Experimantal biology and medicine, 215:53-58
13. Thomas.G.N, Sai-Yin Ho, Edward D, Janus et al (2005). "77ze US National Cholesterol Education Programme Adult Treatment Panel HI (NCEP ATP HI) prevalence of the metabolic syndrome in
a Chinese population". Diabetes Re- '. search and Clinical Practice, 67: 251 -257 14. Van Dokkum W, Wezendonk B, Summary
Srikumar TS, Van den Heuvel EG (1999). Effect of nondigestible oligosac- charides on large-bowel funtions blood lipid concentrations and glucose absorp- tion in yong healthy male subjects. Eur J ClinNutr, 53 91):l-7
15. WHO/IASO/IOTF (2000). The Asia- Pacific perspective: redefining obesity and its treatment. Health Communications Australia: Melbourne
EFFICACY OF POLYDEXTROSE SUPPLEMENTATION ON OVERWEIGHT/OBE- SITY AND LIPIDDEMIA DISORDER IN MILLITARY OFFICERS IN HANOI Objectives: To evaluate the efficacy of polydextrose supplementation on improving overweight- obesity and lipidemia disorder. Methods: a community-based control randomized trial in 108 mil- itary officers, one group used 20g of Vitanl (20g polydextrose) per day and the other used placebo.
Results: After intervention, mean weights of both groups were lower than those at the start, but the intervention group's was lower than that of the control one (p <0.05); Mean BMI, waist and hip circumference, % body fat of both intervention and control group were reduced (p <0.05), but it is at a higher rate in the intervention group than the control; cholesterol, triglycerides, LDL-C was reduced compared to baseline and compared to control group (p <0.05), while HDL-C con- centrations increased (p <0.05); The pliability of fecal was also improved and the ease of bowel movement increased in the intervention more than in the control group (p <0.01). Conclusion:
Supplementation of 20g polydextrose/day in 4 months has been found to improve anthropometry indices, blood biochemical indicators (total cholesterol, triglycerides, HDL-C, LDL-C, glucose) and the pliability of fecal.
'K.tyviorAs: polydextrose, overweight-obesity, lipidemia, military officer
HIEU QUA GIAM ROI LOAN LIPID MAU CUA VIEN LYCOPEN - VI CHAT DINH DUCING
Nguyen Thi Hong Minh', Nguyen Thi Ldm\ Phiing Thi Lien^
Nghien ciiu dugc tien hanh tren 110 ST quan Bg Tu lenh Bg dgi Bien phong d6ng bi thira can beo phi (BMI >=23), c6 rdi loan lipid mau, tu6i tir 30 - 59 tren dia ban Thanh ph6 Ha Ngi. Muc tieu:
danh gia hieu luc cua vien lyeopen - vi chat dinh dudng trong giam roi loan lipid mau. Phuang phap: Thu nghiem cdng dong tmdc sau co doi chiing trong 12 tuin. Nh6m can thiep dugc uong vien lyeopen - vi chat dinh dudng 2 vien/ngay/12 tuan. Nhom chiing dugc u6ng vien gia dugc 2 ' Ths, KS - Vien Dinh dirong
^ PGS, TS - Vien Dinh duang
^ Ths - .Bs - Vien Dinh duo'ng
vien/ngay/ 12 tuan. Ket qua: tinh trang roi loan lipit mau cua nhom sir dung ch6 ph§m lyeopen - vi chat dinh dudng da giam mgt each c6 y nghia hon so vdi nh6m sir dung ch6 phim vien gia dugc. Ca ba thanh phan Cholesterol TP, LDL - C, triglycerid ciia nh6m thir nghiem can thiep dSu thip hon nhom chirng mgt each co y nghia (p< 0,05), dong thdi ham lugng HDL - C va lyeopen huyet thanh cua nh6m can thiep ciing cao hon ro ret so vdi nh6m chirng (p< 0,01). Hieu luc cua vien lyeopen - vi chit dinh dudng deu cao hon so vdi nhom chimg: Cholesterol toan phin (12,8%);
LDL-cholesterol (15,38%), Triglycerid (>2,3 mmol/L) la 6,06 % va HDL- cholesterol (<0,9mmol/L) la 5,22%. Ti so VE/VM va % md ca the giam mgt each c6 y nghia thSng ke. Hieu lire can thiep the hien ro nhat d chi tieu ty Ie % md eo the (16,15%).
Tir khoa: Vien lyeopen — vi chdt dinh du&ng, vien gid dugc, roi logn lipid mdu, BMI, khdu phdn I. D A T VAN D E
Beo phi 11 mgt thlch thuc ve siic khde lo ngai nhlt cua the ky 21, nd lien quan den cli chgt ciia 100.000 - 400.000 ngudi va tieu tdn cua xa hdi khoang 117 ty USD trong mdi nim [1]. Theo sd lieu thdng ke cua WHO d 84 nudc tir nam 1999-2000 da cho thay : chi rieng ty le beo phi (BMI
> 30) 11 8,7%. Dgn nam 2005, tren toln the gidi cd vao khoing 1,6 ty ngudi trudng thinh bi thua can, trong dd cd 700 trieu ngudi bi beo phi [2].
