach, which was then considered by stakeholders. Bakery products containing partially hydrogenated oils (PHOs) are the major sources of TFAs in Thailand. Palm and coconut oil as well as blending technology are locally available as PHO replacements. Thailand's Food and Drug Administration has taken legal action to prohibit the production, import, and distribution of PHOs and their products. Post-marketing TFA levels are currently being monitored, ie, TFAs in fat/oil and butter must not exceed 2% and 6% of fat content, respectively. For other food categories, TFAs must not exceed 0.5 g per serving unless the TFAs are from ruminant sources. The key factor to successfully reducing TFAs in Thailand is the partnership between public and private sectors, professional associations, and consumers, based on scientific evidence regarding the negative impact of TFA intake on cardiovascular health.

Reduction of Sodium Intake from Papaya Salad with the Use of Sodium-Reduced Fermented Fish in Producing Traditional Seasoning Sauce.

Fermented fish is a common seasoning used in Northeastern Thailand and Laos to give food a salty taste. It is also used as a basic ingredient for preparing various seasoning sauces for many local dishes. This study examined the effect of sodium reduced fermented fish (SRFF) on reducing the sodium content in prepared traditional papaya salad. Three local producers provide fermented fresh water fish produced with either normal salt (FF) or 60% sodium-reduced salt (SRFF) that were then used by 3 local sauce producers to make papaya salad seasoning sauces. Three local street food vendors then were used these sauces as the main ingredients for preparing their papaya salads. Sodium contents of the FFs, SRFFs, and papaya salads were analyzed using Inductively Coupled Plasma-Optical Emission Spectrometer. Significant differences between sodium contents in sauces and papaya salads were evaluated using the t-test. Results showed that the SRFF contained 54% less sodium than the FF, while sodium in the SRFF sauces was approximately 42% less than from FF sauces. The papaya salads prepared from SRFF sauces contained on average 492±27 mg sodium per 100 g, which was 33% lower than those prepared from FF sauces. The use of SRFF could significantly reduce sodium content in traditional papaya salad by up to one-third, which could be beneficial in lowering the risk of hypertension among Norteastern Thai and Laotain people with minimal change in eating behaviors.

Iodine stability and sensory quality of fermented fish and fish sauce produced with the use of iodated salt.

BACKGROUND: Universal salt iodization promotes the use of iodated salt for producing industrial food products, although it might affect product quality and iodine stability. OBJECTIVE: To assess iodine loss during fermentation of fermented fish and fish sauces produced by using iodated salt and the effect on product sensory quality. METHODS: Fermented fish and fish sauces were produced with iodated rock and grain sea salts (approximately 30 ppm iodine). Fermented fish was prepared from freshwater fish mixed with salt and rice bran and fermented for 6 months at room temperature. Fish sauces were prepared by mixing anchovy with salt and fermenting either exposed to sunlight or in the shade for 12 months. Residual iodine was determined with a spectrophotometer at day 0 and months 1, 3, and 6 for fermented fish and day 0 and months 3, 6, and 12 for fish sauces. After fermentation, the products were tested for sensory acceptability by Laotian and Thai panelists (approximately 50 in each panel) after they were cooked and served in the traditional manner. RESULTS: After fermentation, the level of residual iodine was 7.61 ppm (16% loss) infermented fish, 5.57 ppm (55% loss) in fish sauce prepared with exposure to sunlight, and 9.52 ppm (13% loss) in fish sauce prepared in the shade. Sensory qualities of the products that were produced from fortified and unfortified salts as well as dishes prepared from these products were not significantly different (p > 0.05). CONCLUSIONS: It is feasible to produce fermented fish and fish sauces with iodated salt and maintain acceptable iodine levels.

Overcoming the Trans Fat Problem in Thailand.

