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Soy flour snack bars lower glycaemic response in type 2 diabetes mellitus subjects: A randomised cross-over design
Naufal Muharam Nurdin, Hana Fitria Navratilova, Karina Rahmadia Ekawidyani & Mohamad Yulianto Kurniawan

doi: https://doi.org/10.31246/mjn-2021-0054

ABSTRACT

Introduction: Low glycaemic snacks may help to improve blood glucose control. However, data on the effect of soybean snack bars on postprandial glucose levels of the diabetic population is scarce. Therefore, the current study aimed to examine the effect of consuming soy flour snack bars on glycaemic response (GR) over a 180-minute period in individuals with diabetes by estimating postprandial glucose levels variation and total area under the curve (AUC).
Methods: Nine subjects (age: 54.6±4.0 years; BMI: 25.0±2.5 kg/m2) with type 2 diabetes mellitus (T2DM) diagnoses without complication enrolled in this randomised, open-label, cross-over trial. On three separate sessions, they consumed glucose standard solution, soy flour snack bar (SF), and wheat flour snack bar (WF) containing 25 g of available carbohydrate, respectively. Finger prick capillary method was executed to measure blood glucose levels at 30, 60, 90, 120, 150, 180 minutes after test product ingestion.
Results: Overall, significantly lower postprandial glucose levels were observed at 30, 60, 90, and 120 minutes (122.3±17.6, 136.3±24.9, 125.7±25.3, and 107.2±24.1 mg/dL; p<0.001) in those who consumed SF snack bars than WF snack bars (147.9±41.3, 168.0±43.6, 152.6±30.0, and 140.6±33.4 mg/dL). The AUC level after the ingestion of SF snack bar was 2044.8±503.1 mg.min/dL, >20% lower compared to ingestion of WF snack bar (4735.0±666.8 mg.min/dL), p<0.001. These glycaemic control benefits can be explained due to the high fibre and protein content linked to the physicochemical properties of SF.
Conclusion: With high nutritional properties, SF snack bar has a low GR and might help control blood glucose in T2DM subjects.
Key words: glycaemic response, hyperglycaemia, snack, soy food, T2DM diet

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Determinants of diet quality among mothers of young children in an urban slum area in Jakarta: Mother’s age, vegetables availability, and eating out frequency
Fitya Safira Birahmatika, Dian Novita Chandra & Luh Ade Ari Wiradnyani

doi: https://doi.org/10.31246/mjn-2021-0031

ABSTRACT

Introduction: Poor diet quality is a major issue, and health concerns may be related to diet. Mothers with young children usually have their meals at home; thus, home food environment plays a role in determining dietary behaviours. This study examined the association between health concerns and diet quality among mothers; additionally, the effect of home food environment on this relationship was assessed.
Methods: This cross-sectional study comprising 229 mothers (aged 19–49 years) with young children was conducted in an urban slum area in North Jakarta. Data were collected via interviews using a structured questionnaire. The General Health Interest Scale and Consumer Behaviour Questionnaire were used to assess health concern and home food environment, respectively. The 24-hour dietary recall method was used to calculate the Diet Quality Index-International (DQI-I) score. Spearman’s correlation, multiple linear regression, and path analysis were used to analyse the data.
Results: Majority of the mothers had poor diet quality (mean DQI-I score, 41.44/100). No significant correlation between health concern and diet quality was observed. After adjusting for age, the relationship between health concern and diet quality was not mediated by vegetables availability or eating out frequency (indirect effect=0.012; p=0.096). Multiple linear regression analysis revealed age as a significant predictor of diet quality (B=0.196; p=0.024).
Conclusion: Diet quality among mothers of young children differed with age and was related to both health concerns and home food environment. Thus, the development of strategies to promote healthy eating based on different age groups is warranted.
Key words: diet quality, healthy diet, home environment, mothers

