In the present study, we investigated nutritional status and health-related factors in a multistage cluster sample of 3119 Thai urban and rural children aged 0·5-12·9 years. In a subsample, blood samples were collected for the measurement of Hb, transferrin receptor, vitamin A and vitamin D concentrations. The prevalence of stunting and underweight was higher in rural children than in urban children, whereas the wasting rate was similar in both rural and urban areas. Among children aged 3·0 -5·9 years, the prevalence of overweight was significantly higher in urban areas than in rural areas and so was the obesity rate in children aged 6·0 -12·9 years. Protein intakes of all age groups were relatively high in both the areas. Intakes of Ca, Fe, Zn and vitamin C were significantly higher in urban areas than in rural areas. The prevalence of anaemia in rural areas was twice as high as that in urban areas, particularly in infants and young children. However, the prevalence of Fe-deficiency anaemia was similar in both urban and rural areas. While the prevalence of vitamin A deficiency (by serum retinol cut-off ,0·7 mmol/l) seemed to be very low, vitamin A insufficiency (by serum retinol cut-off , 1·05 mmol/l) was more prevalent (29·4 -31·7 %) in both the areas. The prevalence of vitamin D insufficiency ranged between 27·7 and 45·6 % among the children. The present study indicates that the double burden of malnutrition is still a major public health problem in Thailand. Further studies need to explore the associated risk factors for these nutrient deficiencies. Effective strategies and actions are needed to tackle the nutritional problems in Thai children.
The study investigated the association between breakfast types consumed, daily energy intake, and body mass index for age Z-score (BAZ). Cross-sectional data from 1258 children aged 7 to 12.9 years were analyzed for breakfast type, nutrient intakes, BAZ, and proportion of overweight or obesity. Analysis of covariance was used to compare energy and nutrient intakes, BAZ, and proportion of overweight/obese children between breakfast groups. Only 19% of children had adequate energy intake from breakfast. Those consuming snacks had a significantly lower BAZ (Z = -0.73), with 5% of them being overweight/obese. Those consuming beverages and desserts had the lowest total daily energy intake (1314 kcal) and lowest protein intake (8.4 g). The results suggest that breakfast type is associated with daily energy intake and BAZ. Most breakfasts are not adequate. School-based nutrition education programs involving families, teachers, and health professionals can contribute to improve this situation.
An emerging evidence suggests that dietary calcium may play a role in the regulation of body weight in humans. This study examined the relationship of calcium intake with body mass index and body fatness in Thai children. Methods: A cross-sectional study in 1570, 6 -12 year-old children were conducted in representative provinces of Thailand. Body weight, height, sitting height and 4 sites skinfolds thickness were measured as well as the dietary intake using a 24 h recall and a food frequency questionnaire (FFQ). General linear model (GLM) analysis was used to determine the effect of calcium intake on body mass index (BMI) and body fatness of children. Results: There were no differences in parental education and family's socio-economic status between genders. Girls had significantly greater sitting height (p = 0.035), sitting height to height ratio (p = 0.014) and sum of four skinfold thickness (p = 0.001) than boys. Mean calcium intake was lower in girls than in boys. GLM analysis demonstrated that lower calcium intake among children was associated with higher body weight, BMI and sum 4-skinfold thickness. Conclusion: Lower calcium intake is associated with higher BMI and body fatness of Thai children. Further studies need to determine the optimal calcium intake to prevent overweight and obesity in children.
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