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Fulltext A Cross-Sectional Study on the Dietary Pattern Impact on Cardiovascular Disease Biomarkers in Malaysia

Karupaiah T, Chuah KA, Chinna K, Pressman P, Clemens RA, Hayes AW, et al.

Sci Rep, 2019 09 20;9(1):13666.
PMID: 31541144 DOI: 10.1038/s41598-019-49911-6

We conducted this cross-sectional population study with a healthy multi-ethnic urban population (n = 577) in Malaysia, combining nutritional assessments with cardiometabolic biomarkers defined by lipid, atherogenic lipoproteins, inflammation and insulin resistance. We found diametrically opposing associations of carbohydrate (246·6 ± 57·7 g, 54·3 ± 6·5%-TEI) and fat (total = 64·5 ± 19·8 g, 31·6 ± 5·5%-TEI; saturated fat = 14·1 ± 2·7%-TEI) intakes as regards waist circumference, HDL-C, blood pressure, glucose, insulin and HOMA2-IR as well as the large-LDL and large-HDL lipoprotein particles. Diets were then differentiated into either low fat (LF, <30% TEI or <50 g) or high fat (HF, >35% TEI or >70 g) and low carbohydrate (LC, <210 g) or high carbohydrate (HC, >285 g) which yielded LFLC, LFHC, HFLC and HFHC groupings. Cardiometabolic biomarkers were not significantly different (P > 0.05) between LFLC and HFLC groups. LFLC had significantly higher large-LDL particle concentrations compared to HFHC. HOMA-IR2 was significantly higher with HFHC (1·91 ± 1·85, P 1.7 in the HFHC group was 2.43 (95% CI: 1·03, 5·72) times more compared to LFLC while odds of having large-LDL <450 nmol/L in the HFHC group was 1.91 (95% CI: 1·06, 3·44) more compared to latter group. Our data suggests that a HFHC dietary combination in Malaysian adults is associated with significant impact on lipoprotein particles and insulin resistance.

Matched MeSH terms: Nutrition Assessment
Fulltext A Food Frequency Questionnaire for Hemodialysis Patients in Bangladesh (BDHD-FFQ): Development and Validation

Ahmed S, Rahman T, Ripon MSH, Rashid HU, Kashem T, Md Ali MS, et al.

Nutrients, 2021 Dec 17;13(12).
PMID: 34960076 DOI: 10.3390/nu13124521

Diet is a recognized risk factor and cornerstone for chronic kidney disease (CKD) management; however, a tool to assess dietary intake among Bangladeshi dialysis patients is scarce. This study aims to validate a prototype Bangladeshi Hemodialysis Food Frequency Questionnaire (BDHD-FFQ) against 3-day dietary recall (3DDR) and corresponding serum biomarkers. Nutrients of interest were energy, macronutrients, potassium, phosphate, iron, sodium and calcium. The BDHD-FFQ, comprising 132 food items, was developed from 606 24-h recalls and had undergone face and content validation. Comprehensive facets of relative validity were ascertained using six statistical tests (correlation coefficient, percent difference, paired t-test, cross-quartiles classification, weighted kappa, and Bland-Altman analysis). Overall, the BDHD-FFQ showed acceptable to good correlations (p < 0.05) with 3DDR for the concerned nutrients in unadjusted and energy-adjusted models, but this correlation was diminished when adjusted for other covariates (age, gender, and BMI). Phosphate and potassium intake, estimated by the BDHD-FFQ, also correlated well with the corresponding serum biomarkers (p < 0.01) when compared to 3DDR (p > 0.05). Cross-quartile classification indicated that <10% of patients were incorrectly classified. Weighted kappa statistics showed agreement with all but iron. Bland-Altman analysis showed positive mean differences were observed for all nutrients when compared to 3DDR, whilst energy, carbohydrates, fat, iron, sodium, and potassium had percentage data points within the limit of agreement (mean ± 1.96 SD), above 95%. In summary, the BDHD-FFQ demonstrated an acceptable relative validity for most of the nutrients as four out of the six statistical tests fulfilled the cut-off standard in assessing dietary intake of CKD patients in Bangladesh.

Matched MeSH terms: Nutrition Assessment
A Short Dietary Assessment Instrument to Evaluate Protein Quality and the Diversity of Protein Sources in Malaysian Diets

Drewnowski A, Monsivais P, Mognard E, Ismail Noor M, Karim N, Laporte C, et al.

