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Fulltext Maternal diet during pregnancy and infant respiratory morbidity: A prospective study

Chong KN, E HC, Zaki RA, Mohd SH, Majid HA, Ng AK, et al.

Asia Pac J Clin Nutr, 2021 Dec;30(4):632-642.
PMID: 34967192 DOI: 10.6133/apjcn.202112_30(4).0010

BACKGROUND AND OBJECTIVES: Maternal diet during pregnancy may impact infant respiratory morbidity. The aim was to determine the association between antenatal maternal diet and respiratory morbidity of their infants during their first 6 months of life.
METHODS AND STUDY DESIGN: This prospective cohort study included healthy motherinfant pairs. Maternal diet during the last trimester was determined with a validated food frequency questionnaire. Infant respiratory morbidity was solicited at 1, 3 and 6 months.
RESULTS: Three hundred mother-baby pairs were recruited. Maternal consumption of milk and dairy products was associated with reduced respiratory symptoms at 1 month (aOR 0.29 [95% CI: 0.10, 0.86], p=0.03) and 3 months old (aOR 0.43 [95% CI: 0.20, 0.93], p=0.03), while intake of confectionery items was associated with increased unscheduled doctor visits at 3 months (aOR 2.01 [95% CI 1.33, 3.06], p=0.001) and increased nebuliser treatment at both 3 months (aOR 1.88 [95% CI 1.12, 3.17], p=0.02) and 6 months (aOR 1.64 [95% CI 1.05, 2.54], p=0.03). Finally, at 6 months, hypertensive disorders during pregnancy was associated with increased nebuliser treatment (aOR 17.3 [95% CI 1.50, 199], p=0.02) while exclusive breastfeeding was associated with reduced incidence of respiratory symptoms (OR 0.47 [95% CI 0.26, 0.83], p=0.01).
CONCLUSIONS: Increased antenatal maternal consumption of milk and dairy products may reduce respiratory morbidity while increased consumption of confectionery items may increase respiratory morbidity in their infants during the first 6 months of life.
Fulltext Malnutrition and its risk factors among children 1-7 years old in rural Malaysian communities

Norhayati M, Noorhayati MI, Mohammod CG, Oothuman P, Azizi O, Fatimah A, et al.

Asia Pac J Clin Nutr, 1997 Dec;6(4):260-4.
PMID: 24394786

The aims of this study were to investigate the nutritional status of children aged 1-7 years in Malaysian rural communities and to identify its risk factors. In all, 221 children were assessed using anthropometric measurements, dietary questionnaires and other tools. Weight-for-age, height-for-age, weight-for-height were analysed. Based on the NCHS standards, the overall prevalence of underweight, stunting and wasting was 46.2%, 18.1% and 30.3% respectively. Almost one-third of the 1-2 years old groups were malnourished. Univariate analysis identified household income £ MR750.00 as a significant risk factor of stunting and wasting.
Fulltext Maintenance vitamin D3 dosage requirements in Chinese women with post menopausal osteoporosis living in the tropics

Venugopal Y, Hatta SFWM, Musa N, Rahman SA, Ratnasingam J, Paramasivam SS, et al.

Asia Pac J Clin Nutr, 2017 May;26(3):412-420.
PMID: 28429905 DOI: 10.6133/apjcn.042016.10

BACKGROUND AND OBJECTIVES: Vitamin D3 (cholecalciferol) dose required to maintain sufficiency in non- Caucasian women with postmenopausal osteoporosis (PMO) inthe tropics has not been well studied. Some guidelines mandate 800-1000 IU vitamin D/day but the Endocrine Society (US) advocates 1500-2000 IU/day to maintain 25-hydroxyvitamin-D (25(OH)D) concentration at >75 nmol/L. We aimed to establish oral cholecalciferol dose required to maintain 25(OH)D concentration at >75 nmol/L in PMO Chinese Malaysian women, postulating lower dose requirements amongst light-skinned subjects in the tropics.

