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  1. Rasyidah Mohamad Basiran, Hanis Mastura Yahya, Suzana Shahar
    Malays J Nutr, 2018;24(3):441-453.
    MyJurnal
    Introduction: Nutrient profiling is the science of ranking food based on the nutrient
    content that enables an individual to make healthier food choice without exceeding
    the daily energy recommendation. This study was aimed at developing and validating
    a nutrient profiling model for Malaysian older population. Methods: A total of six
    nutrient profiling models comprising different combinations of nutrients were
    developed. Each model was tested by scoring 94 food items in terms of 100 kcal and
    100 g, and the Recommended Nutrient Intakes for Malaysian (2017) as the reference
    value. The scores in each model were correlated with energy density per 100 g of
    food. The best model to correctly rank food according to nutrient density was chosen
    for validation. Validation was done by comparing the healthiness classification of
    174 food items as determined by Towards Useful Aging Food Nutrient Density Index
    (TUA FNDI) nutrient profiling model and the Malaysian Dietary Guidelines. Results:
    Models with sodium and total fat were better correlated with energy density. All
    six models were inversely correlated with energy density. TUA FNDI 9-2 model was
    chosen as the best model for validation. Overall, there was substantial agreement
    between TUA FNDI 9-2 model and the food-based dietary guidelines (κ=0.644,
    p=0.001). Conclusion: The inverse correlation between nutrient profiling models
    to energy density shows that foods with higher nutrient density contain lower
    energy. The validated TUA FNDI 9-2 model is recommended for older adults to make
    healthier food choices.
  2. Yeexing You, Suzana Shahar, Hasnah Haron, Hanis Mastura Yahya
    Sains Malaysiana, 2018;47:2713-2729.
    Ulam is the South East Asian traditional vegetables which contains high total phenolic content and exhibits antioxidant
    activity. Several studies have reported the potential of neuroprotective effect of ulam. The objective of this review article
    was to highlight the total phenolic content (TPC) and antioxidant activity of ulam and the roles of phenolic content that
    can contribute to attenuation of cognitive decline. The review includes randomized controlled trial and experimental
    studies from year 2007 to 2017. In this review, PRISMA method was used to report the results (n=15). Phenolic compounds,
    ie plants’ second metabolites of selected ulam in South East Asia were also discussed in this review, with respect to its
    potential for health promotion which and reducing the risk of cognitive disease. Oenanthe javanica (selom), Ocimum
    basilicum (daun selasih) and Anacardium occidentale L. (pucuk gajus) were ranked in the top three highest TPC among
    all the selected ulam. In general, Polygonum minus (kesum), Anacardium occidentale L. (pucuk gajus) and Cosmos
    caudatus (ulam raja) exhibited high DPPH radical scavenging activity whereas Anacardium occidentale L. (pucuk gajus)
    exhibited highest ferric ion reducing potential (FRAP) among all the selected ulam in South East Asia countries. Overall,
    some studies had shown Centella asiatica (pegaga), Oenanthe javanica (selom), Polygonum minus (kesum), Ocimum
    basilicum (daun selasih) and Murraya koenigii (daun kari) are beneficial in improving cognitive status and mood. The
    bioactive compounds in ulam may exhibit neuroprotective effects but human studies are still lacking in exploring the
    relationship between ulam consumption and cognitive status.
  3. Bibi Nabihah Abdul Hakim, Hanis Mastura Yahya, Suzana Shahar, Zahara Abdul Manaf
    Malays J Nutr, 2018;24(4):567-574.
    MyJurnal
    Introduction: Adequacy of fruit intake contributes to an individual’s health
    including reducing the risk of non-communicable disease. This study aimed to
    assess consumption of fruits in various forms and to determine associated factors
    and barriers. Methods: In this cross-sectional study, a total of 300 adults aged
    20-39 years were purposely recruited from several urban locations in the Klang
    Valley. Consumption of fruits in the past 12 months was assessed using a selfadministered food frequency questionnaire (FFQ), assisted with pictures of serving
    size of fruits. Anthropometric measurements were taken and body mass index
    and waist circumference computed. Results: Fruit intake among young adults
    was lower (1.6±1.0 servings/day) than the Malaysian Dietary Guideline 2010 of
    ≥ 2 servings/day. Only 32.3% consumed fruits as recommended, with women
    consuming significantly more fruits than men. Preferred fresh fruits were red apple,
    banana and papaya. Consumption of fruit juice was associated with increase in
    waist circumference (R2=0.261, p=0.027) after adjustment for age, sex, ethnicity,
    education level and marital status. Fruit intake showed no significant association
    with other anthropometric measurements. Sensory appeal, perceived health benefit,
    easy to prepare and influence of family were the main determinants of fruit intake,
    whilst affordability and availability were the major barriers. Conclusion: Fruit
    consumption among young adults in this study was lower than the recommendation
    for daily fruit intake. Studies with larger sample size are suggested to verify the
    finding of significant association between fruit juice consumption and risk of
    abdominal obesity.