BACKGROUND: Owing to the clear impact of trans fatty acids (TFAs) on cardiovascular disease, Thailand urgently needs to evaluate the problem and formulate appropriate policies in order to protect the health of its own people and to benefit exportation. Since 9 January, 2019, Thailand's FDA has not allowed the use of partially hydrogenated oils (PHOs) in foods. OBJECTIVE: The aim of this study was to evaluate the situation and potential health risk from TFAs in foods available in Thailand, changes in fatty acid profiles upon replacement of PHOs, as well as to propose control measures for TFAs in the country. METHODS: A total of 176 food samples representing potential sources of TFAs were analyzed for fatty acid profiles, which were later used to evaluate potential health risk based on Thailand's Food Consumption Survey data and the FAO/WHO Guideline on Diet, Nutrition and the Prevention of Chronic Diseases (FAO/WHO guideline). Criteria for postmarketing monitoring of TFAs in food products were also proposed. RESULTS: TFAs were naturally highest in butter (5%) but lower than the limit in the FAO/WHO guideline regarding consumption pattern. TFAs in refined cooking oils were 0.4-0.8%, which was below the European Union (EU) legislative limit. Bakery products, i.e., puffs, pies, and deep-fried donuts, that used PHOs contained 3-5% TFAs and were the main sources of TFAs in Thailand. The postmarketing monitoring process should be based on the FAO/WHO guideline and EU legislative limit for TFAs. The PHOs in bakery products could be replaced with blended oils, although saturated fatty acids might increase. CONCLUSIONS: Thailand's TFA problem was mainly due to the use of PHOs in bakery products. It is feasible to replace PHOs with blended oils. The international TFA limits should be used for the postmarketing monitoring of TFAs in foods on the market.

Effects of various iron fortificants on sensory acceptability and shelf-life stability of instant noodles.

BACKGROUND: Iron-deficiency anemia is the most common nutritional problem in Thailand and many developing countries. One of the most sustainable and cost-effective strategies for combating iron deficiency is fortification of staple foods with iron. OBJECTIVE: In this study, the feasibility of fortifying instant noodles with different forms of iron fortificants (ferrous sulfate [FS], ferric sodium ethylenediaminetetraacetic acid [NaFeEDTA], and encapsulated H-reduced elemental iron [EEI] was evaluated, and the fortified noodles were compared with unfortified noodles for changes in physical, chemical, and sensory qualities. METHODS: Wheat flour used to make instant noodles was fortified to produce a concentration of 5 mg of iron per 50-g serving of instant noodles (one-third of the Thai recommended dietary intake). RESULTS: Analytical data showed that the iron contents were close to 5 mg per serving of noodles fortified with FS, NaFeEDTA, or EEI (5.27 +/- 0.10, 4.27 +/- 0.07, and 5.26 +/- 0.47 mg, respectively). The color quality (measured by L*, lightness, and b* yellowness) of the raw dough sheet and of uncooked and cooked instant noodles fortified with FS was lower than that of the unfortified, but color quality was not changed by the addition of NaFeEDTA. The overall sensory acceptability scores of unfortified and fortified noodles were about 6 ("like slightly"). No metallic odor was observed. During 3 months of storage at room temperature, the iron fortificants did not affect the peroxide level, color, or sensory qualities of the product. CONCLUSIONS: Iron fortification of wheat flour used to make instant noodles is feasible. NaFeEDTA is the preferred fortificant because of its nonsignificant effect on the color and sensory quality of the products.

Feasibility and use of vitamin A-fortified vegetable oils among consumers of different socioeconomic status in Thailand.