Tdng dieu tra dinh dudng cua Vien Dinh Dudng Qudc Gia ( 2000) tren 7.686 hg gia dinh tren pham vi ca nudc nhan thay:
d nhdm tudi 20 - 24 tudi, ty le thua can tinng binh la 1,8% (nam 1,8%, nu 1,8%).
Nhdm tudi 30 - 33, ty le thira can 114,4%) ( nam 2,9%, nu 5,8% ). Nhdm hidi 40 - 44, ty le thua can la 6,3 % (nam 4,5%), nu 7,9 %). Nhdm tudi 50 - 54, ty le thua can 11 9,0 % ( nam 6,9%, nQ 10,8%). Xu hudng thua cin d Viet Nam cung nhu mgt sd nudc dang phit trien, gap nhiSu d dd thi ban ndng thdn. Theo Tran Dinh Toln (2003) [9],
Rdi loan lipid mlu: ting cholesterol mlu, ting triglyceride, gilm HDL, tang LDL, tang ty le LDL/HDL. Thudng thiy rdi
loan lipid mlu d hau bet cic benh nhan beo phi vdi tich IQy md trong d bung vl thudng cd lien quan vdi ting nguy co cic benh tim mach. Nhieu nghien ciin tren cic sd lieu trong cic benh vien deu cho thay: d cic benh nhin dii thio dudng, tang HA, benh tim mach, tai bien mach mlu nao deu cd mdi lien quan chat che tdi tinh tiang rdi loan lipid mlu cQng nhu thua can beo phi.
Hien nay cic bien phip can thiep de gilm tinh trang rdi loan lipid mlu tren nhiing ngudi trudng thanh bi thua cin beo phi cd rat nhieu. Ngoli cic che do In hgp ly, che do an thay the ket hgp van ddng the luc thudng xuyen v l su dung cic thude tdng hgp theo phuang phip hda hgc, hole cd ngudn gdc tii dugc lieu. Trong sd do, Dau gac v l Lyeopen la mdt trien vgng ldn.
Trudc tinh hinh gia ting cua thuc trang thua can beo phi kem theo rdi loan lipid mlu, viec dinh gil tinh trang thua cin beo phi v l hieu qui cic bien phip can thiep len rdi loan lipid mlu cd y nghTa rit ldn ddi vdi cdng ddng trong viec ban che nhQng nii ro, thiet hai ve siic khde vl kinh te. Vi vay, chung tdi thuc hien &h tii niy vdi muc tieu :
Ddnh gid hieu qud cua vien lyeopen - vi chdt dinh du&ng tren si quan co roi logn lipid mdu.
I I : D O I T i r O N G VA P H t T O N G P H A P NGHlfeN ClTU
l.Doi tu'O'ng nghien ciru.
ST quan bi thua can beo phi, cd rdi loan lipid mlu, mdi tir 30 - 59.
Tieu chudn Iwa chgn doi tuffng:
- T u d i t u ' 3 0 - 5 9 ; BMI >=23
- Cd rdi loan lipid mlu (dyslipidaemias), theo phin loai Hgi Tim mach Viet Nam (2006) [12]:
Cholesterol huyk thanh tdng so >=5,2 mmol/L (200mg/dL)
Hole Triglycerid huy§t thaiih>2,26 mmoI/L (200mg/dL)
Hole HDL - C huyk thanh<=0,9 mmol/L (35mg/dL)
Hole LDL - C huyet thanh > 3,38 mmoI/L ( 130mg/dL)
- Khdng cd dj tat, khdng cd tien sii mac cic benh min tinh ( lao, benh gan, dii thio dudng, tim mach, suy than).
- Huyet Ip tim thu < 160 mmHg, huygt Ip tim truang < 100 mmHg.
- Hien tai v l trong vdng 3 thing qua khdng tham gia bit ky chl do In kieng hole chuong trinh gilm can hole gilm rdi loan lipid mlu.
Th&i gian nghien cwu: 3 thing ( 6 - 9/2009)
2. Phu'O'ng p h a p nghien cihi.
C d m l u :
Su dung cdng thiic tinh cd mau sau (cdng thiic Kirkwood)
n = (Mi-Mif
n: so doi tuo'ng cho moi nhom do chinh xac 95% va luc mau 80%
Z].Q( ( 2-tailed) = 1,96; Z,_p ( 2-tailed) = 0,842 SD : do chenh lech chuan trung binh cua 2 nhom Pl - |i2 • trung binh khac biet truac va sau can thiep cua 2 nhom.