  4. Suzana Shahar, Huijin Lau, Hanis Mastura Yahya, Nor Fadilah Raj, Normah Che Din
    Jurnal Sains Kesihatan Malaysia, 2018;16(101):239-240.
    MyJurnal
    There is some evidence stated that mood states might influence cognitive functioning, such as episodic memory, working memory and creative problem solving. This study was conducted to evaluate the relationship between mood states and cognitive functioning among older adults with Mild Cognitive Impairment (MCI). This study involved 12 male and 37 female subjects from Klang Valley aged 60 year old and above. MCI was defined based on criteria proposed by Peterson. Cognitive functions of the subjects were accessed using Mini Mental State Examination (MMSE), Rey Auditory Verbal Learning Test (RAVLT), Digit Span, Digit Symbol Substituition Test (DSST) and Visual Reproduction; while mood states including tension, depression, anger, vigour, esteem related affect, fatigue and confusion were accessed using Profile of Mood States (POMS) questionnaire. Total positive subscales score, total negative subscales score and total mood disturbance (TMD) were also calculated. There were significant positive correlations between tension (r = 0.325, p = 0.30), vigour (r = 0.235, p = 0.036), esteem related affect (r = 0.316, p = 0.034) and total positive subscales score (r = 0.307, p = 0.040) with verbal episodic memory as measured using RAVLT fifth trial. In addition, positive correlations were also observed between vigour (r = 0.228, p = 0.035) and total positive subscales score (r = 0.237, p = 0.025) with DSST. After adjusted for confounding factors, subjects who scored higher in esteem related affect (Adjusted OR = 0.390, 95% CI [0.069-0.711], p = 0.019) and tension (Adjusted OR = 0.253, 95% CI [0.075-0.431], p = 0.007) had better verbal episodic memory. Subjects who have higher total positive subscales score were also had faster processing speed (OR = 0.856, 95% CI [0.099-1.614], p = 0.028). However after adjusted for confounding factors, the relationship was not significant (Adjusted OR = 0.383, 95% CI [-0.247-1.013], p = 2.226). Older adults with MCI who had a more positive mood tend to have a better short-term verbal memory and faster processing speed.
  5. Ismarulyusda Ishak, Penny George, Farah Wahida Ibrahim, Hanis Mastura Yahya, Nor Farah Mohamad Fauzi
    Jurnal Sains Kesihatan Malaysia, 2018;16(101):105-111.
    MyJurnal
    Postprandial hyperglycemia is independently related to cardiovascular disease. Garlic, ginger, lemon, honey and apple cider vinegar are known to have anti-glycemic properties. However, the effectiveness of combination of these natural products on reducing postprandial glycemia is uncertain. The aim of the present study was to investigate the glucose-lowering effect of a novel mixture consisting of apple cider vinegar, garlic, ginger, lemon, and honey; alone and in combination with exercise in response to a high-carbohydrate meal in non-diabetic individuals. Ten, female subjects (mean age: 25 ± 2.67 years, mean BMI: 22.6 ± 3.5 kg/m2) participated in this randomised, cross-over intervention consisting of four trials: control (CON), mixture only (MIX), exercise only (EX), and exercise + mixture (EX-MIX). All trials involved consumption of a high-carbohydrate breakfast, then followed by rest in CON, consumption of natural product mixture in MIX, brisk-walking exercise in EX, and combination of mixture and exercise in EX-MIX. Blood glucose was measured at fasting, and at 30, 60, 90, 120 minutes post meal. Postprandial glucose response was calculated as area under the glucose curve. Two-way repeated measures ANOVA showed a significant group and time interaction (p < 0.001). Compared to CON, postprandial glucose responses were 8%, 13% and 15% lower in MIX (p = 0.049), EX (p = 0.001) and EX-MIX (p = 0.005) respectively. Postprandial glucose was 8% lower in EX-MIX compared to MIX (p = 0.002). In conclusion, consuming natural product mixture containing garlic, ginger, lemon, honey and apple cider vinegar reduced postprandial glycemia to a certain extent, however, combining mixture with exercise produced a greater attenuation effect compared to consuming mixture alone. This finding is indicative of a potential benefit of the novel mixture as a complementary management of hyperglycemia in high-risk individuals.
