A Comparison of a Healthy Thai Diet and Contemporary Thai Diet on Health Indices in Individuals With Noncommunicable Diseases: A Randomized Controlled Trial
DOI:
https://doi.org/10.33165/rmj.48.01.e270918Keywords:
Noncommunicable diseases, Plant-based diet, Dietary intervention, Lifestyle medicine, Lifestyle modificationAbstract
Background: Studies have suggested that dietary patterns emphasizing low-fat, plant-based foods like vegetarian, Mediterranean, and Dietary Approaches to Stop Hypertension (DASH) diets reduce noncommunicable disease risk.
Objectives: To compare the effects of a Healthy Thai Diet (HTD) and a Contemporary Thai Diet (CTD) on body mass index (BMI), blood pressure, cholesterol, and glycemia. The HTD is characterized by low-fat, plant-based Thai food that substitutes animal products with plant-based ingredients while maintaining traditional seasonings (eg, fish sauce, shrimp paste, and coconut milk).
Methods: Individuals exhibiting at least 1 abnormal health index (BMI, blood pressure, low-density lipoprotein cholesterol [LDL-C], fasting blood sugar [FBS]) or undergoing chronic disease treatment were randomly assigned to the HTD (n = 30) orCTD (n = 32) for 12 weeks. Health indices were measured at baseline and at week 12. Statistical analyses included paired t tests for within-group comparisons and student’s t tests for between-group comparisons.
Results: After 12 weeks, the HTD group experienced significant weight loss (-3.03 kg vs 0.43 kg in CTD, P < .01), particularly in participants with BMI greater or equal to 23 kg/m² (-3.99 kg vs 0.04 kg, P < .01). Systolic blood pressure dropped significantly in the HTD (-17.4 mmHg vs -6.3 mmHg in CTD, P = .05), especially in those with initial readings greater or equal to 140 mmHg (-32 mmHg vs -12 mmHg, P = .01). LDL-C decreased notably in the HTD (-34.1 mg/dL vs -12.9 mg/dL in CTD, P < .05). Participants with type 2 diabetes in the HTD were able to reduce or discontinue medications while maintaining stable glycemic control. Significant changes in gut microbial abundance and improvement in estimated glomerular filtration rate (eGFR) (P < .05) were observed in the HTD.
Conclusions: These results suggest that the HTD may be a promising dietary intervention for managing obesity, hypertension, dyslipidemia, and type 2 diabetes in Thailand.
References
Health Information Group. Public Health Statistics A.D. 2021. Bureau of Strategy and Planning, Office of the Permanent Secretary, Ministry of Public Health; 2022. Accessed 3 November 2024 https://spd.moph.go.th/wp-content/uploads/2022/11/Hstatistic64.pdf
The InterAct Consortium. Association between dietary meat consumption and incident type 2 diabetes: the EPIC-InterAct study. Diabetologia. 2013;56(1):47-59. doi:10.1007/s00125-012-2718-7
The InterAct Consortium. Adherence to predefined dietary patterns and incident type 2 diabetes in European populations: EPIC-InterAct Study. Diabetologia. 2014;57(2):321-333. doi:10.1007/s00125-013-3092-9
de Lorgeril M, Renaud S, Mamelle N, et al. Mediterranean alpha-linolenic acid-rich diet in secondary prevention of coronary heart disease. Lancet. 1994;343(8911):1454-1459. doi:10.1016/s0140-6736(94)92580-1
Orlich MJ, Singh PN, Sabaté J, et al. Vegetarian dietary patterns and mortality in Adventist Health Study 2. JAMA Intern Med. 2013;173(13):1230-1238. doi:10.1001/jamainternmed.2013.6473
Gould KL, Ornish D, Scherwitz L, et al. Changes in myocardial perfusion abnormalities by positron emission tomography after long-term, intense risk factor modification. JAMA. 1995;274(11):894-901. doi:10.1001/jama.1995.03530110056036
Ornish D. Avoiding revascularization with lifestyle changes: the multicenter lifestyle demonstration project. Am J Cardiol. 1998;82(10B):72T-76T. doi:10.1016/s0002-9149(98)00744-9
Keys A. Seven Countries: A Multivariate Analysis of Death and Coronary Heart Disease. Harvard University Press; 1980. doi:10.4159/harvard.9780674497887
Yerushalmy J, Hilleboe HE. Fat in the diet and mortality from heart disease; a methodologic note. N Y State J Med. 1957;57(14):2343-2354.
