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Dietary patterns and its associations with adipokines (adiponectin and leptin) among adults: a narrative review

Nor Syamimi Zakarai, Mohd Razif Shahril

Sains Malaysiana, 2017;46:1849-1857.

To compile and analyse existing scientific evidence regarding the association of dietary patterns with adiponectin and
leptin. Medline and PubMed electronic databases were searched for articles related to the association of dietary patterns
with adiponectin and leptin from 2005 to 2015. Only full text articles using English as a language of publication were
included. Studies were limited to the use of food frequency questionnaires in assessing dietary intake, factor analysis
using principal component analysis, cluster analysis or reduced rank regression method in determining dietary pattern.
A total of six relevant studies involving a total of 6467 subjects (47% men and 53% women) met the inclusion criteria
from 1407 reviewed articles Twelve dietary patterns were extracted i.e. healthy pattern, meat and fat, sweet pattern,
potatoes and refined grains, Japanese pattern, westernized pattern, mixed pattern, traditional pattern, vegetables, fruits
and lean meat pattern, high alcohol, ‘Izakaya’ pattern and dieting. Two studies showed association with leptin which
serum leptin concentration showed significantly higher in vegetables, fruits and lean meat compared to western pattern
and lower circulating levels of leptin in westernized breakfast dietary pattern. Adiponectin concentration resulting
significant positive relationship with fruits and vegetables, dieting, Japanese and healthy dietary pattern. Adherence
to healthy dietary patterns plays an important role on serum adiponectin and leptin concentration. However, in most
studies that resulted in a significant relationship, adiponectin, leptin and diet components were evaluated separately.
Therefore, further well-designed studies were required to clarify the mechanism mediating relationship between dietary
patterns and adipokines.
Fulltext Dietary intake among breast cancer survivors in East Coast of Peninsular Malaysia

Laila Ruwaida Mohd Zainuddin, Nor Syamimi Zakarai, Noor Aini Mohd Yusoff, Aryati Ahmad, Mohd Razif Shahril, Suhaina Sulaiman

Malaysian Journal of Public Health Medicine, 2017;17(2):59-65.

A balanced dietary intake plays an important role in the prognosis of breast cancer and is one of the modifiable factors in preventing cancer recurrence. This study aims to determine the dietary intake among breast cancer survivors in East Coast of Peninsular Malaysia. A total of 125 breast cancer survivors, aged 37 to 72 years, with mean duration of survivorship of 6.1 ± 3.9 years were recruited from two main referral hospitals in Terengganu and Kelantan. Majority of the respondents were Malay (94.4%) with a mean BMI of 27.7 ± 5.07 kg/m², and were diagnosed with stage II cancer (66.0%). Dietary intake was estimated using a semi-quantitative food frequency questionnaire (FFQ). The results show that the mean daily intake of energy was 1764 ± 378 kcal/day, protein was 72.38 ± 33.6 g/day (16.5% of energy), carbohydrate was 243.0 ± 62.2 g/day (55% of energy) and fat was 55.8 ± 15.6 g/day (28% of energy). Overall, breast cancer survivors in this study had an adequate daily intake of vitamins and minerals according to Malaysian Recommended Nutrient Intakes (RNI) except for dietary fibre (10.6 ± 4.2 g/day), monounsaturated fatty acids (20.7 ± 5.7 g/day), polyunsaturated fatty acids (8.0 ± 2.2 g/day), calcium (561.0 ± 257.1 mg/day), iron (18.3 ± 7.2 mg/day) and potassium (1813.4 ± 531.1 mg/day) which was lower than the recommendation. Meanwhile, intake of sodium (2592 ± 1697 mg/day), protein (80.4 ± 33.6 g/day), saturated fatty acids (26.9 ± 14.2 g/day), vitamin B2 (1.9 ± 1.1 mg/day) and vitamin C (151.1 ± 149.3 mg/day) exceeded the recommendation by 135.0%, 139.0%, 166.9%, 154.6% and 152.0%, respectively. There was no significant difference in dietary intake between cancer survivors who were diagnosed in the past five years and those who were diagnosed more than five years ago (p>0.05) except for fat (p<0.001), saturated fatty acid (p=0.006), monounsaturated fatty acid (p=0.005) and polyunsaturated fatty acid (p=0.003). As a conclusion, breast cancer survivors in East Coast of Peninsular Malaysia had an adequate intake of most nutrients except for dietary fibre, monounsaturated fatty acids, polyunsaturated fatty acids, calcium, iron and potassium which was below the recommendation and sodium, protein, saturated fatty acids, vitamin B2, vitamin C which was above the recommendation. The intakes between long-term and short-term survivors were also comparable showing sustained dietary intake throughout survivorship.
Fulltext Health-related quality of life among long term and short term breast cancer survivors

