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  1. Fulltext Glycaemic index of eight types of commercial rice in Malaysia
    Mohd Yusof BN, Abdul Talib R, Abdul Karim N
    Malays J Nutr, 2005;11(2):151-163.
    MyJurnal
    This experimental study was carried out to investigate the effect of eight types of commercial rice in Malaysia on blood glucose response and to determine their glycaemic index (GI) values. Ten healthy Malay volunteers (7 males, 3 females, BMI=23.6kgm-2, age=25.1years) participated in this study. The eight types of rice tested were three high fibre rice (HFR A, HFR B & HFR C), three white rice (WR D, WR E and WR F) and two fragrant rice (FR G and FR H). The subjects were required to go through the study protocol on eleven separate occasions (eight tests for the test rice samples and three repeated tests for the reference food) after an overnight fasting. Capillary blood samples were taken immediately before (0min) and 15, 30, 45, 60, 90 and 120min after consumption of the test foods. The blood glucose response was obtained by calculating the incremental area under the curve (iAUC). The GI was determined according to the standardised methodology. This study showed that out of eight types of rice tested, three (HFR B, WR E and WR F) could be categorised as having intermediate GI while the remaining five were considered high GI foods (HFR A, HFR C, WR D, FR G and FR H). The GI of HFR B (60 ± 5.8) and WR E (61 ± 5.8) were significantly lower than the reference food (glucose; GI=100) (p0.05). The GI value of the rice tested in descending order were HFR C, 87 ± 9.0 followed by HFR A (81 ± 6.7), FR G (80 ± 5.5), FR H (79 ± 7.6), WR D (72 ± 8.5), WR F (69 ± 8.3), WR E (61 ± 5.8) and HFR B (60 ± 5.8). There was no relationship between the dietary fibre content of the rice with the iAUC (r= -0.05, p=0.63) and GI values (r= -0.08, p=0.46). This shows that the GI values of the test rice were independent of the dietary fibre content of the rice. Other factors that may influence the GI value of rice include amylose content, gelatinisation process and botanical sources. The results of this study will provide useful information for dietitians and nutritionists in selecting the appropriate type of rice for the daily diet of diabetics.
  2. A low-GI diet is associated with a short-term improvement of glycaemic control in Asian patients with type 2 diabetes
    Yusof BN, Talib RA, Kamaruddin NA, Karim NA, Chinna K, Gilbertson H
    Diabetes Obes Metab, 2009 Apr;11(4):387-96.
    PMID: 19175374 DOI: 10.1111/j.1463-1326.2008.00984.x
    AIMS: The aim of this study is to compare the efficacy of low glycaemic index (GI) vs. conventional carbohydrate exchange (CCE) dietary advice on glycaemic control and metabolic parameters in patients with type 2 diabetes.
    METHODS: A total of 104 patients with type 2 diabetes were randomly assigned to either a low GI (GI) or CCE dietary advice over a 12-week period. The primary end-point was glycaemic control as assessed by glycated haemoglobin A1c (HbA1c), fructosamine level and plasma glucose. The secondary end-points were anthropometric measurements and metabolic parameters that include blood pressure, lipid profile and insulin levels. The oral antidiabetic medications remained unchanged throughout the duration of the study.
    RESULTS: A low-GI diet was associated with significant changes in the fructosamine level (DeltaGI = -0.20 +/- 0.03; DeltaCCE = -0.08 +/- 0.03 mmol/l, p < 0.01) and waist circumference (DeltaGI group = -1.88 +/- 0.30 cm; DeltaCCE group: -0.36 +/- 0.4 cm, p < 0.05) at week 4. At week 12, the changes in fasting glucose (DeltaGI = -0.03 +/- 0.3; DeltaCCE = 0.7 +/- 0.3 mmol/l; p < 0.05) and waist circumference (DeltaGI = -2.35 +/- 0.47 cm; DeltaCCE group = -0.66 +/- 0.46 cm; p < 0.05) in the GI group was significantly lower than the CCE group. With the low-GI diet, the changes in postprandial glycaemia at time 0, 60, 150 and 180 min after consuming the standard test meal was lower than with the CCE diet (p < 0.05). No significant differences were found between the groups for the remaining parameters that were measured.
