Introduction: Type 2 diabetes is increasing at an alarming rate worldwide. One of the leading factors to this condition is obesity. Low glycemic index (GI) and glycemic load (GL) diets have been proposed as lifestyle changes to address obesity, however, there is a lack of consensus on the optimal approach for weight loss, glycemic control and improving insulin sensitivity. In addition, the outcome of these diets are equivocal, with some studies suggesting beneficial outcomes and others suggesting otherwise. Furthermore, discrepant study designs have led to divergent conclusions. In order to provide a comprehensive overview of the low GI and low GL diets, a systematic review of literature on relevant observational studies and randomised control trials was performed on these databases:- The Cochrane Library, Medline, PubMed, Embase, Cinahl and Web of Science. Methods: The review was conducted based on the methodological standards for the conduct and reporting of Cochrane intervention reviews, Version 1.07, November 2018. Population, Intervention, Comparison and Outcomes (PICO) tool was used as the organising framework to define key elements of the review question. Results: Pertinent outcome variables include body weight, insulin resistance, HbA1c, fasting serum glucose, BMI, waist-to-hip ratio, triglyceride, HDL and LDL cholesterol. Our current understanding of these diets has been complicated by the reports that were based on different study designs and study populations. This review defines the issues, gaps in the research, study design, and evidence that is needed to inform practice, policy making and future research. There is also a dearth of information on the effect of low GI and GL diets on the Asian populations, specifically on improving insulin resistance. High carbohydrate diets are a mainstay of Asian societies. Conclusion: As cases of obesity and type 2 diabetes surge, there is an urgent need for research on low GI and GL dietary modifications among the Asian populations.
Seventeen members of the national sepaktakraw squad undergoing centralised training participated in a comprehensive study to determine their daily food intake, activity patterns and energy requirements. Food intake was recorded as a mean of 3-days weighed food intake and the nutrient contents were calculated using a local food composition table. The energy cost of standardised activities was determined by indirect calorimetry while time and motion study was used to estimate the daily energy expenditure of each subject. The mean daily energy intake was 2784±373 kcal (11.6±1.6 MJ) while the mean daily energy expenditure was 3004±298 kcal (12.6±1.2 MJ), with a negative energy balance of 220 kcal ((0.9 MJ). Intake of other nutrients were adequate when compared with the Malaysian RDA, with the exception of niacin. The results of the activity pattern study indicated that the subjects spent about 80% of the day doing light activities while 20% of the day was devoted to their training programme comprising of moderate to heavy activities. This data set represents the first of its kind in Malaysia and should provide impetus for further research in this area which would help establish dietary guidelines for Malaysian sportsmen.
The energy intake and expenditure of 20 healthy soldiers (mean age, 25 years, weight 61 kg and height 1.67 m) was assessed. Trained personnel stayed in the camp throughout the 5 weeks study period. Each soldier was subjected to a 7-day comprehensive protocol involving anthropometric, food intake, activity pattern and energy expenditure measurements. The mean change in body weight and fat content was minimal, -0.2kg and -0.25%, respectively. Body fat and BMI ranges from 10.0-21.6% and 19.8-24.9, respectively. The mean energy intake of 2190 ± 197 kcal was well below (81%) the recommended allowance of 2700 kcal for the Malaysian Armed Forces. The ration scale analysed chemically provides 2900 kcal thus suggesting a 24% wastage of daily ration. Contribution of protein (15%), fat (25%) and carbohydrate (60%) to energy intake appears to be in line to healthy dietary guidelines. Energy cost of standardised activities were found to be lower in Malaysian soldiers as compared to British soldiers studied under similar environment in the tropics. The mean total daily energy expenditure (TDEE) for soldiers were 2886 ± 222 kcal with a negative energy balance of about 700 kcal. The results suggested that there is a need to review the current provision with regard to food supply and preparation in army camps, to ensure that the menu provided are appealing as well as nutritious for the soldiers.