METHODS AND STUDY DESIGN: 90 Chinese Malaysian PMO women in Kuala Lumpur, Malaysia (2°30'N) with baseline serum 25(OH)D levels >=50 nmol/L were recruited. Prior vitamin D supplements were discontinued and subjects randomized to oral cholecalciferol 25,000 IU/4-weekly (Group-A) or 50,000 IU/4-weekly (Group- B) for 16 weeks, administered under direct observation. Serum 25(OH)D, PTH, serum/urinary calcium were measured at baseline, 8 and 16 weeks.

RESULTS: Baseline characteristics, including osteoporosis severity, sun exposure (~3 hours/week), and serum 25(OH)D did not differ between treatment arms. After 16 weeks, 91% of women sufficient at baseline, remained sufficient on 25,000 IU/4-weekly compared with 97% on 50,000 IU/4-weekly with mean serum 25(OH)D 108.1±20.4 and 114.7±18.4 SD nmol/L respectively (p=0.273). At trial's end, 39% and 80% of insufficient women at baseline attained sufficiency in Group A and Group B (p=0.057). Neither dose was associated with hyperparathyroidism or toxicity.

CONCLUSIONS: Despite pretrial vitamin D supplementation and adequate sun exposure, 25.6% Chinese Malaysian PMO women were vitamin D insufficient indicating sunshine alone cannot ensure sufficiency in the tropics. Both ~900 IU/day and ~1800 IU/day cholecalciferol can safely maintain vitamin D sufficiency in >90% of Chinese Malaysian PMO women. Higher doses are required with baseline concentration <75 nmol/L.
Fulltext Low physical activity and energy dense Malaysian foods are associated with non-alcoholic fatty liver disease in centrally obese but not in non-centrally obese patients with diabetes mellitus

Chan WK, Tan AT, Vethakkan SR, Tah PC, Vijayananthan A, Goh KL

Asia Pac J Clin Nutr, 2015;24(2):289-98.
PMID: 26078246 DOI: 10.6133/apjcn.2015.24.2.15

To study the dietary intake and level of physical activity (PA) of patients with diabetes mellitus and the association with non-alcoholic fatty liver disease (NAFLD).
Long-term tocotrienol supplementation and glutathione-dependent enzymes during hepatocarcinogenesis in the rat

Rahmat A, Wan Ngah WZ, Gapor A, Khalid BA

Asia Pac J Clin Nutr, 1993 Sep;2(3):129-34.
PMID: 24352144

The effects of long-term administration of tocotrienol on hepatocarcinogenesis in rats induced by diethyl nitrosamine (DEN) and 2-acetylaminofluorene (AAF) were investigated by the determination of plasma and liver gamma-glutamyl transpeptidase (GGT), cytosolic glutathione reductase (GSSG-Rx), glutathione peroxidase (GSH-Px) and glutathione S-transferase (GST). Twenty-eight male Rattus norwegicus rats (120-160g) were divided according to treatments into four groups: control group, tocotrienol - supplemented diet group (30mg/kg food), DEN/AAF-treated group and DEN/AAF treated plus tocotrienol-supplemented-diet group (30mg/kg food). The rats were sacrificed after nine months. The results obtained indicated no difference in the morphology and histology of the livers of control and tocotrienol-treated rats. Greyish-white neoplastic nodules (two per liver) were found in all the DEN/ AAF treated rats (n-10) whereas only one nodule was found in one of the carcinogen treated rats receiving tocotrienol supplementation (n-6). Histological examination showed obvious cellular damage for both the DEN/AAF-treated rats and the tocotrienol-supplemented rats but were less severe in the latter. Treatment with DEN/AAF caused increases in GGT, GSH-Px, GST and GSSG-Rx activities when compared to controls. These increases were also observed when tocotrienol was supplemented with DEN/AAF but the increases were less when compared to the rats receiving DEN/AAF only.
Lipidaemic effects of tocotrienols, tocopherols and squalene: studies in the hamster

