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Surawit A, Pongkunakorn T, Manosan T, Mongkolsucharitkul P, Chamnan P, Suvarnabhumi K, Puangpet T, Suta S, Pumeiam S, Pinsawas B, Ophakas S, Pisitpornsuk S, Utchin C, Mayurasakorn K. Factors influencing optimal diabetes care and clinical outcomes in Thai patients with type 2 diabetes mellitus: a multilevel modelling analysis. BMJ Open 2024; 14:e079415. [PMID: 38702083 PMCID: PMC11086275 DOI: 10.1136/bmjopen-2023-079415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 04/23/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND Increasing levels of poor glycaemic control among Thai patients with type 2 diabetes mellitus (T2DM) motivated us to compare T2DM care between urban and suburban primary care units (PCUs), to identify gaps in care, and to identify significant factors that may influence strategies to enhance the quality of care and clinical outcomes in this population. METHODS We conducted a cross-sectional study involving 2160 patients with T2DM treated at four Thai PCUs from 2019 to 2021, comprising one urban and three suburban facilities. Using mixed effects logistic regression, we compared care factors between urban and suburban PCUs. RESULTS Patients attending suburban PCUs were significantly more likely to undergo eye (adjusted OR (AOR): 1.83, 95% CI 1.35 to 1.72), foot (AOR: 1.61, 95% CI 0.65 to 4.59) and HbA1c (AOR: 1.66, 95% CI 1.09 to 2.30) exams and achieved all ABC (HbA1c, blood pressure (BP) and low-density lipoprotein cholesterol (LDL-C)) goals (AOR: 2.23, 95% CI 1.30 to 3.83). Conversely, those at an urban PCU were more likely to undergo albuminuria exams. Variables significantly associated with good glycaemic control included age (AOR: 1.51, 95% CI 1.31 to 1.79), T2DM duration (AOR: 0.59, 95% CI 0.41 to 0.88), FAACE (foot, HbA1c, albuminuria, LDL-C and eye) goals (AOR: 1.23, 95% CI 1.12 to 1.36) and All8Q (AOR: 1.20, 95% CI 1.05 to 1.41). Chronic kidney disease (CKD) was significantly linked with high triglyceride and HbA1c levels (AOR: 5.23, 95% CI 1.21 to 7.61). Elevated HbA1c levels, longer T2DM duration, insulin use, high systolic BP and high lipid profile levels correlated strongly with diabetic retinopathy (DR) and CKD progression. CONCLUSION This highlights the necessity for targeted interventions to bridge urban-suburban care gaps, optimise drug prescriptions and implement comprehensive care strategies for improved glycaemic control, DR prevention and CKD progression mitigation among in Thai patients with T2DM. The value of the clinical target aggregate (ABC) and the process of care aggregate (FAACE) was also conclusively demonstrated.
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Affiliation(s)
- Apinya Surawit
- Population Health and Nutrition Research Group, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Tanyaporn Pongkunakorn
- Population Health and Nutrition Research Group, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Thamonwan Manosan
- Population Health and Nutrition Research Group, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Pichanun Mongkolsucharitkul
- Population Health and Nutrition Research Group, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Parinya Chamnan
- Department of Social Medicine, Sunpasithiprasong Hospital, Ubon Ratchathani, Thailand
| | - Krishna Suvarnabhumi
- Department of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Thanapat Puangpet
- Department of Social Medicine, Samutsakhon Hospital, Samut Sakhon, Thailand
| | - Sophida Suta
- Population Health and Nutrition Research Group, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Sureeporn Pumeiam
- Population Health and Nutrition Research Group, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Bonggochpass Pinsawas
- Population Health and Nutrition Research Group, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Suphawan Ophakas
- Population Health and Nutrition Research Group, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Sananon Pisitpornsuk
- Division of Nursing, Siriraj Primary Care Unit, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Chalita Utchin
- Division of Nursing, Siriraj Primary Care Unit, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Korapat Mayurasakorn
