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  1. Fulltext Nutritional characteristics and clinical outcomes of critically ill patients with and without diabetes mellitus: a single-center prospective observational study in Malaysia
    Zheng-Yii Lee, Ibrahim Noor Airini, Osama Hamdy, Mohd-Yusof Barakatun-Nisak
    Malaysian Journal of Medicine and Health Sciences, 2020;16(106):116-121.
    MyJurnal
    Introduction: This study aimed to compare the nutritional characteristics and clinical outcomes among critically ill patients with diabetes (DM) and without diabetes (WDM). Methods: Mechanically ventilated, critically ill patients who were admitted into the intensive care unit (ICU) within 48 hours and remained in ICU 72 hours were prospec- tively recruited and followed for up to 12 days. They were stratified to DM or WDM, depending on their diabetes status at ICU admission and comparison were made for nutritional characteristics and clinical outcomes including 60-day mortality. Results: A total of 154 patients were included with 73 (47.4%) DM patients. In comparison to WDM, patients with DM were older, more severely ill, had higher nutritional risk and body mass index, presented with a higher blood glucose level, and required more insulin. DM was fed relatively earlier but had lower energy adequacy. They experienced more frequent EN interruption. Both groups had comparable ICU and hospital stay, ventilation support duration and mortality. In multivariable logistic regression, no association was found between diabetes status and for ICU and hospital mortality. However, There was a trend towards an increase in 60-day mor- tality in DM patients (Odds Ratio: 2.220, 95% Confidence Interval: 0.764-6.452; p=0.143). Conclusion: Critically ill patients with DM had higher nutritional risks, were fed relatively earlier, but with frequent EN interruption leading to lower energy adequacy than patients WDM. Diabetes status does not affect clinical outcomes.
  2. Fulltext Medical nutrition therapy administered by a dietitian yields favourable diabetes outcomes in individual with type 2 diabetes mellitus
    Mohd Yusof BN, Ruzita AT, Norimah AK, Kamaruddin NA
    Med J Malaysia, 2013;68(1):18-23.
    PMID: 23466761 MyJurnal
    AIM: This prospective, single-group, pre-post design trial was conducted to evaluate the effect of individualised Medical Nutrition Therapy intervention administered by a dietitian in individuals with type 2 diabetes mellitus on glycaemic control, metabolic parameters and dietary intake.
    METHODS: Subjects (n=104; age=56.4 ±9.9 years; 37% male; years of diagnosis = 6.3 ±4.9 years) treated with diet and on a stabile dose of oral anti-diabetic agents were given dietary advice by a dietitian for a 12 week period. Individualised dietary advice was based on Malaysian Medical Nutrition Therapy for adults with type 2 diabetes mellitus. The primary outcome measure was glycaemic control (fructosamine and HbA1c level) and the secondary outcome included measures of anthropometry, blood pressure, lipid profile, insulin levels dietary intake and knowledge on nutrition.