Asia Pac J Public Health, 2024 Jan;36(1):36-42.
PMID: 38186372 DOI: 10.1177/10105395231219049

The diversity of protein food sources, animal and plant, may be a proxy measure of protein quality and adequate protein nutrition. A population-based sample of 1604 Malaysians aged ≥18 y completed one 24-h dietary recall and a new 29-item protein diversity indicator (PDI). Socio-demographic data were obtained by self-report. Mean total protein intakes were 75.2 g/d from 24-h recalls and 74.9 g/d from PDI. Protein diversity indicator-estimated protein intakes were 36.2% from meat and poultry, 8.8% from fish, 16.0% from eggs and dairy, and 39.0% from plants. Intakes of animal proteins varied with socioeconomic status and ethnicity and were associated with higher protein quality, defined as the adequacy of essential amino acids (EAAs) relative to protein requirements. Protein intakes and protein quality in Malaysia were generally adequate. Protein diversity indicator metrics can complement current methods of dietary assessment and may be useful for monitoring protein diversity and quality in other countries currently undergoing nutrition transition.

Matched MeSH terms: Nutrition Assessment*
Fulltext A Systematic Review Examining Contributors to Misestimation of Food and Beverage Intake Based on Short-Term Self-Report Dietary Assessment Instruments Administered to Adults

Whitton C, Ramos-García C, Kirkpatrick SI, Healy JD, Dhaliwal SS, Boushey CJ, et al.

Adv Nutr, 2022 Dec 22;13(6):2620-2665.
PMID: 36041186 DOI: 10.1093/advances/nmac085

Error in self-reported food and beverage intake affects the accuracy of dietary intake data. Systematically synthesizing available data on contributors to error within and between food groups has not been conducted but may help inform error mitigation strategies. In this review we aimed to systematically identify, quantify, and compare contributors to error in estimated intake of foods and beverages, based on short-term self-report dietary assessment instruments, such as 24-h dietary recalls and dietary records. Seven research databases were searched for studies including self-reported dietary assessment and a comparator measure of observed intake (e.g., direct observation or controlled feeding studies) in healthy adults up until December 2021. Two reviewers independently screened and extracted data from included studies, recording quantitative data on omissions, intrusions, misclassifications, and/or portion misestimations. Risk of bias was assessed using the QualSyst tool. A narrative synthesis focused on patterns of error within and between food groups. Of 2328 articles identified, 29 met inclusion criteria and were included, corresponding to 2964 participants across 15 countries. Most frequently reported contributors to error were omissions and portion size misestimations of food/beverage items. Although few consistent patterns were seen in omission of consumed items, beverages were omitted less frequently (0-32% of the time), whereas vegetables (2-85%) and condiments (1-80%) were omitted more frequently than other items. Both under- and overestimation of portion size was seen for most single food/beverage items within study samples and most food groups. Studies considered and reported error in different ways, impeding the interpretation of how error contributors interact to impact overall misestimation. We recommend that future studies report 1) all error contributors for each food/beverage item evaluated (i.e., omission, intrusion, misclassification, and portion misestimation), and 2) measures of variation of the error. The protocol of this review was registered in PROSPERO as CRD42020202752 (https://www.crd.york.ac.uk/prospero/).

Matched MeSH terms: Nutrition Assessment*
Fulltext A multidimensional assessment of nutritional and health status of rural elderly Malays

Shahar S, Ibrahim Z, Fatah AR, Rahman SA, Yusoff NA, Arshad F, et al.

Asia Pac J Clin Nutr, 2007;16(2):346-53.
PMID: 17468093

A multidimensional assessment of nutritional and health status comprised of subjective global assessment (SGA), anthropometry function, biochemistry, dietary intake, social and health aspects was carried out on 820 older people (52.8% men and 47.2% women) from four rural areas of Peninsular Malaysia. A proportion of the subjects had been classified as either overweight (25.7%) or chronic energy deficient (20.3%). Although 49% of subjects had normal body weight, 68.4% have been classified as having mild to moderate malnutrition according to the SGA. Only 1.1% and 2.3% had low serum albumin and ferritin, respectively. Almost 80% of subjects, especially men, were at high risk of cardiovascular diseases on the basis of the assessment of total cholesterol and LDL-cholesterol. The majority of the subjects (87.2%) were fully independent in performing daily tasks, with men having a significantly higher score compared to women (p<0.001). However, men were less likely to be able to perform a flexibility test (50.7%) than were women (27.0%) (p<0.05). The mean energy intake for men (1412 +/- 461 kcal/d) and women (1201 +/- 392 kcal/d) were below the Recommended Nutrient Intake (RNI) for Malaysia, although this is a difficult assertion to make in an age-group which generally experiences declining energy expenditure. Moreover, 52.5% of men and 47.5% of women might have underreported their food intake. Dietary micronutrients most likely to be deficient were thiamin, riboflavin and calcium. It is concluded that a substantial proportion of rural elderly Malays had problems related to both undernutrition and overnutrition. An appropriate nutrition intervention program is needed to improve the nutritional status of rural elderly Malays.