- Population Health and Nutrition Research Group, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Mongkolsucharitkul P, Pinsawas B, Surawit A, Pongkunakorn T, Manosan T, Ophakas S, Suta S, Pumeiam S, Mayurasakorn K. Diabetes-Specific Complete Smoothie Formulas Improve Postprandial Glycemic Response in Obese Type 2 Diabetic Individuals: A Randomized Crossover Trial. Nutrients 2024; 16:395. [PMID: 38337679 PMCID: PMC10857113 DOI: 10.3390/nu16030395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 01/25/2024] [Accepted: 01/27/2024] [Indexed: 02/12/2024] Open
Abstract
This study aimed to compare newly developed diabetes-specific complete smoothie formulas with a standard diabetes-specific nutritional formula (DSNF) regarding their effects on glucose homeostasis, insulin levels, and lipid metabolism in obese type 2 diabetes (T2DM) patients. We conducted a randomized, double-blind, crossover study with 41 obese T2DM participants to compare two developed diabetes-specific complete smoothie formulas, a soy-based regular smoothie (SM) and a smoothie with modified carbohydrate content (SMMC), with the standard DSNF, Glucerna. Glycemic and insulin responses were assessed after the participants randomly consumed 300 kilocalories of each formulation on three separate days with a 7-day gap between. Postprandial effects on glycemic control, insulin levels, and lipid metabolism were measured. SMMC resulted in a significantly lower glucose area under the curve (AUC0-240) compared to Glucerna and SM (p < 0.05 for both). Insulin AUC0-240 after SMMC was significantly lower than that after SM and Glucerna (p < 0.05). During the diets, the suppression of NEFA was more augmented on SM, resulting in a less total AUC0-240 of NEFA compared to the SMMC diet (p < 0.05). C-peptide AUC0-240 after SMMC was significantly lower than that after Glucerna (p < 0.001). Conversely, glucagon AUC0-240 after SMMC was significantly higher than that after SM and Glucerna (p < 0.05). These results highlight SMMC as the better insulin-sensitive formula, potentially achieved through increased insulin secretion or a direct reduction in glucose absorption. The unique composition of carbohydrates, amino acids, and fats from natural ingredients in the smoothies may contribute to these positive effects, making them promising functional foods for managing diabetes and obesity.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Korapat Mayurasakorn
- Siriraj Population Health and Nutrition Research Group, Department of Research Group and Research Network, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; (P.M.); (B.P.); (A.S.); (T.P.); (T.M.); (S.O.); (S.S.); (S.P.)
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Suta S, Ophakas S, Manosan T, Honwichit O, Charoensiddhi S, Surawit A, Pongkunakorn T, Pumeiam S, Mongkolsucharitkul P, Pinsawas B, Sutheeworapong S, Puangsombat P, Khoomrung S, Mayurasakorn K. Influence of Prolonged Whole Egg Supplementation on Insulin-like Growth Factor 1 and Short-Chain Fatty Acids Product: Implications for Human Health and Gut Microbiota. Nutrients 2023; 15:4804. [PMID: 38004198 PMCID: PMC10674712 DOI: 10.3390/nu15224804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 11/13/2023] [Accepted: 11/14/2023] [Indexed: 11/26/2023] Open
Abstract
The gut microbiota exert a profound influence on human health and metabolism, with microbial metabolites playing a pivotal role in shaping host physiology. This study investigated the impact of prolonged egg supplementation on insulin-like growth factor 1 (IGF-1) and circulating short-chain fatty acids (SCFAs). In a subset of a cluster-randomized trial, participants aged 8-14 years were randomly assigned into three groups: (1) Whole Egg (WE)-consuming 10 additional eggs per week [n = 24], (2) Protein Substitute (PS)-consuming yolk-free egg substitute equivalent to 10 eggs per week [n = 25], and (3) Control Group (C) [n = 26]. At week 35, IGF-1 levels in WE significantly increased (66.6 ± 27.7 ng/mL, p < 0.05) compared to C, with positive SCFA correlations, except acetate. Acetate was stable in WE, increasing in PS and C. Significant propionate differences occurred between WE and PS (14.8 ± 5.6 μmol/L, p = 0.010). WE exhibited notable changes in the relative abundance of the Bifidobacterium and Prevotella genera. Strong positive SCFA correlations were observed with MAT-CR-H4-C10 and Libanicoccus, while Roseburia, Terrisporobacter, Clostridia_UCG-014, and Coprococcus showed negative correlations. In conclusion, whole egg supplementation improves growth factors that may be related to bone formation and growth; it may also promote benefits to gut microbiota but may not affect SCFAs.
