Summary
I N I T I A L P I L O T S rUDY T O P R O D U C E N U T R I T I O N A L G R U E L KOR T H E E L D E R L Y AND P E O P L E S U F F E R I N G F R O M C H R O N I C D I S E A S E S . Among many daily loDds. gruel is a suitable one for the elderly and those who sulTer rmiii chronic diseases because it is easily digested and rapidly absorbed. The study has tried several t'omuilas, in which formula 1 with 57.50% of ordinary rice, 1.5% vegetable {sauropus androuynus (L.) Merr.} and few oilier nutntion supplements can meet nutritional requirements of those people, es- pecially the vegetable ilbcr content of the sauropus androgynus (L.) Merr. plays an imporiani role for the digestion. This makes of the nutritional gmel has good organoleptic characteristics and a reasonable price.
Keywords; Nutritional gruel. , Sauropus androgynus (L.) Merr, elderly, chronic diseases.
HIEU QUA BO SUNG CHAT X d POLYDEXTROSE DEN TINH TRANG THtfA CAN-BEO PHt, TANG LIPID MAU 6 SI QUAN
QUAN DOI TAI HA NOI
Phgm Thi Thu Huong', Nguyen ThiLdm^, Trdn Chdu Quyen\ Thdi Thi Thu Cue \ Dinh Van Trung \ Hodng Ngge Lan''.
Muc tieu: Nham danh gia gia hieu qua cai thien tinh trang thira can-beo phi va tang lipid mau bang bo sung chat xa polydextrose. Phuang phdp: Thii nghiem can thiep cong dong ngau nhien co doi chimg tren 108 sT quan, mot nh6ra su dung 20g san pham Vitanl (chiia 20g polydextrose)/ngay con nh6m chimg duge diing 2 vien gia dugc. Ket qud: Sau can thiep, can nang tmng binh cua ca hai nhom deu giam so vdi ban dau nhung nhom can thiep giam hon so vdi nh6m chiing (p < 0,05);
Cac chi so tmng binh BMI, vong eo, vong mong, % md co the cua nhom can thiep va nhom chimg deu giam so vdi tmdc can thiep (p < 0,05) trong d6 ti le giam d nh6m can thiep cao hon; nong do cholesterol, triglycerid, LDL-C giam so vdi ban dau va so vdi nhom chirng (p<0,05), trong khi d6 nong do HDL-C tang (p<0,05); Do mem ciia phan ciing dugc cai thien va de dang di dai tiend nliom can thiep tot hon nh6m chimg (p< 0,01). Ket ludn: Bo sung 20g/ngay polydextrose trong thdi gian 4 thang da cai thien dugc cac chi so nhan trac, chi so sinh h6a mau (Cholesterol toan phan, Triglycerid, HDL-C, LDL-C, Glucose) va do mem cua phan.
Tir khoa: Chdt xo; thiea cdn - beo phi. Lipid, si quan qudn doi
I. D A T VAN D E t i n g nhanh chdng d Viet Nam ndi chung Rdi loan lipid m l u 11 mgt trong v l trong ddi hrgng cdng chuc ndi rieng.
nhQng ygu td nguy co ph6 bien gay benh Vi v a y viec nghien cuu dg tim ra c i c gili mach v i n h , t h u d n g ph6i hgp vdi tinh p h I p gop p h i n kiSm s o i t rdi loan lipid trang thua can- beo phi. NbiSu nghien m l u , can thiep thua can-beo phi II c i n Cliu cho t h i y ti le thua can- beo phi dang thiet. C I c nghien cuu thuc nghiem cho ' TS, BS - Vien Dinh duang , ; ,,
^ PGS, TS - Vien Dinh du'O-ng ; '
^ BS - Vien Dinh duo'ng " = ' , ^' '
" Cn - Vien Dinh duang ,;, -., . , 5TS,BS-Vien 108
thay bd sung chat xa lam gilm lipid mlu d nhQng ddi tugng cd rdi loan, tuy nhien hieu qua khic nhau tuy thugc vio Ioai chat xa, ndng do lipid mlu ban diu.
