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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 Population-based studies of nutrition and health in Asia Pacific elderly

Lee MS, Wahlqvist ML

Asia Pac J Clin Nutr, 2005;14(4):294-7.
PMID: 16326634

The systematic observation of food habits and health amongst the elderly, both cross-sectionally and longitudinally, in the Asia Pacific region is increasing as reflected in the recent collective report of a number of intake and health variables in Taiwanese communities. Most studies are of Chinese and Japanese-speaking populations, with some from elsewhere in Northeast Asia (notably Korea) and Southeast Asia (notably the Philippines, Indonesia, Malaysia and Singapore). These, and other international studies, demonstrate that older people can eat in various ways and yet achieve longevity and minimum morbidity, provided they remain physically and mentally active and eat a variety of relatively intact foods, including fish and pulses (lentils, legumes, beans). Such studies are the foundation of a new generation of food and health policy for the aged, with reference to EBN (evidence-based nutrition) and reflected in FBDGs (food-based dietary guidelines) which acknowledge cultural difference and support sustainable food systems.
Fulltext Validation of skinfold thickness and hand-held impedance measurements for estimation of body fat percentage among Singaporean Chinese, Malay and Indian subjects

Deurenberg P, Deurenberg-Yap M

Asia Pac J Clin Nutr, 2002;11(1):1-7.
PMID: 11890632

Body fat percentage (BF%) was measured in 298 Singaporean Chinese, Malay and Indian men and women using a chemical four-compartment model consisting of fat, water, protein and mineral (BF%4C). In addition, weight, height, skinfold thickness and segmental impedance (from hand to hand) was measured. Body fat percentage was predicted using prediction equations from the literature (for skinfolds BF%SKFD) and using the manufacturer's software for the hand-held impedance analyser (BF%IMP). The subjects ranged in age from 18-70 years and in body mass index from 16.0 to 40.2 kg/m2. Body fat ranged from 6.5 to 53.3%. The biases for skinfold prediction (BF%4C-BF%SKFD, mean +/- SD) were -0.4+/-3.9, 2.3+/-4.1 and 3.1+/-4.2 in Chinese, Malay and Indian women, respectively, the Chinese being different from the Malays and Indians. The differences were significant from zero (P < 0.05) in the Malays and Indians. For the men, the biases were 0.5+/-3.8, 0.0+/-4.8 and 0.9+/-4.0 in Chinese, Malays and Indians, respectively. These biases were not significantly different from zero and not different among the ethnic groups. The biases for hand-held impedance BF% were -0.7+/-4.5, 1.5+/-4.4 and 0.4+/-3.8 in Chinese, Malay and Indian women. These biases were not significantly different from zero but the bias in the Chinese was significantly different from the biases in the Malays and Indians. In the Chinese, Malay and Indian men, the biases of BF%IMP were 0.7+/-4.6, 1.9+/-4.8 and 2.0+/-4.4, respectively. These biases in Malay and Indian men were significantly different from zero and significantly different from the bias in Chinese men. The biases were correlated with level of body fat and age, and also with relative arm span (arm span/height) for impedance. After correction, the differences in bias among the ethnic groups disappeared. The study shows that the biases in predicted BF% differ between ethnic groups, differences that can be explained by differences in body composition and differences in body build. This information is important and should be taken into account when comparing body composition across ethnic groups using predictive methods.
Fulltext Can dietary factors explain differences in serum cholesterol profiles among different ethnic groups (Chinese, Malays and Indians) in Singapore?

Deurenberg-Yap M, Li T, Tan WL, van Staveren WA, Chew SK, Deurenberg P

Asia Pac J Clin Nutr, 2001;10(1):39-45.
PMID: 11708607

In Singapore. there exists differences in risk factors for coronary heart disease among the three main ethnic groups: Chinese, Malays and Indians. This study aimed to investigate if differences in dietary intakes of fat, types of fat, cholesterol, fruits, vegetables and grain foods could explain the differences in serum cholesterol levels between the ethnic groups. A total of 2408 adult subjects (61.0% Chinese, 21.4% Malays and 17.6% Indians) were selected systematically from the subjects who took part in the National Health Survey in 1998. The design of the study was based on a cross-sectional study. A food frequency questionnaire was used to assess intakes of energy, total fat, saturated fat, polyunsaturated fat, monounsaturated fat, cholesterol, fruits, vegetables and cereal-based foods. The Hegsted score was calculated. Serum total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol were analysed and the ratio of total cholesterol to high density lipoprotein cholesterol was computed. The results showed that on a group level (six sex-ethnic groups), Hegsted score, dietary intakes of fat, satutrated fat, cholesterol, vegetables and grain foods were found to be correlated to serum cholesterol levels. However, selected dietary factors did not explain the differences in serum cholesterol levels between ethnic groups when multivariate regression analysis was performed, with adjustment for age, body mass index, waist-hip ratio, cigarette smoking, occupation, education level and physical activity level. This cross-sectional study shows that while selected dietary factors are correlated to serum cholesterol at a group level, they do not explain the differences in serum cholesterol levels between ethnic groups independently of age, obesity, occupation, educational level and other lifestyle risk factors.
Fulltext Ocular manifestation of vitamin A deficiency among Orang asli (Aborigine) children in Malaysia