Khor HT, Chieng DY

Asia Pac J Clin Nutr, 1997 Mar;6(1):36-40.
PMID: 24394651

Syrian Golden hamsters have been widely used as a experimental model for the investigation of the aetiology and development of atherosclerosis and cardiovascular disease. The responses of the hamster to dietary fat manipulations are in many ways similar to that observed in humans. The lipidaemic effect of a tocotrienol rich fraction (TRF) from palm oil on human trials has not been consistent. In this study, the cholesterolaemic effect of tocotrienols and tocopherols were differentiated by using pure tocotrienols (that were isolated from palm oil fatty acid distillate) and pure commercial tocopherols and squalene. A palm oil triacylglycerol fraction (POTG), free of all unsaponifiable matter, was used as the dietary fat in different feeding experiments. Tocotrienols added at 162 ppm to POTG (POTG-T3L) significantly (p<0.05) lowered serum total cholesterol (TC) level as compared to that of the POTG group; but the serum LDL-C , HDL-C and TG levels of the POTG-T3L group were not significantly lower than that of the POTG group (P>0.05). Increasing the level of tocotrienol supplementation to the diet (POTG-T3H) appeared to raise rather then reduce the serum TC, LDL-C and HDL-C levels as compared to that of POTG-T3L group. This observation that lower level of tocotrienol supplementation appeared to exhibit stronger hypocholesterolaemic effect than a higher level of tocotrienol supplementation is interesting; but its explanation is not yet forthcoming. When tocopherols were supplemented at 72 ppm to the POTG diet it was observed that the serum TC, LDL-C and HDL-C levels were all somewhat increased when compared to that of the POTG group. These results suggest that tocotrienols and tocopherols may have opposite cholesterolaemic effects in the hamster, and further experiments need to clarify the mode of action of these vitamin E isomers. In our second series of experiments the cholesterolaemic effects of tocotrienols and tocopherols were studied in the presence of squalene, a key intermediate in the cholesterol synthesis pathway and a controversial cholesterol lowering agent. Squalene added to the diet at 0.1% level significantly lowered (p<0.05) serum TC level when compared to that of the POTG group. The LDL-C, HDL-C and TG levels appeared to be lowered by the squalene supplementation also but the differences between the POTG-SQ and POTG groups were not statistically significant (P>0.05). When tocotrienols or tocopherols were added to the squalene-containing POTG diets, the serum TC and LDL-C levels were further reduced (p<0.01) when compared to that of the POTG and POTG-SQ groups. The HDL-C and TG levels were not affected by tocotrienol or tocopherol supplementation in the presence of squalene. These results indicate that in the presence of tocotrienols and squalene POTG exhibit hypocholesterolaemic action whereas tocopherols may have a hypercholesterolaemic effect in the hamster.
Isolation of Bifidobacteria infantis and its antagonistic activity against ETEC 0157 and Salmonella typhimurium S-285 in weaning foods

Yusof RM, Haque F, Ismail M, Hassan Z

Asia Pac J Clin Nutr, 2000 Jun;9(2):130-5.
PMID: 24394399

Probiotic organism Bifidobacteria was isolated from the faeces of breast-fed infants at Universiti Putra Malaysia. Trypticase phytone peptone yeast extract agar (TPY) was used as a selective media for the isolation. Morphological examination of the isolates indicated that Bifidobacteria was Gram-positive rods in nature, curved with characteristics of V and Y shapes. The organisms were non-catalase producing, non-nitrate reducing, non-motile, had an absence of indole and were unable to liquify gelatin. The ratios of acetic and lactic acids were determined using high performance liquid chromatography (HPLC). Using carbohydrate fermentation profile test API-CH-50 kits, 20 Bifidobacteria strains had been identified: they were the species of Bifidobacteria infantis and two different sub-species, mainly infantis and lacentis. Based on a wide zone of inhibition, three suitable strains of B. infantis, Bifi-11, Bifi-19 and Bifi-20, were tested in weaning foods for antimicrobial activity towards two human pathogens: E. coli-0157 (World Health Organization) and Salmonella typhimurium S-285. The pH, titratable acidity of weaning foods and total colony count for Bifidobacteria, enteropathogenic Escherichia coli and S. typhimurium were recorded at 3-h intervals for 30 h. It was found that after 9 h of incubation of weaning foods, the pH declined to < 3.6 from pH 6.0, whereas titratable acidity increased from 0.026 to 0.08%. It was indicated that Bifidobacteria inhibited E. coli better than did S typhimurium due to low pH. After 24 h of incubation, approximately 98% of E. coli was inhibited by Bifidobacteria. It is suggested that the inhibitory effect of Bifidobacteria strains in weaning foods towards the growth of enteropathogenic E. coli and S. typhimurium was solely due to low pH and the production of volatile acid components by the organism.
Fulltext Iron status and dietary iron intake of adolescents from a rural community in Sabah, Malaysia

