Introduction: This study aimed to (i) determine rapid weight loss (RWL) practices among Malaysian elite combat sports athletes and (ii) examine the relationship between the characteristics of athletes, self-reported history of weight loss, perceived influence on weight loss and RWL practices.
Methods: This was a cross-sectional study conducted at the Malaysian National Sports Institute among elite combat sports athletes (n=40) recruited via a convenience sampling method. The athletes completed a self-administered validated Rapid Weight Loss Questionnaire. Each response was provided a score and the total RWL score corresponded to the aggressiveness of weight management methods. Partial correlations were used to assess the relationships between total RWL score and independent variables.
Results: The prevalence of RWL among the athletes was high (92.5%). Training with rubber or plastic suits (62.2%) and meal-skipping (27.0%) were the most common RWL techniques practised by the respondents. Aggressive weight-cutting as depicted by a higher total RWL score that correlated with most weight ever lost, duration taken to lose weight, influence of training colleagues and coaches, BMI, current weight and post-competition weight regain (all p
The Infant and Early Childhood Nutrition Task Force, International Life Sciences Institute Southeast Asia (ILSI SEA) Region, organised the 1st and 2nd Expert Consultation and Planning Meeting on Infant and Early Childhood Nutrition in 2009 and 2011, respectively. The goal of the consultations was "to generate and promote relevant science-based information that will help improve nutritional status, growth and development of infants and young children in Southeast Asia."
INTRODUCTION: There is a lack of information on the trans fatty acid (TFA) content in Malaysian foods. The objective of this study is to determine the TFA content of bakery products, snacks, dairy products, fast foods, cooking oils and semisolid fats, and breakfast cereals and Malaysian fast foods. This study also estimated the quantity of each isomer in the foods assayed.
METHODS: The trans fatty acid content of each food sample was assessed in duplicate by separating the fatty acid methyl esters (FAME) in a gas chromatography system equipped with HP-88 column (USA: split ratio 10: 1) for cis/trans separation. Five major TFA isomers, palmitoelaidic acid (16: 1t9), petroselaidic acid (18:1t6), elaidic acid (18:1t9), vaccenic acid (18: 1t11) and linoelaidic acid (18:2t9, 12), were measured using gas chromatography (GC) and the data were expressed in unit values of g/100 g lipid or g/100 g food.
RESULTS: The total TFA contents in the studied foods were < 0.001 g-8.77 g/100 g lipid or < 0.001 g-5.79 g/100 g foods. This value falls within the standard and international recommendation level for TFA. The measured range of specific TFA isomers were as follows: palmitoelaidic acid (< 0.001 g-0.26 g/100 g lipid), petroselaidic acid (< 0.001 g - 3.09 g/100 g lipid), elaidic acid (< 0.001 g-0.87 g/100 g lipid), vaccenic acid (< 0.001 g-0.41 g/100 g lipid) and linoelaidic acid (< 0.001 g-6.60 g/100 g lipid).
CONCLUSION: These data indicate that most of the tested foods have low TFA contents (< 1 g/100 g lipid).
Introduction: Shellfish is likely to be contaminated with heavy metals brought about by various environmental factors such as climate change, bioaccumulation of environmental contaminants and imbalanced natural ecosystem.
Methods: Shellfish were selected for heavy metal detection as they are mainly consumed by the locals in Kudat. Arsenic, Cadmium, Chromium, Nickel, and Plumbum (As, Cd, Cr, Ni, and Pb) content in clam (Meretrix spp.), scallop (Amusium pleuronectes) and conch (Strombus canabrium) were determined by the US EPA 200.3 acid digestion method and Inductively Coupled Plasma Mass Spectrophotometer (ICP-MS). Risk assessment was calculated to assess the total exposure of heavy metals among the population of Kudat.
Results: Among all the heavy metals, studied, As was found to have the highest concentration and this was found in scallop with the concentration level being 18.93±5.30 μg/g compared to clam and conch. Estimated daily intake of the heavy metals by the population ranged from 0.60-6.82 g/ day/ kg for As, 0.02-1.58μg/day/kg for Cd, 0.37-0.94μg/day/kg for Cr, 0.16-0.61 g/day/ kg for Ni and 0.10-0.25μg/day/kg for Pb based on previous calculation to exposure. The hazard quotient of As and Cd in scallop was greater than 1.0. No acceptable exposure level for these shellfish has been previously reported. The rate of consumption of these metals did not exceed the standards prescribed in the Food Act 1983 and Food Regulations 1985.
