MJN 2023 Issues
Malaysian Journal of Nutrition (Mal J Nutr)
Volume 29 No.1, 2023
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Table of Content
Growth patterns of urban Malaysian children under 24
months of age in Selangor, Malaysia
Heng Yaw Yong, Zalilah Mohd Shariff & Chee Yen Wong
doi: https://doi.org/10.31246/mjn-2021-0103
ABSTRACT
Introduction: To identify the growth patterns of young children during the first two years of life according to gestational age, birth weight, and growth status at 24 months of age.
Methods: This was a retrospective cohort study of 4,570 young children in Selangor. Data were extracted from children’s health records in government health clinics. Growth data were analysed using the Anthro Plus software that utilises the World Health Organization growth standards.
Results: Generally, wasting prevalence was the highest at birth and 24 months, but stunting was more predominant from 1 to 21 months. Weight-for-age z-scores (WAZ), lengthfor- age z-scores (LAZ), and weight-for-length z-scores (WLZ) from birth to 24 months were within -3.00 to 0.00 standard deviation (SD) for pre-term low birth weight children, –1.50 to 0.00 SD for pre-term normal birth weight children, and –2.50 to 0.50 SD for full-term low birth weight children. While WAZ, LAZ, and WLZ from birth to 24 months for underweight/stunted/wasted children were within –2.50 to 0.50 SD, the values for overweight/obese (OV/OB) children were within –1.00 to 2.00 SD. For normal children, WAZ, LAZ, and WLZ exhibited comparable trends, with values within –1.00 to 0.00 SD from birth to 24 months.
Conclusion: While stunting and wasting persisted as the most common forms of malnutrition in this sample of young children, the prevalence of OV/OB increased by 24 months. Interventions to promote child growth should focus not only on the prevention of undernutrition, but also on OV/OB.
Key words: Malaysia, malnutrition, obesity, overweight, retrospective studies
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Introduction: To identify the growth patterns of young children during the first two years of life according to gestational age, birth weight, and growth status at 24 months of age.
Methods: This was a retrospective cohort study of 4,570 young children in Selangor. Data were extracted from children’s health records in government health clinics. Growth data were analysed using the Anthro Plus software that utilises the World Health Organization growth standards.
Results: Generally, wasting prevalence was the highest at birth and 24 months, but stunting was more predominant from 1 to 21 months. Weight-for-age z-scores (WAZ), lengthfor- age z-scores (LAZ), and weight-for-length z-scores (WLZ) from birth to 24 months were within -3.00 to 0.00 standard deviation (SD) for pre-term low birth weight children, –1.50 to 0.00 SD for pre-term normal birth weight children, and –2.50 to 0.50 SD for full-term low birth weight children. While WAZ, LAZ, and WLZ from birth to 24 months for underweight/stunted/wasted children were within –2.50 to 0.50 SD, the values for overweight/obese (OV/OB) children were within –1.00 to 2.00 SD. For normal children, WAZ, LAZ, and WLZ exhibited comparable trends, with values within –1.00 to 0.00 SD from birth to 24 months.
Conclusion: While stunting and wasting persisted as the most common forms of malnutrition in this sample of young children, the prevalence of OV/OB increased by 24 months. Interventions to promote child growth should focus not only on the prevention of undernutrition, but also on OV/OB.
Key words: Malaysia, malnutrition, obesity, overweight, retrospective studies
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Effect of date palm cultivars on chemical and
phytochemical properties of date vinegars
Wilawan Boonsupa, Chananthon Thammajit, Thidarat Sittisumran, Onanong
Thiansai & Tharakorn Kaewsura
doi: https://doi.org/10.31246/mjn-2022-0035
ABSTRACT
Introduction: Phoenix dactylifera, commonly known as date or date palm, is a flowering plant species in the palm family Arecaceae, cultivated for its edible sweet fruit called dates. Dates are high in dietary fibre and antioxidant compounds, known for preventing cancer and cardiovascular diseases. This research studied the chemical properties, antioxidant activities, and total phenolic content of fermented date vinegars from Phoenix dactylifera L. fruits, which had three cultivars - Barhi, Siam S1, and KL1.
Methods: The first step was making date wines by using Saccharomyces cerevisiae (0.75% v/v of date juice content) to produce alcohol; the second step was making date vinegars by using Acetobacter pasteurianus (10% v/v of inoculum). Thereafter, the wines and vinegars were analysed for their chemical properties [high performance liquid chromatography (HPLC)], antioxidant activities [2,2-Diphenyl-1-picrylhydrazyl (DPPH) assay], and total phenolic content (folin ciocalteu method).
Results: Results showed that the highest alcohol content was 9.35% (v/v) in Siam S1 wine. The highest acetic acid was 7% (v/v) in Siam S1 vinegar. From the phytochemical analysis of vinegars, the highest antioxidant activity was found to be 24.96 mg/mL in Siam S1 vinegar, while the highest total phenolic content was found to be 208.35 mg GAE/L in KL1 vinegar.