Td chuc NCEP (National Choleste- rol Education Programme) cua Hoa Ky khuyen nghi nhu cau chat xa la 14 g/lOOOkcal [13]. Nhieu nghien cuu ve chat xo vdi tic dung Iam gilm lipid mlu da dugc tien binh, trong dd cd polydex- trose. 6 Viet Nam, cho tdi nay chua cd nhieu nghien ciin ve hieu qui cua poly- dextrose ddi vdi tinh trang rdi loan lipid mlu v l tinh trang dinh dudng. De tii niy tien hinh nhim muc tieu dinh gil hieu qui cli thien tinh tiang thua cin-beo phi v l ting lipid mlu d sT quan quan ddi blng bd sung chat xa polydextrose.
II. DOI TU'ONG VA PHl/ONG PHAP NGHIEN ClJtJ
1. Doi tuong nghien ciiu
ST quan quan dgi, tudi tu 40-59, tu nguyen tham gia nghien ciin, cd BMI >
23, dugc chan doln rdi loan lipid mlu (Cholesterol> 5,2 mmoI/L; HDL- C <
0,9 mmol/L; LDL- C > 3,35 mmol/L;
Triglycerid > 2,26 mmol/L); khdng cd thai va/hoac dang trong giai doan cho con bu; khdng mic benh cap tinh va man tinh, khdng tham gia bat ky che do In kieng hole chuang trinh gilm can hole giam rdi loan lipid mlu;
2. Phuong phap nghien ciiu
2.1.Thiet ke nghien ciiu: Thu nghiem can thiep cdng ddng ngau nhien cd ddi chiing
2.2. Cff mau va chon mau: 54 ddi tugng cho mdi nhdm (da bao gdm 10% bd cugc du tinh), tdng 11 108 ngudi cho c l 2 nhdm. [2]
Cach chgn mdu: DiSu tra sang Igc 992 ddi tugng sT quan quan ddi, chgn ra 108 ddi tugng du tieu chuin tham gia nghien Clin; Phan cic ddi tugng vio nhdm can thiep va nhdm ddi chung blng ky thuat nglu nhien phan tang (cic yeu td quan tam de phan tang: muc do thua can-beo phi. Cholesterol tdng sd (TC), LDL-C, HDL-C, triglycerid
2.3. Dia diem- thoi gian nghien ciiu; tai Quan chung PK-KQ tii 7/2008-11/2008.
2.4. Vat lieu can thiep
- Chat xa hoi tan Vi-tanl: (polydextrose) cua Cdng ty cd phan Viet nam Ky nghe hot my, xuat xii tii Danico Sweeteners- HoaKy
- Vien gia dugc: Vien nang mem, cd trgng lugng Ig/vien do cdng ty cd phan dugc Hau Giang sin xuat. Thinh phan trong mdi vien: Vitamin E: 0,07 mg
Lieu luong can thiep:
- Nhdm can thiep: Ngly 2 lan mdi lan lOgVi-tanl hda tan trong 100 ml nudc am (^70°C), dung trudc hole tiong cic bua In chinh (trua, tdi).
- Nhdm chiing: 2 vien gia dugc/ngay, udng vao budi sang (8-9h).
Thoi gian can thiep: 4 thing
2.5. Cac chi so nghien cuu va phuong phap thu thap so lieu
2.5.1. Thong tin cd nhdn
Phdng van cic thdng tin chung theo bd cau bdi: tinh tiang siic khde, tham gia the due the thao, cic thuoc dang su dung.
2.5.2. Miec tieu thu Iwffng thwc thwc phdm vd tap qudn dn uong: sir dung phuong phap hdi ghi muc tieu thu luong thuc pham 24 gid qua [1,9] v l tin xult tieu thu luong thuc thuc phim trong 4 148
thing can thiep [9].
2.5.3. Cde chi so nhdn trac: Can nang (CN), C h i k cao (CC), Vdng eo (VE), vdng mdng (VM), % md ca the, chi sd BMI [10] v l ti so VE/VM [3] tai cic thdi diem sang Igc hole dieu tra ban dau, dieu tra sau can thiep.
2.5.4. Cac chi so ldm sdng: khim lam sing xlc dinh sa bd benh Iy theo yeu cau cua nghien ciiu trudc v l sau can thiep;
cdng tic vien ghi nhan blng ngay cic dau hieu theo yen cau trong bieu mau theo ddi: Tan xuat di dai tien, muc do de khd cua di dai tien; CIc diu hieu khdng mong mudn cua viec sii dung san pham bao gdm: Dau bung, rdi loan tieu hda, trieu chiing ha dudng huyet.