Physical inactivity is strongly associated with obesity and an increased risk of cardiovascular disease in children and adolescents. A cross-sectional study using multistage random sampling was conducted to determine associations between demographic characteristics, sedentary behaviours and physical activity among adolescents. Data were collected from 785 (414 males and 371 females) Form four students attending 15 schools in Petaling District, Selangor using an adapted self-administered questionnaire. Results showed that more females (50.1%) were physically inactive compared to males (39.6%) (Adjusted odds ratio (OR): 1.55, 95% confidence interval (CI): 1.12-2.15). Physically inactive adolescents were less likely to participate in intramural/house league sports (OR: 1.71, 95% CI: 1.19-2.44), school team sports (OR: 1.45, 95% CI: 1.03-2.04) and individual physical activities outside school (OR: 1.53, 95% CI: 1.11-2.12) compared to their physically active counterparts. Physically inactive adolescents were also less engaged in sedentary activities, such as television watching (OR: 0.69, 95% CI: 0.50-0.94), playing computer/video game (OR: 0.44, 95% CI: 0.28-0.72), talking on the telephone/mobile phone text messaging (OR: 0.47, 95% CI: 0.32-0.69) and reading (OR:0.45, 95% CI: 0.24-0.86) compared to those who were physically active. In this study, physical activity coexists with sedentary behaviour in adolescents. Sedentary activities may not necessarily displace physical activity among youth. In addition, these data suggest that promoting organised sports in school and outside the school among youths may be a potential strategy for increasing physical activity in this population.
A study to predict energy requirements of national athletes, 84 males and 24 females in 9 and 4 different types of sports respectively, were conducted during centralised training. Parameters assessed were anthropometry, 3-day activity pattern and energy cost (kcal/min) of common activities to derive total daily energy expenditure (TDEE). Based on body mass index (BMI), 68 males or 81% and 19 females or 79% of the athletes were classified as normal. The mean body fat content for males and females were 13.8 ± 4.5% and 24.7 ± 5.3%, respectively. The mean daily activity pattern of males and females athletes were similar for light activities (16½ hr or 68% of day), for moderate activities (3½ hr or 15% of day in male, 4 hr or 17% in females) while moderate to heavy activities related to training were 4 hr (17%) and 3½ hr (15%) in males and females, respectively. Energy cost of some common activities ranges from 1.00-3.00 kcal/min in males and 0.84-2.04 kcal/min in females, while values for jogging were 6.60 kcal/min and 5.62 kcal/min in males and females, respectively. The mean TDEE in male ranges from 2938 kcal (12.3 MJ) in boxers (57 kg) to 4861 kcal (20.3 MJ) in weightlifters (110 kg) while the mean TDEE in female ranges from 2099 kcal (8.8 MJ) in athletics (51 kg) to 3098 kcal (13.0 MJ) in basketball (61.4 kg). The calculated physical activity level (PAL) values using measured BMR for males and females athletes ranges from 1.99-2.58 and 1.77-2.34, respectively. In conclusion, the estimated energy requirement for the various sports event studied ranges from 44-55 kcal/kg/day in males and 38-50 kcal/kg/day in female athletes.
This cross-sectional study investigates the association between energy intake and macronutrient composition of the diet with overweight and obesity among Malaysian women. One hundred and fifteen adult Malay women aged 20 to 59 years (mean age 37.2±7.6 years) were interviewed. Dietary intake was assessed using the food history method. Body weight status was assessed using weight, height, waist circumference and fat percentage measurements. When energy intake was assessed for accuracy, only 41% of the subjects (n=47) were normal energy reporters. Among the normal energy reporters, 55% were of normal weight whereas 32% and 13% were overweight and obese. Mean energy intake for normal weight, overweight and obese subjects was 1685±199 kcal/day, 1810±166 kcal/day and 2119±222 kcal/day, respectively. Energy intake increased with body mass index (BMI) category. Among the overweight and obese, energy intake was respectively higher by 125 kcal/day and 434 kcal/day as compared to their normal weight counterparts (p< 0.001). There was also a significant, moderate and positive correlation between energy intake and BMI (r=0.635), waist circumference (r=0.545), and body fat percentage (r=0.534). When macronutrient composition of diet was analysed (% energy and g/1000 kcal), there was no significant difference in carbohydrate, protein or fat intake between the obese, overweight and normal weight subjects. There was also no significant correlation between macronutrient composition of the diet and body weight status. Based on these findings, we conclude that the subjects' body weight status is likely to be influenced by energy intake rather than the macronutrient composition of the diet.
