Displaying publications 1 - 20 of 58 in total

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  1. 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.
  2. Shyam S, Greenwood D, Mai CW, Tan SS, Mohd Yusof BN, Moy FM, et al.
    Cancers (Basel), 2021 Mar 02;13(5).
    PMID: 33801191 DOI: 10.3390/cancers13051036
    (1) Background: We studied the association of both conventional (BMI, waist and hip circumference and waist-hip ratio) and novel (UK clothing sizes) obesity indices with pancreatic cancer risk in the UK women's cohort study (UKWCS). (2) Methods: The UKWCS recruited 35,792 women from England, Wales and Scotland from 1995 to 1998. Cancer diagnosis and death information were obtained from the National Health Service (NHS) Central Register. Cox's proportional hazards regression was used to evaluate the association between baseline obesity indicators and pancreatic cancer risk. (3) Results: This analysis included 35,364 participants with a median follow-up of 19.3 years. During the 654,566 person-years follow up, there were 136 incident pancreatic cancer cases. After adjustments for age, smoking, education and physical activity, each centimetre increase in hip circumference (HR: 1.03, 95% CI: 1.01-1.05, p = 0.009) and each size increase in skirt size (HR: 1.12, 95% CI: 1.02-1.23, p = 0.041) at baseline increased pancreatic cancer risk. Baseline BMI became a significant predictor of pancreatic cancer risk (HR: 1.04, 95% CI: 1.00-1.08, p = 0.050) when latent pancreatic cancer cases were removed. Only baseline hip circumference was associated with pancreatic cancer risk (HR: 1.03, 95% CI: 1.00-1.05, p = 0.017) when participants with diabetes at baseline were excluded to control for reverse causality. (4) Conclusion: Hip circumference and skirt size were significant predictors of pancreatic cancer risk in the primary analysis. Thus, hip circumference is useful to assess body shape relationships. Additionally, standard skirt sizes offer an economical and objective alternative to conventional obesity indices for evaluating pancreatic cancer risk in women.
  3. 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.
  4. Mohammad A, Falahi E, Mohd Yusof BN, Hanipah ZN, Sabran MR, Mohamad Yusof L, et al.
    Clin Nutr ESPEN, 2021 Dec;46:66-72.
    PMID: 34857250 DOI: 10.1016/j.clnesp.2021.10.013
    OBJECTIVES: The effect of ginger supplements on inflammatory biomarkers and oxidative stress in patients with type 2 diabetes (T2DM) has been investigated, but findings are inconsistent. This systematic review and meta-analysis were conducted to determine the effects of ginger supplementation on inflammatory parameters (high-sensitivity C-reactive protein [hs-CRP], tumour necrosis factor-alpha [TNF-α], and interleukin-6 [IL-6]) in patients with T2DM.

    METHODS: We performed a systematic search using PubMed, Scopus, Cochrane Library, Web of Science for randomised controlled trials (RCTs), published until March 17, 2021. The quality assessment was carried out using the Cochrane Collaboration risk of bias tool. The Q-test and I 2 tests were used for the determination of heterogeneity of the included studies. Data were pooled using a random-effects model, and weighted mean difference (WMD) was used for the overall effect size.

    RESULTS: Pooled findings of the five RCTs demonstrated that ginger supplementations had significantly reduced hs-CRP (WMD -0.42 mg/L; 95% CI, -0.78, -0.05, P = 0.03), TNF-α (-2.13 pg/mL; 95% CI: -3.41, -0.86, P = 0.001), and IL-6 (WMD: -0.61 pg/mL; 95% CI: -0.92, -0.30, P = 0.001) levels in patients with T2DM. The quality assessment of the studies showed that all of the included studies were at high risk of bias.

    CONCLUSIONS: The meta-analysis shows that ginger supplementations reduced inflammatory parameters in patients with T2DM. Nonetheless, the reduction is relatively small, and its meaningful clinical effects are unknown. Future high-quality RCTs are needed to confirm the beneficial effects of ginger supplementation in patients with T2DM.

  5. Abolfathi M, Mohd-Yusof BN, Hanipah ZN, Mohd Redzwan S, Yusof LM, Khosroshahi MZ
    Complement Ther Med, 2020 Jan;48:102273.
    PMID: 31987257 DOI: 10.1016/j.ctim.2019.102273
    OBJECTIVE: The beneficial effects of carnitine supplementation on nonalcoholic fatty liver disease are unclear. We conducted a systematic review and meta-analysis to evaluate the effects of carnitine supplementation on liver function, lipid profile, body mass index, body weight, and homeostasis model assessment of insulin resistance in patients with nonalcoholic fatty liver disease.

