This study was conducted to determine the inhibitory potential of selected Malaysian plants against key enzymes related to type 2 diabetes and hypertension.
Introduction: Awareness of the importance of dietary fibre (DF) in health among adolescents is seldom reported in Malaysia. This study aimed to compare the knowledge, attitude and practice (KAP) of DF intake between Malaysian rural and urban school-going adolescents. Pulau Pangkor in Perak and Damansara in Selangor were randomly selected as rural and urban schools, respectively. Methods: A total of 305 school adolescents with a mean age of 13.5±0.6 years were randomly selected from rural (72 Malay, 85 Chinese) and urban (86 Malay, 62 Chinese) schools completed socio-demographic, validated KAP on DF intake questionnaire, as well as a 24-hour dietary recall. Results: Adolescents from both areas have moderate knowledge (54.4±11.3%), positive attitude (78.7±13.1%) and good practice (65.8±19.9%) scores towards DF intake. Although rural adolescents had significantly (p=0.022) higher DF intake (7.8±3.5 g) compared to urban adolescents (6.9±3.5 g), their DF intake was still lower than the Malaysian recommendation of 20-30 g/day. The attitude of DF intake of rural (r=0.390) and urban (r=0.370) adolescents showed significant positive correlations with practice score of DF intake. While a significant correlation was found between the practice score and DF intake (r=0.191, p=0.017), no significant correlation was found between knowledge and attitude scores with DF intake. Conclusion: Public health authorities and schools should raise awareness on health benefit of consuming DF to promote an increase in DF consumption among school adolescents.
Introduction: This randomised school-based controlled study aimed to evaluate the baseline results of nutrition knowledge, attitude, and practice (NKAP), health-related quality of life (HRQoL), and parents’ report of parenting skills (PRPS) among overweight and obese children.
Methods: This study was performed on three intervention groups and one control group. It was conducted among Year Five students from primary schools who had overweight or obese status and were generally healthy without any chronic diseases. The children completed NKAP and child self-report of Pediatric Quality of Life (PedsQoL) questionnaires, while parents completed parent proxy report of PedsQoL and PRPS questionnaires. Descriptive statistics and parametric test in SPSS were utilised.
Results: Out of 139 participants involved in the baseline study, 18.7% and 81.3% were overweight and obese respectively. This study revealed a significantly higher knowledge score among boys (p = 0.016) and among those who lived in urban areas (p = 0.019). The children’s selfreport PedsQoL recorded highest score for Social Functioning domain and lowest score for Emotional Functioning domain. A contradictory finding was obtained from the parent proxy report, where the Physical Functioning domain scored the lowest and the Emotional Functioning domain had the highest score. Notably, some of the findings from PRPS questionnaires completed by their parents were unfavourable.
Conclusions: This study provided prospective evidence of the current status of NKAP, HRQoL among overweight and obese children as well as findings from PRPS among their parents.
This study investigated the role of antioxidant enzyme system following crude hydroethanolic extract of Moringa oleifera leaves (MO) in acute paracetamol (PCM) induced hepatotoxicity. Hydroethanolic extract (80%) of MO (200 mg/kg and 800 mg/kg; p.o) was pre-administered before a single oral dose of 3 g/kg PCM intoxication to male Sprague-Dawley rats. Pre-treatment of the extract was found to have reduced lipid peroxidation level when compared to the group treated with PCM only. The level of glutathione peroxidase (GPx), glutathione-Stransferase (GST) and glutathione reductase (GR) was restored to near normal in groups that were pre-treated with MO. Histopathological studies have further confirmed the hepatoprotective activity of MO compared to group treated with PCM only. The results obtained were comparable to silymarin (200 mg/kg; p.o). The MO extract was found to have significantly protected the liver against toxicity following PCM intoxication by enhancing the level of antioxidant enzyme activity.
Introduction: This study aimed to develop and examine the validity and reproducibility of a semi-quantitative food frequency questionnaire (FFQ) among Malay pregnant women in Kelantan, Malaysia.
Methods: A total of 177 Malay pregnant women participated in the validation study while 85 of them participated in the reproducibility study which was carried out in the antenatal clinic of Universiti Sains Malaysia Hospital. The newly developed FFQ was validated against two 24-hour dietary recalls (DR). The FFQ was repeated 20 to 28 days apart.
