The objective of the present experiments are to determine if sheep could safely consume high amount of PKC in their diets and if sheep's consumption of PKC require a chelating agent to tie up the high copper level in PKC to protect it against toxicity. Two experiments were carried out. Experiment 1, with four treatment groups of animals, using from 30 to 100% PKC, mixed with other feed ingredients except minerals. Mineral mixtures were separately mixed with Sodium Molybdate, acting as the chelating agent, and the mineral was offered in separate feed troughs ad.libitum, in the pens for each animal group. Although all groups gave high ADG, the animals in the 100% group had high copper in their blood, which were above4 the normal physiological level at the end of the experimental duration of three months. Three animals from this group died and their liver copper contents were very high. The groups fed up to 72% PKC in their ration did not show any significant elevation of copper or toxicity. Sheep fed similar proportions of ingredients in experiment 2, but with Molybdate incorporated together into all the four similar rations as in experiment 1, did not show any signs of toxicity or elevated blood copper. The animals in all groups produced high ADG. The experiment proved that sheep can take up to 100% PKC in their diet, but a chelating agent must be incorporated into the feed to ensure its sufficient uptake to protect it against toxicity. Giving Molybdate separately from the feed would not ensure sufficient intake of the chelating agent voluntarily. This would result in copper toxicity in the animals.
Introduction: Detailed clinical information is important for the Casemix System to
generate valuable Case Based Group (CBG) for malnourished geriatric patients. Clinical
coding for malnutrition provides useful information on the nutritional health of patients
for treatment purposes.
Methods: This cross-sectional study with purposive sampling
involved a total of 130 geriatric patients (>60 years) at Hospital Universiti Sains Malaysia
(USM). Nutritional assessments were performed such as anthropometrics measurement,
Subjective Global Assessment (SGA), and biochemical assessment. The patients’ medical
records and coded data were systematically reviewed to observe the documentation of
nutritional information and coding criteria based on the International Classification for
Diseases (ICD-10).
Results: The prevalence of malnutrition among the geriatric patients
was 35.4%. Proper documentation of required nutritional information was found in less
than 50% of the cases. None of the malnourished patients were documented and coded
with malnutrition diagnosis, despite being given nutritional interventions. The reasons
given for this omission were related to the lack of awareness (50%) and incomplete
medical documentation (50%). Further analysis revealed that uncoded diagnosis,
miscoding, missing, and unavailable codes for nutritional counselling and oral nutritional
supplementation were the main contributors to the incomplete records.
Conclusion:
The quality of clinical coding for malnourished geriatric patients in the hospital should
be improved. A structured assessment and standard documentation is recommended to
improve the quality of healthcare provision for malnourished geriatric patients.
Introduction: Goats milk provides health benefits due to its unique fatty acid composition that
comprises relatively high amounts of short- and medium-chain fatty acids, which make goats
milk easy to digest.
Methods: A total of 20 powdered goats milk samples were selected based
on ease of availability in shops in Kubang Kerian, Kelantan. Proximate composition and fatty
acids, specifically C6:0, C8:0 and C10:0 were determined using AOAC methods (2000), and
gas-chromatography, respectively.
Results were compared with commercial pure goats milk
(CBM®). Results: Wide variations in the proximate composition and fatty acid contents were
found among the samples when compared with the CBM® sample. The mean range values for
energy were 368 to 498 kcal/100 g, moisture: 2.46 to 4.28 g/100 g, ash: 2.04 to 6.61 g/100 g,
protein: 2.80 to 26.24 g/100 g, fat: 1.68 to 25.90 g/100 g and carbohydrates: 44.81 to 87.64
g/100 g. The total short and medium-chain fatty acids contents ranged from 3.22% to 12.97%.
Conclusion: There is a need for standardisation of the proximate composition and fatty acids
contents of goats milk available in Malaysia.