Matched MeSH terms: Nutrition Assessment*
Fulltext A nutrition care process knowledge, attitudes, practices, and perceived barriers questionnaire

Bahari Z, Ibrahim Z, Adznam SNA, Yusof BNM

Asia Pac J Clin Nutr, 2017 8 15;26(5):781-787.
PMID: 28802285 DOI: 10.6133/apjcn.102016.02

BACKGROUND AND OBJECTIVES: Assessment of the nutrition care process (NCP) knowledge, attitudes, practices, and perceived barriers (KAPB) of dietetics practitioners is imperative before NCP is implemented completely in dietetics practice. No questionnaire assessing NCP KAPB has been developed and validated. Hence, we developed an NCP KAPB questionnaire called the KAPB-NCP and established its content validity.
METHODS AND STUDY DESIGN: A total of 116 items associated with sociodemographic characteristics (7 items), professional development (3 items), organisational culture's support for the NCP (2 items), knowledge (27 items), attitudes (39 items), practices (20 items), and perceived barriers to implementing the NCP (14 items) were generated for potential inclusion in the KAPB-NCP questionnaire. The questionnaire was reviewed online by an expert panel for its content validity. An in-depth review was conducted by the research team for evaluating the overall comprehensiveness of the questionnaire.
RESULTS: In total, 87 of 100 items of the KAPB sections showed an excellent content validity index (CVI; k* >0.74), whereas 10 showed a satisfactory CVI (k*=0.60-0.74). Only 3 items had a low CVI (k* <0.40). According to the expert panel revisions and the in-depth review, 72 items were incorporated into the questionnaire.
CONCLUSIONS: The KAPB-NCP questionnaire is a content-valid instrument that can assess NCP KAPB.

Matched MeSH terms: Nutrition Assessment*
Fulltext Abdominal Obesity in Malaysian Adults: National Health and Morbidity Survey III (NHMS III, 2006)

Kee CC, Jamaiyah H, Noor Safiza MN, Khor GL, Suzana S, Jamalludin AR, et al.

Malays J Nutr, 2008 Sep;14(2):125-35.
PMID: 22691770 MyJurnal

Abdominal obesity (AO) is an independent risk factor for cardiovascular disease, hypertension and diabetes mellitus in adults. There is a lack of data on the magnitude and socio-demographic profile of AO among Malaysian adults at the national level. In the Third National Health and Morbidity Survey (NHMS III) conducted in 2006, AO of adults aged 18 years and above was determined based on the waist circumference as part of the nutritional status assessment. This article reports the prevalence of AO in relation to socio-economic factors and demographic characteristics of adult subjects. Out of a total of 33,465 eligible individuals 18 years and above, waist circumference was measured in 32,900 (98.3%) individuals. The prevalence of AO was assessed using the cut-off points recommended by World Health Organization. The mean waist circumference in men and women was 84.0cm [95% confidence interval (95% CI): 83.8, 84.3] and 80.3cm (95% CI: 80.1, 80.6) respectively. The national prevalence of AO was 17.4% (95% CI: 16.9, 17.9). The identified risks of AO were women (OR: 4.2, 95% CI: 3.8, 4.6), aged 50-59 years (OR: 5.6, 95% CI: 4.0, 7.7), Indians (OR: 3.0, 95% CI: 2.4, 3.8), housewives (OR: 1.4, 95% CI: 1.1, 1.7), subjects with primary education (OR: 1.3, 95% CI: 1.1, 1.5) and ever married (OR: 1.4, 95% CI: 1.2, 1.6). Being the largest population-based study on AO among Malaysians, these findings have important public health implications. There is an urgent need to revise public health policies and programmes aimed at prevention of abdominal obesity especially in the groups at risk.
Study name: National Health and Morbidity Survey (NHMS-2006)

Matched MeSH terms: Nutrition Assessment
Fulltext Acrylamide and Glycidamide Hemoglobin Adducts and Epithelial Ovarian Cancer: A Nested Case-Control Study in Nonsmoking Postmenopausal Women from the EPIC Cohort

Obón-Santacana M, Lujan-Barroso L, Travis RC, Freisling H, Ferrari P, Severi G, et al.