Foo LH, Khor GL, Tee ES, Prabakaran D

Asia Pac J Clin Nutr, 2004;13(1):48-55.
PMID: 15003914

Iron deficiency anaemia (IDA) is the most prevalent micronutrient deficiency in the world affecting the general health and wellbeing of millions. In Malaysia, moderately high prevalences of anaemia have been reported amongst infants, young children and women of childbearing age. Data is scant for the adolescents. This study was undertaken to assess the iron status and dietary intake of 165 adolescents, comprising 74 male and 91 female subjects, aged 12 to 19 years, from the rural communities in Tuaran District of Sabah, Malaysia. Convenience sampling was used for the selection of study subjects. Multiple iron status indicators namely, serum ferritin (SF), transferrin saturation (TS), mean corpuscular volume (MCV) and haemoglobin (Hb) were determined for the study. The mean age of the subjects was 15.2 +/-2.1 years. While the majority of the subjects (77.6%) had normal body mass index (BMI) values, 17.6% were underweight and 4.8% overweight. About 35% to 40% of the subjects showed deficient values for haematocrit, serum ferritin, serum iron, mean corpuscular haemoglobin (MCH), mean corpuscular volume (MCV) and transferrin saturation (TS), and 20% were anaemic (Hb <12 g/L). Using the multiple criteria of iron status indicators, the prevalence of iron depletion, iron deficiency and IDA in the male and female adolescents were 5.4% vs. 6.6%, 18.9% vs. 26.4% and 5.4% vs. 26.4%, respectively. Iron deficiency anaemia (85.0%) contributed largely to the prevalence of anaemia. The dietary iron intake of the adolescents was unsatisfactory, with approximately 98% of subjects failing to meet the Malaysian RDA level. Almost all the female subjects (91%) had dietary iron intake below two-thirds of the RDA level compared with a much smaller proportion for the male adolescents (68%). The prevalence of IDA in the present study population, especially in the female adolescents, appears to be a significant public health problem. Priority should therefore be given to the eradication of iron deficiency in adolescents from low-income areas by dietary modification and micronutrient supplementation amongst female adolescents.
Fulltext Iodized salt supplementation and its effects on thyroid status amongst Orang Asli in Hulu Selangor, Malaysia

Lim KK, Wong M, Mohamud WN, Kamaruddin NA

Asia Pac J Clin Nutr, 2013;22(1):41-7.
PMID: 23353609 DOI: 10.6133/apjcn.2013.22.1.02

BACKGROUND: This research was performed to determine the prevalence of iodine deficiency disorder (IDD) and the effects of iodized salt supplementation on thyroid status amongst Orang Asli in Hulu Selangor, Malaysia.
METHODS: Study respondents were from three target groups, i.e. pre-school children (PSC), primary school-going children (SGC) and adult women. Each household was supplied with iodized salt fortified with iodate fortificant for a period of 12 months and the iodine levels in the salt ranged from 20 to 30 μg/L. Samples collected before and after 6 and 12 months of introduction to iodized salt were urine from all groups, as well as serum samples from adult women.
RESULTS: A total of 200 respondents were recruited; 58 (29.0%) PSC, 65 (32.5%) SGC and 77 (38.5%) adult women. The median urine-iodine concentration (mUIC) in all groups were of moderately low before the iodized salt intervention, but increased significantly in all study groups after 6 and 12 months of intervention. However, at the end of the study, there was an increase in severe iodine deficiency (mUIC <20 μg/L) from 7.5% to 12% and about 9% of PSC and SGC respondents had mUIC level of more than 300 μg/L while the adult women showed a significant increase in free triiodothyronine (fT3) levels.
CONCLUSION: The study demonstrated that iodized salt supplementation was able to show an improvement in iodine level amongst Orang Asli. However, an increase in severe iodine deficiency and iodine excess indicated that the iodized salt programme needs to be carefully monitored.
Fulltext Iodine status among pregnant women in rural Sabah, Malaysia

Lim KK, Chan YY, Teh CH, Ismail H, Yusof R, Muhi J, et al.

