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Modified Munich chronotype questionnaire for application to short-interval split sleep of non-shift workers

Mazri FH, Manaf ZA, Shahar S, Mat Ludin AF, Karim NA, Ban AY, et al.

Chronobiol Int, 2021 05;38(5):659-665.
PMID: 33733959 DOI: 10.1080/07420528.2021.1887209

The Munich Chronotype Questionnaire (MCTQ) has been widely validated among various types of populations. However, determination of chronotype among individuals who have a split sleep pattern with short intervals between the first and second sleep bouts on free days has not yet been reported. This study aimed to validate the MCTQ modified for this purpose by assessing the actual sleep-wake timing against the Morningness-Eveningness Questionnaire (MEQ). The modified calculation for the midpoint of sleep on free days (MSF) of the split sleep pattern considers the second sleep bout as the total sleep duration on free days. We recruited 161 participants (mean age: 38.7 ± 7.8 years; 73% females, 29% with split sleep pattern) were recruited to administer the modified version of the MCTQ and MEQ. All of the MCTQ original parameters: midpoint of sleep on work days (MSW, r = -0.575), midpoint of sleep on free days (MSF, r = -0.568), and midpoint of sleep on free days corrected for sleep debt (MSFsc,r = -0.566) were significantly correlated with MEQ. The MEQ was further tested against MSF in four conditions of the split sleep pattern. The MSF modified for split sleep within 60 minutes after the first awakening showed highest correlation (r = -0.576) against MEQ score. The results demonstrate the modified version of MCTQ is valid to determine the chronotype in participants who practice consolidated and split sleep patterns.
Corrigendum: Effects of aerobic exercise and dietary flavonoids on cognition: a systematic review and meta-analysis

Joseph DK, Mat Ludin AF, Ibrahim FW, Ahmadazam A, Che Roos NA, Shahar S, et al.

Front Physiol, 2023;14:1287170.
PMID: 37817985 DOI: 10.3389/fphys.2023.1287170

[This corrects the article DOI: 10.3389/fphys.2023.1216948.].
Fulltext Effects of aerobic exercise and dietary flavonoids on cognition: a systematic review and meta-analysis

Joseph DK, Mat Ludin AF, Ibrahim FW, Ahmadazam A, Che Roos NA, Shahar S, et al.

Front Physiol, 2023;14:1216948.
PMID: 37664425 DOI: 10.3389/fphys.2023.1216948

Introduction: Studies have shown that exercise increases angiogenesis and perfusion in the hippocampus, activates neurogenesis in the dentate gyrus and increases synaptic plasticity, as well as increases the complexity and number of dendritic spines, all of which promote memory function and protect against cognitive decline. Flavonoids are gaining attention as antioxidants in health promotion due to their rich phenolic content, particularly for their modulating role in the treatment of neurodegenerative diseases. Despite this, there has been no comprehensive review of cognitive improvement supplemented with flavonoid and prescribed with exercise or a combination of the two interventions has been conducted. The purpose of this review is to determine whether a combined intervention produces better results when given together than when given separately. Methods: Relevant articles assessing the effect of physical exercise, flavonoid or in combination on cognitive related biomarkers and neurobehavioral assessments within the timeline of January 2011 until June 2023 were searched using three databases; PubMed, PROQUEST and SCOPUS. Results: A total of 705 articles were retrieved and screened, resulting in 108 studies which are in line with the objective of the current study were included in the analysis. Discussion: The selected studies have shown significant desired effect on the chosen biomarkers and neurobehavioral assessments. Systematic Review Registration: identifier: [CRD42021271001].
Fulltext A 16-Week Home-Based Progressive Resistance Tube Training Among Older Adults With Type-2 Diabetes Mellitus: Effect on Glycemic Control

Ooi TC, Mat Ludin AF, Loke SC, Fiatarone Singh MA, Wong TW, Vytialingam N, et al.