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Milk supplementation increases mid-upper arm circumference and haemoglobin level among pregnant women in Kupang, Indonesia: Evidence from a regression discontinuity design
Ahmad Syafiq, Sandra Fikawati, Nindhita Priscillia Muharrani & Mardatillah

doi: https://doi.org/10.31246/mjn-2021-0023

ABSTRACT

Introduction: The high prevalence of chronic energy deficiency (CED) and anaemia among pregnant women in Indonesia is worrying. Nusa Tenggara Timur (NTT) is one of the provinces in Indonesia with the highest prevalence of CED. This study aimed to determine the effect of fortified milk supplementation on changes in mid-upper arm circumference (MUAC) and haemoglobin level among pregnant women.
Methods: This quasi-experimental study was conducted in three locations of Community Health Centers in NTT from May to August 2019. Purposive sampling was used to recruit 69 pregnant women who were divided into two groups based on haemoglobin levels; the intervention group consisted of 31 pregnant women with haemoglobin levels below 11 g/dL, and control group consisted of 38 pregnant women with haemoglobin levels above 11 g/dL. Intervention group was provided with fortified milk supplementation, while control group received education about prevention of CED and anaemia. Data were analysed using regression discontinuity design with haemoglobin of 11 g/dL as cut-off.
Results: Using regression discontinuity method, we were able to determine the effect of milk supplementation based on haemoglobin levels and confirm the result that milk supplementation significantly increased MUAC by 4.69 cm. Despite no discontinuity found, a positive increase of 0.98 g/dL in haemoglobin level was important to note.
Conclusion: Milk supplementation of 300 kcal/day for three months significantly increased MUAC and to some extent, increased haemoglobin level. Thus, it should be considered when planning nutrition programmes to improve the nutritional status of pregnant women.
Key words: haemoglobin level, milk supplementation, MUAC, pregnant women, regression discontinuity design

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Knowledge, attitude and practices (KAP) towards anaemia among female university students in Malaysia: A cross-sectional survey
Cheryl Huong, Jing Lin Chua, Rui Yi Ng, Dhanashri Kshitij Panse, Snigdha Misra & Afshan Sumera

doi: https://doi.org/10.31246/mjn-2021-0067

ABSTRACT

Introduction: Anaemia is a common health problem in Malaysia, most common being iron deficiency anaemia (IDA). This study aimed to assess knowledge, attitude, practices (KAP), and health-seeking behaviour (HSB) towards anaemia among undergraduate female students.
Methods: A cross-sectional study was conducted among 180 female university students from a medical university in Malaysia. Data were collected using an online questionnaire comprising KAP and HSB. SPSS version 25.0 was used for statistical analysis.
Results: Most participants (60%) had an appropriate level of knowledge about anaemia. A positive attitude was shown with adequate awareness of anaemia. A total of 55.5% of participants reported having good health practices. However, 52.9% of the participants consumed less iron-rich foods and 81.7% reported skipping meals. The overall observed healthseeking behaviour was good. A statistically significant relationship was found between knowledge with attitude (p=0.003) and practice (p=0.005). This study observed that the study population had poor nutritional status, long menstrual duration, and vegetarianism. Moreover, infrequent consumption of vitamin C-rich fruits and low iron-folate supplementation were also observed.
Conclusion: A good level of knowledge on IDA among students was noted. However, most of the students showed a lack of positive attitude and good practices towards preventing anaemia. University students are prone to IDA due to a lack of KAP, which can significantly affect health-seeking behaviour. This issue should not be neglected; therefore, implementing intervention programmes to educate students on the preventive measures against the risk factors of IDA is recommended.
Key words: anaemia, health-seeking behaviour, knowledge attitude practice

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Formulation of local food multimix sprinkle to enhance nutritional adequacy of preschool children in southernmost provinces of Thailand
Laksana Chaimongkol & Bisri Soison

doi: https://doi.org/10.31246/mjn-2021-0102

ABSTRACT

Introduction: This study aimed to formulate an effective Food Multimix-Sprinkle (FMM-S) by using locally available materials.
Methods: Fish (Threadfin bream), cow liver, and orange fleshed sweet potato (OSP) were cooked and dried by using applicable household (HH) method and drum drying (DD). Then, the dried materials were milled and sieved through a 20 mesh screen. Fish, cow liver, and OSP sprinkles were mixed in various proportions to meet nutrient level targets [at least 30% of Thai Recommended Dietary Allowance (RDA) for 1-3 years old children per 15 g serving size].
Results: Six alternative mixes were formulated. The mixture of 3 g of liver, 7 g of fish, and 5 g of OSP (3:7:5) when processed by HH method, and the mixture of 4 g of liver, 8 g of fish, and 3 g of OSP (4:8:3) when processed by DD method, had significant advantage in preference scores in all attributes over the others. Nutritional values of these formulas were 37-55% RDA of protein, 146-194% RDA of vitamin A, and 30-40% RDA of iron for a serving size.
Conclusion: This study demonstrated that household preparation, as well as preparation using drum drying could be used to process raw fish, cow liver, and OSP into a sprinkle mix. The FMM-S provided appropriate amounts of protein, vitamin A, and iron to supplement nutrient intake in pre-schoolers. However, a consumer test is needed to ensure acceptance by the target population.
Key words: food multimix, nutritional formulation, sprinkle

