Displaying publications 1 - 20 of 194 in total

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  1. Zunura'in Z, Almardhiyah AR, Gan SH, Arifin WN, Sirajudeen K, Bhavaraju V, et al.
    Asian Pac J Cancer Prev, 2016;17(9):4439-4444.
    PMID: 27797258
    The objective of this case-control study was to determine anthropometric and reproductive factors associated with the development of breast cancer among women. Fifty-six newly diagnosed breast cancer patients were recruited from the Oncology Clinic, Universiti Sains Malaysia (USM), and 56 healthy female hospital employees were recruited as controls. Socio-demographic and reproductive data were obtained using a standard questionnaire. Anthropometric factors (body weight, height, body fat percentage, visceral fat and waist and hip circumference) were assessed. A high waist circumference (adjusted OR= 1.04, [95% CI: 1.00, 1.09]) and being more than 30 years of age at rst full-term pregnancy (adjusted OR=3.77, [95% CI: 1.10, 12.90]) were predictors of breast cancer development. The results of this study indicate that weight and reproductive health management should be emphasized for breast cancer prevention in Malaysia.

    Study site: Oncology clinic, Hospital Universiti Sains Malaysia (HUSM)
  2. Zainal Arifen ZN, Shahril MR, Shahar S, Mohamad H, Mohd Yazid SFZ, Michael V, et al.
    Foods, 2023 Mar 14;12(6).
    PMID: 36981160 DOI: 10.3390/foods12061234
    Despite growing evidence of increased saturated and trans fat contents in street foods, little is known about their fatty acid (FA) compositions. This study aimed to analyse the saturated fatty acids (SFAs), monounsaturated fatty acids (MUFAs), polyunsaturated fatty acids (PUFAs), and trans fatty acids (TFAs) content of 70 selected and most commonly available street foods in Malaysia. The street foods were categorised into main meals, snacks, and desserts. TFAs were not detected in any of the street foods. Descriptively, all three categories mainly contained SFAs, followed by MUFAs, and PUFAs. However, the one-way ANOVA testing showed that the differences between each category were insignificant (p > 0.05), and each FA was not significantly different (p > 0.05) from one to another. Nearly half of the deep-fried street foods contained medium to high SFAs content (1.7 g/100 g-24.3 g/100 g), while the MUFAs were also high (32.0-44.4%). The Chi-square test of association showed that the type of preparation methods (low or high fat) used was significantly associated (p < 0.05) with the number of SFAs. These findings provide valuable information about fat composition in local street foods for the Malaysian Food Composition Database and highlight the urgency to improve nutritional composition.
  3. Zainal Arifen ZN, Haron H, Shahar S, Harun Z, Michael V, You YX, et al.
    Public Health Nutr, 2023 Dec 15;27(1):e12.
    PMID: 38098442 DOI: 10.1017/S136898002300277X
    OBJECTIVE: To explore the perspectives, barriers and enablers on salt reduction in out-of-home sectors in Malaysia among street food vendors, caterers and consumers.

    DESIGN: A qualitative study involving twenty-two focus group discussions and six in-depth interviews was conducted, recorded and transcribed verbatim. An inductive thematic analysis approach was employed to analyse the data.

    SETTING: Two in-depth interviews and twenty-two focus group discussions were conducted face-to-face. Four in-depth interviews were conducted online.

    PARTICIPANTS: Focus group discussions were conducted among twenty-three street food vendors, twenty-one caterers and seventy-six consumers of various eateries. In-depth interviews were conducted among two street food vendors and four caterers, individually.

    RESULTS: Consumers and food operators perceived a high-salt intake within Malaysia's out-of-home food sectors. Food operators emphasised the necessity for a comprehensive salt reduction policy in the out-of-home sector involving all stakeholders. Consumers faced limited awareness and knowledge, counterproductive practices among food operators and challenges in accessing affordable low-Na food products, whereas food operators faced the lack of standardised guidelines and effective enforcement mechanisms and uncooperative consumer practices. Both groups expressed that food quality and price of salt were also the barriers, and they advocated for awareness promotion, enhanced regulation of manufactured food products and stricter enforcement targeting vendors. Consumers also suggested promoting and recognising health-conscious food premises, whereas food operators suggested on knowledge enhancement tailored to them, strategies for gaining consumers acceptance and maintaining food quality.

