4# MINISTR Y OF EDUCATION A ND TRAINING MINITRY OF HEALTH HANOI MEDICAL UNIVERSITY NGUYEN QUYNH HOA THE EFFECT OF USING OKARA TO IMPROVE THE QUALITY OF MEAL FOR DIABETES PATIENTS IN HANOI MEDICAL UNIVERSITY HOSPITAL Major: Bachelor of Nutrition GRADUATION THESIS BACHELOR OF MEDICINE COURSE 2017- 2021 Supervisor: NGUYEN THEY LINH PhD MD HANOI-2021 ÌÌ rf TM/ V*: • -u ACKNOWLEDGEMENT It is ail honor to become a student of Hanoi Medical University (HMU) Four years study in here I’m not only gain new knowledge, but also get more skills and especially I have wonderful teachers and friends First and foremost I have to thank HMU Board of President Department of Undergraduate Training and Management for giving me the opportunity to conduct and complete my graduation thesis I am thankful to Hanoi Medical University Hospital for giving me the best conditions to collect the data I would like to give thanks Jumonji University and Asia Nutrition and Food Culture Research Center for supporting my study and give me one chance exchange in Japan I am deeply indebted to my respected teacher Professor Yamamoto Shigeru He is an experienced researcher and gave me valuable advice on research Especially, my sincere thanks also go to Mrs Nguyen Thuy Link PhD MD HMU my supervisor for support my study, for her patience, motivation, enthusiasm and immense knowledge Her guidance helped me in all the time of research and writing of this thesis I have learned many things from her I’m greatly indebted to her a lot and could not haw imagined having a better advisor and mentor for my graduation thesis I am also grateful to volunteer patients who agreed to spend their time to complete the questionnaire and implement the diets which we prepared Their contribution is very important I submit my heartiest gratitude to my investigators my wonderful classmates They were very enthusiastic to participate in my research considering it as their research They also accompanied me during the period of collecting difficult research data It is very fortunate to work with them Finally I want to express the deepest thank my mother for her continuous and unparalleled love, supporting me spiritually throughout my life I am forever indebted to my mother for gi\ing me tile opportunities and experiences that have made me who I am She encouraged me to explore new directions in life and seek my own destiny This journey would not have been possible if not for her and I dedicate this milestone to her Thank for all! Hanoi 2021 Nguyen Quynh Hoa COMMITMENT I declare that this diesis represents my own work and lias not been submitted for any degree in any university previously The data and results presented in this thesis are to the best of my knowledge, tme and accurate All sources of information of information which have been used in the thesis and external contributions are referenced and acknowledged Hanoi 2021 Nguyen Quvnh Hoa ABBREVIATION BMI : Body Mass Index DALY : The disability-adjusted life year (DALY') DKA : Diabetes ketoacinosid ESPEN : European Society for Clinical Nutrition and Metabolism GBD : Global Burden of Disease GDM : Gastrointestinal diabetes mellitus GI : Glycemic index GL : glycemic load IDF international Diabetes Federation LDL : Low density lipoprotein MST : Malnutrition Screening Tool NIDDM : Non-insulin-dependent diabetes mellitus NIN : National Institute of Nutrition SGA : Subjective Global Assessment YLDs : Years Lived with Disability YLL : Years of life lost WHO : World Health Organization TABLE OF CONTENTS REFERENCES LIST OF TABLES LIST OF FIGURES SUMMARY Diabetes Mellitus has been increasing rapidly in Vietnam, we hypothesized that the main reason that Vietnamese people using fiber and vegetable less than the amount of fiber rather than the recommendation of WHO at about 10g/1000kcal/day Regarding source, fiber comes mainly from vegetable However, most types of Vietnamese vegetable in Vietnam are significantly lower in fiber, at about 2g fiber /100g vegetable So it is very difficult for Vietnamese people, especially with patients who has diabetes to consume enough the amount of fiber regarding to the recommendation of WHO In Study we tried to use okara to improve the amount of fiber in daily meal for diabetes patient and access the acceptability of patient with dishes which contain okara We selected 20 patients diagnosed with diabetes in Hanoi Medical University hospital We divide all participant into group, each group using days of okara meal and days of Hospital meal (not using okara) and take the sensory test in all patient At tlie baseline and final period, anthropo metric measurement, there was a significant higher in the amount of fiber of patient who using okara from 10,75 to 13.8 (p