Gerontol Geriatr Med, 2021 08 12;7:23337214211038789.
PMID: 34409130 DOI: 10.1177/23337214211038789

Research has proven that aerobic exercise improves glucose homeostasis among patients with type 2 diabetes mellitus (T2DM). Elastic resistance (tube or band) is suggested as a good alternative for home-based strength training among older adults including those with T2DM due to its low cost, simplicity, portability, and versatility. This study aimed to measure the effects of 16-week home-based progressive resistance training (PRT), using a resistance tube on glucose homeostasis and cardiovascular risk factors among older adults with T2DM. A total of 70 participants aged 61.68 (5.50) years with T2DM were assigned to the intervention (n = 35) and control (n = 35) groups in this quasi-experimental trial. The intervention group underwent 16 weeks of home-based PRT using a resistance tube. Significant improvements in HbA1c (-1.34% point, p < 0.001), fasting blood glucose (-1.30 mmol/L, p < 0.001), and systolic blood pressure (-1.42 mmHg, p < 0.05) were observed after 16 weeks of intervention. However, no significant changes were observed in lipid profile, diastolic blood pressure, resting heart rate, and ankle-brachial index. The finding suggests that 16 weeks of home-based PRT using a resistance tube has the potential to improve glycemic control and reduce systolic blood pressure among older adults with T2DM and caused no adverse events.
Mediation effect of coping strategies on general psychological health among middle-aged and older adults during the COVID-19 pandemic

Malek Rivan NF, Shahar S, Singh DKA, Ibrahim N, Mat Ludin AF, Yahya HM, et al.

Aging Ment Health, 2021 Sep 06.
PMID: 34486885 DOI: 10.1080/13607863.2021.1972281

OBJECTIVE: In this study, we aim to assess general psychological health, associated factors, and the potential of coping strategies as a mediator for middle-aged and older Malaysian adults during the COVID-19 pandemic.
METHODS: A total of 535 individuals aged 52 years and above from the previous cohort and interventional studies in Peninsular Malaysia were contacted during the Movement Control Order (MCO) issued during the COVID-19 pandemic. Telephonic interviews were conducted to obtain participant information concerning socio-demography, physical activity, subjective well-being (SWB) as assessed using flourishing scale, coping strategies, and general psychological health (GHQ-12). Simple linear regression (SLR) and multiple linear regression (MLR) analyses were performed to identify the factors associated with GHQ-12. The associated factors were further analysed using mediation analysis to determine the potential of coping strategies as a mediator.
RESULTS: It was observed that participants had a low mean GHQ-12 score (M = 0.80, SD = 2.19), indicating good psychological health. Living arrangement, physical activity, and flourishing scale were associated with psychological health (R2 = 0.412, p
Fulltext Knowledge, Attitude and Practice Related to Vitamin D and Its Relationship with Vitamin D Status among Malay Female Office Workers

Jamil NA, Shahudin NN, Abdul Aziz NS, Jia Qi C, Wan Aminuddin WAA, Mat Ludin AF, et al.

Int J Environ Res Public Health, 2019 11 27;16(23).
PMID: 31783521 DOI: 10.3390/ijerph16234735

This study assessed knowledge, attitude and practice (KAP) related to vitamin D and its relationship with vitamin D status among Malay female office workers. A total of 147 women aged between 20 and 55 years were recruited from a university in Kuala Lumpur. They answered questionnaires related to KAP on vitamin D, sun exposure, dietary vitamin D intake and physical activity. Serum 25-hydroxyvitamin D (25OHD) was analysed using an enzyme-linked immunoassay. Nearly half (45%) of the subjects had good knowledge but moderate attitude (76%) and practice (84%) towards sunlight exposure and dietary vitamin D intake. Median serum 25OHD was 34.1 nmol/L with the majority (91%) had vitamin D insufficiency (25OHD < 50 nmol/L). Knowledge was weakly associated with attitude (r = 0.29, p < 0.001) but no association was found between knowledge and practice (r = 0.08, p = 0.355) nor attitude and practice (r = -0.001, p = 0.994). Serum 25OHD was positively associated with sunlight exposure (r = 0.22, p = 0.008) and dietary vitamin D intake (r = 0.37, p < 0.001). It can be implied that this group is at increased risk of low bone health status, which highlights the needs of public health campaigns to improve their vitamin D status.
Fulltext Do Temporal Eating Patterns Differ in Healthy versus Unhealthy Overweight/Obese Individuals?

Mazri FH, Manaf ZA, Shahar S, Mat Ludin AF, Karim NA, Hazwari NDD, et al.