Conclusion: This novel research showed that the Siam S1 date had the highest acetic acid and antioxidant activity in vinegar. Thus, this cultivar could be processed to make new, healthy products that can further lead to income generation for the people in Thailand.
Key words: antioxidant activity, chemical properties, date fruits, vinegar, wine
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Introduction: Phoenix dactylifera, commonly known as date or date palm, is a flowering plant species in the palm family Arecaceae, cultivated for its edible sweet fruit called dates. Dates are high in dietary fibre and antioxidant compounds, known for preventing cancer and cardiovascular diseases. This research studied the chemical properties, antioxidant activities, and total phenolic content of fermented date vinegars from Phoenix dactylifera L. fruits, which had three cultivars - Barhi, Siam S1, and KL1.
Methods: The first step was making date wines by using Saccharomyces cerevisiae (0.75% v/v of date juice content) to produce alcohol; the second step was making date vinegars by using Acetobacter pasteurianus (10% v/v of inoculum). Thereafter, the wines and vinegars were analysed for their chemical properties [high performance liquid chromatography (HPLC)], antioxidant activities [2,2-Diphenyl-1-picrylhydrazyl (DPPH) assay], and total phenolic content (folin ciocalteu method).
Results: Results showed that the highest alcohol content was 9.35% (v/v) in Siam S1 wine. The highest acetic acid was 7% (v/v) in Siam S1 vinegar. From the phytochemical analysis of vinegars, the highest antioxidant activity was found to be 24.96 mg/mL in Siam S1 vinegar, while the highest total phenolic content was found to be 208.35 mg GAE/L in KL1 vinegar.
Conclusion: This novel research showed that the Siam S1 date had the highest acetic acid and antioxidant activity in vinegar. Thus, this cultivar could be processed to make new, healthy products that can further lead to income generation for the people in Thailand.
Key words: antioxidant activity, chemical properties, date fruits, vinegar, wine
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Eating self-regulatory skill, diet quantity, and diet
quality of Malaysian healthcare university students:
A cross-sectional study
Ching Li Lee, Jamilah Abd Jamil, Jia Tian Chang, Kar Xsin Yap, Hsin Yuen
Yap & Wei Jin Khoo
doi: https://doi.org/10.31246/mjn-2022-0025
ABSTRACT
Introduction: The ability to self-regulate eating can improve health. This study aimed to determine the relationship between eating self-regulatory skills, diet quantity, and diet quality among Malaysian university students.
Methods: This cross-sectional study involved 132 university students. Eating self-regulatory skill was assessed using the Self-Regulation of Eating Behaviour Questionnaire (SREBQ). Dietary intakes from two 24-hour dietary recalls were used to assess diet quantity and quality. Diet quantity was measured as energy and macronutrient intakes, analysed using NutritionistPro. Diet quality was measured using the Malaysian Healthy Eating Index (M-HEI). The relationship between eating self-regulatory skills, diet quantity, and diet quality were evaluated using tests for differences between means and multiple linear regression.
Results: Male participants (n=47) consumed more energy than female participants (n=85) (Male: 1850±570 kcal/day, Female: 1596±567 kcal/day, p=0.015). Participants from the Nutrition and Dietetics (N&D) course (n=49) had better M-HEI scores than participants from other health courses (n=83) (N&D course: 52.7±10.5, non-N&D course: 47.2±10.7, p=0.005). The predictors of energy intake were gender (β=-0.193, p=0.023) and SREBQ score (β=- 0.223, p=0.009). Being female and having higher eating self-regulatory skills were associated with lower energy intake. The predictors of diet quality were university course (β=0.240, p=0.005) and SREBQ score (β=0.181, p=0.033). Studying N&D and having higher eating self-regulatory skills were associated with higher M-HEI scores.
Conclusion: Higher self-regulation of eating behaviour score is a factor that contributes to lower daily energy intake and higher diet quality score.
Key words: diet quality, diet quantity, self-regulation, university students
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Introduction: The ability to self-regulate eating can improve health. This study aimed to determine the relationship between eating self-regulatory skills, diet quantity, and diet quality among Malaysian university students.
Methods: This cross-sectional study involved 132 university students. Eating self-regulatory skill was assessed using the Self-Regulation of Eating Behaviour Questionnaire (SREBQ). Dietary intakes from two 24-hour dietary recalls were used to assess diet quantity and quality. Diet quantity was measured as energy and macronutrient intakes, analysed using NutritionistPro. Diet quality was measured using the Malaysian Healthy Eating Index (M-HEI). The relationship between eating self-regulatory skills, diet quantity, and diet quality were evaluated using tests for differences between means and multiple linear regression.
Results: Male participants (n=47) consumed more energy than female participants (n=85) (Male: 1850±570 kcal/day, Female: 1596±567 kcal/day, p=0.015). Participants from the Nutrition and Dietetics (N&D) course (n=49) had better M-HEI scores than participants from other health courses (n=83) (N&D course: 52.7±10.5, non-N&D course: 47.2±10.7, p=0.005). The predictors of energy intake were gender (β=-0.193, p=0.023) and SREBQ score (β=- 0.223, p=0.009). Being female and having higher eating self-regulatory skills were associated with lower energy intake. The predictors of diet quality were university course (β=0.240, p=0.005) and SREBQ score (β=0.181, p=0.033). Studying N&D and having higher eating self-regulatory skills were associated with higher M-HEI scores.