BACKGROUND: Vitamin A losses infortified vegetable oils can differ, depending upon the cooking and distribution conditions of a country. OBJECTIVE: To determine vitamin A losses in different vegetable oils during transportation, cooking, and storage among consumets of different socioeconomic status. METHODS: Soybean, rice bran, and palm oils were fortified with vitamin A palmitate at 267 microg/15 mL. The oils were packaged in 5-L metal cans and 250-mL polyethylene terephthalate (PET) bottles and then stored under light and dark conditions. Unopened and opened bottles were stored for 13 and 4 weeks, respectively. Fortified palm oil also was bulk transported in trucks and packaged in 1-kg polypropylene bags that were closed with rubber bands. Vitamin losses were measured after cooking at 120 degrees and 170 degrees C for 5 and 10 minutes in iron, aluminum, Teflon, and glass pans. RESULTS: Vitamin A losses of oils in PET bottles stored under light conditions were 20% to 25% at the 5th week and became greater than 80% after 13 weeks, whereas losses under dark conditions and in metal containers were less than 15%. Loss during bulk transportation was 25%, with no change in peroxide value. Losses in opened bottles after 4 weeks under light conditions were 50% to 90% based on the degree of oil unsaturation; however, losses under dark conditions were less than 5%. Losses after cooking at 120 degrees and 170 degrees C for 10 minutes were less than 5% and 15%, respectively. The type of pan did not affect the amount of loss. The peroxide values of oils in bottles increased during storage under light conditions. CONCLUSIONS: Fortification of vegetable oils with vitamin A for consumers of different socioeconomic status is feasible; however, light protection is needed for better stability.

Fortification of soy sauce using various iron sources: sensory acceptability and shelf stability.

BACKGROUND: Soy sauces are available in different types and grades, which allows them to reach consumers of all socioeconomic groups. Ferric sodium ethylenediaminetetraacetic acid (NaFeEDTA) has been used for iron fortification of soy sauces in some countries, however, its high cost may make it unattractive to policymakers and industry. OBJECTIVE: We evaluated the feasibility of using more economical iron sources for iron fortification, with soy sauce of various types and grades used as a vehicle. METHODS: Seven iron sources were tested for their feasibility for fortification of four types of soy sauce: naturally fermented in the traditional style, naturally fermented according to large-scale industrial formulas 1 and 5, and chemically hydrolyzed at 5 mg per serving (15 mL, per Thailand's food labeling regulations). Either citric acid or sodium citrate was added at 0.1% as a chelator. RESULTS: Five iron sources--ferrous sulfate, NaFeEDTA, ferric ammonium citrate, ferrous lactate, and ferrous gluconate--did not significantly affect the sensory qualities of the product over a period of 3 months (p > .05). Ferrous fumarate and ferrous bisglycinate caused unacceptable precipitation. Less than 3% of 260 and 306 commonly cooked foods out of 871 and 772 preparations using soy sauces fortified with NaFeEDTA and ferrous sulfate, respectively, were found to be different from normal with regard to sensory qualities. The cost of fortification was US 0.22 cents to US 3.28 cents per bottle (700 mL). CONCLUSIONS: Both naturally fermented and chemically hydrolyzed soy sauces could be fortified with all five iron sources. Ferrous sulfate is the most appropriate source because of its low cost and acceptable sensory characteristics. Soy sauce is a promising vehicle for iron fortification, however, the bioavailability of iron in the products examined here needs to be evaluated under normal use conditions.

Comparison of the efficacy of wheat-based snacks fortified with ferrous sulfate, electrolytic iron, or hydrogen-reduced elemental iron: randomized, double-blind, controlled trial in Thai women.