Conclusion: Based on this study, it is concluded that the exposure to heavy metals risk from the consumption of these shellfish among the population in Kudat, Sabah is at an acceptable level.
Introduction: The Infant and Early Childhood Nutrition Task Force, International Life Sciences Institute Southeast Asia (ILSI SEA) Region, organised the 1st and 2nd Expert Consultation and Planning Meeting on Infant and Early Childhood Nutrition in 2009 and 2011, respectively. The goal of the consultations was “to generate and promote relevant science-based information that will help improve nutritional status, growth and development of infants and young children in Southeast Asia.” Methods: An Expert Panel Core Group was created whose role is to provide advice and recommendations through a review of current scientific knowledge regarding issues related to early childhood growth and nutrition. The Panel is composed of experts representing 7 countries (China, Indonesia, Malaysia, Philippines, Singapore, Thailand, and Vietnam). In July 2012, the Panel convened the 3rd Expert Consultation and Planning Meeting on Infant and Young Child Nutrition in Singapore. This report presents the highlights of the meeting and recommendations made by the Panel on ways to improve infant and young child nutrition in Southeast Asia. Results and Conclusion: The effective use of WHO indicators for assessing infant and young child feeding practices, mitigating the effects of maternal employment on breastfeeding, using behaviour change communication, updating the education of health personnel, and improving maternal health were considered important actions to be taken. Since current feeding practices in Southeast Asia fall short of WHO recommendations, studies are needed to develop strategies which take into consideration the diverse cultural settings that characterise the region.
Introduction: The ability to perform daily living activities among the elderly is
important, as physical disability may lead to dependency and various public
health implications. This study aimed to determine the prevalence of instrumental
activities of daily living (IADL) disability and its association with socio-demographic
characteristics, dietary intake, social participation, perceived-health-status and risk
of falls. Methods: This cross-sectional study was conducted among communitybased elderly in the Gombak District of Selangor. 258 respondents aged 60-88
years old (mean age 66±6.5 years) were recruited through multi-stage proportional
sampling. Most of the respondents (88.4%) aged 60-74 years and 11.6% were ≥75
years. IADL disability was determined using an eight-item IADL scale. The presence
of IADL disability was defined as needing help in at least one or more of eight-IADL
activities. Dietary intake and fall risk were assessed using diet history questionnaire
(DHQ) and 21-item fall risk index (FRI-21), respectively. Results: The prevalence
of IADL disability among the respondents was 58.1%. A binary logistic regression
analyses showed that the following factors predicted IADL disability: advanced age
(≥75 years, OR=6.4; 95% CI: 1.3, 30.8), being unmarried (OR=2.5; 95% CI: 1.1, 5.9),
unemployed/retired (OR=2.3; 95% CI: 1.2, 4.3), and at risk of falls (OR=2.5; 95%
CI: 1.3, 6.1). Conclusion: Predictors such as marriage and employment highlight
the importance of social support among elderly. In practical terms, this means that it
is incumbent upon caregivers, family members, and the community to provide both
physical and emotional support if the functional status of the elderly is to be improved.
Underlying causes of most nutrition related problems are diverse, including biological, social, cultural, and economic factors. Qualitative approaches complement quantitative methods in identifying the underlying meanings and patterns of relationships involved in managing malnutrition. This study examined perceptions regarding malnutrition among health workers from 7 clinics (community and health clinics) in Tumpat, Kelantan. A total of 18 nurses and 2 doctors, who were involved in monitoring child health and nutrition, were included in the study. These health workers were interviewed using a semi-structured questionnaire adapted from Sastry's framework on malnutrition (Sastry, 1996). The questionnaire included biological, behavioral and environmental factors that influence child health and nutrition. All the health workers perceived that mothers/caregivers play the main role in improving the health of malnourished children. The quality of childcare was rated as moderately satisfactory by the health workers. Most of the affected families who were given the Food Baskets did not fully use all the items for the malnourished child. Child feeding practice was based on the needs of the whole family rather than according to the target child's needs. Most of the mothers preferred processed cereals than rice porridge because the former is easier to prepare for the child. Although they were from a low socioeconomic background, most of the mothers were not earning additional income for the family. The qualitative methodology provided information that can be used as a basis for the designing of quantitative questionnaires to assess malnutrition among children. The induction characteristic of qualitative methods was used to gain an understanding of the underlying reasons or phenomena such as behaviours that are directly observable.