Persons with disabilities (PWD) are susceptible to malnutrition. Caregivers or teachers in rehabilitation centres may not be adequately trained in nutrition management of PWD. The aims of this study were (i) to assess the nutrition knowledge, attitude and practice among teachers in community-based rehabilitation centres for PWD; and (ii) to evaluate changes in the nutrition knowledge and attitude of the teachers before and after exposure to a training workshop on nutrition management for PWD.
Introduction: Compliance with medical nutrition therapy is important to improve patient outcomes. The purpose of this study was to determine dietary compliance and its association with glycemic control among outpatients with poorly controlled type 2 diabetes mellitus (T2DM) in Hospital Universiti Sains Malaysia (HUSM).
Methods: In this cross-sectional study, patients who had a glycosylated hemoglobin (HbA1c) level of at least 6.5%, after attending a diet counseling session at the Outpatient Dietetic Clinic, HUSM, were enrolled. Out of 150 diabetic patients reviewed between 2006 and 2008, 61 adults (32 men and 29 women) agreed to participate in this study. A questionnaire-based interview was used to collect socio-demographic, clinical and diabetes self-care data. The patient’s dietary compliance rate was determined by the Summary of Diabetes Self-Care Activities (SDSCA) measure. Anthropometric and biological measurements were also taken.
Results: Only 16.4% of the respondents adhered to the dietary regimen provided by dietitians. Among the 7 dietary self-care behaviours, item number 6 (eat lots of food high in dietary fibre such as vegetable or oats) had the highest compliant rate (54.1%); whereas item number 3 (eat five or more servings of
fruits and vegetables per day) had the lowest compliant rate (23.0%). There was a significant association between gender (p=0.037) and fasting blood sugar (FBS) (p=0.007) with the compliance status. Conclusion: Dietary non-compliance is still common among T2DM patients. Dietitians need to improve their skills and use more effective intervention approaches in providing dietary counseling to patients.
Keywords: Dietary compliance, diet counseling, type 2 diabetes mellitus
The antioxidant activity of two edible medicinal plants commonly used in Malaysian traditional medicine i.e. Piper sarmentosum (kadok) and Morinda elliptica (mengkudu) were tested for antioxidant activity. The methanolic leave extracts of kadok and mengkudu, at 250ug/ml, were tested using the Xanthine/Xanthine Oxidase (X/XOD) Superoxide Scavenging assay. Both extracts showed high superoxide scavenging assay, 88% and 80% respectively compared to superoxide dismutase (SOD) standard. The crude extracts were further fractionated using column chromatography and tested for superoxide scavenging activity, to obtain antioxidant active fractions. Two active fractions were obtained from kadok, PsFr6-71.3%, PsFr7-71.3%, and one active fraction from mengkudu, MeFr3-86.6%. These active fractions were compared against 14 phenolic compound standards. After a series of HPLC analysis of samples and standards, a natural antioxidant compound was identified in kadok and mengkudu i.e. Naringenin (4',5,7-Trihydroxyflavanone) with 75.7% superoxide scavenging activity. Naringenin is a highly potent natural antioxidant that has been reported in the raw materials of larch and grapefruit extracts. Thus, kadok and mengkudu which contain Naringenin, could be used as antioxidant dietary supplements.
Introduction: The consumption of ready-to-eat cereals (RTECs) has been associated with lower anthropometric status as well as a lower risk of childhood obesity. This relationship has not been investigated among school children in Malaysia. This study aimed to determine the association between consumption of RTECs and anthropometric status among primary school children in Kuala Lumpur. Method: In this cross-sectional study, a total of 208 school children aged 10 and 11 years were recruited from Kuala Lumpur, Malaysia. Information on socio-demographics, RTECs consumption and anthropometric measurements (height, weight and waist circumference) were obtained. Results: The overall median body mass index (BMI) and waist circumference (WC) were 17.95(IqR 6.45) kg/m2 and 57.35 (IqR 13.00) cm, respectively. The majority of the children (73%) consumed RTECs. The prevalence of obesity was 23.1%, with more boys (31%) than girls (17.4%) being obese. Meanwhile, 16.8% of the children were overweight. BMI (U=3335.50, z=-2.278, p=0.023) and WC (U=3273.50, z=-2.440, p=0.015) of those who consumed RTECs were significantly lower than those who did not consume RTECs. Meanwhile, children who did not consume RTECs were significantly more likely to develop abdominal adiposity than those who consumed RTECS, X2(2, N=208) =7.61, p=0.022. Conclusion: Children who consumed RTECs have significantly lower BMI and WC, as well as a lower chance of developing abdominal adiposity. Consumption of RTECs indicates an overall healthy lifestyle with an excellent nutritional profile to promote healthy body weight in children and decreased risk of childhood obesity.
