MJN 2017 Issues
Malaysian Journal of Nutrition
Volume 23 No.1, 2017
Table of Content
INVITED REVIEW
Food Fortification in Indonesia
Soekirman & Idrus Jus'at
ABSTRACT
The paper highlights the history, policy, programs of food fortification intervention and its impact on reducing micronutrient deficiency, especially iodine deficiency disorders (IDD), iron deficiency anaemia (IDA), and vitamin A deficiency (VAD) in Indonesia. General issues in the management of food fortification, and lessons learned from the Indonesian experience are discussed in this paper.
Keywords : Cooking oil fortification, mandated fortification, micronutrient deficiency, salt iodisation, wheat flour fortification
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The paper highlights the history, policy, programs of food fortification intervention and its impact on reducing micronutrient deficiency, especially iodine deficiency disorders (IDD), iron deficiency anaemia (IDA), and vitamin A deficiency (VAD) in Indonesia. General issues in the management of food fortification, and lessons learned from the Indonesian experience are discussed in this paper.
Keywords : Cooking oil fortification, mandated fortification, micronutrient deficiency, salt iodisation, wheat flour fortification
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NUTRITIONAL STATUS, DIETRY INTAKE AND BODY COMPOSITION
Determinants of Zinc Status of 2-3-Year-Old Children in Laguna, Philippines
Rodesa T Naupal-Forcadilla, Corazon VC Barba, Maria Theresa M. Talavera & Marison R Dy
ABSTRACT
Introduction: Zinc deficiency has been considered a micronutrient problem of high magnitude in the Philippines. The effect of zinc deficiency on physical growth manifests during the first two years of life and is associated with high rates of infection and inadequate nutrition. The study aims to assess the zinc status of children and identify factors that affect zinc status.
Methods: A multi-stage stratified random sampling was used in a cross-sectional study of 2 -3-year-old children currently residing in the province of Laguna, Philippines. Data were collected through a structured questionnaire. A 24-hour food recall data sheet was used for evaluation of food intake. The physical dimensions of children were measured using salter weighing scale and height board. A static biochemical test of nutrients in the blood was carried out to assess the level of zinc and presence of infection in the body. The Early Childhood Care and Development program checklist, Metro Manila Developmental Screening Test and Child Development Index were adapted to determine the level of cognitive development of children.
Results: Correlation analysis revealed that anthropometric indices and food intake had a significant and positive linear association with zinc status (energy r=.014; P=.000; protein r=.027; P=.000; zinc r=.044; P=.000; iron r=.070; P=.000). The presence of infection was found to have a negative but significant relationship with zinc status. Zinc status was significantly associated with cognitive development.
Conclusion: The study showed that determinants of zinc status are nutrient intake (such as energy and zinc), infection, height-for-age index and cognitive development.
Key words: Associated factors, cognitive development, height-for-age, infection, zinc status
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Introduction: Zinc deficiency has been considered a micronutrient problem of high magnitude in the Philippines. The effect of zinc deficiency on physical growth manifests during the first two years of life and is associated with high rates of infection and inadequate nutrition. The study aims to assess the zinc status of children and identify factors that affect zinc status.
Methods: A multi-stage stratified random sampling was used in a cross-sectional study of 2 -3-year-old children currently residing in the province of Laguna, Philippines. Data were collected through a structured questionnaire. A 24-hour food recall data sheet was used for evaluation of food intake. The physical dimensions of children were measured using salter weighing scale and height board. A static biochemical test of nutrients in the blood was carried out to assess the level of zinc and presence of infection in the body. The Early Childhood Care and Development program checklist, Metro Manila Developmental Screening Test and Child Development Index were adapted to determine the level of cognitive development of children.
Results: Correlation analysis revealed that anthropometric indices and food intake had a significant and positive linear association with zinc status (energy r=.014; P=.000; protein r=.027; P=.000; zinc r=.044; P=.000; iron r=.070; P=.000). The presence of infection was found to have a negative but significant relationship with zinc status. Zinc status was significantly associated with cognitive development.
Conclusion: The study showed that determinants of zinc status are nutrient intake (such as energy and zinc), infection, height-for-age index and cognitive development.
Key words: Associated factors, cognitive development, height-for-age, infection, zinc status
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Nutrition Knowledge, Attitude and Practices (NKAP) and Health-Related Quality of Life (HRQOL) Status among Overweight and Obese Children: An Analysis of Baseline Data from the Interactive Multimedia-based Nutrition Education Package(IMNEP) study.
Wan Putri Elena Wan Dali, Hamid Jan JanMohamed & HafzanYusoff
ABSTRACT
Introduction: This randomised school-based controlled study aimed to evaluate the baseline results of nutrition knowledge, attitude, and practice (NKAP), health-related quality of life (HRQoL), and parents’ report of parenting skills (PRPS) among overweight and obese children.
Methods: This study was performed on three intervention groups and one control group. It was conducted among Year Five students from primary schools who had overweight or obese status and were generally healthy without any chronic diseases. The children completed NKAP and child self-report of Pediatric Quality of Life (PedsQoL) questionnaires, while parents completed parent proxy report of PedsQoL and PRPS questionnaires. Descriptive statistics and parametric test in SPSS were utilised.
Results: Out of 139 participants involved in the baseline study, 18.7% and 81.3% were overweight and obese respectively. This study revealed a significantly higher knowledge score among boys (p = 0.016) and among those who lived in urban areas (p = 0.019). The children’s self-report PedsQoL recorded highest score for Social Functioning domain and lowest score for Emotional Functioning domain. A contradictory finding was obtained from the parent proxy report, where the Physical Functioning domain scored the lowest and the Emotional Functioning domain had the highest score. Notably, some of the findings from PRPS questionnaires completed by their parents were unfavourable.
Conclusion: This study provided prospective evidence of the current status of NKAP, HRQoL among overweight and obese children as well as findings from PRPS among their parents.
Key words: Health-related quality of life, nutrition knowledge, overweight and obese children, parenting skills
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Introduction: This randomised school-based controlled study aimed to evaluate the baseline results of nutrition knowledge, attitude, and practice (NKAP), health-related quality of life (HRQoL), and parents’ report of parenting skills (PRPS) among overweight and obese children.
Methods: This study was performed on three intervention groups and one control group. It was conducted among Year Five students from primary schools who had overweight or obese status and were generally healthy without any chronic diseases. The children completed NKAP and child self-report of Pediatric Quality of Life (PedsQoL) questionnaires, while parents completed parent proxy report of PedsQoL and PRPS questionnaires. Descriptive statistics and parametric test in SPSS were utilised.
Results: Out of 139 participants involved in the baseline study, 18.7% and 81.3% were overweight and obese respectively. This study revealed a significantly higher knowledge score among boys (p = 0.016) and among those who lived in urban areas (p = 0.019). The children’s self-report PedsQoL recorded highest score for Social Functioning domain and lowest score for Emotional Functioning domain. A contradictory finding was obtained from the parent proxy report, where the Physical Functioning domain scored the lowest and the Emotional Functioning domain had the highest score. Notably, some of the findings from PRPS questionnaires completed by their parents were unfavourable.
Conclusion: This study provided prospective evidence of the current status of NKAP, HRQoL among overweight and obese children as well as findings from PRPS among their parents.
Key words: Health-related quality of life, nutrition knowledge, overweight and obese children, parenting skills
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Maternal Calorie Intake is a Significant Factor Associated with 6 Months of Exclusive Breastfeeding among Lactating Mothers in Depok City, Indonesia
Fikawati S, Syafiq A & Mardatillah
ABSTRACT
Introduction: The target of achieving exclusive breastfeeding for the first 6 months of life in Indonesia remains a challenge. Studies show a relationship between calorie intake of lactating mothers and success in 6 months of exclusive breastfeeding. This study aimed to compare the calories consumed between mothers who succeeded in 6 months of exclusive breastfeeding and those who did not and to investigate the effect of different types of supplementation.
Methods: Three groups of lactating mothers (n=201) selected from cadres’ lists were followed for 6 months between June 2015 – July 2016. The first group was a control, the second group received milk (140 kcal/day), and the third group received milk and eggs (220 kcal/day). All food supplementation were given five days a week for as long as the mother was exclusively breastfeeding the infant. Cadres provided the mother supplements and ensured complete consumption. Each month, all groups were observed and measured on status of breastfeeding, anthropometry, and food consumption.
Results: For all groups, calorie intake of those who succeeded in exclusive breastfeeding was significantly (p - value < 0.05) higher than those who failed. Calorie intake of lactating mothers is the most dominant factor (OR=5.6) for the success of 6 months of exclusive breastfeeding. The milk supplementation group had the highest calorie intake and highest percentage of mothers who were successful in providing 6 months of exclusive breastfeeding.
Conclusion: Calories supplementation was found to be a significant factor in successfully achieving 6 months of exclusive breastfeeding. In this study, milk supplementation was more effective than milk and egg supplementation.
Key words: Exclusive breastfeeding, Indonesia, maternal calorie intake
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Introduction: The target of achieving exclusive breastfeeding for the first 6 months of life in Indonesia remains a challenge. Studies show a relationship between calorie intake of lactating mothers and success in 6 months of exclusive breastfeeding. This study aimed to compare the calories consumed between mothers who succeeded in 6 months of exclusive breastfeeding and those who did not and to investigate the effect of different types of supplementation.
Methods: Three groups of lactating mothers (n=201) selected from cadres’ lists were followed for 6 months between June 2015 – July 2016. The first group was a control, the second group received milk (140 kcal/day), and the third group received milk and eggs (220 kcal/day). All food supplementation were given five days a week for as long as the mother was exclusively breastfeeding the infant. Cadres provided the mother supplements and ensured complete consumption. Each month, all groups were observed and measured on status of breastfeeding, anthropometry, and food consumption.
Results: For all groups, calorie intake of those who succeeded in exclusive breastfeeding was significantly (p - value < 0.05) higher than those who failed. Calorie intake of lactating mothers is the most dominant factor (OR=5.6) for the success of 6 months of exclusive breastfeeding. The milk supplementation group had the highest calorie intake and highest percentage of mothers who were successful in providing 6 months of exclusive breastfeeding.
Conclusion: Calories supplementation was found to be a significant factor in successfully achieving 6 months of exclusive breastfeeding. In this study, milk supplementation was more effective than milk and egg supplementation.
Key words: Exclusive breastfeeding, Indonesia, maternal calorie intake
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Access to Healthy Foods and Indications of Food Insecurity among Private University Students in a Colombo Suburb, Sri Lanka
Deepika Priyadarshani WM, Jayasekera JMTK, Gunasekara MA, Ariyathilaka SKL, Kosgahakumbura KNMHH & Thalangama TAKL
ABSTRACT
Introduction:The limited availability of nutritionally adequate and safe foods or inadequate accessibility to acquire foods can result in food insecurity. This study was conducted to investigate access and attitudes among private university students in a Colombo suburb, Sri Lanka to acquire healthy foods.
Methods: A self-administered pre-validated questionnaire was used to interview a total of 103 undergraduate students who were conveniently recruited from private universities. Indications of food insecurity were assessed in terms of dietary habits. Relationships between demographic characteristics and dietary habits were determined. Access to healthy foods was based on availability of healthy foods such as herbal porridge, boiled grains and fruit salads at their university premises, and the students’ willingness to buy them.
Results: The majority of the subjects were females (60.2%) and 66.7% of the subjects resided outside their family homes. Frequency of consuming at least one serving per week of grain, milk, fruits & vegetables showed no significant relationship with gender. Location of residence was significantly related to consumption of grains (P=<0.000). The results revealed that 73.1% of the subjects had no access to healthy foods in their respective university premises, while more than half (61.3%) were not satisfied with the foods they consumed.
Conclusion: This study revealed a lack of access to healthy foods in private higher educational premises in the Colombo suburb, indicating the risk of food insecurity among university students.
Key words: Dietary habits, food insecurity, healthy foods, university students
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Introduction:The limited availability of nutritionally adequate and safe foods or inadequate accessibility to acquire foods can result in food insecurity. This study was conducted to investigate access and attitudes among private university students in a Colombo suburb, Sri Lanka to acquire healthy foods.
Methods: A self-administered pre-validated questionnaire was used to interview a total of 103 undergraduate students who were conveniently recruited from private universities. Indications of food insecurity were assessed in terms of dietary habits. Relationships between demographic characteristics and dietary habits were determined. Access to healthy foods was based on availability of healthy foods such as herbal porridge, boiled grains and fruit salads at their university premises, and the students’ willingness to buy them.
Results: The majority of the subjects were females (60.2%) and 66.7% of the subjects resided outside their family homes. Frequency of consuming at least one serving per week of grain, milk, fruits & vegetables showed no significant relationship with gender. Location of residence was significantly related to consumption of grains (P=<0.000). The results revealed that 73.1% of the subjects had no access to healthy foods in their respective university premises, while more than half (61.3%) were not satisfied with the foods they consumed.
Conclusion: This study revealed a lack of access to healthy foods in private higher educational premises in the Colombo suburb, indicating the risk of food insecurity among university students.
Key words: Dietary habits, food insecurity, healthy foods, university students
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Association of Maternal Social Capital with Nutritional Status of 6 to 24-month- -Old Children Living in Urban and Rural Areas in Laguna, Philippines
Divine Grace C. Domingo, Corazon VC Barba, Ma. Theresa M. Talavera, Lutgarda L. Tolentino & Rodesa T. Naupal-Forcadilla
ABSTRACT
Introduction: Malnutrition in young children is often viewed as an outcome of the interactions of dietary consumption, socio-economic, and demographic factors. Social capital is a widely explored subject because of its implications on health and socio-economic factors, but has not gained recognition in its role as a determinant of nutritional status.
Objectives: The study aimed to determine the association between maternal social capital and nutritional status of 6 to 24-month-old children living in urban and rural areas and to compare the effect of maternal social capital on the child’s nutritional status between an urban and a rural community setting.
Methods: A total of 135 randomly selected mothers were interviewed in selected urban and rural communities in San Pablo City and Municipality of Rizal, Laguna, Philippines. Chi-square and Spearman’s test were used to determine the association of variables. Binary logistic regression was used to predict the effect of maternal social capital on nutritional status.
Results: Levels of maternal social capital were the same in the urban and rural areas (p=0.24) and had a strong association with household food security (p<0.05). In the urban area, maternal social capital was strongly associated with mother’s education (p<0.01) and weight-for-age (p<0.01) and height-for-age (p<0.05). In the rural area, maternal social capital was strongly associated with mother’s education (p<0.01), ethnicity (p<0.01), marital status (p<0.05) and weight-for-age (p<0.01).
Conclusion: There is an association between material social capital and nutritional status. Improvements in education and household food security as well as having parents living-in together may lead to better nutritional outcomes as these factors are associated with maternal social capital which in turn affects nutritional status of children aged 6 to 24 months.
Key words: Child care practices, food security, maternal social capital, nutritional status
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Introduction: Malnutrition in young children is often viewed as an outcome of the interactions of dietary consumption, socio-economic, and demographic factors. Social capital is a widely explored subject because of its implications on health and socio-economic factors, but has not gained recognition in its role as a determinant of nutritional status.
Objectives: The study aimed to determine the association between maternal social capital and nutritional status of 6 to 24-month-old children living in urban and rural areas and to compare the effect of maternal social capital on the child’s nutritional status between an urban and a rural community setting.
Methods: A total of 135 randomly selected mothers were interviewed in selected urban and rural communities in San Pablo City and Municipality of Rizal, Laguna, Philippines. Chi-square and Spearman’s test were used to determine the association of variables. Binary logistic regression was used to predict the effect of maternal social capital on nutritional status.
Results: Levels of maternal social capital were the same in the urban and rural areas (p=0.24) and had a strong association with household food security (p<0.05). In the urban area, maternal social capital was strongly associated with mother’s education (p<0.01) and weight-for-age (p<0.01) and height-for-age (p<0.05). In the rural area, maternal social capital was strongly associated with mother’s education (p<0.01), ethnicity (p<0.01), marital status (p<0.05) and weight-for-age (p<0.01).
Conclusion: There is an association between material social capital and nutritional status. Improvements in education and household food security as well as having parents living-in together may lead to better nutritional outcomes as these factors are associated with maternal social capital which in turn affects nutritional status of children aged 6 to 24 months.
Key words: Child care practices, food security, maternal social capital, nutritional status
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Prevalence and Risk Factors Associated with Malnutrition among Children with Learning Disabilities: A Scoping Review
Nur Hamiza Ruzaini Hashim, Sakinah Harith, Raishan Shafini Bakar & Nur-FazimahSahran
ABSTRACT
Introduction: By the end of 2015, about 72,152 children with learning disabilities were registered under the Malaysian Welfare Service Department (JKM). Malnutrition has been found to be a common setback among children with learning disability (LD). This study presents available evidence on the prevalence and risk factors associated with malnutrition in children with LD.
Methods: A framework suggested by Arksey & O`Male (2005) was used to carry out this scoping review. Published articles, reviews and reports were identified through a complete search. Inclusion criteria for the search were English articles related to LD, published from 2005 to 2016.
Results: Seventeen international studies published from 2005 until 2015 with a total of 318,596 participants and one study involving 281 participants from Malaysia, were identified and included in this review (n=18). The target age range of the sample in these 18 studies was 2 - 20 years, with a mean age of 3.2 - 14.2 years. The prevalence of underweight among children with LD was 3.4 - 36%, overweight 7.6 - 37% and obesity 5.7 - 52%. Several studies reveal that malnutrition risk among children with LD is significantly associated with gender, age, genetic syndrome, type of disability, medication used, and country economic status.