Asia Pac J Clin Nutr, 2017 8 15;26(5):861-866.
PMID: 28802296 DOI: 10.6133/apjcn.092016.06

BACKGROUND AND OBJECTIVES: In 2000, legislation on mandatory universal salt iodisation was enacted in Sabah, Malaysia, to reduce the incidence of iodine deficiency disorders among its population. To evaluate the iodine levels among pregnant women from selected rural divisions in Sabah 13 years after the enactment of the universal salt iodisation programme.
METHODS AND STUDY DESIGN: This cross-sectional study was conducted from 1 May to 30 June, 2013, in three rural divisions of Sabah (the Interior, the West Coast, and Kudat). Data regarding domestic iodised salt use and iodine-containing supplement consumption were obtained from respondents through face-to-face interviews; goitre enlargement was examined through palpation and graded according to the World Health Organization classification. Spot urine samples were also obtained to assess urinary iodine levels by using an in-house modified micromethod.
RESULTS: In total, 534 pregnant women participated. The prevalence of goitre was 1.0% (n=5), noted only in the West Coast and Kudat divisions. Although all pregnant women consumed iodised salt, overall median urinary iodine concentration was only 106 μg/L, indicating insufficient iodine intake, with nearly two-thirds of the women (60%) having a median urinary iodine concentrations of <150 μg/L.
CONCLUSIONS: Pregnant women from the rural divisions in Sabah still exhibit iodine deficiency disorder despite the mandatory universal salt iodisation programme. Iodine supplementation programmes targeting pregnant women are warranted.
Fulltext Iodine deficiency status and iodised salt consumption in Malaysia: findings from a national iodine deficiency disorders survey

Selamat R, Mohamud WN, Zainuddin AA, Rahim NS, Ghaffar SA, Aris T

Asia Pac J Clin Nutr, 2010;19(4):578-85.
PMID: 21147721

A nationwide cross-sectional school-based survey was undertaken among children aged 8-10 years old to determine the current iodine deficiency status in the country. Determination of urinary iodine (UI) and palpation of the thyroid gland were carried out among 18,012 and 18,078 children respectively while iodine test of the salt samples was done using Rapid Test Kits and the iodometric method. The results showed that based on WHO/ ICCIDD/UNICEF criteria, the national median UI was 109 μg/L [25th, 75th percentile (67, 166)] showing borderline adequacy. The overall national prevalence of iodine deficiency disorders (IDD) with UI<100 μg/L was 48.2% (95% CI: 46.0, 50.4), higher among children residing in rural areas than in urban areas. The highest prevalence of UI<100 μg/L was noted among the aborigines [(81.4% (95% CI: 75.1, 86.4)]. The national total goitre rate (grade 1 and grade 2 goitre) was 2.1%. Of 17,888 salt samples brought by the school children, 28.2% (95% CI: 26.4, 30.2) were found to have iodine content. However, the overall proportion of the households in Malaysia using adequately iodised salt as recommended by Malaysian Food Act 1983 of 20-30 ppm was only 6.8% (95% CI: 5.1, 9.0). In conclusion, although a goitre endemic was not present in Malaysia, almost half of the states in Peninsular Malaysia still have large proportion of UI level <100 μg/L and warrant immediate action. The findings of this survey suggest that there is a need for review on the current approach of the national IDD prevention and control programme.
Fulltext Iodine deficiency disorders in Sarawak, Malaysia