Conclusion: Higher self-regulation of eating behaviour score is a factor that contributes to lower daily energy intake and higher diet quality score.
Key words: diet quality, diet quantity, self-regulation, university students
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Associations between body mass index and physical
activity level with mindful eating behaviour among
undergraduate medical students of Universiti Sains
Malaysia
Nurul Zulaikha Talib, Shu Qing Ang, Juliana Shamsudin & Zafirah Mohd Nor
doi: https://doi.org/10.31246/mjn-2022-0040
ABSTRACT
Introduction: Mindful eating is being fully present in the moment of eating and it is critical in preventing poor eating habits. The main objective for this study was to determine the associations of body mass index (BMI) and physical activity level with mindful eating behaviour among undergraduate medical students of Universiti Sains Malaysia (USM), Health Campus, Kubang Kerian, Kelantan.
Methods: A cross-sectional study was conducted among 158 students (Years 1-5; 69% females and 31% males) by using a self-administered online questionnaire consisting of socio-demographic data, anthropometric data, short version of the International Physical Activity Questionnaire (IPAQ), and Mindful Eating Questionnaire (MEQ). The associations between BMI and physical activity with MEQ were determined by Spearman’s Correlation and One-Way ANOVA or Kruskal-Wallis Test, respectively.
Results: Majority of the students had normal BMI (66.4%, n=105), and 39.9% (n=63) had low physical activity levels. The mean MEQ summary score of the students was considered high (2.82±0.26). There was a significant negative association between MEQ summary score (r=-0.191; p=0.016) and disinhibition subscale score (r=-0.340; p<0.001) with BMI, whereby MEQ summary and disinhibition subscale scores increased as BMI decreased. However, there was no significant association between physical activity level with MEQ score (p>0.05).
Conclusion: A student with positive mindful eating behaviour has the potential to lower his/her BMI. However, further research is required to verify this finding.
Key words: body mass index (BMI), medical students, mindful eating behaviour, physical activity
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Introduction: Mindful eating is being fully present in the moment of eating and it is critical in preventing poor eating habits. The main objective for this study was to determine the associations of body mass index (BMI) and physical activity level with mindful eating behaviour among undergraduate medical students of Universiti Sains Malaysia (USM), Health Campus, Kubang Kerian, Kelantan.
Methods: A cross-sectional study was conducted among 158 students (Years 1-5; 69% females and 31% males) by using a self-administered online questionnaire consisting of socio-demographic data, anthropometric data, short version of the International Physical Activity Questionnaire (IPAQ), and Mindful Eating Questionnaire (MEQ). The associations between BMI and physical activity with MEQ were determined by Spearman’s Correlation and One-Way ANOVA or Kruskal-Wallis Test, respectively.
Results: Majority of the students had normal BMI (66.4%, n=105), and 39.9% (n=63) had low physical activity levels. The mean MEQ summary score of the students was considered high (2.82±0.26). There was a significant negative association between MEQ summary score (r=-0.191; p=0.016) and disinhibition subscale score (r=-0.340; p<0.001) with BMI, whereby MEQ summary and disinhibition subscale scores increased as BMI decreased. However, there was no significant association between physical activity level with MEQ score (p>0.05).
Conclusion: A student with positive mindful eating behaviour has the potential to lower his/her BMI. However, further research is required to verify this finding.
Key words: body mass index (BMI), medical students, mindful eating behaviour, physical activity
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Coeliac disease knowledge and treatment: Potential
factors associated with adherence to gluten-free diet
Najla Alorayyidh, Maram H. Alswaji, Elham Almujammay, Bander Alhujairy,
Nada Benajiba & Abeer Salman Alzaben
doi: https://doi.org/10.31246/mjn-2022-0082
ABSTRACT
Introduction: Lack of adherence to a strict gluten-free diet (GFD) is the main reason for poorly controlled disease in patients with coeliac disease (CD). This study aimed to assess the association between knowledge of CD and its medical diet to the adherence of GFD among adult patients with CD.
Methods: A cross-sectional study was carried out with a total of 90 adult patients with CD (aged between 18-65 years). The data collecting instruments were a combination of four questionnaires as follows: assessment of knowledge of coeliac disease (AKCD), gluten-free diet knowledge scale (GFD-KS), coeliac disease adherence test (CDAT), and questions on potential factors influencing GFD adherence among patients.
Results: An average knowledge score of five points out of seven was obtained from 46 participants (51%). Mean score for knowledge on gluten-free diet was seven points out of 17 in 59 participants (65%). Adequate adherence to GFD was observed in 56% of the participants. No association was found between knowledge of CD and GFD to the adherence of GFD (p>0.050). Participants who had higher adherence scores were discussing GFD with a specialist, obtaining educational materials, had enhanced symptoms associated with CD, and did not complain about the taste of GFD (p<0.050).