Pei Lin Lua, Nor Syamimi Zakarai, Ali Nurnazahiah, Ab Hadi Imisairi, Mohamad Hussain, Aryati Ahmad, et al.

Malaysian Journal of Medicine and Health Sciences, 2020;16(4):146-152.
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Introduction: The number of breast cancer survivors in developing Asian countries is still lacking compared to Western countries. Health-related quality of life (HRQoL) of cancer patients is one of the significant predictors of survival. Hence, this study was conducted to determine HRQoL status among breast cancer survivors of different diagnosis duration in East Coast of Peninsular Malaysia. Methods: Cross-sectional data were collected for 128 breast cancer survivors, aged 37 to 72 years who were recruited by using purposive sampling method at two main govern- ment hospitals in Kelantan (n=67) and Terengganu (n=61). The validated European Organization for Research and Treatment of Cancer Quality of Life Questionnaires (EORTC QLQ–C30) and Breast Cancer Supplementary Measure (EORTC QLQ-BR23) which had been translated into the Malay language were used to measure HRQoL. Indepen- dent t-test was used to compare HRQoL status among short term (5 years duration since diagnosis) and long term (>5 years duration since diagnosis) breast cancer survivors. Results: Overall, our breast cancer survivors reported good HRQoL, with high scores for global health status, functional status and low symptoms scores. Long term breast cancer survivors had better social functioning compared to short term survivors (p=.038). Nevertheless, there was no significant difference found for other HRQoL status between short and long term breast cancer survivors. Conclusion: Breast cancer survivors in East Coast of Peninsular Malaysia generally experienced good HRQoL. The relatively sim- ilar HRQoL status between long-term and short-term survivors indicated a constant HRQoL profile among survivors throughout their survivorship.
Fulltext Relationship of objectively measured physical activity and sedentary behaviour with health-related quality of life among breast cancer survivors

Nurnazahiah A, Shahril MR, Nor Syamimi Z, Ahmad A, Sulaiman S, Lua PL

Health Qual Life Outcomes, 2020 Jul 10;18(1):222.
PMID: 32650777 DOI: 10.1186/s12955-020-01478-x

BACKGROUND: Lack of physical activity throughout one's lifetime has been associated with obesity and it is also an important risk factor of breast cancer. This study aimed to determine the relationship between objectively measured physical activity and sedentary behaviour with health-related quality of life (HRQoL) among breast cancer survivors in the East Coast region of Peninsular Malaysia.
METHODS: A cross-sectional study involving 83 breast cancer survivors was carried out in two main government referral hospitals in the region. Participants wore the ActivPAL3™ microdevice physical activity monitor for seven consecutive days. The validated European Organization for Research and Treatment of Cancer Quality of Life Questionnaires (EORTC QLQ-C30) and Breast Cancer Supplementary Measure (EORTC QLQ-BR23) were used to measure their HRQoL. Multiple linear regression analysis was conducted to determine the relationship between objectively measured physical activity and sedentary behaviour with HRQoL.
RESULTS: Longer time spent on moderate to vigorous physical activity (MVPA) was significantly associated with an improvement of HRQoL (p = 0.039) whereas longer time spent on sedentary behaviour significantly reduced the functioning score (p = 0.005). In addition, prolonged sedentary bouts were also significantly associated with better body image that led to improved HRQoL (p = 0.013).
CONCLUSIONS: The study findings suggest that an increase in the time spent on MVPA was associated with improved HRQoL while sedentary behaviour was associated with poorer HRQoL among breast cancer survivors. Thus, it is essential to displace sedentary behaviour with MVPA to improve the quality of life of breast cancer survivors.