Cancer Epidemiol Biomarkers Prev, 2016 Jan;25(1):127-34.
PMID: 26598536 DOI: 10.1158/1055-9965.EPI-15-0822

BACKGROUND: Acrylamide was classified as "probably carcinogenic to humans (group 2A)" by the International Agency for Research on Cancer. Epithelial ovarian cancer (EOC) is the fourth cause of cancer mortality in women. Five epidemiological studies have evaluated the association between EOC risk and dietary acrylamide intake assessed using food frequency questionnaires, and one nested case-control study evaluated hemoglobin adducts of acrylamide (HbAA) and its metabolite glycidamide (HbGA) and EOC risk; the results of these studies were inconsistent.
METHODS: A nested case-control study in nonsmoking postmenopausal women (334 cases, 417 controls) was conducted within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Unconditional logistic regression models were used to estimate ORs and 95% confidence intervals (CI) for the association between HbAA, HbGA, HbAA+HbGA, and HbGA/HbAA and EOC and invasive serous EOC risk.
RESULTS: No overall associations were observed between biomarkers of acrylamide exposure analyzed in quintiles and EOC risk; however, positive associations were observed between some middle quintiles of HbGA and HbAA+HbGA. Elevated but nonstatistically significant ORs for serous EOC were observed for HbGA and HbAA+HbGA (ORQ5vsQ1, 1.91; 95% CI, 0.96-3.81 and ORQ5vsQ1, 1.90; 95% CI, 0.94-3.83, respectively); however, no linear dose-response trends were observed.
CONCLUSION: This EPIC nested case-control study failed to observe a clear association between biomarkers of acrylamide exposure and the risk of EOC or invasive serous EOC.
IMPACT: It is unlikely that dietary acrylamide exposure increases ovarian cancer risk; however, additional studies with larger sample size should be performed to exclude any possible association with EOC risk.

Matched MeSH terms: Nutrition Assessment
Fulltext Adherence to the WCRF/AICR Dietary Recommendations for Cancer Prevention and Risk of Cancer in Elderly from Europe and the United States: A Meta-Analysis within the CHANCES Project

Jankovic N, Geelen A, Winkels RM, Mwungura B, Fedirko V, Jenab M, et al.

Cancer Epidemiol Biomarkers Prev, 2017 Jan;26(1):136-144.
PMID: 27793797 DOI: 10.1158/1055-9965.EPI-16-0428

BACKGROUND: It is unknown whether dietary recommendations for cancer prevention are applicable to the elderly. We analyzed WCRF/AICR recommendations in cohorts of European and U.S. adults ages 60 years and above.
METHODS: Individual participant data meta-analysis included 362,114 participants (43% women), from seven prospective cohort studies, free from cancer at enrollment. The WCRF/AICR diet score was based on: (i) energy-dense foods and sugary drinks, (ii) plant foods, (iii) red and processed meat, and (iv) alcoholic drinks. Cox proportional hazards regression was used to examine the association between the diet score and cancer risks. Adjusted, cohort-specific HRs were pooled using random-effects meta-analysis. Risk advancement periods (RAP) were calculated to quantify the time period by which the risk of cancer was postponed among those adhering to the recommendations.
RESULTS: After a median follow-up of 11 to 15 years across cohorts, 70,877 cancer cases were identified. Each one-point increase in the WCRF/AICR diet score [range, 0 (no) to 4 (complete adherence)] was significantly associated with a lower risk of total cancer [HR, 0.94; 95% confidence interval (CI), 0.92-0.97], cancers of the colorectum (HR, 0.84; 95% CI, 0.80-0.89) and prostate (HR, 0.94; 95% CI, 0.92-0.97), but not breast or lung. Adherence to an additional component of the WCRF/AICR diet score significantly postponed the incidence of cancer at any site by 1.6 years (RAP, -1.6; 95% CI, -4.09 to -2.16).
CONCLUSIONS: Adherence to WCRF/AICR dietary recommendations is associated with lower risk of cancer among older adults.
IMPACT: Dietary recommendations for cancer prevention are applicable to the elderly. Cancer Epidemiol Biomarkers Prev; 26(1); 136-44. ©2016 AACR.