    METHODS: A comprehensive search of PubMed, Web of Science, Scopus, Cochrane Library, and Google Scholar databases were performed. Only randomized placebo-controlled human studies that examined the effects of carnitine supplementation on liver function, lipid profile, body mass index, body weight, and homeostasis model assessment of insulin resistance up to September 2019 were included. Fixed effects or random-effects models were applied to compute the pooled effect size. Heterogeneity assessments were performed using Cochran's Q test and I-squared statistics. The quality of the studies was assessed using the Jaded scale.

    RESULTS: A total of 5 articles were selected, including 334 individuals (167 in control and 167 in intervention groups). The results demonstrated that carnitine supplementation significantly reduced homeostasis model assessment of insulin resistance (HOMA-IR) (WMD: -0.91; 95 % CI: -1.11, -0.72; p 

  6. Yong HY, Mohd Shariff Z, Mohd Yusof BN, Rejali Z, Appannah G, Bindels J, et al.
    PLoS One, 2020;15(1):e0227246.
    PMID: 31923230 DOI: 10.1371/journal.pone.0227246
    Generally, dietary patterns (DP)s have been linked to the risk of diabetes mellitus, however, only few studies examined the associations between DPs in early pregnancy and the risk of gestational diabetes mellitus (GDM). This study aims to determine the association between DPs before and during pregnancy and risk of GDM in Malaysian pregnant women. DPs were derived using principal component analysis of consumed 126 food and beverage items assessed using a validated semi-quantitative food frequency questionnaire collecting data retrospectively for pre-pregnancy, but prospectively for the first and second trimester. Three different DPs were identified at each time point and labelled as DP 1-3 (pre-pregnancy), DP 4-6 (first trimester), and DP 7-9 (second trimester). About 10.6% (n = 48) of pregnant women were diagnosed with GDM in our cohort. Women with high adherence (HA) to DP 2 (adjusted OR: 0.45, 95% CI: 0.20-0.91) and DP 5 (adjusted OR: 0.28, 95% CI: 0.11-0.68) showed a significantly reduced risk of GDM compared to women with low adherence (LA). Other DPs were not significantly associated with GDM risk. Compared to women with GDM, non-GDM women showed HA scores for all DPs throughout pregnancy. Overall, a relative low percentage of women with GDM was found in this cohort. The risk was lower in women with HA to a relatively unhealthy dietary pattern, i.e. DP 2 and DP 5. The lower body mass index (BMI) status and energy intake of women showing a HA to DP 2 in the first trimester may underlie the observed association with a lower GDM risk. Additionally, genetic variance might explain the less susceptibility to GDM despite HA to unhealthy DPs among non-GDM women.
  7. Kaur S, Yim HS, Abdul Jalil R, Mohd-Yusof BN, Jan Mohamed HJ
    J Immigr Minor Health, 2018 Dec;20(6):1380-1386.
    PMID: 29603090 DOI: 10.1007/s10903-018-0731-8
    There are only limited reports on Punjabi's health status in Malaysia. This cross-sectional study assessed the prevalence of metabolic syndrome (Mets) and its risk factors among 277 subjects recruited from the Malaysian Punjabi community. Overall prevalence of Mets was 43%, but 61% among females. Subjects classified with Mets had significantly (p 
  8. 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)
  9. 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.
  10. Yong HY, Mohd Shariff Z, Appannah G, Rejali Z, Mohd Yusof BN, Bindels J, et al.
    Public Health Nutr, 2020 Dec;23(18):3304-3314.
    PMID: 32814606 DOI: 10.1017/S1368980020002372
    OBJECTIVE: To examine the gestational weight gain (GWG) trajectory and its possible association with pregnancy outcomes.

    DESIGN: GWG trajectories were identified using the latent class growth model. Binary logistic regression was performed to examine the associations between adverse pregnancy outcomes and these trajectories.

    SETTING: Negeri Sembilan, Malaysia.

    PARTICIPANTS: Two thousand one hundred ninety-three pregnant women.