Results: Results showed that the FFQ moderately over estimated the nutrient and food intakes compared to the DR. Spearman correlation
coefficients for nutrients ranged from 0.24 (fat) to 0.61 (calcium) and for foods, ranged from 0.13 (organ meats, onion and garlic) to 0.57 (malt drink). For nutrients, 72 to 85% of women were classified into the correct quartiles from the FFQ and the DR while for foods, 67 to 85% of women were classified correctly. Bland-Altman plot showed relatively good agreement between these two dietary methods. The intra-class correlation (ICC) was used to estimate reproducibility. It ranged from 0.75 (vitamin C) to 0.94 (phosphorus) for nutrients while it ranged from 0.73 (confectionary) to 0.96 (coffee) for foods.
Conclusion: On average, at least 90% of pregnant women were correctly classified into the quartiles for nutrients and foods from the two sets of the FFQ. The FFQ presented acceptable reproducibility and appears to be a valid tool for categorising pregnant women according to dietary intake.
Keywords: Assessment of nutritional status, diet, food frequency questionnaire, maternal nutrition
Introduction: The increasing prevalence of adiposity is associated with the development of type 2 diabetes mellitus (T2DM). The two most popular methods to measure adiposity are body mass index (BMI) and waist-hip-ratio (WHR), which measure the overall and abdominal adiposity, respectively. The aim of this study was to determine whether BMI or WHR was more strongly associated with macronutrient intakes and lipid profiles in T2DM patients. Methods: In this cross-sectional study, a total of 210 T2DM patients, mean age of 56.73(SD 10.23) years, were recruited from Penang. Information on socio-demographic, body measurements (height, weight, waist circumference and hip circumference)and macronutrient intakes (three 24-hour dietary recalls) were recorded. Routine laboratory tests (fasting blood glucose, HbA1c, LDL, HDL, triglyceride and total cholesterol) were performed according to standard procedure. Results:Among the respondents, 84% had abdominal and 63% had overall adiposity respectively.There was a significant correlation between WHR and the total calorie(r=0.27; p
Introduction: Conjugated linoleic acid (CLA) has been studied for its fat mass
reduction effects. This study aimed to determine the effects of CLA supplementation
on body fat mass (BFM) and selected blood lipid profiles among overweight Iranian.
Methods: A total of 180 adults with BMI = 26-29 kg/m2 and BFM exceeding 21%
and 28% for men and women, respectively were recruited through voluntary
participation from weight management clinics in Tehran. They were assigned
randomly to three groups as follows: Group (1) (control group) receives weight loss
diet only; Group (2) receives weight loss diet +3 gr/day CLA supplement (mixture
of cis-9, trans-11 and trans-10, cis-12) twice a day and Group (3) weight loss diet
+3 gr/day CLA supplement as Group (2) twice a day + regular exercise (walking at
5.5-6 km/h for at least 160 minutes/week). The trial was conducted for 12 weeks.
Anthropometric measurements and blood lipid profiles were determined at weeks 0,
6 and 12.
Results: Both Group 2 and Group 3 showed a significant between-group
difference in reduction of BFM (1.3% and 2.6% respectively) compared to Group 1.
Group 2 supplementation showed increased free fatty acid (FFA) (0.44 mM to 0.55
mM) and decreased HDL-chol (47.5 mg/dL to 42.0 mg/dL) between weeks 0 and
12. These results were not observed for Group 3.
Conclusion: Combination of CLA
supplementation with exercise showed BFM reduction in overweight Iranian adults.
Further research is suggested to verify the findings of this study.
This study aimed to develop demi-span equations for predicting height in the Malaysian elderly and to explore the applicability of previous published demi-span equations derived from adult populations to the elderly.
A retrospective study of anaemia in pregnancy in rural Kelantan was conducted. The study sample consist of 9,860 mothers who had antenatal care at one of the 102 rural health clinics selected and had delivered a live baby. Anaemia in pregnancy was determined by reviewing the antenatal records for the haemoglobin level recorded at the first and last antenatal visit. Estimation of haemoglobin was done either by photocalorimetric methods or the Sahli's method in these rural clinics. At the time of booking, 47.5% of the mothers were anaemic by WHO criteria (Hb < 11.0 g/dl), with 1.9% having less than 9.0 g/dl. Age of mother, parity and late gestational age at the first antenatal visit were associated with anaemia during pregnancy at the time of booking. However, practise of contraception by the mother did not show any association with anaemia in pregnancy. There were 594 mothers (6.0%) who delivered a baby weighing less than 2.5 kg. There was no association between the low birth weight of the child and the status of anaemia in the mother at the last antenatal visit.
Introduction: This two-phase longitudinal study sought to determine the association between isoflavones intake on cognitive function and comorbidities among older adults from the state of Johor, Malaysia.
