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Fulltext The association between dietary patterns before and in early pregnancy and the risk of gestational diabetes mellitus (GDM): Data from the Malaysian SECOST cohort

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.

Matched MeSH terms: Prenatal Nutritional Physiological Phenomena*
Health-care professionals' approach in feeding term small-for-gestational age infants and its potential implications to later growth outcomes

Lee LY, Muhardi L, Cheah FC, Supapannachart S, Teller IC, Bindels J, et al.

J Paediatr Child Health, 2018 Apr;54(4):370-376.
PMID: 29205630 DOI: 10.1111/jpc.13775

AIM: To understand feeding practices, nutrition management and postnatal growth monitoring of term small-for-gestational age (tSGA) infants in Southeast Asia.
METHODS: Anonymous questionnaires to assess practices on feeding, nutrition management and post-natal growth monitoring of tSGA infants were distributed among health-care professionals (HCPs) participating in regional/local perinatology symposia in Malaysia, Thailand and Singapore.
RESULTS: Three hundred seventy-seven respondents from Malaysia (37%), Thailand (27%), Singapore (18%) and other Asian countries (19%) participated in the survey. Respondents were neonatologists (35%), paediatricians (25%) and other HCPs (40%) including nurses and midwives. Exclusive human milk feeding was reported the most preferred feeding option for tSGA infants, followed by fortified human milk feeding (60% and 20%, respectively). This was consistent among the different countries. The perceived nutrient requirements of tSGA infants varied between countries. Most respondents from Malaysia and Singapore reported requirements to be similar to preterm infants, while the majority from Thailand reported that it was less than those of preterm infants. The World Health Organization Growth Chart of 2006 and Fenton Growth Charts of 2013 were the most frequently used charts for growth monitoring in the hospital and after discharge.
CONCLUSIONS: Nutrition management and perceived nutrient requirements for tSGA infants among practising HCPs in Southeast Asia showed considerable variation. The impetus to form standardised and evidence based feeding regimens is important as adequate nutritional management and growth monitoring particularly in this population of infants will have long term impact on population health.

Matched MeSH terms: Infant Nutritional Physiological Phenomena*
Breast feeding in Kelantan

Balakrishnan S, bin Haji Hussein H

Med J Malaysia, 1977 Sep;32(1):22-4.
PMID: 609338
Matched MeSH terms: Infant Nutritional Physiological Phenomena
Nutrition promotion: the role of monitoring physical growth

Zulkifli SN

Asia Pac J Public Health, 1992;6(4):210-6.
PMID: 1345448

Growth monitoring has been included as one of the basic strategies for child survival. In this paper, the rationale for this is reiterated both for individual as well as population nutritional surveillance. Methods for and approaches to growth monitoring are described. In addition, potential problems in implementing growth monitoring projects and interpreting the results are discussed. Despite its lack of sensitivity and specificity as a diagnostic tool, its advantages in terms of low cost, simplicity, reliability and social acceptability justify its use in nutritional surveillance, particularly in populations at risk of malnutrition.
Publication year: 1992-1993

Matched MeSH terms: Child Nutritional Physiological Phenomena*
Effects of feeding fermented fish on egg cholesterol content in hens

Loh TC, Law FL, Goh YM, Foo HL, Zulkifli I

Anim Sci J, 2009 Feb;80(1):27-33.
PMID: 20163464 DOI: 10.1111/j.1740-0929.2008.00591.x

This study was conducted to investigate the effects of feeding fermented fish (FF) to layers on laying performance, and polyunsaturated fatty acid and cholesterol levels in eggs and plasma. A total of 96, 13-week-old Babcock B380 pullets were used in this study. They were randomly assigned to four numerically equal groups with eight replicates per treatment, three birds per replicate. All the birds were housed in individual cages. The dietary treatments were: Control diet, without FF; FF3 diet containing 3% (w/w) FF, FF6 diet containing 6% (w/w) FF and FF9 diet containing 9% (w/w) FF. The study was carried out for 16 weeks inclusive of two weeks of adjustment. Weekly feed intake and egg production were recorded. Blood plasma cholesterol and fatty acid profiles were assayed at the end of the experiment. FF did not enhance (P > 0.05) egg mass but (P < 0.05) decreased egg weight slightly. However, egg yolk cholesterol and plasma cholesterol concentrations were reduced (P < 0.05) by FF. The n-6:n-3 fatty acids ratio in the egg yolk (Control = 7.9, FF9 = 6.2) and plasma (Control = 10.6, FF9 = 6.2) were decreased by feeding FF. Moreover, FF was able to increase (P < 0.05) the docosahexaenoic acid (DHA) concentrations in egg yolk and plasma. In conclusion, this study demonstrated that FF increased DHA and reduced egg yolk cholesterol in poultry eggs.