    CONCLUSIONS: Use of a low-GI diet resulted in significant changes of serum fructosamine level, plasma glucose and waist circumference in Asian patients with type 2 diabetes over a 12-week period compared with those following a CCE diet. The effect on HbA1c and other metabolic parameters was not significantly different between the two study groups but the improvement within the GI group was more pronounced and of clinical benefit.
  3. Glycaemic index of four commercially available breads in Malaysia
    Yusof BN, Abd Talib R, Karim NA, Kamarudin NA, Arshad F
    Int J Food Sci Nutr, 2009 Sep;60(6):487-96.
    PMID: 18785052 DOI: 10.1080/09637480701804268
    This study was carried out to determine the blood glucose response and glycaemic index (GI) values of four types of commercially available breads in Malaysia. Twelve healthy volunteers (six men, six women; body mass index, 21.9±1.6 kg/m(2); age, 22.9±1.7 years) participated in this study. The breads tested were multi-grains bread (M-Grains), wholemeal bread (WM), wholemeal bread with oatmeal (WM-Oat) and white bread (WB). The subjects were studied on seven different occasions (four tests for the tested breads and three repeated tests of the reference food) after an overnight fast. Capillary blood samples were taken immediately before (0 min) and 15, 30, 45, 60, 90 and 120 min after consumption of the test foods. The blood glucose response was obtained by calculating the incremental area under the curve. The GI values were determined according to the standardized methodology. Our results showed that the M-Grains and WM-Oat could be categorized as intermediate GI while the WM and WB breads were high GI foods, respectively. The GI of M-Grains (56±6.2) and WM-Oat (67±6.9) were significantly lower than the reference food (glucose; GI = 100) (P < 0.05). No significant difference in GI value was seen between the reference food and the GI of WM (85±5.9) and WB (82±6.5) (P > 0.05). Among the tested breads, the GI values of M-Grains and WM-Oat were significantly lower (P < 0.05) than those of WM and WB. There was no relationship between the dietary fibre content of the bread with the incremental area under the curve (r = 0.15, P = 0.15) or their GI values (r = 0.17, P = 0.12), indicating that the GI value of the test breads were unaffected by the fibre content of the breads. The result of this study will provide useful nutritional information for dieticians and the public alike who may prefer low-GI over high-GI foods.
  4. Fulltext Obesity-related behaviors of Malaysian adolescents: a sample from Kajang district of Selangor state
    Rezali FW, Chin YS, Mohd Yusof BN
    Nutr Res Pract, 2012 Oct;6(5):458-65.
    PMID: 23198026 DOI: 10.4162/nrp.2012.6.5.458
    This study aims to determine the association between obesity-related behaviors (dietary practices, physical activity and body image) and body weight status among adolescents. A total of 382 adolescents (187 males and 195 females) aged 13 to 15 years in Kajang, Selangor participated in this study. Majority of the respondents were Malays (56.0%), followed by Chinese (30.1%) and Indians (13.9%). Dietary practices, physical activity and body image of the adolescents were assessed through the eating behaviors questionnaire, two-day dietary record, two-day physical activity record and multi-dimensional body image scale (MBIS), respectively. Body weight and height were measured by trained researchers. The prevalence of overweight and obesity (19.5%) was about twice the prevalence of underweight (10.5%). About two-thirds of the respondents (72.3%) skipped at least one meal and half of them (56.2%) snacked between meals with a mean energy intake of 1,641 ± 452 kcal/day. More than half of the respondents (56.8%) were practicing sedentary lifestyle with a mean energy expenditure of 1,631 ± 573 kcal per day. Energy intake (r = 0.153, P < 0.05), physical activity (r = 0.463, P < 0.01) and body image (r = 0.424, P < 0.01) were correlated with BMI. However, meal skipping, snacking and energy expenditure per kg body weight were not associated with body weight status. Multiple linear regression analysis showed that body image, physical activity and energy intake contributed significantly in explaining body weight status of the adolescents. In short, overweight and obesity were likely to be associated not only with energy intake and physical activity, but also body image. Hence, promoting healthy eating, active lifestyle and positive body image should be incorporated in future obesity prevention programmes in adolescents.
