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Fulltext Physical Activity, Sedentary Behavior, and Weight Status of University Students during the COVID-19 Lockdown: A Cross-National Comparative Study

Tan ST, Tan CX, Tan SS

Int J Environ Res Public Health, 2021 07 03;18(13).
PMID: 34281062 DOI: 10.3390/ijerph18137125

The temporary closure of learning institutions during the COVID-19 pandemic has dramatically reduced the physical activity of students across all ages. Therefore, this study aimed to investigate the prevalence of physical inactivity and the patterns of physical activity among university students in confinement. This cross-sectional study involved 147 Malaysian students and 107 Indonesian students. Body weight before the pandemic and during the pandemic was self-reported by the respondents, and the International Physical Activity Questionnaire-Short Form (IPAQ-SF) was used to assess the physical activity and sedentary behavior of the respondents. The findings revealed that 79.6% of Malaysians and 77.6% of Indonesians were physically active during the confinement. There was no significant difference (p < 0.05) in the duration devoted to vigorous-intensity activity (MMalaysian = 0.00 MET minutes/week and MIndonesian = 480.00 MET minutes/week) and moderate-intensity activity (MMalaysian = 0.00 MET minutes/week and MIndonesian = 0.00 MET minutes/week) among the studied population. During the pandemic, Malaysian students (M = 1386.00 MET minutes/week) devoted a significantly higher duration to walking (M = 1386.00 MET minutes/week) and sedentary behavior (9.16 ± 4.47 h/day) than Indonesian students (M = 990.00 MET minutes/week and sedentary behavior = 7.85 ± 4.27 h/day). Overall, no significant difference was noted in the total physical activity of Malaysian and Indonesian students during the pandemic (MMalaysian = 2826.00 MET minutes/week and MIndonesian = 1782.00 MET minutes/week). Findings from Spearman's rank correlation test suggested that there was a weak inverse correlation between the duration engaged in vigorous-intensity activity and weight change among the Malaysian students (rs = -0.199, p = 0.016), after adjusting for gender and age. Overall, the closure of learning institutions and exercise facilities has further prevented individuals from complying with the WHO recommendation of moderate-to-vigorous physical activity during the period of home confinement.
Fulltext Trajectories of Food Choice Motives and Weight Status of Malaysian Youths during the COVID-19 Pandemic

Tan ST, Tan CX, Tan SS

Nutrients, 2021 Oct 23;13(11).
PMID: 34836008 DOI: 10.3390/nu13113752

Stay-at-home orders have abruptly altered food purchasing behaviour, dietary habits, and food choice motives. Therefore, this study aims to investigate the trajectory of food choice motives and their associations with the weight status of Malaysian youths in the time of COVID-19. Socio-demographic information and anthropometric measurements were self-reported by the respondents, while the food choice motives were assessed using a validated 38-item food choice questionnaire (FCQ). Of the 1013 Malaysian youths, 48.6% gained weight due to the confinement, with an average weight gain of 3.90 ± 2.92 kg. On the other hand, 47.0% to 73.0% of the youths changed their food choice motives in the time of COVID-19. Of the 10 motives, convenience (48.5%) had the largest percentage increase, followed by weight control (47.0%) and health (45.3%). Moreover, the mean scores of health (t = -3.324, p = 0.001), convenience (t = -5.869, p < 0.001), weight control (t = -7.532, p < 0.001), natural content (t = -5.957, p < 0.001), ethical concern (t = -4.419, p < 0.001) and price (t = -3.737, p < 0.001) were significantly higher during the pandemic compared to pre-pandemic. Findings from the multinomial regression model revealed that youths highly concerned for weight control were more likely to be in the weight loss category (Adjusted odds ratio (AOR) = 1.633, Confidence Interval (CI) = 1.230-2.168, p = 0.001). Conversely, those who gained weight due to the pandemic confinement highly valued natural content in foods (AOR = 0.653, CI = 0.481-0.886, p = 0.006) when making their food choices in this unprecedented pandemic. In conclusion, Malaysian youths made healthier food choices to mitigate the risk of COVID-19 infection.
Fulltext Effects of Sonication and Thermal Pasteurization on the Nutritional, Antioxidant, and Microbial Properties of Noni Juice