    CONCLUSIONS: These findings provide valuable insights that serve as foundational evidence for developing and implementing salt reduction policies within Malaysia's out-of-home sectors.

  4. Zainal Arifen ZN, Shahar S, Trieu K, Abdul Majid H, Md Noh MF, Haron H
    Food Chem, 2024 Apr 10;450:139288.
    PMID: 38631211 DOI: 10.1016/j.foodchem.2024.139288
    Street foods are often of poor nutritional quality with high sugar content, in which the overconsumption of sugar is associated with obesity. However, sugar content information on local street foods is scarce. Thus, the individual and total sugar contents of 94 types of street foods in Malaysia were analysed. Compared to snacks and main meals, desserts contained the highest amounts of sugar, sucrose, fructose, glucose, and maltose. Sucrose was predominant in 90% desserts, 79.3% snacks, and 68.6% main meals. Most desserts (93.3%) contained medium to high sugar content (≥5 g to >15 g/100 g), while 82.9% main meals and 65.5% snacks had low sugar content. When comparing the sugar contents of 39 foods with other local databases, 58.3% main meals, 55.6% desserts, and 33.3% snacks contained either significantly (p 
  5. You YX, Shahar S, Rajab NF, Haron H, Yahya HM, Mohamad M, et al.
    Nutrients, 2021 Jan 29;13(2).
    PMID: 33572715 DOI: 10.3390/nu13020434
    Cosmos caudatus (CC) contains high flavonoids and might be beneficial in neuroprotection. It has the potential to prevent neurodegenerative diseases. Therefore, we aimed to investigate the effects of 12 weeks of Cosmos caudatus supplement on cognitive function, mood status, blood biochemical profiles and biomarkers among older adults with mild cognitive impairment (MCI) through a double-blind, placebo-controlled trial. The subjects were randomized into CC supplement (n = 24) and placebo group (n = 24). Each of them consumed one capsule of CC supplement (250 mg of CC/capsule) or placebo (500 mg maltodextrin/capsule) twice daily for 12 weeks. Cognitive function and mood status were assessed at baseline, 6th week, and 12th week using validated neuropsychological tests. Blood biochemical profiles and biomarkers were measured at baseline and 12th week. Two-way mixed analysis of variance (ANOVA) analysis showed significant improvements in mini mental state examination (MMSE) (partial η2 = 0.150, p = 0.049), tension (partial η2 = 0.191, p = 0.018), total mood disturbance (partial η2 = 0.171, p = 0.028) and malondialdehyde (MDA) (partial η2 = 0.097, p = 0.047) following CC supplementation. In conclusion, 12 weeks CC supplementation potentially improved global cognition, tension, total mood disturbance, and oxidative stress among older adults with MCI. Larger sample size and longer period of intervention with incorporation of metabolomic approach should be conducted to further investigate the underlying mechanism of CC supplementation in neuroprotection.
  6. You YX, Shahar S, Mohamad M, Yahya HM, Haron H, Abdul Hamid H
    J Magn Reson Imaging, 2020 04;51(4):1142-1153.
    PMID: 31386268 DOI: 10.1002/jmri.26891
    BACKGROUND: Working memory and cognitive flexibility are supported by the dorsolateral prefrontal cortex (DLPFC). Aging adults from low-income households are individuals with a high risk of cognitive decline who incorporate ulam in their daily diet.

    PURPOSE: To examine relationship between ulam consumption and the working memory and cognitive flexibility among aging adults from low-income households who are more susceptible to cognitive decline.

    STUDY TYPE: Cross-sectional.

    POPULATION/SUBJECTS: Thirty-two aging adults (45-75 years old).

    FIELD STRENGTH/SEQUENCE: Task-based fMRI, 3.0T, T1 -weighted anatomical images, T2 *-weighted imaging data.

    ASSESSMENT: The dietary and ulam consumption were assessed using the respective validated Dietary History and semiquantitative Food Frequency questionnaires. Working memory and cognitive flexibility were evaluated by using neuropsychological batteries (ie, mini-mental state examination [MMSE], Digit Span, and Rey auditory verbal learning test [RAVLT]) and task-based fMRI (N-back and Stroop Color Word Test [SCWT]). Brodmann's areas 9 and 46 were the regions of interest (ROIs) of DLPFC activation.