Study site: Klinik kesihatan, Tumpat, Kelantan, Malaysia
As consumer interest in organically grown vegetables is increasing in Malaysia, there is a need to answer whether the vegetables are more nutritious than those conventionally grown. This study investigates commercially available vegetables grown organically and conventionally, purchased from retailers to analyse β-carotene, vitamin C and riboflavin contents. Five types of green vegetables were selected, namely Chinese mustard (sawi) (Brassica juncea), Chinese kale (kai-lan) (Brassica alboglabra), lettuce (daun salad) (Lactuca sativa), spinach (bayam putih) (Amaranthus viridis) and swamp cabbage (kangkung) (Ipomoea aquatica). For vitamin analysis, a reverse-phase high performance liquid chromatography was used to identify and quantify β -carotene, vitamin C and riboflavin. The findings showed that not all of the organically grown vegetables were higher in vitamins than that conventionally grown. This study found that only swamp cabbage grown organically was highest in β -carotene, vitamin C and riboflavin contents among the entire samples studied. The various nutrients in organically grown vegetables need to be analysed for the generation of a database on nutritional value which is important for future research.
Given the importance of physical activity to health, this study investigated the socio-demographic determinants of physical activity participation in a sample of adults in Penang.
The study was conducted to determine the nutritional status and reproductive health of 34 Orang Asli women, aged 16-45 years, from two Orang Asli villages in Kuantan, Pahang Darul Makmur.The results of the study indicate that on the whole, the women's nutritional status is generally not satisfactory.Their mean iron intakes for example, are very low, about one-quarter to one-third of the required level.All their other mean nutrient intake levels are below the required level. Only their mean intake of vitamin C exceeds the required level due to their frequent intake of raw vegetables. Their main source of carbohydrate is rice, while their main source of protein is fish, and their main source of minerals and vitamins are Chinese mustard and cabbage.From BMI measurements, it is found that less than half of the women (42.9%) have normal weight, 35.7% suffer from chronic energy deficiency (CED), 7.1% (one) are overweight, and 14.3% (two) are obese.The accessibility and availability of food are a problem for the women, limiting their choice of varieties of food sources.For their reproductive health needs, the pregnant women rely on the government hospital and clinics for their antenatal check-ups and birth deliveries.Of all the women, nine suffer from menstrual pain and five from vaginal discharge.Food taboos and cultural practices are practised by the pregnant women during their confinement.It is concluded that the nutritional status of the women needs to be improved since most of them have insufficient nutrient intake.
Coronary Heart Disease (CHD) is recognised as an important public health problem in Malaysia. Hyperlipidaemia is one of the main risk factors related to CHD. The mainstay of treatment is diet therapy which should be maintained even if drug treatment is indicated. Since dietitians are the primary providers of dietary treatment to hyperlipidaemic patients, this retrospective study attempts to report the dietary approaches and methodologies adopted by Malaysian dietitians in managing their patients. A postal questionnaire covering various aspects of dietary management of hyperlipidaemia were sent to 47 dietitians practicing in private and government hospitals. A response rate of 53 % was elicited. The survey found that there was a disparity amongst the respondents in the approach to the dietary management of hyperlipidaemia in Malaysia. This was largely due to the absence of a standardised dietary protocol for general lipid lowering in patients with hyperlipidaemia.
Study site: Private and public hospitals in Malaysia
Introduction: Self-efficacy for eating predicts successful weight loss and maintenance in Type 2 Diabetes Mellitus (T2DM) individuals. The Weight Efficacy
Lifestyle (WEL) questionnaire determines self-efficacy for controlling eating. This study aims to validate the Malay-translated version of the WEL questionnaire and
to establish the cut-off scores to define the level of eating self-efficacy in Malaysian T2DM individuals.
