Displaying publications 1 - 20 of 433 in total

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  1. Tong WT, Vethakkan SR, Ng CJ
    BMJ Open, 2015 Jan 29;5(1):e006407.
    PMID: 25633285 DOI: 10.1136/bmjopen-2014-006407
    OBJECTIVE: To explore factors influencing poor glycaemic control in people with type 2 diabetes using insulin.
    RESEARCH DESIGN: A qualitative method comprising in-depth individual interviews. A semistructured interview guide was used. The interviews were audiorecorded, transcribed verbatim and analysed using a thematic approach.
    PARTICIPANTS: Seventeen people with type 2 diabetes using insulin with glycated haemoglobin (HbA1c) ≥9% for >1 year.
    SETTING: The Primary Care Clinic and Diabetes Clinic in the University of Malaya Medical Centre (UMMC), Malaysia.
    RESULTS: Data analysis uncovered four themes: lifestyle challenges in adhering to medical recommendations; psychosocial and emotional hurdles; treatment-related factors; lack of knowledge about and self-efficacy in diabetes self-care.
    CONCLUSIONS: Factors that explain the poor glycaemic control in people with type 2 diabetes using insulin were identified. Healthcare providers could use these findings to address patients' concerns during consultations and help to improve glycaemic control.
    Study site: Primary Care Clinic and Diabetes Clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
    Matched MeSH terms: Life Style
  2. Pabalan N, Jarjanazi H, Ozcelik H
    J Gastrointest Cancer, 2014 Sep;45(3):334-41.
    PMID: 24756832 DOI: 10.1007/s12029-014-9610-2
    BACKGROUND: Reported associations of capsaicin with gastric cancer development have been conflicting. Here, we examine 10 published articles that explore these associations using 2,452 cases and 3,996 controls.

    METHODS: We used multiple search strategies in MEDLINE through PubMed to seek for suitable articles that had case-control design with gastric cancer as outcome.

    RESULTS: The outcomes of our study shows protection (odds ratio [OR] 0.55, P = 0.003) and susceptibility (OR 1.94, P = 0.0004), both significant with low and medium-high intake of capsaicin, respectively, although under relatively heterogeneous conditions (P(heterogeneity) = <0.0001). Outlier analysis resulted in loss of overall heterogeneity (P = 0.14) without affecting the pooled ORs. Among the subgroups, low intake elicited protection in both Korean (OR 0.37) and Mexican (OR 0.63) populations while high intake rendered these subgroups susceptible (OR 2.96 and OR 1.57, respectively). These subgroup values were highly significant (P = 0.0001-0.01) obtained in heterogeneous conditions (P(heterogeneity) 

    Matched MeSH terms: Life Style
  3. Lee PY, Lee YK, Khoo EM, Ng CJ
    Prim Care Diabetes, 2014 Apr;8(1):49-55.
    PMID: 24315732 DOI: 10.1016/j.pcd.2013.11.003
    Aims: To explore how health care professionals (HCPs) assess patients when initiating insulintherapy in type 2 diabetes.
    Methods: Focus group discussions and in-depth interviews were conducted with 41 healthcare professionals in Malaysia in 2010–2011. A semi-structured topic guide was used for theinterview. The interviews were transcribed verbatim and analysed using the Nvivo9 softwarebased on a thematic approach.
    Results: HCPs were less likely to initiate insulin therapy in patients who were older, withirregular dietary patterns and poor financial status. They also assessed patients’ knowl-edge, views and misconceptions of insulin. However, there was a variation in how doctors assessed patients’ comorbidities before starting insulin therapy. Medical officers were more likely to initiate insulin therapy in patients with comorbidities and complications, whereas family medicine specialists were more cautious. In addition, most HCPs considered patients’ psychosocial status, including self-care ability, social support and quality of life.
    Conclusions: HCPs’ assessment of patients’ need to start insulin therapy depends on their perception rather than objective evaluation of patients’ background, knowledge, perception and abilities. The background and the type of practice of HCPs influence their assessment.
    Matched MeSH terms: Life Style
  4. Lai PS, Chua SS, Chan SP
    Int J Clin Pharm, 2013 Aug;35(4):629-37.
