Gut microbiome profiles in Thai healthy pregnant women and its association with types of foods.

BACKGROUND: Gut microbiome colonization during early life is significant for immunological and physiological development. Maternal microbiome is associated with proper development of infants. The aim of this study was to determine the gut microbiome profiles among Thai healthy pregnant women and its associated factors. METHODS: A multicenter, open trial prospective study was performed at three hospitals in Northern, Central, and Northeastern regions of Thailand. Thai healthy pregnant women attending antenatal clinics were recruited. Fecal samples of subjects at the third trimester of pregnancy were collected with sterilized techniques. The gut microbiome profiles and bacterial diversity were assessed using 16Ss RNA gene sequencing. Demographic data, dietary intake, and anthropometric data were recorded and analyzed. RESULTS: There were 86 healthy pregnant women. The dominant of gut microbiome profiles were Bacteroidetes and Firmicutes. Pregnant women in the Central region had significantly higher of Ruminococcaceae and Lachnospiraceae than those in other regions (p < 0.001). Pregnant women in the Northern region significantly consumed more glutinous rice than those in other regions (p < 0.001). Glutinous rice intake was positively correlated with Bacteroidetes (rho = 0.405, p = 0.01) and negatively correlated with Firmicutes (rho = - 0.440, p = 0.001). Alpha diversity was not correlated with pre-pregnancy body mass index (BMI) or gestational weight gain. CONCLUSIONS: The gut microbiome profiles mainly found in Thai healthy pregnant women were Bacteroidetes and Firmicutes. The gut microbiome profiles in pregnant women found in this study possibly depended on dietary patterns. Glutinous rice with high amylopectin is probably related to abundance of Bacteroidetes.

Living with Family yet Eating Alone is Associated with Frailty in Community-Dwelling Older Adults: The Kashiwa Study.

OBJECTIVES: Eating alone is related to depression, nutritional risk, and mortality. These effects are also influenced by living status. However, little is known about the relationship between eating alone despite living with family and frailty. This study explores the relationship of eating alone and living status with frailty in community-dwelling older adults. DESIGN: Cross-sectional study. SETTING AND PARTICIPANTS: Kashiwa city, Chiba prefecture, Japan; randomly selected community-dwelling older adults (aged 65 years and over). MEASUREMENTS: Eating status was assessed by the question, "Do you eat meals with anyone, at least once a day: yes or no?" Frailty was defined by Kihon Checklist (KCL) score 8 or over. Domains of frailty were divided into instrumental activities of daily living (IADL), physical strength, nutrition, eating, socialization, memory, and mood, based on KCL categories. Binary logistic regression analysis was used, adjusting for age, years of education, chronic diseases, number of teeth and cognitive function. RESULTS: Among the total of 1,914 participants, 49.8% were male, and the overall mean age was 72.9 ± 5.5 years. Of all participants, 56 (5.9%) of men and 112 (11.7%) of women were frail. Older adults who ate alone despite living with others were more likely to be frail (OR 2.49, 95%CI 1.1-5.5 for men and OR 2.16, 95%CI 1.0-4.5 for women). Of particular note, eating and living status were associated with lower physical strength and mood in men, whereas in women these statuses were associated with lower scores for IADL, socialization, memory, and mood. CONCLUSIONS: Eating alone despite living with others was associated with high frailty in both genders; however, the pathways were different between genders. These results might help yield a simple, fundamental intervention approach to multifaceted frailty, reflecting gender and associated high-risk domains.

Vitamin A and E status in very low birth weight infants.

OBJECTIVE: To determine vitamin A and vitamin E status in very low birth weight (VLBW) infants at the time of birth (TB), at the time of full feeding (TFF) and at term postmenstrual age (TT). STUDY DESIGN: An observational study was conducted in VLBW infants. Plasma retinol and α-tocopherol levels were measured at TB, TFF and TT. Multivitamin supplementation was given to all infants to meet the daily requirement. RESULT: A total of 35 infants were enrolled. The median (interquartile range) of gestational age and birth weight was 30 (28 to 32) weeks and 1157 g (982 to 1406 g). The median of vitamin A and vitamin E intakes from TFF to TT was 832 and 5.5 IU kg(-1) day(-1), respectively. Vitamin A deficiency occurred in 67.7% at birth, 51.6% at TFF and 82.1% at TT. Vitamin E deficiency occurred in 77.4% at birth, 16.1% at TFF and 35.7% at TT. Small-for-gestational age was the only risk factor for vitamin A deficiency. Lower amount of breast milk consumption was associated with higher incidence of vitamin E deficiency. No differences in vitamin A- or vitamin E-related morbidities between infants with and without vitamin deficiencies were found. CONCLUSION: High prevalence of vitamin A and vitamin E deficiency was found in VLBW infants starting from birth to term postmenstrual age. Therefore, a higher dose of vitamin supplementation is required.