Ngah NF, Moktar N, Isa NH, Selvara S, Yusof MS, Sani HA, et al.

Asia Pac J Clin Nutr, 2002;11(2):88-91.
PMID: 12074186

This study determined the prevalence of ocular manifestation of vitamin A deficiency in Orang Asli (Aborigine) children. Night blindness was found in 16.0% of the children, conjunctiva xerosis in 57.3%, Bitot's spot in 2.8%, corneal xerosis in 0.5% and corneal scars in 5.6%. These findings show that history of night blindness had sensitivity, specificity and predictive value (positive) of 47.2, 98.1 and 96.2%, respectively, compared with the standard diagnosis procedure using luxometer readings.
Fulltext Current status of nutrition labelling and claims in the South-East Asian region: are we in harmony?

Tee ES, Tamin S, Ilyas R, Ramos A, Tan WL, Lai DK, et al.

Asia Pac J Clin Nutr, 2002;11(2):S80-6.
PMID: 12074192

This review includes the situation of nutrition labelling and claims in six countries in South-East Asia: Brunei, Indonesia, Malaysia, Philippines, Singapore and Thailand. With the exception of Malaysia, there is no mandatory nutrition labelling requirements for foods in these countries except for special categories of foods and when nutritional claims are made for fortified or enriched foods. Nevertheless, several food manufacturers, especially multinationals, do voluntarily label the nutritional content of a number of food products. There is, therefore, increasing interest among authorities in countries in the region to start formulating regulations for nutrition labelling for a wider variety of foods. Malaysia has proposed new regulations to make it mandatory to label a number of foodstuffs with the four core nutrients, protein, carbohydrate, fat and energy. Other countries have preferred to start with voluntary labelling by the manufacturers, but have spelt out the requirements for this voluntary labelling. The format and requirements for nutrition labelling differ widely for countries in the region. Some countries, such as Malaysia, closely follow the Codex guidelines on nutrition labelling in terms of format, components to be included and mode of expression. Other countries, such as the Philippines and Thailand, have drafted nutrition labelling regulations very similar to those of the Nutrition Labeling and Education Act (NLEA) of the United States. Nutrition and health claims are also not specifically permitted under food regulations that were enacted before 1998. However, various food products on the market have been carrying a variety of nutrition and health claims. There is concern that without proper regulations, the food industry may not be certain as to what claims can be made. Excessive and misleading claims made by irresponsible manufacturers would only serve to confuse and mislead the consumer. In recent years, there has been efforts in countries in the region to enact regulations on nutrition claims. Recently enacted regulations or amendments to existing regulations of almost all the countries reviewed have included provisions for nutrition claims. Malaysia is in the process of gazetting regulations to clearly stipulate the permitted nutrition claims and the conditions required to make these claims along the guidelines of Codex Alimentarius Commission. Only two countries in the region permit health claims to be made - Indonesia and Philippines. Other countries in the region are following developments in Codex and examining the need for allowing these claims. There are more differences than similarities in the regulations on nutrition labelling and claims among countries in the South-East Asian region as no previous efforts have been made to address these. Hopefully, through this first regional meeting, countries can initiate closer interaction, with a view to working towards greater harmonization of nutrition labelling and health claims in the region.
Fulltext Nutrition and educational achievement of urban primary schoolchildren in Malaysia