Matched MeSH terms: Nutrition Assessment
Fulltext Anemia in pregnancy in Malaysia: a cross-sectional survey

Haniff J, Das A, Onn LT, Sun CW, Nordin NM, Rampal S, et al.

Asia Pac J Clin Nutr, 2007;16(3):527-36.
PMID: 17704035

Anemia is the most prevalent nutritional deficiency during pregnancy. Except for a study conducted 10 years ago in Kelantan, Malaysia's available statistics are based on isolated small urban maternity hospital studies from the 1980s. There was therefore, a need for a large study at national level to estimate the magnitude of the problem in the country as well as to understand its epidemiology. This multi-center, cross-sectional study was conducted from February to March 2005, to assess the prevalence of anemia. Multistage stratified random sampling technique was used and 59 Ministry of Health (MOH) primary health care clinics were selected. Our final dataset consisted of 1,072 antenatal mothers from 56 clinics. The overall prevalence of anemia in this population was 35 % (SE 0.02) if the cut off level is 11 g/dL and 11 % (SE 0.03) if the cut-off level is 10 g/dL. The majority was of the mild type. The prevalence was higher in the teenage group, Indians followed by Malays and Chinese being the least, grandmultiparas, the third trimester and from urban residence. After multiple linear regression analysis, only gestational age remained significant. These findings are useful for our Maternal Health program planners and implementers to target and evaluate interventions. Work is in progress for outcomes and cost-effectiveness studies to best tackle this problem. In conclusion, the prevalence of anemia is 35% and mostly of the mild type and more prevalent in the Indian and Malays.

Matched MeSH terms: Nutrition Assessment
Fulltext Assessing malnutrition in patients with nasopharyngeal carcinoma: Diagnostic protocol for the development and validation of a new nutritional assessment tool

Wang P, Soh KL, Japar SB, Khazaai HB, Liao J, Ying Y, et al.

PLoS One, 2024;19(3):e0300067.
PMID: 38527072 DOI: 10.1371/journal.pone.0300067

INTRODUCTION: There is currently no gold standard or specific nutritional assessment tool to assess malnutrition in patients with nasopharyngeal carcinoma (NPC). Our study aims to develop a new nutritional assessment tool for NPC patients.
METHODS AND ANALYSIS: NPC patients will be required to complete a risk factor questionnaire after obtaining their informed consent. The risk factor questionnaire will be used to collect potential risk factors for malnutrition. Univariate and multivariate logistic regression analyses will be used to identify risk factors for malnutrition. A new nutritional assessment tool will be developed based on risk factors. The new tool's performance will be assessed by calibration and discrimination. The bootstrapping will be used for internal validation of the new tool. In addition, external validation will be performed by recruiting NPC patients from another hospital.
DISCUSSION: If the new tool is validated to be effective, it will potentially save medical staff time in assessing malnutrition and improve their work efficiency. Additionally, it may reduce the incidence of malnutrition and its adverse consequences.
STRENGTHS AND LIMITATIONS OF THIS STUDY: The study will comprehensively analyze demographic data, disease status, physical examination, and blood sampling to identify risk factors for malnutrition. Furthermore, the new tool will be systematically evaluated, and validated to determine their effectiveness. However, the restricted geographical range may limit the generalizability of the results to other ethnicities. Additionally, the study does not analyze subjective indicators such as psychology.
ETHICS AND DISSEMINATION: The ethical approval was granted by the Ethical Committee of the First Affiliated Hospital of Guangxi Medical University (NO. 2022-KT-GUI WEI-005) and the Second Affiliated Hospital of Guangxi Medical University (NO. 2022-KY-0752).
CLINICAL TRIAL REGISTRATION NUMBER: ChiCTR2300071550.

Matched MeSH terms: Nutrition Assessment
Fulltext Assessing the nutritional status of hospitalized elderly