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Comparative amino acid composition and quality parameters of Moringa oleifera testa and cotyledon
Emmanuel Ilesanmi Adeyeye, Abdul Ademola Olaleye, Oluwajumoke Tolulope Idowu, Habibat Omolara Adubiaro & Kikelomo Elizabeth Ayeni

doi: https://doi.org/10.31246/mjn-2020-0130

ABSTRACT

Introduction: Moringa oleifera is a drought-resistant plant, widely used in the tropical region. The leaves and stems have been extensively utilised in foods and neutraceuticals preparation, with less attention to the seeds. In this study, amino acid (AA) compositions of M. oleifera testa and cotyledon were examined comparatively.
Methods: Samples were separately defatted, hydrolyed, and neutralised. The AA solution was purified by cation-exchange solid-phase extraction, derivatised and analysed by gas chromatography.
Results: Glutamic (acidic amino acid) and phenylalanine (essential amino acid, EAA) were the most concentrated in both samples. Total EAA (g/100g crude protein, cp) was higher in cotyledon (51.0) than testa (41.9). Predicted protein efficiency ratios (P-PERs) were higher in testa (0.605-1.530) than cotyledon 0.286-1.460). EAA index ranged between 0.951-1.13 (soybean comparison) and 83.0-96.9 (egg comparison) with corresponding biological value of 78.7-93.9. The following AA had scores >1.0 in comparison to whole hen’s egg, testa: glycine (Gly), glutamic acid (Glu), phenylalanine (Phe), histidine (His), and cysteine (Cys); cotyledon (Gly), proline (Pro), Glu, Phe, His, arginine (Arg) and Cys. In comparison with requirements of pre-school children, six AA (6/9 or 66.7%) had scores >1.0 in each sample. In provisional AA scoring pattern, isoleucine (Ile) (1.25) and Phe + tyrosine (Tyr) (1.68) had scores >1.0 in testa while methionine (Met) + Cys, Phe+Tyr, and tryptophan (Trp) in cotyledon. However, tryptophan and lysine were the limiting AAs in testa and cotyledon, respectively.
Conclusion: The study showed that both anatomical parts would complement each other in terms of amino acid supply.
Key words: amino acid scores, derivatisation, essential amino acid, hydrolysis, isoelectricpoint

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Combined effects of bee pollen supplementation and resistance training on aerobic capacity, muscular performance, antioxidant status, and bone metabolism markers in young men: A randomised controlled trial
Nurathirah Na’aim, Chee Keong Chen, Foong Kiew Ooi & Mahaneem Mohamed

doi: https://doi.org/10.31246/mjn-2021-0072

ABSTRACT

Introduction: This study investigated the combined effects of bee pollen and resistance training on aerobic capacity, muscular performance, antioxidant status, and bone metabolism markers among young men.
Methods: Forty young men were randomly assigned into four groups: sedentary control (C), bee pollen supplementation (BP), resistance training (RT), and combined bee pollen supplementation and resistance training (BPRT) groups. Bee pollen was consumed by participants in BP and BPRT groups (1500 mg daily for eight weeks). Resistance training was performed thrice per week for eight weeks in RT and BPRT groups. Participants’ anthropometry, aerobic capacity, isokinetic muscular peak torque (strength), and average power were measured. Concentrations of serum total antioxidant status (TAS), serum superoxide dismutase (SOD), serum alkaline phosphatase (ALP), and serum C-terminal telopeptide of type 1 collagen (1CTP) were determined.
Results: After eight weeks of intervention, there was a significant decrease in 1CTP in BP group. In RT group, significant increases were observed in both muscular strength and power. In BPRT group, significant increases in both muscular strength and power, and a significant decrease in 1CTP were observed after 8 weeks. There were no significant changes in aerobic capacity, serum TAS, SOD, and ALP in all the study groups.
Conclusion: Resistance training using dumbbells and elastic bands seemed to elicit beneficial effects on muscular strength and power, while bee pollen supplementation alone reduced the level of bone resorption marker. In addition, combining bee pollen with resistance training seemed to offer additive benefit in muscular strength and power.
Key words: antioxidant status, bee pollen, bone metabolism markers, muscular performance, resistance training