CIc trieu chiing dugc danh gil cd hay khdng, do de hay khd cua dai tien dugc dinh gil theo thang diem - 3 den -1-3 (-3:
rdt kho, -2: kho viea, -1: Kho, I: hai de, 2:
de, 3: rdt de); Tinh chat phan dugc dinh gil theo thang diem tir -3 den + 3 (-3; rdt rdn/cimg, -2:cieng, -1 hai cimg, +1:
khuon mem, 2: khong khuon, 3: long) 2.5.5. Cac chisd sinh hoa mdu: tai thdi diem dieu tra sing Igc hole dieu tra ban diu v l sau can thiep: Dinh lugng chole- sterol TP, triglycerid, HDL-C, LDL-C, apo A, apo B, glucose, acid uric, GOT, GPT, ure, creatinin; Dinh lugng hdng cau, bach cau, cdng thiic bach cau, tieu cau, huyet sic td, hemoglobin tai benh vien TWQD 108.
Nhan dinh kit qud: dua vao Phan loai rdi loan lipid m l u va lipoprotein mlu theo NCEP (National Cholesterol Educa- tion program) [8] v l Phan loai dii thao dudng theo Td chuc Y tS the gidi (WHO) [5]
2.6. Phan tich so lieu:;.,
- Sd lieu khiu phin: Su dung chuang
trinh phin mem Acces (dugc xly dung dua tren sd lieu cua blng thinh phin dinh dudng thuc pham Viet Nam nim 2007) - Phan tich cic sd lieu trudc va sau can thiep: su dung chuang trinh phin mem SPSS 10.05
Kiem tra phan bd chuin cua sd lieu trudc khi phan tich thdng ke; Neu sd lieu khdng phan bd chuan, su dung cic test phi tham sd phu hgp. Y nghTa thdng ke dugc cdng nhan vdi miic tdi thieu p < 0,05.
Cac ddi twffng bi loai ra khoi ket qud phdn tich: cd sd lugng chat xa va thdi gian su dung dat <70% yeu cau; su dung thude gilm hpid mlu trong thdi gian can thiep.
III. KET QUA
1. Dac diem cua cac doi tuwig nghien cii'u Trudc can thiep, trung binh cic chi sd lipid mlu (cholesterol, triglycerid, HDL-C, LDL-C, apoA, apoB) va trung binh cic chi sd nhan trie (can nang, BMI, vdng eo, % md ca the) cua hai nhdm nghien ciin khic nhau khdng cd y nghia thdng ke (p>0,05); Qui tiinh can thiep hoan toln khdng cd su dieu chinh che do In cho c l hai nhdm. Ket qua muc tieu thu luang thuc, thuc pham va gil tri dinh dudng trong khau phan giua 2 nhdm v l giua hai giai doan (trudc v l sau can thiep) deu khdng cd su khic biet (p>0,05); deu dip ling nhu cau de nghi.
2. Hieu qua cai thien cac chi so nhan tr5c ciia bo sung chat x c polydextrose
Sau can thiep, can nang trung binh cua c l hai nhdm deu gilm so vdi ban dau nhung nhdm can thiep gilm ban so vdi nhdm chiing (-0,89 kg so vdi -0,59 kg; p
< 0,05). CIc chi sd tinng binh BMI, vdng eo (VE), vdng mdmg (VM), % md ca the the hien d blng sau:
Bang 1. Thay d6i trung binh BMI va mot s6 chi s6 nhan tr5c sau can thiep
Chi so Nhom CT0i^54) Nhom chiing (n=54) P (Test t)
±SD ±SD
BMI (kg/m2) VE (cm) VM (cm) Ty s6 VE/VM
% ma ca the
-0,32±0,18 -1,55 ±1,01 -1,31 ±0,91 0,0 ±0,01 -0,4 ± 0,45
-0,22±0,24 -0,47 ±0,61 -0,29 ±0,88 0,0 ±0,01 -0,2 ±0,81
<0,05
<0,01
<0,05
>0,05
<0,05
' P<0,05 test T ghep cap so sanh trong ciing nhom truac va sau can thiep
3. Hieu qua cai thien cac chi so lipid mau cua bo sung chat xc polydextrose 3.1. Thay doi cac chi so lipid mdu cua hai nhom sau can thiep
Bdng 2. T h a y doi cac chi so lipid mau cua hai n h o m sau can thiep
Chi so
Cholesterol (mmc
<5,2 5,2-6,2
>6,2
Triglycerid ( m m o
< 1 , 7 1,7-2,26
>2,3
H D L - C (mmol/1)
<0,9 0 , 9 - < l , 5 5
>1,55
L D L - C (mmol/1)
<3,35 3,35-4,15
>4,15
.1/1)
1/1)
N h o m C T (
T r u a c C T n
4 30 20
14 9 31
5 34
15
23 26 5
%
7,4 55,6 37
25,9 16,7 57,4
9,3 63 27,6
42,6 48,1 9,3
n = 5 4 )
SauCT n
16 29 9
22 14 18
0 15 39
40 11 3
%
29,6*
53,7 16,7*
49,7*
25,9 36,7*
0,0 27,8a 72,2*,a
74,l*,a 20,4*
5,6
Nhom chung (n=54)
