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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.
Association Between Body Mass Index and Cardiometabolic Risks Among Malay Obese Adults

Daud A, Shahadan SZ

Clin Nurs Res, 2019 02;28(2):202-216.
PMID: 28782381 DOI: 10.1177/1054773817724041

Cardiometabolic risk (CMR) is a cluster of risk factors that may predict the occurrence of cardiovascular diseases and diabetes mellitus. This study investigated the association between CMR with body mass index (BMI) among obese adults. The CMRs, including waist circumference, systolic and diastolic blood pressure, blood glucose, total cholesterol, low-density and high-density lipoprotein, triglyceride, and high-sensitivity C-reactive protein (hs-CRP) level, were quantified in 82 obese adults. The findings indicate the highest correlation coefficient value ( r) was .618 between BMI and waist circumference; a weak correlation between mass index and systolic ( r = .276) and diastolic ( r = .311) blood pressure and hs-CRP ( r = .384); and a very weak correlation between BMI level and fasting blood glucose ( r = .069), total cholesterol ( r = .014), low-density lipoprotein (.013), high-density lipoprotein (-.154), and triglyceride (.173). Future strategies for CMR reduction among obese adults should focus on waist circumference and hs-CRP level.
Association between sitting time and high-sensitivity C-reactive protein level among obese women

Daud A, Jamal AF, Shahadan SZ

Enferm Clin, 2021 04;31 Suppl 2:S139-S142.
PMID: 33849148 DOI: 10.1016/j.enfcli.2020.12.009

The objective of this study was to determine the time spent on sitting per day, level of serum High sensitivity C-reactive protein (hs-CRP), and the association between sitting time and level of serum hs-CRP among obese women. A descriptive cross-sectional study was conducted. Sixty eight (68) obese women were recruited. They were signed informed consent form prior to the questionnaire answered. Then, sample blood test was taken to check for hs-CRP level. Sitting time spent in hours was found to be not significantly associated with hs-CRP level (p=0.391) among obese women. Longer sitting time spent per day more than 4h is the factor of obesity and hs-CRP level will be higher in obese women compared to normal people. This study can be baseline data for healthcare professionals and may contribute to develop awareness platform on maintaining normal body mass index among women.
Association between walking time spent and high sensitivity C-reactive protein level among obese women

Daud A, Sedek SSHAB, Shahadan SZ

Enferm Clin, 2019 09;29 Suppl 2:96-100.
PMID: 31248730 DOI: 10.1016/j.enfcli.2019.04.015

OBJECTIVE: This study aims to assess the association between the walking time spent and high sensitivity C-reactive protein (hs-CRP) level to determine the risk for cardiovascular disease (CVD) among obese women.
METHODS: Cross-sectional study was conducted in Kuantan, Pahang. The purposive sampling method was chosen. 76 obese women aged 18 years old and above were included in the study. Data were collected by using the set of the self-reported questionnaire consisted of socio-demographic and the walking time for the past 7 days. The sample blood test was taken to check for hs-CRP level.
RESULTS: Walking time spent in minutes was found to be significantly inverse associated with the hs-CRP level (p=0.040) among obese women.
CONCLUSION: The increase in walking time spent can help reduce the hs-CRP level, therefore reduce the risk for CVD.
Fulltext Physical Activity Interventions for Postnatal Weight Management: A Systematic Literature Review

Shahadan SZ, Rahman SJA, Mohamad Ismail MF, Risdiana N

Malays J Med Sci, 2023 Dec;30(6):45-53.
PMID: 38239246 DOI: 10.21315/mjms2023.30.6.5

Physical activity (PA) maintains weight and reduces postnatal weight retention (PWR), thereby lowering obesity-related comorbidities. There is only limited evidence on the most effective postnatal PA for Malaysian women. This review identified evidence-based literature on the effectiveness of PA interventions in managing weight in postnatal women and the preferred type of intervention for them. A systematic literature search was conducted following the preferred reporting items for systematic reviews and meta-analyses guidelines. Randomised controlled trials and quasi-experimental research related to PA interventions for women during the postnatal period (18 months after delivery) published in English from 2011 to 2021 were searched in ProQuest, Scopus, Springer Link and PubMed using the following keywords: 'physical activity', 'weight management' and 'postnatal women'. Intervention groups with weight and body mass index measured after any supervised PA guidance/counselling with a minimum follow-up of 10 weeks were included in the analysis. Those with pharmacological management and a comparator control group were excluded. A total of six articles met the inclusion criteria. Using the revised Cochrane risk of bias tool for randomised trials, one of these articles was classified as low-risk, two as having some concerns and three as having a high risk of bias. Walking, yoga and Pilates were found to be the most appropriate and preferred types of physical activity, despite having a small but significant impact on postnatal women's weight management. Healthcare professionals should adopt programmes that explicitly target these PA interventions to manage PWR.
Learning styles of Malaysian Generation 'Y' healthcare undergraduates

Nurumal MS, Salahuddin MA, Daud A, Shahadan SZ, Abdul-Mumin K, Shorey S

Enferm Clin, 2019 09;29 Suppl 2:471-475.
PMID: 31350157 DOI: 10.1016/j.enfcli.2019.04.070

OBJECTIVE: The learning styles of millennial students, also known as Generation 'Y', have been examined in the past to match the teaching style of an educator with the aim of improving behaviors, attitudes, and academic achievements. However, focus on Generation 'Y' healthcare undergraduates from a multi-cultural Asian society, is scarce and fragmented. Therefore, this research aims to identify the learning style preferences of Generation 'Y' undergraduates enrolled in varied healthcare programs at a Malaysian University.
METHOD: A quantitative cross-sectional study design was adopted. Honey and Mumford's Learning Style Questionnaire was used to explore the learning styles.
RESULTS: The reflector learning style was most preferred by the Malaysian healthcare undergraduates, and no significant difference was found between the learning styles of the clinical group and the semi-clinical group.
CONCLUSIONS: Educators should engage Malaysian healthcare undergraduates in a non-threatening environment - Association between learning style and sociodemographic warrants further investigation.
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.