Matched MeSH terms: Animal Nutritional Physiological Phenomena
Regional study of nutritional status of urban primary schoolchildren. 3. Kuala Lumpur, Malaysia

Tee ES, Khor SC, Ooi HE, Young SI, Zakiyah O, Zulkafli H

Food Nutr Bull, 2002 Mar;23(1):41-7.
PMID: 11975368

A total of 5,995 (7.8% of all 7- to 10-year-old primary schoolchildren in Kuala Lumpur), randomly selected from 166 schools (97.6% of all schools), were measured for their weight and height. The analyses of all weight and height data, including the cutoffs used for defining stunting, underweight, and wasting and for thinness and overweight, were carried out as recommended by the World Health Organization (WHO). The prevalances of stunting (height-for-age Z score < -2 SD), underweight (weight-for-age Z score < -2 SD) and wasting (weight-for-height Z score < -2 SD) among all the children studies were 6.7%, 7.1%, and 4.5%, respectively. Undernutrition among boys was more serious than among girls according to all three indicators. Because it was not possible to analyze the weight-for-height data for most of the children above 8.5 years of age, body mass index (BMI)-for-age was used to determine the prevalences of thinness and overweight for all the children. Based on the reference data, the prevalence of overweight (at or above the 95th percentile) was 9.7% and 7.1% for boys and girls, respectively, and 8.4% overall.

Matched MeSH terms: Child Nutritional Physiological Phenomena*
Fulltext A structural equation model of the determinants of malnutrition among children in rural Kelantan, Malaysia

Cheah WL, Wan Muda WAM, Zamh ZH

Rural Remote Health, 2010;10(1):1248.
PMID: 20184392

Many studies had shown that poor growth in children is associated with malnutrition. The underlying factors are diverse, multisectoral and interrelated, ranging from biological to social, cultural and economically related. Because the highest levels of under-nutrition worldwide are found in South Asia, it is essential that policymakers in the region understand the underlying determinants, in order to design effective public health intervention programs. This is especially so if public resources are limited. The purpose of this cross-sectional study was to examine causal relationships among the biological, behavioural and environmental factors related to malnutrition in children aged 5 years and under.

Matched MeSH terms: Child Nutritional Physiological Phenomena*
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: Maternal Nutritional Physiological Phenomena/physiology*
Effects of varying dietary carbohydrate levels on growth performance, body composition and liver histology of Malaysian mahseer fingerlings (Tor tambroides)

Ishak SD, Kamarudin MS, Ramezani-Fard E, Saad CR, Yusof YA

J Environ Biol, 2016 07;37(4 Spec No):755-64.
PMID: 28779735

We investigated the effects of four iso-nitrogenous (40% crude protein) and iso-caloric (17.6 kJ g(-1)) diets with different dietary carbohydrate levels (15%, 20%, 25% and 30%) on the growth performance, feed utilization efficiency, body composition and liver histology of Malaysian mahseer (Tor tambroides) fingerlings in a 10-week feeding trial. Fish (initial weight of 0.8?0.1 g; initial total length 4.2?0.1 cm) were fed twice daily at 4% body mass. Dietary carbohydrate level had significant effects (P<0.05) on weight gain, SGR (specific growth rate), FCR (feed conversion rate), PER (protein efficiency rate), survival percentage and all nutrient retention values (PRV, LRV, CRV, ERV). Protein, carbohydrate and gross energy composition of the fish body were also significantly differed (P<0.05) among treatments. Liver histology showed mild hepatic steatosis and hypertrophy for fishes receiving a higher dietary carbohydrate inclusion. In general, treatments with 20% and 25% dietary carbohydrate levels produced better growth results compared to the rest of the treatments. Using a second-order polynomial regression analysis model, the optimal dietary carbohydrate level of 23.4% was estimated for mahseer fingerlings. ?

Matched MeSH terms: Animal Nutritional Physiological Phenomena
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: Nutritional Physiological Phenomena
Fulltext Nutritional situation of a Chinese community