BACKGROUND: Although elemental iron powders are widely used to fortify cereal products, little data exist on their efficacy in humans. OBJECTIVE: We compared the efficacy of wheat-based snacks fortified with ferrous sulfate, electrolytic iron, or hydrogen-reduced iron in Thai women with low iron stores. DESIGN: A double-blind intervention was conducted in 18-50-y-old women (n = 330) randomly assigned into 4 groups to receive either no fortification iron or 12 mg Fe/d for 6 d/wk for 35 wk as ferrous sulfate, electrolytic iron, or hydrogen-reduced iron in a baked, wheat-flour-based snack. Snacks were not consumed with meals, and consumption was monitored. At baseline, 20 wk, and 35 wk, hemoglobin status and iron were measured and the groups were compared. RESULTS: Between baseline and 35 wk, geometric mean serum ferritin (SF) increased significantly in all 3 groups receiving iron (P < 0.01), and geometric mean serum transferrin receptor (TfR) decreased significantly in the groups receiving ferrous sulfate and electrolytic iron (P < 0.05). Calculated mean (+/-SD) body iron stores increased from 1.5 +/- 2.8 to 5.4 +/- 2.9 mg/kg in the ferrous sulfate group, from 1.5 +/- 3.5 to 4.4 +/- 3.6 mg/kg in the electrolytic iron group, and from 1.3 +/- 3.2 to 3.2 +/- 4.3 mg/kg in the hydrogen-reduced iron group (P < 0.01 for all 3 groups) but did not change significantly in the control group. CONCLUSIONS: Ferrous sulfate, electrolytic iron, and hydrogen-reduced iron, fortified into wheat-based snacks, significantly improved iron status. On the basis of the change in body iron stores during the 35-wk study, the relative efficacy of the electrolytic and hydrogen-reduced iron compared with ferrous sulfate was 77% and 49%, respectively.

Development of fortified dried broken rice as a complementary food.

BACKGROUND: Commercially produced dried broken rice is widely used to prepare complementary foods for Thai infants, and it is both convenient and acceptable to persons from all socioeconomic classes. However, inadequate levels of calcium, iron, thiamine, and folate are common in complementary foods for breastfed infants. OBJECTIVE: We developed dried broken rice fortified with these nutrients at levels recommended by the 2001 guidelines of the World Health Organization. METHODS: The fortification process involved predrying broken rice at 90 degrees C for 1 hour, soaking in a nutrient solution (2:1 ratio of rice to solution), and drying at 70 degrees C for 1 hour and 50 minutes. Calcium lactate or calcium lactate gluconate was the calcium source, and ferrous sulfate, ferrous lactate, or ferric sodium ethylenediaminetetraacetic acid (NaFeEDTA) was the iron source. The vitamin sources were thiamine hydrochloride and folic acid. The product contained 40 mg of calcium, 5.3 mg of iron, 0.08 mg of thiamine, and 11 microg of folate per 20-g serving. RESULTS: Approximately 5% and 10% of calcium and iron, respectively, were lost during processing, with a thiamine loss of approximately 13%, and a folate loss ranging from 17% to 23%. The thiamine loss during accelerated storage (42 degrees C for three months) was not significant (p > .05). CONCLUSIONS: NaFeEDTA was the most appropriate iron fortificant because it provided prolonged product stability and high in vitro dialyzability.

Physicochemical properties of Terminalia catappa seed oil as a novel dietary lipid source.

Terminalia catappa Linn (TC) is an ornamental tree planted extensively in many countries. It has been known for a long time that the seeds are edible but no research has focused on the realm of its use as food. Our previous data showed that the seed contains high levels of oil content (600 g/kg) and possesses the optimum fatty acid balance indicated in fat dietary guidelines. This study aims to investigate the physical and chemical properties and the possibility of using TC seed oil as a new dietary lipid. The effects of extraction conditions, partial refining process, and storage stability on TC oil properties were conducted compared with soybean oil. The results showed that physicochemical properties including the density, refractive index, melting point, acidity, free fatty acid, saponification value, unsaponifiable, peroxide, and fatty acid composition of the extracted oil were comparable with soybean oil and their values followed the dietary standard of edible oil.

Combating iodine and iron deficiencies through the double fortification of fish sauce, mixed fish sauce, and salt brine.