    RESULTS: At week 12, 100 subjects completed the study with a dropout rate of 3.8%. The post-Medical Nutrition Therapy results showed a significant reduction of fructosamine (311.5 ±50 to 297 ±44 umol/L; P< 0.001) and HbA1c (7.6 ±1.2 to 7.2 +1.1%, p<0.001) with pronounced reduction for subjects who had very high HbA1c levels of >9.3% at baseline. Waist circumference (90.7 ±10.2 to 89.1 ±9.8 cm, p<0.05), HDL-cholesterol (1.1 ±0.3 to 1.2 ±0.3 mmol/L, p<0.05), dietary intake and nutrition knowledge score (42 ±19 vs. 75 ±17%; p< 0.001) were significantly improved from the baseline.
    CONCLUSIONS: Individualised Medical Nutrition Therapy administered by a dietitian resulted in favourable diabetes outcomes, which were more apparent for individuals with higher than optimal HbA1c levels at the start of the study.
  3. Fulltext Glycaemic index of eight types of commercial rice in Malaysia
    Mohd Yusof BN, Abdul Talib R, Abdul Karim N
    Malays J Nutr, 2005;11(2):151-163.
    MyJurnal
    This experimental study was carried out to investigate the effect of eight types of commercial rice in Malaysia on blood glucose response and to determine their glycaemic index (GI) values. Ten healthy Malay volunteers (7 males, 3 females, BMI=23.6kgm-2, age=25.1years) participated in this study. The eight types of rice tested were three high fibre rice (HFR A, HFR B & HFR C), three white rice (WR D, WR E and WR F) and two fragrant rice (FR G and FR H). The subjects were required to go through the study protocol on eleven separate occasions (eight tests for the test rice samples and three repeated tests for the reference food) after an overnight fasting. Capillary blood samples were taken immediately before (0min) and 15, 30, 45, 60, 90 and 120min after consumption of the test foods. The blood glucose response was obtained by calculating the incremental area under the curve (iAUC). The GI was determined according to the standardised methodology. This study showed that out of eight types of rice tested, three (HFR B, WR E and WR F) could be categorised as having intermediate GI while the remaining five were considered high GI foods (HFR A, HFR C, WR D, FR G and FR H). The GI of HFR B (60 ± 5.8) and WR E (61 ± 5.8) were significantly lower than the reference food (glucose; GI=100) (p0.05). The GI value of the rice tested in descending order were HFR C, 87 ± 9.0 followed by HFR A (81 ± 6.7), FR G (80 ± 5.5), FR H (79 ± 7.6), WR D (72 ± 8.5), WR F (69 ± 8.3), WR E (61 ± 5.8) and HFR B (60 ± 5.8). There was no relationship between the dietary fibre content of the rice with the iAUC (r= -0.05, p=0.63) and GI values (r= -0.08, p=0.46). This shows that the GI values of the test rice were independent of the dietary fibre content of the rice. Other factors that may influence the GI value of rice include amylose content, gelatinisation process and botanical sources. The results of this study will provide useful information for dietitians and nutritionists in selecting the appropriate type of rice for the daily diet of diabetics.
  4. Prevalence and duration of reasons for enteral nutrition feeding interruption in a tertiary intensive care unit
    Lee ZY, Ibrahim NA, Mohd-Yusof BN
    Nutrition, 2018 09;53:26-33.
    PMID: 29627715 DOI: 10.1016/j.nut.2017.11.014
    OBJECTIVES: Intensive care unit (ICU) enteral nutrition (EN) can involve frequent feeding interruption (FI). The prevalence, causes, and duration of such interruption were investigated.