Methods: A total of 334 T2DM individuals, aged 55.0±9.0 years, were recruited from a primary healthcare clinic based on sampling ratio. Medical records were reviewed for eligibility. Inclusion criteria included BMI ≥23kg/m2, and no severe diabetes complications. The WEL questionnaire assessed eating resistance during negative emotions, food availability, social pressure, physical discomfort and positive activities, and was back translated into Malay language. Self-efficacy was rated on a 0-9 scale with higher WEL scores indicating greater self-efficacy to resist eating. Factor analysis established the factor structure of the WEL questionnaire. Inter-item and item-total correlations determined construct validity while internal consistency described the reliability of the structure.
Results: A two-factor structure accounting for 49% of variance was obtained, and it had adequate reliability, as indicated by Cronbach’s α of 0.893 and 0.781 respectively. Item-total correlations of r>0.700, p<0.01 and inter-item correlations of r<0.500, p<0.01 demonstrated construct validity. Cut-off scores of ≥44 and ≥32, respectively for factor one and two defined high eating self-efficacies in T2DM individuals.
Conclusion: The Malaytranslated version of the WEL questionnaire appears to be a valid and reliable tool to assess self-efficacy for controlling eating behaviour in Malaysian T2DM population.
Keywords: Diabetes, eating self-efficacy, Malay, reliability, validity
Introduction: Functional constipation is a widespread gastrointestinal ailment associated with infrequent defecation, unfavorably affecting quality of life. However, it has not been well studied worldwide. This study aimed to investigate the effects of black bean vinegar (black bean and black bean yeast) consumption in alleviating functional constipation.
Methods: A randomised, double-blind, placebo-controlled, parallel group study involving 70 adults with functional constipation was conducted in Peninsular Malaysia from May till July 2016. Subjects aged 18-60 years diagnosed with a score of more than 15 based on the Constipation Scoring System were included. A third-party-controller assigned black bean vinegar and placebo drinks to two groups with 1:1 ratio using randomisation software. Participants received once-daily doses of black bean vinegar (20 ml daily) or fruit-flavored squash placebo (20 ml daily) which contained vitamins, minerals, trace elements and carbohydrates, without black bean and black bean yeast, for four weeks. Analysis was conducted on an on-treatment basis (i.e., all randomised participants conformed to the study protocol by consuming 20 ml of drinks daily, with less than 10% leftover drinks at post-intervention assessment). Data were analysed using SPSS version 22.
Results: Administration of black bean vinegar did not demonstrate statistically significant differences in any of the outcomes when compared with a placebo drink at α=5% level. However, black bean vinegar consumption significantly improved overall score at postintervention assessment compared to placebo group (p
L-arginine is an amino acid, which serves as the sole substrate for nitric oxide (NO) synthesis with the concomitant formation of L-citrulline in biologic system. NO has been demonstrated to be involved in smooth muscle relaxation and vasodilation, immune regulation and neurotransmission. It also has an important function as both intercellular and intracellular signals in many physiological systems, including the reproductive system where NO mediates penis erection. This study was undertaken to determine the effects of L-arginine on sperm motility, sperm count, and the nitric oxide level in the seminal plasma. Twelve sexually matured male rabbits (Oryctolagus cuniculus) were randomly divided into four groups with three rabbits each, which were control, low, medium, and high concentration groups. The treatment groups were force-fed with 100mg/kg, 200mg/kg, and 300mg/kg body weight of L-arginine for four weeks, whereas the control group was force-fed with water. Semen samples were collected every three days alternatively for a week before starting treatment and then after four weeks of treatment. Pre-treatment and post-treatment results were compared. Semen samples were collected using artificial vaginas from each group for sperm analysis such as sperm motility, sperm count and NO level in seminal plasma. Sperm motility and sperm count were analysed manually under microscope (twenty power objective), using a Makler counting chamber. NO levels in the seminal plasma were determined using Griess reaction. The results obtained from this study showed that oral consumption of L-arginine exerted a significant (p
Carotenoid-rich red palm oil (RPO)-based snacks have been provided to children in impoverished communities to improve their vitamin A status. The non-availabilty of information on the acceptability of RPO-based snacks by Malaysian aborigines (Orang Asli) children forms the basis of this study.