  5. Effects of flaxseed consumption on systemic inflammation and serum lipid profile in hemodialysis patients with lipid abnormalities
    Khalatbari Soltani S, Jamaluddin R, Tabibi H, Mohd Yusof BN, Atabak S, Loh SP, et al.
    Hemodial Int, 2013 Apr;17(2):275-81.
    PMID: 22998533 DOI: 10.1111/j.1542-4758.2012.00754.x
    Inflammation and lipid abnormalities are two important risk factors for cardiovascular disease in hemodialysis (HD) patients. The present study was designed to investigate the effects of flaxseed consumption on systemic inflammation and serum lipid profile in HD patients with lipid abnormalities. This was an unblinded, randomized clinical trial. Thirty HD patients with dyslipidemia (triglyceride >200 mg/dL and/or high-density lipoprotein-cholesterol (HDL-C) <40 mg/dL) were randomly assigned to either a flaxseed or control group. Patients in the flaxseed group received 40 g/day ground flaxseed for 8 weeks, whereas patients in the control group received their usual diet, without any flaxseed. At baseline and at the end of week 8, 7 mL of blood was collected after a 12- to 14-hour fast and serum concentrations of triglyceride, total cholesterol, low-density lipoprotein-cholesterol (LDL-C), HDL-C, and C-reactive protein (CRP) were measured. Serum concentrations of triglyceride (P < 0.01), total cholesterol (P < 0.01), LDL-C (P < 0.01), and CRP (P < 0.05) decreased significantly in the flaxseed group at the end of week 8 compared with baseline, whereas serum HDL-C showed a significant increase (P < 0.01). These changes in the flaxseed group were significant in comparison with the control group. The study indicates that flaxseed consumption improves lipid abnormalities and reduces systemic inflammation in HD patients with lipid abnormalities.
  6. Fulltext Medical nutrition therapy administered by a dietitian yields favourable diabetes outcomes in individual with type 2 diabetes mellitus
    Mohd Yusof BN, Ruzita AT, Norimah AK, Kamaruddin NA
    Med J Malaysia, 2013;68(1):18-23.
    PMID: 23466761 MyJurnal
    AIM: This prospective, single-group, pre-post design trial was conducted to evaluate the effect of individualised Medical Nutrition Therapy intervention administered by a dietitian in individuals with type 2 diabetes mellitus on glycaemic control, metabolic parameters and dietary intake.
    METHODS: Subjects (n=104; age=56.4 ±9.9 years; 37% male; years of diagnosis = 6.3 ±4.9 years) treated with diet and on a stabile dose of oral anti-diabetic agents were given dietary advice by a dietitian for a 12 week period. Individualised dietary advice was based on Malaysian Medical Nutrition Therapy for adults with type 2 diabetes mellitus. The primary outcome measure was glycaemic control (fructosamine and HbA1c level) and the secondary outcome included measures of anthropometry, blood pressure, lipid profile, insulin levels dietary intake and knowledge on nutrition.
    RESULTS: At week 12, 100 subjects completed the study with a dropout rate of 3.8%. The post-Medical Nutrition Therapy results showed a significant reduction of fructosamine (311.5 ±50 to 297 ±44 umol/L; P< 0.001) and HbA1c (7.6 ±1.2 to 7.2 +1.1%, p<0.001) with pronounced reduction for subjects who had very high HbA1c levels of >9.3% at baseline. Waist circumference (90.7 ±10.2 to 89.1 ±9.8 cm, p<0.05), HDL-cholesterol (1.1 ±0.3 to 1.2 ±0.3 mmol/L, p<0.05), dietary intake and nutrition knowledge score (42 ±19 vs. 75 ±17%; p< 0.001) were significantly improved from the baseline.
    CONCLUSIONS: Individualised Medical Nutrition Therapy administered by a dietitian resulted in favourable diabetes outcomes, which were more apparent for individuals with higher than optimal HbA1c levels at the start of the study.
  7. Fulltext Saffron: A Natural Potent Antioxidant as a Promising Anti-Obesity Drug
    Mashmoul M, Azlan A, Khaza'ai H, Yusof BN, Noor SM
    Antioxidants (Basel), 2013;2(4):293-308.