Shariff ZM, Bond JT, Johnson NE

Asia Pac J Clin Nutr, 2000 Dec;9(4):264-73.
PMID: 24394502

The relationship between nutrition, health and educational achievement of school-age population in less developed countries has been of interest to many researchers due to the frequent observation that many children did not complete primary school and those who completed, did not do as well as children in the developed countries. Nevertheless, nutritional and health status by itself is not the only variable affecting educational achievement, since biological, psychological, socioeconomic and cultural factors could directly or indirectly affect both nutrition, health status and educational achievement. The mechanism by which health and nutrition influence educational achievement is not well established, but poor health and malnutrition in early childhood may affect cognitive abilities, necessary for learning process and consequently educational achievement. A study was conducted in Kuala Lumpur, Malaysia, to investigate the relationship between nutritional status and educational achievement among primary schoolchildren from low income households (n = 399). A high percentage of them were mild-significantly underweight (52%), stunted (47%) and wasted (36%) and increasingly overweight (6%). In general, more boys than girls were found to experience some form of malnutrition. While weight-for-height did not differ significantly according to family, child and school factors, weight-for-age and height-for-age differed significantly by gender. Also, height-for-age was significantly related to household income. This indicates that stunting may be a consequence of prolonged socioeconomic deprivation. Educational achievement was measured based on test scores for Malay language (ML), English language (EL) and mathematics (MT). While a majority of the schoolchildren obtained optimum scores (>75) for ML and MT, the majority of them had insufficient scores (<50) for EL. Children's total score (TS) for the three subjects was significantly associated with household socioeconomic status, gender, birth order and heightfor- age. Even after controlling for household socioeconomic status, significant association between TS and height-for-age persisted. In this sample of schoolchildren, household income, gender, birth order and height-forage were significant predictors of TS. The finding that height-for-age is related to educational achievement agrees with other studies, which have reported that height-for-age, compared to weight-for-height or weight-forage is linked to educational achievement. Height-for-age reflects the accumulation of nutritional deprivation throughout the years, which may consequently affect the cognitive development of the children.
Fulltext Ethnic characteristics of coronary heart disease risk factors and mortality in peninsular Malaysia

Khor GL

Asia Pac J Clin Nutr, 1994 Jun;3(2):93-8.
PMID: 24351241

The types and prevalence of coronary heart disease (CHD) risk factors vary somewhat among the three main ethnic groups in peninsular Malaysia. Indians consistently show the highest prevalence for hypercholesterolemia and diabetes mellitus. Among the Malays, a relatively high prevalence of hypertension and hypertriglyceridemia have been reported. Overweight is also a risk factor among the Indians and Malays. In general, Chinese tend to have a lower prevalence for these CHD risk factors than the Indians and Malays. Parallel to the rapid socio-economic development and urbanization in recent decades is a rise in the percentage of deaths due to cardiovascular disease in peninsular Malaysia, that is from 1.8% of total deaths from all causes in 1950 to about 30% in 1991. Coronary heart disease accounts for 40% of all cardiovascular diseases. The mortality rate for CHD has more than doubled between 1965 and 1991, from 24.6 per 100 000 to 57.2. While Indians have been showing the highest CHD mortality rate so far, that of the Malays has been increasing most rapidly since 1970, concomitant with the latter's increase in their proportion of the urban population in peninsular Malaysia.
Fulltext Clinical nutrition in East Asia and the Pacific

Darnton-Hill I, Cavalli-Sforza LT, Volmanen PV

Asia Pac J Clin Nutr, 1992 Mar;1(1):27-36.
PMID: 24323002

Identifying the nutrition problems of Asia and the Pacific is made difficult by the enormous geographic, socioeconomic and cultural diversity that exists in these areas. With increasing longevity and reduced infant mortality, the more chronic diseases are becoming increasingly important. For almost 90% of the countries that keep such data in the Western Pacific Region of WHO, at least three of the five leading causes of death are noncommunicable diseases. Nevertheless undernutrition is still the most important nutritional problem in the Region. Even though there have been some encouraging declines in the proportion of malnourished under 5-year-olds, increasing populations have meant the actual numbers have not declined. Vitamin A deficiency, iodine deficiency disorders and iron deficiency anaemia remain major public health problems in many countries. There is evidence that vitamin A deficiency is appearing in countries in which it has not previously been a problem. New challenges are occurring, such as childhood obesity, the susceptibility of undernourished populations to the human immunodeficiency virus and the increase in noncommunicable diseases. The three arms of clinical nutrition: therapeutic, research and public health will need to work closely to meet the considerable and continuing threat posed by the nutrition-related diseases.
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 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 Trends and dietary implications of some chronic non-communicable diseases in peninsular Malaysia

Khor GL, Gan CY

Asia Pac J Clin Nutr, 1992 Sep;1(3):159-68.
PMID: 24323170

Non-communicable diseases with dietary implications, ischaemic heart disease, diabetes mellitus and cancers of the breast and colon are discussed in relation to their prevalence and mortality rates in peninsular Malaysia during the past few decades. The mortality rate due to diseases of the circulatory system has more than doubled since 1970, deaths due to ischaemic heart disease being the major cause. The prevalence of diabetes mellitus has risen from 0.65% in 1960 to about 4% currently. The mortality risk for both ischaemic heart disease and diabetes is highest in the Indian compared to Malay and Chinese populations. The Chinese show the highest mortality rate for cancers of the breast and colon. This could reflect, partly, because more people especially in the urban areas are seeking treatment and improved diagnosis. Empirical dietary data indicate an increase in the prevalence of hypercholesterolaemia among urban adults and overweight among urban and rural adults. Aggregate data from food balance sheets indicate increased availability of energy intake from fats and oils, sugar, and animal products, with concomitant decline in available energy from plant products. Continued public health education on the important linkage between diet and disease is called for.
Fulltext Modulation of NFκB signalling pathway by tocotrienol: A systematic review