    PMID: 23677816 DOI: 10.1007/s11096-013-9784-x
    BACKGROUND: This study describes the analysis of secondary outcomes from a previously published randomised controlled trial, which assessed the effects of pharmaceutical care on medication adherence, persistence and bone turnover markers. The main focus of this manuscript is the effect of the provision of pharmaceutical care on these secondary outcomes, and details on the design of the intervention provided, the osteoporosis care plan and materials used to deliver the intervention.
    OBJECTIVES: To evaluate the effects of pharmaceutical care on knowledge, quality of life (QOL) and satisfaction of postmenopausal osteoporotic women prescribed bisphosphonates, and their associating factors.
    SETTING: Randomised controlled trial, performed at an osteoporosis clinic of a tertiary hospital in Malaysia.
    METHODS: Postmenopausal women diagnosed with osteoporosis (T-score ≤-2.5/lowtrauma fracture), just been prescribed weekly alendronate/risedronate were randomly allocated to receive intervention or standard care (controls). Intervention participants received a medication review, education on osteoporosis, risk factors, lifestyle modifications, goals of therapy, side effects and the importance of medication adherence at months 0, 3, 6 and 12.
    MAIN OUTCOMES MEASURE: Knowledge, QOL and satisfaction.
    RESULTS: A total of 198 postmenopausal osteoporotic women were recruited: intervention = 100 and control = 98. Intervention participants reported significantly higher knowledge scores at months 3 (72.50 vs. 62.50 %), 6 (75.00 vs. 65.00 %) and 12 (78.75 vs. 68.75 %) compared to control participants. QOL scores were also lower (which indicates better QOL) at months 3 (29.33 vs. 38.41), 6 (27.50 vs. 36.56) and 12 (27.53 vs. 37.56) compared to control participants. Similarly, satisfaction score was higher in intervention participants (93.67 vs. 84.83 %). More educated women, with back pain, who were provided pharmaceutical care had better knowledge levels. Similarly, older, more educated women, with previous falls and back pain tend to have poorer QOL, whilst women who exercised more frequently and were provided pharmaceutical care had better QOL. Satisfaction also increased as QOL increases and when provided pharmaceutical care.
    CONCLUSION: The provision of pharmaceutical care improved knowledge, QOL and satisfaction in Malaysian postmenopausal osteoporotic women, showing that pharmacists have the potential to improve patients' overall bone health. Policymakers should consider placing a clinical pharmacist in the osteoporosis clinic to provide counselling to improve these outcomes.
    Study site: Osteoporosis clinics, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
    Matched MeSH terms: Life Style
  5. Jiwa M, Othman S, Hanafi NS, Ng CJ, Khoo EM, Chia YC
    Qual Prim Care, 2012;20(5):317-20.
    PMID: 23113999
    Malaysia has achieved reasonable health outcomes even though the country spends a modest amount of Gross Domestic Product on healthcare. However, the country is now experiencing a rising incidence of both infectious diseases and chronic lifestyle conditions that reflect growing wealth in a vibrant and successful economy. With an eye on an ageing population, reform of the health sector is a government priority. As in other many parts of the world, general practitioners are the first healthcare professional consulted by patients. The Malaysian health system is served by public and private care providers. The integration of the two sectors is a key target for reform. However, the future health of the nation will depend on leadership in the primary care sector. This leadership will need to be informed by research to integrate care providers, empower patients, bridge cultural gaps and ensure equitable access to scarce health resources.
    Matched MeSH terms: Life Style
  6. Chandramathi S, Suresh K, Anita ZB, Kuppusamy UR
    Trans R Soc Trop Med Hyg, 2012 Apr;106(4):267-9.
    PMID: 22340948 DOI: 10.1016/j.trstmh.2011.12.008
    Chemotherapy can cause immunosuppression, which may trigger latent intestinal parasitic infections in stools to emerge. This study investigated whether intestinal parasites can emerge as opportunistic infections in breast and colorectal cancer patients (n=46 and n=15, respectively) undergoing chemotherapy treatment. Breast cancer patients were receiving a 5-fluorouracil/epirubicin/cyclophosphamide (FEC) regimen (6 chemotherapy cycles), and colorectal cancer patients were receiving either an oxaliplatin/5-fluorouracil/folinic acid (FOLFOX) regimen (12 cycles) or a 5-fluorouracil/folinic acid (Mayo) regimen (6 cycles). Patients had Blastocystis hominis and microsporidia infections that were only present during the intermediate chemotherapy cycles. Thus, cancer patients undergoing chemotherapy should be screened repeatedly for intestinal parasites, namely B. hominis and microsporidia, as they may reduce the efficacy of chemotherapy treatments.