    STATISTICAL TESTS: Multiple linear regression used to understand the relationship between ulam consumption and the working memory and cognitive flexibility, while analysis of covariance (ANCOVA) was used to compare the difference of working memory and cognitive flexibility among four percentiles of ulam consumption, after age, gender, and education years adjustments. Significance was decided by two-sided, P 

  7. You YX, Shahar S, Mohamad M, Rajab NF, Haron H, Che Din N, et al.
    J Magn Reson Imaging, 2021 12;54(6):1804-1818.
    PMID: 34080265 DOI: 10.1002/jmri.27762
    BACKGROUND: Cosmos caudatus (CC) is traditional Asian vegetable, commonly consumed among the Southeast Asian population. It has been reported to be high in flavonoids and might potentially improve brain activity among older adults with mild cognitive impairment (MCI). The effect of CC in brain activation improvement using neuroimaging is yet to be discovered.

    PURPOSE: To investigate the effects of CC supplement on brain activity using functional magnetic resonance imaging (fMRI) among older adults with MCI.

    STUDY TYPE: Prospective, randomized, double-blind, placebo-controlled trial.

    POPULATION/SUBJECTS: Twenty older adults with mild cognitive impairment (60-75 years old), 14 of them (70%) were female subjects.

    FIELD STRENGTH/SEQUENCE: A 3.0-T, T1-weighted anatomical images, T2*-weighted imaging data, A single shot, gradient echo-echo planar imaging (EPI) sequence.

    ASSESSMENT: All subjects were asked to consume two 500 mg capsules of either CC supplement or placebo (maltodextrin) daily for 12 weeks. Cognitive function was measured using validated neuropsychological tests (i.e. Mini-mental State Examination and Digit Span) and task-based fMRI (N-back and Stroop Color Word Test) at baseline and 12th week. Brodmann's area 9, 46 and anterior cingulate cortex were selected as the regions of interest to define dorsolateral prefrontal cortex (DLPFC) in fMRI analysis.

    STATISTICAL TESTS: Normality test was performed with the Shapiro-Wilk test. Two-way repeated ANOVA determined the intervention effects of the CC supplementation on brain activity after adjustments for covariates. Significance level at P 