    METHODS: Reasons for EN FI identified from extensive literature review were prospectively collected in adult mechanically ventilated critically ill patients. Results were reported by descriptive statistics. Baseline and nutritional characteristics between patients who died and those alive at day 60 were compared.

    RESULTS: A total of 148 patients receiving ≥1 day of EN for the full 12-day observational period were included in the analysis. About 332 episodes of EN FI were recorded and contributed to 12.8% (4190 hours) of the total 1367 evaluable nutrition days. For each patient, FI occurred for a median of 3 days and the total duration of FI for the entire ICU stay was 24.5 hours. Median energy and protein deficits per patient due to FI for the entire ICU stay were -1780.23 kcal and -100.58 g, respectively. Duration of FI, days with FI, and the amount of energy and protein deficits due to FI were not different between patients who had died and those who were still alive at day 60 (all P > 0.05). About 72% of the total duration of EN FI was due to procedural-related and potentially avoidable causes (primarily human factors), while only about 20% was due to feeding intolerances.

    CONCLUSIONS: EN FI occurred primarily due to human factors, which may be minimized by adherence to an evidence-based feeding protocol as determined by a nutrition support team.

  5. Fulltext Overcoming Therapeutic Inertia as the Achilles' Heel for Improving Suboptimal Diabetes Care: An Integrative Review
    Chew BH, Mohd-Yusof BN, Lai PSM, Khunti K
    Endocrinol Metab (Seoul), 2023 Feb;38(1):34-42.
    PMID: 36792353 DOI: 10.3803/EnM.2022.1649
    The ultimate purpose of diabetes care is achieving the outcomes that patients regard as important throughout the life course. Despite advances in pharmaceuticals, nutraceuticals, psychoeducational programs, information technologies, and digital health, the levels of treatment target achievement in people with diabetes mellitus (DM) have remained suboptimal. This clinical care of people with DM is highly challenging, complex, costly, and confounded for patients, physicians, and healthcare systems. One key underlying problem is clinical inertia in general and therapeutic inertia (TI) in particular. TI refers to healthcare providers' failure to modify therapy appropriately when treatment goals are not met. TI therefore relates to the prescribing decisions made by healthcare professionals, such as doctors, nurses, and pharmacists. The known causes of TI include factors at the level of the physician (50%), patient (30%), and health system (20%). Although TI is often multifactorial, the literature suggests that 28% of strategies are targeted at multiple levels of causes, 38% at the patient level, 26% at the healthcare professional level, and only 8% at the healthcare system level. The most effective interventions against TI are shorter intervals until revisit appointments and empowering nurses, diabetes educators, and pharmacists to review treatments and modify prescriptions.
  6. Fulltext Bridging the gap between bariatric surgery and continuous multidisciplinary care
    Ahmad Zawawi M'F, Jahit MS, Mohd Yusof BN
    Malays Fam Physician, 2024;19:8.
    PMID: 38496771 DOI: 10.51866/lte.514
  7. Fulltext Obesity-related behaviors of Malaysian adolescents: a sample from Kajang district of Selangor state
    Rezali FW, Chin YS, Mohd Yusof BN
    Nutr Res Pract, 2012 Oct;6(5):458-65.
    PMID: 23198026 DOI: 10.4162/nrp.2012.6.5.458
    This study aims to determine the association between obesity-related behaviors (dietary practices, physical activity and body image) and body weight status among adolescents. A total of 382 adolescents (187 males and 195 females) aged 13 to 15 years in Kajang, Selangor participated in this study. Majority of the respondents were Malays (56.0%), followed by Chinese (30.1%) and Indians (13.9%). Dietary practices, physical activity and body image of the adolescents were assessed through the eating behaviors questionnaire, two-day dietary record, two-day physical activity record and multi-dimensional body image scale (MBIS), respectively. Body weight and height were measured by trained researchers. The prevalence of overweight and obesity (19.5%) was about twice the prevalence of underweight (10.5%). About two-thirds of the respondents (72.3%) skipped at least one meal and half of them (56.2%) snacked between meals with a mean energy intake of 1,641 ± 452 kcal/day. More than half of the respondents (56.8%) were practicing sedentary lifestyle with a mean energy expenditure of 1,631 ± 573 kcal per day. Energy intake (r = 0.153, P < 0.05), physical activity (r = 0.463, P < 0.01) and body image (r = 0.424, P < 0.01) were correlated with BMI. However, meal skipping, snacking and energy expenditure per kg body weight were not associated with body weight status. Multiple linear regression analysis showed that body image, physical activity and energy intake contributed significantly in explaining body weight status of the adolescents. In short, overweight and obesity were likely to be associated not only with energy intake and physical activity, but also body image. Hence, promoting healthy eating, active lifestyle and positive body image should be incorporated in future obesity prevention programmes in adolescents.
  8. Effect of perioperative immunonutrition intervention among gynecological cancer patients: A systematic review
    Ho C, Mohd Yusof BN, Abdul Majid H, Daud ZAM
    Clin Nutr ESPEN, 2024 Dec;64:168-176.
    PMID: 39362334 DOI: 10.1016/j.clnesp.2024.09.022
    BACKGROUND: Gynecologic cancer (GC) patients often experience systemic inflammation, malnutrition, and compromised postoperative outcomes. This systematic review aims to comprehensively synthesize existing data regarding the impact of perioperative immunonutrition (IMN) intervention on GC patients.

    METHODS: The databases of CENTRAL, EMBASE, Web of Science, and the Cochrane Library were used to conduct a literature search, supplemented by internet search engines and manual searches. Publications released between January 2009 and October 2023 was identified, reviewed, and data extracted.

    RESULTS: The review encompasses six studies involving 712 patients, comprising two randomized controlled trials (RCTs), two prospective studies, and two retrospective cohort studies. Three studies prescribed IMN perioperatively; two pre-operatively and one post-operatively. Four out of six studies reported less post-operative infection and complications. Two studies reported shorter hospitalization using the IMN formula. One study reported a longer hospitalization with IMN supplementation. Overall survival showed no significant difference in the two studies. Four studies reported positive modulation of inflammatory markers and lymphocytes as outcomes, with IMN formulas.

    DISCUSSION AND CONCLUSION: Perioperative IMN emerge as a promising intervention, demonstrating notable benefits included shortened hospitalization as well and positive modulation of inflammatory markers.