Kiyu A, Tambi Z, Ahmad Y

Asia Pac J Clin Nutr, 1998 Dec;7(3/4):256-61.
PMID: 24393680

The state of Sarawak in Malaysia has a high prevalence of iodine deficiency disorders (IDD). This has been revealed through a review of goitre surveys that were carried out in the State from the early 1970s to the 1990s. The primary cause was low iodine intake. Contributory factors were low iodine content in the soil and water as well as high cassava consumption. Virtual elimination of IDD is one of the nutritional goals of the IDD prevention and control programs. The strategies adopted include the iodination of coarse salt, which is sold in the market by shopkeepers and also provided free from government health clinics; legislation requiring that salt sold in IDD-gazetted areas must be iodised; and the use of iodinators to iodise water supplied by the gravity-feed system to villages and boarding schools in rural areas. The indicators used in the monitoring and evaluation of the program include the availability of iodised salt in the market and households, iodine levels in water supply that had been fitted with iodinators, goitre volume measured by ultrasound, and urinary iodine excretion among school children.
Fulltext Iodine content in drinking water not an important determinant of endemic goitre

Osman A, Khalida M, Azman AB, Jamil R, Tan TT, Wu LL, et al.

Asia Pac J Clin Nutr, 1993 Sep;2(3):115-8.
PMID: 24352141

The prevalence of goitre was determined in several communities in rural parts of Pahang. Urine specimens were collected randomly among the participants. Drinking water from various sources such as river and spring, and water from gravity feed systems was also collected to determine the iodine content by using the ashing method. The results were compared to that of Kuala Lumpur City. lt was found that the prevalence of goitre in rural areas was between 20 and 70% depending on village, ethnic group, age and gender. The interior parts of the jungle where Aborigines lived was moderately endemic with goitre prevalence of goitre more than 20% and urinary iodine content 2.0-5.0 μg I/dl). A nearby Malay traditional village which was studied had mild endemia (prevalence 10-30% and urinary iodine content 5.0-10.0 μg I/dl) while a Felda Malay resettlement scheme and Kuala Lumpur City did not have endemic goitre. Endemic goitre in rural areas was associated with low iodine content in drinking water. Even though Kuala Lumpur had low iodine content in its drinking water there was no endemic goitre, indicating that other factors were more important.
Fulltext Interactions of genetic and macronutrient intake with abdominal obesity among middle-aged vegetarians in Malaysia

Ching YK, Chin YS, Appukutty M, Chan YM, Lim PY, Nasir KH

Asia Pac J Clin Nutr, 2023;32(1):168-182.
PMID: 36997497 DOI: 10.6133/apjcn.202303_32(1).0020

BACKGROUND AND OBJECTIVES: Evidence for gene-diet interactions is lacking among individuals with specific dietary practices including vegetarians. This study aimed to determine the interactions of rs174547 in the fatty acid desaturase 1 (FADS1) gene with macronutrient such as carbohydrate (particularly fibre), protein and fat intakes on abdominal obesity among middle-aged Malaysian vegetarians of Chinese and Indian ethnicity.
METHODS AND STUDY DESIGN: The present cross-sectional study was conducted among 163 vegetarians in Kuala Lumpur and Selangor, Malaysia. Dietary intakes of vegetarians were assessed by using a food frequency questionnaire. Waist circumference of vegetarians was measured by using a Lufkin tape W606PM. Genotypes of the rs174547 of vegetarians were determined by using Agena® MassARRAY. A multiple logistic regression model was used to determine the interactions of the rs174547 with macronutrient on abdominal obesity.
RESULTS: About 1 in 2 vegetarians (51.5%) had abdominal obesity. Individuals with CT and TT genotype at T3 intake of carbohydrates, protein, fat and fibre as well as individuals with TT genotype at T2 intake of carbohydrates and protein had higher odds of abdominal obesity (pinteration <0.05). The gene-diet interaction remained significant for fibre intake (OR: 4.71, 95% CI: 1.25-17.74, pinteraction=0.022) among vegetarians with TT genotype at T2 intake of fibre after adjusting for age and sex and considering the effects of ethnicity and food groups.
CONCLUSIONS: The rs174547 significantly interacted with fibre intake on abdominal obesity. A specific dietary fibre recommendation based on genetics is needed among Chinese and Indian middle-aged vegetarians.
Fulltext Interaction between vitamin E and glutathione in rat brain: Effect of chronic ethanol administration