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Affiliation(s)
- Sophida Suta
- Siriraj Population Health and Nutrition Research Group, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; (S.S.); (S.O.); (T.M.); (A.S.); (T.P.); (S.P.); (P.M.); (B.P.)
| | - Suphawan Ophakas
- Siriraj Population Health and Nutrition Research Group, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; (S.S.); (S.O.); (T.M.); (A.S.); (T.P.); (S.P.); (P.M.); (B.P.)
| | - Thamonwan Manosan
- Siriraj Population Health and Nutrition Research Group, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; (S.S.); (S.O.); (T.M.); (A.S.); (T.P.); (S.P.); (P.M.); (B.P.)
| | - Orranich Honwichit
- Department of Food Science and Technology, Faculty of Agro-Industry, Kasetsart University, Bangkok 10900, Thailand; (O.H.); (S.C.)
| | - Suvimol Charoensiddhi
- Department of Food Science and Technology, Faculty of Agro-Industry, Kasetsart University, Bangkok 10900, Thailand; (O.H.); (S.C.)
| | - Apinya Surawit
- Siriraj Population Health and Nutrition Research Group, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; (S.S.); (S.O.); (T.M.); (A.S.); (T.P.); (S.P.); (P.M.); (B.P.)
| | - Tanyaporn Pongkunakorn
- Siriraj Population Health and Nutrition Research Group, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; (S.S.); (S.O.); (T.M.); (A.S.); (T.P.); (S.P.); (P.M.); (B.P.)
| | - Sureeporn Pumeiam
- Siriraj Population Health and Nutrition Research Group, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; (S.S.); (S.O.); (T.M.); (A.S.); (T.P.); (S.P.); (P.M.); (B.P.)
| | - Pichanun Mongkolsucharitkul
- Siriraj Population Health and Nutrition Research Group, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; (S.S.); (S.O.); (T.M.); (A.S.); (T.P.); (S.P.); (P.M.); (B.P.)
| | - Bonggochpass Pinsawas
- Siriraj Population Health and Nutrition Research Group, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; (S.S.); (S.O.); (T.M.); (A.S.); (T.P.); (S.P.); (P.M.); (B.P.)
| | - Sawannee Sutheeworapong
- Systems Biology and Bioinformatics Research Unit, Pilot Plant Development and Training Institute, King Mongkut’s University of Technology Thonburi, Bangkok 10140, Thailand;
| | - Patcha Puangsombat
- Metabolomics and Systems Biology, Department of Biochemistry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; (P.P.); (S.K.)
| | - Sakda Khoomrung
- Metabolomics and Systems Biology, Department of Biochemistry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; (P.P.); (S.K.)
- Siriraj Metabolomics and Phenomics Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Korapat Mayurasakorn
- Siriraj Population Health and Nutrition Research Group, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; (S.S.); (S.O.); (T.M.); (A.S.); (T.P.); (S.P.); (P.M.); (B.P.)