Conclusion: A number of studies show that children with LD have a higher prevalence of being overweight and obese than typically developing children and the risk associated with obesity significantly increases with age.
Key words: Children, learning disabilities, malnutrition, prevalence, risk factors
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Introduction: By the end of 2015, about 72,152 children with learning disabilities were registered under the Malaysian Welfare Service Department (JKM). Malnutrition has been found to be a common setback among children with learning disability (LD). This study presents available evidence on the prevalence and risk factors associated with malnutrition in children with LD.
Methods: A framework suggested by Arksey & O`Male (2005) was used to carry out this scoping review. Published articles, reviews and reports were identified through a complete search. Inclusion criteria for the search were English articles related to LD, published from 2005 to 2016.
Results: Seventeen international studies published from 2005 until 2015 with a total of 318,596 participants and one study involving 281 participants from Malaysia, were identified and included in this review (n=18). The target age range of the sample in these 18 studies was 2 - 20 years, with a mean age of 3.2 - 14.2 years. The prevalence of underweight among children with LD was 3.4 - 36%, overweight 7.6 - 37% and obesity 5.7 - 52%. Several studies reveal that malnutrition risk among children with LD is significantly associated with gender, age, genetic syndrome, type of disability, medication used, and country economic status.
Conclusion: A number of studies show that children with LD have a higher prevalence of being overweight and obese than typically developing children and the risk associated with obesity significantly increases with age.
Key words: Children, learning disabilities, malnutrition, prevalence, risk factors
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Effect of Nutrition Intervention on Macronutrient and Micronutrient Intake in a Group of Sleeve Gastrectomy Patients
Abu Jadayil SM, Takruri HR & Obeidat FW
ABSTRACT
Introduction: There are several approaches to treat obesity including surgery in case of morbid obesity. The number of bariatric surgery patients has increased in Jordan, but in most cases there is a lack of proper nutrition intervention, monitoring, and follow up of patients. Our aim in this study was to assess the intakes of energy, macronutrients and certain micronutrients after 3 and 6 months post-operatively.
Methods: A conventional sample of 50 patients from Jordan University Hospital participated in the study; 25 in the intervention group, and 25 in the control group. The intervention group patients were counseled regarding the use of an adequate low caloric balanced diet, post-operatively. Dietary assessment based on 3-day food intakes was carried out among all the participants before surgery and 3 and 6 months post-operatively.
Results: There were no significant differences between the control and the intervention groups in the intakes of macronutrients and selected micronutrients (calcium, iron, zinc, B12 and folic acid) after 3 months post-operatively. However, there were significant increases (P< 0.05) in the intakes of protein, iron, zinc, and folate in the intervention group compared with the control group after 6 months post-operatively.
Conclusion: Nutrition intervention enhanced the intake of some nutrients, especially protein intake.
Key words: Bariatric surgery, laparoscopic sleeve gastrectomy, macronutrients and micronutrients, nutrition intervention, obesity
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Introduction: There are several approaches to treat obesity including surgery in case of morbid obesity. The number of bariatric surgery patients has increased in Jordan, but in most cases there is a lack of proper nutrition intervention, monitoring, and follow up of patients. Our aim in this study was to assess the intakes of energy, macronutrients and certain micronutrients after 3 and 6 months post-operatively.
Methods: A conventional sample of 50 patients from Jordan University Hospital participated in the study; 25 in the intervention group, and 25 in the control group. The intervention group patients were counseled regarding the use of an adequate low caloric balanced diet, post-operatively. Dietary assessment based on 3-day food intakes was carried out among all the participants before surgery and 3 and 6 months post-operatively.
Results: There were no significant differences between the control and the intervention groups in the intakes of macronutrients and selected micronutrients (calcium, iron, zinc, B12 and folic acid) after 3 months post-operatively. However, there were significant increases (P< 0.05) in the intakes of protein, iron, zinc, and folate in the intervention group compared with the control group after 6 months post-operatively.
Conclusion: Nutrition intervention enhanced the intake of some nutrients, especially protein intake.
Key words: Bariatric surgery, laparoscopic sleeve gastrectomy, macronutrients and micronutrients, nutrition intervention, obesity
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NUTRIENTS, FOOD COMPOSITION AND PHYTOCHEMICALS
Effects of Black Bean Vinegar on Functional Constipation: A Randomised, Double-blind, Placebo-controlled Study
Chee HP
ABSTRACT
Introduction: Functional constipation is a widespread gastrointestinal ailment associated with infrequent defecation, unfavorably affecting quality of life. However, it has not been well studied worldwide. This study aimed to investigate the effects of black bean vinegar (black bean and black bean yeast) consumption in alleviating functional constipation.
Methods: A randomised, double-blind, placebo-controlled, parallel group study involving 70 adults with functional constipation was conducted in Peninsular Malaysia from May till July 2016. Subjects aged 18-60 years diagnosed with a score of more than 15 based on the Constipation Scoring System were included. A third-party-controller assigned black bean vinegar and placebo drinks to two groups with 1:1 ratio using randomisation software. Participants received once-daily doses of black bean vinegar (20 ml daily) or fruit-flavored squash placebo (20 ml daily) which contained vitamins, minerals, trace elements and carbohydrates, without black bean and black bean yeast, for four weeks. Analysis was conducted on an on-treatment basis (i.e., all randomised participants conformed to the study protocol by consuming 20 ml of drinks daily, with less than 10% leftover drinks at post-intervention assessment). Data were analysed using SPSS version 22.
Results: Administration of black bean vinegar did not demonstrate statistically significant differences in any of the outcomes when compared with a placebo drink at α=5% level. However, black bean vinegar consumption significantly improved overall score at post-intervention assessment compared to placebo group (p<0.05).
Conclusion: Since the present study was only able to demonstrate the beneficial effects of black bean vinegar consumption in improving overall score at post-intervention assessment compared to placebo group, further randomised, controlled intervention studies are warranted to confirm whether conventional dietary intervention may play a role in improving functional constipation among Malaysian adults.
Key words: Black bean vinegar, functional constipation, placebo-controlled, randomised
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Introduction: Functional constipation is a widespread gastrointestinal ailment associated with infrequent defecation, unfavorably affecting quality of life. However, it has not been well studied worldwide. This study aimed to investigate the effects of black bean vinegar (black bean and black bean yeast) consumption in alleviating functional constipation.
Methods: A randomised, double-blind, placebo-controlled, parallel group study involving 70 adults with functional constipation was conducted in Peninsular Malaysia from May till July 2016. Subjects aged 18-60 years diagnosed with a score of more than 15 based on the Constipation Scoring System were included. A third-party-controller assigned black bean vinegar and placebo drinks to two groups with 1:1 ratio using randomisation software. Participants received once-daily doses of black bean vinegar (20 ml daily) or fruit-flavored squash placebo (20 ml daily) which contained vitamins, minerals, trace elements and carbohydrates, without black bean and black bean yeast, for four weeks. Analysis was conducted on an on-treatment basis (i.e., all randomised participants conformed to the study protocol by consuming 20 ml of drinks daily, with less than 10% leftover drinks at post-intervention assessment). Data were analysed using SPSS version 22.
Results: Administration of black bean vinegar did not demonstrate statistically significant differences in any of the outcomes when compared with a placebo drink at α=5% level. However, black bean vinegar consumption significantly improved overall score at post-intervention assessment compared to placebo group (p<0.05).
Conclusion: Since the present study was only able to demonstrate the beneficial effects of black bean vinegar consumption in improving overall score at post-intervention assessment compared to placebo group, further randomised, controlled intervention studies are warranted to confirm whether conventional dietary intervention may play a role in improving functional constipation among Malaysian adults.
Key words: Black bean vinegar, functional constipation, placebo-controlled, randomised
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Comparative Study of in vivo Gastrointestinal Absorption of Mustard Oil Emulsions Prepared with Different Types of Medium Chain Fatty Acids
Susmita Roy, Sohini Mukherjee, Avery Sengupta, Tanmoy Kumar Dey, Pubali Dhar & Mahua Ghosh
ABSTRACT
Introduction: Absorption of dietary fats is generally in the form of emulsions. The present study assessed the preparation and gastrointestinal absorption efficiency of three emulsions of mustard oil containing three types of medium chain fatty acids (MCFAs) in a rat model.
Methods: Caprylic acid (C8:0), capric acid (C10:0) and lauric acid (C12:0) were chosen as the MCFAs. Mustard oil emulsions were formulated using each of the MCFAs and lecithin as an emulsifier. The characteristics of the formulations including optical microscopy, particle size, zeta potential analysis and viscosity studies were assessed. Thereafter the intestinal digestion patterns of the three MCFA rich mustard oil emulsions were compared using a single pass perfusion test.
Results: The particle size of the emulsions varied between 212.70 nm and 312.70 nm. Physical characterisation such as a zeta potential study confirmed that all emulsions were thermodynamically stable. The absorption study was monitored at 30 min intervals of up to 2 h The absorption of C8:0 emulsion was found to be maximum (27.78%) followed by C10:0 emulsion (24.81%) and C12:0emulsion (22.50%). The differences in absorption efficiency of the emulsions could be attributed to the smaller chain length of C8:0 which was more rapidly absorbed by the intestine.
Conclusion: In vivo gastrointestinal absorption of MCFA rich mustard oil emulsions was compared; caprylic acid-rich mustard oil showed the highest absorption rate in comparison to the other two emulsions. Further in vivo studies are required to establish the mechanism of absorption of structured lipids containing MCFAs.
Key words: Intestinal absorption, medium chain fatty acids, oil-in-water emulsion
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Introduction: Absorption of dietary fats is generally in the form of emulsions. The present study assessed the preparation and gastrointestinal absorption efficiency of three emulsions of mustard oil containing three types of medium chain fatty acids (MCFAs) in a rat model.
Methods: Caprylic acid (C8:0), capric acid (C10:0) and lauric acid (C12:0) were chosen as the MCFAs. Mustard oil emulsions were formulated using each of the MCFAs and lecithin as an emulsifier. The characteristics of the formulations including optical microscopy, particle size, zeta potential analysis and viscosity studies were assessed. Thereafter the intestinal digestion patterns of the three MCFA rich mustard oil emulsions were compared using a single pass perfusion test.
Results: The particle size of the emulsions varied between 212.70 nm and 312.70 nm. Physical characterisation such as a zeta potential study confirmed that all emulsions were thermodynamically stable. The absorption study was monitored at 30 min intervals of up to 2 h The absorption of C8:0 emulsion was found to be maximum (27.78%) followed by C10:0 emulsion (24.81%) and C12:0emulsion (22.50%). The differences in absorption efficiency of the emulsions could be attributed to the smaller chain length of C8:0 which was more rapidly absorbed by the intestine.
Conclusion: In vivo gastrointestinal absorption of MCFA rich mustard oil emulsions was compared; caprylic acid-rich mustard oil showed the highest absorption rate in comparison to the other two emulsions. Further in vivo studies are required to establish the mechanism of absorption of structured lipids containing MCFAs.
Key words: Intestinal absorption, medium chain fatty acids, oil-in-water emulsion
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Saffron Extract and Crocin Reduced Biomarkers Associated with Obesity in Rats Fed a High-Fat Diet
Maryam Mashmoul, Azrina Azlan, Norhafizah Mohtarrudin, Barakatun Nisak Mohd Yusof & Huzwah Khaza'ai
ABSTRACT
Introduction: This study aimed to investigate the effect of saffron extract and crocin on blood biomarkers associated with obesity using the rat model.
Methods: Obesity was induced by feeding a high-fat diet to 42 male Sprague-Dawley rats for 12 weeks, after which they were equally distributed into seven groups. Three groups served as controls namely, normal diet (ND), high-fat diet (HFD), and high-fat diet plus orlistat (HFD + ORL), while the remaining four treatment groups consisted of HFD added low or high dose (40 and 80mg/kg/day) of either saffron extract or crocin in the food. At the end of 8 weeks, blood samples were collected by cardiac puncture for biochemical analysis.
Results: Obese rats treated with a high dose of saffron extract and crocin showed significantly lower plasma glucose levels (5.26 and 5.67 mmol/L respectively) than the HFD rats (6.92 mmol/L). Saffron extract and crocin at a high dose showed significantly lower levels of plasma insulin (3.97 and 3.88 ng/mL respctively) compared to HFD control (5.41 ng/mL). Adiponectin levels significantly increased in obese rats fed saffron extract and crocin at high doses (7.44 and 7.92 μg/mL respectively) compared to HFD control (5.34 μg/mL). Ghrelin level significantly increased from 419.10 to 284.10 pg/mL,while leptin level significantly decreased from 8.08 to 5.68 ng/mL for the high dose crocin groups compared to HFD control. No significant differences in plasma serotonin levels were found among the groups.
Conclusion: Saffron extract and crocin show potential in reducing blood biomarkers associated with obesity as well as anti-inflammatory and regulatory potential of adipocytokines in an animal model.
Key words: Crocin, high-fat diet, obesity, orlistat, saffron
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Introduction: This study aimed to investigate the effect of saffron extract and crocin on blood biomarkers associated with obesity using the rat model.
Methods: Obesity was induced by feeding a high-fat diet to 42 male Sprague-Dawley rats for 12 weeks, after which they were equally distributed into seven groups. Three groups served as controls namely, normal diet (ND), high-fat diet (HFD), and high-fat diet plus orlistat (HFD + ORL), while the remaining four treatment groups consisted of HFD added low or high dose (40 and 80mg/kg/day) of either saffron extract or crocin in the food. At the end of 8 weeks, blood samples were collected by cardiac puncture for biochemical analysis.
Results: Obese rats treated with a high dose of saffron extract and crocin showed significantly lower plasma glucose levels (5.26 and 5.67 mmol/L respectively) than the HFD rats (6.92 mmol/L). Saffron extract and crocin at a high dose showed significantly lower levels of plasma insulin (3.97 and 3.88 ng/mL respctively) compared to HFD control (5.41 ng/mL). Adiponectin levels significantly increased in obese rats fed saffron extract and crocin at high doses (7.44 and 7.92 μg/mL respectively) compared to HFD control (5.34 μg/mL). Ghrelin level significantly increased from 419.10 to 284.10 pg/mL,while leptin level significantly decreased from 8.08 to 5.68 ng/mL for the high dose crocin groups compared to HFD control. No significant differences in plasma serotonin levels were found among the groups.
Conclusion: Saffron extract and crocin show potential in reducing blood biomarkers associated with obesity as well as anti-inflammatory and regulatory potential of adipocytokines in an animal model.
Key words: Crocin, high-fat diet, obesity, orlistat, saffron
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Formulation of a Protein and Fibre Enriched Soy-Mushroom Health Drink Powder Compared to Locally Available Health Drink Powders
Tasnim Farzana, Suman Mohajan, Md. Nur Hossain & Monzur Morshed Ahmed
ABSTRACT
Introduction: Protein malnutrition is a major concern in Bangladesh where there is a high dependence on cereal-based diets. Use of protein-calorie sources of plants like soybean and mushroom as a dietary supplement may provide a solution. This study was designed to formulate a high protein and fibre enriched soy-mushroom health drink powder, and to compare its nutritional contents with locally available health drink powders.
Methods: Soy-mushroom health drink powder was developed mainly from soy flour, mushroom, germinated wheat flour, malt extract and milk powder. Three locally available health drink powders were randomly selected. Proximate and microbiological analyses and sensory evaluation were undertaken by standard methods. Data were analysed using Statistical Package for the Social Sciences (SPSS).
Results: The moisture, ash, protein, fat, fibre, carbohydrate and energy contents of the developed soy-mushroom health drink powder ranged from 3.04-3.96%, 3.23-7.4%, 8.98-21.37%, 1.10-10.13%, 0.04%-1.50%, 59.93-81.58% and 363.54-416.40 kcal/100g, respectively. The soy-mushroom product had the highest content of protein, fibre, energy and the lowest content of carbohydrate compared to the other health drink powders. Based on sensory analysis, the soy-mushroom product showed high acceptability. Microbiological assessment showed the shelf life of this product to be one year.
Conclusion: The soy-mushroom health drink powder was nutritionally superior to locally available health drink powders and could serve as a nutritional supplement.
Key words: Fibre, food supplementation, health drink powder, mushroom, protein, soy flour
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Introduction: Protein malnutrition is a major concern in Bangladesh where there is a high dependence on cereal-based diets. Use of protein-calorie sources of plants like soybean and mushroom as a dietary supplement may provide a solution. This study was designed to formulate a high protein and fibre enriched soy-mushroom health drink powder, and to compare its nutritional contents with locally available health drink powders.
Methods: Soy-mushroom health drink powder was developed mainly from soy flour, mushroom, germinated wheat flour, malt extract and milk powder. Three locally available health drink powders were randomly selected. Proximate and microbiological analyses and sensory evaluation were undertaken by standard methods. Data were analysed using Statistical Package for the Social Sciences (SPSS).
Results: The moisture, ash, protein, fat, fibre, carbohydrate and energy contents of the developed soy-mushroom health drink powder ranged from 3.04-3.96%, 3.23-7.4%, 8.98-21.37%, 1.10-10.13%, 0.04%-1.50%, 59.93-81.58% and 363.54-416.40 kcal/100g, respectively. The soy-mushroom product had the highest content of protein, fibre, energy and the lowest content of carbohydrate compared to the other health drink powders. Based on sensory analysis, the soy-mushroom product showed high acceptability. Microbiological assessment showed the shelf life of this product to be one year.