Marcus SR, Chandrakala MV, Nadiger HA

Asia Pac J Clin Nutr, 1998 Dec;7(3/4):201-5.
PMID: 24393672

The protection against ethanol-induced lipid peroxidation is rendered by antioxidants such as vitamin E and glutathione (GSH) interacting with each other and also functioning independently. A study of the levels of GSH and activities of glutathione peroxidase (GP), glutathione reductase (GR) and glutathione transferase (GST) in the cerebral cortex (CC), cerebellum (CB) and brain stem (BS) of vitamin E-supplemented and -deficient rats subjected to ethanol administration for 30 days was carried out. Chronic ethanol administration to vitamin E-supplemented rats elevated GP, GR and GST activities in the three regions and GSH levels in the CB. Chronic ethanol administration to vitamin E-deficient rats elevated GR activity in the three regions and GP activity in the CC and CB, decreased GST activity in the CC and CB, but did not alter GSH levels compared with normal rats subjected to chronic ethanol administration. The results indicate that vitamin E helps to maintain GSH levels to combat increased peroxidation while its absence has a deleterious effect.
Fulltext Inter-esterified palm products as alternatives to hydrogenation

Idris NA, Dian NL

Asia Pac J Clin Nutr, 2005;14(4):396-401.
PMID: 16326647

Inter-esterification is one of the processes used to modify the physico-chemical characteristics of oils and fats. Inter-esterification is an acyl-rearrangement reaction on the glycerol molecule. On the other hand, hydrogenation involves addition of hydrogen to the double bonds of unsaturated fatty acids. Due to health implications of trans fatty acids, which are formed during hydrogenation, the industry needs to find alternatives to hydrogenated fats. This paper discusses some applications of inter-esterified fats, with particular reference to inter-esterified palm products, as alternatives to hydrogenation. Some physico-chemical properties of inter-esterified fats used in shortenings are discussed. With inter-esterification, more palm stearin can be incorporated in vanaspati. For confectionary fats and infant formulations, enzymatic inter-esterification has been employed.
Fulltext Intake of added sugar in Malaysia: a review

Amarra MS, Khor GL, Chan P

Asia Pac J Clin Nutr, 2016;25(2):227-40.
PMID: 27222405 DOI: 10.6133/apjcn.2016.25.2.13

The term 'added sugars' refers to sugars and syrup added to foods during processing or preparation, and sugars and syrups added at the table. Calls to limit the daily intakes of added sugars and its sources arose from evidence analysed by WHO, the American Heart Association and other organizations. The present review examined the best available evidence regarding levels of added sugar consumption among different age and sex groups in Malaysia and sources of added sugars. Information was extracted from food balance sheets, household expenditure surveys, nutrition surveys and published studies. Varying results emerged, as nationwide information on intake of sugar and foods with added sugar were obtained at different times and used different assessment methods. Data from the 2003 Malaysian Adult Nutrition Survey (MANS) using food frequency questionnaires suggested that on average, Malaysian adults consumed 30 grams of sweetened condensed milk (equivalent to 16 grams sugar) and 21 grams of table sugar per day, which together are below the WHO recommendation of 50 grams sugar for every 2000 kcal/day to reduce risk of chronic disease. Published studies suggested that, for both adults and the elderly, frequently consumed sweetened foods were beverages (tea or coffee) with sweetened condensed milk and added sugar. More accurate data should be obtained by conducting population-wide studies using biomarkers of sugar intake (e.g. 24-hour urinary sucrose and fructose excretion or serum abundance of the stable isotope 13C) to determine intake levels, and multiple 24 hour recalls to identify major food sources of added sugar.
Fulltext Insulin-like growth factor-I and fast growth-hormone levels in mild and moderately malnourished children

Wan Nazaimoona WM, Osman A, Ng ML, Tan TT, Wu LL, Sakinah O, et al.