Suriah AR, Chong TJ, Yeoh BY

Singapore Med J, 1998 Aug;39(8):348-52.
PMID: 9844494

AIM: To evaluate the anthropometric measurements and dietary intake of the free-living elderly in a Chinese community.
METHOD: A survey was carried out on 48 male and female subjects aged 60 to 96 years using anthropometric, dietary intake and questionnaire techniques.
RESULTS: The study indicated female subjects to have more health problems, like pain at the joints (33%), hypertension (17%) and diabetes (27%) as compared to the male subjects. Dietary intake analysis showed the Chinese male subjects to have a higher energy intake (1,623 kcal) compared to the females (1,197 kcal) even though they did not fulfill the recommended dietary intake. The intake for energy, fats and carbohydrates, was found to be significantly different (p < 0.05) between both sexes. Anthropometric measurements indicated male elderly subjects to be significantly heavier (p < 0.05, 55.4 kg) and taller (161.8 cm) than female elderly subjects (49.5 kg; 146.2 cm respectively). About half of the elderly were normal in their BMI (male 55.6%; female 50%) and only 6.6% of the female subjects were obese. More male subjects were found to be underweight (33%) compared to female subjects (17%). Waist hip ratio was 0.92 for male and 0.87 for female.
CONCLUSION: Our study showed that female elderly subjects had more health problems compared to male elderly subjects. On the whole, the elderly did not fulfill the recommended amount for energy intake while the percentage for carbohydrates, fats and protein from the total calorie intake were not in accordance with the healthy diet guidelines. Anthropometrically, male subjects were heavier and taller than female subjects. Looking at body mass index, most of the male elderly subjects were in the normal to underweight range. With these results, more research is warranted to give a clearer picture of the Chinese elderly in the country.

Study site: Kampung Baru Tabuh Naning, Alor Gajah, Malacca

Matched MeSH terms: Nutritional Physiological Phenomena*
Health effects of soy protein and isoflavones in humans

Xiao CW

J Nutr, 2008 Jun;138(6):1244S-9S.
PMID: 18492864

Epidemiological investigations suggest that soy consumption may be associated with a lower incidence of certain chronic diseases. Clinical studies also show that ingestion of soy proteins reduces the risk factors for cardiovascular disease. This led to the approval of the food-labeling health claim for soy proteins in the prevention of coronary heart disease by the U.S. FDA in 1999. Similar health petitions for soy proteins have also been approved thereafter in the United Kingdom, Brazil, South Africa, the Philippines, Indonesia, Korea, and Malaysia. However, the purported health benefits are quite variable in different studies. The Nutrition Committee of the American Heart Association has assessed 22 randomized trials conducted since 1999 and found that isolated soy protein with isoflavones (ISF) slightly decreased LDL cholesterol but had no effect on HDL cholesterol, triglycerides, lipoprotein(a), or blood pressure. The other effects of soy consumption were not evident. Although the contributing factors to these discrepancies are not fully understood, the source of soybeans and processing procedures of the protein or ISF are believed to be important because of their effects on the content and intactness of certain bioactive protein subunits. Some studies have documented potential safety concerns on increased consumption of soy products. Impacts of soy products on thyroid and reproductive functions as well as on certain types of carcinogenesis require further study in this context. Overall, existing data are inconsistent or inadequate in supporting most of the suggested health benefits of consuming soy protein or ISF.

Matched MeSH terms: Nutritional Physiological Phenomena
The search for the cause of beriberi in the Malay Peninsula: the contribution of Dr. W. L. Braddon

Wylie E

J Malays Branch R Asiat Soc, 1988;61(2):93-122.
PMID: 11617395
Matched MeSH terms: Nutritional Physiological Phenomena*
Diet, nutritional knowledge and health status of urban middle-aged Malaysian women

Pon LW, Noor-Aini MY, Ong FB, Adeeb N, Seri SS, Shamsuddin K, et al.

Asia Pac J Clin Nutr, 2006;15(3):388-99.
PMID: 16837432

The objective of the study was to assess nutritional and health status as well as nutritional knowledge in urban middle-aged Malaysian women. The impact of menopause on diet and health indices was also studied. The study included 360 disease free women, non users of HRT,aged > or =45 years with an intact uterus recruited from November 1999 to October 2001. Personal characteristics, anthropometric measurements and blood sample were acquired followed by clinical examination. Nutrient intake and nutritional knowledge was determined by a quantitative FFQ and KAP. The findings showed that urban middle-aged women, aged 51.65+/-5.40 years had energy intakes (EI) 11% below RDA, consisting of 53% carbohydrates, 15% protein and a 32% fat which declined with age. The sample which comprised of 42.5% postmenopausal women had a satisfactory diet and healthy lifestyle practices. Premenopausal women consumed more dietary fat (6%) with other aspects of diet comparable to the postmenopausal women. Iron intake was deficient in premenopausal women, amounting to 56% RDA contributing to a 26% prevalence of anaemia. Overall, calcium intake reached 440 mg daily but dairy products were not the main source. The postmenopaused had a more artherogenic lipid profile with significantly higher total cholesterol (TC) and LDL-C, but more premenopausal women were overweight/obese (49% versus 35%). EI was the strongest predictor for BMI and waist circumference (WC), with WC itself an independent predictor of fasting blood sugar and TC with BMI strongly affecting glucose tolerance. High nutritional knowledge was seen in 39% whereas 20% had poor knowledge. Newspapers and magazines, followed by the subject's social circle, were the main sources of nutritional information. Nutritional knowledge was positively associated with education, household income, vitamin/ mineral supplementation and regular physical activity but inversely related to TC. In conclusion, middle-aged urban women had an adequate diet with low iron and calcium intakes. Nutritional knowledge was positively associated to healthier lifestyle practices and lower TC. A comparable nutrient intake and lifestyle between pre and postmenopausal women suggested that health changes associated with menopause was largely independent of diet.