Choo YX, Teh LK, Tan CX

Molecules, 2022 Dec 30;28(1).
PMID: 36615507 DOI: 10.3390/molecules28010313

Sonication is recognized as a potential food processing method to improve the functional properties of fruit juice. This study evaluated the effects of different sonication durations (20, 40, and 60 min) and thermal pasteurization on the nutritional, antioxidant, and microbial properties of noni juice. Fresh noni juice served as the control. The main organic acids detected were malic (57.54−89.31 mg/100 mL) and ascorbic (17.15−31.55 mg/100 mL) acids. Compared with the fresh sample, the concentrations of these compounds were significantly improved (p < 0.05) in the 60 min sonicated sample but reduced (p < 0.05) in the pasteurized sample. Moreover, sonication for 60 min resulted in increments of scopoletin, rutin, and vanillic acid compared to the fresh sample. The antioxidant activity of the juice sample was improved in the sample sonicated for 60 min. Irrespective of juice processing method, the level of microbial counts in noni juice was within the satisfactory level over the 8 weeks of refrigerated (4 °C) storage. This study highlights the feasibility of using ultrasound processing to enhance the quality of noni juice on the industrial scale.
Food insecurity, eating behaviour, and relative weight change among young adults in the aftermath of the COVID-19 lockdown

Tan ST, Tan CX, Tan SS

Psychol Health Med, 2024 Aug;29(7):1362-1374.
PMID: 38200665 DOI: 10.1080/13548506.2023.2301226

This study aims to investigate the association between food insecurity, eating behaviour and relative weight change among Malaysian young adults in the aftermath of the pandemic-led lockdown. Socio-demographics, body height, and body weight were self-reported by the young adults. Food security was assessed using the 8-item validated Food Insecurity Experience Scale (FIES), while the Three-Factor Eating Questionnaire-Revised 18-item (TFEQ-R18) was adopted to evaluate the eating behaviour of young adults. Of the 447, 45.9% maintained the same body weight as before the pandemic-led lockdown. While almost half of the young adults (47.2%) were food secure, about one-fourth (24.8%) suffered moderate-to-severe food insecurity. Meanwhile, the standardised raw scores for all the eating behaviour subscales were in the ascending order of cognitive restraint (49.37 ± 18.60) 0.05), suggesting that eating behaviour (cognitive restraint, uncontrolled eating and emotional eating) did not mediate the relationship between moderate-to-severe food insecurity and relative weight change. Health promotion interventions such as introducing food assistance programs, offering incentives for nutritious food purchases, and re-emphasising healthy eating are essential to rectify food insecurity and disordered eating among Malaysians.
Fulltext Food security during the COVID-19 home confinement: A cross-sectional study focusing on adults in Malaysia

Tan ST, Tan CX, Tan SS

Hum Nutr Metab, 2022 Mar;27:200142.
PMID: 38620934 DOI: 10.1016/j.hnm.2022.200142

The surge in coronavirus disease 2019 (COVID-19) transmission cases has led to the decision to execute the Movement Control Order (MCO) by the Federal Government of MalaysiaEconomic activities, psychological wellbeing, and food security may be negatively affected by the implementation of MCO. Therefore, this study aims to assess the prevalence of food insecurity and its associated factors during the enforcement of MCO 1.0. A total of 162 respondents were enrolled in this study using convenience and snowball sampling approaches. Socio-demographic information was self-reported by the respondents. Food security and the presence of depressive symptoms during the MCO 1.0 were assessed with Food Insecurity Experience Scale (FIES) and Patient Health Questionnaire-2 (PHQ-2), respectively. Current findings demonstrated that the prevalence of food insecurity was 43.2%. Ethnicity, marital status, employment status, monthly earned income and being the head of a household were significantly associated (p
Effect of virgin avocado oil on diet-induced hypercholesterolemia in rats via 1 H NMR-based metabolomics approach

Tan CX, Chong GH, Hamzah H, Ghazali HM

Phytother Res, 2018 Nov;32(11):2264-2274.
PMID: 30051518 DOI: 10.1002/ptr.6164

Hypercholesterolemia is a major risk factor for the initiation and development of nonalcoholic fatty liver disease and atherosclerosis. The present study evaluated the hypocholesterolemic effect of virgin avocado oil (VAO) using urinary metabolomic method. Male Sprague-Dawley rats were fed high-cholesterol diet for four weeks to induce hypercholesterolemia. After confirming the establishment of hypercholesterolemia model, the VAO (450 and 900 mg·kg-1 ·day-1 ) and simvastatin (10 mg·kg-1 ·day-1 ) were given orally while maintaining the high-cholesterol diet for another four weeks. Assessment of urinary metabolomics using NMR revealed that VAO treatment could partially recover the metabolism dysfunction induced by hypercholesterolemia mainly via lipid, energy, amino acid, and gut microbiota metabolism.
Fulltext Eating Behaviors among Online Learning Undergraduates during the COVID-19 Pandemic

Pung CYY, Tan ST, Tan SS, Tan CX

Int J Environ Res Public Health, 2021 12 05;18(23).
PMID: 34886546 DOI: 10.3390/ijerph182312820