Sexual maturation in Thai boys.

BACKGROUND: A worldwide secular trend towards earlier onset of puberty in girls has been noted during recent years. However, the data on sexual maturation of boys are relatively scarce and normative data of sexual maturation in Thai boys are still lacking. AIM: To determine the age of secondary sexual maturation in normal Thai boys. METHODS: Three hundred healthy urban boys aged 9-18 years were recruited during January 1997 to December 1999. Genital and pubic hair maturity staging was determined using the method of Marshall and Tanner. Testicular size was assessed by Prader orchidometer. Probit analysis was used to analyze the onset of puberty (gonadarche) and pubarche. RESULTS: Median (range) ages of the onset of puberty and pubarche were 10.8 (9.5-12) and 12.4 (10.9-13.9) years, respectively. CONCLUSION: The age of onset of genital development in boys living in Bangkok seems to be slightly earlier than that of boys in other countries. However, the onset of pubic hair development is comparable.

Calcium absorption from commonly consumed vegetables in healthy Thai women.

The absorbability of calcium from ivy gourd, a green leafy vegetable (Coccinia grandix Voigt.) and winged bean young pods (Psophocarpus tetragonolobus [L] DC) were measured in 19 healthy adult women aged 20 to 45 y, in a 3-way, randomized-order, crossover design with an average calcium load of 100 mg and milk as the referent. The test meals were extrinsically labeled with 44Ca and given with rice as breakfast after an overnight fast. Absorption of calcium was determined on a blood sample drawn 5 h after ingestion of the test meal. Fractional calcium absorption (X+/- SD) was 0.391 +/- 0.128 from winged beans, 0.476 +/- 0.109 from ivy gourd, and 0.552 +/- 0.119 from milk. The difference in fractional calcium absorption for these 2 vegetables was significant (P < 0.05) and the fractional calcium absorption from these 2 vegetables were both significantly lower than from milk. The difference was partly accounted for by the phytate, oxalate, and dietary fiber content of the vegetables. However, calcium bioavailability of these 2 vegetables, commonly consumed among Thais, was relatively good compared to milk (71% to 86% of milk) and could be generally recommended to the public as calcium sources other than milk and Brassica vegetables.

Production and shelf stability of multiple-fortified quick-cooking rice as a complementary food.

Rice-based complementary foods normally contain inadequate amounts of several micronutrients, such as iron, calcium, and zinc. This study aimed at improving the quality of commercially produced rice-based complementary foods. The analysis centered on identifying a rice-based complementary food that is safe, stable, sensory acceptable, and economical in terms of fortificants (iron, calcium, zinc, thiamine, folate) and effectively packaged for industrial production and distribution. Product colors were mostly in green-yellow tone and slightly changed to more yellow during storage. Sensory acceptability was affected by changes in odor and rancidity but not in color. Rancidity scores were low in aluminum foil laminated plastic bags (ALU). Lipid oxidation significantly increased during storage, but at a slower rate when sodium citrate and ALU were used. Color differences of raw products were detected but not in the cooked ones. Mineral and vitamin losses during processing were 2% to 11% and 20% to 30%, respectively, but no losses were found during storage. FeSO(4)+ NaFeEDTA added with sodium citrate resulted in the most acceptable product for all packagings. The multiple-fortified quick-cooking rice (MFQCR) developed from this study could be a potentially useful tool for combating micronutrient deficiencies among infants and young children in the countries where rice is the staple food.

Combined raw cornstarch and nifedipine as an additional treatment in persistent hyperinsulinemic hypoglycemia of infancy.

This study reports the result of treatment with the combination of raw cornstarch and nifedipine in two infants affected with hyperinsulinemic hypoglycemia of variable severity. The first infant developed hypoglycemia during early neonatal period and required subtotal pancreatectomy. She still developed hypoglycemia after her second operation. The second infant developed hypoglycemia at the age of 7 months. Raw cornstarch and nifedipine efficiently normalized both infants' blood glucose levels. Although they still need frequent feedings, no hypoglycemic episode was reported except when they were sick. Their growth and development were markedly improved after initiation of treatment.

Reduction of rotavirus infection in children receiving bifidobacteria-supplemented formula.