  8. You YX, Shahar S, Mohamad M, Rajab NF, Che Din N, Lau HJ, et al.
    Front Hum Neurosci, 2021;15:765451.
    PMID: 35046782 DOI: 10.3389/fnhum.2021.765451
    Working memory is developed in one region of the brain called the dorsolateral prefrontal cortex (DLPFC). The dysfunction of this region leads to synaptic neuroplasticity impairment. It has been reported that several biochemical parameters and anthropometric measurements play a vital role in cognition and brain health. This study aimed to investigate the relationships between cognitive function, serum biochemical profile, and anthropometric measurements using DLPFC activation. A cross-sectional study was conducted among 35 older adults (≥60 years) who experienced mild cognitive impairment (MCI). For this purpose, we distributed a comprehensive interview-based questionnaire for collecting sociodemographic information from the participants and conducting cognitive tests. Anthropometric values were measured, and fasting blood specimens were collected. We investigated their brain activation using the task-based functional MRI (fMRI; N-back), specifically in the DLPFC region. Positive relationships were observed between brain-derived neurotrophic factor (BDNF) (β = 0.494, p < 0.01) and Mini-Mental State Examination (MMSE) (β = 0.698, p < 0.01); however, negative relationships were observed between serum triglyceride (β = -0.402, p < 0.05) and serum malondialdehyde (MDA) (β = -0.326, p < 0.05) with right DLPFC activation (R 2 = 0.512) while the participants performed 1-back task after adjustments for age, gender, and years of education. In conclusion, higher serum triglycerides, higher oxidative stress, and lower neurotrophic factor were associated with lower right DLPFC activation among older adults with MCI. A further investigation needs to be carried out to understand the causal-effect mechanisms of the significant parameters and the DLPFC activation so that better intervention strategies can be developed for reducing the risk of irreversible neurodegenerative diseases among older adults with MCI.
  9. Yeo PS, Shahar S, Rajikan R, Mohd Yusoff NA
    Int J Public Health Res, 2014;4St(1):399-404.
    MyJurnal
    Introduction Low bone mineral density is a significant problem in children with Thalassemia which may lead to increased risk for fragility fractures and suboptimal peak bone mass. This cross-sectional study was conducted to
    determine the bone health status of Thalassemia children Universiti Kebangsaan Malaysia Medical Centre and Paediatrics Insititute Kuala Lumpur Hospital.
    Methods A total of 81 respondents diagnosed with transfusion dependant beta Thalassemia (41 boys and 40 girls) aged between 7 to 19 years old completed the study. The data collected were demographic information, anthropometric measurements, dairy frequency questionnaires, dietary habits of the respondents and their parents, dietary intakes and bone densitometry using Ultrasound Bone Densitometer.
    Results For Quantitative Ultrasound (QUS) parameters, T-score of 9.8% participants were lower than -1.0 and 30.9% of the participants had lower Speed of Sound (SOS) than healthy SOS. This study showed there was no difference in bone density by sex (p>0.05). The median bone density of boys was 1616.00 m/sec (IQR= 39.00) and girls’ was 1579.00 m/ sec (IQR= 116.00). SOS was not increased with age, height and weight; but girls’ Body Mass Index (BMI). Malay children had significantly higher SOS than non-Malay children.
    Conclusions This study highlights a need of proper intervention for the high risk group to achieve optimal bone health.
    Study site: inpatient or outpatient, Institut Pediatrik (Hospital Kuala Lumpur), Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
  10. Yaacob, M., Rajab N.F., Shahar, S., Sharif, R.
    Food Research, 2018;2(2):124-133.
    MyJurnal
    Modern science has found that most traditional practice of using stingless bee honey has
    great potential as an added value in modern medicine and considered to have a higher
    medicinal value than other bee species. However, due to the relatively low output of honey
    compared to other honey so, focus on this honey is limited. Hence, this systematic review
    provides the updated result on the potential value of stingless bee honey as an antioxidant,
    anti-inflammatory, cytotoxicity and antimicrobial. The search strategy was developed in
    four databases (Scopus, Medline and Ovid, EMBASE and PubMed) with the search terms
    "("honey" and "Kelulut", "honey" and "stingless bee", "honey" and "Trigona", "honey"
    and "pot honey", and "honey" and "Melipon")". The merged data was assessed using
    PRISMA guidelines and after the duplicates were removed, 1271 articles were segregated.
    Afterwards, 1232 articles were eliminated because they do not meet the inclusion criteria
    and 39 articles were reevaluated again for eligibility. Finally, after the evaluation process,
    only 26 of the articles were chosen for this review. The data of 26 articles of stingless bee
    honey were deliberated based on antioxidant properties, anti-inflammatory, cytotoxicity
    and analysis of antimicrobial activity. Three articles reported on antioxidant properties,
    one article on anti-inflammatory analysis, two articles on cytotoxicity analysis, and twenty
    articles on analysis of antimicrobial activity. Based on the feasible affirmation from the
    literature, stingless bee honey has an antioxidant capacity that able to decrease the ROS.
    ROS able to lead a variety of health problems thus stingless bee honey can be a dietary
    supplement to overcome this problem.
  11. Wu W, Ding D, Zhao Q, Xiao Z, Luo J, Ganguli M, et al.
    Alzheimers Dement, 2023 Jan;19(1):107-122.
    PMID: 35290713 DOI: 10.1002/alz.12628
    INTRODUCTION: Though consistent evidence suggests that physical activity may delay dementia onset, the duration and amount of activity required remains unclear.

    METHODS: We harmonized longitudinal data of 11,988 participants from 10 cohorts in eight countries to examine the dose-response relationship between late-life physical activity and incident dementia among older adults.

    RESULTS: Using no physical activity as a reference, dementia risk decreased with duration of physical activity up to 3.1 to 6.0 hours/week (hazard ratio [HR] 0.88, 95% confidence interval [CI] 0.67 to 1.15 for 0.1 to 3.0 hours/week; HR 0.68, 95% CI 0.52 to 0.89 for 3.1 to 6.0 hours/week), but plateaued with higher duration. For the amount of physical activity, a similar pattern of dose-response curve was observed, with an inflection point of 9.1 to 18.0 metabolic equivalent value (MET)-hours/week (HR 0.92, 95% CI 0.70 to 1.22 for 0.1 to 9.0 MET-hours/week; HR 0.70, 95% CI 0.53 to 0.93 for 9.1 to 18.0 MET-hours/week).