Metabolic syndrome was once reported only in adults but is now occurring more frequently in children. This study compared the incidence of metabolic syndrome and its components among normal and obese children using the 2007 International Diabetes Federation (IDF) pediatric definition for metabolic syndrome. Subjects comprised 78 school children aged 8-10 years, with 34 obese and 44 normal weight children. Body weight, height, and waist circumference (WC) were measured and body mass index was calculated. Clinical profiles measured included fasting blood glucose, triglyceride, HDL cholesterol, LDL cholesterol, total cholesterol, and blood pressure. Metabolic syndrome (MS) was defined using the 2007 IDF pediatric criteria. Obese subjects had a significantly (p< 0.001) higher mean BMI (26.0 ± 3.6 kg/m2) compared to normal weight subjects (15.1 ± 0.8 kg/m2). Only one obese subject (1.3% of subjects) had metabolic syndrome based on the IDF definition, but all obese subjects had at least one component of metabolic syndrome. In comparison, no normal weight subjects had metabolic syndrome and only 9.1% of normal weight subjects had at least one component of metabolic syndrome. The most common component was central obesity, observed in 43.6% of subjects having WC equal to or greater than the 90th percentile. In concurrence with central obesity as the core feature of the IDF criteria, WC showed the strongest correlation with indicators of obesity such as BMI (r=0.938, p< 0.001), fat mass (r=0.912, p< 0.001) and fat-free mass (r=0.863, p< 0.001). We conclude that the problem of metabolic syndrome is more prominent among obese children, although the incidence of MS as defined by the 2007 pediatric IDF criteria, is low in this population (1.3%).
Anthropometry is the single most portable, easily applied, inexpensive and non-invasive method of assessing body composition. It reflects both health and nutrition and predicts performance, health and survival. The use of body mass index (BMI) as a measure of obesity has been widespread and has recently been promoted for assessment of chronic energy deficiency (CED) in adults. This report provides BMI values of 2636 adult males and 2111 adult females from the three main ethnic groups residing in urban areas and BMI of adult Malay and Dayak (380 males and 496 females) residing in rural areas in Peninsular Malaysia, Sabah and Sarawak. The percent prevalence of obesity and CED in males for the three ethnic groups were apparently quite similar. However, in the females, CED were higher in the Malays and Chinese while overweight problems were more serious in the Indians. Among the Malays, prevalence of CED for males and females were 7% and 11% in urban areas and 11% and 14% in rural areas, respectively. In the males, it is interesting to note that there is a two-fold difference between urban and rural, while a high prevalence of overweight women (20%) even in the rural areas should be viewed as a potential health problem of the future.
INTRODUCTION: The basal metabolic rate (BMR) is essential in deriving estimates of energy requirements for a population. The aim of this study was to measure the BMR in order to derive a predictive equation for the Malaysian Armed Forces (MAF) naval trainees.
METHODS: A total of 79 naval trainees aged 18 to 25 years from a training centre (Group A) and on board a ship (Group B) participated in the study. Anthropometric measurements included height and weight. Body fat and free fat mass were measured using the bioelectrical impedance analysis method. BMR was measured by indirect calorimetry with a canopy system.
RESULTS: The mean height, weight and body fat for Group A was 1.67 +/- 0.04 m, 61.0 +/- 3.9 kg and 12.7 percent +/- 2.5 percent, respectively, and 1.67 +/- 0.05 m, 62.3 +/- 6.2 kg and 14.0 percent +/- 3.5 percent, respectively, for Group B. The mean BMR for Group A (6.28 +/- 0.40 MJ/ day) did not differ significantly (p is more than 0.05) from that of Group B (6.16 +/- 0.67 MJ / day). The Food and Agriculture Organization/World Health Organization/United Nations University and the Henry and Rees equations overestimated the measured BMR by 9 percent (p is less than 0.001) and 0.5 percent (p is more than 0.05), respectively, while the Ismail et al equation underestimated the measured BMR by 5.6 percent (p is less than 0.001). A predictive equation, BMR = 3.316 + 0.047 (weight in kg) expressed in MJ /day with weight as the only independent variable, was derived using regression analysis.
CONCLUSION: We recommend that this predictive equation be used to estimate the energy requirements of MAF naval trainees.