Nasir NAA, Sadikan MZ, Agarwal R

Asia Pac J Clin Nutr, 2021 Sep;30(3):537-555.
PMID: 34587713 DOI: 10.6133/apjcn.202109_30(3).0020

Tocotrienols have been reported to exert anticancer, anti-inflammatory, antioxidant, cardio-protective and boneprotective effects through modulation of NFκB signalling pathway. The objective of this systematic review is to evaluate available literature showing the effect of tocotrienols on NFκB signalling pathway and identify the potential mechanisms involved. A comprehensive search was conducted using PubMed and SCOPUS databases using the keywords "tocotrienol" and "NFκB" or "nuclear factor kappa b". Main inclusion criteria were English language original articles showing the effect of tocotrienol on NFκB signalling pathway. Fifty-nine articles were selected from the total of 117 articles initially retrieved from the literature search. Modulation of regulatory proteins and genes such as inhibition of farnesyl prenyl transferase were found to be the mechanisms underlying the tocotrienol-induced suppression of NFκB activation.
Fulltext Nutrition and physical activity interventions to ameliorate postpartum depression: A scoping review

Yahya NFS, Teng NIMF, Das S, Juliana N

Asia Pac J Clin Nutr, 2021 Dec;30(4):662-674.
PMID: 34967195 DOI: 10.6133/apjcn.202112_30(4).0013

BACKGROUND AND OBJECTIVES: Globally, there is a high prevalence of postpartum depression (17.7%) reported in a recent study among mothers during the postpartum period. It contributes to poor health and well-being among newly delivered women. We reviewed the published effect of nutrition and physical activity interventions on improving and treating postpartum depression.
METHODS AND STUDY DESIGN: The scoping review was performed using Arksey and O'Malley's methodological framework. The systematic search was conducted using Scopus, Pubmed, EBSCOHost and Google Scholar in April 2020, updated in March 2021. Only literature published between January 2010 until February 2021 was searched.
RESULTS: A total of 25 articles were included, of which 23 were randomised controlled trials , and 2 were quasi-experimental studies. Some of studies found improvements in depression (76% out of all studies). On this basis, nutrition or physical activity intervention probably improves postpartum depression. Moreover, the integration of nutrition and physical activity appears to improve depression in the more thorough follow-up of participants . Active involvement of the participant in the interventions was contributory to effectiveness.
CONCLUSIONS: Nutrition and physical activity interventions with appropriate strategy and delivery are promising options for the management of postpartum maternal mental health. More definitive investigation of non-pharmacological interventions to ameliorate depression among postpartum women is warranted.
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 The effectiveness of group dietary counselling among non insulin dependent diabetes mellitus (NIDDM) patients in resettlement scheme areas in Malaysia

Talib R, Ali O, Arshad F, Kadir KA

Asia Pac J Clin Nutr, 1997 Jun;6(2):84-7.
PMID: 24394705

A study was undertaken in FELDA (Federal Land Development Authority) resettlement scheme areas in Pahang, Malaysia, to determine the effectiveness of group dietary counselling in motivating diabetic patients to achieve good dietary habits, and weight and diabetes control. Sixty-one non-insulin dependent diabetes mellitus (NIDDM) patients were randomly assigned to either the experimental or control group. The experimental group received six sessions of group dietary counselling over 5 months and the control group received mass media diabetes-educational program during the same period. The one hour group dietary counselling sessions discussed general knowledge of diabetes, food groups for meal planning, the importance of dietary fibre-rich foods, types of fat in food, exercise and weight control. The experimental group met monthly with a dietitian as a counsellor. Effectiveness was assessed by improvement in food choice, and decline in percentage glycated haemoglobin (total HbA1) or body mass index (BMI). Measurements were made at a baseline visit, every two months during the six month program, and six months afterwards. Patients in the experimental group improved their food choices, resulting in a healthier diet high in unrefined carbohydrates and dietary fibre rich foods, and low in fat. There were significant reductions of their percentage total HbA1 levels and BMI following the counselling sessions, which decreased further six months after the program compared with patients in the control group. Thus group dietary counselling is effective in motivating NIDDM patients to achieve better food choice, and related weight and glycaemic control in a Malaysian setting.
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 A nutrition care process knowledge, attitudes, practices, and perceived barriers questionnaire