    PMID: 26784466 DOI: 10.3390/antiox2040293
    Obesity is associated with various diseases, particularly diabetes, hypertension, osteoarthritis and heart disease. Research on possibilities of herbal extracts and isolated compounds from natural products for treating obesity has an upward trend. Saffron (Crocus Sativus L. Iridaceae) is a source of plant polyphenols/carotenoids, used as important spice and food colorant in different parts of the world. It has also been used in traditional medicine for treatment of different types of illnesses since ancient times. Many of these medicinal properties of saffron can be attributed to a number of its compounds such as crocetin, crocins and other substances having strong antioxidant and radical scavenger properties against a variety of radical oxygen species and pro-inflammatory cytokines. The aim of this article is to assess the potential role of saffron and its constituents in the regulation of metabolic functions, which can beneficially alter obesity pathophysiology.
  8. Weighing the evidence of low glycemic index dietary intervention for the management of gestational diabetes mellitus: an Asian perspective
    Mohd Yusof BN, Firouzi S, Mohd Shariff Z, Mustafa N, Mohamed Ismail NA, Kamaruddin NA
    Int J Food Sci Nutr, 2014 Mar;65(2):144-50.
    PMID: 24517860 DOI: 10.3109/09637486.2013.845652
    This review aims to evaluate the effectiveness of low glycemic index (GI) dietary intervention for the treatment of gestational diabetes mellitus (GDM), specifically from the Asian perspective. A systematic review of the literature using multiple databases without time restriction was conducted. Three studies were retrieved based upon a priori inclusion criteria. While there was a trend towards improvement, no significant differences were observed in overall glycemic control and pregnancy outcomes in GDM women. However, a tendency for lower birth weight and birth centile if the intervention began earlier was noted. Low GI diets were well accepted and had identical macro-micronutrient compositions as the control diets. However, due to genetic, environment and especially food pattern discrepancies between Western countries and Asians, these results may not be contributed to Asian context. Clearly, there are limited studies focusing on the effect of low GI dietary intervention in women with GDM, particularly in Asia.
  9. Chemical compositions and antioxidative and antidiabetic properties of underutilized vegetable palm hearts from Plectocomiopsis geminiflora and Eugeissona insignis
    Ahmad Aufa Z, Hassan FA, Ismail A, Mohd Yusof BN, Hamid M
    J Agric Food Chem, 2014 Mar 5;62(9):2077-84.
    PMID: 24499380 DOI: 10.1021/jf403481p
    Underutilized vegetables are currently studied not only for their nutrient values but also for their health-promoting components for protection against chronic diseases. The present study was performed to evaluate chemical compositions and antioxidant properties of underutilized vegetable palm hearts, namely, lalis (Plectocomiopsis geminiflora) and pantu (Eugeissona insignis). Additionally, the vegetable extracts were evaluated for their activities in the inhibition of digestive enzymes and effects on insulin secretion using BRIN BD11 pancreatic cell lines. Both vegetables contain valuable sources of dietary fiber, potassium, and zinc. For the first time, the phenolic compounds of the vegetables were identified and quantified using HPLC-DAD and LC-ESI-MS. Appreciable amounts of chlorogenic acid were found in the studied vegetables. The sample extracts exhibited potential antioxidant capacities through chemical and biological in vitro assays. High inhibition of α-amylase activity (>50%) was found from the extracts. Thus, it was suggested the vegetable consumption could fulfill the nutrient requirements among local communities.
  10. Fulltext Effectiveness of traditional Malaysian vegetables (ulam) in modulating blood glucose levels
    Bachok MF, Yusof BN, Ismail A, Hamid AA
    Asia Pac J Clin Nutr, 2014;23(3):369-76.
    PMID: 25164446 DOI: 10.6133/apjcn.2014.23.3.01
    Ulam refers to a group of traditional Malaysian plants commonly consumed as a part of a meal, either in the raw form or after a short blanching process. Many types of ulam are thought to possess blood glucose-lowering properties, but relatively little is known on the effectiveness of ulam in modulating blood glucose levels in humans. This review aims to systematically evaluate the effectiveness of ulam in modulating blood glucose levels in humans. A literature review was conducted using multiple databases with no time restriction. Eleven studies were retrieved based on a priori inclusion and exclusion criteria. In these 11 studies, only Momordica charantia, locally known as "peria katak", was extensively studied, followed by Centella asiatica, locally known as "daun pegaga", and Alternanthera sessilis, locally known as "kermak putih". Of the 11 studies, 9 evaluated the effectiveness of M. charantia on blood glucose parameters, and 7 of which showed significant improvement in at least one parameter of blood glucose concentration. The remaining 2 studies reported nonsignificant improvements in blood glucose parameters, despite having high-quality study design according to Jadad scale. None of the studies related to C. asiatica and A. sessilis showed significant improvement in blood glucose-related parameters. Current clinical evidence does not support the popular claim that ulam has glucose-lowering effects, not even for M. charantia. Hence, further clinical investigation is needed to verify the glucose modulation effect of M. charantia, C. asiatica, and A. sessilis.