    Matched MeSH terms: Life Style
  7. Ng TP, Leong T, Chiam PC, Kua EH
    Dement Geriatr Cogn Disord, 2010;29(2):131-8.
    PMID: 20145399 DOI: 10.1159/000275668
    Ethnic variations in dementia rate have been reported worldwide. Understanding these differences is vital for aetiological research, clinical care and health service planning. While age and gender have been consistently implicated, the reasons behind interethnic variation remain unclear.
    Matched MeSH terms: Life Style
  8. Tan MY, Magarey J
    Patient Educ Couns, 2008 Aug;72(2):252-67.
    PMID: 18467068 DOI: 10.1016/j.pec.2008.03.017
    OBJECTIVE: To investigate the self-care practices of Malaysian adults with diabetes and sub-optimal glycaemic control.
    METHODS: Using a one-to-one interviewing approach, data were collected from 126 diabetic adults from four settings. A 75-item questionnaire was used to assess diabetes-related knowledge and self-care practices regarding, diet, medication, physical activity and self-monitoring of blood glucose (SMBG).
    RESULTS: Most subjects had received advice on the importance of self-care in the management of their diabetes and recognised its importance. Sixty-seven subjects (53%) scored below 50% in their diabetes-related knowledge. Subjects who consumed more meals per day (80%), or who did not include their regular sweetened food intakes in their daily meal plan (80%), or who were inactive in daily life (54%), had higher mean fasting blood glucose levels (p=0.04). Subjects with medication non-adherence (46%) also tended to have higher fasting blood glucose levels. Only 15% of the subjects practiced SMBG. Predictors of knowledge deficit and poor self-care were low level of education (p = <0.01), older subjects (p=0.04) and Type 2 diabetes subjects on oral anti-hyperglycaemic medication (p = <0.01).
    CONCLUSION: There were diabetes-related knowledge deficits and inadequate self-care practices among the majority of diabetic patients with sub-optimal glycaemic control.
    PRACTICE IMPLICATIONS: This study should contribute to the development of effective education strategies to promote health for adults with sub-optimal diabetes control.
    Matched MeSH terms: Life Style
  9. Foo LH, Khor GL, Tee ES, Dhanaraj P
    Int J Food Sci Nutr, 2004 Sep;55(6):517-25.
    PMID: 15762316
    Iron deficiency anaemia is the most common micronutrient deficiency worldwide. The prevalence of anaemia in the developing countries is three to four times higher than that in the developed countries. The iron status was assessed in 199 apparently healthy male and female adolescents aged 12-19 years living in a fishing community in Sabah, Malaysia. Data on socio-economic characteristics, lifestyles, anthropometry measurements, iron status, and dietary intake were gathered. Dietary intake of energy, iron, and most nutrients (with the exception of protein and vitamin C) were below the recommended levels for Malaysian adolescents. Three-quarters of the iron was derived from plant foods. The mean haemoglobin value for the male was 13.9 +/- 1.3 g/dl with 9.5% having less than 12 g/dl, while the respective figures for the female were 12.4 +/- 1.6 g/dl and 28.6%. The mean serum ferritin concentrations for male and female adolescents were 21.5 and 15.4 microg/l, respectively; with 25.7% of the males and 49.5% of the females having deficient levels of ferritin. Dietary intake of total energy and iron, and gender were found to be independent determinants of serum ferritin and haemoglobin levels, accounting for over 40% of the variations for each of these iron indicators. In males, but not in females, the intake of dietary protein and iron, and physical activity were also found to be significant determinants of serum ferritin. The age of subjects and household size were significant determinants of haemoglobin levels for male subjects, but not for female subjects. The findings indicate the importance of adequate intake of energy and dietary iron for improving the iron status of adolescents.