    RESULTS: Three GWG trajectories were identified: 'Group 1 - slow initial GWG but followed by drastic GWG', 'Group 2 - maintaining rate of GWG at 0·58 kg/week' and 'Group 3 - maintaining rate of GWG at 0·38 kg/week'. Group 1 had higher risk of postpartum weight retention (PWR) (adjusted OR (AOR) 1·02, 95 % CI 1·01, 1·04), caesarean delivery (AOR 1·03, 95 % CI 1·01, 1·04) and having low birth weight (AOR 1·04, 95 % CI 1·02, 1·05) compared with group 3. Group 2 was at higher risk of PWR (AOR 1·18, 95 % CI 1·16, 1·21), preterm delivery (AOR 1·03, 95 % CI 1·01, 1·05) and caesarean delivery (AOR 1·02, 95 % CI 1·01, 1·03), but at lower risk of having small-for-gestational-age infants (AOR 0·97, 95 % CI 0·96, 0·99) compared with group 3. The significant associations between group 1 and PWR were observed among non-overweight/obese women; between group 1 and caesarean delivery among overweight/obese women; group 2 with preterm delivery and caesarean delivery were only found among overweight/obese women.

    CONCLUSIONS: Higher GWG as well as increasing GWG trajectories was associated with higher risk of adverse pregnancy outcomes. Promoting GWG within the recommended range should be emphasised in antenatal care to prevent the risk of adverse pregnancy outcomes.

  11. Mohd Yusof BN, Yahya NF, Hasbullah FY, Wan Zukiman WZHH, Azlan A, Yi RLX, et al.
    Diabetes Res Clin Pract, 2021 Feb;172:108530.
    PMID: 33157118 DOI: 10.1016/j.diabres.2020.108530
    AIMS: This narrative review aimed to synthesize the evidence on the effects of Ramadan-focused nutrition therapy for people with diabetes.

    METHODS: We searched MEDLINE (via PubMed) and Science Direct databases for articles that included the component of nutrition for adult patients with type 2 diabetes (T2D), published in English between 2010 and 2020.

    RESULTS: Fourteen studies met the criteria. Eight of 14 studies had an intervention with a control arm. In comparison to the control group, all studies (n = 8) showed a reduction in hypoglycemic events. However, only half of these studies (n = 4) had shown at least one positive clinical outcome. Features of nutrition therapy that appeared to have favorable clinical outcomes include individualized caloric prescription; distributing carbohydrates equally between Suhoor, Iftar and snacks; providing meal plans; adjusting food intake to suit Ramadan; and incorporating diabetes-specific formula as part of Suhoor or snack.

    CONCLUSIONS: The review provides evidence for the effectiveness of Ramadan-focused nutrition therapy among people with T2D and identifies key features of nutrition therapy that may provide favourable clinical outcomes. Additional data on dietary quality and adequacy during Ramadan fasting warrants further studies.

  12. Sobri NHM, Ismail IZ, Hassan F, Papachristou Nadal I, Forbes A, Ching SM, et al.
    BMJ Open, 2021 08 26;11(8):e044878.
    PMID: 34446477 DOI: 10.1136/bmjopen-2020-044878
    INTRODUCTION: Women who develop gestational diabetes mellitus (GDM) have an increased risk of developing type 2 diabetes, and to reduce this risk the women have to adopt healthy behaviour changes. Although previous studies have explored the challenges and facilitators to initiate behaviour change among women with GDM, there is limited data from Malaysian women. Thus, this study will explore the factors affecting the uptake of healthy behaviour changes and the use of digital technology among women and their healthcare providers (HCPs) to support healthy behaviour changes in women with GDM.

    METHODS AND ANALYSIS: The study will be modelled according to the Capability, Opportunity, Motivation and Behaviour and Behaviour Change Wheel techniques, and use the DoTTI framework to identify needs, solutions and testing of a preliminary mobile app, respectively. In phase 1 (design and development), a focus group discussion (FGDs) of 5-8 individuals will be conducted with an estimated 60 women with GDM and 40 HCPs (doctors, dietitians and nurses). Synthesised data from the FGDs will then be combined with content from an expert committee to inform the development of the mobile app. In phase 2 (testing of early iterations), a preview of the mobile app will undergo alpha testing among the team members and the app developers, and beta testing among 30 women with GDM or with a history of GDM, and 15 HCPs using semi-structured interviews. The outcome will enable us to optimise an intervention using the mobile app as a diabetes prevention intervention which will then be evaluated in a randomised controlled trial.