  9. Fulltext Effect of microbial cell preparation on renal profile and liver function among type 2 diabetics: a randomized controlled trial
    Firouzi S, Mohd-Yusof BN, Majid HA, Ismail A, Kamaruddin NA
    BMC Complement Altern Med, 2015;15:433.
    PMID: 26654906 DOI: 10.1186/s12906-015-0952-5
    The beneficial effect of probiotics on renal profile and liver function has been reported among patients with chronic kidney disease and fatty liver respectively. However, its effect on renal profile and liver function among type 2 diabetic individuals has not been fully understood. To investigate the effect of microbial cell preparation on renal profile and liver function tests among type 2 diabetic individuals.
  10. Chemical compositions and antioxidative and antidiabetic properties of underutilized vegetable palm hearts from Plectocomiopsis geminiflora and Eugeissona insignis
    Ahmad Aufa Z, Hassan FA, Ismail A, Mohd Yusof BN, Hamid M
    J Agric Food Chem, 2014 Mar 5;62(9):2077-84.
    PMID: 24499380 DOI: 10.1021/jf403481p
    Underutilized vegetables are currently studied not only for their nutrient values but also for their health-promoting components for protection against chronic diseases. The present study was performed to evaluate chemical compositions and antioxidant properties of underutilized vegetable palm hearts, namely, lalis (Plectocomiopsis geminiflora) and pantu (Eugeissona insignis). Additionally, the vegetable extracts were evaluated for their activities in the inhibition of digestive enzymes and effects on insulin secretion using BRIN BD11 pancreatic cell lines. Both vegetables contain valuable sources of dietary fiber, potassium, and zinc. For the first time, the phenolic compounds of the vegetables were identified and quantified using HPLC-DAD and LC-ESI-MS. Appreciable amounts of chlorogenic acid were found in the studied vegetables. The sample extracts exhibited potential antioxidant capacities through chemical and biological in vitro assays. High inhibition of α-amylase activity (>50%) was found from the extracts. Thus, it was suggested the vegetable consumption could fulfill the nutrient requirements among local communities.
  11. Weighing the evidence of low glycemic index dietary intervention for the management of gestational diabetes mellitus: an Asian perspective
    Mohd Yusof BN, Firouzi S, Mohd Shariff Z, Mustafa N, Mohamed Ismail NA, Kamaruddin NA
    Int J Food Sci Nutr, 2014 Mar;65(2):144-50.
    PMID: 24517860 DOI: 10.3109/09637486.2013.845652
    This review aims to evaluate the effectiveness of low glycemic index (GI) dietary intervention for the treatment of gestational diabetes mellitus (GDM), specifically from the Asian perspective. A systematic review of the literature using multiple databases without time restriction was conducted. Three studies were retrieved based upon a priori inclusion criteria. While there was a trend towards improvement, no significant differences were observed in overall glycemic control and pregnancy outcomes in GDM women. However, a tendency for lower birth weight and birth centile if the intervention began earlier was noted. Low GI diets were well accepted and had identical macro-micronutrient compositions as the control diets. However, due to genetic, environment and especially food pattern discrepancies between Western countries and Asians, these results may not be contributed to Asian context. Clearly, there are limited studies focusing on the effect of low GI dietary intervention in women with GDM, particularly in Asia.
  12. Effects of flaxseed consumption on systemic inflammation and serum lipid profile in hemodialysis patients with lipid abnormalities
    Khalatbari Soltani S, Jamaluddin R, Tabibi H, Mohd Yusof BN, Atabak S, Loh SP, et al.
    Hemodial Int, 2013 Apr;17(2):275-81.
    PMID: 22998533 DOI: 10.1111/j.1542-4758.2012.00754.x
    Inflammation and lipid abnormalities are two important risk factors for cardiovascular disease in hemodialysis (HD) patients. The present study was designed to investigate the effects of flaxseed consumption on systemic inflammation and serum lipid profile in HD patients with lipid abnormalities. This was an unblinded, randomized clinical trial. Thirty HD patients with dyslipidemia (triglyceride >200 mg/dL and/or high-density lipoprotein-cholesterol (HDL-C) <40 mg/dL) were randomly assigned to either a flaxseed or control group. Patients in the flaxseed group received 40 g/day ground flaxseed for 8 weeks, whereas patients in the control group received their usual diet, without any flaxseed. At baseline and at the end of week 8, 7 mL of blood was collected after a 12- to 14-hour fast and serum concentrations of triglyceride, total cholesterol, low-density lipoprotein-cholesterol (LDL-C), HDL-C, and C-reactive protein (CRP) were measured. Serum concentrations of triglyceride (P < 0.01), total cholesterol (P < 0.01), LDL-C (P < 0.01), and CRP (P < 0.05) decreased significantly in the flaxseed group at the end of week 8 compared with baseline, whereas serum HDL-C showed a significant increase (P < 0.01). These changes in the flaxseed group were significant in comparison with the control group. The study indicates that flaxseed consumption improves lipid abnormalities and reduces systemic inflammation in HD patients with lipid abnormalities.
  13. Dairy intake and type 2 diabetes risk factors: A narrative review
    Mitri J, Mohd Yusof BN, Maryniuk M, Schrager C, Hamdy O, Salsberg V
    Diabetes Metab Syndr, 2019 08 01;13(5):2879-2887.
    PMID: 31425952 DOI: 10.1016/j.dsx.2019.07.064
    AIM: The interest regarding the potential role of dairy products in the prevention of type 2 diabetes (T2D) has emerged. Although results remain mixed, numerous cohort studies have shown that increased dairy consumption is inversely associated with T2D risk. This narrative review evaluates the recent evidence of dairy products intake on T2D risk factors for the prevention of T2D.