Abd Aziz NAS, Teng NIMF, Abdul Hamid MR, Ismail NH

Clin Interv Aging, 2017;12:1615-1625.
PMID: 29042762 DOI: 10.2147/CIA.S140859

PURPOSE: The increasing number of elderly people worldwide throughout the years is concerning due to the health problems often faced by this population. This review aims to summarize the nutritional status among hospitalized elderly and the role of the nutritional assessment tools in this issue.
METHODS: A literature search was performed on six databases using the terms "malnutrition", "hospitalised elderly", "nutritional assessment", "Mini Nutritional Assessment (MNA)", "Geriatric Nutrition Risk Index (GNRI)", and "Subjective Global Assessment (SGA)".
RESULTS: According to the previous studies, the prevalence of malnutrition among hospitalized elderly shows an increasing trend not only locally but also across the world. Under-recognition of malnutrition causes the number of malnourished hospitalized elderly to remain high throughout the years. Thus, the development of nutritional screening and assessment tools has been widely studied, and these tools are readily available nowadays. SGA, MNA, and GNRI are the nutritional assessment tools developed specifically for the elderly and are well validated in most countries. However, to date, there is no single tool that can be considered as the universal gold standard for the diagnosis of nutritional status in hospitalized patients.
CONCLUSION: It is important to identify which nutritional assessment tool is suitable to be used in this group to ensure that a structured assessment and documentation of nutritional status can be established. An early and accurate identification of the appropriate treatment of malnutrition can be done as soon as possible, and thus, the malnutrition rate among this group can be minimized in the future.

Matched MeSH terms: Nutrition Assessment*
Fulltext Assessment of muscle mass and its association with protein intake in a multi-ethnic Asian population: relevance in chronic kidney disease

Teo BW, Toh QC, Chan XW, Xu H, Li JL, Lee EJ

Asia Pac J Clin Nutr, 2014;23(4):619-25.
PMID: 25516320 DOI: 10.6133/apjcn.2014.23.4.01

Clinical practice guidelines recommend objective nutritional assessments in managing chronic kidney disease (CKD) patients but were developed while referencing to a North-American population. Specific recommendations for assessing muscle mass were suggested (mid-arm circumference, MAC; corrected mid-arm muscle area, cAMA; mid-arm muscle circumference, MAMC). This study aimed to assess correlation and association of these assessments with dietary protein intake in a multi-ethnic Asian population of healthy and CKD patients.

Matched MeSH terms: Nutrition Assessment
Fulltext Association between drinking water sources and diarrhea with malnutrition among kindergarten's children in Baghdad city, Iraq

Hasanain, F.G., Jamsiah, M., Zaleha, M.I., Azmi M. Tamil, Mohammed, A.A.

Malaysian Journal of Public Health Medicine, 2012;12(1):45-48.
MyJurnal

Malnutrition is associated with childhood diseases such as diarrhea or other severe illness. Children who suffer from
repeated episodes of diarrhea are more likely to suffer from malnutrition. In addition, the source of drinking water is
a very important factor affecting the nutritional status. The objective of this study was to find out the prevalence of
malnutrition condition among children aged 3 to 5 years old and the factors associated with it. A cross sectional study
using simple random sampling was conducted among 220 children aged 3 to 5 years old from four kindergartens in
Baghdad city, Iraq. Nutritional assessment was carried out using the indicator weight-for-age z-score based on World
Health Organization cut off points. Acute malnutrition was found in 18.2 % of the respondents. In this study 65 % of
the respondents used tap water to drink as compared to 35 % who used sterilized bottles as source of drinking water.
The environmental factors mainly the source of drinking water was significantly associated with child nutritional
status (p=0.034). The prevalence of diarrhea and admissions to the hospital due to diarrhea were also significantly
associated with malnutrition (p < 0.01, p

Matched MeSH terms: Nutrition Assessment
Fulltext Association of health literacy and nutritional status assessment with glycemic control in adults with type 2 diabetes mellitus

Hashim SA, Barakatun-Nisak MY, Abu Saad H, Ismail S, Hamdy O, Mansour AA

Nutrients, 2020 Oct 15;12(10).
PMID: 33076406 DOI: 10.3390/nu12103152

While the role of medical and nutrition factors on glycemic control among adults with type 2 diabetes mellitus (T2DM) has been well-established, the association between health literacy (H.L.) and glycemic control is inconsistent. This study aims to determine the association of H.L. and nutritional status assessments with glycemic control in adults with type 2 diabetes mellitus. A total of 280 T2DM respondents (mean (SD) age = 49.7 (10.3) years, Glycated hemoglobin (HbA1c) = 9.9 (2.6) %, and Body Mass Index = 32.7 (15.1) kg/m2) were included in this study. A short-form Test of Functional Health Literacy in Adults (S-TOFHLA) assessed the H.L. levels. Nutritional status assessments included client history, glycemic control, anthropometric, and biochemical data. The mean (S.D.) H.L. score was 45.7 (24.6), with 56% of the respondents had inadequate H.L. Inadequate H.L. was more common among those females; housewives, low education, received oral antidiabetic therapy, and shorter diabetes duration. Respondents with inadequate H.L. were significantly older and had higher HbA1c than those with marginal and adequate H.L. Meanwhile, respondents with inadequate and marginal H.L. levels had significantly higher total cholesterol, LDL-cholesterol, and systolic blood pressure than the respondents with adequate H.L. Low H.L. scores, self-employment status, received dual antidiabetic therapy (insulin with oral agents), received insulin alone, and had higher fasting blood glucose explained about 21% of the total variation in HbA1c (adjusted R2 = 0.21; p < 0.001). Respondents with inadequate H.L. had poor glycemic control. The H.L. scores, together with nutritional status assessments, were the factors that predicted poor glycemic control among adults with T2DM.
Study site: Faiha Specialized Diabetes, Endocrine, and Metabolism Centre (FDEMC), Basrah, Iraq