Conclusion: Patients with CD has adequate knowledge of CD and adherence of GFD. No association was found between the knowledge of CD and GFD to the adherence of GFD. Further research might explore other potential factors influencing the adherence to GFD.
Key words: adherence, coeliac disease, gluten-free diet, knowledge
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Introduction: Lack of adherence to a strict gluten-free diet (GFD) is the main reason for poorly controlled disease in patients with coeliac disease (CD). This study aimed to assess the association between knowledge of CD and its medical diet to the adherence of GFD among adult patients with CD.
Methods: A cross-sectional study was carried out with a total of 90 adult patients with CD (aged between 18-65 years). The data collecting instruments were a combination of four questionnaires as follows: assessment of knowledge of coeliac disease (AKCD), gluten-free diet knowledge scale (GFD-KS), coeliac disease adherence test (CDAT), and questions on potential factors influencing GFD adherence among patients.
Results: An average knowledge score of five points out of seven was obtained from 46 participants (51%). Mean score for knowledge on gluten-free diet was seven points out of 17 in 59 participants (65%). Adequate adherence to GFD was observed in 56% of the participants. No association was found between knowledge of CD and GFD to the adherence of GFD (p>0.050). Participants who had higher adherence scores were discussing GFD with a specialist, obtaining educational materials, had enhanced symptoms associated with CD, and did not complain about the taste of GFD (p<0.050).
Conclusion: Patients with CD has adequate knowledge of CD and adherence of GFD. No association was found between the knowledge of CD and GFD to the adherence of GFD. Further research might explore other potential factors influencing the adherence to GFD.
Key words: adherence, coeliac disease, gluten-free diet, knowledge
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Government-Industry-Academia Alliance: A multisectoral
collaboration for improved nutrition of
children and well-being of mothers
Divorah V. Aguila, Julieta B. Dorado & Mario V. Capanzana
doi: https://doi.org/10.31246/mjn-2022-0019
ABSTRACT
Introduction: Consistent with the Sustainable Development Goal 17 highlighting partnership to achieve development, this study demonstrated the convergence among government, industry and academe in carrying out a nutrition intervention to improve the nutritional status, knowledge, attitude and behaviour of school community (school children and mothers).
Methods: A school-based intervention study comprising of school lunch feeding and nutrition lessons was conducted. Quasi-experimental design was used in the intervention research. Data were analysed using Stata 12.0. Descriptive statistics were generated using the survey module (svy) of Stata. The food and nutrition intervention mix composed of the governmentpartner School Feeding Programme (SFP) and the nutrition education campaign. The government-partner SFP involved lunch feeding of 7 to 9 years old students based on the standardised Pinggang Pinoy® recipes. The government-partner nutrition education component involved teaching of the developed modules to students and their mothers.
Results: The intervention resulted in improvements in nutritional status, knowledge, attitude and behaviour of students. Investing an average of Php 15.00 or USD 0.29 (as of 2017) in a school feeding programme following the government-partner food and nutrition intervention mix improved nutritional status and shifted the number of underweight children to normal nutritional status by 25.3% after 120 feeding days. This intervention was implemented through a multisectoral collaboration during the pre-implementation, implementation, and post-implementation phases of the study.
Conclusion: Partnerships among stakeholders provided the context towards healthier children as demonstrated by improved nutritional status, knowledge, attitude and behaviour of participants.
Key words: Filipino school children, multi-sectoral collaboration, nutrition, partnership, school feeding programme
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Introduction: Consistent with the Sustainable Development Goal 17 highlighting partnership to achieve development, this study demonstrated the convergence among government, industry and academe in carrying out a nutrition intervention to improve the nutritional status, knowledge, attitude and behaviour of school community (school children and mothers).
Methods: A school-based intervention study comprising of school lunch feeding and nutrition lessons was conducted. Quasi-experimental design was used in the intervention research. Data were analysed using Stata 12.0. Descriptive statistics were generated using the survey module (svy) of Stata. The food and nutrition intervention mix composed of the governmentpartner School Feeding Programme (SFP) and the nutrition education campaign. The government-partner SFP involved lunch feeding of 7 to 9 years old students based on the standardised Pinggang Pinoy® recipes. The government-partner nutrition education component involved teaching of the developed modules to students and their mothers.
Results: The intervention resulted in improvements in nutritional status, knowledge, attitude and behaviour of students. Investing an average of Php 15.00 or USD 0.29 (as of 2017) in a school feeding programme following the government-partner food and nutrition intervention mix improved nutritional status and shifted the number of underweight children to normal nutritional status by 25.3% after 120 feeding days. This intervention was implemented through a multisectoral collaboration during the pre-implementation, implementation, and post-implementation phases of the study.
Conclusion: Partnerships among stakeholders provided the context towards healthier children as demonstrated by improved nutritional status, knowledge, attitude and behaviour of participants.