Bahari Z, Ibrahim Z, Adznam SNA, Yusof BNM

Asia Pac J Clin Nutr, 2017 8 15;26(5):781-787.
PMID: 28802285 DOI: 10.6133/apjcn.102016.02

BACKGROUND AND OBJECTIVES: Assessment of the nutrition care process (NCP) knowledge, attitudes, practices, and perceived barriers (KAPB) of dietetics practitioners is imperative before NCP is implemented completely in dietetics practice. No questionnaire assessing NCP KAPB has been developed and validated. Hence, we developed an NCP KAPB questionnaire called the KAPB-NCP and established its content validity.
METHODS AND STUDY DESIGN: A total of 116 items associated with sociodemographic characteristics (7 items), professional development (3 items), organisational culture's support for the NCP (2 items), knowledge (27 items), attitudes (39 items), practices (20 items), and perceived barriers to implementing the NCP (14 items) were generated for potential inclusion in the KAPB-NCP questionnaire. The questionnaire was reviewed online by an expert panel for its content validity. An in-depth review was conducted by the research team for evaluating the overall comprehensiveness of the questionnaire.
RESULTS: In total, 87 of 100 items of the KAPB sections showed an excellent content validity index (CVI; k* >0.74), whereas 10 showed a satisfactory CVI (k*=0.60-0.74). Only 3 items had a low CVI (k* <0.40). According to the expert panel revisions and the in-depth review, 72 items were incorporated into the questionnaire.
CONCLUSIONS: The KAPB-NCP questionnaire is a content-valid instrument that can assess NCP KAPB.
Fulltext Association of energy intake and physical activity with overweight among Indonesian children 6-12 years of age

Harahap H, Sandjaja S, Soekatri M, Khouw I, Deurenberg P

Asia Pac J Clin Nutr, 2017 12 10;27(1):211-216.
PMID: 29222901 DOI: 10.6133/apjcn.032017.05

BACKGROUND AND OBJECTIVES: Indonesia is currently facing double burden malnutrition in children. As overweight and obesity are due to a disturbed energy balance, this study aimed to assess the association of total energy intake and physical activity with the prevalence of overweight among Indonesian children.
METHODS AND STUDY DESIGN: The data used for this analysis were from 1143 children, 6-12 years old, that participated in the South East Asian Nutrition Survey (SEANUTS). Physical activity (PA) was measured using pedometers for 2 consecutive days and was categorized low, moderate and high. Child nutritional status was categorized based on body mass index for age z-scores (BAZ) into normal weight (-2 SD ≤BAZ≤1 SD) or overweight (BAZ >1 SD). Energy intake was calculated from a one day 24 hour recall and compared to the Indonesian recommended dietary allowance (RDA) for energy.
RESULTS: Children with low PA had higher risk (ODDs 3.4, 95% CI: 2.0, 6.0) of being overweight compared to children who had high PA. Children with moderate PA and energy take >100% RDA had higher risk (ODDs 4.2, 95% CI 1.9, 9.3) of being overweight than children with high PA and energy intakes ≤100% RDA.
CONCLUSIONS: Low physical activity independently or moderate physical activity and high energy intake are risk factors for Indonesian children to get overweight. Program intervention such as increasing physical activity at school and home is needed to reduce overweight among children.
Fulltext Platelet-related cytokines among normal body mass index, overweight, and obese Malaysians

Riyahi N, Tohit ERM, Thambiah SC, Ibrahim Z

Asia Pac J Clin Nutr, 2017 12 10;27(1):182-188.
PMID: 29222897 DOI: 10.6133/apjcn.032017.01

BACKGROUND AND OBJECTIVES: Recent studies have reported that obesity is associated with platelet activation and systemic inflammation. Malaysia has the highest prevalence of obesity, hence, this research is performed to evaluate the development of low-grade inflammation and platelet activation, measured using soluble CD40 ligand (sCD40L) and soluble P-selectin (sP-sel), and to determine their association with obesity. In addition, we assessed the mean platelet volume (MPV) and platelet count (PLT), which are novel parameters consistently associated with obesity.
METHODS AND STUDY DESIGN: A cross-sectional study was conducted on 112 healthy men and women from 3 main ethnic group (Malay, Chinese, and Indian) who were aged 18-60 years. The participants were categorized into normal body mass index (BMI), overweight and obese groups according to WHO criteria for BMI in Asian populations (18.5 kg/m2

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