METHODS AND STUDY DESIGN: We searched Medline, Embase, Cochrane Central Registry of Controlled Trials and CINAHL. Clinical trials were eligible if they compared palm oil-rich diets with diets rich in MUFAs or PUFAs. We pooled results of included studies using a random effects model and assessed the quality of the evidence and certainty of conclusions using the GRADE approach.
RESULTS: Intake of palm oil intake compared to oils rich in MUFA was associated with increased levels of total cholesterol (TC) [mean difference (MD)=0.27 mmol/L; 95% CI 0.08 to 0.45], LDL-C (MD=0.20 mmol/L; 95% CI 0.02 to 0.37) and HDL-C (MD=0.06 mmol/L; 95% CI 0.02 to 0.10). Similarly, for comparison with oils rich in PUFAs, palm oil showed increased in TC (MD=0.38 mmol/L; 95% CI 0.14 to 0.62), LDL-C (MD= 0.44 mmol/L; 95% CI 0.01 to 0.88) and HDL-C (MD=0.08 mmol/L; 95% CI 0.03 to 0.13). For both comparisons, there were no significant effects on triglycerides.
CONCLUSIONS: Even though palm oil increases marginally the level of serum lipids, the evidence is mostly of low to moderate quality.
METHODS AND STUDY DESIGN: Eating behaviors namely Cognitive Restraint, Uncontrolled Eating and Emotional Eating scores were assessed by the Three Factor Eating Questionnaire-R18. The preference/intake frequency/craving of 26 common high-fat Malaysian foods was assessed using a 7-point hedonic scale. Anthropometric measurements were taken and Taq1 gene polymorphisms were genotyped by PCR-Restriction Fragment Length Polymorphism using DNA extracted from mouthwash samples.
RESULTS: The overall minor allele frequencies of Taq1A, Taq1B and Taq1D according to ethnicities (Chinese/Indian) were 0.37/0.29, 0.39/0.28, 0.06/0.30, respectively; genotype and allele distributions of Taq1B and Taq1D were significantly different between ethnicities. Eating behaviorscores were not significantly different between gender and ethnicities. Those with A1 or B1 allele had lower Cognitive Restraint score and higher Uncontrolled Eating score, while those with A1/A1 or B1/B1 genotype had higher fast food preference. D1 allele was associated with increased starchy food craving and mamak (Malaysian Indian-Muslim) food preference, but not eating behavior scores. All three gene variants were not associated with obesity and adiposity.
CONCLUSION: Taken together, we posit that three DRD2 Taq1 gene polymorphisms influence the eating behavior and preference/intake frequency/craving of certain high-fat foods in Malaysian adults, but their role in obesity and adiposity is still inconclusive and needs further investigation.
METHODS AND STUDY DESIGN: A randomized controlled intervention study was carried out to determine the impact of self-efficacy education based on the Health Belief Model (HBM) in 240 patients with type 2 diabetes at the Golestan Hospital, Ahvaz, Iran between October 2014 and August 2015. The education duration was three months followed by a 24-week follow-up visit to determine the progress of the subjects. In this study, reliable and validated diabetes educational booklet and questionnaires based on knowledge, health beliefs and quality of life were used. The participants were randomly allocated to either the intervention group (n=120) or to the conventional dietary counseling group as controls (n=120), and assessed at the baseline, week 12 and week 36. The study was divided into primary outcome measurements consisting of glycated hemoglobin A1c (HbA1c), fasting blood glucose, lipid profile, and anthropometric levels. Secondary outcome measures were related to nutrition knowledge, health beliefs and quality of life.
RESULTS: The results showed that subjects in the intervention group had significantly better metabolic and glycemic profiles compared with those in the control group. It also showed that knowledge, health belief and quality of life significantly increased in the intervention group.
CONCLUSIONS: Findings indicate that through tailored self-efficacy education, the quality of life and metabolic profile of diabetes patients can be improved.
METHODS AND STUDY DESIGN: Collective food data from MyHeARTs 2012 database were used to construct the MyUM Adolescent FFQ. Seventy-eight participants between 13 and 15 years old in 2014 were selected through convenient sampling for test-retest study. They completed the MyUM Adolescent FFQ twice, with an interval period of one week. One hundred and fifty-six MyHeARTs study participants who were 15 years old in 2014 were randomly selected for this comparative valid-ity study. They completed a 7-day diet history (7DDH) and subsequently completed the self-administered MyUM Adolescent FFQ.
RESULTS: Pearson's correlations between the FFQ and 7DDH for all macronutrients were statistically significant. Energy-adjusted correlations for protein, carbohydrate, and fat were 0.54, 0.63 and 0.49 respectively. Most of the micronutrients and minerals, were statistically correlated ranging from 0.31 to 0.49 after energy adjustment. Cross-classification analyses revealed that more than 70 percent of adolescents were classified into either the same or adjacent quartile of nutrient intake when comparing data of 7DDH and FFQ. No serious systematic bias was evident in the Bland-Altman plots.
CONCLUSION: The 200-item FFQ developed for Malaysian adolescents has moderate to good comparative validity for assessment of macronutrient and micronutrient intake.
METHODS AND STUDY DESIGN: This study had two phases: a cross-sectional growth study of under-five Orang Asli children (N=304; Phase 1) and a 2-year prospective cohort growth study of Orang Asli children aged 0-3 years (N=214; Phase 2) in the Temerloh district of Pahang, Malaysia. Weight-for-age, length/height-for-age, weight-for-length/height, and body mass index-for-age were determined.