Key words: Filipino school children, multi-sectoral collaboration, nutrition, partnership, school feeding programme
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Association of dietary pattern and childhood obesity
with cardiovascular disease in patients from Tangail
city, Bangladesh
Khan Md. Murtaja Reza Linkon, Nur-E-Safa Meem, Ssm. Habibullah
Noory, Md. Hanif Hossain, Rehnova Mustafa Nitu, Md. Faridu Islam, Md.
Shyfullah, Sharmin Jalil, Md. Esrafil & Md. Abdul Alim
doi: https://doi.org/10.31246/mjn-2022-0063
ABSTRACT
Introduction: Obesity in childhood is a major cause for developing cardiovascular diseases (CVD) at adulthood. The present study was a cross-sectional research aimed to examine the relationship between childhood obesity and dietary pattern with CVD in patients (n=100) from Tangail City, Bangladesh.
Methods: Dietary patterns, laboratory tests, demographic, and anthropometric interrelated data were measured in patients with stroke and heart attack from five hospitals. The research also used 24-hour recall method and a food frequency questionnaire for assessing daily energy and macronutrient intakes.
Results: Weight (p=0.004), body mass index (BMI) (p=0.001), mid-upper arm circumference (MUAC) (p=0.009), and waist circumference (WC) (p=0.030) was significantly different between males and females whereas lipid profile was not significantly different between genders. There were no significant associations between intakes of red meat, salt, fast food, fish, egg, nuts and seeds with heart attack and stroke. On the contrary, there were significant associations between fried food intake with heart attack and stroke (p=0.080 and p=0.020). The results indicated that there was a significant relationship between carbohydrate (p=0.001), protein (p=0.001), and fat (p=0.001) intakes with the total energy intake of respondents. The findings also showed that there was a significant relationship between carbohydrate (p=0.003), protein (p=0.001), and fat (p=0.001) intakes with body mass index of the respondents.
Conclusion: CVD diagnosis in adult patients was found to be associated with fried food intake but not with childhood obesity.
Key words: body mass index, cardiovascular disease, childhood obesity, dietary pattern, lipid profile
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Introduction: Obesity in childhood is a major cause for developing cardiovascular diseases (CVD) at adulthood. The present study was a cross-sectional research aimed to examine the relationship between childhood obesity and dietary pattern with CVD in patients (n=100) from Tangail City, Bangladesh.
Methods: Dietary patterns, laboratory tests, demographic, and anthropometric interrelated data were measured in patients with stroke and heart attack from five hospitals. The research also used 24-hour recall method and a food frequency questionnaire for assessing daily energy and macronutrient intakes.
Results: Weight (p=0.004), body mass index (BMI) (p=0.001), mid-upper arm circumference (MUAC) (p=0.009), and waist circumference (WC) (p=0.030) was significantly different between males and females whereas lipid profile was not significantly different between genders. There were no significant associations between intakes of red meat, salt, fast food, fish, egg, nuts and seeds with heart attack and stroke. On the contrary, there were significant associations between fried food intake with heart attack and stroke (p=0.080 and p=0.020). The results indicated that there was a significant relationship between carbohydrate (p=0.001), protein (p=0.001), and fat (p=0.001) intakes with the total energy intake of respondents. The findings also showed that there was a significant relationship between carbohydrate (p=0.003), protein (p=0.001), and fat (p=0.001) intakes with body mass index of the respondents.
Conclusion: CVD diagnosis in adult patients was found to be associated with fried food intake but not with childhood obesity.
Key words: body mass index, cardiovascular disease, childhood obesity, dietary pattern, lipid profile
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Dietary patterns associated with the risk of type
2 diabetes in women with and without a history of
gestational diabetes mellitus: A pilot study
Farah Yasmin Hasbullah, Barakatun Nisak Mohd Yusof, Rohana Abdul
Ghani, Geeta Appannah, Zulfitri ’Azuan Mat Daud & Faridah Abas
doi: https://doi.org/10.31246/mjn-2022-0056
ABSTRACT
Introduction: There is limited evidence on dietary patterns and the risk of type 2 diabetes (T2D) in women with a history of gestational diabetes mellitus (GDM) compared to their non-GDM counterparts, especially in the Asian population. The pilot study investigated dietary patterns in women with a history of GDM (HGDM) and without a history of GDM (non-HGDM), and the association with T2D risk.
Methods: This comparative cross-sectional study involved 64 women (32 HGDM, 32 non-HGDM). Food intake was assessed using a validated food frequency questionnaire. Principal component analysis derived the dietary patterns. T2D risk score was determined using the Finnish Diabetes Risk Score tool.
Results: HGDM group had significantly higher proportion of first-degree family history of diabetes; higher risk of T2D and better diabetes knowledge; lower gestational weight gain and postpartum weight retention; and consumed more fast food than non- HGDM. ‘Rice-noodle-pasta-meat’ dietary pattern was significantly associated with increased T2D risk after adjusting for age (β=0.272, p=0.032). ‘Bread-cereals-fast food-meat’ dietary pattern was positively and significantly associated with T2D risk after adjusting for confounders, including age, education level, family history of diabetes, diabetes knowledge score, gestational weight gain, and postpartum weight retention (β=0.251, p=0.012).