Conclusion: The soy-mushroom health drink powder was nutritionally superior to locally available health drink powders and could serve as a nutritional supplement.
Key words: Fibre, food supplementation, health drink powder, mushroom, protein, soy flour
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In Vitro Release Study of Freeze-Dried and Oven-Dried Microencapsulated Kenaf Seed Oil
Hue Wan Ling & Nyam Kar Lin
ABSTRACT
Introduction: The high amounts of polyunsaturated fatty acid (PUFA) in kenaf seed oil (KSO) is susceptible to oxidation. However, KSO is rapidly oxidised due to its high PUFA content.
Methods: In order to prevent oxidation, kenaf seed oil was encapsulated using a co-extrusion technique to produce microencapsulated kenaf seed oil (MKSO). The shell materials used were formulated from alginate with high methoxy pectin and chitosan. MKSO was freeze-dried and in vitro behaviour of MKSO was investigated and compared with oven-dried MKSO. After in vitro digestion, the antioxidant and bioactive compounds in freeze-dried MKSO were investigated.
Results: Freeze-dried MKSO released more oil (95.35%) compared to oven-dried MKSO (83.88%) after in vitro digestion. Total phenolic content (TPC) and, 2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging activities showed decreases, compared to before in vitro digestion while 2,2’-azino-bis(3-ethylbenzothiazoline-6-sulphonic acid) (ABTS) radical-scavenging assay and tocopherol content showed increases in released oil from MKSO after in vitro digestion compared to before in vitro digestion. For phytosterol composition, the decreases in released oil were not significant.
Conclusion: The studies showed that microencapsulation allowed for site- controlled oil delivery and protected the bioactive compounds.
Key words: Co-extrusion, polyunsaturated fatty acids, radical scavenging activities, radical-scavenging assay, tocopherol content, total phenolic content
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Introduction: The high amounts of polyunsaturated fatty acid (PUFA) in kenaf seed oil (KSO) is susceptible to oxidation. However, KSO is rapidly oxidised due to its high PUFA content.
Methods: In order to prevent oxidation, kenaf seed oil was encapsulated using a co-extrusion technique to produce microencapsulated kenaf seed oil (MKSO). The shell materials used were formulated from alginate with high methoxy pectin and chitosan. MKSO was freeze-dried and in vitro behaviour of MKSO was investigated and compared with oven-dried MKSO. After in vitro digestion, the antioxidant and bioactive compounds in freeze-dried MKSO were investigated.
Results: Freeze-dried MKSO released more oil (95.35%) compared to oven-dried MKSO (83.88%) after in vitro digestion. Total phenolic content (TPC) and, 2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging activities showed decreases, compared to before in vitro digestion while 2,2’-azino-bis(3-ethylbenzothiazoline-6-sulphonic acid) (ABTS) radical-scavenging assay and tocopherol content showed increases in released oil from MKSO after in vitro digestion compared to before in vitro digestion. For phytosterol composition, the decreases in released oil were not significant.
Conclusion: The studies showed that microencapsulation allowed for site- controlled oil delivery and protected the bioactive compounds.
Key words: Co-extrusion, polyunsaturated fatty acids, radical scavenging activities, radical-scavenging assay, tocopherol content, total phenolic content
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SHORT COMMUNICATIONS
Assessing the Validity and Reliability of a Questionnaire on Child Television Watching in Tehran City, Iran
Kalantari N, Malmir H, Doaei S, Gholamalizadeh S, Javadi F, Rashidkhani B & Gorgani SN
ABSTRACT
Introduction: Watching television (TV) is a popular pastime among Iranian children to the extent that it has been attributed to the rise of childhood obesity. The present study investigated the validity and reliability of a questionnaire on television watching of preschool children from the perspective of parents.
Methods: A total of 114 mothers of children aged 2-6 years from 10 preschools in District 2, Tehran City, recruited by convenience, were interviewed after receiving their consent. The questionnaire consisted of 23 questions and two subscales on the amount of time and the perceived impact of watching TV. The validity (content and construct) and reliability (test-retest and internal consistency) of the questionnaire were analysed using SPSS (version 21).
Results: Out of the original 23 questions, only 11 questions that met the criteria of the content validity ratio (CVR) and content validity index (CVI) were selected and internal correlation of each subscale with total score was calculated and found to be satisfactory (0.566 and 0.685 respectively). Intraclass correlation coefficient was between 0.796 and 0.889 and Cronbach’s alpha was between 0.887 and 0.941.
Conclusion: Overall, the validity of the questionnaire developed for this study was found to be satisfactory. This questionnaire could be applied in similar settings using larger sample sizes.
Key words: Preschool children, questionnaire, reliability, television, validity
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Introduction: Watching television (TV) is a popular pastime among Iranian children to the extent that it has been attributed to the rise of childhood obesity. The present study investigated the validity and reliability of a questionnaire on television watching of preschool children from the perspective of parents.
Methods: A total of 114 mothers of children aged 2-6 years from 10 preschools in District 2, Tehran City, recruited by convenience, were interviewed after receiving their consent. The questionnaire consisted of 23 questions and two subscales on the amount of time and the perceived impact of watching TV. The validity (content and construct) and reliability (test-retest and internal consistency) of the questionnaire were analysed using SPSS (version 21).
Results: Out of the original 23 questions, only 11 questions that met the criteria of the content validity ratio (CVR) and content validity index (CVI) were selected and internal correlation of each subscale with total score was calculated and found to be satisfactory (0.566 and 0.685 respectively). Intraclass correlation coefficient was between 0.796 and 0.889 and Cronbach’s alpha was between 0.887 and 0.941.
Conclusion: Overall, the validity of the questionnaire developed for this study was found to be satisfactory. This questionnaire could be applied in similar settings using larger sample sizes.
Key words: Preschool children, questionnaire, reliability, television, validity
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Estimation of Stature in Iranian Adults Using Knee Height
Mosavi Maleki S & Vahdat Shariatpanahi Z
ABSTRACT
Introduction: This study aimed to establish an equation for stature prediction using knee height in the Iranian population.
Methods: Anthropometric measurements of 320 (193 women and 127 men) healthy dormitory students of a medical sciences university were taken by a trained dietitian to minimise errors. Linear regression analysis was used to estimate stature with height as the dependent variable and knee height and age as independent variables. A control group (63 women and 67 men) was used for validation of prediction equations.
Results: The developed regression equations for height estimation by using knee height in Iranian men and women were 62.913 + (2.077 × Knee height) and 76.362 + (1.76 × Knee height) respectively. There was no significant difference between estimated mean height derived from the present study equation and actual mean height in the control group.
Conclusion: New stature prediction equations for both sexes using knee height are presented for the Iranian adult population, which may be different from those for other populations.
Key words: Iranian adults, knee height, stature prediction
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Introduction: This study aimed to establish an equation for stature prediction using knee height in the Iranian population.
Methods: Anthropometric measurements of 320 (193 women and 127 men) healthy dormitory students of a medical sciences university were taken by a trained dietitian to minimise errors. Linear regression analysis was used to estimate stature with height as the dependent variable and knee height and age as independent variables. A control group (63 women and 67 men) was used for validation of prediction equations.
Results: The developed regression equations for height estimation by using knee height in Iranian men and women were 62.913 + (2.077 × Knee height) and 76.362 + (1.76 × Knee height) respectively. There was no significant difference between estimated mean height derived from the present study equation and actual mean height in the control group.
Conclusion: New stature prediction equations for both sexes using knee height are presented for the Iranian adult population, which may be different from those for other populations.
Key words: Iranian adults, knee height, stature prediction
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In Memorium
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Malaysian Journal of Nutrition
Volume 23 No.2, 2017
Table of Content
NUTRITIONAL STATUS, DIETARY INTAKE AND Body composition
Prevalence of Malnutrition among Hospitalised Adult Cancer Patients at the National Cancer Institute, Putrajaya, Malaysia
Norshariza J, Siti Farrah Zaidah MY, Aini Zaharah AJ, Betti Sharina MHL, Neoh MK, Aeininhayatey A & Nur Hafizah MS
ABSTRACT
Introduction: Malnutrition in cancer patients affects the quality of life (QoL) of the patients and brings about adverse outcomes including morbidity and mortality. This study aims to determine the prevalence of malnutrition among cancer patients at the National Cancer Institute (NCI), Putrajaya.
Methods: A cross-sectional study was conducted among 97 respondents who were admitted to the NCI between August 2014 and January 2015. Information on socio-demographic characteristics, clinical characteristics, anthropometric measurements, dietary intake and biochemical data were obtained. The Malnutrition Screening Tool (MST) was used to identify malnutrition risk, while the Subjective Global Assessment (SGA) determined patients’ nutritional status.
Results: Approximately 61.9% and 43.5% of the patients were malnourished upon admission based on the MST and SGA scores, respectively. Four most common types of cancer among the malnourished patients were nasopharyngeal (NPC), lung, breast and colorectal cancer. About 56.9% and 21.6% of the malnourished patients, according to MST, were at Stage 4 and Stage 3 cancer, respectively. Meanwhile 69.7% of the malnourished respondents, based on SGA, were at Stage 4 cancer. Mean energy intake was 1463±577 kcal and protein intake was 54±22 g proteins.
Conclusion: Prevalence of malnutrition in hospitalised cancer patients in the NCI was high, depending on age, body mass index (BMI), tumour location and cancer stage. Early identification of malnutrition status is required for proper nutritional intervention.
Key words: Cancer, malnutrition, Malnutrition Screening Tool (MST), National Cancer Institute (NCI) Putrajaya, Subjective Global Assessment (SGA)
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Introduction: Malnutrition in cancer patients affects the quality of life (QoL) of the patients and brings about adverse outcomes including morbidity and mortality. This study aims to determine the prevalence of malnutrition among cancer patients at the National Cancer Institute (NCI), Putrajaya.
Methods: A cross-sectional study was conducted among 97 respondents who were admitted to the NCI between August 2014 and January 2015. Information on socio-demographic characteristics, clinical characteristics, anthropometric measurements, dietary intake and biochemical data were obtained. The Malnutrition Screening Tool (MST) was used to identify malnutrition risk, while the Subjective Global Assessment (SGA) determined patients’ nutritional status.
Results: Approximately 61.9% and 43.5% of the patients were malnourished upon admission based on the MST and SGA scores, respectively. Four most common types of cancer among the malnourished patients were nasopharyngeal (NPC), lung, breast and colorectal cancer. About 56.9% and 21.6% of the malnourished patients, according to MST, were at Stage 4 and Stage 3 cancer, respectively. Meanwhile 69.7% of the malnourished respondents, based on SGA, were at Stage 4 cancer. Mean energy intake was 1463±577 kcal and protein intake was 54±22 g proteins.
Conclusion: Prevalence of malnutrition in hospitalised cancer patients in the NCI was high, depending on age, body mass index (BMI), tumour location and cancer stage. Early identification of malnutrition status is required for proper nutritional intervention.
Key words: Cancer, malnutrition, Malnutrition Screening Tool (MST), National Cancer Institute (NCI) Putrajaya, Subjective Global Assessment (SGA)
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Factors Related to Exclusive Breastfeeding among Mothers in the City of Palu, Central Sulawesi, Indonesia
Nurdin Rahman, Nikmah Utami Dewi, Siti Ika Fitrasyah, Bohari, Via Oktaviani & Mohammad Rifai
ABSTRACT
Introduction: The rate of exclusive breastfeeding in Indonesia is still low. In Palu City, Central Sulawesi, exclusive breastfeeding practice in 2014 was only 59.7% which was far below the national target of 80%. This study aimed to assess modifiable potential factors that can promote exclusive breastfeeding among mothers in Palu City.
Methods: A total of 80 mothers with a child over the age of 6-24 months attending the Bulili Health Center were recruited into the study using convenience sampling. For purposes of the study potential factors identified for assessment using a standardised questionnaire were knowledge, attitude, practice, socio-culture, formula milk exposure to commercials, and support from health professionals and family. Bivariate and logistic regression analyses were applied.
Results: Young mothers aged 20-35 years made up more than half the sample (57.5%). In terms of education, 42.5% had graduated from junior high school. Almost two-thirds (63.75%) of the mothers were housewives. Only 26.2% of the subjects practised exclusive breastfeeding. The factors related to exclusive breastfeeding (p<0.05) were attitude, practice, socio-culture factors such as religion, culture and, influence of community and formula milk and exposure to commercials. Multivariate analysis indicated that only practice (p=0.000), socio-culture (p=0.002) and exposure to formula milk commercials (p=0.000) were significantly associated with exclusive breastfeeding.
Conclusion: The main modifiable factors that lead to exclusive breastfeeding among mothers in Palu are socio-culture followed by practice and formula milk commercials. Besides promotion of cultural aspects, a definite policy on infant formula commercials is needed to support exclusive breastfeeding.
Key words: Exclusive breastfeeding, exposure to formula milk commercials, practices, socio-culture
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Introduction: The rate of exclusive breastfeeding in Indonesia is still low. In Palu City, Central Sulawesi, exclusive breastfeeding practice in 2014 was only 59.7% which was far below the national target of 80%. This study aimed to assess modifiable potential factors that can promote exclusive breastfeeding among mothers in Palu City.
Methods: A total of 80 mothers with a child over the age of 6-24 months attending the Bulili Health Center were recruited into the study using convenience sampling. For purposes of the study potential factors identified for assessment using a standardised questionnaire were knowledge, attitude, practice, socio-culture, formula milk exposure to commercials, and support from health professionals and family. Bivariate and logistic regression analyses were applied.
Results: Young mothers aged 20-35 years made up more than half the sample (57.5%). In terms of education, 42.5% had graduated from junior high school. Almost two-thirds (63.75%) of the mothers were housewives. Only 26.2% of the subjects practised exclusive breastfeeding. The factors related to exclusive breastfeeding (p<0.05) were attitude, practice, socio-culture factors such as religion, culture and, influence of community and formula milk and exposure to commercials. Multivariate analysis indicated that only practice (p=0.000), socio-culture (p=0.002) and exposure to formula milk commercials (p=0.000) were significantly associated with exclusive breastfeeding.
Conclusion: The main modifiable factors that lead to exclusive breastfeeding among mothers in Palu are socio-culture followed by practice and formula milk commercials. Besides promotion of cultural aspects, a definite policy on infant formula commercials is needed to support exclusive breastfeeding.
Key words: Exclusive breastfeeding, exposure to formula milk commercials, practices, socio-culture
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Knowledge and Use of Complementary Food Fortification with Multiple Micronutrient Powders in Selected Communities in the Philippines
Normahitta P Gordoncillo, Maria Theresa M Talavera, Corazon VC Barba & Maria Ana T Quimbo
ABSTRACT
Introduction: Micronutrient malnutrition among young Filipino children is attributed to inadequate food intake and improper feeding practices. To improve nutrient intake, home fortification using multiple micronutrient powders (MNPs) targeting 6 -23 month-old children became an intervention program referred to as Point of Use Complementary Food Fortification with Multiple Micronutrient Powders in Zamboanga City and the Municipality of Aurora in Region IX, Philippines. This study aimed to determine the extent of knowledge and use of complementary food with MNPs in the context of the said intervention program and implementation areas.
Methods: A cross-sectional survey was conducted among 120 randomly selected primary caregivers with 6 -23-month-old children in the covered program areas. A questionnaire designed to elicit knowledge and use of MNPs was developed and pre-tested before data collection.
Results: Results showed that all respondents were aware of MNPs, with local health workers as the information source. Percentage of respondents with knowledge of the purpose of MNPs varied widely. Among those who did, the most well-known function was improving children’s health status. The most common practice of fortifying food with MNP involved adding it to boiled rice and vegetable dishes. Home fortification is popularly practised after cooking the food. Of the 20% respondents who claimed to observe changes in their children due to MNP, the top two positive results were children’s increased appetite and increased growth.
Conclusion: Awareness of the MNP does not necessarily translate into knowledge of what the MNP is made up of or its purpose. Although home food fortification using MNP was practised by most households, this study revealed deviations from recommendations on how to properly fortify their foods using the MNPs. Based on the findings in this study, there is a need to complement awareness of the primary caregivers with knowledge on MNPs through ounselling and initiating support groups among caregivers to serve as credible and first hand examples of the proper use of MNPs.
Key words: Complementary food, knowledge, multiple micronutrient powders, use
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Introduction: Micronutrient malnutrition among young Filipino children is attributed to inadequate food intake and improper feeding practices. To improve nutrient intake, home fortification using multiple micronutrient powders (MNPs) targeting 6 -23 month-old children became an intervention program referred to as Point of Use Complementary Food Fortification with Multiple Micronutrient Powders in Zamboanga City and the Municipality of Aurora in Region IX, Philippines. This study aimed to determine the extent of knowledge and use of complementary food with MNPs in the context of the said intervention program and implementation areas.
Methods: A cross-sectional survey was conducted among 120 randomly selected primary caregivers with 6 -23-month-old children in the covered program areas. A questionnaire designed to elicit knowledge and use of MNPs was developed and pre-tested before data collection.