Sau khi d l tinh toln cho tit cl cic chi sd nghien cuu. cd mau Idn nhit 11 cd mlu tinh toln theo chi sd triglyceride huygt thanh:
SD cua triglyceride mlu = 0,6; 5 cua triglyceride mlu = 0,35
n= 2(1,96 + 0,842)2x(0.6)2 / (0,35)^, n= 46 Ty le bd cudc udc tinh = 10%
1
N= X n (f= ty Ie nd cudc du tinh);
1 - / • • •
n X 46 = 45 1 1-0,1
Du phdng bd cudc nghien ciin khoing 10%, nen cd mau cin cd n =110
3.Cac bien so, chi tieu va phuong phap, kl thuat thu thap so Heu.
Ddnh gid tinh trgng the Iwc vd dinh dwffng:
CIc bien sd: cin nang, chieu cao, chi sd BMI, vdng eo, vdng mdng, ty Ie vdng eo/
vdng mdng ( WHR), ty Ie % md ca the, huyet Ip.
Phwffng phdp thu thdp so lieu:
- Cdn : sii' dung cin SECA cua Nhlt Bin ( do chinh xlc 0,1 kg). Trgng lugng ca the dugc ghi theo kg vdi mdt sd Ie. Can ddi tugng v l budi sing khi chua In udng gi vl d l di dai tieu tien. Khi can chi mac quin lo ggn nlie nhlt v l tru bdt cin nang trung binh cua quin lo khi tinh k8t qui.
Ddi tugng diing giQa bin cin khdng cu dgng, mit nhin thing, trgng lugng phan bd deu c l hai chin. CIn dugc dat d vi tri dn dinh va blng phang.
- Do: do chieu cao dimg blng thude gd do Trung Qudc sin xuat, cd do chia chinh xlc tdi mihmet. Chieu cao dugc ghi theg cm v l mdt sd le. Khi do 2 chan ddi tugng khdng mang gily, gudc, dep, di chan khdng, dung quay lung vdi thude do, gdt chan, mdng, vai, dau theo mgt dudng thing Ip sit vio thude do dung, mit nhin thing theo mdt dudng thing nim ngang, hai tay thing theo hai ben minh. Ngudi do keo cli chin dau cua thude tu tren xudng, khi ap sit den dinh dau nhin vio thude dgc ket qui.
- Do ty lephdn trdm ma ca the: ty le phan tram md ca the dugc do dua tren nguyen ly do dien trd sinh hgc cua co the. Dugc thuc hien blng miy do % md OMRON cua Nhat, vdi ddc chinh xac 0,1%). Ty le md ca the cao khi ty Ie md > 30%) doi vdi nu v l > 25% ddi vdi nam.
- Do vdng eo vd vdng mong: do blng thude day khdng co gian, k8t qui ghi theo cm vdi mdt sd le. Vdng eo do d miic ngang rdn tuong iing vdi dilm giua cua bd dudi xuong sudn cudi vdi bd tren mio chau tren dudng nich giua. Vdng mdng do tai -vnung to nhat cua mdng. Vdng eo
>=90cm ddi vdi nam v l >=80 doi vdi nu thi dugc coi 11 beo bung, tieu chuin dinh gil: ty sd vdng eo/ vdng mdng (VE/VM), dugc coi 11 cao khi gil h:i niy > 0,8 ddi vdi nu v l 0,9 ddi vdi nam [4].
- Do huyet dp: ddi tugng nim ngay ngin tien giudng dugc do huyit Ip 2 lln cich nhau 2 phut tren cung cinh tay trii. Kit qui dugc ghi theo don vi mmHg. Sd do huyet Ip cua ddi tugng se dugc tinh 11 kit
qui tmng binh cua 2 lin do. Neu ket qui huyet Ip giua 2 lin do chenh lech nhau >
10 mmHg thi phii do lai lin thir 3. Dung cu su dung 11 miy do huyet Ip thuy ngan cua Nhat Bin.
- Ddnh gid tinh trgng thiea cdn, beo phi:
dinh gil blng chi sd khdi ca the (BMI - Body Mass Index), dugc tinli theo cong thiic sau:
CIn nang (kg) BMI =
( Chieu cao)- (m)
Ngudng dinh gil tinh tiang dinh dudng dua vio BMI, theo phan loai cua td chuc Y te The Gidi khu vuc Chau A Thii Binh Duang (IDI & WPRO, 2000) [4].
Danh gia tinh trang dinh dirong theo BMI Tinh trang dinh
dirong (IDl & WPRO, 2000)
Gay Binh thucmg
Thira can Tien beo phi Beo phi dp 1 Beo phi dp 2 Beo phi dp 3
Chi s6 BMI (kg/m2)
< 18,5 1 8 , 5 - 2 2 , 9
>23,0 23,0 - 24,9 2 5 , 0 - 2 9 , 9
30 - 34,9
>35,0
Khdu phdn: Dieu tra khau phan blng phuang phip hai ghi 24h qua. Cdng cu II bd clu hdi da dugc thu nghiem trudc khi trien khai. Sii dung blng quy ddi dugc chuin thiic tu trudc (Blng thinh phan thuc pham Viet Nam - Bd Y t l 2007) [11].