Two iodine and seven iron compounds were tested for use in the fortification of pure fish sauce, mixed fish sauce, and salt brine for cooking as a means to combat iodine and iron deficiencies. Ferrous sulfate, sodium iron ethylenediaminetetraacetic acid, ferric ammonium citrate, and ferrous lactate were combined with potassium iodide with no effect on sensory quality. Product shelf-life testing revealed that no iron or iodine losses occurred during a three-month storage period. Although the color of most products darkened, the color was not significantly different from that of nonfortified products after two to three months. Sensory home-use tests revealed that the fortified products were acceptable to highly acceptable, with only 1.2% to 8.2% of the dishes cooked using the fortified products being reported as discolored. The cost of fortification was minimal, at 0.13 to 2.73 baht per bottle (750 ml) (42 baht = US$1). Consequently, these products show a potential for inclusion in national programs for the prevention of micronutrient deficiencies in Asian countries where fish sauce and its products are routinely consumed.

Development of cereal and legume based food products for the elderly.

Diets for elderly must contain nutritious foods, fit their physiological limitations, and match with their food culture. Cereals and legumes are suggested food choices regardless of their cultures and beliefs. Ready-to-eat products containing suitable macronutrient patterns from cereals and legumes were developed. Energy distributions from carbohydrate (60 kcal/100 kcal), protein (15 kcal/100 kcal), and fat (25 kcal/100 kcal), protein quality, and percent energy from saturated fatty acid and free sugar were criteria for the formulation. Carbohydrate sources were rice flour, brown rice flour, mung bean starch, which carbohydrate in rice flour was the most digestible on in vitro test. Protein and fat sources were soybean flour, black sesame seed, and rice bran oil. Three products, i.e., flake snack, instant beverage, and instant soup were produced by drying basic ingredients as flakes on a double-roller drum dryer and directly used or dry-mixed with other ingredients. The products (Aw <0.3) had balanced energy distribution, good quality protein, and energy from saturated fat < 8 kcal/100 kcal and free sugar < 10 kcal/100 kcal. Results from sensory central location test in 219 elderly subjects indicated that the flake snacks from both carbohydrate sources were significantly more acceptable than the other two products.

Lactose-free milk prolonged endurance capacity in lactose intolerant Asian males.

BACKGROUND: Several studies on Caucasian volunteers have proven that milk is an effective recovery drink for athletes. Such benefit, however, cannot be directly applied to the lactose-intolerant Asian population. This study investigated the effects of ingesting water (WT), sports drink (SPD) and lactose-free milk (LFM) on cycling capacity. METHODS: Ten healthy young men completed 3 randomized experimental trials. Each trial consisted of an intermittent glycogen depleting session, a 2 h recovery period during which they ingested the test drink, followed by cycling at 70% of their maximum oxygen consumption (VO2max) to volitional exhaustion. Each trial was separated by at least one week. RESULTS: There were no complaints or symptoms of lactose intolerance during any of the trials. The cycling periods were different (p < 0.05) amongst the 3 trials, namely, lactose-free milk (LFM; 69.6 ± 14.0 min), sports drink (SPD; 52.1 ± 11.6 min), and water (WT; 36.0 ± 11.1 min), respectively. The VO2 and VCO2 of LFM (30 ± 4 and 29 ± 4 ml/kg/min) were lower (p < 0.05) than that of SPD (34 ± 4 and 34 ± 4 ml/kg/min) and WT (35 ± 4 and 33 ± 5 ml/kg/min). There were no differences (p = 0.45) in VO2 and VCO2 between SPD and WT. Mean rating of perceived exertion was lowest in LFM (14 ± 5; p < 0.05), while no difference was found between the other two trials (SPD: 16 ± 4 and WT: 16 ± 4; p = 0.18). CONCLUSION: Lactose-free milk is likely to be an effective recovery drink for enhancing subsequent cycling capacity in lactose intolerant Asian males.

In vitro retardation of glucose diffusion with gum extracted from malva nut seeds produced in Thailand.