    Matched MeSH terms: Life Style
  10. Hanipah ZN, Schauer PR
    Annu Rev Med, 2020 01 27;71:1-15.
    PMID: 31986081 DOI: 10.1146/annurev-med-053117-123246
    Metabolic surgery is increasingly becoming recognized as a more effective treatment for patients with type 2 diabetes (T2D) and obesity as compared to lifestyle modification and medical management alone. Both observational studies and clinical trials have shown metabolic surgery to result in sustained weight loss (20-30%), T2D remission rates ranging from 23% to 60%, and improvement in cardiovascular risk factors such as hypertension and dyslipidemia. Metabolic surgery is cost-effective and relatively safe, with perioperative risks and mortality comparable to low-risk procedures such as cholecystectomy, hysterectomy, and appendectomy. International diabetes and medical organizations have endorsed metabolic surgery as a standard treatment for T2D with obesity.
    Matched MeSH terms: Life Style
  11. Chan JCN, Lim LL, Wareham NJ, Shaw JE, Orchard TJ, Zhang P, et al.
    Lancet, 2021 Dec 19;396(10267):2019-2082.
    PMID: 33189186 DOI: 10.1016/S0140-6736(20)32374-6
    Matched MeSH terms: Life Style
  12. Ibrahim N, Ming Moy F, Awalludin IA, Mohd Ali Z, Ismail IS
    PLoS One, 2016;11(12):e0167123.
    PMID: 27935988 DOI: 10.1371/journal.pone.0167123
    BACKGROUND: The prevalence of type 2 diabetes among Malaysian adults has increased by more than two folds over the past two decades. Strategies to collaborate with the existing community partners may become a promising channel for wide-scale dissemination of diabetes prevention in the country. The objectives of this study were to determine the effects of community-based lifestyle interventions delivered to adults with prediabetes and their health-related quality of life as compared to the usual care group.

    METHODS: This was a quasi-experimental study conducted in two sub-urban communities in Seremban, Malaysia. A total of 268 participants with prediabetes aged between 18 to 65 years old were assigned to either the community-based lifestyle intervention (Co-HELP) (n = 122) or the usual care (n = 146) groups. The Co-HELP program was delivered in partnership with the existing community volunteers to incorporate diet, physical activity, and behaviour modification strategies. Participants in the Co-HELP group received twelve group-based sessions and two individual counselling to reinforce behavioural change. Participants in the usual care group received standard health education from primary health providers in the clinic setting. Primary outcomes were fasting blood glucose, 2-hour plasma glucose, and HbA1C. Secondary outcomes included weight, BMI, waist circumference, total cholesterol, triglyceride, LDL cholesterol, HDL cholesterol, systolic and diastolic blood pressure, physical activity, diet, and health-related quality of life (HRQOL).

    RESULTS: An intention-to-treat analysis of between-groups at 12-month (mean difference, 95% CI) revealed that the Co-HELP participants' mean fasting plasma glucose reduced by -0.40 mmol/l (-0.51 to -0.28, p<0.001), 2-hour post glucose by -0.58 mmol/l (-0.91 to -0.24, p<0.001), HbA1C by -0.24% (-0.34 to -0.15, p<0.001), diastolic blood pressure by -2.63 mmHg (-3.79 to -1.48, p<0.01), and waist circumference by -2.44 cm (-4.75 to -0.12, p<0.05) whereas HDL cholesterol increased by 0.12 mmol/l (0.05 to 0.13, p<0.01), compared to the usual care group. Significant improvements were also found in HRQOL for both physical component (PCS) by 6.51 points (5.21 to 7.80, p<0.001) and mental component (MCS) by 7.79 points (6.44 to 9.14, p<0.001). Greater proportion of participants from the Co-HELP group met the clinical recommended target of 5% or more weight loss from the initial weight (24.6% vs 3.4%, p<0.001) and physical activity of >600 METS/min/wk (60.7% vs 32.2%, p<0.001) compared to the usual care group.

    CONCLUSIONS: This study provides evidence that a culturally adapted diabetes prevention program can be implemented in the community setting, with reduction of several diabetes risk factors and improvement of HRQOL. Collaboration with existing community partners demonstrated a promising channel for the wide-scale dissemination of diabetes prevention at the community level. Further studies are required to determine whether similar outcomes could be achieved in communities with different socioeconomic backgrounds and geographical areas.