Matched MeSH terms: Nutritional Physiological Phenomena*
Fulltext Population-based studies of nutrition and health in Asia Pacific elderly

Lee MS, Wahlqvist ML

Asia Pac J Clin Nutr, 2005;14(4):294-7.
PMID: 16326634

The systematic observation of food habits and health amongst the elderly, both cross-sectionally and longitudinally, in the Asia Pacific region is increasing as reflected in the recent collective report of a number of intake and health variables in Taiwanese communities. Most studies are of Chinese and Japanese-speaking populations, with some from elsewhere in Northeast Asia (notably Korea) and Southeast Asia (notably the Philippines, Indonesia, Malaysia and Singapore). These, and other international studies, demonstrate that older people can eat in various ways and yet achieve longevity and minimum morbidity, provided they remain physically and mentally active and eat a variety of relatively intact foods, including fish and pulses (lentils, legumes, beans). Such studies are the foundation of a new generation of food and health policy for the aged, with reference to EBN (evidence-based nutrition) and reflected in FBDGs (food-based dietary guidelines) which acknowledge cultural difference and support sustainable food systems.

Matched MeSH terms: Nutritional Physiological Phenomena
The dietary pattern of schoolchildren in the Muar District, Malaya

GRANT MW, TAN PHUI YONG, WADSWORTH GR

J Trop Med Hyg, 1959 May;62(5):118-22.
PMID: 13655347
Matched MeSH terms: Nutritional Physiological Phenomena*
Experiments and rights

Vollrath J

Bioethics, 1989 Apr;3(2):93-105.
PMID: 11649247 DOI: 10.1111/j.1467-8519.1989.tb00331.x
Matched MeSH terms: Nutritional Physiological Phenomena
Fulltext Fructans in the first 1000 days of life and beyond, and for pregnancy

Firmansyah A, Chongviriyaphan N, Dillon DH, Khan NC, Morita T, Tontisirin K, et al.

Asia Pac J Clin Nutr, 2016 Dec;25(4):652-675.
PMID: 27702710 DOI: 10.6133/apjcn.092016.02

Inulin-based prebiotics are non-digestible polysaccharides that influence the composition of the gut microbiota in infants and children, notably eliciting a bifidogenic effect with high short chain fatty acid levels. Inulin, a generic term that comprises β-(2,1)-linked linear fructans, is typically isolated from the chicory plant root, and derivatives such as oligofructose and long chain inulin appear to have different physiological properties. The first 1000 days of a child's life are increasingly recognized as a critical timeframe for health also into adulthood, whereby nutrition plays a key role. There is an ever increasing association between nutrition and gut microbiota composition and development, with life health status of an individual. This review summarizes the latest knowledge in the infant gut microbiota from preterms to healthy newborns, as well as in malnourished children in developing countries. The impact of inulin or mixtures thereof on infants, toddlers and young children with respect to intestinal function and immunity in general, is reviewed. Possible benefits of prebiotics to support the gut microbiome of malnourished infants and children, especially those with infections in the developing world, are considered, as well as for the pregnant mothers health. Importantly, novel insights in metabolic programming are covered, which are being increasing recognized for remarkable impact on long term offspring health, and eventual potential beneficial role of prebiotic inulins. Overall increasing findings prompt the potential for gut microbiota-based therapy to support health or prevent the development of certain diseases from conception to adulthood where inulin prebiotics may play a role.

Matched MeSH terms: Infant Nutritional Physiological Phenomena*; Maternal Nutritional Physiological Phenomena*
Fulltext A randomised controlled trial of glutamine-enriched neonatal parenteral nutrition in Malaysia

Mohamad Ikram I, Quah BS, Noraida R, Djokomuljanto S, Faris Irfan CY, Van Rostenberghe H

Singapore Med J, 2011 May;52(5):356-60.
PMID: 21633770

The addition of glutamine to parenteral nutrition (PN) in neonates has not shown significant benefits as compared to adults thus far. This study aimed to determine the potential benefits of the addition of glutamine to neonatal PN in a tertiary hospital in a middle-income country.

Matched MeSH terms: Infant Nutritional Physiological Phenomena
Recommended Nutrient Intake Levels for Preterm Infants

Koletzko B, Wieczorek S, Cheah FC, Domellöf M, van Goudoever JB, Poindexter BB, et al.

World Rev Nutr Diet, 2021;122:191-197.
PMID: 34352778 DOI: 10.1159/000514772
Matched MeSH terms: Infant Nutritional Physiological Phenomena*

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