The outbreak of Coronavirus Disease-2019 (COVID-19) has upended education systems. The pandemic switched traditional face-to-face classes to online classes. Poor eating behaviors in undergraduate students' lives may affect the well-being of their later stages of life. This study aimed to investigate the eating behaviors among online learning undergraduates during the COVID-19 pandemic. A total of 122 students were recruited. The results revealed more than half of the respondents (52.46%) skipped meals. Breakfast (46.72%) was the most skipped meal. The majority of the respondents (94.26%) snacked between meals. Biscuits (88.52%), bread (84.43%), and fruits (80.33%) were the most common snacked foods. Meal skipping was found to be associated with gender (χ2 = 6.83, p < 0.05). In the future, more health interventions program aimed to promote healthy eating behaviors among undergraduates are highly warranted.
Globus pharyngeus due to a lymphangiomatous polyp arising from the tonsil

Tan CX, Yeo SW, Wong YP, Tan GC

Malays J Pathol, 2023 Aug;45(2):271-273.
PMID: 37658536

INTRODUCTION: Lymphangiomatous polyp of the tonsil is generally accepted as a hamartomatous lesion. Its differential diagnosis includes fibroepithelial polyp, squamous papilloma, angiofibroma, haemangioma, arteriovenous malformation, hamartoma and lymphangioma.
CASE REPORT: A 33-year-old man presented with 2 months history of feeling of foreign body sensation in the throat. Examination revealed a nodular red coloured polyp on the left tonsil. Histologically, the polyp was covered by squamous epithelium and is composed of numerous vascular channels containing lymphocytes and eosinophilic material, in a fibrous stroma. Immunohistochemically, the endothelial cells were positive toward CD31 and D2-40.
DISCUSSION: The characteristic histological features of a lymphangiomatous polyp are benign vascular proliferation with variable fibrous, adipose and lymphoid stromal components. Nested intraepithelial epidermotropism of lymphocytes can be observed. The vascular channels are typically thin-walled and contain eosinophilic proteinaceous material and lymphocytes. There is no reported incidence of recurrent or malignant transformation.
High-dose pulse methylprednisolone vs. dexamethasone standard therapy for severe and critical COVID-19 pneumonia: Efficacy assessment in a retrospective single-centre experience from Malaysia

Soo CI, Poon KV, Ayub A, You HW, Tan CX, Loh KJJ, et al.

Med J Malaysia, 2024 Jan;79(1):15-20.
PMID: 38287752

INTRODUCTION: The use of dexamethasone (DXM) has been associated with decreased mortality in the patients with hypoxemia during the coronavirus disease-2019 (COVID-19) pandemic, while the outcomes with methylprednisolone (MTP) have been mixed. This real-life study aimed to evaluate the outcomes of patients with severe respiratory failure due to COVID-19 who were treated with high doses of MTP.
MATERIALS AND METHODS: This retrospective cohort study enrolled hospitalised patients between May 2021 and August 2021, aged 18 years and above, with severe respiratory failure defined by a ratio of oxygen saturation to fraction of inspired oxygen (SF ratio) of less than 235. The treatment protocol involved administering high-dose MTP for 3 days, followed by DXM, and the outcomes were compared with those of patients who received DXM alone (total treatment duration of 10 days for both groups).
RESULTS: A total of 99 patients were enrolled, with 79 (79.8%) receiving pulse MTP therapy and 20 (20.2%) being treated with DXM only. The SF ratio significantly improved from a mean of 144.49 (±45.16) at baseline to 208 (±85.19) at 72 hours (p < 0.05), with a mean difference of 63.51 (p < 0.001) in patients who received ≤750 mg of MTP. Additionally, in patients who received >750 mg of MTP, the SF ratio improved from a baseline mean of 130.39 (±34.53) to 208.44 (±86.61) at 72 hours (p < 0.05), with a mean difference of 78.05 (p = 0.001). In contrast, patients who received DXM only demonstrated an SF ratio of 132.85 (±44.1) at baseline, which changed minimally to 133.35 (±44.4) at 72 hours (p = 0.33), with a mean difference of 0.50 (p = 0.972). The incidence of nosocomial infection was higher in the MTP group compared with the DXM group (40.5% vs. 35%, p = 0.653), with a relative risk of 1.16 (95% CI: 0.60-2.23).
CONCLUSION: MTP did not demonstrate a significant reduction in intubation or intensive care unit admissions. Although a high dose of MTP improved gas exchange in patients with severe and critical COVID-19, it did not provide an overall mortality benefit compared to standard treatment.