    TRIAL REGISTRATION: IRCT201104106163N1.

    Matched MeSH terms: Life Style
  13. Matejcic M, de Batlle J, Ricci C, Biessy C, Perrier F, Huybrechts I, et al.
    Int J Cancer, 2017 Mar 15;140(6):1246-1259.
    PMID: 27905104 DOI: 10.1002/ijc.30536
    Epidemiological studies have reported inconsistent findings for the association between B vitamins and breast cancer (BC) risk. We investigated the relationship between biomarkers of folate and vitamin B12 and the risk of BC in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Plasma concentrations of folate and vitamin B12 were determined in 2,491 BC cases individually matched to 2,521 controls among women who provided baseline blood samples. Multivariable logistic regression models were used to estimate odds ratios by quartiles of either plasma B vitamin. Subgroup analyses by menopausal status, hormone receptor status of breast tumors (estrogen receptor [ER], progesterone receptor [PR] and human epidermal growth factor receptor 2 [HER2]), alcohol intake and MTHFR polymorphisms (677C > T and 1298A > C) were also performed. Plasma levels of folate and vitamin B12 were not significantly associated with the overall risk of BC or by hormone receptor status. A marginally positive association was found between vitamin B12 status and BC risk in women consuming above the median level of alcohol (ORQ4-Q1  = 1.26; 95% CI 1.00-1.58; Ptrend  = 0.05). Vitamin B12 status was also positively associated with BC risk in women with plasma folate levels below the median value (ORQ4-Q1  = 1.29; 95% CI 1.02-1.62; Ptrend  = 0.03). Overall, folate and vitamin B12 status was not clearly associated with BC risk in this prospective cohort study. However, potential interactions between vitamin B12 and alcohol or folate on the risk of BC deserve further investigation.
    Matched MeSH terms: Life Style
  14. Brand JS, Czene K, Eriksson L, Trinh T, Bhoo-Pathy N, Hall P, et al.
    PLoS One, 2013;8(12):e81876.
    PMID: 24349146 DOI: 10.1371/journal.pone.0081876
    BACKGROUND: Mammographic density is a strong risk factor for breast cancer. Apart from hormone replacement therapy (HRT), little is known about lifestyle factors that influence breast density.
    METHODS: We examined the effect of smoking, alcohol and physical activity on mammographic density in a population-based sample of postmenopausal women without breast cancer. Lifestyle factors were assessed by a questionnaire and percentage and area measures of mammographic density were measured using computer-assisted software. General linear models were used to assess the association between lifestyle factors and mammographic density and effect modification by body mass index (BMI) and HRT was studied.
    RESULTS: Overall, alcohol intake was positively associated with percent mammographic density (P trend  = 0.07). This association was modified by HRT use (P interaction  = 0.06): increasing alcohol intake was associated with increasing percent density in current HRT users (P trend  = 0.01) but not in non-current users (P trend  = 0.82). A similar interaction between alcohol and HRT was found for the absolute dense area, with a positive association being present in current HRT users only (P interaction  = 0.04). No differences in mammographic density were observed across categories of smoking and physical activity, neither overall nor in stratified analyses by BMI and HRT use.
    CONCLUSIONS: Increasing alcohol intake is associated with an increase in mammography density, whereas smoking and physical activity do not seem to influence density. The observed interaction between alcohol and HRT may pose an opportunity for HRT users to lower their mammographic density and breast cancer risk.
    Matched MeSH terms: Life Style
  15. Chiang PP, Lamoureux EL, Shankar A, Tai ES, Wong TY, Sabanayagam C
    BMC Public Health, 2013;13:730.
    PMID: 23919264 DOI: 10.1186/1471-2458-13-730
    BACKGROUND: Prehypertension has been shown to be an early risk factor of cardiovascular disease (CVD). We investigated the prevalence and pattern of cardiometabolic risk factors in prehypertension in three ethnic Asian populations in Singapore.