Mucilage of malva nut fruit has been used as traditional medicine in Thailand. Our laboratory has succeeded in extracting malva nut gum (MNG) from malva nut seeds by using alkaline-extraction method. The extract had higher gelling properties compared to water-extracted MNG. This research was aimed to investigate the effect of MNG on the retardation of glucose diffusion in in vitro dialysis processes. The results showed that alkaline-extracted MNG significantly (p<0.05) reduced glucose content in dialysate compared to control containing no dietary fibre. MNG at 1% (w/w) concentration was more effective than that of 0.5% (w/w) concentration. The mixture of MNG and guar gum significantly (p<0.05) reduced glucose in dialysate by 50-82% compared to that of control. In starch digestion process, the mixture of MNG and guar gum showed greater reduction of glucose (3-7 folds) in dialysate at 15-30min.

A comparative intervention trial on fish sauce fortified with NaFe-EDTA and FeSO4+citrate in iron deficiency anemic school children in Kampot, Cambodia.

BACKGROUND: Inhabitants of agrarian villages of rural Cambodia suffer from high prevalences of iron deficiency and anemia in the context of a monotonous diet. OBJECTIVE: To compare the efficacy and safety of placebo Khmer fish sauce to that of 10 mL of fish sauce containing 10 mg of iron, added to daily school meals either as NaFe-EDTA or as FeSO4+ citrate. METHODS: 140 students aged 6-21 years were enrolled in a double-blinded, placebo-controlled intervention trial. They were randomly allocated to one of three treatment groups, and followed for 21 weeks during which 114 school meals seasoned with 10 mL of fish sauce were consumed by each participant. Changes in the concentrations of hemoglobin (hb), serum ferritin (SF), and C-reactive protein (CRP) and in body weight and standing height were determined. Prevalences of vomiting, diarrhea, and acute respiratory infections were monitored weekly. RESULTS: Both iron-fortified fish sauces increased hb and SF concentrations significantly as compared to placebo. No significant differences were observed between FeSO4+citrate and NaFe-EDTA fortification, regarding mitigation of iron-deficiency anemia (IDA) or regarding CRP, growth, infections, or side-effects. CONCLUSIONS: Iron-fortified Khmer fish sauce added to Khmer food is a suitable vehicle for iron fortification in children and adolescents. FeSO4+citrate and NaFe-EDTA show equivalent efficacy and safety.

A micronutrient-fortified seasoning powder reduces morbidity and improves short-term cognitive function, but has no effect on anthropometric measures in primary school children in northeast Thailand: a randomized controlled trial.

BACKGROUND: Reductions in iodine and zinc deficiencies and improvements in hemoglobin were achieved from a micronutrient-fortified seasoning powder consumed in school lunches by children in northeast Thailand. OBJECTIVE: The objective was to determine whether fortification with 4 micronutrients in a school lunch results in changes in children's growth, morbidity, and cognitive function compared with no fortification. DESIGN: In a randomized controlled trial of 569 children aged 5.5-13.4 y from 10 schools, we compared the efficacy of a seasoning powder fortified with or without 5 mg Fe, 5 mg Zn, 50 mug I, and 270 mug vitamin A per serving consumed with a school lunch 5 d/wk. Here we report on results of the secondary functional outcomes. RESULTS: The groups were comparable concerning compliance and loss to follow-up. The intervention had no statistically significant effect on anthropometric measures over 31 wk, but reduced the incidence of respiratory-related illnesses [rate ratio (RR): 0.83; 95% CI: 0.73, 0.94], symptoms of runny nose (RR: 0.80; 95% CI: 0.70, 0.92), cough (RR: 0.80; 95% CI: 0.66, 0.96), and diarrhea (RR: 0.38; 95% CI: 0.16, 0.90). For the visual recall test, those in the fortified group recalled 0.5 more items (95% CI: 0.1, 0.9) than did the controls. There were no statistically significant differences between groups in the results of the digits forward and backward tests or in school grades at the conclusion of the 2 semesters. CONCLUSION: The beneficial effects on morbidity and visual recall over a short period, in addition to some biochemical improvements, highlight the potential of this micronutrient-fortified seasoning powder supplied in a school lunch. This trial was registered at clinical trials.gov as ACTRN12605000341628.