This study was conducted at Pakkred Babies Home, Bangkok, Thailand; with the hypothesis that children receiving probiotic-supplemented milk-based formula may be protected from developing diarrheal diseases. Salivary rotavirus-specific IgA antibody was used as an indicator of rotavirus infection. One hundred and seventy-five children, aged 6-36 months, were enrolled in the study. They were divided into 3 groups according to the type of formula given. There were 81 episodes of diarrhea during an 8-month study period, most of which were caused by bacterial enteropathogens. Ninety-seven pairs of salivary samples were adequate for the analysis of rotavirus antibody. Among 23 children receiving milk-based follow-up formula and serving as control group, 30.4 per cent of them had > or = 4-fold increase in the antibody titre, indicating subclinical rotavirus infection. The majority of children in the other 2 study groups, receiving the same formula supplemented with either Bifidobacterium Bb12 alone or together with Streptococcus thermophilus, had no significant change in the antibody titres between the two time points. The results of this study support our hypothesis that children receiving bifidobacteria-supplemented milk-based formula may be protected against symptomatic rotavirus infection.

Elevated serum cholesterol levels in Bangkok children and adolescents.

Hypercholesterolemia is a major cardiovascular risk factor. This study aimed to assess serum total cholesterol (TC) levels of children and adolescents living in Bangkok, Thailand. During 1995-1997, nonfasting blood samples were obtained from 570 healthy school children and adolescents aged 9-18 years. The mean TC levels ranged from 143-180 mg/dl in males and from 145-202 mg/dl in females. The prevalences of hypercholesterolemia (TC > or = 200 mg/dl) were 12.2 per cent and 20.3 per cent in males and females, respectively. Twenty-eight per cent of males and 26.9 per cent of females had borderline values (TC 170-199 mg/dl). TC inversely correlated with age (r = -0.16, P < 0.01) in males. The findings indicate that notable percentage of these children had elevated cholesterol levels and warrant additional study concerning risk factors and tracking of lipoprotein levels from childhood into adulthood.

Effects of tuna fish oil on hyperlipidemia and proteinuria in childhood nephrotic syndrome.

This is a randomized, double-blind, placebo-controlled, cross-over study to determine whether tuna fish oil decreased hyperlipidemia and proteinuria in children with steroid-resistant nephrotic syndrome. Five boys were supplemented with both 4 grams of tuna fish oil and placebo in a randomized order for 8 weeks of each treatment separated by 6-week washout period. The results showed no statistically significant difference in serum creatinine, triglyceride, cholesterol, urine protein and creatinine clearance between fish oil supplemented group and placebo group. Small sample size, low dosage, short duration of supplementation and wash-out period are among the important limitations in this study. Further study should be performed to identify the effects of fish oil on this entity in nephrotic syndrome.

Allogeneic bone marrow transplantation in an osteopetrosis patient: first report in Thailand.

We described the successful allogeneic matched sibling bone marrow transplantation (BMT) in a 5-year-old Thai boy in whom osteopetrosis was diagnosed on the basis of anemia, thrombocytopenia, leukoerythroblastosis, sclerotic bone, hepatosplenomegaly, and visual deficit from an encroachment of cranial nerve foramina. The preparative regimen included 4 days of busulfan 4 mg/kg/day, and 4 days of cyclophosphamide 50 mg/kg/day. Complete hematopoietic engraftment and no evidence of graft versus host disease were shown after BMT. Complete hematologic findings were corrected. His hematopoietic chimerism was changed to that of his donor. Post BMT, he has no hepatosplenomegaly. His bone radiographic findings revealed normal after BMT. Bone marrow biopsy showed normalized bone and bone marrow matrix. However, his vision remained impaired. We believe that this is the first case of successful bone marrow transplantation in an osteopetrosis patient in Thailand.

Effects of multivitamin supplementation for improvement of thiamin, riboflavin, and retinol nutrition in pediatric patients.

The effect of multivitamin supplementation on thiamin, riboflavin and retinol nutrition was studied in ten male chronic pediatric patients at Ramathibodi Hospital. MTV forte (Government Pharmaceutical Organization) was given 1 tablet daily for ten days and the effect was compared with the preceding ten-day control period. Anthropometric biochemical, clinical and dietary assessments were performed throughout the study. Biochemical assessments of vitamin nutrition at the beginning and the end of a 10-day non-supplementation period revealed multiple vitamin deficiencies in the subjects, though clinical manifestation was not seen. Hospital diets improved vitamin nutrition of some patients but most of them still showed subclinical vitamin deficiencies. Improvement of vitamin nutrition was clearly shown in most patients after MTV supplementation. Multiple vitamin supplements should be prescribed in high-risk patients since there was no definite pattern of vitamin deficiencies in various diseases and early detection of vitamin deficiency was difficult to perform. The dosage between 1-2 times of RDA was considered adequate in most of our patients.