Methods: Phase I involved baseline data collection to examine the association between isoflavones intake and cognitive function among 400 respondents aged 60-years and above, recruited through multistage random sampling. Phase 2 determined the association between isoflavones intake at the baseline and comorbidities at an 18-month follow-up. The baseline data collected included information on socio-demographics, health status, andunpometric measurements, and dietary intake using a dietary history questionnaire (DHQ). Each participant's cognitive function was evaluated using a mini mental state examination (MMSE), digit span, digit symbol, and geriatric depression scale (GDS).
Results: The daily intake of total isoflavones, daidzein, and genistein were 19.1±19.7,11.7±12.3 and 7.6+8.1 mg/day, respectively. There was no significant association between isoflavones intake, and specific cognitive function including global, memory, executive functions, and depression. However, there was a significant association (p 0.05).
Conclusion: This study found an association between isoflavones intake and memory function, but not with global cognitive, executive functions, depression, and comorbidities. There is a need to promote adequate isoflavones intake in view of its association with memory function.
Introduction: Chinese Herbal Medicine (CHM) is becoming increasingly popular among cancer patients worldwide. While health-related quality of life (HRQoL) in relation to cancer outcomes has attracted global attention, there are few studies on CHM use and HRQoL among cancer patients in Malaysia. This study attempted to determine the association between use of CHM, including the types, reasons, and beliefs, and HRQoL among Malaysian cancer patients.
Methods: A cross-sectional study was conducted among 120 cancer patients (60 male and 60 female) recruited from government oncology clinics in Johor state. A purposive non-probability sampling was applied to recruit respondents.
Results: Use of CHM was reported by about half of the patients (49.2%). Common types of CHM used included Chinese herbal extracts (27.5%), Sabah snake grass (12.2%), and ginger (11.5%). The median score for overall belief in CHM significantly differed between
CHM users (71.7%) and non-users (65.0%) (p<0.001). The HRQoL was generally reported as ‘good’ with high scores for overall functioning scales and low scores for symptom scales. However, no significant difference in HRQoL between CHM users and non-users was noted. ‘Social Functioning’ scores between both groups showed a significant difference (p < 0.001) with respect to sex, with females scoring higher than males. No significant association was noted between CHM use and socio-demographic characteristics except for sex.
Conclusion: There is a high prevalence of self-prescription of CHM among the cancer patients studied. Nonetheless use of CHM did not show any significant difference in terms of quality of life among CHM users.
Study site: Oncology clinics, Hospital Sultan Ismail (Johor Bahru) and Hospital Sultanah Nora Ismail (Batu Pahat), Johor, Malaysia
INTRODUCTION: University students are potentially important targets for the promotion of healthy lifestyles as this may reduce the risks of lifestyle-related disorders later in life. This cross-sectional study examined differences in eating behaviours, dietary intake, weight status, and body composition between male and female university students.
METHODOLOGY: A total of 584 students (59.4% females and 40.6% males) aged 20.6 +/- 1.4 years from four Malaysian universities in the Klang Valley participated in this study. Participants completed the Eating Behaviours Questionnaire and two-day 24-hour dietary recall. Body weight, height, waist circumference and percentage of body fat were measured.
RESULTS: About 14.3% of males and 22.4% of females were underweight, while 14.0% of males and 12.3% of females were overweight and obese. A majority of the participants (73.8% males and 74.6% females) skipped at least one meal daily in the past seven days. Breakfast was the most frequently skipped meal. Both males and females frequently snacked during morning tea time. Fruits and biscuits were the most frequently consumed snack items. More than half of the participants did not meet the Malaysian Recommended Nutrient Intake (RNI) for energy, vitamin C, thiamine, riboflavin, niacin, iron (females only), and calcium. Significantly more males than females achieved the RNI levels for energy, protein and iron intakes.
CONCLUSION: This study highlights the presence of unhealthy eating behaviours, inadequate nutrient intake, and a high prevalence of underweight among university students. Energy and nutrient intakes differed between the sexes. Therefore, promoting healthy eating among young adults is crucial to achieve a healthy nutritional status.
A cross-sectional study was conducted to determine physical activity, eating behaviour, body weight management knowledge, perception of body image and their association with body weight status of adolescents.
Introduction: Breakfast skipping is an unhealthy eating behaviour reportedly common among adolescents. A cross-sectional study was carried out to determine the differences in body weight status, socio-demographic, behavioural, and psychological characteristics between daily breakfast takers and breakfast skippers.
Methods: Data were collected from form four students of four randomly selected secondary schools in Sibu, Sarawak using a self-administered questionnaire. Body weight and height were measured using standard procedures and BMI-for-age z-scores were determined.