Conclusion: Dietary patterns high in bread, cereals and cereal products, fast food and meat, as well as rice, noodle, pasta and meat were associated with an elevated T2D risk. A more extensive study is warranted to establish the association between dietary patterns and risk of T2D, focusing on women with a history of GDM.
Key words: dietary patterns, gestational diabetes mellitus, type 2 diabetes
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Introduction: There is limited evidence on dietary patterns and the risk of type 2 diabetes (T2D) in women with a history of gestational diabetes mellitus (GDM) compared to their non-GDM counterparts, especially in the Asian population. The pilot study investigated dietary patterns in women with a history of GDM (HGDM) and without a history of GDM (non-HGDM), and the association with T2D risk.
Methods: This comparative cross-sectional study involved 64 women (32 HGDM, 32 non-HGDM). Food intake was assessed using a validated food frequency questionnaire. Principal component analysis derived the dietary patterns. T2D risk score was determined using the Finnish Diabetes Risk Score tool.
Results: HGDM group had significantly higher proportion of first-degree family history of diabetes; higher risk of T2D and better diabetes knowledge; lower gestational weight gain and postpartum weight retention; and consumed more fast food than non- HGDM. ‘Rice-noodle-pasta-meat’ dietary pattern was significantly associated with increased T2D risk after adjusting for age (β=0.272, p=0.032). ‘Bread-cereals-fast food-meat’ dietary pattern was positively and significantly associated with T2D risk after adjusting for confounders, including age, education level, family history of diabetes, diabetes knowledge score, gestational weight gain, and postpartum weight retention (β=0.251, p=0.012).
Conclusion: Dietary patterns high in bread, cereals and cereal products, fast food and meat, as well as rice, noodle, pasta and meat were associated with an elevated T2D risk. A more extensive study is warranted to establish the association between dietary patterns and risk of T2D, focusing on women with a history of GDM.
Key words: dietary patterns, gestational diabetes mellitus, type 2 diabetes
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Validity and reliability of online questionnaire on
awareness, knowledge, attitude and self-efficacy
(AKAS) on healthy eating for nutrition education and
promotion
Milflor S. Gonzales, Idelia G. Glorioso, Celina Ann J. Navarro & Theresa Krista
B. Jolejole
doi: https://doi.org/10.31246/mjn-2021-0099
ABSTRACT
Introduction: This study entailed the process of developing an online questionnaire to determine awareness, knowledge, attitude and self-efficacy (AKAS) on healthy eating for nutrition education. Currently, there is no local validated questionnaire that can be used to assess AKAS on healthy eating among Filipino adults.
Methods: The study developed the questionnaire based on theoretical frameworks and literature review. The draft questionnaire underwent three stages of development: (1) online modified Delphi technique composing of seven subject matter experts (SME) for content validity; (2) online cognitive debriefing with 32 participants (14 nutrition experts and 18 general public) for construct validity; and (3) online pre-testing with 35 participants (non-nutritionists) using test-retest method.
Results: For first stage, the questionnaire contained 16 questions for awareness, 17 questions for knowledge, 17 questions for attitude, and 15 questions for self-efficacy. For second stage, significantly different scores (p-value<0.00) between nutritionist experts and general public were observed, showing good construct validity. For third stage, Spearman’s correlation of test-retest method was 0.640. The questionnaire yielded Cronbach’s alpha of 0.467 to 0.923 (round 1) and 0.435 to 0.923 (round 2). A second analysis was done to improve the internal consistency of the questionnaire. By combining two question categories (awareness and knowledge), the Cronbach’s alpha increased to 0.659 (round 2), and by deleting three questions in attitude category, the Cronbach’s alpha improved to 0.626 (round 2).
Conclusion: The process used ensured the questionnaire’s validity and reliability. Hence, this online questionnaire may be adopted by parties interested in developing and assessing nutrition education.
Key words: cognitive debriefing, Delphi technique, nutrition education
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Introduction: This study entailed the process of developing an online questionnaire to determine awareness, knowledge, attitude and self-efficacy (AKAS) on healthy eating for nutrition education. Currently, there is no local validated questionnaire that can be used to assess AKAS on healthy eating among Filipino adults.
Methods: The study developed the questionnaire based on theoretical frameworks and literature review. The draft questionnaire underwent three stages of development: (1) online modified Delphi technique composing of seven subject matter experts (SME) for content validity; (2) online cognitive debriefing with 32 participants (14 nutrition experts and 18 general public) for construct validity; and (3) online pre-testing with 35 participants (non-nutritionists) using test-retest method.