Truac CT n
5 30
19
20 9 25
29 18
24 24 6
%
9,3 55,6 35,2
37,0 16,7 46,3
13,0 53,7 33,3
44,4 44,4 11,1
SauCT n
7 23 24
12 8 34
4 21 29
27 26 1
%
13,0 42,6 44,4
22,2 14,8 63,0
7,4 38,9 53,7
50,0 48,1 1,9
" P<0,05 testx^ so sdnh trong ciing nhdm; 'P<0,05
3.2. Thay doi mot so chi tieu sinh hoa ciia hai nhom doi tuong sau can thiep.
CIc chi sd nhu glucose, acid uric, GOT, GPT, urea, creatinin cua c l hai nhdm trudc nghien cun II tuang duong nhau (p > 0,05) v l deu nim trong gidi ban
test X- so sdnh gida hai nhdm
binh thudng. Sau can thiep, nhdm udng chat xo cd chi sd glucose m l u v l acid mlu gilm so vdi ban diu v l so vdi nhdm chiing cd y nghTa thdng ke (p < 0,01), cic cbi so khic cung gilm hole ting nhung khdng cd y nghTa v l deu nim trong gidi
ban binh thudng (p > 0,05). 6 nhdm chiing, ele chi sd cd thay doi, nhung khong cd y nghTa vl d£u nim trong gidi ban binh thudng (p > 0,05).
3.3. Thay doi te bao mau ngoai vi d hai nhom doi tuong trudc va sau can thiep CIc gil tri cua te blo mlu ngoai vi d bai nhdm trudc can thiep la tuang duong nhau (p > 0,05). Sau can thiep chi sd hdng cau, huyet sic td cua ca hai nhdm deu ting so vdi ban diu cd y nghTa thdng ke (p < 0,05), tuy nhien sir khic nhau giua hai nhdm khdng cd y nghTa thdng ke. Tat c l cic chi sd khic thay ddi khdng cd y nghTa thdng ke v l deu nam trong gidi ban binh thudng, khdng cd bien ddi nao gay bat lgi cho ca the.
4. Hieu qua cai thien cac dau hieu tieu hoa cua bo sung chat xa polydextrose
Ngay nhiing ngly dau can thiep chat xo cQng nhu trong sudt thdi gian can thiep khdng gap trudng hgp nio buon ndn/ndn hole chudng bung. Nhdm udng chit xo cd muc do de ding khi dai tien va do mem cua phin dugc cli thien sau thdi gian can thiep cd y nghTa thdng ke so vdi nhdm chiing (p<0,01).
IV. BAN LUAN
Nghien ciin cho thay viec sii dung chat xa Polydextrose cd tic dung cai thien cic chi sd nhan trie giQa nhdm can thiep v l nhdm chiing. Ket qui nay cQng tuong tu nhu nghien cun cua Betul Cicek (2009) [7]. Rieng nhdm chiing cung gilm cic chi sd nhan trie cd le nghien ciin ti6n hinh vao 2 thing mua he (thing 8-9) cic ddi tugng ra nhieu md hdi trong qui trinh luyen tap vi vay tieu hao nang lugng nhigu ban v l giam cin (0,59 kg). Mdt sd nghien ciiu da gili thich hieu qui llm
gilm can cua bd sung chat xa do gilm hap thu lipid v l gilm nang lugng khiu phin [II]. Gilm can cd tic dung llm gilm cic chi sd lipid mlu d nhung ngudi thua can-beo phi. Rdi loan lipid mlu lien quan vdi beo phi bao gdm tang triglyc- erid, ting cholesterol TP v l LDL-C. CIc chi sd niy cQng cd the trd ve binh thudng sau khi gilm cin d mu'c vua phii.