Introduction: The consumption of processed food is increasing in developing
countries. Nutrition labels on food packaging are important for the education of
consumers, particularly adolescents, to help them make healthier food choices.
However, there is evidence to suggest that adolescents generally do not use nutrition
labels. This study aims to explore the personal factors that influence the practice of
Malaysian adolescents in reading nutrition labels. Methods: The participants were
adolescents, aged 13-16 years, from five public schools in Negeri Sembilan. Five
semi-structured focus group discussions (FGDs) were conducted. The participants
discussed their personal views, knowledge and perceptions regarding the use of
nutrition labels and food selection. Data gathered from the FGDs were coded through
thematic analysis using the NVivo software. Results: While the participants were
familiar with nutrition labels, their usage was relatively low during food selection
due to the lack of interest in nutrition information, past experiences, hunger and
cravings, time constraints and the taste of the food. The main reasons for using
nutrition labels were health consciousness and their curiosity about specific
nutrition information provided on the labels. The majority of participants believed
that information provided on the labels was accurate because it was provided by
reliable institutions. There was also misperception among some participants, mixing
up nutrition labels with list of ingredients and the expiry dates. A few participants
were unconvinced by the labels and stated that the labels provided misleading
information. Conclusion: Personal factors such as knowledge, misperception,
awareness and trust significantly impact how adolescents read nutrition labels.
Introduction: Food insecurity exists whenever people are unable to access sufficient
food at all times for an active and healthy life. University students are a potentially
vulnerable group of people to face food insecurity. This study aimed to identify the
prevalence and determinants of food insecurity among a population of university
students in Kuantan, in the state of Pahang. Methods: Food security status was
identified using the United States Adult Food Security Survey Module (USAFSSM).
Factors, which include demographic background, spending expenditure pattern
and time constraints, were assessed. A total of 316 students were selected through
stratified random sampling throughout six faculties of the International Islamic
University Malaysia, of whom 307 successfully completed the survey. Results:
The result shows that 54.4% of the students were experiencing food insecurity,
from which 32.9% were sub-categorised as low food security and 21.5% as very low
food security. Food insecurity was found to be significantly associated with time
constraints (p
Methylenetetrahydrofolate reductase (MTHFR) C677T is involved in folate and homocysteine metabolism. Disruption in the activity of this enzyme will alter their levels in the body.
Introduction: The benefits of breastfeeding for both mothers and infants are
widely recognised. Breastfeeding confirms a woman’s unique ability to care for her
infant in the best way possible and promotes optimum infant and maternal health.
Methods: A qualitative research method involving five focus group discussions
(n=33) was chosen in this study to compare and contrast the breastfeeding practice
in two different locations: the communities of Pos Pulat and the regroupment
scheme settlement at Rancangan Pengumpulan Semula (RPS) Kuala Betis in
Kelantan, Malaysia which represents different lifestyle experiences of indigenous
Temiar population. Results: The benefits of breastfeeding to the infants reported
by some Temiar women (42.4%) were for the infant’s health and growth. Responses
from urban RPS Kuala Betis women include breast milk contains antibodies (3.0%),
delays in the return of regular ovulation (6.1%), thus lengthening birth intervals
and bonding between maternal-baby (6.1%). In general, respondents from Pos
Pulat seemed to have little knowledge regarding this issue, except for a woman who
mentioned that maternal milk contains vitamins. Based on the narrative analysis,
knowledge gap was observed between these two communities. Conclusion: Although
all the women interviewed had the experience of breastfeeding their infants, most
of them lacked the knowledge regarding the benefits of the breastfeeding either
to the infants or to the mothers. The findings from this study are crucial for the
preservation of breastfeeding culture among the Temiar women and can be used to
improve promotion of breastfeeding to other Orang Asli groups in Malaysia.