Results: A total of 375 students were recruited (male: 32.0%, female: 68.0%; Chinese: 39.5%, Than: 26.4%, Malay: 17.1% and Melanau: 17.1 %; mean age = 16.45 ± 0.53 years). The prevalence rate of breakfast skippers at 40.3% was higher compared to the national prevalence of 32.7%. About 19.7% of the students were found to be at risk of eating disorders. In addition, the prevalence rates of overweight and obesity were 10.9% and 7.7%, respectively. Significant associations were found between breakfast skipping with sex, lunch skipping, dinner skipping, eating attitudes, and body weight status. Binary logistic regression analysis showed that female students and those who skipped lunch or dinner were more likely to skip breakfast.
Conclusion: Breakfast skipping was quite common in this sample of adolescents in Sarawak. As frequent breakfast skipping has negative health and academic performance implications, increased nutrition education and health awareness campaigns on the importance of breakfast taking among school students should be undertaken.
A study was carried out on 117 schoolchildren comprising 51 boys and 66 girls between the ages of 10 and 13 years to evaluate the effect of Ramadan-fasting on body weight. The results revealed that more than 90% of the subjects experienced a decrease in body weight during Ramadan. The initial mean body weight of the boys and girls were 35.7 ± 6.7 kg and 35.2 ± 6.1 kg respectively. After four weeks' fast, the boys and girls significantly lost (p<0.001) an average of 4.2% and 3.7% of their initial body weight respectively. Dietary intake and activity pattern were also assessed in a subgroup of 20 boys and 30 girls during the same period. The mean daily energy intake during Ramadan-fasting {boys 1230 ± 363 kcal (5.15 ± 1.52 MJ), girls 1034 ± 290 kcal (4.33 ± 1.21 MJ)} was significantly lower (p<0.001) than intake assessed before Ramadan {boys 1520 ± 463 kcal (6.36 ± 1.94 MJ), girls 1344 ± 428 kcal (5.62 ± 1.79 MJ)}. Both values were found to be below the suggested daily dietary intake for Malaysians of similar sex and age group recommended by Teoh (1975). Both boys and girls significantly decreased their intakes of fat, carbohydrate and thiamine during Ramadan. However, intakes of protein, niacin, vitamins A and C were found to be comparable to non-fasting values. During Ramadan, the mean intake of all nutrients analysed except protein were lower than recommended values. The boys spent significantly more (p<0.05) time sitting and significantly less (p<0.05) time standing and in moderately active pursuits during Ramadan. During this period, the boys spent more time in prayers compared with the girls. Time spent on all other activities did not differ between the fasting and non-fasting months. The findings suggest that the decrease in body weight during Ramadan may be primarily due to the reduction in energy intake since activity pattern remain fairly constant. The nutrient intake pattern of the adolescents studied may be of great concern in the long-term, as it does not meet the requirements for the normal growth of adolescents.
A longitudinal study was conducted to relate basal metabolic rate (BMR) with growth during adolescence. Subjects comprise 70 boys and 69 girls aged between ten and thirteen years at the time of recruitment. Parameters studied include anthropometric measurements and BMR, which was measured by indirect calorimetry using the Deltatrac metabolic monitor. Measurements were carried out serially once every six months, with a total of 713 BMR data points collected over three years. Mean BMR of boys aged 11, 12, 13 and 14 years were 4.96 ± 0.63 MJ/day, 5.28 ± 0.71 MJ/day, 5.73 ± 0.68 MJ/day and 5.92 ± 0.63 MJ/day, respectively; while mean BMR of girls in the 10, 11, 12 and 13 year age groups were 4.96 ± 0.63 MJ/day, 4.85 ± 0.63 MJ/day, 5.05 ± 0.55 MJ/day and 4.94 ± 0.51 MJ/day, respectively. Comparison of measured BMR with BMR values predicted from the FAO/WHO/UNU (1985) equations shows that the predictive equations overestimated the BMR of Malaysian boys by 3% and that of girls by 5%. The Henry and Rees (1991) equations for populations in the tropics underestimated BMR of boys and girls by 1% and 2%, respectively. Linear regression equations to predict BMR based on body weight were derived according to sex and age groups. It is recommended that these predictive equations be used for the estimation of BMR of Malaysian adolescents.