This study was conducted to determine changes in nutrition knowledge, attitude and practice of 8-year-old school children after receiving a nutrition education package. A total of 418 school children from urban and rural areas participated in this study. The intervention group consisted of 237 children while 181 children who did not receive the nutrition education package acted as controls. The nutrition education programme that was conducted for 3 weeks comprised of a video viewing session and a comic reading session followed by exercise questions as reinforcement for each session, and also classroom activities. Knowledge, attitude and practice questionnaires were distributed to the children before (pre-intervention) and after (postintervention) receiving the nutrition education programme. A follow-up visit was conducted six months after the programme had elapsed. The results obtained indicated that the nutrition knowledge score increased significantly in the intervention group from 48.3±13.2 at pre-test to 54.6±16.2 in post-test and 55.0±14.3 in follow-up test (p<0.05). The nutrition attitude score also increased significantly from 68.7±15.5 at pre-intervention to 72.6±15.0 and 74.7±15.8 during post-test and follow-up test respectively (p<0.05). However, the nutrition practice score had no significant improvement in both groups throughout the study period. There were no significant changes in the control group in knowledge, attitude and practice scores at pre, post and follow-up tests. In conclusion, this study showed that a good nutrition education programme had a positive impact whereby better nutrition knowledge, attitude and healthy eating habits in children were seen. It is hoped that the improvements would be sustained throughout their lives.
Enzymatic activity and microbial fermentation play a prominent role in the bioconversion of complex muscle tissue into smaller units of peptides and amino acids, possibly contribute to sensory properties. Thus, this study screens and evaluate anchovy proteins with taste-active peptides and amino acids by the reaction of multiple enzymes using an in silico approach. Information about sensory components was provided based on an in silico analysis using tools available in the BIOPEP-UWM database. Proteins from anchovy, namely myosin heavy chain 6 alpha, myosin light chain 1, cytochrome B, and NADH ubiquinone oxidoreductase, were subjected to in silico digestion with the combination of 23 enzymes. This led to the release of taste-active peptides and amino acids, including umami, sweet, salty, sour, and bitter sensory properties. The combination of multiple enzymes released a more significant number of taste-active peptides and amino acids for both myosins compared to other proteins.
The assessment of nutritional status among paediatric patients is important for the planning and execution of nutritional strategies that strive to optimise the quality of life and growth among sick children. The present study aimed to evaluate the nutritional status and dietary intake among children with acute leukaemia.
This study was undertaken to assess the recent data on Malaysian adult body weights and associations of ethnic differences in overweight and obesity with comorbid risk factors, and to examine measures of energy intake, energy expenditure, basal metabolic rate (BMR) and physical activity changes in urban and rural populations of normal weight. Three studies were included (1) a summary of a national health morbidity survey conducted in 1996 on nearly 29 000 adults > or =20 years of age; (2) a study comparing energy intake, BMR and physical activity levels (PALs) in 409 ethnically diverse, healthy adults drawn from a population of 1165 rural and urban subjects 18-60 years of age; and (3) an examination of the prevalence of obesity and comorbid risk factors that predict coronary heart disease and type 2 diabetes in 609 rural Malaysians aged 30-65 years. Overweight and obesity were calculated using body mass index (BMI) measures and World Health Organization (WHO) criteria. Energy intake was assessed using 3-d food records, BMR and PALs were assessed with Douglas bags and activity diaries, while hypertension, hyperlipidaemia and glucose intolerance were specified using standard criteria. The National Health Morbidity Survey data revealed that in adults, 20.7% were overweight and 5.8% obese (0.3% of whom had BMI values of >40.0 kg m(-2)); the prevalence of obesity was clearly greater in women than in men. In women, obesity rates were higher in Indian and Malay women than in Chinese women, while in men the Chinese recorded the highest obesity prevalences followed by the Malay and Indians. Studies on normal healthy subjects indicated that the energy intake of Indians was significantly lower than that of other ethnic groups. In women, Malays recorded a significantly higher energy intake than the other groups. Urban male subjects consumed significantly more energy than their rural counterparts, but this was not the case in women. In both men and women, fat intakes (%) were significantly higher in Chinese and urban subjects. Men were moderately active with the exception of the Dayaks. Chinese women were considerably less active than Chinese men. Chinese and Dayak women were less active than Malay and Indian women. In both men and women, Indians recorded the highest PALs. Hence, current nutrition and health surveys reveal that Malaysians are already affected by western health problems. The escalation of obesity, once thought to be an urban phenomenon, has now spread to the rural population at an alarming rate. As Malaysia proceeds rapidly towards a developed economy status, the health of its population will probably continue to deteriorate. Therefore, a national strategy needs to be developed to tackle both dietary and activity contributors to the excess weight gain of the Malaysian population.