Results: For first stage, the questionnaire contained 16 questions for awareness, 17 questions for knowledge, 17 questions for attitude, and 15 questions for self-efficacy. For second stage, significantly different scores (p-value<0.00) between nutritionist experts and general public were observed, showing good construct validity. For third stage, Spearman’s correlation of test-retest method was 0.640. The questionnaire yielded Cronbach’s alpha of 0.467 to 0.923 (round 1) and 0.435 to 0.923 (round 2). A second analysis was done to improve the internal consistency of the questionnaire. By combining two question categories (awareness and knowledge), the Cronbach’s alpha increased to 0.659 (round 2), and by deleting three questions in attitude category, the Cronbach’s alpha improved to 0.626 (round 2).
Conclusion: The process used ensured the questionnaire’s validity and reliability. Hence, this online questionnaire may be adopted by parties interested in developing and assessing nutrition education.
Key words: cognitive debriefing, Delphi technique, nutrition education
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Effects of chocolate milk consumption on muscle
recovery following rowing exercise: A randomised
crossover study
Anna Fitriani, Asih Setiarini, Engkus Kusdinar Ahmad, Desiani Rizki
Purwaningtyas & Fitria
doi: https://doi.org/10.31246/mjn-2022-0086
ABSTRACT
Introduction: For athletes, an excessive increase in blood urea nitrogen (BUN) after multiple endurance exercises indicates muscle glycogen depletion that induces a diminution in performance. Our study aimed to examine the efficacy of chocolate milk (CM) compared with carbohydrate-protein replacement drink (CHOPRO) in suppressing the increase in BUN level following multiple rowing exercises among national male rowing athletes aged 18–23 years.
Methods: Seven male athletes from the Rowing National Training Centre, Pengalengan, West Java, participated in this single-blind, randomised crossover study. They received CM or CHOPRO during four hours of recovery between two endurance exercises. Before (pre) and after (post) multiple exercises, a venous blood sample was collected to measure the increase in BUN level. The effects of each beverage on BUN level were compared using an independent t-test.
Results: The increase in pre-post BUN level was significantly lower for CM trial compared to CHOPRO trial (164.0±61.3 mmol/L vs 293.5±88.3 mmol/L, p=0.012).
Conclusion: It was observed that CM reduced rate of increase in BUN level following multiple rowing exercises. Thus, CM can be useful for athletes during intense training regimen with multiple exercise sessions. Future studies should investigate the effect of CM in various types of sports, using convenient, non-invasive, and real-time measurement.
Key words: athletes, glycogen, milk, muscles, water sports
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Introduction: For athletes, an excessive increase in blood urea nitrogen (BUN) after multiple endurance exercises indicates muscle glycogen depletion that induces a diminution in performance. Our study aimed to examine the efficacy of chocolate milk (CM) compared with carbohydrate-protein replacement drink (CHOPRO) in suppressing the increase in BUN level following multiple rowing exercises among national male rowing athletes aged 18–23 years.
Methods: Seven male athletes from the Rowing National Training Centre, Pengalengan, West Java, participated in this single-blind, randomised crossover study. They received CM or CHOPRO during four hours of recovery between two endurance exercises. Before (pre) and after (post) multiple exercises, a venous blood sample was collected to measure the increase in BUN level. The effects of each beverage on BUN level were compared using an independent t-test.
Results: The increase in pre-post BUN level was significantly lower for CM trial compared to CHOPRO trial (164.0±61.3 mmol/L vs 293.5±88.3 mmol/L, p=0.012).
Conclusion: It was observed that CM reduced rate of increase in BUN level following multiple rowing exercises. Thus, CM can be useful for athletes during intense training regimen with multiple exercise sessions. Future studies should investigate the effect of CM in various types of sports, using convenient, non-invasive, and real-time measurement.
Key words: athletes, glycogen, milk, muscles, water sports
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Weight cycling among Indonesian college students in
West Java province during the COVID-19 pandemic
Boyke Mulyana, Asti Dewi Rahayu Fitrianingsih, Syifa F. Syihab & Novriza
Achmad Novan
doi: https://doi.org/10.31246/mjn-2021-0125
ABSTRACT
Introduction: Changes in our bodies can cause several problems, particularly for students who are concerned about maintaining an ideal body shape. Many of them try to diet, but their body returns to its previous weight or even increases in weight. Thus, this study aimed to determine the factors that influence the incidence of weight cycling in Indonesian students during the COVID-19 pandemic.
Methods: This cross-sectional study used purposive sampling to collect data. Three hundred college students from West Java province, Indonesia, participated. Weight cycling was the dependent variable and the independent variables were physical activity, sex, and weight management. Multivariate logistic regression analysis was used to determine the factors influencing the incidence of weight cycling.
Results: Sex, physical activity, skipping meals, and snacking were determinants related to weight cycling incidence. Females had a 0.7 times higher risk of experiencing weight cycling than males. Inactive students were 4.7 times more likely to become weight cyclers, and those who rarely skipped mealtime had lower risk of being weight cyclers. Students who sometimes and always consumed snacks had higher risk of becoming weight cyclers by 3.3 and 2.7 times, respectively, compared to those who rarely consumed snacks.