Ddng thdi tim hieu thdi quen tieu thu cic thuc phim giiu lipit v l mdt sd thdi quen In udng trong mdt sd benh khdng lay nhiim. Ning lugng va cic chit dinh dudng trong khiu phin cua cic sT quan dugc so sinh giQa hai nhdm vdi "nhu ciu khuyin nghi cho ngudi Viet Nam" [10]
- Khdm ldm sdng: CIc dau hieu llm sing dugc khim va ghi theo biiu mlu (phu luc pMeu kham sing Igc, philu dilu tra can thiep) Xet nghiem mau:
Lay mlu tTnh mach tai hai thdi diem To vl T3 de Iam cic xet nghiem dinh Iugng cholesterol toln phin, triglycerid, H D L - C, LDL - C, glucose.
3. To chuc can thiep Sdn phdm can thiep
- Vien lyeopen - vi chat dinh duong.
Thanh phin: Lyeopen, vitamn E, Vitamin B6, Vitamin B12, axit fohc.
STT 1 2 3 4 5
Thanh phan Vitamin E Vitamin B6 Vitamin B12
Acid folic Lyeopen
Dem vi/vien mg mg meg
mg mg
Ham lugng 5 0,8
1 0,18
5
Vien gia duac.
Thinh phin: DIu ninh tinh luyen vdi him lugng vitamin E 11 0,49 mg/ vien Hai loai che pham (vien lyeopen - vi chat dinh dudng, vien gia dugc) cd hinh ding, kich cd, mlu sic gidng bet nhau. Ca hai che phim dugc dung trong cung mdt loai Ig cd nhan mic nhu nhau. Tren mdi Ig cd din ten tung ddi tugng sao cho cic ddi tugng thugc nhdm can thiep se cd ten tren Ig che phim vien lyeopen - vi chat dudng, ddi tugng thugc nhdm chiing se cd ten tren Ig che phim vien gil dugc.
- Chl phim ddng Ig 100 vien, kem theo hudng din su' dung rd ring, chi tiet.
Phdn phoi vien lyeopen vd vien gid dwac
+ HIng thing cdng tic vien phit vien vl vien gil dugc cho cic ddi tugng theo timg don vi. Thdi gian phin phdi sin pbim can thiep: 2 ngly cudi cung blng thing.
So luang sdn phdm phdn phoi:
+ Nhdm can thiep: udng 180 vien lyeopen trong thdi gian 3 thing
2 vien/ngay x 30 ngly x 3 = 180 vien -I- Nhdm chiing: udng 180 vien gil dugc trong thdi gian 3 thing
2 vien/ngay x 30 ngly x 3 = 180 vien 4. Phan tich so lieu va khong che sai so:
- Sd lieu dugc llm sach trudc khi nhap vio miy vi tinh, cic sd lieu dieu tra dugc nhap bdi phan mem Epidata, va dugc xu ly bang chuang trinh SPSS 16.0 thuc hien tren miy vi tinh tai Trung tam thuc phim Dinh dudng - vien Dinh dudng.
- CIc tham sd chinh dugc tinh toln bao gdm tan xuat, trung binh, do lech chuin.
So sinh cic gia tri trung binh bang kiem dinh t - test, Anova - test.
* Ddnh gid hieu qud thw nghiem Dinh gil hieu qua cua giai doan thu nghiem lam sang tren cdng ddng cd ddi chiing qua chi sd hieu qui.
Cdng thiic tinh hieu qui can thiep:
H3 = H I - H 2 ; Trong dd:
H3: 11 hieu qua can thiep; HI: 11 chi sd bieu qui cua nhdm can thiep; H2: 11 chi sd hieu qui cua nhdm chung
Chi sd hieu qui cua nhdm chiing v l nhdm can thiep dugc tinh theo cdng thiic:
H = ( P j - P(,) X 100/P(j. Trong dd:
H: 11 hieu qui thu nghiem
P j : Ty le mic benh vio thdi diem bit diu trien khai
Pp: Ty le mac benh vio thdi diem cudi, ket thiic thu nghiem
III: KET QUA NGHIEN ClTU
1. Hieu qua vien lyeopen - vi chat dinh duong toi giam lipit mau
Bdng 1. Mot s6 chi s6 sinh hoa ciia hai nhom tru-ac thu- nghiem Nhom can thiep
(n=55) ±SD
Nhom chirng (n=55) ±SD
p (t-test) Cholesterol (mmol/1)
Triglycerid (mmol/1) HDL - C (mmol/1) L D L - C (mmol/1) Lyeopen (pmol/1)
5,98 ± 1,55 4,14 ±5,73 1,06 ±0,21 3,39 ± 1,13 0,19 ±0,04
5,79 ± 1,21 2,96 ±2,21 1,08 ±0,25 3,47 ± 1,40 0,19 ±0,04
p > 0,05 p > 0,05 p > 0,05 p > 0,05 p > 0,05
Ket qui cho thiy: trudc khi tiien khai nghien cuu thu nghiem, tinh trang lipit m l u cua hai nhdm ddi tugng 11 tuong duong nhau (p> 0,05).