Results: Results showed that all respondents were aware of MNPs, with local health workers as the information source. Percentage of respondents with knowledge of the purpose of MNPs varied widely. Among those who did, the most well-known function was improving children’s health status. The most common practice of fortifying food with MNP involved adding it to boiled rice and vegetable dishes. Home fortification is popularly practised after cooking the food. Of the 20% respondents who claimed to observe changes in their children due to MNP, the top two positive results were children’s increased appetite and increased growth.
Conclusion: Awareness of the MNP does not necessarily translate into knowledge of what the MNP is made up of or its purpose. Although home food fortification using MNP was practised by most households, this study revealed deviations from recommendations on how to properly fortify their foods using the MNPs. Based on the findings in this study, there is a need to complement awareness of the primary caregivers with knowledge on MNPs through ounselling and initiating support groups among caregivers to serve as credible and first hand examples of the proper use of MNPs.
Key words: Complementary food, knowledge, multiple micronutrient powders, use
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Rapid Weight Loss Practices among Elite Combat Sports Athletes in Malaysia
Ng Qi Xiong, Choe Yee Xian, Haemamalar Karppaya, Chai Wen Jin & Amutha Ramadas
ABSTRACT
Introduction: This study aimed to (i) determine rapid weight loss (RWL) practices among Malaysian elite combat sports athletes and (ii) examine the relationship between the characteristics of athletes, self-reported history of weight loss, perceived influence on weight loss and RWL practices.
Methods: This was a cross-sectional study conducted at the Malaysian National Sports Institute among elite combat sports athletes (n=40) recruited via a convenience sampling method. The athletes completed a self-administered validated Rapid Weight Loss Questionnaire. Each response was provided a score and the total RWL score corresponded to the aggressiveness of weight management methods. Partial correlations were used to assess the relationships between total RWL score and independent variables.
Results: The prevalence of RWL among the athletes was high (92.5%). Training with rubber or plastic suits (62.2%) and meal-skipping (27.0%) were the most common RWL techniques practised by the respondents. Aggressive weight-cutting as depicted by a higher total RWL score that correlated with most weight ever lost, duration taken to lose weight, influence of training colleagues and coaches, BMI, current weight and post-competition weight regain (all p<0.05). In contrast, negative correlations were seen between total RWL score, and the age at which the athletes began competing (p<0.001), duration of competition (p<0.001), age at first participation (p<0.05), duration of participation (p<0.05) and influence of nutritionists on weight loss (p<0.05).
Conclusion: A high prevalence of aggressive weight loss among elite combat sports athletes and its association with perceived influence of sports professionals, colleagues and actual weight-related characteristics are of great concern.
Key words: Combat sports, elite athletes, rapid weight loss, weight management
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Introduction: This study aimed to (i) determine rapid weight loss (RWL) practices among Malaysian elite combat sports athletes and (ii) examine the relationship between the characteristics of athletes, self-reported history of weight loss, perceived influence on weight loss and RWL practices.
Methods: This was a cross-sectional study conducted at the Malaysian National Sports Institute among elite combat sports athletes (n=40) recruited via a convenience sampling method. The athletes completed a self-administered validated Rapid Weight Loss Questionnaire. Each response was provided a score and the total RWL score corresponded to the aggressiveness of weight management methods. Partial correlations were used to assess the relationships between total RWL score and independent variables.
Results: The prevalence of RWL among the athletes was high (92.5%). Training with rubber or plastic suits (62.2%) and meal-skipping (27.0%) were the most common RWL techniques practised by the respondents. Aggressive weight-cutting as depicted by a higher total RWL score that correlated with most weight ever lost, duration taken to lose weight, influence of training colleagues and coaches, BMI, current weight and post-competition weight regain (all p<0.05). In contrast, negative correlations were seen between total RWL score, and the age at which the athletes began competing (p<0.001), duration of competition (p<0.001), age at first participation (p<0.05), duration of participation (p<0.05) and influence of nutritionists on weight loss (p<0.05).
Conclusion: A high prevalence of aggressive weight loss among elite combat sports athletes and its association with perceived influence of sports professionals, colleagues and actual weight-related characteristics are of great concern.
Key words: Combat sports, elite athletes, rapid weight loss, weight management
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Factors Associated with Obesity among School Children in Amman, Jordan
Al- Dalaeen AM & Al-Domi HA
ABSTRACT
Introduction: This study aimed to investigate the association between obesity, sedentary behaviour, television (TV) watching, small screen recreation (SSR), and perinatal life influences (breast-feeding, birth weight) among Jordanian school children.
Methods: A total of 117 school children (56 obese and 61 normal weight) aged between 11 and 15 years were selected by using multistage cluster sampling method. Parents were requested to complete the first part of a questionnaire on family background, while the second part on adolescent sedentary behaviour was completed by the participants in the school. Anthropometric data were collected and presence of fat mass (%FM) was measured using bioelectrical impedance analysis.
Results: Sedentary behaviour (hours/day) was significantly higher in obese school children compared to normal weight (4.43±0.60, 3.29±0.68, respectively; P<0.05), and positively associated with BMI (r=0.270, P<0.05). Normal weight children spent less time on watching TV (hours/day) compared to obese children (2.01±0.10, 2.34±0.16, respectively; P<0.05), and spent 2.55±1.6 (hours/day) in small screen recreation (SSR) compared to 3.89±1.0 (hours/day) of obese children. Both watching TV and SSR was significantly associated with BMI (r=0.260, r=0.201, respectively; P<0.05). Duration of exclusive breastfeeding (months) was significantly higher in normal weight than obese children (7.70±3.01, 5.05±2.01, respectively; P<0.05), and negatively associated with BMI (r=-0.254) and %FM (r=-0.330).
Conclusion: Sedentary behaviour and watching TV were important risk factors for obesity among 11-15 years old Jordanian school children. A national policy promoting active living and reducing sedentary behaviour among school children is recommended.
Key words: Birth weight, breastfeeding, obesity, school children, sedentary behaviour
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Introduction: This study aimed to investigate the association between obesity, sedentary behaviour, television (TV) watching, small screen recreation (SSR), and perinatal life influences (breast-feeding, birth weight) among Jordanian school children.
Methods: A total of 117 school children (56 obese and 61 normal weight) aged between 11 and 15 years were selected by using multistage cluster sampling method. Parents were requested to complete the first part of a questionnaire on family background, while the second part on adolescent sedentary behaviour was completed by the participants in the school. Anthropometric data were collected and presence of fat mass (%FM) was measured using bioelectrical impedance analysis.
Results: Sedentary behaviour (hours/day) was significantly higher in obese school children compared to normal weight (4.43±0.60, 3.29±0.68, respectively; P<0.05), and positively associated with BMI (r=0.270, P<0.05). Normal weight children spent less time on watching TV (hours/day) compared to obese children (2.01±0.10, 2.34±0.16, respectively; P<0.05), and spent 2.55±1.6 (hours/day) in small screen recreation (SSR) compared to 3.89±1.0 (hours/day) of obese children. Both watching TV and SSR was significantly associated with BMI (r=0.260, r=0.201, respectively; P<0.05). Duration of exclusive breastfeeding (months) was significantly higher in normal weight than obese children (7.70±3.01, 5.05±2.01, respectively; P<0.05), and negatively associated with BMI (r=-0.254) and %FM (r=-0.330).
Conclusion: Sedentary behaviour and watching TV were important risk factors for obesity among 11-15 years old Jordanian school children. A national policy promoting active living and reducing sedentary behaviour among school children is recommended.
Key words: Birth weight, breastfeeding, obesity, school children, sedentary behaviour
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Validity of Different Methods for Assessing Overweight among Children Aged 6-10 Years in Kolkata, India
Bharati S, Pal M, Hossain MG & Bharati P
ABSTRACT
Introduction: Various anthropometric measures including Body Mass Index (BMI) are used to assess overweight among children. The aim of the study was to assess the validity and compare the performance of different methods for assessing overweight children aged 6-10 years in Kolkata, India, taking BMI as standard.
Methods: A total number of 5216 children (2738 girls and 2478 boys) were selected using multistage stratified sampling. Data collection was carried out from September 2013 to October 2014 by a team of trained researchers.
Results: Prevalence of over nourished children was 32.4%. Sensitivity value was noticeably low for the fitness gram (FG) method, which was assessed by skinfold thickness at different body sites, but high for waist circumference (WC) and WC to height ratio (WHR). Low specificity was observed for weight-for-age (WAZ) and FG. Both positive and negative predictive values were high for WAZ and FG results, where positive/negative predictive values were the proportion of correct prediction among positive/negative prediction. High negative predictive values and low positive predictive values were observed for WC and WHR measures.
Conclusion: This study suggests that if BMI measures are not available, other measures, namely waist circumference (WC) and WC-to-height ratio (WHR) can be used as proxy indicators for overweight among children.
Key words: Body mass index, children, India, over nutrition, waist circumference, waist circumference to height ratio
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Introduction: Various anthropometric measures including Body Mass Index (BMI) are used to assess overweight among children. The aim of the study was to assess the validity and compare the performance of different methods for assessing overweight children aged 6-10 years in Kolkata, India, taking BMI as standard.
Methods: A total number of 5216 children (2738 girls and 2478 boys) were selected using multistage stratified sampling. Data collection was carried out from September 2013 to October 2014 by a team of trained researchers.
Results: Prevalence of over nourished children was 32.4%. Sensitivity value was noticeably low for the fitness gram (FG) method, which was assessed by skinfold thickness at different body sites, but high for waist circumference (WC) and WC to height ratio (WHR). Low specificity was observed for weight-for-age (WAZ) and FG. Both positive and negative predictive values were high for WAZ and FG results, where positive/negative predictive values were the proportion of correct prediction among positive/negative prediction. High negative predictive values and low positive predictive values were observed for WC and WHR measures.
Conclusion: This study suggests that if BMI measures are not available, other measures, namely waist circumference (WC) and WC-to-height ratio (WHR) can be used as proxy indicators for overweight among children.
Key words: Body mass index, children, India, over nutrition, waist circumference, waist circumference to height ratio
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Use of Chinese Herbal Medicine and Health-Related Quality of Life among Cancer Patients in Johor, Malaysia
Loke Mi Mi, Chong Kah Hui, Noor Salihah Zakaria & Hayati Mohd Yusof
ABSTRACT
Introduction: Chinese Herbal Medicine (CHM) is becoming increasingly popular among cancer patients worldwide. While health-related quality of life (HRQoL) in relation to cancer outcomes has attracted global attention, there are few studies on CHM use and HRQoL among cancer patients in Malaysia. This study attempted to determine the association between use of CHM, including the types, reasons, and beliefs, and HRQoL among Malaysian cancer patients.
Methods: A cross-sectional study was conducted among 120 cancer patients (60 male and 60 female) recruited from government oncology clinics in Johor state. A purposive non-probability sampling was applied to recruit respondents.
Results: Use of CHM was reported by about half of the patients (49.2%). Common types of CHM used included Chinese herbal extracts (27.5%), Sabah snake grass (12.2%), and ginger (11.5%). The median score for overall belief in CHM significantly differed between CHM users (71.7%) and non-users (65.0%) (p<0.001). The HRQoL was generally reported as ‘good’ with high scores for overall functioning scales and low scores for symptom scales. However, no significant difference in HRQoL between CHM users and non-users was noted. ‘Social Functioning’ scores between both groups showed a significant difference (p< 0.001) with respect to sex, with females scoring higher than males. No significant association was noted between CHM use and socio-demographic characteristics except for sex.
Conclusion: There is a high prevalence of self-prescription of CHM among the cancer patients studied. Nonetheless use of CHM did not show any significant difference in terms of quality of life among CHM users.
Key words:
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Introduction: Chinese Herbal Medicine (CHM) is becoming increasingly popular among cancer patients worldwide. While health-related quality of life (HRQoL) in relation to cancer outcomes has attracted global attention, there are few studies on CHM use and HRQoL among cancer patients in Malaysia. This study attempted to determine the association between use of CHM, including the types, reasons, and beliefs, and HRQoL among Malaysian cancer patients.
Methods: A cross-sectional study was conducted among 120 cancer patients (60 male and 60 female) recruited from government oncology clinics in Johor state. A purposive non-probability sampling was applied to recruit respondents.
Results: Use of CHM was reported by about half of the patients (49.2%). Common types of CHM used included Chinese herbal extracts (27.5%), Sabah snake grass (12.2%), and ginger (11.5%). The median score for overall belief in CHM significantly differed between CHM users (71.7%) and non-users (65.0%) (p<0.001). The HRQoL was generally reported as ‘good’ with high scores for overall functioning scales and low scores for symptom scales. However, no significant difference in HRQoL between CHM users and non-users was noted. ‘Social Functioning’ scores between both groups showed a significant difference (p< 0.001) with respect to sex, with females scoring higher than males. No significant association was noted between CHM use and socio-demographic characteristics except for sex.
Conclusion: There is a high prevalence of self-prescription of CHM among the cancer patients studied. Nonetheless use of CHM did not show any significant difference in terms of quality of life among CHM users.
Key words:
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Oral Health Knowledge, Attitude and Practice of Parents, and Frequency of Cariogenic Food Intake among Their Non Syndromic Cleft Lip with or without Cleft Palate Children in North-east Peninsular Malaysia
Rathmawati Ahmad, Normastura Abd Rahman, Ruhaya Hasan & Azizah Yusoff
ABSTRACT
Introduction: Appropriate oral health knowledge is essential to enable parents to be responsible for the oral health care of their children especially those with special needs. This study aimed to determine the oral health knowledge, attitude and practice (KAP) of parents and cariogenic food intake of their non-syndromic cleft lip with or without cleft palate children (NSCLP) compared to non-cleft children.
Methods: A comparative cross-sectional study was conducted on randomly selected parents with children aged 1 to 6 years at Hospital Universiti Sains Malaysia and Kota Bharu Dental Clinic. A face-to-face interview using a validated questionnaire on oral health KAP and cariogenic food intake of their children was done. Data were analysed by using IBM SPSS version 22.0.
Results: Sixty-four Malay parents with NSCLP (n=33) and non-cleft (n=31) children were recruited. The mean (SD) percentage score of oral health knowledge of parents in both groups (NSCLP and non-cleft) was fair, 59.5%(11.85) and 62.0%(15.00), P=0.4722; oral health attitude was good, 78.0% (9.30) and 80.2% (15.40), P=0.504; but oral health practice was poor 33.8% (5.94) and 36.1 (8.44), P=0.220. The cariogenic food frequency score was significantly higher in non-cleft children; 40.2(10.32) compared to NSCLP children, 34.8(9.46), P=0.032.
Conclusion: Parents of both groups had fair knowledge and good attitude but poor oral health practice. Cariogenic foods were consumed more by the non-cleft children. Oral health awareness among the parents needs to be strengthened towards good oral health attitude and practice and non-cariogenic food choices for the betterment of oral health status of their children.
Key words: Awareness, attitude, cleft lip, cleft palate, diet, knowledge
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Introduction: Appropriate oral health knowledge is essential to enable parents to be responsible for the oral health care of their children especially those with special needs. This study aimed to determine the oral health knowledge, attitude and practice (KAP) of parents and cariogenic food intake of their non-syndromic cleft lip with or without cleft palate children (NSCLP) compared to non-cleft children.
Methods: A comparative cross-sectional study was conducted on randomly selected parents with children aged 1 to 6 years at Hospital Universiti Sains Malaysia and Kota Bharu Dental Clinic. A face-to-face interview using a validated questionnaire on oral health KAP and cariogenic food intake of their children was done. Data were analysed by using IBM SPSS version 22.0.
Results: Sixty-four Malay parents with NSCLP (n=33) and non-cleft (n=31) children were recruited. The mean (SD) percentage score of oral health knowledge of parents in both groups (NSCLP and non-cleft) was fair, 59.5%(11.85) and 62.0%(15.00), P=0.4722; oral health attitude was good, 78.0% (9.30) and 80.2% (15.40), P=0.504; but oral health practice was poor 33.8% (5.94) and 36.1 (8.44), P=0.220. The cariogenic food frequency score was significantly higher in non-cleft children; 40.2(10.32) compared to NSCLP children, 34.8(9.46), P=0.032.
Conclusion: Parents of both groups had fair knowledge and good attitude but poor oral health practice. Cariogenic foods were consumed more by the non-cleft children. Oral health awareness among the parents needs to be strengthened towards good oral health attitude and practice and non-cariogenic food choices for the betterment of oral health status of their children.
Key words: Awareness, attitude, cleft lip, cleft palate, diet, knowledge
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Infant Feeding Practices of HIV Positive Mothers in Lagos, South-western Nigeria
Agatha N David, Oliver C Ezechi, Endurance Aghahowa, Lilian O Ezechi, Zaidat S Musa, Agatha E Wapmuk, Titilola A Gbajabiamila, Idigbe Ifeoma & Aigbe G Ohihoin
ABSTRACT
Introduction: Infant feeding choices made by mothers in the context of HIV infection depend on a number of factors. In our environment, the relative contribution of some of these factors is not known.
Methods: The infant feeding practices of HIV positive mothers seen over a decade (July 2004 and December 2015) at a large HIV treatment centre in Lagos, South-western Nigeria were reviewed. Information on maternal socio-economic characteristics, obstetric, HIV treatment history and infant feeding choices were extracted from the program data base for analysis with SPSS version 20.