Vitamin E status, glutathione peroxidase activity and the effect of vitamin E supplementation in children with thalassemia.

Vitamin E and selenium statuses were studied in thalassemic children in comparison with 16 normal controls. Twelve Hb H disease, 46 beta-thal/Hb E and 7 beta-thal major patients had lower plasma vitamin E level than controls but plasma vitamin E/total lipids ratio of Hb H disease subjects was not different from normal. Twelve Hb H disease and 33 beta-thal/Hb E patients had normal RBC Se but increased RBC GSH-Px activity. Ten vitamin E-deficient thalassemic subjects had been supplemented with 200 mg of oral vitamin E for 4-8 weeks. After supplementation, their plasma vitamin E increased and H2O2 hemolysis decreased to normal values. Their RBC GSH-Px activity also decreased but hematocrit did not change significantly. The results demonstrate that some types of thalassemic patients have vitamin E deficiency and support that vitamin E and selenium have related functions in the prevention of RBC oxidation. Vitamin E supplementation increased RBC resistance to oxidative damage.

Maple syrup urine disease: case report of 2 Thai infants.

Maple syrup urine disease (MSUD) is a rare inborn error of metabolism characterized by typical urine odor. The deficiency of branched-chain ketoacid decarboxylase enzyme is responsible for the clinical abnormalities. The classical disease usually manifests in the neonatal period with lethargy, refused feeding, seizures and death. Since 1984, at the Department of Pediatrics, Ramathibodi hospital, 2 patients with classical MSUD have been seen. The parents of one patient were relatives and already had 2 affected but undiagnosed daughters. Both patients had strong urine odor which was described as the odor of boiled Chinese herbal medicine. The first child died at 4 months old and the second was severely retarded at one year old. The importance of early diagnosis and genetic counselling are emphasized.

Short-term malnutrition in neonatal rabbits. I. Brush border enzymes.

Seventy-two hour starvation in neonatal rabbits was studied. Fasted animals received no feeds, only water every 8 h for 72 h. Fed animals were suckled by the dam. There was no difference in birth weight, serum albumin, blood urea nitrogen, electrolytes, or urine specific gravity between fed and fasted animals. Weight at 72 hr was less in fasted (p less than 0.01) than fed rabbits. Serum cortisol (p less than 0.05) and corticosterone (p less than 0.01) levels were higher in the fasted group. Proximal and distal small bowel homogenates had less DNA and protein (p less than 0.01) in the fasted group, but the protein/DNA ratio was the same in the proximal and distal small bowel homogenates from both groups. Sucrase (E.C.3.2.1.26) specific activity was significantly increased in proximal small bowel homogenates from the fasted group (p less than 0.01) but was the same in distal small bowel homogenates from both groups. Sucrase total activity per proximal segment was the same in fed and fasted animals but was significantly less per segment in distal small bowel homogenates from fasted animals. Alkaline phosphatase (E.C.3.1.3) total and specific activity was decreased in proximal (p less than 0.01) and distal (p less than 0.05) small bowel homogenates from the fasted group. Lactase (E.C.3.2.1.23) total activity was decreased in proximal and distal (p less than 0.01) small bowel homogenates from the fasted group but lactase specific activity was unchanged. Thus, a brief period of malnutrition in neonatal animals can result in a variety of regional functional changes in the gastrointestinal mucosa.

Wheat extract and milk mixture as a milk substitute for children with milk intolerance.

PIP: A mixture of milk with wheat extract and oil provides a low lactose formula which contains higher concentrations of energy than does diluted infant formula. To evaluate this mixture in malnourished children with diarrhea of more than 1 week's duration, 28 patients aged 3-18 months were studied at the pediatric isolation and metabolic wards of Ramathibodi Hospital. They were divided equally into study and control groups. The experimenta formula was a mixture of wheat extract, powdered whole milk and corn oil. The control diet was an infant formula. The lactose contents of the experimental and control formulas were, respectively, 1.1 and 7.2 g/100 ml. Amounts of fat, protein and carbohydrates were almost identical in both formulas. After rehydration with intravenous or oral electrolyte solutions, patients were fed full strength experimental formula or diluted infant formula. The latter's concentration was increased gradually according to clinical response, determined by daily weight, and stool frequency and consistency. All study group patients and 11 of 14 control group patients recovered from diarrhea. The mean +or- SD treatment durations in the study and control groups were 3.2 +or- 1.1 and 5.3 +or- 2.2 days respectively (p 0.01). The result suggested that a combined wheat extract/milk mixture is beneficial as a milk substitute for children with lactose intolerance.^ieng