    DISCUSSION: This cross-national analysis suggests that performing 3.1 to 6.0 hours of physical activity and expending 9.1 to 18.0/MET-hours of energy per week may reduce dementia risk.

  12. Wong CY, Tham JS, Foo CN, Ng FL, Shahar S, Zahary MN, et al.
    Biosaf Health, 2023 Feb;5(1):37-44.
    PMID: 36588928 DOI: 10.1016/j.bsheal.2022.12.005
    Vaccination is crucial in controlling the spread of the coronavirus disease 2019 (COVID-19) that triggered the pandemic, but herd immunity can only work with high vaccination coverage in the population. This study aims to measure the COVID-19 knowledge level and determine the factors influencing COVID-19 vaccination intention among university students in Malaysia. A cross-sectional online survey was carried out with 1,274 Malaysian university students in July 2021. Univariate and multivariate analyses were employed to examine the relationships between the study variables. Results showed that the majority of university students had an acceptable level of knowledge of COVID-19. The knowledge, risk perception of COVID-19, social norms, and perceived benefit of COVID-19 vaccination were positively associated with vaccination intention. However, perceived trust in information sources of COVID-19 vaccination and the government's response to COVID-19 did not affect the university students' desire to receive the vaccination. These findings are essential for health policymakers and healthcare providers to implement evidence-based interventions to increase COVID-19 vaccination uptake among university students.
  13. Won H, Singh DK, Din NC, Badrasawi M, Manaf ZA, Tan ST, et al.
    Clin Epidemiol, 2014;6:343-50.
    PMID: 25328418 DOI: 10.2147/CLEP.S62392
    Cognitive impairment is correlated with physical function. However, the results in the literature are inconsistent with cognitive and physical performance measures. Thus, the aim of this study was to determine the association between cognitive performance and physical function among older adults.
  14. Won H, Abdul Manaf Z, Mat Ludin AF, Shahar S
    Geriatr Gerontol Int, 2017 Apr;17(4):554-560.
    PMID: 27231255 DOI: 10.1111/ggi.12753
    AIM: Studies of the association between body composition, both body fat and body muscle, and cognitive function are rarely reported. The aim of the present study was to determine the association between a wide range of body composition measures with cognitive function in older adults.

    METHODS: A total of 2322 Malaysian older adults aged 60 years and older were recruited using multistage random sampling in a population-based cross-sectional study. Out of 2322 older adults recruited, 2309 (48% men) completed assessments on cognitive function and body composition. Cognitive functions were assessed using the Malay version of the Mini-Mental State Examination, the Bahasa Malaysia version of Montreal Cognitive Assessment, Digit Span Test, Digit Symbol Test and Rey Auditory Verbal Learning Test. Body composition included body mass index, mid-upper arm circumference, waist circumference, calf circumference, waist-to-hip ratio, percentage body fat and skeletal muscle mass.

    RESULTS: The association between body composition and cognitive functions was analyzed using multiple linear regression. After adjustment for age, education years, hypertension, hypercholesterolemia, diabetes mellitus, depression, smoking status and alcohol consumption, we found that calf circumference appeared as a significant predictor for all cognitive tests among both men and women (P 

  15. Won H, Abdul MZ, Mat Ludin AF, Omar MA, Razali R, Shahar S
    Clin Interv Aging, 2017;12:275-282.
    PMID: 28223785 DOI: 10.2147/CIA.S118942
    PURPOSE: Older adults are at risk of mild cognitive impairment (MCI), and simple anthropometric measurements can be used to screen for this condition. Thus, the aim of this study was to explore the cut-off values of body mass index (BMI) and waist circumference (WC) for predicting the risk of MCI in older Malaysian adults.

    METHODS: A total of 2,240 Malaysian older adults aged ≥60 years were recruited using multistage random sampling in a population based cross-sectional study. Receiver operating characteristic (ROC) curve was used to determine the cut-off values of BMI and WC with optimum sensitivity and specificity for the detection of MCI. Age, gender, years of education, smoking habit, alcohol consumption, depression, and medical conditions were used as confounding factors in this analysis.

