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Fulltext The effect of lifestyle modification intervention with motivational construct on dietary macronutrient intake among obese adults.

Shahadan SZ, Daud A, Md. Isa ML, Ibrahim M, Deraman S

IIUM Medical Journal Malaysia, 2019;18(2):13-22.
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An unhealthy dietary practice as a result of environmental and societal changes is increasingly exposed to adults. These unhealthy practices lead to an increased cardiometabolic risk, and obese adults are at a higher risk as compared to normal-weight adults. The best strategy to promote healthy lifestyle practices among Malaysian obese adult is still fragmented. Materials and Methods: A single-centre randomised controlled trial was carried out to determine the effect of the lifestyle modification intervention (LMI) with the motivational construct, in comparison to the current standard LMI on the dietary macronutrient intake among obese adults. The dietary macronutrient intake and changes in body weight were assessed at baseline and after six months. Seventy-nine participants completed the study. Results: Our finding showed that six months of LMI with motivational construct resulted in a higher reduction of total fat and cholesterol from the dietary intake as compared to the control. In addition, the participants in the intervention group had a significant body weight loss after six months (-1.97 kg, 95% CI: -0.324, 1.360, t(39) = 3.397, p= 0.002). Conclusion: This study demonstrates that the intervention had a meaningful impact on improving the dietary macronutrient intake, which is beneficial to support body weight loss in obese adults. Future trials with additional nutritional biomarkers are needed to extend these findings.
Fracture risk prediction in post-menopausal women with osteopenia and osteoporosis: preliminary findings

Nik Mohd Hatta NNK, Lokman M, Said N M, Daud A, Ibrahim M, Sharifudin MA, et al.

Enferm Clin, 2018 Feb;28 Suppl 1:232-235.
PMID: 29650194 DOI: 10.1016/S1130-8621(18)30074-3

OBJECTIVE: The study aims to identify the risk of obtaining a fracture among post-menopausal women with osteopenia and osteoporosis.

METHOD: This work was a cross-sectional study involving a purposive sample of 87 post-menopausal women who attended the orthopedic and menopause clinics of Hospital Tengku Ampuan Afzan, Kuantan. The data were entered into the WHO fracture risk assessment tool (FRAX®) to predict major fracture and risk for hip fracture in 10 years' time.

RESULTS: The mean age of the respondents was 61.6 years (SD=7.9). Among the respondents, 50.6% had osteopenia and nearly half (48.3%) had osteoporosis. The mean number of menopausal years of the respondents was 11.9 (SD=8.5), ranging between 1 and 44 years. The FRAX findings indicated 9.7% major osteoporotic fracture probability and 3.5% hip fracture probability, which were denoted as high risk. A Pearson correlation coefficient was computed to assess the relationship between menopausal years and the FRAX major osteoporotic fracture probability. A significant positive correlation was found between the two, but the correlation was weak (r=0.581, n=87, p < 0.001).

CONCLUSIONS: The present findings indicate that menopausal years have a positive correlation with the risk of obtaining a fracture.

Study site: orthopedic and menopause clinics of Hospital Tengku Ampuan Afzan, Kuantan.
Prevalence and association between triglyceride level and lifestyle factors among Malay obese class I and II adults

Daud A, Shahadan SZ, Ibrahim M, Lokman Md Isa M, Deraman S

Enferm Clin, 2018 8 18;28 Suppl 1:310-315.
PMID: 30115355 DOI: 10.1016/S1130-8621(18)30176-1

OBJECTIVE: Hypertriglyceridemia is an independent risk factor for cardiovascular diseases. This study aimed to determine the prevalence and association of triglyceride level and lifestyle factors among Malay obese class I and II adults.
METHOD: This is a cross-sectional study of 65 Malay obese class I and class II adults aged 20-62 years (21 male, 44 female) from sub-urban areas of Malaysia. Overnight fasting venous blood samples were obtained to determine the triglyceride level (mmol/L). Subjects were classified into either normal or elevated triglyceride level groups based on the triglyceride level (normal < 1.6 mmol/L, elevated > 1.7 mmol/L). Unhealthy lifestyle behaviors, defined as smoking status, hours per day spent on sitting passively and sitting with active motion, and the amount of saturated fat, mono-unsaturated and polyunsaturated fat from dietary intake, were measured from 24-h dietary intake and physical activity recall. We compare the variables of unhealthy lifestyle behaviors between subjects with normal and elevated triglyceride level using independent samples t-test.
RESULTS: Among 65 obese class I and II adults, 16 subjects (24.6%) were found to have elevated triglyceride levels (mean ± standard deviation of body mass index 31.89 ± 3.29 kg/m2). There are significant differences between subjects having normal and elevated triglyceride level with gender, marital status, the number of children, smoking status, weight and monounsaturated fat intake (all P-values < .05).
CONCLUSIONS: The findings of this study highlighted elevated triglyceride level in obese adults might be influenced by unhealthy lifestyle behaviors. We suggest that lifestyle modification intervention is appropriate to prevent cardiovascular disease among Malay obese class I and II adults.
Knowledge and Attitudes of Maintaining Bone Health among Post-Menopausal Women in Malaysia

Mohd Hatta NNKN, Nurumal MS, Isa MLM, Daud A, Ibrahim M, Sharifudin MA, et al.

Cent Asian J Glob Health, 2019;8(1):348.
PMID: 32002313 DOI: 10.5195/cajgh.2019.348

Introduction: Public awareness of osteoporosis is low among women in the developing countries. Health education was shown to be effective in improving knowledge and awareness on maintaining bone health. This study aims to identify the level of knowledge and attitudes among post-menopausal women in Malaysia on achieving bone health throughout the menopausal transition period.
Methods: A total of 116 post-menopausal female patients of orthopedic menopause clinic were recruited using a purposive sampling approach. Data on osteoporosis awareness and knowledge were collected using validated structured questionnaires Osteoporosis Prevention and Awareness Tool and Osteoporosis Attitude Knowledge Test. The chi-square test was used to determine the association between post-menopausal women's socio-demographic characteristics and their knowledge and attitude towards maintaining bone health.
Results: Participants' age ranged between 49 and 82 years (61.84, SD=7.87). The knowledge of osteoporosis varied significantly by age (p=0.014) and education (p=0.001) among the studied population. No significant diffrences were found for participants' attitude towards bone health.
Conclusion: This study showed that the age and education levels have significantly different knowledge of bone health.