Matched MeSH terms: Nutrition Assessment
Fulltext Blood Metabolic Signatures of Body Mass Index: A Targeted Metabolomics Study in the EPIC Cohort

Carayol M, Leitzmann MF, Ferrari P, Zamora-Ros R, Achaintre D, Stepien M, et al.

J Proteome Res, 2017 Sep 01;16(9):3137-3146.
PMID: 28758405 DOI: 10.1021/acs.jproteome.6b01062

Metabolomics is now widely used to characterize metabolic phenotypes associated with lifestyle risk factors such as obesity. The objective of the present study was to explore the associations of body mass index (BMI) with 145 metabolites measured in blood samples in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Metabolites were measured in blood from 392 men from the Oxford (UK) cohort (EPIC-Oxford) and in 327 control subjects who were part of a nested case-control study on hepatobiliary carcinomas (EPIC-Hepatobiliary). Measured metabolites included amino acids, acylcarnitines, hexoses, biogenic amines, phosphatidylcholines, and sphingomyelins. Linear regression models controlled for potential confounders and multiple testing were run to evaluate the associations of metabolite concentrations with BMI. 40 and 45 individual metabolites showed significant differences according to BMI variations, in the EPIC-Oxford and EPIC-Hepatobiliary subcohorts, respectively. Twenty two individual metabolites (kynurenine, one sphingomyelin, glutamate and 19 phosphatidylcholines) were associated with BMI in both subcohorts. The present findings provide additional knowledge on blood metabolic signatures of BMI in European adults, which may help identify mechanisms mediating the relationship of BMI with obesity-related diseases.

Matched MeSH terms: Nutrition Assessment
Fulltext Blood pressure and risk of cancer in the European Prospective Investigation into Cancer and Nutrition

Christakoudi S, Kakourou A, Markozannes G, Tzoulaki I, Weiderpass E, Brennan P, et al.

Int J Cancer, 2020 May 15;146(10):2680-2693.
PMID: 31319002 DOI: 10.1002/ijc.32576

Several studies have reported associations of hypertension with cancer, but not all results were conclusive. We examined the association of systolic (SBP) and diastolic (DBP) blood pressure with the development of incident cancer at all anatomical sites in the European Prospective Investigation into Cancer and Nutrition (EPIC). Hazard ratios (HRs) (95% confidence intervals) were estimated using multivariable Cox proportional hazards models, stratified by EPIC-participating center and age at recruitment, and adjusted for sex, education, smoking, body mass index, physical activity, diabetes and dietary (in women also reproductive) factors. The study included 307,318 men and women, with an average follow-up of 13.7 (standard deviation 4.4) years and 39,298 incident cancers. We confirmed the expected positive association with renal cell carcinoma: HR = 1.12 (1.08-1.17) per 10 mm Hg higher SBP and HR = 1.23 (1.14-1.32) for DBP. We additionally found positive associations for esophageal squamous cell carcinoma (SCC): HR = 1.16 (1.07-1.26) (SBP), HR = 1.31 (1.13-1.51) (DBP), weaker for head and neck cancers: HR = 1.08 (1.04-1.12) (SBP), HR = 1.09 (1.01-1.17) (DBP) and, similarly, for skin SCC, colon cancer, postmenopausal breast cancer and uterine adenocarcinoma (AC), but not for esophageal AC, lung SCC, lung AC or uterine endometroid cancer. We observed weak inverse associations of SBP with cervical SCC: HR = 0.91 (0.82-1.00) and lymphomas: HR = 0.97 (0.93-1.00). There were no consistent associations with cancers in other locations. Our results are largely compatible with published studies and support weak associations of blood pressure with cancers in specific locations and morphologies.