    MATERIAL AND METHOD: The review is framed within the systematic review and meta-analyses of cohort studies and the individual randomized controlled trials evidence. We searched for existing meta-analyses of cohort studies that addressed the association of dairy intake with incidence of T2D in adults using the MEDLINE (via PubMed) database. For the interventional studies, the literature searched was conducted using MEDLINE (via PubMed) with the following Medical Subjects Heading (MeSH) terms i.e. dairy OR milk OR cheese OR yogurt AND glucose OR diabetes OR insulin resistance OR insulin sensitivity OR pre-diabetes.

    RESULTS: Most of the meta-analyses and systematic reviews of the cohort studies point to a reduced risk of T2D with dairy intake of 3 servings per day. This effect was mainly attributed to low-fat dairy, particularly yogurt and cheese. However, there is no evidence in cohort studies that high-fat dairy intake poses any harm.

    CONCLUSION: Dairy products, when incorporated into a healthy diet, likely do not have detrimental effects on glucose-related outcomes. The potential impact of dairy consumption on glucose tolerance tests, insulin levels, insulin sensitivity measures, and plasma glucose levels warrant future investigation.

  14. Fulltext Traditional and Novel Adiposity Indicators and Pancreatic Cancer Risk: Findings from the UK Women's Cohort Study
    Shyam S, Greenwood D, Mai CW, Tan SS, Mohd Yusof BN, Moy FM, et al.
    Cancers (Basel), 2021 Mar 02;13(5).
    PMID: 33801191 DOI: 10.3390/cancers13051036
    (1) Background: We studied the association of both conventional (BMI, waist and hip circumference and waist-hip ratio) and novel (UK clothing sizes) obesity indices with pancreatic cancer risk in the UK women's cohort study (UKWCS). (2) Methods: The UKWCS recruited 35,792 women from England, Wales and Scotland from 1995 to 1998. Cancer diagnosis and death information were obtained from the National Health Service (NHS) Central Register. Cox's proportional hazards regression was used to evaluate the association between baseline obesity indicators and pancreatic cancer risk. (3) Results: This analysis included 35,364 participants with a median follow-up of 19.3 years. During the 654,566 person-years follow up, there were 136 incident pancreatic cancer cases. After adjustments for age, smoking, education and physical activity, each centimetre increase in hip circumference (HR: 1.03, 95% CI: 1.01-1.05, p = 0.009) and each size increase in skirt size (HR: 1.12, 95% CI: 1.02-1.23, p = 0.041) at baseline increased pancreatic cancer risk. Baseline BMI became a significant predictor of pancreatic cancer risk (HR: 1.04, 95% CI: 1.00-1.08, p = 0.050) when latent pancreatic cancer cases were removed. Only baseline hip circumference was associated with pancreatic cancer risk (HR: 1.03, 95% CI: 1.00-1.05, p = 0.017) when participants with diabetes at baseline were excluded to control for reverse causality. (4) Conclusion: Hip circumference and skirt size were significant predictors of pancreatic cancer risk in the primary analysis. Thus, hip circumference is useful to assess body shape relationships. Additionally, standard skirt sizes offer an economical and objective alternative to conventional obesity indices for evaluating pancreatic cancer risk in women.
  15. Fulltext Impact of Diabetes-Specific Nutritional Formulas versus Oatmeal on Postprandial Glucose, Insulin, GLP-1 and Postprandial Lipidemia
    Mottalib A, Mohd-Yusof BN, Shehabeldin M, Pober DM, Mitri J, Hamdy O
    Nutrients, 2016 Jul 22;8(7).
    PMID: 27455318 DOI: 10.3390/nu8070443