  6. Bibi Nabihah Abdul Hakim, Suzana Shahar, Zahara Abdul Manaf, Hanis Mastura Yahya
    Sains Malaysiana, 2018;47:2381-2390.
    Fruit and vegetable are the natural foods that contained various nutrients vital for good health and help in weight loss
    by suppressing an individual’s appetite. Therefore, this review aimed to investigate the acute effect of fruit and vegetable
    intake on satiety and energy intake. We included randomized controlled trial or experimental designs measuring fruit
    and/or vegetable intake on satiety using subjective appetite rating and appetite related hormone and energy intake among
    healthy adults, published in English-language. The use of extract, powder form or concentrated fruit and/or vegetable
    and animal study were excluded. Twelve studies were identified from Pubmed, Science Direct and Cochrane from the
    year 1995 to August 2017, consists of six studies on fruit and six studies on vegetable. This review discussed the preload
    of fruit and vegetable in promoting satiety and reducing the energy intake. Manipulating energy density rather than
    portion size was effective in reducing total energy intake and promotes satiety. Fruit and vegetable in solid form had a
    greater satiety effect and significantly reduce energy intake compared to liquid or pureed form. The variation in time
    interval between fruit and/or vegetable intake and the test meal may also account a significant effect on satiety up to 2
    h and diminished 3 h onward. The satiety effect of fruit and vegetable would be beneficial in body weight management.
  7. Yee, Xing You, Suzana Shahar, Hasnah Haron, Hanis Mastura Yahya, Normah Che Din
    Jurnal Sains Kesihatan Malaysia, 2019;17(3):139-148.
    MyJurnal DOI: 10.17576/JSKM-2019-16
    Ulam is fresh traditional Malaysian vegetables which normally consumed in raw form or after a short blanching process.It contains high antioxidants and polyphenols. However, there is limited study about the relationship between ulam consumption and cognitive status. Thus, a cross sectional study was conducted to determine the relation with cognitive function among 132 middle-aged Malays adults (45-59 years old), ecruited by convenient sampling from low income residences in Klang Valley. Respondents were interviewed to obtain data on sociodemography, dietary intake and total ulam intake and also measured for anthropometric parameters at respective community centres. Cognitive status was measured using Digit Span (attention and working memory), Rey auditory verbal learning test (RAVLT) (verbal memory) and comprehensive trail making test (CTMT) (cognitive flexibility). The average ulam intake by the respondents was 15.1 ± 8.2g/day and the top five highest consumed ulam were petai (68.1%), pucuk paku (62.9%), ulam raja (56.8%), pegaga (54.6%) and kesum (44.7%).There was a significant correlation between ulam intake with Digit Span (r = 0.265, p = 0.006), total immediate recall of RAVLT (r = 0.427, p < 0.001) and CTMT (r = 0.257, p = 0.007). Analysis of multiple regression indicated that total ulam intake was a significant predictor for Digit Span (R2 = 0.152, p < 0.05), RAVLT (R2 = 0.335, p = 0.001) and CTMT (R2 = 0.310, p < 0.001). In conclusion, this study showed that ulam has the potential to protect against cognitive decline, however, randomized control trials should be conducted to determine the efficacy of the ulam as neuroprotective agent.
  8. Nik Nur Izzati Nik Mohd Fakhruddin, Suzana Shahar, Nurul Atiqah Abd Aziz, Roslee Rajikan, Hanis Mastura Yahya
    Sains Malaysiana, 2016;45:1381-1391.