Study name: National Health and Morbidity Survey (NHMS-2006)
The Malaysian Dietary Guidelines (MDG) with eight key messages were first published in 1999. An updated version consisting of 14 key messages is being developed. The objective of this study was to evaluate the understanding of five key messages of the updated MDG among adults aged 18-59 years in Kuala Lumpur. A total of 773 adults comprising 330 Malays, 364 Chinese and 79 Indians were included in the study. A self-administrated questionnaire was used to obtain demographic data and to determine the level of understanding of key words and messages to be included in the new MDG. The results showed that 63% of the subjects were not aware of the existence of the MDG published in 1999. Overall, the understanding of the five messages in the updated MDG was moderate with a mean score of 60.0 ± 16.5. Between 52% to 93% of the subjects did not understand such key words as serving size, sedentary habits, blended vegetable oil and shortenings. The mean scores of understanding were significantly higher (p< 0.05) among the Chinese subjects (61.3 ± 17.8) than Malays (58.6 ± 14.2) and Indians (60.0 ± 18.9). The younger subjects (61.2 + 16.0) scored significantly (p< 0.05) higher than the older (58.7 ± 17.0) counterparts. There was also a significant association between the level of understanding of MDG with education level (p< 0.001) and occupational status (p< 0.001), respectively. This study suggests that some key words and messages in the updated MDG should be simplified to ensure that they are understood by Malaysians.
The Malaysian society is experiencing and coping with a fast modernization process, which is characterized by a rapid urbanization and rural exodus, an important reduction of the size of households, and the emergence of a new middle class. The Malaysian Food Barometer launched in 2013 has provided better understanding how these macro issues have affected the lifestyles and especially the food habits of the Malaysians. The country has indeed undergone a transition period from under-nutrition to over-nutrition in a few decades, with the prevalence of overweight and obesity having markedly and rapidly increased. A quantitative survey (n = 2000), elaborated from a qualitative preliminary phase, was carried out with the aim of analyzing the transformation of food habits at the national level. The present article focuses on the BMI issue in Malaysia, and investigates its relationships with the socio-demographic variables of the population, as well as their eating patterns. The mean BMI is 23.64 kg/m2, with 9.5% of the sample being obese, and 22% overweight. Strong statistical associations have been identified between BMI and independent variables such as size of the living area, ethnicity, level of education, gender, and age. Contrary to general believe, overweight and obesity were neither associated with the number of food intakes taken per day (including snacks) nor with the frequency of eating out. Nonetheless, obesity is over-represented in people who have dissonant eating behaviors, i.e. who declare having fewer food intakes a day (food norms) than they do actually (food practices). This process testifies that the Malaysians are experiencing a "food transition", which is linked with socio-economic development.
To develop and cross-validate bioelectrical impedance analysis (BIA) prediction equations of total body water (TBW) and fat-free mass (FFM) for Asian pre-pubertal children from China, Lebanon, Malaysia, Philippines and Thailand.
The generation of power and fuel sustainability that contributes to a cleaner output of exhaust gases is one of the most important objectives the world seeks. In this paper, oxyhydrogen gas is used to retrofit into a two-stroke engine. The water was electrolysed and generated a mixture of oxygen (O2) and hydrogen (H2) or known as oxyhydrogen (HHO) gas via an electrolytic dry cell generator. The HHO was retrofitted experimentally to investigate the engine emissions and exhaust gas temperature from a 1.5 kW gasoline engine. The engine was tested with different power ratings (84-720 W) to investigate the performance and emissions of the engine using gasoline followed by the addition of HHO. The emissions of CO and NOx were measured with different amounts of HHO added. The exhaust temperature was calculated as one of the variables to be considered in relation to pollution. The air-fuel ratios are varied from 12 to 20% in the experiment. The most appropriate air-fuel ratio needed to start the generator with the most environmentally friendly gas emission was analysed. The results showed that the addition of HHO to the engine is successful in reducing fuel consumption up to 8.9%. A higher percentage of HHO added also has improved the emissions and reduced exhaust gas temperature. In this study, the highest quantity of HHO added at 0.15% of the volume fraction reduced CO gas emission by up to 9.41%, NOx gas up to 4.31%, and exhaust gas temperature by up to 2.02%. Generally, adding oxyhydrogen gas has significantly reduced the emissions, and exhaust temperature and provided an eco-friendly environment.