    Diabetes-specific nutritional formulas (DSNFs) are frequently used as part of medical nutrition therapy for patients with diabetes. This study aims to evaluate postprandial (PP) effects of 2 DSNFs; Glucerna (GL) and Ultra Glucose Control (UGC) versus oatmeal (OM) on glucose, insulin, glucagon-like peptide-1 (GLP-1), free fatty acids (FFA) and triglycerides (TG). After an overnight fast, 22 overweight/obese patients with type 2 diabetes were given 200 kcal of each of the three meals on three separate days in random order. Blood samples were collected at baseline and at 30, 60, 90, 120, 180 and 240 min. Glucose area under the curve (AUC0-240) after GL and UGC was lower than OM (p < 0.001 for both). Insulin positive AUC0-120 after UGC was higher than after OM (p = 0.02). GLP-1 AUC0-120 and AUC0-240 after GL and UGC was higher than after OM (p < 0.001 for both). FFA and TG levels were not different between meals. Intake of DSNFs improves PP glucose for 4 h in comparison to oatmeal of similar caloric level. This is achieved by either direct stimulation of insulin secretion or indirectly by stimulating GLP-1 secretion. The difference between their effects is probably related to their unique blends of amino acids, carbohydrates and fat.
  16. Fulltext Effects of Cocoa Polyphenols and Dark Chocolate on Obese Adults: A Scoping Review
    Halib H, Ismail A, Mohd Yusof BN, Osakabe N, Mat Daud ZA
    Nutrients, 2020 Nov 30;12(12).
    PMID: 33266002 DOI: 10.3390/nu12123695
    Obesity remains a major public health problem due to its increasing prevalence. Natural products have become common as adjunct therapeutic agents for treating obesity and preventing metabolic diseases. Cocoa and its products are commonly consumed worldwide. Dark chocolate, a rich source of polyphenols, has received attention lately for its beneficial role in the management of obesity; however, conflicting results are still being reported. This scoping review aims to provide a comprehensive understanding of the existing literature on the relationship and effects of cocoa and dark chocolate intake among obese adults. We searched multiple databases for research investigating the consumption of cocoa and/or dark chocolate in managing obesity among adults. This review includes epidemiological and human studies that were published in English over the last 10 years. Our review of the current literature indicates that epidemiological and human trials with obese adults have shown inconsistent results, which may be due to the different populations of subjects, and different types of cocoa products and doses used for intervention. Studies among obese adults are mainly focusing on obese individuals with comorbidities, as such more studies are needed to elucidate the role of cocoa polyphenols in weight control and preventing the risk of chronic diseases among obese individuals without comorbidities as well as healthy individuals. Careful adjustment of confounding factors would be required. The effects of cocoa and dark chocolate intake on obese adults were discussed, and further research is warranted to identify the gaps.
  17. Factors associated with dietary glycemic index and glycemic load in pregnant women and risk for gestational diabetes mellitus
    Hasbullah FY, Mohd Yusof BN, Shariff ZM, Rejali Z, Yong HY, Mitri J
    Int J Food Sci Nutr, 2020 Jun;71(4):516-524.
    PMID: 31686557 DOI: 10.1080/09637486.2019.1686752
    The risk of gestational diabetes mellitus (GDM) increases during the second trimester of pregnancy. However, the role of dietary glycemic index (GI) and glycemic load (GL) on GDM risk is controversial. We aimed to determine the association of established risk factors of GDM with GI and GL among healthy pregnant women, and whether GI and GL were subsequently related to GDM risk. Dietary GI and GL were assessed in healthy pregnant women from the Seremban Cohort Study using a food frequency questionnaire. After adjusting for energy intake, high GI was significantly associated with lower household income, shorter stature, higher proportion of carbohydrate intake, lower sugar proportion and lower fibre intake. High GL was significantly associated with younger maternal age, higher carbohydrate proportion and lower fibre intake. GI and GL intakes were not significantly associated with GDM risk. However, they were associated with a few established risk factors of GDM.
  18. Fulltext Currents Nutritional Practices of Nutritionists in the Management of Type 2 Diabetes Patients at Public Health Centres in Padang, Indonesia
    Puri IY, Mohd Yusof BN, Abu Zaid Z, Ismail A, Haron H, Lipoeto NI