Bdng 2. Mot so chi so sinh hoa ciia hai nhom sau thir nghiem
Cholesterol (mmol/1 Triglycerid (mmol/1) HDL - C (mmol/1) L D L - C (mmol/1) Lyeopen (|imol/l)
Nhom can thiep ± SD 5,34± 1,1 3,16±3,1 1,28 ± 0,29 2,98 ±0,97 1,42 ±0,76
Nhom chirng ± SD 5,89 ±0,97 : 2,95 ± 1,48 1,46 ±0,44 3,64 ± 1 , 1 0 0,18 ± 0 , 0 4
P, (t-test) p < 0,001
p < 0,05 p < 0,001
p < 0 , 0 1 p < 0,001 Tinh tiang lipit mlu cua hai nhdm
da cd sir thay ddi sau 12 tuan thu nghiem.
Nhdm su dung che pham lyeopen - vi chat dinh dudng cd nhieu bien ddi tich cue ve tinh trang lipit m l u ban so vdi nhdm su dung che pham vien gil dugc.
C l ba thinh phin Cholesterol TP, LDL -
Bang 3. Chi so hieu qua, hieu qua can thiep
C, triglycerid cua nhdm can thiep deu thip ban nhdm chiing mgt cich cd y nghTa (p< 0,05), ddng thdi h i m Iugng HDL - C v l lyeopen huyet thanh cua nhdm can thiep cQng cao hon rd ret so vdi nhdm chiing (p> 0,01)
Chi so lipids
Cholesterol TP (>5.2mmol/L) Triglycerid (>2.3 mmol/L) HDL_cholesterol (<0.9mmol/L) LDL_cholesterol (>3.38 mmol/L)
Thoi diem Tl T3 HO (%)
Tl T3 HO (%)
Tl T3 HO (%)
Tl T3 HO (%)
Nhom can thiep (n=55)
41,3 35,2 14,77
56,3 51,4 8,7 19,2 18,0 6,25 34,5 29,5 14,49
Nhom chii'ng (n=55)
40,6 39,8 1,97 56,7 55,2 2,65 19,4 19,2 1,03 33,9 34,8 -0,88
hieu qua (%) Can thiep
12,8
6,06
5,22
15,38
Hieu qui cua vien lyeopen - vi (15,38%). Nhdm chiing cQng cli thien chit dinli dudng d nhdmcan thiep diu cao lipit mlu nhung ty Ie thip ban nhdm can ban nhdm chiing, tuy nhien hieu qui thiep.
vican thiep rd nhit vdi chi sd Cholesterol 2. Tinh trang dinh duong toan phin (12,8%) v l LDL-choIesteroI
Bang 4. Tinh trang dinh du&ng cua hai nhom tru'oc va sau can thiep (Tl, T3)
BMI (kg/m2) Ty so (VE/VM)
% ma ca the
Nhom __ T l X ± S D 24, 2± 1,9*
0,91 ±0,05*
27,09± 4,02*
can thiep _ T3
;r±sD
23,6 ± 3 , 8 ' 0,88 ± 0,05 2 25,09± 4,02 3
Nhom _ T l X ± S D 24,1 ± 1 , 9 1 * 0,91 ±0,06*
27,9±4,1*
chiing
_ T3
ir±sD
24,0 ±2,12' 0,91 ±0,06^
27,8±4,1^
p (t - test)
p > 0,05 p > 0,05 p > 0,05
* su khac biet giira 2 nhom can thiep va nhom chimg a ' su khac biet giQa 2 nhom can thiep va nhom chimg
^ sir khac biet giira 2 nhom can thiep va nhom chimg
^ su khac biet giQa 2 nhom can thiep va nhom chung
Blng 4 cho thiy: Trudc khi trien khai nghien ciin thu nghiem, nhdm chiing va nhdm can thiep da dugc chgn vdi cic chi tieu ve tinh trang dinh dudng tuang duang nhau. Vi vay, die diem ve BMI, VE/VM, % md CO the cua hai nhdm trudc thu nghiem khdng cd su khic biet (p > 0,05)
Bdng 5; Chi so hieu qua.