    METHODS: We examined data from Chinese (n=1177), Malay (n=774), and Indian (n=985) adults aged 40-80 years who participated in three independent population based studies conducted from 2004-2011 in Singapore who were free of diabetes, hypertension and previous CVD. Prehypertension was defined as systolic blood pressure (BP) 120-139 mm Hg or diastolic BP 80-89 mm Hg. Random blood glucose, glycated haemoglobin (HbA1c), body mass index (BMI), triglycerides, low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol were examined as indicators of adverse cardiometabolic profile. The association between metabolic variables and prehypertension was examined using logistic regression models adjusting for potential confounders.
    RESULTS: The prevalence of prehypertension was 59.8% (Chinese), 68.9% (Malays) and 57.7% Indians. Higher levels of blood glucose, HbA1c and BMI were significantly associated with prehypertension in all three ethnic groups, odds ratio (95% confidence interval) of prehypertension in Chinese, Malays and Indians were: 1.42 (1.10, 1.83), 1.53 (1.05, 2.24), 1.49 (1.13, 1.98) for high-glucose; 3.50 (1.01, 12.18), 3.72 (1.29, 10.75), 2.79 (1.31, 5.94) for high-HbA1c; 1.86 (1.34, 2.56), 2.96 (2.10, 4.18), 1.68 (1.28, 2.20) for high-BMI. In addition, higher levels of LDL cholesterol in Chinese and higher levels of triglycerides were significantly associated with prehypertension. These associations persisted when metabolic variables were analysed as continuous variables.
    CONCLUSIONS: Higher levels of blood glucose, HbA1c and BMI were associated with prehypertension in all three ethnic groups in Singapore. Screening for prehypertension and lifestyle modifications could potentially reduce the burden of CVD in otherwise healthy Asian adults living in Singapore.
    Matched MeSH terms: Life Style
  16. Loh SY, Chew SL, Lee SY
    Asian Pac J Cancer Prev, 2011;12(1):87-94.
    PMID: 21517237
    INTRODUCTION: Physical activity participation amongst cancer survivors is low. This potent modifiable host factor has been disregarded in the cancer treatment plan for decades, despite its role in cancer control. The purpose of this study was to explore perception of physical activity among women with breast cancer.
    METHODS: Focus group with purposive sampling methods were conducted on women at different cancer trajectory - ie. completed treatment (n = 6) and undergoing treatment (n = 8). The taped discussions were transcribed verbatim and analyzed using a grounded theory approach. Concepts were identified as unique or shared between the two groups, and ordered into subcategories.
    RESULTS AND DISCUSSION: Three key categories on barriers to exercise; facilitator/motivator towards exercise; and myths around exercise were highlighted. There were more myths and reservations about physical activity in the UT (undergoing treatment) group, than in the CT (completed-treatment) group. Facilitators included positive experience from physical activity engagement, easy-access to facility, and good social support.
    CONCLUSIONS: Although both groups expressed difficulties in engaging in physical activity, the newly diagnosed have more negative perception of physical activity engagement. Both groups did not note the significant role of physical activity and cancer prevention/ recurrence, which is a key strategy to promote the uptake of exercise and acceptance of active lifestyle for cancer survivors. Health care clinicians like occupational therapists need to play greater public health role in educating and counseling lifestyle redesign for survivors living with cancer.
    Matched MeSH terms: Life Style
  17. Khoo EM, Tan HM, Low WY
    J Sex Med, 2008 Dec;5(12):2925-34.
    PMID: 18761590 DOI: 10.1111/j.1743-6109.2008.00988.x
    INTRODUCTION: Erectile dysfunction (ED), lower urinary tract symptoms (LUTS), cardiovascular disease (CVD), depression, and androgen deficiency are common conditions affecting aging men over 50 years. However, data were limited in developing countries.
    AIMS: To investigate the prevalence of ED, LUTS, chronic diseases, depression, androgen deficiency symptoms, and lifestyle of aging men in Malaysia, and to examine their associations with sociodemographic factors.
    MAIN OUTCOME MEASURES: ED, LUTS, chronic diseases, depression, positive Androgen Deficiency in the Aging Male (ADAM) questionnaire
    METHODS: A randomized survey of 351 men using structured questionnaires consisting of self-reported medical conditions, International Index for Erectile Function-5, International Prostate Symptom Score, Geriatric Depression Scale-15, and St Louis University questionnaire for ADAM. Blood samples were taken for glucose, lipid, prostate specific antigen (PSA), and hormones.