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Pongkunakorn T, Manosan T, Surawit A, Ophakas S, Mongkolsucharitkul P, Pumeiam S, Suta S, Pinsawas B, Sookrung N, Saelim N, Mahasongkram K, Prangtaworn P, Tungtrongchitr A, Tangjittipokin W, Mangmee S, Boonnak K, Narkdontri T, Teerawattanapong N, Wanitphadeedecha R, Mayurasakorn K. Immune Response after SARS-CoV-2 Infection with Residual Post-COVID Symptoms. Vaccines (Basel) 2023; 11:1413. [PMID: 37766091 PMCID: PMC10535557 DOI: 10.3390/vaccines11091413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 08/17/2023] [Accepted: 08/21/2023] [Indexed: 09/29/2023] Open
Abstract
Many patients develop post-acute COVID syndrome (long COVID (LC)). We compared the immune response of LC and individuals with post-COVID full recovery (HC) during the Omicron pandemic. Two hundred ninety-two patients with confirmed COVID infections from January to May 2022 were enrolled. We observed anti-SARS-CoV-2 receptor-binding domain immunoglobulin G, surrogate virus neutralization test, T cell subsets, and neutralizing antibodies against Wuhan, BA.1, and BA.5 viruses (NeuT). NeuT was markedly reduced against BA.1 and BA.5 in HC and LC groups, while antibodies were more sustained with three doses and an updated booster shot than ≤2-dose vaccinations. The viral neutralization ability declined at >84-days after COVID-19 onset (PC) in both groups. PD1-expressed central and effector memory CD4+ T cells, and central memory CD8+ T cells were reduced in the first months PC in LC. Therefore, booster vaccines may be required sooner after the most recent infection to rescue T cell function for people with symptomatic LC.
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Affiliation(s)
- Tanyaporn Pongkunakorn
- Siriraj Population Health and Nutrition Research Group, Research Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; (T.P.); (T.M.); (A.S.); (S.O.); (P.M.); (S.P.); (S.S.); (B.P.)
| | - Thamonwan Manosan
- Siriraj Population Health and Nutrition Research Group, Research Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; (T.P.); (T.M.); (A.S.); (S.O.); (P.M.); (S.P.); (S.S.); (B.P.)
| | - Apinya Surawit
- Siriraj Population Health and Nutrition Research Group, Research Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; (T.P.); (T.M.); (A.S.); (S.O.); (P.M.); (S.P.); (S.S.); (B.P.)
| | - Suphawan Ophakas
- Siriraj Population Health and Nutrition Research Group, Research Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; (T.P.); (T.M.); (A.S.); (S.O.); (P.M.); (S.P.); (S.S.); (B.P.)
| | - Pichanun Mongkolsucharitkul
- Siriraj Population Health and Nutrition Research Group, Research Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; (T.P.); (T.M.); (A.S.); (S.O.); (P.M.); (S.P.); (S.S.); (B.P.)
| | - Sureeporn Pumeiam
- Siriraj Population Health and Nutrition Research Group, Research Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; (T.P.); (T.M.); (A.S.); (S.O.); (P.M.); (S.P.); (S.S.); (B.P.)
| | - Sophida Suta
- Siriraj Population Health and Nutrition Research Group, Research Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; (T.P.); (T.M.); (A.S.); (S.O.); (P.M.); (S.P.); (S.S.); (B.P.)
| | - Bonggochpass Pinsawas
- Siriraj Population Health and Nutrition Research Group, Research Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; (T.P.); (T.M.); (A.S.); (S.O.); (P.M.); (S.P.); (S.S.); (B.P.)
| | - Nitat Sookrung
- Center of Research Excellence on Therapeutic Proteins and Antibody Engineering, Department of Parasitology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; (N.S.); (N.S.); (K.M.); (P.P.); (A.T.)
| | - Nawannaporn Saelim
- Center of Research Excellence on Therapeutic Proteins and Antibody Engineering, Department of Parasitology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; (N.S.); (N.S.); (K.M.); (P.P.); (A.T.)
| | - Kodchakorn Mahasongkram
- Center of Research Excellence on Therapeutic Proteins and Antibody Engineering, Department of Parasitology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; (N.S.); (N.S.); (K.M.); (P.P.); (A.T.)
| | - Pannathee Prangtaworn
- Center of Research Excellence on Therapeutic Proteins and Antibody Engineering, Department of Parasitology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; (N.S.); (N.S.); (K.M.); (P.P.); (A.T.)