    RESULTS: A BMI cut-off value of 26 kg/m(2) (area under the receiver operating characteristic curve [AUC] 0.725; sensitivity 90.5%; specificity 38.8%) was appropriate in identifying the risk of getting MCI in both men and women. The optimum WC cut-offs for likelihood of MCI were 90 cm (AUC 0.745; sensitivity 78.0%; specificity 59.8%) for men and 82 cm (AUC 0.714; sensitivity 84.3%; specificity 49.7%) for women. The optimum calf circumference (CC) cut-off values for identifying MCI were 29 cm (AUC 0.731; sensitivity 72.6%; specificity 61.1%) for men and 26 cm (AUC 0.598; sensitivity 79.1%; specificity 45.3%) for women.

    CONCLUSION: The cut-off values could be advocated and used as part of the screening of MCI among older Malaysian adults. There is a need to further determine the predictive values of these cut-off points on outcomes through longitudinal study design.

  16. Wan Mohd Azam WM, Din NC, Ahmad M, Ghazali SE, Ibrahim N, Said Z, et al.
    Asia Pac Psychiatry, 2013 Apr;5 Suppl 1:134-9.
    PMID: 23857850 DOI: 10.1111/appy.12061
    INTRODUCTION: Loneliness has long been known to have strong association with depression. The relationship between loneliness and depression, however, has been associated with other risk factors including social support. The aim of this paper is to describe the role of social support in the association between loneliness and depression.
    METHODS: This cross-sectional study examined the mediating effects of social support among 161 community-based elderly in agricultural settlement of a rural area in Sungai Tengi, Malaysia. Subjects were investigated with De Jong Gierveld Loneliness Scale, Geriatric Depression Scale and Medical Outcome Survey Social Support Survey. Data were analyzed using Pearson correlation, linear and hierarchical regression.
    RESULTS: Results indicated that social support partially mediated the relationship between loneliness and depression.
    DISCUSSION: This suggests that social support affects the linear association between loneliness and depression in the elderly.
    KEYWORDS: depression; elderly; loneliness; rural community; social support
    Study site; FELDA Sungai Tengi, Selangor, Malaysia
    Device, Questionnaire & Scale: De Jong Gierveld Loneliness Scale; Geriatric Depression Scale (GDS-15): Medical Outcome Survey Social Support Survey
  17. Vanoh D, Shahar S, Rosdinom R, Din NC, Yahya HM, Omar A
    Clin Interv Aging, 2016;11:579-87.
    PMID: 27274208 DOI: 10.2147/CIA.S102925
    BACKGROUND AND AIM:
    Focus on screening for cognitive impairment has to be given particular importance because of the rising older adult population. Thus, this study aimed to develop and assess a brief screening tool consisting of ten items that can be self-administered by community dwelling older adults (TUA-WELLNESS).
    METHODOLOGY:
    A total of 1,993 noninstitutionalized respondents aged 60 years and above were selected for this study. The dependent variable was mild cognitive impairment (MCI) assessed using neuropsychological test batteries. The items for the screening tool comprised a wide range of factors that were chosen mainly from the analysis of ordinal logistic regression (OLR) and based on past literature. A suitable cut-off point was developed using receiver operating characteristic analysis.
    RESULTS: A total of ten items were included in the screening tool. From the ten items, eight were found to be significant by ordinal logistic regression and the remaining two items were part of the tool because they showed strong association with cognitive impairment in previous studies. The area under curve (AUC), sensitivity, and specificity for cut-off 11 were 0.84%, 83.3%, and 73.4%, respectively.
    CONCLUSION: TUA-WELLNESS screening tool has been used to screen for major risk factors of MCI among Malaysian older adults. This tool is only suitable for basic MCI risk screening purpose and should not be used for diagnostic purpose.
    KEYWORDS: TUA-WELLNESS; mild cognitive impairment; screening; sensitivity; specificity
  18. Vanoh D, Shahar S, Mahmood NR
    Asia Pac J Clin Nutr, 2015;24(4):610-9.
    PMID: 26693745 DOI: 10.6133/apjcn.2015.24.4.11