    RESULTS: Mean age was 58+/-7 years. Prevalence of ED was 70.1% (mild ED 32.8%, mild to moderate ED 17.7%, moderate ED 5.1%, and severe ED 14.5%). There were 29% of men with moderate and severe LUTS; 11.1% had severe depression; 25.4% scored positive on ADAM questionnaire; 30.2% self-reported hypertension, 21.4% self-reported diabetes mellitus; 10.8% self-reported coronary artery disease; 19.1% were smokers; and 34% consumed alcohol. There were 78.6% of men that are overweight and obese; 28.8% had a fasting blood sugar (FBS) >or=6.1 mmol/L, 70.1% had total cholesterol >5.2 mmol/L, 19.1% had total testosterone >or=11.0 nmoL/L, 14.0% had calculated free testosterone <0.0225 nmoL/dL; 4% had PSA >4 microg/L; 9.4% had insulin-like growth factor-1 (IGF-1) level below age specific range, 5.1% had abnormal sex hormone binding globulin (<15 nmoL/L and >70 nmol/L). ED was found to be significantly associated with LUTS, depression (P<0.001 respectively). Similarly, LUTS was significantly associated with depression and ADAM questionnaire status (P<0.001 respectively); and ADAM questionnaire status was also significantly associated with depression (P<0.001).
    CONCLUSION: ED, LUTS, depression, and androgen deficiency symptoms are common in urban aging men. As these conditions are possibly interrelated, strategies for early disease prevention and detection are warranted when one disease presents.
    Matched MeSH terms: Life Style
  18. Lim PS, Ong FB, Adeeb N, Seri SS, Noor-Aini MY, Shamsuddin K, et al.
    Osteoporos Int, 2005 Dec;16(12):2069-79.
    PMID: 16234999 DOI: 10.1007/s00198-005-2003-4
    The aim of this study was to identify risk factors associated with osteoporosis in urban midlife Malaysian women and to assess the effectiveness of lifestyle intervention in bone loss prevention with hormone replacement therapy (HRT) as a positive control. A total of 514 disease-free, uterus-intact, non-HRT-using women aged 45 years and older were recruited into the study. After initial bone mineral density (BMD) assessments, they were randomized into three groups: GI (control), G2 (lifestyle intervention), and G3 (lifestyle intervention with HRT). The study group was composed of 67.5% Chinese, 27.8% Malay, and 4.2% Indians with a mean age of 51.07+/-5.28 years. Two-fifths were postmenopausal, and the prevalence of osteoporosis was 24.1%, seen predominantly at the hip. Postmenopausal women had significantly lower mean BMD and a higher incidence of osteoporosis compared with the premenopausal women, 42.1% vs. 11.1% (p<0.0005). A lower incidence of osteoporosis was found in women who took calcium supplementation regularly as opposed to those who do not, 18.7% vs. 29.3% (p=0.036). Age and a greater postmenopausal duration showed a significant negative association with BMD, whereas higher family income, weight, body mass index, and waist and hip circumference were positively correlated. After 18-20 months, the effect of intervention was assessed based on BMD values of 279 women at baseline and after intervention. Lifestyle intervention alone was effective in premenopausal women, preventing over 90% of spinal bone loss compared with the controls, who lost 11.6% (0.046 g/cm2) bone mass with similar losses of hip bone, 2.0% (0.026 g/cm2) vs. 1.5% (0.020 g/cm2). Premenopausal women on HRT also showed a substantial decrease in spine and hip BMD, 18.6% (0.081 g/cm2) and 9.0% (0.122 g/cm2), respectively. The lifestyle intervention program retarded postmenopausal bone loss by 21% and 37% compared with controls, who lost 9.6% (0.141 g/cm2) and 6.0% (0.138 g/cm2) bone mass at the spine and hip. In comparison, lifestyle intervention with HRT increased postmenopausal BMD by 12.7% (0.216 g/cm2) at the spine and 1.9% (0.042 g/cm2) at the hip. The changes in hip BMD were influenced by current age, ethnicity, and income, while intervention had the strongest effect on spine BMD changes. In conclusion, lifestyle intervention prevented spinal bone loss in premenopausal women and retarded postmenopausal spine and hip bone loss compared with controls. The benefits of physical activity on spine and hip BMD highlight its potential as a safe and cost-effective alternative to HRT, which is not advocated because of its potential adverse effects.