thoi diem Tl vai p > 0,05 a thai diem T3 voi p > 0,05 a thai diem T3 vai p < 0,05 a thai diem T3 vai p < 0,001
Sau 12 tuan thu nghiem BMI cd xu hudng gilm so vdi trudc thu nghiem tuy nhien su khic biet chua cd y nghTa thdng ke (p>0,05). Ty so VE/VM, % md ca thi cua hai nhdm d l gilm mdt cich cd y nghTa (vdi p<0,05; p<0,001).
hieu qua can thiep Chi so
BMI (kg/m2)
Ty so (VE/VM)
% ma CO the
Thoi diem Tl T3 HQ
Tl T3 HQ Tl T3 HQ
Nhom can thiep (n=55)
51,4 49 4,67 27,7 23,5 15,16
29,1 24,3 16,49
Nhom chirng (n=55)
51,3 49,1 4,29 27,5 26,8 2,55 29,3 29,2 0,34
Hieu qua can thiep %
0,38
12,6
16,15
Hieu qui can thiep vien lyeopen - vi chit dinh dudng diu cao ban so vdi nhdm chiing, Hieu qui can thiep the hien rd nhit d ty Ie % md -ca thi (16,15%)) VE/VM (12,6%). Hieu qua v l su thay ddi
BMI d nhdm chung (4,67) so vdi nhdm can thiep (4,29%) gin tuong duong nhau 3. Dac diem khau phan cua hai nhom nghien ciiu
Bdng 6. Mirc tieu thu lu'OTig thye
Gia tri dinh du'&ng
Tong nang lugng Protein (g) Lipit (g) Glucid Chat xo Vitamin Bl (mg) B2 (mg) C (mg) PP (mg) Chat khoang Canxi (mg) Phospho (mg)
sat (mg)
Nhom can Truffc CT
X ± S D 2522,0 ±616,2
107,7 ±33,3 49,2 ± 26,2 320,2 ±91,7 28,0 ±10,7
1,7 ± 0 , 4 0,9 ± 0,4
167,5 ±48,9 13,2 ±5,1 513 ±108,4
1004,3 ±441,9 21,2 ±12,6
: thuc pham giiia thiep (n=105)
S a u C T X ± S D 2680,6 ± 482,8 86,6 ± 27,7 41,4 ± 16,2 324,1 ±90,2 21,7 ± 9 , 9
1,8 ± 0 , 4 1,0 ± 0 , 4 123,6 ±71,9 14,9 ± 4 , 1 515,7 ±107,5
1007,3 ±387,1 22,5 ± 8,3
hai nhom tru'dc va sau can thiep Nhom ch'
Tru-ffc CT X ± S D 2612,4 ±478,4
111,9 ±40,8 47,0 ± 22,3 319,6 ±77,2 27,7 ±11,8
1,56 ±0,41 0,8 ± 0,3
173,5 ± 6 2 , 7 13,4 ± 5 , 4 516,1 ±103,8
1038,8 ±446,8 21,6 ± 1 4 , 7
ling (n=105) Sau CT X i S D 2410,6 ±530,7 90,2 ± 27,3 41,1 ±22,9 339,2 ±83,9 23,1 ±7,5
1,81 ±0,42 0,9 ± 0,3
123,7 ±62,7 13,8 ±4,3 514,4 ± 199,9 1058,4 ±428,9 22,9 ± 9,2
Trudc v l sau thdi gian tien banh nghien ciiu thu nghiem, gil tri dinh dudng khiu phin cua hai nhdm can thiep v l nhdm chung tuong duong nhau (p>
0,05).
IV: BAN LUAN
1. Tinh trang lipit mau ciia hai nhom si quan trudc va sau t h u nghiem can thiep
Tai thdi diem trudc khi can thiep ( TO) tinh trang lipit mau cua hai nhdm ddi tugng II tuang duang nhau (p>
0,05).Tinh tiang lipit mlu cua hai nhdm da cd sir thay ddi sau 12 tuin (T3) thu nghiem (Blng 2). Nhdm sii dung vien lyeopen - vi chat dinh dudng cd nhieu bien ddi tich cue ve tinh trang lipit mlu hon so vdi nhdm su dung che phim vien gia dugc. C l ba thinh phin Cholesterol TP, LDL - C, triglycerid ciia nhdm can thiep deu thip hon nhdm chiing mgt cleh
cd y nghTa (p< 0,05), ddng thdi him lugng HDL - C v l lyeopen huyet thanh cua nhdm can thiep ciing cao ban rd ret so vdi nhdm chung (p< 0,01). Sau thdi gian thii nghiem hieu qua can thiep vien lyeopen - vi chat dinh dudng deu cao ban so vdi nhdm chiing, my nhien chi so hieu qui v l hieu qui can thiep thay rd nhlt vdi chi sd Cholesterol toln phin (12,8%) va LDL-cholesterol (15,38%). Nhdm chiing ciing cli thien mdt sd ty le nhung it han nhdm can thiep.