The trial was carried out at a commercial pig farm in Bukit Pelanduk, Negeri Sembilan, Malaysia. The objective of the study was to assess the efficacy of supplemental iron in drinking water and iron in paste form in comparison with the iron dextran injection. A total of 12 litters were used divided into three treatments : iron dextran injection (ID), Fedexx" - iron in paste form (IP) and Opti-iron" - iron in drinking water (IW). Hemoglobin level and growth performance parameters were monitored weekly over a period of 28 days. ID piglets had significantly higher (p < 0.05) body weight and weekly weight gain compared with IW piglets at 21 and 28 days of age whereas no significant different (p > 0.05) results were found between IP and IW piglets. Hemoglobin level from days 0 to 28 showed statistical difference (p > 0.05) between piglets in IP and IW groups. Mild anemia was found in IP piglets but not for ID and IW piglets compared with normal value (> 9 g/dL). Hemoglobin (Hb) levels were positively correlated (p < 0.05, r = .47) with body weight at 28 days of age. In conclusion, pigs supplemented with iron in paste form and drinking water had poorer growth performance than iron dextran injection piglets. Piglets given iron in paste form had mild anemia. It is advisable to give multiple doses of oral iron to piglets in order to prevent iron deficiency anemia. During the first 4 weeks of life, the body weights of the piglets increased by up to 5-fold. The dietary requirement for iron during this period is 7 mg per day but only 1 mg per day can be supplied by the sow's milk (Cunha, 1977; Miller and Ullrey, 1997; Roberts, 1998). The need to provide the piglets with an adequate amount of iron before weaning is therefore imperative because sow's milk alone will not meet the iron requirements of rapid growth and expanding blood volume (Hannan, 1971). Several different methods can be used to offer iron to preweaning piglets. The most common administration method for iron in piglets is through an intramuscular injection of iron dextran complex at 3 days of age. A single dose of 200 mg/ml iron-dextran is effective against iron deficiency anemia. However, the method is very stressful to the piglets. They will suffer more pain if a greater dosage of iron is given intramuscularly. Furthermore, poor iron injection techniques may cause considerable trauma to the muscles, staining of hams or create abscesses and lead to downgrading of the carcasses (Roberts, 1998). Since there are several drawbacks to the iron injection, alternative methods need to be considered in intensive farming i.e. supply iron orally (Miller and Ullrey, 1997). The oral administration of iron has two advantages: cost and the fact that absorption is regulated by the intestinal mucosae. However, oral administration requires multiple doses. This is because a single dose may not be sufficient to protect the piglets from iron deficiency anemia for the first 4 weeks post-partum. The iron bioavailability in oral iron depends greatly on iron status of animals (Amine et al., 1972; Susan and Wright, 1985). In addition, dietary factors such as amino acids and protein sources (Martinez et al., 1981), pectin content, phytate (Morris and Ellis, 1982) and the other minerals (Elvehjem and Hart, 1932; Hedges and Kornegay, 1973; Suttle and Mills, 1966) may also influence the bioavailability of iron. Oral iron can be given as paste or drinking water. Early administration of oral iron within the first few days of life will meet the iron needs of the suckling pig. However, it is critical to administer early before gut closure to large molecules (Harmon et al., 1974; Thoren-Tolling, 1975). This study was conducted to determine the efficacy of iron supplementation in drinking water or paste form in comparison with the injection of iron compounds in suckling pigs.
Introduction: Scientific evidence indicates that higher dietary fibre consumption protects against various chronic diseases and leads to recovery enhancement. Young corn ear is very rich in total dietary fibre (TDF). The study objective was to evaluate the effects of young corn ear addition on the nutritional composition, textural properties and sensory attributes of conventional cake. Methods: Wheat flour used in the preparation of conventional cake was substituted with different percentages (0%, 5%, 10% and 15%) of young corn ear powder (YCP). Moisture, total ash, fat, protein and TDF content of conventional cake samples were investigated. Textural properties including firmness, cohesiveness, springiness, gumminess and chewiness were examined. The aroma, colour, chewiness, tenderness, flavour and overall acceptance of conventional cake were evaluated via sensory evaluation. Results: The conventional cake with addition of 15% YCP recorded the highest moisture content. There was no predictable trend observed in the ash and fat content following the incorporation of YCP. Addition of 15% of YCP increased the protein content significantly while TDF content of conventional cake increased proportionally (1.42%-2.88%) with the level of YCP added. The incorporation of YCP did not produce any trend on all the textural properties of conventional cake. Conventional cake with 10% of YCP was the most preferred manifested by the highest scores in chewiness, tenderness and flavour attributes. Conclusion: In conclusion, 10% of YCP could be recommended as the ideal formulation in order to produce a healthier conventional cake without jeopardising acceptability.