    Older adults quite often had an inadequate diet leading to micronutrient deficiencies and impaired immune response with subsequent development of degenerative diseases. This study aimed to determine the adequacy of energy and nutrient intake and its distribution among three aging groups i.e. successful aging (SA), usual aging (UA) and mild cognitive impairment (MCI). This is a cross-sectional study involving a large sample size (n = 2322) of older adults recruited through multistage random sampling from four states of Malaysia. An interview was conducted to measure dietary intake, neurocognitive status and functional status by using the Diet History Questionnaire (DHQ), Mini-Mental State Examination (MMSE), Rey Auditory Learning Test (RAVLT), Geriatric Depression Scale (GDS), Instrumental Activity of Daily Living (IADL) and Quality of Life Questionnaire. For comparison of dietary intake, a sub-sample of 173 respondents from each aging groups were matched and selected using a comparative cross-sectional approach. Women in SA group had the highest mean intake of vitamin A, calcium (p <0.05), vitamin C, riboflavin and iron (p<0.001). The same aging group also achieved the highest RNI percentage for the same nutrients. More than 80% of respondents for all aging groups did not met the recommended nutrient intake (RNI) for vitamin E, thiamin, niacin, folate, calcium and zinc. In women, MCI respondents were more likely to have an inadequate intake of vitamin A, C, riboflavin and iron followed by UA and SA. Inadequate vitamin E, niacin, folate and calcium were prevalent among all gender and aging groups. There is a need to further distinguish specific dietary patterns associated with these three aging groups to promote optimal nutrient intake for cognitive health.
  9. Hanis Mastura Yahya, Suzana Shahar, Siti Nur Arina Ismail, Ainor Farahin Aziz, Normah Che Din, Bibi Nabihah Abdul Hakim
    Sains Malaysiana, 2017;46:245-254.
    Polygonum minus is a plant rich in flavonoids and antioxidants beneficial for reducing oxidative stress and lipid peroxidation in neuronal membranes. This randomized, double-blind, placebo-controlled study evaluated the potential benefits of P. minus extract (LineMinusTM) towards improving cognitive function, mood status and quality of life. Thirty five middle-aged women (35-55 years old) were randomized into intervention (n=17) and control group (n=18). Two capsules of P. minus (250 mg) or placebo (100 mg maltodextrin) each were taken once daily for six weeks. Cognitive tests, mood and anthropometric measurements were measured at baseline, week 3 and week 6, whilst biomarkers were measured at baseline and week 6. Parameters related to mood and quality of life including energy/fatigue, social functioning and general health significantly improved from baseline to week 6 in the intervention group (p<0.05). Mean score for cognitive tests (i.e. digit span, comprehensive trail making test (CTMT) and three domains of CNS vital sign (CNSVS)] improved significantly in both intervention and control groups (p<0.05). There was a significant decrease of mean uric acid, estimated glomerular filtration rate (eGFR), total cholesterol and glycated hemoglobin (HbA1C) in the intervention group from baseline to week 6. P. minus supplementation has the potential to improve mood and quality of life and no adverse effects were reported by the participants after 6 weeks supplementation.
  10. Ismarulyusda Ishak, Farah Wahida Ibrahim, Santibuana Abd Rahman, Nor Malia Abd Warif, Ahmad Rohi Ghazali, Faisal Ariffin, et al.
    Jurnal Sains Kesihatan Malaysia, 2018;16(101):129-136.
    MyJurnal
    Tahfiz education has been well accepted by Muslims in Malaysia. Memorizing the Quran through rote learning can assist in improving the brain ability to process, store information and build memory. In addition, dietary intakes were reported to contribute in the process of memorizing the Quran and to increase the levels of intelligence (IQ) among huffaz students. This cross-sectional study was conducted to measure and to determine the correlation between IQ and dietary intake as well as between IQ and the level of trace elements among students in selected tahfiz schools and non-tahfiz school in Selangor. Questionnaires were used to obtain demographic data. Dietary intake was assessed via 3 days dietary record. Levels of trace elements in the nail samples were analyzed by using ICP-MS. Test for intelligence using WASI-II was conducted to measure the students’ IQ. The results showed that there was a moderate positive correlation between IQ and carbohydrate (r = 0.425, p < 0.001, a weak positive correlation between IQ and energy (r = 0.260, p < 0.05), vitamin B6 (r = 0.189, p < 0.05), vitamin B12 (r = 0.207, p < 0.05) and vitamin C (r = 0.211, p < 0.05). The levels of trace elements in nail samples showed no correlation with IQ, whereas there were moderate positive correlations between IQ and dietary zinc (r = 0.375, p < 0.001) as well as between IQ and dietary iron (r = 0.303, p < 0.001). There was also a moderate positive correlation between IQ and the level of memorization (r = 0.375, p < 0.001). The results of stepwise multiple linear regression showed that al-Quran memorization influence the level of IQ by 20 %. As a conclusion, dietary intake of certain nutrients including energy, vitamins and selected trace elements can potentially improve memorization activities and also IQ.
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