Tren the gidi da cd nhieu tic gil nghien ciin mdi lien quan giiia che do In, ndng do lyeopen huyet tbanb v l benh tim mach. NIm 1997, Fubrman, Elis, Aviram nghien cuu tren 6 nam gidi vdi che do an bd sung 60 mg lycopen/ngly. Kit qui sau 3 thing, ndng do LDL-C gilm 14% [6].
Nghien ciin cua Rao v l cdng su (2002) tren 12 ngudi (6 nam, 6 nii) cho thiy khi
bd sung che do In 5 mg lycopen/ngly, sau 2 tuan ndng do lyeopen huyit thanh tang 113%, ddng thdi cd sir gilm qui trinh peroxit lipit (gilm 10% MDA huyet thanh). Tuy nhien trong nghien ciin ciia chiing tdi sau 12 tuin ciing chi ting dugc 74,7% va da cli thien mdt cleh cd y ngliTa tinh trang rdi loan lipid mlu. Mdt nghien Cliu khic ciia Rao (2002) ciing chi ra ring che do In bd sung lyeopen d miic 20 - 150 mg/ngly trong 1 tuan se llm gilm 15
% LDL dien lien hgp (LDL conjugated dienes), yeu td do ludng miic do oxi hda LDL [3,7]
Nghien ciiu cua nhdm tic gil Hin Qudc, Oh Yoen va cdng su (2009) ciing chi ra mdi tuang quan ty le nghich giiia ndng do lyeopen huyet thanh v l Cholesterol toan phan, LDL - C, triglycerid v l mdi tuang quan ty le thuan giira ndng do HDL-C v l lyeopen huyet thanh [8]. Nghien ciiu ciia chiing tdi tai bang 2,4 ciing cho ket qui tuong tu.
2. Bien doi ve ty le % md ca the va chi so BMI cua hai nhom trudc va sau thir nghiem
Sau thdi gian nghien ciiu thii nghiem, nhdm su dung vien lyeopen - vi chit dinh dudng da cd su thay ddi ve tinh tiang dinh dudng so vdi nhdm chiing. Kit qui d blng 4 cho thay ty le VE/VM, % md ca the ciia nhdm can thiep thap ban cd y nghTa so vdi nhdm chiing (p<0,05), BMI ciia nhdm can thiep ciing cd xu hudng gilm so vdi nhdm chiing. Hieu qui v l he sd hieu qui chi ra trong blng 6 cho thiy nhdm can thiep cd tic dung gilm % md ca the ldn nhat (he sd hieu qua 16,15%).
3 Dac diem che do dinh duong ciia hai
nhom doi tuo'ng trong thoi gian thu nghiem
Miic tieu thu luang thuc, thuc phim ciia hai nhdm trudc thdi gian tien hinh nghien Cliu can thiep 11 tuong duong nhau ve tan xuat sir dung luang thuc, rau, cu, qui, cic loai chat beo v l thit tning. Trong qui trinh can thiep holn toan khdng cd su dieu chinh che do In trong nhdm can thiep. Ket qui miic tieu thu lugng thuc, thuc pham cua nhdm can thiep khdng cd su thay ddi so vdi nhdm chiing, mac du cd su khic nhau ve tieu thu gao, ngii cde, rau, cu, hoa qui nhung khdng ding ke . Trudc v l sau thdi gian tien hinh nghien Cliu thir nghiem (blng 6), gil tri dinh dudng trong khau phan In cua hai nhdm can thiep v l nhdm chiing tuang duang nhau (p > 0,05). Tdng ning lugng cung cap cho CO the ciia c l hai nhdm 11 nhu nhau, cac ty le protid, lipit, glucid, cic loai mudi khoing, vitamin d nhdm can thiep ciing can ddi so ban vdi nhdm chirng.
V. KET LUAN
Sau 12 tuan sir dung vien lyeopen - vi chit dinh dudng, da cli thien tinh tiang rdi loan lipit mlu:
1. Cholesterol toln phin gilm 10,7% (tir 5,98 mmol/1 xudng 5,34 mmol/1 (p<
0,001)). He sd hieu qui 12,8%
2. Triglycerid gilm 23,6% (tii 4,14 mmol/1 xudng 3,16 mmoI/l (p< 0,05)). He sd hieu qui 6,06 %
- H i m lugng HDL - C ting 20% (tu l,06mmol/l din l,28mmol/l (p< 0,001)).