Background: Children living in orphanages tend to be neglected and may be malnourished. This study assessed the socio-economic background and nutritional status of children living in an orphanage in Dhaka city, Bangladesh.
Methods: A cross-sectional study was conducted among the children in Sir Salimullah Muslim Orphanage, Dhaka from January to November 2014. Systematic sampling was adopted to collect data from 232 children using a semi-structured questionnaire. Anthropometric measurements of the children were taken and the WHO reference growth chart was used to determine the children’s nutritional status. Weight-for-age was categorised by mild, moderate and severe malnutrition. The Pearson Chi-square test was performed to determine the association between the extent of malnutrition and socio-demographic characteristics of the children.
Results: The majority of the children (60.3%) in the orphanage were malnourished, with mild, moderate and severe malnourished being 43.1%, 16.8% and 0.4%, respectively. Malnutrition was higher among the boys than girls in the age group of 15-18 years. The orphans suffered significantly (P
Background: Population-based physical activity (PA) data are lacking in multicultural South East Asia. Malaysian elderly Malays, for example, are occupied daily with religious and community activities. Those living in rural areas also have a distinctively different lifestyle in terms of walking habits and leisure-time activities, compared to people from urban areas.
Methods: A cross-sectional study was conducted with 146 community-dwelling Malay adults aged 60 to 85 years (mean (SD) = 67.6 (6.4) years) living in semi-rural areas in Seberang Perai Utara, Penang, Malaysia. Each participant was interviewed using a questionnaire for their socio-economic background and self-reported PA levels. Then, the participants were invited to wear an accelerometer (ActiGraph GT3X or GT3X+) during their waking hours for seven consecutive days.
Results: Daily activity patterns of the participants were dominated by sedentary time (7.9 (SD 2.1) hours/day; 52% of wear time) and light intensity activity (7.0 (1.9) hours/day; 46% of wear time). The participants spent 24 (SD 30) minutes daily in ‘health enhancing’ (i.e. moderatevigorous intensity) activities. Men spent significantly more time in higher intensity acti-vities than women. Average daily step count was more than 10,000 (mean = 12,542 [4,857]) steps/day.
Conclusion: Based on the accelerometer counts, these elderly Malay participants were assessed to be sedentary for most of the time during the day, though their daily step count exceeded 10,000 on average. Community-living older adults, especially women,should be encouraged to increase their physical activity levels.
Malnutrition is common among patients with cancer and it is also associated with their negative health outcomes. Generally, cancer patients undergoing chemotherapy have a high risk of malnutrition, secondary to both the disease and the treatment. It is important that patients maintain a good nutritional status to improve the effects, and minimise the side effects of cancer treatment. A good nutritional status should be maintained for patients through nutritional intervention during cancer treatment. There appears to be no published studies on the effects of intense dietary counselling versus usual dietary care on the nutritional status of colorectal cancer (CRC) patients undergoing chemotherapy alone. Furthermore, there have been no randomised controlled trials (RC1) undertaken in Malaysia, where CRC is increasing. It is therefore important to undertake a RCT of a dietary and lifestyle counselling intervention of CRC outpatients undergoing chemotherapy.
Methods: The intervention study was an open (masking not used), prospective, and Rcr to examine the effects of intensive individualised dietary and lifestyle counselling on dietary intake and nutritional status in CRC patients undergoing chemotherapy. It was designed as an 8-week program of intensive, individualised dietary and lifestyle counselling followed up with another 8-week post-intervention period without dietary and lifestyle counselling, and compared to a control arm given the usual care. A total of forty-two participants took part in this study and were randomised into two groups, namely, the intervention group (IG) (n=22) and the control group(CG) (n=20) at Kuala Lumpur Hospital and SelayangHospital, Malaysia.
Results: In this study, 67% of CRC patients were malnourished at baseline. In the IQ the prevalence of malnutrition dropped from 72.7% at baseline to 27.3% eight weeks after the intervention. This repesents a large, and clinically meaningful shift. In the CG, the prevalence of malnutrition, or at risk of malnutrition, was still at 75% at the end of the sixteen weeks.
Conclusion: Intensive, individualised dietary and lifestyle counselling resulted in improved nutritional status in patients with CRC undergoing chemotherapy.