Pleurotus ostreatus better known as oyster mushroom is widely cultivated and consumed as food in Malaysia. The present study aims to assess the antioxidative potential and total phenolic content of P. ostreatus aqueous extract. The antioxidant activities were evaluated against DPPH and ABTS radical-scavenging activity, ferric-reducing antioxidant power (FRAP) and β-carotene-linoleate bleaching assay, and the Folin-Ciocalteu method for total phenolic content (TPC). The DPPH and ABTS radical-scavenging activity was found to be 63.20% and 87.29% respectively; antioxidant activity using FRAP at 1.45 mM FE/100g and β-carotenelinoleate bleaching assay was 83.51%, while the TPC was found to be 798.55 mg GAE/100g. These antioxidant activities were compared to synthetic antioxidant, BHA and ascorbic acid. Ascorbic acid showed highest scavenging effects on DPPH and ABTS radical, followed by P. ostreatus and BHA (at maximum safety limit). The ferric reducing power of P. ostreatus was significantly higher than BHA and ascorbic acid. The antioxidant activity as assessed in β-carotene-linoleate bleaching assay was found to be higher in BHA compared to P. ostreatus. The aqueous extract of P. ostreatus was found to respond differently in antioxidant assays. The antioxidative activity of the aqueous extract of P. ostreatus correlated with its total phenolic content. Generally, the antioxidant activities of P. ostreatus' aqueous extract are comparable to that of BHA and ascorbic acid to a certain extent.
Introduction: Rectal adenocarcinoma patients are advised to increase protein intake
especially after surgery for speedy recovery. Concentrated collagen peptides might help to
improve compliance of protein prescription and ultimately muscle bulk.
Case presentation:
A 35-year-old man diagnosed with low rectal adenocarcinoma was discharged and referred
to diet clinic for continuous intervention. At the time of attending the diet clinic, patient
looked cachectic and lethargic. Patient’s height was 164cm, weight 44kg, BMI 16.4 kg/m2, muscle mass 37.6kg and body fat 9.7%. He had lost 27% of his weight (16kg within 6 months)
and had a C for SGA (Score Global Assessment). Estimated intake was 1560kcal/day and
38g/day protein. Patient reached satiety early and did not comply with oral nutritional
supplement (ONS) due to distaste and concern for his high stoma output. The nutritional
diagnosis was inadequate protein intake related to decreased ability to consume sufficient
protein as evidence by diet history. High protein high calorie diet (HPHC) and collagen
peptides supplement daily were prescribed. Patient was requested to recall diet and to
drink a bottle of collagen peptides in the diet clinic daily for a week to ensure compliance to
diet prescription. After a week, his anthropometry improved: weight reached 46.2kg, muscle
mass 38.6kg and body fat 12.7%. Patient was able to walk and to start working the following
week. Total energy intake was 1690kcal/day with 56g/day protein. As patient was able
to achieve protein requirement via food, collagen peptide was withheld. After a month,
anthropometry improved and complied to HPHC as well as ONS. Concentrated collagen
peptides were found to help the malnourished patient to achieve protein requirement in
small volumes.
Conclusion: Concentrated collagen peptides improve lean muscle mass
in patients with rectal adenocarcinoma postoperatively. It is recommended that further
investigations be conducted to provide concrete evidence on the role of collagen peptides.
Introduction: Malnutrition is a common problem associated with increased risk of
morbidity and mortality among haemodialysis (HD) patients.
Methods: This study
determined the correlation between anthropometric measurements, biochemical
indicators, dietary intake and dialysis malnutrition score among HD patients in
Sibu, Sarawak. A total of 55 patients were recruited by purposive sampling and
their biochemical parameters were retrieved from dialysis records. Anthropometric
measurements and dietary intake were determined using standardised protocols
while Dialysis Malnutrition Score (DMS) was computed to determine patients’
nutritional status.
Results: Mean age of the patients was 53.0±12.2 years. Mean
DMS was low, indicating low tendency of malnutrition among the patients.
Approximately one-third of the patients had high interdialytic weight gain (IDWG),
indicating a poor adherence on fluid recommendation. Mean intakes of dietary
energy (DEI) and protein (DPI) were low, with only approximately 15% achieving
the recommendations according to Kidney Disease Outcomes Quality Initiative (K/
DOQI). Increase in age (r=0.337, p=0.012) and dialysis vintage (r=0.403, p=0.002)
were associated with poorer nutritional status while higher BMI, MUAC, and
serum albumin were associated with better nutritional status.
Conclusion: This
study revealed a high proportion of the HD patients with poor adherence on fluid
intake, and the prevalence of inadequate DEI and DPI, indicating the importance
of regular dietary counselling for HD patients. In view of their non-invasive nature
and close relationship with nutritional status, body mass index, mid-upper arm
circumference, and serum albumin should be included as part of the comprehensive
periodic nutrition assessment of HD patients.