| | - Anchalee Tungtrongchitr
- Center of Research Excellence on Therapeutic Proteins and Antibody Engineering, Department of Parasitology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; (N.S.); (N.S.); (K.M.); (P.P.); (A.T.)
| | - Watip Tangjittipokin
- Department of Immunology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; (W.T.); (S.M.); (K.B.)
| | - Suthee Mangmee
- Department of Immunology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; (W.T.); (S.M.); (K.B.)
| | - Kobporn Boonnak
- Department of Immunology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; (W.T.); (S.M.); (K.B.)
| | - Tassanee Narkdontri
- Research Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; (T.N.); (N.T.)
| | - Nipaporn Teerawattanapong
- Research Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; (T.N.); (N.T.)
| | - Rungsima Wanitphadeedecha
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand;
| | - Korapat Mayurasakorn
- Siriraj Population Health and Nutrition Research Group, Research Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; (T.P.); (T.M.); (A.S.); (S.O.); (P.M.); (S.P.); (S.S.); (B.P.)
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Suta S, Surawit A, Mongkolsucharitkul P, Pinsawas B, Manosan T, Ophakas S, Pongkunakorn T, Pumeiam S, Sranacharoenpong K, Sutheeworapong S, Poungsombat P, Khoomrung S, Akarasereenont P, Thaipisuttikul I, Suktitipat B, Mayurasakorn K. Prolonged Egg Supplement Advances Growing Child's Growth and Gut Microbiota. Nutrients 2023; 15:nu15051143. [PMID: 36904143 PMCID: PMC10005095 DOI: 10.3390/nu15051143] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 02/20/2023] [Accepted: 02/22/2023] [Indexed: 03/12/2023] Open
Abstract
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.
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Affiliation(s)
- Sophida Suta
- Population Health and Nutrition Research Group, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Apinya Surawit
- Population Health and Nutrition Research Group, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Pichanun Mongkolsucharitkul
- Population Health and Nutrition Research Group, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Bonggochpass Pinsawas
- Population Health and Nutrition Research Group, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Thamonwan Manosan
- Population Health and Nutrition Research Group, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Suphawan Ophakas
- Population Health and Nutrition Research Group, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Tanyaporn Pongkunakorn
- Population Health and Nutrition Research Group, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Sureeporn Pumeiam
- Population Health and Nutrition Research Group, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | | | - Sawannee Sutheeworapong
- Systems Biology and Bioinformatics Research Unit, Pilot Plant Development and Training Institute, King Mongkut’s University of Technology Thonburi, Bangkok 10140, Thailand
| | - Patcha Poungsombat
- Metabolomics and Systems Biology, Department of Biochemistry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Sakda Khoomrung
- Metabolomics and Systems Biology, Department of Biochemistry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
- Siriraj Metabolomics and Phenomics Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Pravit Akarasereenont
- Department of Pharmacology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Iyarit Thaipisuttikul
- Department of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Bhoom Suktitipat
- Department of Biochemistry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Korapat Mayurasakorn
- Population Health and Nutrition Research Group, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
- Correspondence: ; Tel.: +66-9-4189-3266
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Nirdnoy N, Sranacharoenpong K, Surawit A, Pinsawas B, Mongkolsucharitkul P, Pongkunakorn T, Manosan T, Ophakas S, Suta S, Pumeiam S, Mayurasakorn K. Validation of a Thai semiquantitative food frequency questionnaire (semi-FFQ) for people at risk of metabolic syndrome. J Health Popul Nutr 2023; 42:13. [PMID: 36814306 PMCID: PMC9948462 DOI: 10.1186/s41043-023-00353-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 02/10/2023] [Indexed: 06/18/2023]
Abstract
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.