  11. Fulltext The relationship between household income and dietary intakes of 1-10 year old urban Malaysian
    Mohd Shariff Z, Lin KG, Sariman S, Lee HS, Siew CY, Mohd Yusof BN, et al.
    Nutr Res Pract, 2015 Jun;9(3):278-87.
    PMID: 26060540 DOI: 10.4162/nrp.2015.9.3.278
    Diet plays an important role in growth and development of children. However, dietary intakes of children living in either rural or urban areas can be influenced by household income. This cross-sectional study examined energy, nutrient and food group intakes of 749 urban children (1-10 years old) by household income status.
  12. Fulltext Evaluation of diet quality and its associated factors among adolescents in Kuala Lumpur, Malaysia
    Rezali FW, Chin YS, Mohd Shariff Z, Mohd Yusof BN, Sanker K, Woon FC
    Nutr Res Pract, 2015 Oct;9(5):511-6.
    PMID: 26425281 DOI: 10.4162/nrp.2015.9.5.511
    This study aims to determine contribution of meal frequency, self-efficacy for healthy eating, and availability of healthy foods towards diet quality of adolescents in Kuala Lumpur, Malaysia.
  13. Fulltext Effect of microbial cell preparation on renal profile and liver function among type 2 diabetics: a randomized controlled trial
    Firouzi S, Mohd-Yusof BN, Majid HA, Ismail A, Kamaruddin NA
    BMC Complement Altern Med, 2015;15:433.
    PMID: 26654906 DOI: 10.1186/s12906-015-0952-5
    The beneficial effect of probiotics on renal profile and liver function has been reported among patients with chronic kidney disease and fatty liver respectively. However, its effect on renal profile and liver function among type 2 diabetic individuals has not been fully understood. To investigate the effect of microbial cell preparation on renal profile and liver function tests among type 2 diabetic individuals.
  14. Fulltext Effect of Cosmos caudatus (Ulam raja) supplementation in patients with type 2 diabetes: Study protocol for a randomized controlled trial
    Cheng SH, Ismail A, Anthony J, Ng OC, Hamid AA, Yusof BN
    BMC Complement Altern Med, 2016 Feb 27;16:84.
    PMID: 26920910 DOI: 10.1186/s12906-016-1047-7
    BACKGROUND: Type 2 diabetes mellitus is a major health threat worldwide. Cosmos caudatus is one of the medicinal plants used to treat type 2 diabetes. Therefore, this study aims to determine the effectiveness and safety of C. caudatus in patients with type 2 diabetes. Metabolomic approach will be carried out to compare the metabolite profiles between C. Caudatus treated diabetic patients and diabetic controls.

    METHODS AND DESIGN: This is a single-center, randomized, controlled, two-arm parallel design clinical trial that will be carried out in a tertiary hospital in Malaysia. In this study, 100 patients diagnosed with type 2 diabetes will be enrolled. Diabetic patients who meet the eligibility criteria will be randomly allocated to two groups, which are diabetic C. caudatus treated(U) group and diabetic control (C) group. Primary and secondary outcomes will be measured at baseline, 4, 8, and 12 weeks. The serum and urine metabolome of both groups will be examined using proton NMR spectroscopy.

    DISCUSSION: The study will be the first randomized controlled trial to assess whether C. caudatus can confer beneficial effect in patients with type 2 diabetes. The results of this trial will provide clinical evidence on the effectiveness and safety of C. caudatus in patients with type 2 diabetes.

    TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT02322268.