    Matched MeSH terms: Life Style
  19. Hussein Z, Taher SW, Gilcharan Singh HK, Chee Siew Swee W
    Ann Glob Health, 2016 4 25;81(6):851-62.
    PMID: 27108152 DOI: 10.1016/j.aogh.2015.12.016
    BACKGROUND: Diabetes is a major public health concern in Malaysia, and the prevalence of type 2 diabetes (T2D) has escalated to 20.8% in adults above the age of 30, affecting 2.8 million individuals. The burden of managing diabetes falls on primary and tertiary health care providers operating in various settings.

    OBJECTIVES: This review focuses on the current status of diabetes in Malaysia, including epidemiology, complications, lifestyle, and pharmacologic treatments, as well as the use of technologies in its management and the adoption of the World Health Organization chronic care model in primary care clinics.

    METHODS: A narrative review based on local available health care data, publications, and observations from clinic experience.

    FINDINGS: The prevalence of diabetes varies among the major ethnic groups in Malaysia, with Asian Indians having the highest prevalence of T2D, followed by Malays and Chinese. The increase prevalence of overweight and obesity has accompanied the rise in T2D. Multidisciplinary care is available in tertiary and primary care settings with integration of pharmacotherapy, diet, and lifestyle changes. Poor dietary adherence, high consumption of carbohydrates, and sedentary lifestyle are prevalent in patients with T2D. The latest medication options are available with increasing use of intensive insulin regimens, insulin pumps, and continuous glucose monitoring systems for managing glycemic control. A stepwise approach is proposed to expand the chronic care model into an Innovative Care for Chronic Conditions framework to facilitate implementation and realize better outcomes in primary care settings.

    CONCLUSIONS: A comprehensive strategy and approach has been established by the Malaysian government to improve prevention, treatment, and control of diabetes as an urgent response to this growing chronic disease.

    Matched MeSH terms: Life Style
  20. Duarte-Salles T, Fedirko V, Stepien M, Aleksandrova K, Bamia C, Lagiou P, et al.
    Int J Cancer, 2015 Dec 01;137(11):2715-28.
    PMID: 26081477 DOI: 10.1002/ijc.29643
    The role of amount and type of dietary fat consumption in the etiology of hepatocellular carcinoma (HCC) is poorly understood, despite suggestive biological plausibility. The associations of total fat, fat subtypes and fat sources with HCC incidence were investigated in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, which includes 191 incident HCC cases diagnosed between 1992 and 2010. Diet was assessed by country-specific, validated dietary questionnaires. A single 24-hr diet recall from a cohort subsample was used for measurement error calibration. Hazard ratios (HR) and 95% confidence intervals (95% CI) were estimated from Cox proportional hazard models. Hepatitis B and C viruses (HBV/HCV) status and biomarkers of liver function were assessed separately in a nested case-control subset with available blood samples (HCC = 122). In multivariable calibrated models, there was a statistically significant inverse association between total fat intake and risk of HCC (per 10 g/day, HR = 0.80, 95% CI: 0.65-0.99), which was mainly driven by monounsaturated fats (per 5 g/day, HR = 0.71, 95% CI: 0.55-0.92) rather than polyunsaturated fats (per 5 g/day, HR = 0.92, 95% CI: 0.68-1.25). There was no association between saturated fats (HR = 1.08, 95% CI: 0.88-1.34) and HCC risk. The ratio of polyunsaturated/monounsaturated fats to saturated fats was not significantly associated with HCC risk (per 0.2 point, HR = 0.86, 95% CI: 0.73-1.01). Restriction of analyses to HBV/HCV free participants or adjustment for liver function did not substantially alter the findings. In this large prospective European cohort, higher consumption of monounsaturated fats is associated with lower HCC risk.
    Matched MeSH terms: Life Style
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