Trong nghien ciin nay, chung tdi bd sung 20g polydextrose trong thdi gian 4 thing cho 54 ddi tugng, ket qua (blng 3.7) cho thay ndng do cholesterol, triglyc- erid, LDL-C gilm cd y nghTa thdng ke so vdi ban dau va so vdi nhdm chiing (p<0,05), trong khi dd nong do HDL-C ting cd y nghTa thdng ke (p<0,05). CIc nghien ciiu khic cQng cho thay bd sung polydextrose da cli thien cic chi sd lipid mlu. Nghien ciiu cua Andizej (2006), nhan thay bd sung 30g polydextrose/ngly trong 4 tuan da gilm LDL-C cd y nghTa thdng ke, trong khi khdng nhan thiy hieu qui niy kbi bd sung 15g/ngly [6]
Polydextrose cd tic dung cli thien cic chi sd lipid mau cd the do: Chit xa khiu phan hda tan cd hieu qua lic che hap thu lipid llm ting dio thii lipid qua phin va llm gilm lipid trong mlu. Nghien ciiu ciia Ogata (1997) tren chugt cho thiy polydextrose llm gilm hap thu triglycerid va cholesterol, do llm giam van chuyen cic chat nay vio he bach huyet [12].
Ddi vdi sir thay ddi cic gil tri cua te blo mau ngoai vi, ket qua nghien ciin chi ra tit c l nhQng bien ddi nay deu nim trong gidi han binh thudng, khdng cd bien ddi nio gay bat lgi cho ca the.
Die biet, khi bd sung 20 g/ngay poly- dextrose da cli thien cd y nghTa do mem
cua phan, lam t i n g miic do dai tien de d i n g , ket q u i nghien cuu cua A c h o u r (1994) [4] bd sung I 5 g / n g l y khdng cho ket qua nhu tren.
IV. K E T L U A N
Bd sung 2 0 g / n g l y polydextrose trong thdi gian 4 t h i n g d l cli thien d u g c c i c chi sd nhan trie, chi sd sinh hda m l u (Cholesterol t o l n phan, Triglycerid, H D L - C , L D L - C , Glucose) v l do m e m cua phan.
V. K H U Y E N N G H I
C I n tuyen truyen cho cdng ddng t i c dung tdt cua chat x a polydextrose trong phdng va dieu trj thua can-beo phi, rdi loan lipid m l u , kiem s o i t glucose m l u , ddng thdi can cd su hudng d i n cho cdng ddng su dung diing c l e h v l diing lieu de dat hieu qua tdt.
TAI LIEU THAM KHAO
1. Ha Huy Khoi (1997). Phuang phdp dich te hoc dinh duang. Nha xuat ban Y hgc 2. Duong Dinh Thien (1997). Dich ti hoc
ldm sdng. Nha xuat ban Y hgc, tap 1, trang 55-77
3. Nguyin Thi Lam (2003;. Thdng nhdt phucmg phdp ley thuat sie ditng trong ddnh gid thiea can-beo phi cua cac nhom tuoi khdc nhau. Dinh dudng va thuc pham, sd 1, trang 17-19
4. Achour L, Flourie B, Brief et al (1994).
Gastrointestinal effects and energy va- lues of polydextrose in healthy non-obese men. Am J Clin Nutr,59; 1362-8
5. Alberti KGGM, Zimmet PZ (1998).
Denifition, diagnosic and classification of diabetes mellitus and its complication.
Part I diagnosic and classification of di-
abetes mellitus. . Provisional report of a WHO consultation. Diabet Med, 15, 539-553
6. Andizej Pronczuk, Hayes KC. (2006).
Hypocholesterolemic effect fi dielaiy polydextrose in gerbils and human. Nu- trition research. 26(1):27-31
7. Betul Cicek, Perihan Arslan, Fehrettin Kelestimur (2009). The effects ofi oligofructose andpolydexxtrose on meta- bolic control parameters in type 2-dia- betes. Pak I Med Sci, 25 (4): 573-578 8. Expert panel on detection, evaluation and
treatment of high blood cholesterol in adults (2002). Excutive sumary of the third report of the national cholesterol education program (NCEP). Expert panel on deletion, evaluation and treat- ment of high blood cholessterol in adult (aduh treatment Panel III). JAMA. 285:
2486-2497 . 9. Gibson RS (1990/ Principles of nutri-
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treatment", Heathl communication Aus- tralia Pty Limited Febmary
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Experimantal biology and medicine, 215:53-58
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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
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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
