Nutrient Intake of Working Women in Bangkok, Thailand, As Studied by Total Food Duplicate Method
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European Journal of Clinical Nutrition (2000) 54, 187±194 ß 2000 Macmillan Publishers Ltd All rights reserved 0954±3007/00 $15.00 www.nature.com/ejcn Nutrient intake of working women in Bangkok, Thailand, as studied by total food duplicate method N Matsuda-Inoguchi1, S Shimbo2, Z-W Zhang2, S Srianujata3,4, O Banjong4, C Chitchumroonchokchai4, T Watanabe5, H Nakatsuka1, K Higashikawa6 and M Ikeda6* 1Miyagi University, Taiwa-cho 981 ± 3298, Japan; 2Department of Food and Nutrition, Kyoto Women's University, Kyoto 605 ± 8501, Japan; 3Research Center, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand; 4Institute of Nutrition, Mahidol University, Salaya, Phuthamonthon, Nakhonpathom 73170, Thailand; 5Miyagi University of Education, Sendai 980 ± 0845, Japan; and 6Kyoto Industrial Health Association, Kyoto 604 ± 8472, Japan Objectives: To establish a general view of food habits in Thailand, and to make a quantitative assessment of rice dependency of Thai people. Design: Cross-sectional study. Setting: Community. Subjects: 52 non-smoking and non-habitually drinking adult women in Bangkok participated in the study. Methods: The participants offered 24 h food duplicates and peripheral blood samples, and underwent clinical examination including anthropometry. The duplicates were subjected to nutritional evaluation taking advantage of the Thai food composition tables (FCTs), and analyzed for eight nutrient elements by inductively coupled plasma mass spectrometry (ICP-MS). Results: The participants took 1630 kcal from 55 g protein (63% from animal sources), 57 g lipid (mostly from vegetable oil), and 224 g carbohydrate (60% from rice) daily. Nutrient intake at lunch was as large as that at dinner. About a half of the women had insuf®cient energy intake (ie < 80% RDA) whereas 4% had an excess ( > 120%). Protein intake was suf®cient in most cases, whereas lipid intake was in excess in more than a half of the women. Ca, Fe, Mg, Zn and possibly P intakes were below the RDA values in many participants. FCT-based estimates agreed well with the ICP-MS measures in cases of Fe and Ca but tended to be greater than the measures by 50% with regard to P. Conclusions: Lunch as substantial as dinner for Thai urbanites. There was a marked dependency on rice as an energy source. Whereas protein intake is generally suf®cient, the intake of Ca (and to a lesser extent Fe) was insuf®cient in a majority of the study participants. Sponsorship: Dai-ichi Mutual Life Insurance, Japan; the Ministry of Health and Welfare, the government of Japan. Descriptors: Bangkok; food composition tables; ICP-MS; mineral insuf®ciency; rice; women European Journal of Clinical Nutrition (2000) 54, 187±194 Introduction This study group has conducted nutritional studies on rice-dependant populations in Asia (Shimbo et al, 1996a, b, Insuf®cient intakes of nutrient minerals, calcium and iron 1997; Moon et al, 1997; Zhang et al, 1997a). The present in particular, are common problems in many Asian coun- paper describes the current nutritional status of working tries, eg, Japan, Korea, etc. (Shimbo et al, 1996a, b, 1997; women in Bangkok, the capital city of Thailand. The focus Yamada et al, 1996; Moon et al, 1997; Zhang et al, 1997a), of attention is to obtain an overall view of food habits of where people are not accustomed to take milk or organ Thai people, including a quantitative assessment of rice meats (such as liver and kidney). In parallel with historical dependency (Shimbo et al, 1997). An additional focus of de®ciency issues, new problems associated with excess interest is to examine the accuracy of food composition food intake such as obesity have also been gradually table-based estimation of nutrient element intake (Shimbo emerging in Asia after modernization and economic et al, 1998; Zhang et al, 1998). Although small in survey growth (INCLEN Multicentre Collaborative Group, 1992; scale, information obtained in this survey will offer a sound Mo-suwan et al, 1993). scienti®c basis for designing a nationwide nutritional survey, which is yet to be carried out by the authorities *Correspondence: M Ikeda, Kyoto Industrial Health Association, 67 Nishinokyo-Kitatsuboicho, Nakagyo-ku, Kyoto 604 ± 8472, Japan. in Thailand. Guarantor: M Ikeda Contributors: M Ikeda designed the study and drafted the paper. S Srianujata, O Banjong and C Chitchumroonchokchai took full Materials and methods responsibility for sample collection. N Matsuda-Inoguchi made nutritional analysis and evaluation with support of H Nakatsuka. Z-W Zhang and Donors of food duplicates and blood samples T Watanabe analyzed materials for elements. S Shimbo was responsible This study was carried out in February, 1998, in a period for clinical evaluation. K