Matched MeSH terms: Nutrition Assessment
Fulltext Body mass index and illness in rural Sarawak

Strickland SS, Ulijaszek SJ

Eur J Clin Nutr, 1994 Nov;48 Suppl 3:S98-108; discussion S108-9.
PMID: 7843165

This paper reports findings of a cross-sectional anthropometric survey of 447 men and 564 women aged > 18 years of the Iban tribe in rural Sarawak. The percentage of each approximately 10 year cohort with body mass index (BMI: kg/m2) < 18.5 increased progressively with age > 40 years in both sexes. BMI and arm-muscle plus bone cross-sectional area (AMBA) were influenced significantly by reported single symptoms in men and two concurrent symptoms in women. Sensitivity of BMI < 18.5 for identifying those reporting symptoms of illness was 21% in men and 29% in women. Independently of illness effects, values of stature, BMI and AMBA in men, and stature alone in women, were significantly greater in those farming plots with the shortest time left fallow, suggesting their comparative success. The BMI of men may reflect primarily their economic activities, while that of women their experience of illness; the AMBA may also be a better overall index of health than BMI in this population.

Matched MeSH terms: Nutrition Assessment
Fulltext Can Malaysian Young Adults Report Dietary Intake Using a Food Diary Mobile Application? A Pilot Study on Acceptability and Compliance

Chen YS, Wong JE, Ayob AF, Othman NE, Poh BK

Nutrients, 2017 Jan 13;9(1).
PMID: 28098770 DOI: 10.3390/nu9010062

Mobile applications may improve dietary reporting among young adults due to their high accessibility and embedded camera function. This pilot study aimed to (i) evaluate users' acceptability and compliance in reporting dietary intake using a newly developed food diary mobile application (food app); and (ii) identify issues and recommendations for improving dietary assessment using this food app via quantitative and qualitative protocols. Twenty-eight university students each used a food app for seven consecutive days and attended one of five focus group interviews. A 42% decrement in reporting compliance was observed throughout the seven-day recording period. An average of 5.9 recording days were reported and 4.8 occasions of meal data were uploaded each day. Based on questionnaires, high levels of agreement were reported in terms of perceived usefulness (69.3%), perceived ease of use (77.1%), attitude (73.6%), perceived enjoyment (62.6%), and smartphone experience (91.1%), but such agreement was not reported for intention to use (38.1%) and social influence (33.4%). Four major themes emerged from the focus group interviews, namely, (i) features; (ii) potential use; (iii) utility issues of the food app; and (iv) suggestions for improvements. While the food app was well-accepted by most of the young adults, the current prototype would benefit from incorporation of a barcode scanning function, customizable reminders, in-app tutorial, an entertainment component, and enhancement in overall appearance.

Matched MeSH terms: Nutrition Assessment
Fulltext Coffee and tea drinking in relation to the risk of differentiated thyroid carcinoma: results from the European Prospective Investigation into Cancer and Nutrition (EPIC) study

Zamora-Ros R, Alghamdi MA, Cayssials V, Franceschi S, Almquist M, Hennings J, et al.

Eur J Nutr, 2019 Dec;58(8):3303-3312.
PMID: 30535794 DOI: 10.1007/s00394-018-1874-z

PURPOSE: Coffee and tea constituents have shown several anti-carcinogenic activities in cellular and animal studies, including against thyroid cancer (TC). However, epidemiological evidence is still limited and inconsistent. Therefore, we aimed to investigate this association in a large prospective study.
METHODS: The study was conducted in the EPIC (European Prospective Investigation into Cancer and Nutrition) cohort, which included 476,108 adult men and women. Coffee and tea intakes were assessed through validated country-specific dietary questionnaires.
RESULTS: During a mean follow-up of 14 years, 748 first incident differentiated TC cases (including 601 papillary and 109 follicular TC) were identified. Coffee consumption (per 100 mL/day) was not associated either with total differentiated TC risk (HRcalibrated 1.00, 95% CI 0.97-1.04) or with the risk of TC subtypes. Tea consumption (per 100 mL/day) was not associated with the risk of total differentiated TC (HRcalibrated 0.98, 95% CI 0.95-1.02) and papillary tumor (HRcalibrated 0.99, 95% CI 0.95-1.03), whereas an inverse association was found with follicular tumor risk (HRcalibrated 0.90, 95% CI 0.81-0.99), but this association was based on a sub-analysis with a small number of cancer cases.
CONCLUSIONS: In this large prospective study, coffee and tea consumptions were not associated with TC risk.

Matched MeSH terms: Nutrition Assessment*

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