Introduction: Identified parameters associated with geriatric malnutrition add greatly to the knowledge of clinical nutrition and facilitate patient-centred nutritional care management.
Methods: A six-month cross-sectional study with the aims of deterrninine the prevalence of malnutrition and its associated parameters was conducted among hospitalised geriatrics admitted to Hospital USM. A total of 130 (49 men, 81 women) eligible participants with a mean age of 69.7 (6.99) were recruited for this study. Anthropometric tests, biochemical tests, and subjective global assessments (SGA) were applied in this study to assess the nutritional status of the participants. Meanwhile, socio-demographics, nutritional risk factors, and clinical elements were examined to identify the associated factors of malnutrition.
Results: The findings of this study revealed that 35.4% of the participants were malnourished based on SGA ratings of B (26.2%) and C (9.2%), with women having a significantly higher proportion (43.5%) compared to men (22 4%) with p
This paper highlights the marked presence of nutritional disorders in a sample (190 males, 237 females, aged 18-80 years) obtained from the adult population in three kampungs i.e. Pasang Api, Sungai Nipah Baroh and Sungai Balai Darat, in the Mukim of Bagan Datoh, Perak in 1992. All subjects (except pregnant females) were measured for blood pressure, weight, height, waist circumference, and hip circumference from which the body mass index (BMI) and waist-hip ratios (WHR) were calculated. A random blood sample was obtained by finger-prick from each subject and analysed for total cholesterol (TC) and glucose, using the Reflotron compact analyser. Elevated means for BMI and WHR indicated that obesity (BMI ≥30.0) was a serious public health problem in these three kampungs, affecting about 5% of males and 14% of females. Another 24% of males and 46% of females had an overweight problem (BMI 25.0-29.9), indicating that on the average, about half the adult population in these kampungs were either overweight or obese. This contrasted with the situation a decade ago in similar-type kampungs in the Peninsula where underweight was the major nutritional disorder in adults, especially males. Overall, there was a shift of an underweight problem to one of overweight, as exemplified by increments of 2.0 to 3.0 BMI units in the adult population, with the phenomenon being more marked in the females. Hypertension (21%) and hyperglycaemia (6.5%) affected the males and females approximately equally. Female adults had higher mean plasma TC compared to males (204 versus 199 mg/dl); these means were some 20 mg/dl (0.52 mmol/L) higher than the corresponding means for adults in similar rural communitites in the early eighties, and approximate the corresponding means for present-day urban adults. The above findings serve to emphasise the nutritional transition undergoing in the rural communities in the Peninsula, viz, the marked emergence in these rural communities of nutritional disorders normally associated with affluent populations.