Conclusion: Regular physical activity, not skipping meals, especially breakfast, and practising a healthy diet every day are recommended strategies to avoid weight cycling during a pandemic.
Key words: dietary habits, physical activity, weight cycling, weight management
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Introduction: Changes in our bodies can cause several problems, particularly for students who are concerned about maintaining an ideal body shape. Many of them try to diet, but their body returns to its previous weight or even increases in weight. Thus, this study aimed to determine the factors that influence the incidence of weight cycling in Indonesian students during the COVID-19 pandemic.
Methods: This cross-sectional study used purposive sampling to collect data. Three hundred college students from West Java province, Indonesia, participated. Weight cycling was the dependent variable and the independent variables were physical activity, sex, and weight management. Multivariate logistic regression analysis was used to determine the factors influencing the incidence of weight cycling.
Results: Sex, physical activity, skipping meals, and snacking were determinants related to weight cycling incidence. Females had a 0.7 times higher risk of experiencing weight cycling than males. Inactive students were 4.7 times more likely to become weight cyclers, and those who rarely skipped mealtime had lower risk of being weight cyclers. Students who sometimes and always consumed snacks had higher risk of becoming weight cyclers by 3.3 and 2.7 times, respectively, compared to those who rarely consumed snacks.
Conclusion: Regular physical activity, not skipping meals, especially breakfast, and practising a healthy diet every day are recommended strategies to avoid weight cycling during a pandemic.
Key words: dietary habits, physical activity, weight cycling, weight management
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Diabetes prevention through digital therapy for highrisk
individuals: Study protocol for the Malaysia
Diabetes Prevention Programme (MyDiPP)
Nurul Fatihah Mohd Fauzi, Sharifah Wajihah Wafa Syed Saadun Tarek Wafa,
Naresh Bhaskar Raj, Mohd Ibrahim Abdullah, Norkhairani Abdul Rawi,
Nurulhuda Mat Hassan & Rohayah Husain
doi: https://doi.org/10.31246/mjn-2022-0015
ABSTRACT
Introduction: Intervention approaches that integrate human coaching into technology are considered as a convenient, accessible and scalable method to reach a larger population at risk. The objective of this paper is to present the protocol for a randomised controlled trial that evaluates the efficacy of a lifestyle intervention programme via a mobile phone app (MyDiPP), which aims to prevent diabetes among adults at risk of developing diabetes.
Methods: MyDiPP intervention is to be delivered for 12 months with multiple approaches (weight loss, dietary modification, physical activity, and quality of life). Eligible adults aged 18-65 years, overweight/obese (body mass index, BMI ≥ 23kg/m2), and at high risk of type 2 diabetes [American Diabetes Association (ADA) Diabetes Risk Score ≥5, or haemoglobin A1c (HbA1c) of 5.6-6.2%], will be randomly assigned to one of two study groups (intervention or usual care control groups) in a 1:1 ratio using simple randomisation.
Results: Changes in weight and HbA1c level (primary outcomes), and changes in physical activity level, dietary intake, and quality of life (secondary outcomes) will be assessed at 6 and 12 months.
Conclusion: This study protocol describes the first digital therapy for diabetes prevention in Malaysia, which will determine whether the effect of this intervention is larger than the effect of usual care in reducing body weight and HbA1c level, and improving dietary intake, physical activity, and quality of life of high-risk individuals. Results from this trial may be useful for preventing type 2 diabetes mellitus in Malaysia.
Key words: lifestyle intervention, prediabetes, protocol, randomised controlled trial, T2DM
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Introduction: Intervention approaches that integrate human coaching into technology are considered as a convenient, accessible and scalable method to reach a larger population at risk. The objective of this paper is to present the protocol for a randomised controlled trial that evaluates the efficacy of a lifestyle intervention programme via a mobile phone app (MyDiPP), which aims to prevent diabetes among adults at risk of developing diabetes.
Methods: MyDiPP intervention is to be delivered for 12 months with multiple approaches (weight loss, dietary modification, physical activity, and quality of life). Eligible adults aged 18-65 years, overweight/obese (body mass index, BMI ≥ 23kg/m2), and at high risk of type 2 diabetes [American Diabetes Association (ADA) Diabetes Risk Score ≥5, or haemoglobin A1c (HbA1c) of 5.6-6.2%], will be randomly assigned to one of two study groups (intervention or usual care control groups) in a 1:1 ratio using simple randomisation.
Results: Changes in weight and HbA1c level (primary outcomes), and changes in physical activity level, dietary intake, and quality of life (secondary outcomes) will be assessed at 6 and 12 months.
Conclusion: This study protocol describes the first digital therapy for diabetes prevention in Malaysia, which will determine whether the effect of this intervention is larger than the effect of usual care in reducing body weight and HbA1c level, and improving dietary intake, physical activity, and quality of life of high-risk individuals. Results from this trial may be useful for preventing type 2 diabetes mellitus in Malaysia.
Key words: lifestyle intervention, prediabetes, protocol, randomised controlled trial, T2DM
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