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Fulltext Effect of physical activity intervention on physical activity, body mass index, blood pressure, blood lipid and fasting blood sugar among overweight and obese military personnel

Ahmad Fuad AF, Ismail S, Abdul Rahman H

Malaysian Journal of Medicine and Health Sciences, 2019;15(203):8-14.
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Introduction: About 18% of Malaysian Armed Forces (MAF) personnel are diagnosed with either hypertension, diabetes or coronary artery disease, while another 8% are obese. The rising prevalence necessitates intervention.
Methods: This is a single blinded randomized controlled trial among overweight and obese MAF personnel attending medical checkup in MAF hospital in Kuala Lumpur. An intervention module was developed to increase their physical activity level. Short version of International Physical Activity Questionnaire was used to assess physical activity in metabolic equivalent of task score (METs score), while blood pressure, body mass index (BMI), blood lipid profile and fasting blood sugar measurements were also obtained. These parameters were measured at baseline and again at 6 months. Generalized estimating equations (GEE) statistical test were applied to evaluate the effect of the intervention.
Results: Response rate was 100%. Most of participants were aged above 40 years, male, from Malay ethnic group, completed secondary education and had monthly income above RM 4000. Most of the respondents were obese and had moderate level of physical activity at baseline. All variables compared between groups at baseline showed no significant difference. At six months, after controlling for covariates, the significant difference was only in METs score. The odds of having high METs score in the intervention group after receiving intervention was nearly 3 times higher than those in the control group, after adjusting for interaction between time and group as well as other covari- ates (AOR = 2.908, 95% CI 1.323 – 6.391, P=0.008).
Conclusion: Intervention was effective in increasing physical activity among overweight and obese military personnel.
Study site: Malaysian Armed Forces Hospital, Kuala Lumpur, Malaysia
Fulltext Risk Assessment of Fishing Trawl Activities to Subsea Pipelines of Sabah and Labuan Waters

Ahmad Fuad AF, Said MH, Samo K, Rahman MAA, Mohd MH, Zainol I

ScientificWorldJournal, 2020;2020:6957171.
PMID: 33414690 DOI: 10.1155/2020/6957171

Introduction. Trawling is a method of catching fish in a large volume where fish nets are pulled through water using one or two boats. Bottom trawling is where the nets are pulled over on the seabed. The gear of the bottom trawling would impact the exposed subsea pipeline, on the seabed. Subsea pipelines transport crude oil and gas from the offshore platform to shore facility. This study assesses the risk of fish trawling activities to the subsea pipelines at Sabah and Labuan offshore. The specification of trawl equipment used by local trawlers in Sabah was determined by the on-site survey. The frequency of a fish trawler crossing over the pipelines was calculated based interview on operation and site survey. The calculation of the pull-over load of the otter board was calculated using the DNVGL algorithm. The severity and frequency index of the risk matrix was developed based on literature review. Results showed that the pull-over load of the otter board would not damage the pipelines. The risk posed by the fish trawler activity to the pipelines is low and moderate.
Fulltext Vascular Dysfunction among Malaysian Men with Increased BMI: An Indication of Synergistic Effect of Free Testosterone and Inflammation

Aminuddin A, Salamt N, Ahmad Fuad AF, Chin KY, Ugusman A, Soelaiman IN, et al.

Medicina (Kaunas), 2019 Sep 08;55(9).
PMID: 31500378 DOI: 10.3390/medicina55090575