He sd hieu qui 5,22 %
- Him lugng LDL - C gilm 11,3% (tii 3,36 mmol/1 xudng 2,98 mmol/1 (p<
0,01)). He so hieu qua 15,38 %
3. N d n g do lyeopen huyet thanh da t i n g len mdt c i c h cd y nghTa tu 0,19 pmol/l d i n 1,42 p m o l / l ( p < 0,001)
VI. K H U Y E N N G H I
1. Nen tien banh nghien ciin can thiep sii dung s i n pham d qui md rdng hon . 2. Q u i n Y c i c d a n vi ciia Bg tu lenh Bd dgi Bien phdng c i n theo ddi nhiing sT quan cd thira c i n - beo phi, rdi loan lipit m l u , tich c u e tu van phdng ngua c i c benh man tinh dinh dudng, che do In hgp li, dinh ki k i i m tra c i c chi sd lipit m l u v l hdi chiing chuyen hda. Trong dieu kien cho phep cd the su dung vien lyeopen - VCDD
TAX LIEU THAM KHAO
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12. Hgi Tim mach hgc Viet Nam (2006), Khuyen cdo cde benh ly tim mach vd chuyen hoa giai dogn 2006 - 2010, NXB Y hgc, TP Hd Chi Minh, 365 - 387 Summary
E F F I C A C Y A S S E S S M E N T OF L Y C O P E N - M I C R O N U T R I E N T T A B L E T S IN R E D U C I N G B L O O D LIPID D I S O R D E R S
The study was conducted among officers of the Border Guard High Command camping aging from 30 to 59 years old in Hanoi area. Objective: to assess the efficacy of Lycopen-micronutrient
tablets in reducing blood lipid disorders. Method: Community pre-post intervention trial in 12 weeks among 110 millitary officers, who were overweight (BMI >=23) and having blood lipid dis- orders. The intervention group was administered with 2 tablets of lycopen-micronutrients a day.
The control group was administered with placebo, also 2 tablets a day for 12 weeks. Results: the blood lipid disorders have reduced significantly in the intervention group than in the control. All 3 indicators: total Cholesterol, L D L - C , triglycerid of the intervention group were significantly lower than those of the control (p< 0.05), meanwhile the concentration of H D L - C and blood ly- eopen of the intervention were higher than those of the control (p< 0.01). The efficacy of lycopen- micronutrient tablets is higher in the intervention group as total Cholesterol (12.8%);
LDL-cholesterol (15.38%), Triglycerid (>2.3 mmol/L) was 6.06% and HDL- cholesterol (<0.9mmol/L) was 5.22%. Waist/Hip ratio and body fat proportion have reduced significantly.
The intervention efficacy was observed most clearly in body fat proportion (16.15%).
Keywords: lyeopen — micronutrients, placebo, blood lipid disorders, BMI, food intake
THANH PHAN DINI|DirCfNG CHINH v A CAC ACID BEO CAN THIET TRONG KHAU PHAN CUA NGUdi TRlTdNG
T H A N HVIET NAM
Hd Thi Anh Ddo', Le Hong DUng^, Le Thi Hffp', Nguyen Vdn Sy^, Nguyen Thuy Dungf, Pham Thanh Nga^
Nghien ciiu dugc tien hanh tii nam 2008 den nam 2009 tai Vien Dinh dudng. Muc tieu: xac dinh ham lugng protein, lipid, glucid, cellulose va cac acid beo can thiet trong khau phan ciia ngudi trudng thanh tai 4 vung sinh thai khac nhau d Viet Nam. Phuang phap: Phan tich thanh phan dinh dudng cua tren 120 mau khau phan thu thap tai gia dinh trong phong thi nghiem khoa Thuc pham - Ve sinh an toan thuc pham Ket qua: Khau phan d viing thanh pho c6 ham lugng protein, glucid, lipid va chat xo cao nhat, cung cap nang lugng tmng binh la 2129,1 Kcal dat 92,6% so vdi nhu cau khuyen nghi cho ngudi Viet Nam. Trong khi do khau phan d -viing duyen hai lai c6 ham lugng lipid, protein va chat xo thap nhat, con nang lugng khau phan d -viing mien niii, dong bang va duyen hai ciing chi dat miic tir 56,2 den 68,1% so vdi nhu cau khuyen nghi. Ham lugng cac acid beo bao hoa, acid beo khong bao hoa Omega-3 va Omega-6 cao nhat d khau phan cua ngudi trudng thanh d -viing thanh phd va thap nhat trong khau phan vung duyen hai. Tuy nhien, khau phan viing duyen hai co ty le acid beo Omega-3/lipid tong sd va acid beo Omega-6/lipid tong so cao nhat, con ty le acid beo Omega-6/Omega-3 lai thap nhat. Ket qua phan tich cac acid beo can thiet trong khau phan ciia nghien ciin nay da cho thay chat lugng lipid trong khau phan ngudi trudng thanh d vimg duyen hai la tot va co lgi cho siic khde nhat.
Tir khoa: thdnh phdn dinh du&ng, acid beo trong khdu phdn, khdu phdn ngu&i tru&ng thdnh, nhu cdu khuyen nghi
' PGS, TS - Vien Dinh duang
^ Ths - Vien Dinh duang '<, ;.•.:•.:
3 KS - Vien Dinh duang