  15. Higher dietary energy density is associated with stunting but not overweight and obesity in a sample of urban Malaysian children
    Shariff ZM, Lin KG, Sariman S, Siew CY, Yusof BN, Mun CY, et al.
    Ecol Food Nutr, 2016 Jul-Aug;55(4):378-89.
    PMID: 27231732 DOI: 10.1080/03670244.2016.1181065
    Although diets with high energy density are associated with increased risk of overweight and obesity, it is not known whether such diets are associated with undernutrition. This study assessed the relationship between dietary energy density (ED) and nutritional status of 745 urban 1- to 10-year-old children. Dietary intakes were obtained using food recall and record for two days. Dietary energy density was based on food and caloric beverages. Higher dietary ED was associated with lower intakes of carbohydrate, sugar, vitamins C and D, and calcium but higher fat, fiber, iron, and folate intakes. While intakes of fruits and milk/dairy products decreased, meat, fish, and legume intakes increased with higher dietary ED. Stunting, but not other growth problems, was associated with higher dietary ED. Future studies should confirm the cause-and-effect relationship between higher dietary ED and stunting.
  16. Fulltext Impact of Diabetes-Specific Nutritional Formulas versus Oatmeal on Postprandial Glucose, Insulin, GLP-1 and Postprandial Lipidemia
    Mottalib A, Mohd-Yusof BN, Shehabeldin M, Pober DM, Mitri J, Hamdy O
    Nutrients, 2016 Jul 22;8(7).
    PMID: 27455318 DOI: 10.3390/nu8070443
    Diabetes-specific nutritional formulas (DSNFs) are frequently used as part of medical nutrition therapy for patients with diabetes. This study aims to evaluate postprandial (PP) effects of 2 DSNFs; Glucerna (GL) and Ultra Glucose Control (UGC) versus oatmeal (OM) on glucose, insulin, glucagon-like peptide-1 (GLP-1), free fatty acids (FFA) and triglycerides (TG). After an overnight fast, 22 overweight/obese patients with type 2 diabetes were given 200 kcal of each of the three meals on three separate days in random order. Blood samples were collected at baseline and at 30, 60, 90, 120, 180 and 240 min. Glucose area under the curve (AUC0-240) after GL and UGC was lower than OM (p < 0.001 for both). Insulin positive AUC0-120 after UGC was higher than after OM (p = 0.02). GLP-1 AUC0-120 and AUC0-240 after GL and UGC was higher than after OM (p < 0.001 for both). FFA and TG levels were not different between meals. Intake of DSNFs improves PP glucose for 4 h in comparison to oatmeal of similar caloric level. This is achieved by either direct stimulation of insulin secretion or indirectly by stimulating GLP-1 secretion. The difference between their effects is probably related to their unique blends of amino acids, carbohydrates and fat.
  17. Protective effects of saffron extract and crocin supplementation on fatty liver tissue of high-fat diet-induced obese rats
    Mashmoul M, Azlan A, Mohtarrudin N, Mohd Yusof BN, Khaza'ai H, Khoo HE, et al.
    BMC Complement Altern Med, 2016 Oct 22;16(1):401.
    PMID: 27770798
    Saffron is the dried stigma of Crocus sativus L. flower which commonly used as a natural remedy to enhance health and even fights disease in the Middle-East and Southeast Asian countries.
  18. Fulltext Seremban Cohort Study (SECOST): a prospective study of determinants and pregnancy outcomes of maternal glycaemia in Malaysia
    Yong HY, Mohd Shariff Z, Rejali Z, Mohd Yusof BN, Yasmin F, Palaniveloo L
    BMJ Open, 2018 01 21;8(1):e018321.
    PMID: 29358431 DOI: 10.1136/bmjopen-2017-018321
    INTRODUCTION: Both gestational diabetes mellitus (GDM) and hyperglycaemia less severe than GDM are associated with risk of adverse pregnancy outcomes. We describe the study design of a prospective cohort of pregnant women recruited in early pregnancy with follow-ups of mothers and infants up to 2 years after birth. The primary aim of the study was to identify the determinants and outcomes of maternal glycaemia.