Results: Exclusive formula feeding (EFF) was the most common feeding practice of the mothers ( 86.4%). However, it decreased from 95.3 % before 2010 to 79.5% after 2010. Exclusive breastfeeding (EBF) was practised by only 9.0% of the mothers. Mixed breastfeeding practice increased from 1.1% pre-2010 to 4.1% post-2010. The provision of free infant formula was found not to influence significantly the EFF or EBF rates but the MBF rate. MBF rate decreased from 3.0% pre-free formula to 1.7% after the introduction of free infant formula.
Conclusion: Exclusive formula feeding was the most practised infant feeding method in this study (86.4%). Change in infant feeding guidelines was found to influence the infant feeding choice of HIV positive mothers. Health workers implementing PMTCT programs in our setting should be made aware of the risk of mixed breastfeeding with the new guidelines and educate mothers on its dangers at every contact with the health system.
Key words: Breastfeeding, infant feeding, infant formula, HIV, mixed feeding
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Introduction: Infant feeding choices made by mothers in the context of HIV infection depend on a number of factors. In our environment, the relative contribution of some of these factors is not known.
Methods: The infant feeding practices of HIV positive mothers seen over a decade (July 2004 and December 2015) at a large HIV treatment centre in Lagos, South-western Nigeria were reviewed. Information on maternal socio-economic characteristics, obstetric, HIV treatment history and infant feeding choices were extracted from the program data base for analysis with SPSS version 20.
Results: Exclusive formula feeding (EFF) was the most common feeding practice of the mothers ( 86.4%). However, it decreased from 95.3 % before 2010 to 79.5% after 2010. Exclusive breastfeeding (EBF) was practised by only 9.0% of the mothers. Mixed breastfeeding practice increased from 1.1% pre-2010 to 4.1% post-2010. The provision of free infant formula was found not to influence significantly the EFF or EBF rates but the MBF rate. MBF rate decreased from 3.0% pre-free formula to 1.7% after the introduction of free infant formula.
Conclusion: Exclusive formula feeding was the most practised infant feeding method in this study (86.4%). Change in infant feeding guidelines was found to influence the infant feeding choice of HIV positive mothers. Health workers implementing PMTCT programs in our setting should be made aware of the risk of mixed breastfeeding with the new guidelines and educate mothers on its dangers at every contact with the health system.
Key words: Breastfeeding, infant feeding, infant formula, HIV, mixed feeding
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Assessment of Fish and Shellfish Consumption of Coastal Barangays along the Marilao-Meycauayan-Obando River System (MMORS), Philippines
Jennifer Marie S Amparo, Ma Theresa Talavera, Aimee Sheree A Barrion, Maria Emilinda T Mendoza & Marife B Dapito
ABSTRACT
Introduction: Fishes and shellfish not only contribute to food and nutrition security but also to the livelihood of coastal communities in the Philippines. However, some fishing grounds are contaminated and health advisories against seafood consumption are issued, which may negatively affect the fishing communities’ livelihood. This study aimed to assess fish and shellfish consumption of households living in selected coastal barangays of the Marilao-Meycauayan-Obando River System (MMORS). The food systems framework was applied whereby fish and shellfish consumption and livelihoods were viewed as part of a larger food system.
Methods: The study was conducted in five barangays of the MMORS. A total of 110 household respondents were selected based on systematic random sampling. Key informants were interviewed to determine fish farm production and distribution. The final questionnaire included questions on socio-demographic information, household consumption information on frequency of consumption of fishes and shellfishes, sources of produce, fish and shellfish preparation and cooking methods, and perceptions on the fish produce in the area. Data were encoded and tabulated while qualitative data were analysed using thematic analysis.
Results: Fishes and shellfishes are grown in earth-diked fish ponds using river water or harvested along the river system. No post-harvest processing is done and harvests are directly sold in fish markets within the area or nearby towns depending on the price and size of harvests. Fish consumption in both areas is affected by taste, tradition, price, nutritional value, age, gender and intra-household roles, and is found to be higher compared to national levels in the Philippines.
Conclusion: The feedback of health and nutrition advisories which are based on food consumption patterns to other food outcomes like livelihoods and ecological health were included in this study. Based on the findings, it is suggested that appropriate interventions should be implemented to balance food system outcomes.
Key words: Fish and shellfish consumption, fish farming, food system, food and nutrition security, health risk, river pollution
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Introduction: Fishes and shellfish not only contribute to food and nutrition security but also to the livelihood of coastal communities in the Philippines. However, some fishing grounds are contaminated and health advisories against seafood consumption are issued, which may negatively affect the fishing communities’ livelihood. This study aimed to assess fish and shellfish consumption of households living in selected coastal barangays of the Marilao-Meycauayan-Obando River System (MMORS). The food systems framework was applied whereby fish and shellfish consumption and livelihoods were viewed as part of a larger food system.
Methods: The study was conducted in five barangays of the MMORS. A total of 110 household respondents were selected based on systematic random sampling. Key informants were interviewed to determine fish farm production and distribution. The final questionnaire included questions on socio-demographic information, household consumption information on frequency of consumption of fishes and shellfishes, sources of produce, fish and shellfish preparation and cooking methods, and perceptions on the fish produce in the area. Data were encoded and tabulated while qualitative data were analysed using thematic analysis.
Results: Fishes and shellfishes are grown in earth-diked fish ponds using river water or harvested along the river system. No post-harvest processing is done and harvests are directly sold in fish markets within the area or nearby towns depending on the price and size of harvests. Fish consumption in both areas is affected by taste, tradition, price, nutritional value, age, gender and intra-household roles, and is found to be higher compared to national levels in the Philippines.
Conclusion: The feedback of health and nutrition advisories which are based on food consumption patterns to other food outcomes like livelihoods and ecological health were included in this study. Based on the findings, it is suggested that appropriate interventions should be implemented to balance food system outcomes.
Key words: Fish and shellfish consumption, fish farming, food system, food and nutrition security, health risk, river pollution
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Knowledge, Attitude and Practices towards Osteoporosis Prevention among Adults in Kuala Lumpur, Malaysia
Lim Suit Leng, Asma' Ali & Hayati Mohd Yusof
ABSTRACT
Introduction: Osteoporosis is a major health problem worldwide. In Asia, few studies have measured knowledge, attitude and practices (KAP) of osteoporosis. This study aimed to determine the KAP of osteoporosis, including the main factors influencing attitude towards osteoporosis, and the relationship between osteoporosis knowledge, attitude, and practices among adults in Kuala Lumpur, Malaysia.
Methods: A cross-sectional study via a self-administrated KAP questionnaire was carried out among 232 respondents aged 21 to 50 years in Kuala Lumpur. Random sampling was applied to select five districts in Kuala Lumpur, while convenient sampling was used for recruitment of apparently healthy subjects from community and institutional settings. The data were analysed using Mann-Whitney, Kruskal-Wallis, Chi-Square, Spearman Correlation and multiple logistic regression tests.
Results: The findings indicate a moderate level of knowledge and attitude towards osteoporosis prevention with median scores of 51.6% and 68.6%, respectively. Osteoporosis knowledge varied significantly with gender, educational level and household income (p<0.05). Furthermore, attitude was significantly different in relation to educational level and household income. Based on the multiple logistic regression test, relatives and friends appeared to be the most significant factor influencing attitude (R=0.319, p<0.0001). Poor dietary and lifestyles practices were indicated, and a significant relationship was found between practice of weight-bearing activities and educational level (p<0.05). A significant correlation was found (ρ=0.348, p<0.0001) between knowledge and attitude, while no relationship was noted between knowledge and practice of weight-bearing activities or attitude and practice of weight-bearing activities.
Conclusion: Knowledge played a significant role in affecting attitudes towards osteoporosis. However, understanding of osteoporosis is still at a moderate level. Friends and family were the most influential factor.
Key words: Adults, attitude, knowledge, osteoporosis, practices
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Introduction: Osteoporosis is a major health problem worldwide. In Asia, few studies have measured knowledge, attitude and practices (KAP) of osteoporosis. This study aimed to determine the KAP of osteoporosis, including the main factors influencing attitude towards osteoporosis, and the relationship between osteoporosis knowledge, attitude, and practices among adults in Kuala Lumpur, Malaysia.
Methods: A cross-sectional study via a self-administrated KAP questionnaire was carried out among 232 respondents aged 21 to 50 years in Kuala Lumpur. Random sampling was applied to select five districts in Kuala Lumpur, while convenient sampling was used for recruitment of apparently healthy subjects from community and institutional settings. The data were analysed using Mann-Whitney, Kruskal-Wallis, Chi-Square, Spearman Correlation and multiple logistic regression tests.
Results: The findings indicate a moderate level of knowledge and attitude towards osteoporosis prevention with median scores of 51.6% and 68.6%, respectively. Osteoporosis knowledge varied significantly with gender, educational level and household income (p<0.05). Furthermore, attitude was significantly different in relation to educational level and household income. Based on the multiple logistic regression test, relatives and friends appeared to be the most significant factor influencing attitude (R=0.319, p<0.0001). Poor dietary and lifestyles practices were indicated, and a significant relationship was found between practice of weight-bearing activities and educational level (p<0.05). A significant correlation was found (ρ=0.348, p<0.0001) between knowledge and attitude, while no relationship was noted between knowledge and practice of weight-bearing activities or attitude and practice of weight-bearing activities.
Conclusion: Knowledge played a significant role in affecting attitudes towards osteoporosis. However, understanding of osteoporosis is still at a moderate level. Friends and family were the most influential factor.
Key words: Adults, attitude, knowledge, osteoporosis, practices
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Nutritional Status of Children Living in an Orphanage in Dhaka City, Bangladesh
Chowdhury ABMA, Wasiullah S, Haque MI, Muhammad F, Hasan MM, Ahmed KR & Chowdhury M
ABSTRACT
Introduction: Children living in orphanages tend to be neglected and may be malnourished. This study assessed the socio-economic background and nutritional status of children living in an orphanage in Dhaka city, Bangladesh.
Methods: A cross-sectional study was conducted among the children in Sir Salimullah Muslim Orphanage, Dhaka from January to November 2014. Systematic sampling was adopted to collect data from 232 children using a semi-structured questionnaire. Anthropometric measurements of the children were taken and the WHO reference growth chart was used to determine the children’s nutritional status. Weight-for-age was categorised by mild, moderate and severe malnutrition. The Pearson Chi-square test was performed to determine the association between the extent of malnutrition and socio-demographic characteristics of the children.
Results: The majority of the children (60.3%) in the orphanage were malnourished, with mild, moderate and severe malnourished being 43.1%, 16.8% and 0.4%, respectively. Malnutrition was higher among the boys than girls in the age group of 15-18 years. The orphans suffered significantly (P<0.05) from malnutrition compared to those, who had at least one parent alive.
Conclusion: Malnutrition is highly prevalent among children and adolescents under residential care and needs to be addressed. In particular, early identification and intervention can improve the quality of nutritional status of the urban orphanage population. An investigation with a large sample is highly desirable to explore the severity of the problem in the national context.
Key words: Children, Dhaka City, malnutrition, orphanage, poverty, urban
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Introduction: Children living in orphanages tend to be neglected and may be malnourished. This study assessed the socio-economic background and nutritional status of children living in an orphanage in Dhaka city, Bangladesh.
Methods: A cross-sectional study was conducted among the children in Sir Salimullah Muslim Orphanage, Dhaka from January to November 2014. Systematic sampling was adopted to collect data from 232 children using a semi-structured questionnaire. Anthropometric measurements of the children were taken and the WHO reference growth chart was used to determine the children’s nutritional status. Weight-for-age was categorised by mild, moderate and severe malnutrition. The Pearson Chi-square test was performed to determine the association between the extent of malnutrition and socio-demographic characteristics of the children.
Results: The majority of the children (60.3%) in the orphanage were malnourished, with mild, moderate and severe malnourished being 43.1%, 16.8% and 0.4%, respectively. Malnutrition was higher among the boys than girls in the age group of 15-18 years. The orphans suffered significantly (P<0.05) from malnutrition compared to those, who had at least one parent alive.
Conclusion: Malnutrition is highly prevalent among children and adolescents under residential care and needs to be addressed. In particular, early identification and intervention can improve the quality of nutritional status of the urban orphanage population. An investigation with a large sample is highly desirable to explore the severity of the problem in the national context.
Key words: Children, Dhaka City, malnutrition, orphanage, poverty, urban
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NUTRIENTS, FOOD COMPOSITION, PHYTOCHEMICALS
Plasma Arsenic and Selenium in Apparently Healthy Individuals in Ebonyi State, South- Eastern Nigeria
Ugwuja EI, Uro-Chukwu HC & Ikaraoha IC
ABSTRACT
Introduction: Although reports are conflicting on arsenic-selenium interactions, there is paucity of data on the determinants of plasma selenium (Se) and arsenic (As) in healthy individuals in Ebonyi State, South Eastern Nigeria. Ebonyi State is richly endowed with mineral deposits which are mined without consideration of their health hazards. This study is aimed at assessing the socio-demographic determinants of plasma arsenic and selenium in apparently healthy individuals in Ebonyi State.
Methods: Apparently healthy individuals (n=441) consisting of 117 males, 184 females and 140 pregnant females, aged ≥ 18 years (mean=38.5±0.6 yrs) were randomly selected from 130 geo-political Wards (10 Wards from each of the 13 Local Government Areas of Ebonyi state) to constitute the study population. Plasma arsenic and selenium were determined in blood samples using atomic absorption spectrophotometer. Socio-demographic data were collected using questionnaires while anthropometric measurements were determined using standard methods.
Results: The mean plasma arsenic levels were 0.204±0.02 (males), 0.209±0.02 (females), 0.186±0.02 μg/dl (pregnant females) and plasma selenium levels were 0.134±0.01 (males), 0.138±0.01 (females), 0.147±0.01 μg/dl (pregnant females), respectively. Plasma Se levels were generally lower than the value (5.92 μg/dl) considered universally as inadequate. While plasma levels of As and Se were not significantly different between male and female, obese subjects had significantly lower plasma levels of both elements. There was a significant negative correlation between BMI and plasma As. Neither smoking nor alcohol consumption was associated with plasma levels of As and Se.
Conclusion: Apparently healthy individuals in Ebonyi State exhibited elevated plasma levels of As and low plasma Se, which may potentially place them at risk of adverse health associated with As toxicity.
Key words: Anthropometrics, arsenic, interactions, selenium, socio-demographic features
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Introduction: Although reports are conflicting on arsenic-selenium interactions, there is paucity of data on the determinants of plasma selenium (Se) and arsenic (As) in healthy individuals in Ebonyi State, South Eastern Nigeria. Ebonyi State is richly endowed with mineral deposits which are mined without consideration of their health hazards. This study is aimed at assessing the socio-demographic determinants of plasma arsenic and selenium in apparently healthy individuals in Ebonyi State.
Methods: Apparently healthy individuals (n=441) consisting of 117 males, 184 females and 140 pregnant females, aged ≥ 18 years (mean=38.5±0.6 yrs) were randomly selected from 130 geo-political Wards (10 Wards from each of the 13 Local Government Areas of Ebonyi state) to constitute the study population. Plasma arsenic and selenium were determined in blood samples using atomic absorption spectrophotometer. Socio-demographic data were collected using questionnaires while anthropometric measurements were determined using standard methods.
Results: The mean plasma arsenic levels were 0.204±0.02 (males), 0.209±0.02 (females), 0.186±0.02 μg/dl (pregnant females) and plasma selenium levels were 0.134±0.01 (males), 0.138±0.01 (females), 0.147±0.01 μg/dl (pregnant females), respectively. Plasma Se levels were generally lower than the value (5.92 μg/dl) considered universally as inadequate. While plasma levels of As and Se were not significantly different between male and female, obese subjects had significantly lower plasma levels of both elements. There was a significant negative correlation between BMI and plasma As. Neither smoking nor alcohol consumption was associated with plasma levels of As and Se.
Conclusion: Apparently healthy individuals in Ebonyi State exhibited elevated plasma levels of As and low plasma Se, which may potentially place them at risk of adverse health associated with As toxicity.
Key words: Anthropometrics, arsenic, interactions, selenium, socio-demographic features
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Enterococci Isolated from Traditional Cheese Alters Serum Lipid and Cytokine Levels in Adult Male NMRI Mice
Solati J & Kalkhorani N
ABSTRACT
Introduction: The present study aimed to isolate Enterococci bacteria from Iranian traditional cheese and to evaluate the effects of the isolated bacteria on serum lipid levels and the activation of the immune system in animals.
Methods: Enterococci bacteria were isolated from cheese using particular cultures and identified using analytical profile index (API) kits. NMRI mice were divided into different groups and Enterococci was orally administrated at doses of 2 (6×108 CFU/ml), 3 (9×108 CFU/ml), and 4 (12×108 CFU/ml) MacFarland for 2 weeks. Blood samples were collected from a retro-orbital sinus, and serum lipids level was measured using the spectrophotometer method and interleukin levels were measured using ELISAkits.
Results: Treatment with E.faecium serotype decreased serum total cholesterol and LDL and increased serum IL-10 levels, while having no significant effect on serum triglycerides, HDL, IL-2, and IL-6 concentrations (p < 0.05). Administration of E. faecalis serotype had no significant effect on serum lipid levels. Moreover, results revealed that treatment with the E. faecalis serotype increased Il-6 and IL-10 concentrations. None of the mentioned serotypes significantly affected gut pathogen growth (p < 0.05)
Conclusion: Enterococci bacteria from Iranian traditional cheese showed no significant inhibitory effects on gut pathogens, but exhibited significant decreases in serum total cholesterol and LDP-chol. More studies are suggested to confirm the potential role of the E.faecalis serotype and anti-inflammatory/inflammatory reactions in the body.