    ETHICS AND DISSEMINATION: The project has been approved by the Malaysia Research Ethics Committee. Informed consent will be obtained from all participants. Outcomes will be presented at both local and international conferences and submitted for publications in peer-reviewed journals.

  13. 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.
  14. 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.

  15. Yong HY, Mohd Shariff Z, Mohd Yusof BN, Rejali Z, Tee YYS, Bindels J, et al.
    PMID: 31590213 DOI: 10.3390/ijerph16193735
    Poor diet quality in pregnancy could impact gestational weight gain (GWG) and consequently fetal growth and development. But today there is limited data available on gestational diet quality. This study investigated the association between diet quality in each pregnancy trimester and GWG in Malaysian women. Diet quality was assessed using the modified Healthy Eating Index for Malaysians (HEI). Total GWG was defined as the difference between measured weight at last prenatal visit and pre-pregnancy weight. About one-fourth of women (23.3%) had excessive total GWG. There were significant differences in the HEI component score across trimesters, except for fruits. Overall, overweight/obese women had lower total HEI score (51.49-55.40) during pregnancy compared to non-overweight/obese women (53.38-56.50). For non-overweight/obese women, higher total HEI scores in the second and third trimesters were significantly associated with lower risk of inadequate GWG (aOR = 0.97, 95% CI = 0.95-0.99, p = 0.01) and higher risk of excessive GWG (aOR = 1.04, 95% CI = 1.01-1.07, p = 0.03), respectively. Overweight/obese women with higher total HEI scores in the second (aOR = 1.04, 95% CI = 1.01-1.07, p = 0.02) and third trimester (aOR = 1.04, 95% CI = 1.01-1.08, p = 0.02) were significantly at higher risk for excessive GWG. Pregnant women had relatively low diet quality throughout pregnancy. Diet quality and GWG association differed according to pre-pregnancy BMI with excessive GWG more likely to be associated with higher total HEI scores in the third trimester.
  16. Chan SP, Mumtaz M, Ratnasingam J, Tan ATB, Lim SC, Rosman A, et al.
    PMID: 37292224 DOI: 10.51866/cpg.255
    Insulin degludec/insulin aspart (IDegAsp) co-formulation provides both basal and mealtime glycaemic control in a single injection. The glucose level-lowering efficacy of IDegAsp is reported to be superior or non-inferior to that of the currently available insulin therapies with a lower rate of overall hypoglycaemia and nocturnal hypoglycaemia. An expert panel from Malaysia aims to provide insights into the utilisation of IDegAsp across a broad range of patients with type 2 diabetes mellitus (i.e. treatment-naive or insulin-naive patients or patients receiving treatment intensification from basal-only regimens, premixed insulin and basal-bolus insulin therapy). IDegAsp can be initiated as once-daily dosing for the main meal with the largest carbohydrate content with weekly dose adjustments based on patient response. A lower starting dose is recommended for patients with cardiac or renal comorbidities. Dose intensification with IDegAsp may warrant splitting into twice-daily dosing. IDegAsp twice-daily dosing does not need to be split at a 50:50 ratio but should be adjusted to match the carbohydrate content of meals. The treatment of patients choosing to fast during Ramadan should be switched to IDegAsp early before Ramadan, as a longer duration of titration leads to better glycated haemoglobin level reductions. The pre-Ramadan breakfast/lunch insulin dose can be reduced by 30%-50% and taken during sahur, while the preRamadan dinner dose can be taken without any change during iftar. Education on the main meal concept is important, as carbohydrates are present in almost all meals. Patients should not have a misconception of consuming more carbohydrates while taking IDegAsp.
  17. Lau ZC, Mohd Yusof BN, Abas F, Abd Wahab N, Wan Zukiman WZH, Ismail A
    Malays J Med Sci, 2022 Oct;29(5):5-16.
    PMID: 36474545 DOI: 10.21315/mjms2022.29.5.2
    The Identifying the dynamic metabolome of the individual in response to a particular stimulus using a metabolomic approach is an emerging research area. Measuring the postprandial metabolite response utilising a meal-challenge test (MCT) provides information beyond the fasting state, which is especially important since human beings spend most of their time in the postprandial state. This is pertinent as an excessive rise in postprandial glycaemia is common in individuals with type 2 diabetes mellitus (T2DM), which puts them at a high risk of developing cardiovascular disease (CVD). While a low glycaemic index (GI) meal improves postprandial glycaemia and insulin levels in MCT studies among individuals with T2DM, its effect on metabolite changes in the postprandial state is unclear. This review summarises the