Asia Pac J Clin Nutr, 1992 Dec;1(4):207-10.
PMID: 24323236

Insulin-like growth factor-I (IGF-I)and fasting growth hormone levels were measured in a group of 255 children (163 males and 92 females. age ranged 6-17 years) of varying pubertal development and body mass index (BMI); well-nourished (BMI> 18). mildly-malnourished (BMI = 15-18) and moderately-malnourished (BMI<15). In well-nourished children IGF-I levels increased significantly (P = 0.02) with pubertal development. where girls at Tanner 5 had significantly higher (p = 0.03) IGF-I levels than the boys. Whilst there was no change in fasting GH levels with nutritional status, IGF-I levels of prepubertal boys and girls decreased significantly with BMI (P<0.001 and P = 0.01 respectively). Hence. measurement of IGF-I levels is a sensitive biochemical index in the assessment of mild and moderate form of malnutrition in prepubertal children.
Fulltext Infant feeding concerns in times of natural disaster: lessons learned from the 2014 flood in Kelantan, Malaysia

Sulaiman Z, Mohamad N, Ismail TA, Johari N, Hussain NH

Asia Pac J Clin Nutr, 2016;25(3):625-30.
PMID: 27440698 DOI: 10.6133/apjcn.092015.08

The flood that hit Kelantan in December 2014 was the worst in Malaysian history. Women and their infants accounted for a large proportion of the people at risk who were badly affected, as almost half of the population in Kelantan was in the reproductive age group. This report serves to raise awareness that breastfeeding mothers and infants are a special population with unique needs during a disaster. Four of their concerns were identified during this massive flood: first, the negative impact of flood on infant nutritional status and their health; second, open space and lack of privacy for the mothers to breastfeed their babies comfortably at temporary shelters for flood victims; third, uncontrolled donations of infant formula, teats, and feeding bottles that are often received from many sources to promote formula feeding; and lastly, misconceptions related to breastfeeding production and quality that may be affected by the disaster. The susceptibility of women and their infant in a natural disaster enhances the benefits of promoting the breastfeeding rights of women. Women have the right to be supported which enables them to breastfeed. These can be achieved through monitoring the distribution of formula feeding, providing water, electricity and medical care for breastfeeding mothers and their infants. A multifaceted rescue mission team involving various agencies comprising of local government, including the health and nutrition departments, private or non-governmental organizations and individual volunteers have the potential to improve a satisfactory condition of women and infants affected by floods and other potential natural disasters.
Fulltext Implications of maternal diet on breast milk docosahexaenoic acid 22:6n-3 (DHA) and arachidonic acid 20:4n-6 (AA) contents: A narrative review

Khor GL

Asia Pac J Clin Nutr, 2022;31(4):576-583.
PMID: 36576276 DOI: 10.6133/apjcn.202212_31(4).0001

BACKGROUND AND OBJECTIVES: This narrative review aims to provide recent understanding of the implications of maternal diet on fatty acid composition of breast milk, with focus on the docosahexaenoic acid (22:6n-3 (DHA) and arachidonic acid 20:4n-6 (AA) contents, for fetal growth and development. Breast milk n6/n3 polyunsaturated fatty acids (PUFA) ratio will also be highlighted in relations to maternal lipid intake.
METHODS AND STUDY DESIGN: PubMed and Google Scholar were searched for relevant publications in English focusing on but not limited to the use of the key words stated below.
RESULTS: Studies since the 1950s of different population groups worldwide affirmed the recognition that breastmilk fatty acid compositions are highly sensitive to maternal diet. Colostrum is richer in long-chain PUFA (LC-PUFA) metabolites of both linoleic and linolenic acids than mature milk. Among these LC-PUFA, both DHA and AA are incorporated preferentially and rapidly within the cerebral cortex and the retina during the last trimester of pregnancy and postnatal 18 months. Maternal supply of DHA and AA include maternal fatty acid stores, endogenous synthesis or directly from diet. Decreasing fish intake concomitant with increased intake of meat and vegetable oil leading to decreased intake of DHA and EPA, and an increase in AA intake, have resulted in an imbalanced n-6/n-3 PUFA ratio in breastmilk.
CONCLUSIONS: A balanced intake of PUFAs during pregnancy and lactation is recommended for fetal and childhood growth and development.

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