    Nutrients, 2021 Jun 08;13(6).
    PMID: 34201355 DOI: 10.3390/nu13061975
    (1) Background: The interest in nutrition practices and education is slowly gaining traction among Indonesian nutritionists. However, there is a lack of local studies that evaluate nutritional practices, especially in the management of type 2 diabetes (T2DM). This cross-sectional study aimed to determine the nutritional practices among nutritionists and the adequacy of the current practices in the management of Type 2 Diabetes Mellitus (T2DM) patients at the Public Health Clinic in Padang (PHC), Indonesia. (2) Methods: An online survey form was distributed to all the nutritionists (n = 50) involved in the management of T2DM patients in their daily practices at the PHC. Socio-demographic characteristics, the current practice of T2DM, the need for DM nutrition education, and an evaluation questionnaire on the Indonesian Non-Communicable Diseases guideline and the Public Health Centre guideline were captured in the survey. (3) Result: A total of 48 completed survey forms were received, providing a response rate of 96% from the recruited nutritionists. One-third (37.5%) of the respondents counselled between one and ten patients per day. Nearly half (41.7%) conducted a monthly follow-up session for the patients at their respective PHC in the previous three months. Each nutritionist educated five to ten T2DM patients. The most common nutrition education topics delivered included appropriate menus (89.6%) as well as the etiology and symptoms of T2DM (85.5%). Almost all the nutritionists (93.8%) used leaflets and about 35.4% used poster education. Around 70.8% of counseling sessions lasted 30 min and two-thirds (66.7%) of the sessions included nutrition education. Based on the results, about half (52.1%) of them claimed that T2DM patients were reluctant to attend individual nutrition education. One-fifth of them (20.8%) claimed that it was because the T2DM patients were not interested in the tool kits and materials used. (4) Conclusions: T2DM patients are reluctant to attend individual nutrition education due to uninteresting tool kits and materials.
  19. Protective effects of saffron extract and crocin supplementation on fatty liver tissue of high-fat diet-induced obese rats
    Mashmoul M, Azlan A, Mohtarrudin N, Mohd Yusof BN, Khaza'ai H, Khoo HE, et al.
    BMC Complement Altern Med, 2016 Oct 22;16(1):401.
    PMID: 27770798
    Saffron is the dried stigma of Crocus sativus L. flower which commonly used as a natural remedy to enhance health and even fights disease in the Middle-East and Southeast Asian countries.
  20. Fulltext Effects of nutrition therapy on HbA1c and cardiovascular disease risk factors in overweight and obese patients with type 2 diabetes
    Mottalib A, Salsberg V, Mohd-Yusof BN, Mohamed W, Carolan P, Pober DM, et al.
    Nutr J, 2018 04 07;17(1):42.
    PMID: 29626933 DOI: 10.1186/s12937-018-0351-0
    BACKGROUND: Nutrition Therapy (NT) is essential in type 2 diabetes (T2D) management. Standards of care recommend that each patient engages with a nutritionist (RDN) to develop an individualized eating plan. However, it is unclear if it is the most efficient method of NT. This study evaluates the effects of three different methods of NT on HbA1c and cardiovascular disease risk factors in overweight and obese patients with T2D.

    METHODS: We randomized 108 overweight and obese patients with T2D (46 M/62F; age 60 ± 10 years; HbA1c 8.07 ± 1.05%; weight 101.4 ± 21.1 kg and BMI 35.2 ± 7.7 kg/m2) into three groups. Group A met with RDN to develop an individualized eating plan. Group B met with RDN and followed a structured meal plan. Group C did similar to group B and received weekly phone support by RDN.

    RESULTS: After 16 weeks, all three groups had a significant reduction of their energy intake compared to baseline. HbA1c did not change from baseline in group A, but decreased significantly in groups B (- 0.66%, 95% CI -1.03 to - 0.30) and C (- 0.61%, 95% CI -1.0 to - 0.23) (p value for difference among groups over time 

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