    This was a cross-sectional study that investigated the relationship between nutrient intake and psychosocial factors with the overall rate of weight loss after bariatric surgery among patients who had undergone sleeve gastrectomy in University Kebangsaan Malaysia Medical Centre (UKMMC). Forty-three subjects (15 men and 28 women) were recruited for this study. Subjects completed assessment questionnaires including the Binge Eating Scale (BES), Beck Depression Inventory (BECK), Family Support Questionnaires, and the Index of Peer Relation (IPR). Results showed that the median overall rate of weight loss was 4.3±5.5 kg/month, which was lower when compared to the rate of weight loss at three months which was 5.0±5.6 kg/month. Pre-operative weight was the predictor of overall rate of weight loss (p<0.05, R²=0.52). Binge eating disorder (BED) and depression were also closely associated with each other after bariatric surgery (p<0.001, R²=0.46). Subjects with good compliance to dietary advice had lower scores on the binge eating scale. The mean caloric and protein intake was very low, only 562±310 kcal/day and 29.6±16.1 g/day. The intake of vitamin A, B-1, B-2, B-3, B-12, C, folate, and iron met the Malaysian Recommended Nutrient Intake (RNI). However, the RNI for calcium, zinc, selenium, vitamin D, and vitamin E was not met. In conclusion, although bariatric surgery had many health benefits, several factors hindered weight loss after bariatric surgery. Health care professionals should closely monitor patients after bariatric surgery.
  19. Vanoh D, Shahar S, Din NC, Omar A, Vyrn CA, Razali R, et al.
    Aging Clin Exp Res, 2017 Apr;29(2):173-182.
    PMID: 26980453 DOI: 10.1007/s40520-016-0553-2
    BACKGROUND: Concepts of successful aging (SA), usual aging (UA), and mild cognitive impairment (MCI) have been developed to identify older adults at high risk of Alzheimer's diseases (AD), however, the predictors have rarely been investigated in a single study. Thus, this study aims to explore the risk factors of MCI as compared to UA and SA among older adults, in a large community based cohort study in Malaysia.
    METHOD: 1993 subjects from four states in Malaysia were recruited. A comprehensive interview-based questionnaire was administered to determine socio-demographic information, followed by assessments to evaluate cognitive function, functional status, dietary intake, lifestyle and psychosocial status. Risk factors of cognitive impairment were assessed using the ordinal logistic regression (OLR).
    RESULT: The prevalence of SA, UA and MCI in this study was 11, 73 and 16 % respectively. OLR indicated that higher fasting blood sugar, hyperlipidemia, disability, lower education level, not regularly involved in technical based activities, limited use of modern technologies, lower intake of fruits and fresh fruit juices and not practicing calorie restriction were among the risk factors of poor cognitive performance in this study.
    CONCLUSION: This study will be a stepping stone for future researchers to develop intervention strategies to prevent cognitive decline.
  20. Vanoh D, Shahar S, Yahya HM, Che Din N, Mat Ludin AF, Ajit Singh DK, et al.
    Clin Interv Aging, 2021;16:161-175.
    PMID: 33531799 DOI: 10.2147/CIA.S266587
    Purpose: Use of dietary supplements by older adults has been increasing for improving micronutrient deficiencies, cognitive function, and overall health status. Thus, the objective of this secondary investigation is to explore the longitudinal association of baseline supplement intake in improving cognitive function, biochemical parameters, anthropometric variables and physical fitness among older adults.

    Methods: Towards Useful Aging (TUA) is a three-year longitudinal study conducted at baseline (2013-2014) and at follow-up (2015-2017) surveys. The number of participants dropped from 2322 during baseline study to 1787 and 1560 during the 18th and 36th month follow-up, respectively. Data on socio-demography, use of dietary supplement, biochemical indices, anthropometry, cognitive function, physical fitness and depressive symptoms were obtained. Longitudinal associations were done using the linear mixed model analysis among 1285 subjects with complete data.

    Results: The most common vitamin and mineral supplementations consumed were multivitamin, B-complex, and calcium. Meanwhile, the herbal supplements consumed by participants were Eurycoma longifolia, Morinda citrifolia and Orthosiphon aristatus. Longitudinal analysis adjusted for multiple covariates showed improvement in both supplement users and non-users for global cognitive function, working memory, visual memory, 2-minute step test, chair stand test, chair sit and reach and time up and go test, waist circumference and hip circumference in both the supplement users and non-users.

    Conclusion: Our findings indicated that dietary supplement intake is not associated with cognitive function, physical fitness, nutritional status, depressive symptoms or biochemical indices since improvement in the parameters was observed among both supplement users and non-users.

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