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  1. Mustafa SE, Mustafa S, Abas F, Manap MYABD, Ismail A, Amid M, et al.
    Food Chem, 2019 Apr 25;278:767-772.
    PMID: 30583440 DOI: 10.1016/j.foodchem.2018.11.107
    This study analyzed the effect of pH (X1), temperature (X2) and inulin amount (X3) on transformation of isoflavones (daidzin and daidzein) to equol in soymilk fermented with Bifidobacterium spp. All responses significantly (p  0.05) difference between the experimental and predicted values, suggested the suitability of established models in explaining the daidzin and daidzein transformation to equol as a function of pH, temperature and inulin.
  2. Yusof ZYM, Anwar NH, Mohd Nor NA, Nor MM, Mustafa SE
    Trials, 2021 Feb 22;22(1):156.
    PMID: 33618735 DOI: 10.1186/s13063-021-05111-0
    BACKGROUND: Despite the implementation of the preschool oral healthcare programme (POHP) for 5-6-year-old children over the past 3 decades in Malaysia, dental plaque and caries levels in this age group remain high. Among the child-level attributable factors are unhealthy self-care behaviours (poor oral hygiene and high sugary diet). In order to improve the children's oral health, an improved programme called the 'Senyuman Indah Milik Semua' Programme (SIMSP) or 'Beautiful Smile for All' programme is introduced. In this programme, a triad of dental hygienist-teacher-parent works together to improve children's oral hygiene levels compared with the existing POHP that involves dental hygienists only. The aim of this study is to compare the effect of the SIMSP versus the existing POHP on oral hygiene levels of 5-6-year-old children in the Kampar district, Perak state, Malaysia.

    METHODS: This study is a pragmatic, cluster-randomised, parallel-group, matched pair, controlled trial with blinded outcome assessment. Randomisation is performed using a computer-generated table with a 1:1 allocation comparing the SIMSP and the POHP involving 28 preschools in the Kampar district, Perak, Malaysia. The intervention consists of preschool visits by a group of dental therapists, in-class oral health lessons and daily toothbrushing conducted by class teacher, child home toothbrushing supervised by parents, and infographic oral health messages to parents. The control consists of the existing POHP that involves preschool visits by a group of dental therapists only. The trial lasts for 6 months. Primary outcome variable is the mean plaque score change after 6 months. To determine the feasibility of the SIMSP, a process evaluation will be conducted using the perspectives of dental therapists, teachers, and parents on the appropriateness, effectiveness, facilitators, and barriers to the SIMSP implementation as well as an audit trail to assess the trial intervention.

    DISCUSSION: Cluster randomisation may lead to a random effect and cluster selection bias. These factors will be accounted for when analysing the data and interpreting the outcomes. The effectiveness of the SIMSP will be evaluated by comparing the results with those of the POHP.

    TRIAL REGISTRATION: ClinicalTrials.gov NCT04339647 . Registered on 5 April 2020 - Retrospectively registered.

  3. Mustafa SE, Mustafa S, Ismail A, Abas F, Abd Manap MY, Ahmed Hamdi OA, et al.
    Heliyon, 2020 Oct;6(10):e05298.
    PMID: 33134584 DOI: 10.1016/j.heliyon.2020.e05298
    The influence of commercial prebiotics (fructo-oligosaccharides and inulin) and sugars (glucose and sucrose) on enhancing equol production from soymilk isoflavones by Bifidobacterium longum BB536 and Bifidobacterium breve ATCC 15700 was evaluated in vitro. Sterilized soymilk was inoculated with each bacterial species at 37 °C for 48 h. The growth and β-glucosidase enzyme activity for the two Bifidobacterium species in soymilk throughout fermentation were assessed. The highest viable count for B. breve (8.75 log CFU/ml) was reached at 36 h and for B. longum (8.55 log CFU/ml) at 24 h. Both bacterial species displayed β-glucosidase activity. B. breve showed increased enzyme activity (4.126 U) at 36 h, while B. longum exhibited maximum activity (3.935 U) at 24 h of fermentation. Among the prebiotics screened for their effect in isoflavones transformation to equol, inulin delivered the highest effect on equol production. The co-culture of B. longum BB536 and B. breve ATCC15700 in soymilk supplemented with inulin produced the highest level (11.49 mmol/l) of equol at 48 h of fermentation process. Level of daidzin declined whereas that of daidzein increased, and then gradually decreased due to formation of equol when soymilk was fermented using bifidobacterial. This suggests that the nutritional value of soymilk may be increased by increasing bioavailability of the bioactive ingredients. Collectively these data identify probiotics and prebiotic combinations suitable for inclusion in soymilk to enhance equol production.
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