Higashikawa made statistical analysis including when there were no social events. Non-smoking and non- table preparation. Most of the contributors worked together in the ®eld survey, and all of them reviewed the paper. habitually drinking women staff of a large non-clinical Received 4 January 1999; revised 7 September 1999; accepted 14 health sciences institution (located just outside of the city September 1999 of Bangkok) were invited to participate in the study, and 52 Nutrient intake of working women in Bangkok N Matsuda-Inoguchi et al 188 women accepted the invitation. The participants were fully Nutritional evaluation informed of the study objectives and were asked (a) to Following an established protocol (Shimbo et al, 1996a, b; have a clinical interview (on current health condition, Moon et al, 1997; Qu et al, 1997; Zhang et al, 1997a; past history of major diseases, social habits of smoking Nakatsuka et al, 1998), food items in each food duplicate and drinking, and marital status), (b) to have a health sample were manually isolated under supervision of a examination (as to be detailed below), and (c) to offer a veteran Thai nutritionist in this study group (OB), and the 24 h duplicate of food together with a menu record. weight of individual item was measured and recorded. Each food item was then coded by the nutritionist in accordance with Thai food composition tables (Institute of Nutrition, Health examination Mahidol University, 1997). Nutrient components in each Health examination was conducted in the morning (without food item were estimated taking advantage of the food fasting), and included measurements of height, weight and composition tables (Institute of Nutrition, Mahidol Uni- blood pressure, together with sampling of blood and spot versity, 1997). The data on nutrient minerals were supple- urine, as previously described in detail (Zhang et al, 1997b; mented by ICP-MS determination (see below). Nakatsuka et al, 1998). The items in clinical hematology, Evaluation of the nutrient intakes was made after the serum biochemistry, etc. were also previously detailed recommended dietary allowances (RDA) for Thai (Com- (Nakatsuka et al, 1998). mittee on RDA, Department of Health, Ministry of Public Body weight was measured clothed and without shoes, Health, the Government of Thailand, 1989). The RDAs for and the measure was corrected for the weight of the clothes adult healthy women with moderate physical exercise are by subtracting 1 kg, so that quoted in Table 1; the intake of 80 ± 120% RDA was tentatively considered as acceptable [ie, insuf®cient when Body mass index BMIweight kg1=height m2 < 80% RDA and in excess when > 120% RDA (Shimbo et al, 1996a, b; Moon et al, 1997; Qu et al, 1997; Zhang et al, 1997b; Nakatsuka et al, 1998)]. A criterion of 30% for the A woman was considered to be overweight when her BMI ratio of lipid-based energy over total energy (Committee on was 25 or greater (INCLEN Multicentre Collaborative Diet and Health, US National Research Council, 1989) was Group, 1992; Department of Health, the Government of taken as the upper acceptable limit for Thai women. Thailand, 1998; Nakatsuka et al, 1998). Instrumental analysis for nutrient elements Food duplicate collection Each food duplicate, after homogenization and wet-ashing Procedures for collection of 24 h total food duplicates (Watanabe et al, 1982), was subjected to determination of (Acheson et al, 1980) and menu records have been detailed eight nutrient elements of calcium (Ca), copper (Cu), iron previously (Shimbo et al, 1996a, b; Moon et al, 1997; Qu (Fe), magnesium (Mg), sodium (Na), potassium (K), phos- et al, 1997; Zhang et al, 1997a; Nakatsuka et al, 1998); phorus (P) and zinc (Zn) by inductively coupled plasma donors were carefully instructed to prepare and collect mass spectrometry (ICP-MS) (Shimbo et al, 1998; Zhang everyday foods and no special dishes. et al, 1997b, 1998). Table 1 Recommended dietary allowances for Thai women by age range Age range (y) Nutrient (Unit=day) 16 ± 19 20 ± 29 30 ± 39 40 ± 49 50 ± 59 60 Energy (kcal) 1850 2000 2000 2000 2000 1850 Protein (g) 45 44 44 44 44 44 Minerals calcium (mg) 1200 800 800 800 800 800 iron (mg) 15 15 15 15 10 10 magnesium (mg) 400 300 300 300 300 300 phosphorus (mg) 1200 800 800 800 800 800 zinc (mg) 15 15 15 15 15 15 Vitamins vitamin A (mgREa) 600 600 600 600 600 600 vitamin B1 (mg) 1.1 1.0 1.0 1.0 1.0 1.0 vitamin B2 (mg) 1.3 1.2 1.2 1.2 1.2 1.2 vitamin B6 (mg) 2.0 2.0 2.0 2.0 2.0 2.0 vitamin B12 (mg) 2.0 2.0 2.0 2.0 2.0 2.0 niacin (mg) 14 13 13 13 13 13 vitamin C (mg) 60 60 60 60 60 60 vitamin D (mg) 10 7.5 5 5 5 5 vitamin E (a-TE mgb)888888 folate (mg) 145 150 150 150 150 150 Body weightc (kg) 48 50 50 50 50 50 Cited from Committee on RDA, Department of Health, Ministry of Public Health, the government of Thailand (1989): RDAs are given by sex and age range.