Nutrients, 2021 Nov 17;13(11).
PMID: 34836375 DOI: 10.3390/nu13114121

This study examined whether the temporal patterns of energy and macronutrient intake in early and late eating windows were associated with metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO) among non-shift workers. A total of 299 overweight/obese non-shift workers (Age: 40.3 ± 6.9 years; 73.6% women; BMI: 31.7 ± 5.0 kg/m2) were recruited in the Klang Valley area of Malaysia. The biochemical parameters were determined from fasting blood samples, whereas information on dietary intake and timing was obtained from a 7-day diet history questionnaire. The midpoint of eating was used to determine the early and late windows. Compared to MHO non-shift workers (n = 173), MUO non-shift workers (n = 126) had lower energy intake from carbohydrates and protein during the early window. In contrast, MUO participants had greater energy intake from carbohydrates and fat during the late window. Participants with unhealthy metabolic status (regardless of their chronotypes) had similar temporal patterns of energy intake characterized by smaller energy intake during the early window and greater energy intake during the late window compared with participants with healthier metabolic status. Overall, the lowest percentile of energy intake during the early window was associated with an increased risk of MUO, after adjustment for potential confounders [odds ratio (OR) = 4.30, 95% confidence interval (CI) 1.41-13.11]. The greater the energy intake during the late window, the greater the risk of MUO (OR = 2.38, 95% CI 1.11-5.13) (OR = 2.33, 95% CI 1.03-5.32) (OR = 4.45, 95% CI 1.71-11.56). In summary, consuming less energy earlier in the day and more energy and carbohydrate later in the day was associated with a greater risk of MUO. Thus, a prospective study is needed to explore the potential role of chrono-nutrition practices in modifying risk factors to delay the transition of MHO to MUO.
Fulltext Associations between biopsychosocial factors and transportation patterns of older adults residing in Klang Valley, Malaysia

Mohd Rosnu NS, Ishak WS, Abd Rahman MH, Shahar S, Musselwhite C, Mat Ludin AF, et al.

Front Public Health, 2023;11:1153822.
PMID: 37275505 DOI: 10.3389/fpubh.2023.1153822

INTRODUCTION: Aging is associated with physiological changes in multiple systems in the body and may impact the transportation choices of older adults. In this study, we examine the associations between biopsychosocial factors and the transportation choices of Malaysian older adults.
METHODS: One hundred and nineteen (119) older adults, aged 60 and above, living in Klang Valley, Malaysia were recruited for this cross-sectional study. Participants were interviewed face-to-face to obtain sociodemographic data, health status (whether there were and, if yes, the number of comorbidities), outdoor mobility and transportation patterns, Instrumental Activity Daily Living (IADL) status and cognitive function. Participants' physical performance (dominant handgrip strength, 10-m walk, and timed up and go tests), hearing threshold (pure tone audiometry), and vision function (visual acuity, contrast sensitivity) were measured. Transportation patterns of older adults were categorized into three groups, that is, flexible (using public transport and/or private vehicles), using only private vehicles and restricted (relying on others or walking).
RESULTS: Further information is needed to enable such older adults as older women, those with comorbidities and poorer functional status to access transportation, especially to meet their health care needs.
DISCUSSION: The majority (51%) of participants were in the 'using only private vehicles' group, followed by the 'flexibles' (25%) and the 'restricted' (24%). Factors significantly associated with the restricted transportation group were: (a) being female (AdjOR 15.39, 95% CI 0.86-23.39, p
Fulltext The Impact of Poor Nutrient Intakes and Food Insecurity on the Psychological Distress among Community-Dwelling Middle-Aged and Older Adults during the COVID-19 Pandemic

Malek Rivan NF, Yahya HM, Shahar S, Ajit Singh DK, Ibrahim N, Mat Ludin AF, et al.

Nutrients, 2021 Jan 25;13(2).
PMID: 33503860 DOI: 10.3390/nu13020353

This study aimed to investigate the impact of food insecurity and poor nutrient intake on the psychological health of middle-aged and older adults during the COVID-19 pandemic. A sub-sample of 535 individuals aged 52 years and above, from the earlier cohort and interventional studies (n = 4) from four selected states in Peninsular Malaysia, were recruited during the COVID-19 outbreak (April to June 2020). Telephone interviews were conducted by trained interviewers with a health sciences background to obtain participants' information on health status, physical activity, food security, and psychological health (General Health Questionnaire-12; normal and psychological distress). Univariate analyses were performed for each variable, followed by a logistic regression analysis using SPSS Statistics version 25.0. Results revealed food insecurity (OR = 17.06, 95% CI: 8.24-35.32, p < 0.001), low protein (OR = 0.981, 95% CI: 0.965-0.998, p < 0.05), and fiber intakes (OR = 0.822, 95% CI: 0.695-0.972, p < 0.05) were found to be significant factors associated with the psychological distress group after adjusting for confounding factors. The findings suggested that food insecurity and insufficiencies of protein and fiber intakes heightened the psychological distress during the COVID-19 pandemic. Optimal nutrition is vital to ensure the physical and psychological health of the older population, specifically during the current pandemic.