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Affiliation(s)
- Nattvara Nirdnoy
- Institute of Nutrition, Mahidol University, 999 Phuttamonthon 4 Road, Salaya, Phuttamonthon, Nakhon Pathom, 73130, Thailand
| | - Kitti Sranacharoenpong
- Institute of Nutrition, Mahidol University, 999 Phuttamonthon 4 Road, Salaya, Phuttamonthon, Nakhon Pathom, 73130, Thailand
| | - Apinya Surawit
- Population Health and Nutrition Research Group, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Siriraj, Bangkoknoi, Bangkok, 10700, Thailand
| | - Bonggochpass Pinsawas
- Population Health and Nutrition Research Group, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Siriraj, Bangkoknoi, Bangkok, 10700, Thailand
| | - Pichanun Mongkolsucharitkul
- Population Health and Nutrition Research Group, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Siriraj, Bangkoknoi, Bangkok, 10700, Thailand
| | - Tanyaporn Pongkunakorn
- Population Health and Nutrition Research Group, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Siriraj, Bangkoknoi, Bangkok, 10700, Thailand
| | - Thamonwan Manosan
- Population Health and Nutrition Research Group, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Siriraj, Bangkoknoi, Bangkok, 10700, Thailand
| | - Suphawan Ophakas
- Population Health and Nutrition Research Group, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Siriraj, Bangkoknoi, Bangkok, 10700, Thailand
| | - Sophida Suta
- Population Health and Nutrition Research Group, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Siriraj, Bangkoknoi, Bangkok, 10700, Thailand
| | - Sureeporn Pumeiam
- Population Health and Nutrition Research Group, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Siriraj, Bangkoknoi, Bangkok, 10700, Thailand
| | - Korapat Mayurasakorn
- Population Health and Nutrition Research Group, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Siriraj, Bangkoknoi, Bangkok, 10700, Thailand.
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Pinsawas B, Mongkolsucharitkul P, Suta S, Pumeiam S, Sranacharoenpong K, Mayurasakorn K. A Healthy Asian Ketogenic Diet, Regardless of Dietary Cholesterol Intake Improves Metabolic Parameters in Individuals With Metabolic Syndrome. Curr Dev Nutr 2022. [DOI: 10.1093/cdn/nzac065.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
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 < 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 < 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 < 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 < 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 < 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.
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Affiliation(s)
| | | | - Sophida Suta
- Mahidol University, Faculty of Medicine Siriraj Hospital
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Suta S, Khoomrung S, Manosan T, Mayurasakorn K, Mongkolsucharitkul P, Ophakas S, Phuangsombut P, Pinsawas B, Pongkunakorn T, Sranacharoenpong K, Surawit A. Long Term Whole Egg, but Not Egg White Supplementation Promotes Growth and Bifidobacteria and Lachnospira Without Increasing LDL-Cholesterol in Primary School Children. Curr Dev Nutr 2022. [PMCID: PMC9194010 DOI: 10.1093/cdn/nzac065.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
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 < 0.001 and 5.11 ± 0.92 cm, P < 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 < 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.
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Affiliation(s)
- Sophida Suta
- Population Health and Nutrition Research Group, Siriraj Medical Research Center, Mahidol University
| | - Sakda Khoomrung
- Mahidol University, Department of Biochemistry, Faculty of Medicine Siriraj Hospital
| | - Thamonwan Manosan
- Population Health and Nutrition Research Group, Siriraj Medical Research Center, Mahidol University
| | - Korapat Mayurasakorn
- Population Health and Nutrition Research Group, Siriraj Medical Research Center, Mahidol University
| | | | - Suphawan Ophakas
- Population Health and Nutrition Research Group, Siriraj Medical Research Center, Mahidol University
| | | | - Bonggochpass Pinsawas
- Population Health and Nutrition Research Group, Siriraj Medical Research Center, Mahidol University
| | - Tanyaporn Pongkunakorn
- Population Health and Nutrition Research Group, Siriraj Medical Research Center, Mahidol University
| | | | - Apinya Surawit
- Population Health and Nutrition Research Group, Siriraj Medical Research Center, Mahidol University
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Nirdnoy N, Sranacharoenpong K, Mayurasakorn K, Surawit A, Pinsawas B, Mongkolsucharitkul P, Pongkunakorn T, Suta S. Development of the Thai semiquantitative food frequency questionnaire (semi-FFQ) for people at risk for metabolic syndrome. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-020-01444-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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