perturbation in postprandial metabolites following a low GI meal in comparison to that following a usual or high GI meal and maps the metabolites in their metabolic pathways. We undertook a literature review using electronic databases, with the Medical Subject Headings (MeSH) terms, to retrieve relevant studies based on specific criteria. A total of seven related studies were documented. For the majority of metabolites studied, it was identified that metabolic regulation following an MCT extends beyond the glucose pathway. Altered metabolic pathways after the consumption of a low GI meal include: i) essential amino acid metabolism by altering the levels of plasma phenylalanine, tyrosine, lysine, leucine, isoleucine and valine; ii) glycolysis and tricarboxylic acid (TCA) metabolism by altering citrate and alanine, and iii) gut microbiota metabolism by altering betaine and acetate. The altered metabolites regulated the pancreatic insulin secretion and related to other dietary factors beyond GI modifications. These metabolomics data need to be interpreted cautiously because the metabolic changes analysed might not be due to the beneficial effects of a low GI meal. Validation of the putative metabolomic biomarkers following a dietary intervention MCT is suggested because researchers need to fully understand the kinetics and metabolism of individuals metabolite before reaching a solid conclusion. Further research characterising the metabotype based on habitual dietary patterns is warranted.
  18. Chew BH, Mohd-Yusof BN, Lai PSM, Khunti K
    Endocrinol Metab (Seoul), 2023 Feb;38(1):34-42.
    PMID: 36792353 DOI: 10.3803/EnM.2022.1649
    The ultimate purpose of diabetes care is achieving the outcomes that patients regard as important throughout the life course. Despite advances in pharmaceuticals, nutraceuticals, psychoeducational programs, information technologies, and digital health, the levels of treatment target achievement in people with diabetes mellitus (DM) have remained suboptimal. This clinical care of people with DM is highly challenging, complex, costly, and confounded for patients, physicians, and healthcare systems. One key underlying problem is clinical inertia in general and therapeutic inertia (TI) in particular. TI refers to healthcare providers' failure to modify therapy appropriately when treatment goals are not met. TI therefore relates to the prescribing decisions made by healthcare professionals, such as doctors, nurses, and pharmacists. The known causes of TI include factors at the level of the physician (50%), patient (30%), and health system (20%). Although TI is often multifactorial, the literature suggests that 28% of strategies are targeted at multiple levels of causes, 38% at the patient level, 26% at the healthcare professional level, and only 8% at the healthcare system level. The most effective interventions against TI are shorter intervals until revisit appointments and empowering nurses, diabetes educators, and pharmacists to review treatments and modify prescriptions.
  19. 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.
  20. Fazliana M, Nor Hanipah Z, Mohd Yusof BN, Zainal Abidin NA, Tan YZ, Mohkiar FH, et al.
    Metabolites, 2023 Mar 10;13(3).
    PMID: 36984853 DOI: 10.3390/metabo13030413
    Metabolic surgery is an essential option in the treatment of obese patients with type 2 diabetes (T2D). Despite its known advantages, this surgery still needs to be introduced in Malaysia. In this prospective study, the pathophysiological mechanisms at the molecular level will be studied and the metabolomics pathways of diabetes remission will be explored. The present study aims to evaluate the changes in the anthropometric measurements, body composition, phase angle, diet intake, biochemistry parameters, adipokines, microRNA, and metabolomics, both pre- and post-surgery, among obese diabetic patients in Malaysia. This is a multicenter prospective cohort study that will involve obese patients (n = 102) with a body mass index (BMI) of ≥25 kg/m2 (Asian BMI categories: WHO/IASO/IOTF, 2000) who will undergo metabolic surgery. They will be categorized into three groups: non-diabetes, prediabetes, and diabetes. Their body composition will be measured using a bioimpedance analyzer (BIA). The phase angle (PhA) data will be analyzed. Venous blood will be collected from each patient for glycated hemoglobin (HbA1c), lipids, liver, renal profile, hormones, adipokines, and molecular and metabolomics analyses. The serum microRNA will be measured. A gene expression study of the adipose tissue of different groups will be conducted to compare the groups. The relationship between the 1HNMR-metabolic fingerprint and the patients' lifestyles and dietary practices will be determined. The factors responsible for the excellent remission of T2D will be explored in this study.
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