Key words: Cheese, enterococci, cheese, lipid level, probiotics, serum
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Introduction: The present study aimed to isolate Enterococci bacteria from Iranian traditional cheese and to evaluate the effects of the isolated bacteria on serum lipid levels and the activation of the immune system in animals.
Methods: Enterococci bacteria were isolated from cheese using particular cultures and identified using analytical profile index (API) kits. NMRI mice were divided into different groups and Enterococci was orally administrated at doses of 2 (6×108 CFU/ml), 3 (9×108 CFU/ml), and 4 (12×108 CFU/ml) MacFarland for 2 weeks. Blood samples were collected from a retro-orbital sinus, and serum lipids level was measured using the spectrophotometer method and interleukin levels were measured using ELISAkits.
Results: Treatment with E.faecium serotype decreased serum total cholesterol and LDL and increased serum IL-10 levels, while having no significant effect on serum triglycerides, HDL, IL-2, and IL-6 concentrations (p < 0.05). Administration of E. faecalis serotype had no significant effect on serum lipid levels. Moreover, results revealed that treatment with the E. faecalis serotype increased Il-6 and IL-10 concentrations. None of the mentioned serotypes significantly affected gut pathogen growth (p < 0.05)
Conclusion: Enterococci bacteria from Iranian traditional cheese showed no significant inhibitory effects on gut pathogens, but exhibited significant decreases in serum total cholesterol and LDP-chol. More studies are suggested to confirm the potential role of the E.faecalis serotype and anti-inflammatory/inflammatory reactions in the body.
Key words: Cheese, enterococci, cheese, lipid level, probiotics, serum
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Book Review : Feeding the Preterm Infant: a Practical Handbook Fook-Choe Cheah et al. (2017), Patridge Publishing, Singapore
Download PDFMalaysian Journal of Nutrition
Volume 23 No.3, 2017
Table of Content
Invited Editorial: Recommendations to Improve Body Image Research in an Increasingly Globalised World
Swami V & Barron D
Nutritional Quality of Meals, Food Intake, Physical Activity and Length of Stay Predict Nutritional Status of Institutionalised Elderly Filipinos
de Guzman AB, Lago BMM, Nieves RAA, Parungao Ma NCC, Tin CKS & Urquiza KCJO
ABSTRACT
Introduction: Increasingly, the threat of malnutrition in geriatric institutions is affected by several factors such as cognition, immobility, oral problems, and psychological status. Low food intake is seen to be the primary cause of geriatric malnutrition. Further, greater length of stay and higher physical activity were significantly associated with reduced body weight and good health status, respectively. This study aimed to identify how nutritional quality of meals, food intake, physical activity and length of stay affect the nutritional status of institutionalised elderly in the Philippines.
Methods: Data for this study were obtained using food weighing records, 24-hour food recall, Physical Activity Scale for Elderly (PASE), and Mini Nutritional Assessment (MNA) among 100 purposively recruited institutionalised elderly. Macronutrients were computed based on the Philippine Food Composition Table (FCT) while adequacy was evaluated based on the Philippine Dietary Reference Intake (PDRI).
Results: The use of Partial Least Square (PLS) regression analysis revealed that of the variables, only food intake (β=0.17; p=0.04), physical activity (β=0.16; p=0.04) and length of stay of elderly in the institution (β=0.18; p<.01) had a weak positive effect on the nutritional status of the institutionalised elderly.
Conclusion: This study showed the role of food intake, physical activity and length of stay in the nutritional status of elderly in home care settings. This implies that assessment of the nutritional status and its associated factors remains vital in the development of nutrition intervention and the provision of quality food planning and service in institutionalised settings.
Key words: Elderly, food intake, length of stay (LOS), nutritional quality of meals, nutritional status, physical activity.
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Introduction: Increasingly, the threat of malnutrition in geriatric institutions is affected by several factors such as cognition, immobility, oral problems, and psychological status. Low food intake is seen to be the primary cause of geriatric malnutrition. Further, greater length of stay and higher physical activity were significantly associated with reduced body weight and good health status, respectively. This study aimed to identify how nutritional quality of meals, food intake, physical activity and length of stay affect the nutritional status of institutionalised elderly in the Philippines.
Methods: Data for this study were obtained using food weighing records, 24-hour food recall, Physical Activity Scale for Elderly (PASE), and Mini Nutritional Assessment (MNA) among 100 purposively recruited institutionalised elderly. Macronutrients were computed based on the Philippine Food Composition Table (FCT) while adequacy was evaluated based on the Philippine Dietary Reference Intake (PDRI).
Results: The use of Partial Least Square (PLS) regression analysis revealed that of the variables, only food intake (β=0.17; p=0.04), physical activity (β=0.16; p=0.04) and length of stay of elderly in the institution (β=0.18; p<.01) had a weak positive effect on the nutritional status of the institutionalised elderly.
Conclusion: This study showed the role of food intake, physical activity and length of stay in the nutritional status of elderly in home care settings. This implies that assessment of the nutritional status and its associated factors remains vital in the development of nutrition intervention and the provision of quality food planning and service in institutionalised settings.
Key words: Elderly, food intake, length of stay (LOS), nutritional quality of meals, nutritional status, physical activity.
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Effect of Probiotic Microbial Cell Preparation (MCP) on Fasting Blood Glucose, Body Weight, Waist Circumference, and Faecal Short Chain Fatty Acids among Overweight Malaysian Adults: A Pilot Randomised Controlled Trial of 4 Weeks
Mahadzir MDA, ShyamS, Barua A, Krishnappa P & Ramamurthy
ABSTRACT
Introduction: Probiotic microbial cell preparation (MCP) supplementation is one of the approaches to modulate alterations in gut microbiota (GM). This double-blind randomised controlled trial investigated the effect of 4 weeks of MCP supplementation on fasting blood glucose levels (FBG), body weight (BW), waist circumference (WC), and faecal short chain fatty acids (SCFA) among 24 healthy and overweight (with BMI ≥ 23 kg/m2) Malaysian adults.
Methods: Twenty-six subjects were randomised to receive either MCP (n= 12) or placebo (n=14), twice daily, for 4 weeks. The probiotic powder contained a mix of six strains namely, Lactobacillus acidophilus, Lactobacillus lactis, Lactobacillus casei,Bifidobacterium longum, Bifidobacterium bifidum and Bifidobacterium infantis (3.0 x 1010 cfu). FBG, BW, WC, WHR, faecal SCFA, physical activity levels and dietary intake were measured and changes were determined using repeated measures ANOVA.
Results: Twenty-four subjects successfully completed the 4-week study period. Changes in FBG, BW, WC and SCFA were not significantly different between the groups. Only subjects in the MCP group significantly reduced their energy intake compared to baseline (1671±476 vs 1386±447 kcal, P=0.045).
Conclusion: A 4-week supplementation of the MCP mix powder did not have significant effects on the variables studied. However, the significant reduction in dietary energy intake in the MCP group suggests the potential of probiotics as an adjuvant to dietary therapy for weight loss.
Key words: Microbial cell preparation, obesity, overweight, probiotics, randomised controlled trial
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Introduction: Probiotic microbial cell preparation (MCP) supplementation is one of the approaches to modulate alterations in gut microbiota (GM). This double-blind randomised controlled trial investigated the effect of 4 weeks of MCP supplementation on fasting blood glucose levels (FBG), body weight (BW), waist circumference (WC), and faecal short chain fatty acids (SCFA) among 24 healthy and overweight (with BMI ≥ 23 kg/m2) Malaysian adults.
Methods: Twenty-six subjects were randomised to receive either MCP (n= 12) or placebo (n=14), twice daily, for 4 weeks. The probiotic powder contained a mix of six strains namely, Lactobacillus acidophilus, Lactobacillus lactis, Lactobacillus casei,Bifidobacterium longum, Bifidobacterium bifidum and Bifidobacterium infantis (3.0 x 1010 cfu). FBG, BW, WC, WHR, faecal SCFA, physical activity levels and dietary intake were measured and changes were determined using repeated measures ANOVA.
Results: Twenty-four subjects successfully completed the 4-week study period. Changes in FBG, BW, WC and SCFA were not significantly different between the groups. Only subjects in the MCP group significantly reduced their energy intake compared to baseline (1671±476 vs 1386±447 kcal, P=0.045).
Conclusion: A 4-week supplementation of the MCP mix powder did not have significant effects on the variables studied. However, the significant reduction in dietary energy intake in the MCP group suggests the potential of probiotics as an adjuvant to dietary therapy for weight loss.
Key words: Microbial cell preparation, obesity, overweight, probiotics, randomised controlled trial
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Effects of Consuming Yellowstripe Scad versus Salmon on Lipid Profile, Fasting Glucose, Body Weight Status, and Blood Pressure among Healthy Malaysian Overweight Adults
Chang WL, Azrina A, Sabariah MN, Irmi Zarina I & Loh SP
ABSTRACT
Introduction: This is a preliminary result of an on-going randomised cross-over trial to compare the effects of consuming yellowstripe scad (YSS) and salmon, both rich in omega-3 fatty acids, on lipid profile, fasting glucose, body weight status, and blood pressure among healthy overweight adults.
Methods: Fifty healthy overweight Malaysians aged 21-55 years were recruited voluntarily through advertisements. During the first period of intervention, subjects were randomised equally to receive eight weeks of either steamed whole YSS fish (YSS group) or salmon fillet (salmon group), three days per week, obtaining approximately 7000 mg EPA+DHA per week. The diets were switched after an eight-week washout period. Lipid profile, fasting glucose, body mass index, and blood pressure were evaluated before and after each intervention period.
Results: The mean ages of YSS group (n=25) and salmon (n=25) group were 30.6±9.1 and 27.9±7.1 years respectively. Both groups had no statistically significant differences on socio-demographic characteristics (p>0.05). After the first intervention period, there was a significant increase in total cholesterol within the YSS group (p<0.05) but not within the salmon group (p>0.05). Both YSS and salmon groups had significantly higher HDL-cholesterol levels after 8 weeks compared to baseline (p<0.05). There was no significant between-group difference in all the variables after eight weeks (time x group interaction, p>0.05). However, there was a significant effect of time on diastolic blood pressure (p<0.05).
Conclusion: These preliminary findings indicate that YSS and salmon may have similar beneficial effects on HDL-cholesterol level among healthy overweight adults. The second intervention period is on-going to confirm these findings.
Key words: Dietary fish, healthy overweight adults, lipid profile, omega-3 fatty acids, randomised cross-over trial
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Introduction: This is a preliminary result of an on-going randomised cross-over trial to compare the effects of consuming yellowstripe scad (YSS) and salmon, both rich in omega-3 fatty acids, on lipid profile, fasting glucose, body weight status, and blood pressure among healthy overweight adults.
Methods: Fifty healthy overweight Malaysians aged 21-55 years were recruited voluntarily through advertisements. During the first period of intervention, subjects were randomised equally to receive eight weeks of either steamed whole YSS fish (YSS group) or salmon fillet (salmon group), three days per week, obtaining approximately 7000 mg EPA+DHA per week. The diets were switched after an eight-week washout period. Lipid profile, fasting glucose, body mass index, and blood pressure were evaluated before and after each intervention period.
Results: The mean ages of YSS group (n=25) and salmon (n=25) group were 30.6±9.1 and 27.9±7.1 years respectively. Both groups had no statistically significant differences on socio-demographic characteristics (p>0.05). After the first intervention period, there was a significant increase in total cholesterol within the YSS group (p<0.05) but not within the salmon group (p>0.05). Both YSS and salmon groups had significantly higher HDL-cholesterol levels after 8 weeks compared to baseline (p<0.05). There was no significant between-group difference in all the variables after eight weeks (time x group interaction, p>0.05). However, there was a significant effect of time on diastolic blood pressure (p<0.05).
Conclusion: These preliminary findings indicate that YSS and salmon may have similar beneficial effects on HDL-cholesterol level among healthy overweight adults. The second intervention period is on-going to confirm these findings.
Key words: Dietary fish, healthy overweight adults, lipid profile, omega-3 fatty acids, randomised cross-over trial
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Enteral Feeding of Critical Patients in Juan A Fernandez Hospital in Buenos Aires, Argentina. Does it Lead to Protein Deficit and Caloric Excess?
Cardone F, Alfonso J, Castaño F, Antonini M & Baccaro F
ABSTRACT
Introduction: The critical patient is characterised by an alteration in the function of one or several organs or systems, a situation that may compromise his survival. The purpose of the present study was to deduce if patients who were fed by Enteral Nutrition (NE) in the Intensive Care Unit (ICU) had a protein deficit combined with caloric overfeeding.
Methods: This cross-sectional study was undertaken between August 2013 and April 2014 in the ICU, Hospital General deAgudos “Juan A. Fernández“, Buenos Aires, Argentina. The energy and protein prescriptions were obtained from medical indications. For the estimation of energy, the recommendations of the American Society of Parenteral and Enteral Nutrition (ASPEN) of less than 20-25 kcal/kg/day during the acute phase were taken into account. T-test and Mann-Whitney U test for comparison of groups was calculated with significance at p<0.05.
Results: This study had a sample of 52 patients.The average daily energy requirements, calculated from the third day of ICU admission, was 1637 kcal (SD +/- 385, CI 95% 1529.8/1744.1), while the mean daily energy delivered was 1726 Kcal (DE +/- 365, IC95% 1624.4/1827.6). All patients had negative A ccumulated Protein Balance (APB).
Conclusion: The majority of the patients presented with energy over-prescription and protein deficit. Energy overfeeding could lead to an increase in hospital stay, which would further increase health costs
Key words: Critical care, enteral feeding, prescription
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Introduction: The critical patient is characterised by an alteration in the function of one or several organs or systems, a situation that may compromise his survival. The purpose of the present study was to deduce if patients who were fed by Enteral Nutrition (NE) in the Intensive Care Unit (ICU) had a protein deficit combined with caloric overfeeding.
Methods: This cross-sectional study was undertaken between August 2013 and April 2014 in the ICU, Hospital General deAgudos “Juan A. Fernández“, Buenos Aires, Argentina. The energy and protein prescriptions were obtained from medical indications. For the estimation of energy, the recommendations of the American Society of Parenteral and Enteral Nutrition (ASPEN) of less than 20-25 kcal/kg/day during the acute phase were taken into account. T-test and Mann-Whitney U test for comparison of groups was calculated with significance at p<0.05.
Results: This study had a sample of 52 patients.The average daily energy requirements, calculated from the third day of ICU admission, was 1637 kcal (SD +/- 385, CI 95% 1529.8/1744.1), while the mean daily energy delivered was 1726 Kcal (DE +/- 365, IC95% 1624.4/1827.6). All patients had negative A ccumulated Protein Balance (APB).
Conclusion: The majority of the patients presented with energy over-prescription and protein deficit. Energy overfeeding could lead to an increase in hospital stay, which would further increase health costs
Key words: Critical care, enteral feeding, prescription
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Nutritional Status and Quality of Life of Oncology Patients Prior to Pelvic Radiotherapy
Dzairudzee Rosli, Suzana Shahar, Zahara Abdul Manaf, Hazreen Abd Majid & Mohd Roslan Haron
ABSTRACT
Introduction: Malnutrition among cancer patients is associated with a higher risk of gastrointestinal toxicity which develops during treatment and may affect quality of life (QOL). Thus, this cross-sectional study aimed to determine the nutritional status and QOL of 30 oncology patients (mean age 50.0 + 10.7 years) prior to pelvic radiotherapy at Hospital Sultan Ismail, Johor Bahru.
Methods: Patients were assessed for anthropometry measurements, 24-h diet recall and nutritional status using Scored Patient-Generated Subjective Global Assessment (PG-SGA) questionnaire while the European Organization for Research and Treatment of Cancer Care Quality of Life Questionnaire (EORTC QLQ-C30) was used to assess QOL two weeks prior to the initiation of pelvic radiotherapy.
Results: Mean Body Mass Index (BMI) of patients was 23.3+3.3kg/m2 and 33% of patients experienced weight loss prior to pelvic radiotherapy. The PG-SGA rating indicated that 63% of patients were at Stage A (well-nourished) and 37% were in Stage B (moderate malnutrition). The PG-SGA numerical score was a significant predictor of QOL, after adjusting for socio-demographic factors (R2=0.861, p<0.05).
Conclusion: In general, the low nutritional status of the patients indicates the need for early nutritional assessment, education and intervention in ensuring optimal nutritional status throughout the pelvic radiotherapy treatment.
Key words: EORTC QLQ-C30, malnutrition, pelvic radiotherapy, PG-SGA
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Introduction: Malnutrition among cancer patients is associated with a higher risk of gastrointestinal toxicity which develops during treatment and may affect quality of life (QOL). Thus, this cross-sectional study aimed to determine the nutritional status and QOL of 30 oncology patients (mean age 50.0 + 10.7 years) prior to pelvic radiotherapy at Hospital Sultan Ismail, Johor Bahru.
Methods: Patients were assessed for anthropometry measurements, 24-h diet recall and nutritional status using Scored Patient-Generated Subjective Global Assessment (PG-SGA) questionnaire while the European Organization for Research and Treatment of Cancer Care Quality of Life Questionnaire (EORTC QLQ-C30) was used to assess QOL two weeks prior to the initiation of pelvic radiotherapy.