This quasi-experimental study was carried out to evaluate the effectiveness of an eight-week multi-disciplinary pulmonary rehabilitation programme in improving nutritional and functional status and quality of life of COPD out patients at Hospital Universiti Kebangsaan Malaysia. A total of 9 COPD outpatients aged 40 years and above (6 men and 3 women) completed at least 50% of 16 sessions of an eight-week pulmonary rehabilitation programme. Their nutritional and functional status and rating of quality of life were measured at baseline (0 day) and after 8 weeks and these were compared to those of the control group matched for age, comprising 13 subjects (11 men and 2 women). Nutritional status was determined using anthropometry, body composition (Bioelectrical Impedance Analysis) and three-day food record. Assessment of appetite for food was also carried out using the Simplified Nutritional Assessment Questionnaire (SNAQ). Functional status was assessed using the Pulmonary Functional Status and Dyspnea Questionnaire-modified version(PFSDQ-M). The handgrip strength was also measured using handgrip dynamometer. The SF36 questionnaire was used to measure the quality of life of the subjects. There was a reduction in dyspnea (-49.0%, p<0.05) and fatigue (-47.8%, p<0.05) in men after the intervention programme, as compared to their controls (dyspnea -2.9% and fatigue 8.9%). Quality of life in this group was also significantly improved by 31.8% (p<0.05) as compared to their controls (-3.0%,p>0.05). Similar trends were noted for the women, although the difference was not significant. No significant changes were seen in nutritional status assessed by anthropometry, dietary intake and appetite. However, there was a trend of increased nutrient intake and SNAQ score in the intervention group as compared to control. An eight-week pulmonary rehabilitation programme was effective in improving the functional status particularly in men, by reducing dyspnea and fatigue; and also improving their quality of life, but was not effective in changing the nutritional status.
Study site: Physiotherapy Unit, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
Introduction: Nutrition screening is recommended as a first step of nutrition care to allow early identification and intervention of malnourished patients. The present study determined the validities and reliabilities of two malnutrition screening tools namely, the Malnutrition Universal Screening Tool (MUST) and Malnutrition Screening Tool (MST) among adult patients at the Hospital Kuala Lumpur. Methods: The sensitivity, specificity and predictive value of MUST and MST were conducted against the Subjective Global Assessment (SGA), anthropometric parameters including body mass index (BMI), calf circumference (CC), mid-upper arm circumference (MUAC) and energy intake. Inter-rater reliability was evaluated using kappa value (κ) to determine the level of agreement between raters. Results: A total of 151 subjects with mean age of 45.2 ± 13.7 years participated in this study. Prevalence of malnutrition according to MUST, MST and SGA was 34.4%, 33.8% and 19.9%, respectively. As compared to SGA, MUST and MST had a sensitivity of 96.6% and 93.3% respectively, whereas the specificity was 80.9% for both tools. The sensitivity and specificity of MUST against the anthropometric parameters (BMI, CC and MUAC) were between 53.8% to 88.8% and 67.4% to 69.9%, respectively. The sensitivity values for MST were between 46.1% to 63.6% and specificity values were between 64.4% to 67.6%. The inter-rater reliability of MUST was higher (substantial, mean (κ) = 0.78) than for MST (moderate, mean (κ) = 0.52). Conclusions: In conclusion, MUST was found to have similar validity levels but higher reliability result than MST. Based on our result, MUST is recommended for use in identifying adult patients who are at high risk of malnutrition. It can be used as a malnutrition screening tool but there is a need to evaluate the cost effectiveness of its implementation.
In a biological system the product of free-radical induced-lipid peroxidation are conjugated dienes (CDs), lipid peroxides and malondialdehyde (MDA). Its control depends on antioxidant activities. Antioxidant defend the body system by controlling the damage caused by the free radicals. This paper describes lipid peroxidation process and antioxidant activities present in three species of holothuroid obtained from the coastal waters of Terengganu, Malaysia. Among the three species studied, the coelomic fluid of Bohadschia mamorata vitiensis contained the highest level of protein (7.24 + 0.04)g/L. The coelomic fluid of Stichopus badionotus Selenka contained the highest level of superoxide dismutase (SOD) (9.46 + 0.99)X 105 IU/g protein, MDA (16.46 + 1.28)nmol/g protein and total antioxidant activities (AOA) (58.81 + 5.70) %. In Stichopus variegatus Semper the coelomic fluid only demonstrated the highest level of CDs (94.19 + 11.34) RU/g protein compared with the other two species. This preliminary study indicated that some form of antioxidant activities are present in the coelomic fluid of holothuroids.
INTRODUCTION: The present study describes a randomised controlled trial (RCT) based on a novel, generalisable intervention for childhood obesity, comparing the intervention with a no-treatment control group.