RESULTS: The prevalence rates of stunting, underweight, wasting, and thinness in under-five Orang Asli children (Phase 1) were 64%, 49%, 14%, and 12%, respectively. In the cohort of 214 children (Phase 2), weight-for-age was initially documented and maintained closely at -1.50 standard deviations (SD) in the first 6 months, but it declined to approximately -2.00 SD at 15 months and remained close to -2.00 SD thereafter. Length/height-for-age declined rapidly to approximately -2.50 SD at 18 months and fluctuated between -2.30 and -2.50 SD thereafter. Weight-for-length/height increased sharply to -0.40 SD at 2-3 months, declined gradually to less than -1.00 SD at 12 months, and plateaued between -1.00 and -1.30 SD thereafter.
CONCLUSIONS: Undernutrition is prevalent among Orang Asli children, with length rather than weight faltering being more pronounced in the first 2 years of life. Identifying the causes of early growth retardation in this population is required to inform future preventive strategies.
METHODS AND STUDY DESIGN: Using a stratified multi-stage sampling, a total of 816 children (282 boys and 534 girls) aged 10 to 11 years from 12 selected primary schools in the state of Selangor, participated in this study. Data were collected on socio-demographic characteristics, pubertal status and disordered eating behaviors. The Pubertal Development Scale and the Children's Eating Attitudes Test (ChEAT) were used to assess pubertal status and disordered eating, respectively. Logistic regression analysis was conducted to determine the risk factors of disordered eating.
RESULTS: The prevalence of disordered eating was 30.8% (32.8% in boys and 29.7% in girls). However, the sex difference in the prevalence was not statistically significant. Age, ethnicity and pubertal status were significantly associated with disordered eating in univariate logistic regression analysis. Multivariate logistic regression analysis showed that among boys, being either in an advanced or post-pubertal stage (adjusted OR=8.64) and older age group (adjusted OR=2.03) were risk factors of disordered eating. However, among girls, being a Malay (adjusted OR=3.79) or Indian (adjusted OR=5.04) in an advanced or post-pubertal stage (adjusted OR=2.34) and older age group (adjusted OR=1.53) were risk factors of disordered eating.
CONCLUSION: This study found one in three children had disordered eating. Since ethnicity and pubertal status were identified as risk factors, ethnicity-specific intervention programs on the prevention of disordered eating among children should take into consideration their pubertal status.
METHODS AND STUDY DESIGN: A randomized controlled study was conducted on obese women with high breast adiposity (<0.1 Sm-1), aged 40-60 years in Klang Valley, Malaysia. Subjects were assigned to intervention (n=16) and control group (n=15). Intervention group received a home based health education package with close monitoring weekly, personal diet consultation and physical training in group. Assessment was ascertained at three time points; baseline, weeks 8 and 16. Outcome measures were the energy intake, physical activity, body composition, blood tests, blood biomarkers and electrical impedance tomography (EIT) quantitative values. Analyses were done using 2-way repeated measures ANOVA.
RESULTS AND CONCLUSIONS: All subjects completed the program without any drop-out. The HSI group had 100% compliance towards the intervention program; their energy intake was reduced for approximately 35% and their activity score was increased for approximately 11%. A significant interaction effect was found in body weight, body mass index (BMI), total cholesterol/HDL, vitamin C intake and matrix metallopeptidase 9 (MMP-9) (p<0.05). Interestingly, their EIT extremum values were also significantly increased indicating a reduction of breast adiposity. The intervention program was successful in improving body composition, physical activities, MMP9 and breast adipose tissue composition.
METHODS AND STUDY DESIGN: A case-control study was conducted involving 57 acne vulgaris patients and 57 age-, gender- and ethnicity-matched controls. All participants were aged 14 and above. The Comprehensive Acne Severity Scale (CASS) was used to categorise patients (grades 2 to 5) and controls (grades 0 to 1). Information such as the demographics, family history, smoking habits and dietary intake were collected using a self-administered questionnaire.
RESULTS: In the patient arm, the gender ratio of male to female was 1.5:1. 43 patients (75.4%) had a family history of acne vulgaris. No significant association was found for acne in patients with a history of smoking. Milk consumption was significantly higher in patients (63.2%, n=36) versus controls (43.9%, n=25), (OR=2.19, p<0.05). In addition, chocolate consumption was also significantly higher in patients (43.9%, n=25) versus controls (24.6%, n=14), (OR=2.4, p<0.05). No significant association was found with the intakes of sweets, potatoes, chips, nuts, yoghurt, ice-cream or carbonated drinks.
CONCLUSIONS: Dietary intake of milk and chocolate may play a role in acne vulgaris. Prospective cohort and intervention studies are recommended to explore whether a causal relationship might obtain.
METHODS AND STUDY DESIGN: The group convened and discussed evidence-based recommendations and clinical experiences in the management of malnutrition in hospitalized and community-dwelling adults, and the relevance of oral nutritional supplements in clinical practice. Supported by a literature search from January 2007-September 2017, consensus statements on key aspects of malnutrition management were developed.
RESULTS: Malnutrition management should be considered as an integral part of patient care and managed by a multidisciplinary team. Hospitalized patients and outpatients should be screened for risk of malnutrition with validated tools. Nutrition intervention, including oral, enteral, or parenteral nutrition, should be accessible and individualized to all patients who are malnourished or at risk of malnutrition. Education on nutrition care is imperative for healthcare professionals, patients and caregivers.
CONCLUSION: These consensus recommendations provide practical guidance to improve nutrition practice within healthcare in Southeast Asia. With collaborative efforts from the clinical community, professional societies and policy makers, this regional effort may also facilitate change in the nutrition practice at the institutional and national level.