    METHODS AND ANALYSIS: Seremban Cohort Study (SECOST) is an ongoing prospective cohort study in which eligible pregnant women in first trimester (<10 weeks of gestation) are recruited from Maternal and Child Health clinics in Seremban District, Negeri Sembilan with seven follow-ups during pregnancy through 2 years postnatally. Infants are followed up every 6 months after birth until 2 years old. A standard 75 g oral glucose tolerance test is performed between 24 and 32 of weeks of gestation and as close to 28 weeks of gestation. Pregnancy and birth information are obtained from medical records. Sociodemographic, anthropometric, biochemical, dietary, physical activity, smoking, depression, child feeding and other data of mothers and infants are obtained at follow-ups.
    ETHICS AND DISSEMINATION: This study is approved by the Medical Research Ethics Committee (MREC), Universiti Putra Malaysia (UPM/FPSK/100-9/2-MJKEtika) and MREC, Ministry of Health Malaysia (KKM/NIHSEC/08/0804/P12- 613). Permission to conduct this study is also obtained from the Head of Seremban District Health Office. All participants are required to provide written informed consent prior to data collection. The research findings will be disseminated at journals and conference presentations.
    Study name: Seremban Cohort Study (SECOST)
  19. Fulltext Effects of nutrition therapy on HbA1c and cardiovascular disease risk factors in overweight and obese patients with type 2 diabetes
    Mottalib A, Salsberg V, Mohd-Yusof BN, Mohamed W, Carolan P, Pober DM, et al.
    Nutr J, 2018 04 07;17(1):42.
    PMID: 29626933 DOI: 10.1186/s12937-018-0351-0
    BACKGROUND: Nutrition Therapy (NT) is essential in type 2 diabetes (T2D) management. Standards of care recommend that each patient engages with a nutritionist (RDN) to develop an individualized eating plan. However, it is unclear if it is the most efficient method of NT. This study evaluates the effects of three different methods of NT on HbA1c and cardiovascular disease risk factors in overweight and obese patients with T2D.

    METHODS: We randomized 108 overweight and obese patients with T2D (46 M/62F; age 60 ± 10 years; HbA1c 8.07 ± 1.05%; weight 101.4 ± 21.1 kg and BMI 35.2 ± 7.7 kg/m2) into three groups. Group A met with RDN to develop an individualized eating plan. Group B met with RDN and followed a structured meal plan. Group C did similar to group B and received weekly phone support by RDN.

    RESULTS: After 16 weeks, all three groups had a significant reduction of their energy intake compared to baseline. HbA1c did not change from baseline in group A, but decreased significantly in groups B (- 0.66%, 95% CI -1.03 to - 0.30) and C (- 0.61%, 95% CI -1.0 to - 0.23) (p value for difference among groups over time 

  20. Prevalence and duration of reasons for enteral nutrition feeding interruption in a tertiary intensive care unit
    Lee ZY, Ibrahim NA, Mohd-Yusof BN
    Nutrition, 2018 09;53:26-33.
    PMID: 29627715 DOI: 10.1016/j.nut.2017.11.014
    OBJECTIVES: Intensive care unit (ICU) enteral nutrition (EN) can involve frequent feeding interruption (FI). The prevalence, causes, and duration of such interruption were investigated.

    METHODS: Reasons for EN FI identified from extensive literature review were prospectively collected in adult mechanically ventilated critically ill patients. Results were reported by descriptive statistics. Baseline and nutritional characteristics between patients who died and those alive at day 60 were compared.

    RESULTS: A total of 148 patients receiving ≥1 day of EN for the full 12-day observational period were included in the analysis. About 332 episodes of EN FI were recorded and contributed to 12.8% (4190 hours) of the total 1367 evaluable nutrition days. For each patient, FI occurred for a median of 3 days and the total duration of FI for the entire ICU stay was 24.5 hours. Median energy and protein deficits per patient due to FI for the entire ICU stay were -1780.23 kcal and -100.58 g, respectively. Duration of FI, days with FI, and the amount of energy and protein deficits due to FI were not different between patients who had died and those who were still alive at day 60 (all P > 0.05). About 72% of the total duration of EN FI was due to procedural-related and potentially avoidable causes (primarily human factors), while only about 20% was due to feeding intolerances.

    CONCLUSIONS: EN FI occurred primarily due to human factors, which may be minimized by adherence to an evidence-based feeding protocol as determined by a nutrition support team.

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