METHOD: The Malaysian Childhood Obesity Treatment Trial (MASCOT) was a single-blind RCT of a dietetic treatment for childhood obesity in children of primary school age (7 to 11 years old) in Kuala Lumpur, Malaysia. The MASCOT comprising eight sessions, of an 8-hour family-centred group treatment programme is described, based on behavioural change techniques. The study sample was characterised by BMI z-score, health related quality of life reported by participants and their parents (PedsQL questionnaire), objectively measured habitual physical activity and sedentary behaviour (Actigraph accelerometry)
RESULTS: The MASCOT sample of 107 children was characterised by a low quality of life, mean total score on PedsQL 67.7 (4.5) as reported by the children, and 66.0 (16.4) as reported by their parents. The children spent, on average, 89% of their waking day on sedentary activity, and 1% of the day in moderate-vigorous intensity physical activity, equivalent to only around 8 minutes/day.
CONCLUSION: Obese children in the MASCOT study had an impaired quality of life, high levels of sedentary behaviour and very low levels of physical activity.
Introduction: Probiotic microbial cell preparation (MCP) supplementation is one of the
approaches to modulate alterations in gut microbiota (GM). This double-blind randomised
controlled trial investigated the effect of 4 weeks of MCP supplementation on fasting blood
glucose levels (FBG), body weight (BW), waist circumference (WC), and faecal short chain
fatty acids (SCFA) among 24 healthy and overweight (with BMI ≥ 23 kg/m2) Malaysian
adults.
Methods: Twenty-six subjects were randomised to receive either MCP (n= 12) or
placebo (n=14), twice daily, for 4 weeks. The probiotic powder contained a mix of six
strains namely, Lactobacillus acidophilus, Lactobacillus lactis, Lactobacillus casei,Bifidobacterium
longum, Bifidobacterium bifidum and Bifidobacterium infantis (3.0 x 1010 cfu). FBG, BW, WC,
WHR, faecal SCFA, physical activity levels and dietary intake were measured and changes
were determined using repeated measures ANOVA.
Results: Twenty-four subjects
successfully completed the 4-week study period. Changes in FBG, BW, WC and SCFA were
not significantly different between the groups. Only subjects in the MCP group significantly
reduced their energy intake compared to baseline (1671±476 vs 1386±447 kcal, P=0.045).
Conclusion: A 4-week supplementation of the MCP mix powder did not have significant
effects on the variables studied. However, the significant reduction in dietary energy intake
in the MCP group suggests the potential of probiotics as an adjuvant to dietary therapy for
weight loss.
The World Health Organization (WHO), National Cholesterol Education Program Adults Treatment Panel III (NCEP ATP III) and International Diabetes Federation (IDF) have proposed different criteria to diagnose metabolic syndrome (MetS). However, there is no single definition to accurately diagnose MetS. The objective of this study is to estimate the prevalence of MetS using WHO, NCEP ATP III and IDF in the Malaysian community, and to determine the concordance between these definitions for MetS. 109 men and women aged > 30 years participated in the study, and the prevalence of MetS was determined according to the three definitions. Weight, height, body mass index (BMI), waist-hip circumference, blood pressure, blood lipid profile and plasma fasting glucose were measured. In order to determine the concordance between IDF and the other two definitions, the kappa index (κ-test) was used. The prevalence of MetS (95% confidence interval) was 22.9% (22.8-23.1) by IDF definition, 16.5% (16.3-16.9) by NCEP ATP III definition and 6.4% (6.2-6.6) by modified WHO definition. The sensitivity and specificity of IDF against NCEP ATP III were 88.9% and 90.1% respectively, IDF against WHO definition were 85.7% and 81.4%. The κ statistics for the agreement of the IDF definition was 68.3 ± 0.1 with the NCEP ATP III, and 30.5 ± 0.1 with the modified WHO definition. The prevalence of the MetS among respondents using the IDF definition was highest, followed by NCEP ATP III, and finally modified WHO definition. There was a good concordance between the IDF and NCEP ATP III definitions, and a low concordance between IDF and modified WHO definitions.