Results: Mean Body Mass Index (BMI) of patients was 23.3+3.3kg/m2 and 33% of patients experienced weight loss prior to pelvic radiotherapy. The PG-SGA rating indicated that 63% of patients were at Stage A (well-nourished) and 37% were in Stage B (moderate malnutrition). The PG-SGA numerical score was a significant predictor of QOL, after adjusting for socio-demographic factors (R2=0.861, p<0.05).
Conclusion: In general, the low nutritional status of the patients indicates the need for early nutritional assessment, education and intervention in ensuring optimal nutritional status throughout the pelvic radiotherapy treatment.
Key words: EORTC QLQ-C30, malnutrition, pelvic radiotherapy, PG-SGA
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Relationship between Quality of Life and Nutritional Status in Colorectal Cancer Patients Undergoing Chemotherapy
Zalina Abu Zaid, Kathryn Jackson, Lynne Cobiac & Mirnalini Kandiah
ABSTRACT
Introduction: Malnutrition is associated with poorer outcomes following treatment for colorectal cancer (CRC). This study evaluates the relationship between nutritional status using scored Patient Generated-Subjective Global Assessment (PG-SGA) with the validated European Organisation for Research and Treatment of Cancer questionnaire (EORTC-QLQ C30) which consists of five functional scales, three symptoms scales and one item of global health/quality of life (QOL).
Methods: A total of 42 CRC patients at oncology outpatient clinics from two hospitals in Malaysia participated in the study from March 2011 to March 2012. The participants were classified as either well-nourished (PG-SGA A) or malnourished (PG-SGA B and C).
Results: The majority of patients were Chinese, male, with a mean age of 57.1 ± 9.8 years and had been diagnosed with stage 2 CRC. Well-nourished patients had statistically significantly better QOL scores on symptom scales: fatigue (p<0.001), nausea and vomiting (p<0.05), and pain (p<0.001) compared to malnourished patients. PG-SGA was strongly correlated with the main domains of the QOL: global health status (r = -0.395, p<0.05), fatigue (r = 0.816, p<0.001), nausea and vomiting (r = 0.730, p<0.001) and pain (r = 0.629, p<0.001). The better the nutritional status (lower total mean score of PG-SGA), the higher the QOL (high mean score of global health status).
Conclusion: The scored PG-SGA is suitable for use as a nutrition assessment tool to identify malnutrition and it is associated with QOL among this population.
Key words: Chemotherapy, colorectal cancer patient, malnutrition, nutritional status, PG-SGA score, quality of life
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Introduction: Malnutrition is associated with poorer outcomes following treatment for colorectal cancer (CRC). This study evaluates the relationship between nutritional status using scored Patient Generated-Subjective Global Assessment (PG-SGA) with the validated European Organisation for Research and Treatment of Cancer questionnaire (EORTC-QLQ C30) which consists of five functional scales, three symptoms scales and one item of global health/quality of life (QOL).
Methods: A total of 42 CRC patients at oncology outpatient clinics from two hospitals in Malaysia participated in the study from March 2011 to March 2012. The participants were classified as either well-nourished (PG-SGA A) or malnourished (PG-SGA B and C).
Results: The majority of patients were Chinese, male, with a mean age of 57.1 ± 9.8 years and had been diagnosed with stage 2 CRC. Well-nourished patients had statistically significantly better QOL scores on symptom scales: fatigue (p<0.001), nausea and vomiting (p<0.05), and pain (p<0.001) compared to malnourished patients. PG-SGA was strongly correlated with the main domains of the QOL: global health status (r = -0.395, p<0.05), fatigue (r = 0.816, p<0.001), nausea and vomiting (r = 0.730, p<0.001) and pain (r = 0.629, p<0.001). The better the nutritional status (lower total mean score of PG-SGA), the higher the QOL (high mean score of global health status).
Conclusion: The scored PG-SGA is suitable for use as a nutrition assessment tool to identify malnutrition and it is associated with QOL among this population.
Key words: Chemotherapy, colorectal cancer patient, malnutrition, nutritional status, PG-SGA score, quality of life
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Quality Coding of Malnutrition under the Casemix System in Hospital Universiti Sains Malaysia
Nur Fazimah S, Rosminah M & Sakinah H
ABSTRACT
Introduction: Detailed clinical information is important for the Casemix System to generate valuable Case Based Group (CBG) for malnourished geriatric patients. Clinical coding for malnutrition provides useful information on the nutritional health of patients for treatment purposes.
Methods: This cross-sectional study with purposive sampling involved a total of 130 geriatric patients (>60 years) at Hospital Universiti Sains Malaysia (USM). Nutritional assessments were performed such as anthropometrics measurement, Subjective Global Assessment (SGA), and biochemical assessment. The patients’ medical records and coded data were systematically reviewed to observe the documentation of nutritional information and coding criteria based on the International Classification for Diseases (ICD-10).
Results: The prevalence of malnutrition among the geriatric patients was 35.4%. Proper documentation of required nutritional information was found in less than 50% of the cases. None of the malnourished patients were documented and coded with malnutrition diagnosis, despite being given nutritional interventions. The reasons given for this omission were related to the lack of awareness (50%) and incomplete medical documentation (50%). Further analysis revealed that uncoded diagnosis, miscoding, missing, and unavailable codes for nutritional counselling and oral nutritional supplementation were the main ontributors to the incomplete records.
Conclusion: The quality of clinical coding for malnourished geriatric patients in the hospital should be improved. A structured assessment and standard documentation is recommended to improve the quality of healthcare provision for malnourished geriatric patients.
Key words: Casemix system, clinical coding, documentation, malnutrition, nutritional information
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Introduction: Detailed clinical information is important for the Casemix System to generate valuable Case Based Group (CBG) for malnourished geriatric patients. Clinical coding for malnutrition provides useful information on the nutritional health of patients for treatment purposes.
Methods: This cross-sectional study with purposive sampling involved a total of 130 geriatric patients (>60 years) at Hospital Universiti Sains Malaysia (USM). Nutritional assessments were performed such as anthropometrics measurement, Subjective Global Assessment (SGA), and biochemical assessment. The patients’ medical records and coded data were systematically reviewed to observe the documentation of nutritional information and coding criteria based on the International Classification for Diseases (ICD-10).
Results: The prevalence of malnutrition among the geriatric patients was 35.4%. Proper documentation of required nutritional information was found in less than 50% of the cases. None of the malnourished patients were documented and coded with malnutrition diagnosis, despite being given nutritional interventions. The reasons given for this omission were related to the lack of awareness (50%) and incomplete medical documentation (50%). Further analysis revealed that uncoded diagnosis, miscoding, missing, and unavailable codes for nutritional counselling and oral nutritional supplementation were the main ontributors to the incomplete records.
Conclusion: The quality of clinical coding for malnourished geriatric patients in the hospital should be improved. A structured assessment and standard documentation is recommended to improve the quality of healthcare provision for malnourished geriatric patients.
Key words: Casemix system, clinical coding, documentation, malnutrition, nutritional information
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Accelerometer-Measured Physical Activity and its Relationship with Body Mass Index (BMI) and Waist-Circumference (WC) Measurements: A Cross-Sectional Study on Malaysian Adults
Lee Yi Yi, Narimah Samat & Wan Manan Wan Muda
ABSTRACT
Introduction: Physical activity has been shown to be beneficial for the prevention of obesity and non-communicable diseases. Our contemporary way of life that is technology dependent has significantly reduced physical activity. This study aimed to determine accelerometer-measured physical activity (moderate-to-vigorous physical activity (MVPA)) among adults in high and low walkability neighbourhoods in Penang and Kota Bharu, Malaysia.
Methods: Participants (n=490) were sampled using multistage sampling method from neighbourhoods with varied levels of walkability using Geographical Information System (GIS). Physical activity was measured objectively using Actigraph GT3X+ accelerometers, worn by the participants on their waists for a period of 5 to 7 days.
Results: The participants had a mean of 13.5 min/day of MVPA. Total MVPA was significantly higher among participants in high walkability neighbourhoods (19.7 min/day vs. 9.1 min/day). Results from t-test showed that the time spent on MVPA per day was significantly lower among participants residing in low walkability neighbourhoods. The final model of the MIXED model statistical tests showed that total MVPA was significantly associated with BMI, but not with WC measurements, after adjusting for covariates.
Conclusion: Most of the participants had very low MVPA and did not achieve the current physical activity recommendations, implying that Malaysian adults residing in these two cities were not physically active to achieve health benefits. Results are suggestive of the importance of the walkability concept in neighbourhoods in encouraging physical activity and healthy body weight among Malaysians.
Key words: Accelerometry, moderate-to-vigorous physical activity, obesity, physical activity, walkability
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Introduction: Physical activity has been shown to be beneficial for the prevention of obesity and non-communicable diseases. Our contemporary way of life that is technology dependent has significantly reduced physical activity. This study aimed to determine accelerometer-measured physical activity (moderate-to-vigorous physical activity (MVPA)) among adults in high and low walkability neighbourhoods in Penang and Kota Bharu, Malaysia.
Methods: Participants (n=490) were sampled using multistage sampling method from neighbourhoods with varied levels of walkability using Geographical Information System (GIS). Physical activity was measured objectively using Actigraph GT3X+ accelerometers, worn by the participants on their waists for a period of 5 to 7 days.
Results: The participants had a mean of 13.5 min/day of MVPA. Total MVPA was significantly higher among participants in high walkability neighbourhoods (19.7 min/day vs. 9.1 min/day). Results from t-test showed that the time spent on MVPA per day was significantly lower among participants residing in low walkability neighbourhoods. The final model of the MIXED model statistical tests showed that total MVPA was significantly associated with BMI, but not with WC measurements, after adjusting for covariates.
Conclusion: Most of the participants had very low MVPA and did not achieve the current physical activity recommendations, implying that Malaysian adults residing in these two cities were not physically active to achieve health benefits. Results are suggestive of the importance of the walkability concept in neighbourhoods in encouraging physical activity and healthy body weight among Malaysians.
Key words: Accelerometry, moderate-to-vigorous physical activity, obesity, physical activity, walkability
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Knowledge and Attitude Related to Nutritional Supplements and Risk of Doping among National Elite Athletes in Malaysia
Balaravi B, Chin MQ, Karppaya H, Chai W J, Samantha Quah LW & Ramadas A
ABSTRACT
Introduction: Often considered a legitimate strategy to enhance health and performance, the consumption of nutritional supplements (NS) has become a common practice which frequently results in unintentional doping among athletes. Despite a probable association between NS and doping, there are limited studies on this topic in developing countries such as Malaysia. Thus, this study aimed to identify the prevalence of NS usage among national elite athletes and assess their knowledge and attitude regarding its use and doping.
Methods: This was a cross-sectional study conducted at the Malaysian National Sports Institute among national elite athletes (n=50) recruited via convenience sampling. The athletes completed a self-administered questionnaire documenting their demographic characteristics, training information, NS consumption, knowledge and attitude related to supplement-doping. The total knowledge and attitude scores were compared according to demography, training information, and NS consumption.
Results: The prevalence of NS use among the athletes was 72%. NS usage was significantly associated with training duration (p=0.029), source of nutrition information (p=0.047) and self-exploration on supplements (p=0.045). Supplement-doping knowledge was significantly higher among athletes with tertiary level education (p=0.027), NS users (p=0.044), those obtaining information from nutritionists (p=0.048) and those who had attended nutrition workshops (p<0.001). The attitude score was significantly higher among males (p=0.021), professional athletes (p=0.041), athletes with lower training hours (p=0.010), those obtaining information from nutritionists (p=0.035) and those who had attended nutrition workshops (p=0.005).
Conclusion: A demographic- and training-specific education on NS should be provided by qualified nutritionists to reduce the risk of doping amongst athletes.
Key words: Athletes, attitude, doping, knowledge, nutritional supplements
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Introduction: Often considered a legitimate strategy to enhance health and performance, the consumption of nutritional supplements (NS) has become a common practice which frequently results in unintentional doping among athletes. Despite a probable association between NS and doping, there are limited studies on this topic in developing countries such as Malaysia. Thus, this study aimed to identify the prevalence of NS usage among national elite athletes and assess their knowledge and attitude regarding its use and doping.
Methods: This was a cross-sectional study conducted at the Malaysian National Sports Institute among national elite athletes (n=50) recruited via convenience sampling. The athletes completed a self-administered questionnaire documenting their demographic characteristics, training information, NS consumption, knowledge and attitude related to supplement-doping. The total knowledge and attitude scores were compared according to demography, training information, and NS consumption.
Results: The prevalence of NS use among the athletes was 72%. NS usage was significantly associated with training duration (p=0.029), source of nutrition information (p=0.047) and self-exploration on supplements (p=0.045). Supplement-doping knowledge was significantly higher among athletes with tertiary level education (p=0.027), NS users (p=0.044), those obtaining information from nutritionists (p=0.048) and those who had attended nutrition workshops (p<0.001). The attitude score was significantly higher among males (p=0.021), professional athletes (p=0.041), athletes with lower training hours (p=0.010), those obtaining information from nutritionists (p=0.035) and those who had attended nutrition workshops (p=0.005).
Conclusion: A demographic- and training-specific education on NS should be provided by qualified nutritionists to reduce the risk of doping amongst athletes.
Key words: Athletes, attitude, doping, knowledge, nutritional supplements
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Assessment of Dietary Diversity Score, Nutritional Status and Socio-demographic Characteristics of Under-5 Children in Some Rural Areas of Imo State, Nigeria
Ukegbu Patricia Ogechi & Ogu Victoria Chilezie
ABSTRACT
Introduction: The study assessed dietary diversity score (DDS) of rural under-five children and the relationship with their nutritional status and socio-demographic characteristics of their mothers/caregivers.
Methods: The study was a descriptive cross-sectional survey involving 226 mothers and their under-five children selected at random from rural communities in Imo state, Nigeria. A pre-tested questionnaire was used to obtain information on socio-demographics. Qualitative recall of the child’s food consumption during the previous 24-h was used to calculate individual dietary diversity score (DDS=representing the number of food groups, based on a scale of 12 groups) and the scores were divided into terciles low= ≤4, medium=5 - 8, and high= 9 - 12). Weight-for-age (WAZ), height-for-age (HAZ) and eight-for-height (WHZ) Z-scores were used to determine nutritional status of the children. Descriptive statistics, Chi square and linear regression analyses were performed.
Results: Average age of the children was 4.2±0.7years, with 51.8% being males, and 48.2% females. Stunting, wasting and underweight were 11.5%, 5.4% and 2.7%, respectively. Mean DDS for all food groups was 6.04±4.18. Cereals and vegetables had higher mean values (0.78±0.29 and 0.78±0.30, respectively), while eggs had the least value (0.15±0.25). The prevalence of low, medium and high DDS (in terciles) was 73.5%, 25.2% and 1.3%, respectively. DDS was significantly associated with HAZ (χ2=10.63;p=0.03), while total family income remained significantly and positively associated with dietary diversity score (p<0.05) in the linear regression model.
Conclusion: Children with low DDS were more likely to be stunted. Therefore, efforts aimed at increasing diversity in meals, both at home and in schools, are likely to benefit children at nutritional risk.
Key words: Dietary diversity score, nutritional status, rural areas, socio-demographics, under-5 children
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Introduction: The study assessed dietary diversity score (DDS) of rural under-five children and the relationship with their nutritional status and socio-demographic characteristics of their mothers/caregivers.
Methods: The study was a descriptive cross-sectional survey involving 226 mothers and their under-five children selected at random from rural communities in Imo state, Nigeria. A pre-tested questionnaire was used to obtain information on socio-demographics. Qualitative recall of the child’s food consumption during the previous 24-h was used to calculate individual dietary diversity score (DDS=representing the number of food groups, based on a scale of 12 groups) and the scores were divided into terciles low= ≤4, medium=5 - 8, and high= 9 - 12). Weight-for-age (WAZ), height-for-age (HAZ) and eight-for-height (WHZ) Z-scores were used to determine nutritional status of the children. Descriptive statistics, Chi square and linear regression analyses were performed.
Results: Average age of the children was 4.2±0.7years, with 51.8% being males, and 48.2% females. Stunting, wasting and underweight were 11.5%, 5.4% and 2.7%, respectively. Mean DDS for all food groups was 6.04±4.18. Cereals and vegetables had higher mean values (0.78±0.29 and 0.78±0.30, respectively), while eggs had the least value (0.15±0.25). The prevalence of low, medium and high DDS (in terciles) was 73.5%, 25.2% and 1.3%, respectively. DDS was significantly associated with HAZ (χ2=10.63;p=0.03), while total family income remained significantly and positively associated with dietary diversity score (p<0.05) in the linear regression model.
Conclusion: Children with low DDS were more likely to be stunted. Therefore, efforts aimed at increasing diversity in meals, both at home and in schools, are likely to benefit children at nutritional risk.
Key words: Dietary diversity score, nutritional status, rural areas, socio-demographics, under-5 children
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Job Stress on Abdominal Obesity: The Moderating Effects of Anger and Overeating Behaviour
Rosnah I, Idris MA, Azmi MT & Noor Hassim I
ABSTRACT
Introduction: Individual differences pertaining to cognitive and affective processes toward job stress stimuli may influence food choice and intake, leading to overeating and obesity. This study was conducted to determine the relationship between job stress and abdominal obesity with anger as a personality trait and overeating as moderators among male workers in Malaysia.