Song M, Fung TT, Hu FB, et al. Association of animal and plant protein intake with all-cause and cause-specific mortality. JAMA Intern Med. 2016;176(10):1453-1463. doi:10.1001/jamainternmed.2016.4182
Filippou CD, Tsioufis CP, Thomopoulos CG, et al. Dietary Approaches to Stop Hypertension (DASH) diet and blood pressure reduction in adults with and without hypertension: a systematic review and meta-analysis of randomized controlled trials. Adv Nutr. 2020;11(5):1150-1160. doi:10.1093/advances/nmaa041
Chen X, Wei G, Jalili T, et al. The associations of plant protein intake with all-cause mortality in CKD. Am J Kidney Dis. 2016;67(3):423-430. doi:10.1053/j.ajkd.2015.10.018
Juraschek SP, Gelber AC, Choi HK, Appel LJ, Miller ER 3rd. Effects of the Dietary Approaches to Stop Hypertension (DASH) diet and sodium intake on serum uric acid. Arthritis Rheumatol. 2016;68(12):3002-3009. doi:10.1002/art.39813
Molina-Montes E, Salamanca-Fernández E, Garcia-Villanova B, Sánchez MJ. The impact of plant-based dietary patterns on cancer-related outcomes: a rapid review and meta-analysis. Nutrients. 2020;12(7):2010. doi:10.3390/nu12072010
Asnicar F, Berry SE, Valdes AM, et al. Microbiome connections with host metabolism and habitual diet from 1,098 deeply phenotyped individuals. Nat Med. 2021;27(2):321-332. doi:10.1038/s41591-020-01183-8
Yang Q, Zhang Z, Gregg EW, Flanders WD, Merritt R, Hu FB. Added sugar intake and cardiovascular diseases mortality among US adults. JAMA Intern Med. 2014;174(4):516-524. doi:10.1001/jamainternmed.2013.13563
Pereira RM, Botezelli JD, da Cruz Rodrigues KC, et al. Fructose consumption in the development of obesity and the effects of different protocols of physical exercise on the hepatic metabolism. Nutrients. 2017;9(4):405. doi:10.3390/nu9040405
Aune D, Norat T, Romundstad P, Vatten LJ. Whole grain and refined grain consumption and the risk of type 2 diabetes: a systematic review and dose-response meta-analysis of cohort studies. Eur J Epidemiol. 2013;28(11):845-858. doi:10.1007/s10654-013-9852-5
Sun Q, Spiegelman D, van Dam RM, et al. White rice, brown rice, and risk of type 2 diabetes in US men and women. Arch Intern Med. 2010;170(11):961-969. doi:10.1001/archinternmed.2010.109
DeSantis TZ, Hugenholtz P, Larsen N, et al. Greengenes, a chimera-checked 16S rRNA gene database and workbench compatible with ARB. Appl Environ Microbiol. 2006;72(7):5069-5072. doi:10.1128/AEM.03006-05
Coen PM, Goodpaster BH. Role of intramyocelluar lipids in human health. Trends Endocrinol Metab. 2012;23(8):391-398. doi:10.1016/j.tem.2012.05.009
Savage DB, Watson L, Carr K, et al. Accumulation of saturated intramyocellular lipid is associated with insulin resistance. J Lipid Res. 2019;60(7):1323-1332. doi:10.1194/jlr.M091942
Kahleova H, Tura A, Hill M, Holubkov R, Barnard ND. A Plant-based dietary intervention improves beta-cell function and insulin resistance in overweight adults: a 16-week randomized clinical trial. Nutrients. 2018;10(2):189. doi:10.3390/nu10020189
Kahleova H, Petersen KF, Shulman GI, et al. Effect of a low-fat vegan diet on body weight, insulin sensitivity, postprandial metabolism, and intramyocellular and hepatocellular lipid levels in overweight adults: a randomized clinical trial. JAMA Netw Open. 2020;3(11):e2025454. doi:10.1001/jamanetworkopen.2020.25454
Louis P, Flint HJ. Diversity, metabolism and microbial ecology of butyrate-producing bacteria from the human large intestine. FEMS Microbiol Lett. 2009;294(1):1-8. doi:10.1111/j.1574-6968.2009.01514.x
Vital M, Howe AC, Tiedje JM. Revealing the bacterial butyrate synthesis pathways by analyzing (meta)genomic data. mBio. 2014;5(2):e00889. doi:10.1128/mBio.00889-14
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 by the Author(s). Licensee RMJ.
This work is licensed under a Creative Commons Attribution 4.0 International License.
.png){kind=logo}