Background and objectives: Obesity is associated with poor vascular function and may lead to future cardiovascular disease (CVD). Obesity is also related to increased inflammation and a low testosterone level. This study was conducted to determine the relationship between inflammation, testosterone level, and vascular function among subjects with an increased body mass index (BMI) and to determine whether both low testosterone and high inflammation have synergistic effects towards vascular dysfunction. Materials and Methods: A total of 303 men aged 40-80 years were recruited from Klang Valley, Malaysia. Their height, weight, blood pressure (BP), lipid, blood glucose level, total testosterone (TT), free testosterone (FT), and C-reactive protein (CRP) were measured. The carotid femoral pulse wave velocity (PWVCF) and augmentation index (AI) were also recorded as markers of vascular function. Results: The mean age of all the subjects was 54.46 ± 9.77 years. Subjects were divided into a low/normal body mass index (BMI) group (BMI < 25 kg/m2; NG, n = 154) and high BMI group (BMI ≥ 25 kg/m2; OG, n = 149). The mean BMI for NG was 22.20 ± 1.94 kg/m2 while for OG was 28.87 ± 3.24 kg/m2 (p < 0.01). The level of TT (OG = 21.13 ± 6.44 versus NG = 16.18 ± 6.16 nmol/L, p < 0.01) and FT (OG = 0.34 ± 0.12 versus NG = 0.39 ± 0.11 nmol/L, p < 0.01) were reduced while the level of CRP [OG = 1.05 (2.80) versus NG = 0.50 (1.50) mmol/L, p = 0.01] was increased in OG compared to NG. PWVCF (OG = 8.55 ± 1.34 versus NG = 8.52 ± 1.42 m/s, p = 0.02) and AI (OG = 16.91% ± 6.00% versus 15.88% ± 5.58%, p < 0.01) were significantly increased in OG after adjustment for other CVD risk factors. The subjects that had both a low FT and an increased CRP had higher AI when compared to those with a high CRP and high FT (p < 0.01). Conclusions: The increased BMI was associated with vascular dysfunction, mediated by a low testosterone level and increased inflammation. Furthermore, having both conditions concurrently lead to higher vascular dysfunction. Weight loss, testosterone supplementation, and the anti-inflammatory agent may be beneficial for men to prevent vascular dysfunction.
The Impact of Military Tobacco Control Policy: A Systematic Review

Hashim MAB, Bin Sebri KF, Bin Mohd Hanim MF, Binti Anwar DS, Binti Mohd Radzi NA, Bin Ahmad Fuad AF, et al.

Mil Med, 2024 Feb 08.
PMID: 38330180 DOI: 10.1093/milmed/usad507

INTRODUCTION: Tobacco use is synonymous with the military. Despite that military personnel are trained to follow commands, opportunities exist to implement various tobacco control strategies. We conducted a systematic review to evaluate the impact of tobacco control policy employed in military settings.
MATERIALS AND METHODS: We searched for published English articles in Medline, Web of Science, Scopus, and Google Scholar databases using relevant subject headings without year restriction. We included randomized controlled trials, nonrandomized controlled trials, case-control, cohort, controlled before and after, and uncontrolled before and after studies evaluating the impact of tobacco control policy in the military population. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, three independent reviewers independently screened initially identified articles, reviewed the full text, and extracted the data and any disagreements resolved by consensus after data recheck. Five reviewers used a validated tool to assess the quality of the included studies. The primary outcome was the reduction of any tobacco or nicotine-contained products (TNCPs) use among the troops. The impacts of the tobacco control policy were synthesized and analyzed qualitatively. This study is registered with the International Prospective Register of Systematic Review (CRD42022314117).
RESULTS: Fourteen studies were included in the analysis from 5372 studies screened. Most of the studies were from the USA, and fractions were from Thailand, France, and Taiwan. These studies were methodologically heterogeneous. Most studies employed a total ban policy on TNCP use during basic military training or operational deployment as the primary strategy. Other methods utilized were the brief tobacco intervention, targeted treatment, support, and counseling provided through telephone or mailing systems, the adjunctive behavioral intervention, providing free nicotine gum, the "Pharsai clinic", active and regular smoking restriction, and interventions aimed at intrapersonal, interpersonal, and organizational levels. There is a moderate quality of evidence that the tobacco control policies effectively reduced the prevalence of TNCP use, increased the cessation rate, reduced the intake, and lowered the dependency. The adjunctive interventions provided after the total ban on TNCP use may increase its effectiveness. However, findings from this review need to be carefully considered as the definition of TNCP use status was not universal between studies and lacked a biochemical validation procedure.
CONCLUSIONS: There is reasonable evidence to support that the tobacco control policy employed in the military population has multiple positive impacts in reducing the prevalence of TNCP use, increasing the cessation rates, reducing the intake, and lowering dependency. Other evidence-based strategies need to be fully utilized to materialize the tobacco endgame.