Methods: This cross-sectional study involved 492 male employees from 33 private companies in various states in Malaysia. The companies and workers were approached by convenience sampling. Workers who fulfilled the study inclusion criteria completed validated questionnaires assessing job stress, anger as a personality trait and overeating, using the Oldenburg Burnout Inventory-Exhaustion, Spielberger Trait Anger Scale and Three Factor Eating Questionnaire-Uncontrolled, respectively. Weight, height and abdominal circumference were taken for each participant. Moderation effect analyses were conducted based on standard multiple regression.
Results: For two-way interaction, a significant curvilinear regression equation was found to predict overeating based on job stress as a predictor and anger as a moderator (β=0.93, SE=0.46, t=2.03, p=0.043). High anger was associated with higher overeating behaviour on exposure to high job stress level (F (7, 484) = 9.36, p<0.001, R2=0.118). For three-way interaction, a significant curvilinear regression equation was found to predict abdominal obesity based on job stress as a predictor and both anger and overeating as moderators (β= -0.73, SE=0.39, t=1.87, p=0.032). High anger trait and high overeating behaviour predict lower abdominal obesity upon exposure to high job stress in contrast to the combined moderation effects of low anger trait and high overeating behaviour (F (14, 477)= 5.93, p<0.001, R2=0.123).
Conclusion: Effect of job stress on overeating was shown in this study to depend on the level of anger as a personality trait, while the effect of job stress on abdominal obesity depended on the level of anger as a personality trait and overeating behaviour.
Key words: Abdominal obesity, anger trait, job stress, moderation analyses, overeating
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Introduction: Individual differences pertaining to cognitive and affective processes toward job stress stimuli may influence food choice and intake, leading to overeating and obesity. This study was conducted to determine the relationship between job stress and abdominal obesity with anger as a personality trait and overeating as moderators among male workers in Malaysia.
Methods: This cross-sectional study involved 492 male employees from 33 private companies in various states in Malaysia. The companies and workers were approached by convenience sampling. Workers who fulfilled the study inclusion criteria completed validated questionnaires assessing job stress, anger as a personality trait and overeating, using the Oldenburg Burnout Inventory-Exhaustion, Spielberger Trait Anger Scale and Three Factor Eating Questionnaire-Uncontrolled, respectively. Weight, height and abdominal circumference were taken for each participant. Moderation effect analyses were conducted based on standard multiple regression.
Results: For two-way interaction, a significant curvilinear regression equation was found to predict overeating based on job stress as a predictor and anger as a moderator (β=0.93, SE=0.46, t=2.03, p=0.043). High anger was associated with higher overeating behaviour on exposure to high job stress level (F (7, 484) = 9.36, p<0.001, R2=0.118). For three-way interaction, a significant curvilinear regression equation was found to predict abdominal obesity based on job stress as a predictor and both anger and overeating as moderators (β= -0.73, SE=0.39, t=1.87, p=0.032). High anger trait and high overeating behaviour predict lower abdominal obesity upon exposure to high job stress in contrast to the combined moderation effects of low anger trait and high overeating behaviour (F (14, 477)= 5.93, p<0.001, R2=0.123).
Conclusion: Effect of job stress on overeating was shown in this study to depend on the level of anger as a personality trait, while the effect of job stress on abdominal obesity depended on the level of anger as a personality trait and overeating behaviour.
Key words: Abdominal obesity, anger trait, job stress, moderation analyses, overeating
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Potential Hypocholesterolemic Activity of Flour from Leaves of Moringa (Moringa oleifera L.)
Indah Asrifah, Teti Estiasih & Hidayat Sujuti
ABSTRACT
Introduction: Moringa (Moringa oleifera L.) leaves contain phytosterols and dietary fibres which may be beneficial in controlling blood cholesterol levels. This study was aimed at assessing the hypocholesterolemic effect of flour from leaves of M. oleifera L. (MLF) with white and red stalk in rats.
Methods: Thirty male rats were divided into 6 groups, comprising a normal group (negative control), a hypercholestrolemic group (positive control) both of which were without MLF feeding, and 4 hypercholesterolemic groups fed MLF for 4 weeks in the following manner: (i) 0.822 mg/g bw/d white stalk (WM); (ii) 0.822 mg/g bw/d red stalk (RM); (iii) 0.02 ml/g bw/d commercial plant stanol ester (FS); and (iv) 0.001 mg/g bw/d ezetimibe (ET). At the end, serum total cholesterol (TC) and low density lipoprotein cholesterol (LDL-c), viscosity and pH of digesta, faecal cholesterol, and short chain fatty acids (SCFAs) were analysed.
Results: TC levels in the WM, RM, FS and ET groups decreased by 42.0, 48.8, 48.4 and 52.8% respectively, compared to initial levels. The four groups also showed decreases in serum LDL-c levels by 30.3, 39.2, 37.9 and 46.7% respectively, over the feeding period. Faecal cholesterol levels of WM and RM were higher (63.93±1.87 and 90.11±1.77 mg/100 g faeces, respectively) than that of the positive control (51.30±4.03 mg/100 g) after 4 weeks.
Conclusion: Flour from moringa leaves of white and red stalk trees showed potential hypocholesterolemic activity in rats.
Key words: Fecal cholesterol, hypercholesterolemia, moringa, phytosterols
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Introduction: Moringa (Moringa oleifera L.) leaves contain phytosterols and dietary fibres which may be beneficial in controlling blood cholesterol levels. This study was aimed at assessing the hypocholesterolemic effect of flour from leaves of M. oleifera L. (MLF) with white and red stalk in rats.
Methods: Thirty male rats were divided into 6 groups, comprising a normal group (negative control), a hypercholestrolemic group (positive control) both of which were without MLF feeding, and 4 hypercholesterolemic groups fed MLF for 4 weeks in the following manner: (i) 0.822 mg/g bw/d white stalk (WM); (ii) 0.822 mg/g bw/d red stalk (RM); (iii) 0.02 ml/g bw/d commercial plant stanol ester (FS); and (iv) 0.001 mg/g bw/d ezetimibe (ET). At the end, serum total cholesterol (TC) and low density lipoprotein cholesterol (LDL-c), viscosity and pH of digesta, faecal cholesterol, and short chain fatty acids (SCFAs) were analysed.
Results: TC levels in the WM, RM, FS and ET groups decreased by 42.0, 48.8, 48.4 and 52.8% respectively, compared to initial levels. The four groups also showed decreases in serum LDL-c levels by 30.3, 39.2, 37.9 and 46.7% respectively, over the feeding period. Faecal cholesterol levels of WM and RM were higher (63.93±1.87 and 90.11±1.77 mg/100 g faeces, respectively) than that of the positive control (51.30±4.03 mg/100 g) after 4 weeks.
Conclusion: Flour from moringa leaves of white and red stalk trees showed potential hypocholesterolemic activity in rats.
Key words: Fecal cholesterol, hypercholesterolemia, moringa, phytosterols
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Antidiabetic and Immunomodulatory Potential of Purple Soymilk Enriched with Crude Palm Oil Microcapsule in Type-2 Diabetes Mellitus Respondents
Reno Fitri Hasrini, Fransiska Rungkat Zakaria, Dede Robiatul Adawiyah & Irma Herawati Suparto
ABSTRACT
Introduction: Purple soymilk produced from black soybean has been reported to reduce fasting blood glucose (FBG) and HbA1c of type 2 diabetes mellitus (T2DM) patients. Crude palm oil (CPO) is known to have immunomodulatory activity. This study aimed to investigate the antidiabetic and immunomodulatory potential of purple soymilk enriched with CPO microcapsule (PSPOM) in T2DM respondents.
Methods: A total of 25 T2DM patients from Katili clinic and Bogor Agricultural University, Indonesia were recruited by purposive cluster sampling, and divided into control and test groups. The test group consumed PSPOM, made up of 240 mL of purple soymilk with 0.4g CPO microcapsule, containing 295.24 μg carotenoid/g capsule daily for 4 weeks. Blood sample of 2 mL was collected from each subject before and after the intervention. Dietary intakes were assessed using the 24-h food recall method.
Results: When compared between the start and end of the intervention, the test group showed significant mean decreases in fasting blood glucose from 177.20 ± 93.55 to 154.87 ± 71.13 mg/dL, and in HbA1c from 0.29 ± 0.07 to 0.26 ± 0.06 OD450. The test group also showed a mean increase of IL-6 level from 0.23 ± 0.04 to 0.25 ±0.06 OD450, and significant increases in the level of insulin from 0.18 ± 0.05 to 0.21 ± 0.07 OD450 over the same duration. Results also showed increases of CD4+ from 563.13 ± 194.62 to 679.95 ± 278.86 cell/μL blood, and CD8+ T cells from 317.91 ± 105.40 to 343.74 ± 162.27 86 cell/μL blood during the intervention period.
Conclusion: Consumption of PSPOM in this study showed potential antidiabetic and immunomodulatory activities in T2DM respondents. Further studies should be undertaken to confirm these results.
Key words: Antidiabetic, crude palm oil, immune-modulatory activity, microcapsules, purple soymilk
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Introduction: Purple soymilk produced from black soybean has been reported to reduce fasting blood glucose (FBG) and HbA1c of type 2 diabetes mellitus (T2DM) patients. Crude palm oil (CPO) is known to have immunomodulatory activity. This study aimed to investigate the antidiabetic and immunomodulatory potential of purple soymilk enriched with CPO microcapsule (PSPOM) in T2DM respondents.
Methods: A total of 25 T2DM patients from Katili clinic and Bogor Agricultural University, Indonesia were recruited by purposive cluster sampling, and divided into control and test groups. The test group consumed PSPOM, made up of 240 mL of purple soymilk with 0.4g CPO microcapsule, containing 295.24 μg carotenoid/g capsule daily for 4 weeks. Blood sample of 2 mL was collected from each subject before and after the intervention. Dietary intakes were assessed using the 24-h food recall method.
Results: When compared between the start and end of the intervention, the test group showed significant mean decreases in fasting blood glucose from 177.20 ± 93.55 to 154.87 ± 71.13 mg/dL, and in HbA1c from 0.29 ± 0.07 to 0.26 ± 0.06 OD450. The test group also showed a mean increase of IL-6 level from 0.23 ± 0.04 to 0.25 ±0.06 OD450, and significant increases in the level of insulin from 0.18 ± 0.05 to 0.21 ± 0.07 OD450 over the same duration. Results also showed increases of CD4+ from 563.13 ± 194.62 to 679.95 ± 278.86 cell/μL blood, and CD8+ T cells from 317.91 ± 105.40 to 343.74 ± 162.27 86 cell/μL blood during the intervention period.
Conclusion: Consumption of PSPOM in this study showed potential antidiabetic and immunomodulatory activities in T2DM respondents. Further studies should be undertaken to confirm these results.
Key words: Antidiabetic, crude palm oil, immune-modulatory activity, microcapsules, purple soymilk
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Short Communication, Case Report: Hypocholesterolemic Effect of Moringa oleifera Polyphenols in Rats Fed High Fat-Cholesterol Diet
Vanitha Reddy P, Asna Urooj, Sudha Sairam, Faiyaz Ahmed, & Prasad NN
ABSTRACT
Introduction: One of the greatest risk factors for cardiovascular diseases is hypercholesterolemia. Moringa oleifera is a good source of phytochemicals and is well explored for its antioxidant properties.
Methods: The main aim of the present study was to assess the potential cholesterol lowering effect of Moringa oleifera leaf polyphenols (MOP) in an animal model. Five groups of male Wister rats were fed for 45 days as follows: a standard diet (GI); high fat-cholesterol diet (GII); high fat-cholesterol with MOP (100 and 200mg/kg body wt GIII & GIV respectively); and high fat-cholesterol with statins (Atorvastatin) (G-V).
Results: Administration of MOP rich extract (GII and GIV) significantly (p≤0.05) lowered the serum cholesterol, triglycerides and low-density lipoprotein cholesterol. A significant (p≤0.05) decrease in the activity of the HMG CoA reductase enzyme was observed in GIII, GIV and GV but not in GI & GII.
Conclusion: The results demonstrate that the polyphenol extract of Moringa oleifera leaves has a significant cholesterol lowering effect through inhibiting HMG CoA reductase activity and faecal bile acid binding.
Key words: Bile acids hypercholesterolamia, HMG CoA reductase, lipid profile
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Introduction: One of the greatest risk factors for cardiovascular diseases is hypercholesterolemia. Moringa oleifera is a good source of phytochemicals and is well explored for its antioxidant properties.
Methods: The main aim of the present study was to assess the potential cholesterol lowering effect of Moringa oleifera leaf polyphenols (MOP) in an animal model. Five groups of male Wister rats were fed for 45 days as follows: a standard diet (GI); high fat-cholesterol diet (GII); high fat-cholesterol with MOP (100 and 200mg/kg body wt GIII & GIV respectively); and high fat-cholesterol with statins (Atorvastatin) (G-V).
Results: Administration of MOP rich extract (GII and GIV) significantly (p≤0.05) lowered the serum cholesterol, triglycerides and low-density lipoprotein cholesterol. A significant (p≤0.05) decrease in the activity of the HMG CoA reductase enzyme was observed in GIII, GIV and GV but not in GI & GII.
Conclusion: The results demonstrate that the polyphenol extract of Moringa oleifera leaves has a significant cholesterol lowering effect through inhibiting HMG CoA reductase activity and faecal bile acid binding.
Key words: Bile acids hypercholesterolamia, HMG CoA reductase, lipid profile
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Collagen Peptide Supplementation Improves Lean Muscle Mass in Patients with Rectal Adenocarcinoma Postoperatively - A Case Report
Ho CY, Norshariza J & Zuliehaiza K
ABSTRACT
Introduction: Rectal adenocarcinoma patients are advised to increase protein intake especially after surgery for speedy recovery. Concentrated collagen peptides might help to improve compliance of protein prescription and ultimately muscle bulk.
Case presentation: A 35-year-old man diagnosed with low rectal adenocarcinoma was discharged and referred to diet clinic for continuous intervention. At the time of attending the diet clinic, patient looked cachectic and lethargic. Patient’s height was 164cm, weight 44kg, BMI 16.4 kg/m2, muscle mass 37.6kg and body fat 9.7%. He had lost 27% of his weight (16kg within 6 months) and had a C for SGA (Score Global Assessment). Estimated intake was 1560kcal/day and 38g/day protein. Patient reached satiety early and did not comply with oral nutritional supplement (ONS) due to distaste and concern for his high stoma output. The nutritional diagnosis was inadequate protein intake related to decreased ability to consume sufficient protein as evidence by diet history. High protein high calorie diet (HPHC) and collagen peptides supplement daily were prescribed. Patient was requested to recall diet and to drink a bottle of collagen peptides in the diet clinic daily for a week to ensure compliance to diet prescription. After a week, his anthropometry improved: weight reached 46.2kg, muscle mass 38.6kg and body fat 12.7%. Patient was able to walk and to start working the following week. Total energy intake was 1690kcal/day with 56g/day protein. As patient was able to achieve protein requirement via food, collagen peptide was withheld. After a month, anthropometry improved and complied to HPHC as well as ONS. Concentrated collagen peptides were found to help the malnourished patient to achieve protein requirement in small volumes.
Conclusion: Concentrated collagen peptides improve lean muscle mass in patients with rectal adenocarcinoma postoperatively. It is recommended that further investigations be conducted to provide concrete evidence on the role of collagen peptides.
Key words: Collagen peptides, rectal adenocarcinoma, postoperation
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Introduction: Rectal adenocarcinoma patients are advised to increase protein intake especially after surgery for speedy recovery. Concentrated collagen peptides might help to improve compliance of protein prescription and ultimately muscle bulk.
Case presentation: A 35-year-old man diagnosed with low rectal adenocarcinoma was discharged and referred to diet clinic for continuous intervention. At the time of attending the diet clinic, patient looked cachectic and lethargic. Patient’s height was 164cm, weight 44kg, BMI 16.4 kg/m2, muscle mass 37.6kg and body fat 9.7%. He had lost 27% of his weight (16kg within 6 months) and had a C for SGA (Score Global Assessment). Estimated intake was 1560kcal/day and 38g/day protein. Patient reached satiety early and did not comply with oral nutritional supplement (ONS) due to distaste and concern for his high stoma output. The nutritional diagnosis was inadequate protein intake related to decreased ability to consume sufficient protein as evidence by diet history. High protein high calorie diet (HPHC) and collagen peptides supplement daily were prescribed. Patient was requested to recall diet and to drink a bottle of collagen peptides in the diet clinic daily for a week to ensure compliance to diet prescription. After a week, his anthropometry improved: weight reached 46.2kg, muscle mass 38.6kg and body fat 12.7%. Patient was able to walk and to start working the following week. Total energy intake was 1690kcal/day with 56g/day protein. As patient was able to achieve protein requirement via food, collagen peptide was withheld. After a month, anthropometry improved and complied to HPHC as well as ONS. Concentrated collagen peptides were found to help the malnourished patient to achieve protein requirement in small volumes.
Conclusion: Concentrated collagen peptides improve lean muscle mass in patients with rectal adenocarcinoma postoperatively. It is recommended that further investigations be conducted to provide concrete evidence on the role of collagen peptides.
Key words: Collagen peptides, rectal adenocarcinoma, postoperation
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