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The effect of goat’s milk consumption on the clinical health of middle-aged adults with lactose intolerance
Chanchira Phosat, Charupan Phosat, Chatrapa Hudthagosol, Pornpimo Panprathip Phienluphon & Karunee Kwanbunjan

doi: https://doi.org/10.31246/mjn-2021-0087

ABSTRACT

Introduction: People with lactose intolerance are suggested to consume dietary items containing less lactose, such as goat’s milk. This study aimed to investigate the effects of goat’s milk powder on the health of lactose intolerant middle-aged adults.
Methods: A total of 60 subjects were recruited into this randomised controlled trial. They were divided into four groups and received different dietary interventions (goat’s milk, goat’s milk with curcumin, goat’s milk with coffee, lactose-free milk) for five weeks. Health effects were compared between pre- and post-intervention. Anthropometric and biochemical parameters (blood glucose, insulin, lipid profile, C-reactive protein, and lactoferrin) were evaluated. Dietary intake was recorded using a food record.
Results: Fifty-one lactose intolerant subjects completed the study. After ingestion of goat’s milk, there were significant reductions in body fat (p=0.033) and a significant increase in the percentage of muscle (p=0.021). Waist circumference (WC) decreased in both the goat’s milk with curcumin and goat’s milk with coffee groups (p<0.05 for all). Unfortunately, high-density lipoprotein cholesterol (HDL-C) dropped after the five-week intervention in the goat’s milk group (p=0.002). Lactoferrin level of the goat’s milk group was higher than other groups at post-intervention (p<0.001). Besides, the goat’s milk with coffee group seemed to consume more carbohydrates after completing the intervention (p=0.034).
Conclusion: A five-week intake of goat’s milk reduced the risk of abdominal obesity among middle-aged adults. In addition, it resulted in improved lactoferrin levels.
Key words: goat’s milk, lactoferrin, lactose-free, lactose intolerance, middle-aged adults

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Validation of a Sustainable Diet Index among young Malaysian adults
Nur Fadzlina Zulkefli & Foong Ming Moy

doi: https://doi.org/10.31246/mjn-2021-0060

ABSTRACT

Introduction: A sustainable diet which is healthy and environmentally friendly provides the means of climate change mitigation in addition to promoting health of the population. There is an urgent need to have an indicator to measure if one’s diet is sustainable. This paper aimed to validate a newly developed Sustainable Diet Index (SDI) among young Malaysian adults. The SDI was developed based on the dietary guidelines of a sustainable diet.
Methods: Five indicators (rice, animal-based food, plant-based food, food waste, and packaging) were included in the SDI. The index was validated via content validity, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA) among young Malaysian adults. The dietary assessment tool used was an Android application named Sustainable Food Record.
Results: Content validity showed fair to moderate correlations (0.331 - 0.816) between the indicators in the SDI. EFA produced five final factors with eight indicators in the index as follows: 1) fruits and vegetables; 2) dairy, eggs, and meat; 3) rice, cereals, and grain products; 4) food packaging; and 5) food waste management with strong factor loadings (0.760 – 0.984). All five factors with eight indicators were retained and proceeded with CFA. The fit indices from CFA demonstrated that the model was an absolutely fit.
Conclusion: The validated SDI can be used as a tool to measure the sustainability of an individual’s diet in Malaysia, incorporating both health and environment considerations.
Key words: environment, health, sustainable diet index, validation

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Household income, frequency of purchasing outside meals, eating behaviour and body mass index status among undergraduate students during first phase of COVID-19 lockdown
Nur Hazirah Abdul Razak & Divya Vanoh

doi: https://doi.org/10.31246/mjn-2021-0129

ABSTRACT

Introduction: COVID-19 lockdown has changed the eating behaviours of people, which could affect their body mass index (BMI). These changes affected meal purchasing habits of university students, depending on their household income. Thus, the current study aimed to investigate the association between eating behaviour, household income, frequency of purchasing outside meals with BMI among undergraduate students.
Methods: This was a retrospective cross-sectional study conducted among 112 undergraduate students. Subjects recalled information during the first phase of COVID-19 lockdown, which was from March 2020 till July 2020. Questionnaire consisted of socio-demography, anthropometry, frequency of purchasing outside meals, and eating behaviour using the Malay version Dutch Eating Behaviour Questionnaire (DEBQ).
Results: About 64.3% of subjects reported purchasing outside meals 1-2 times per week. Higher restrained eating behaviour score was correlated with purchasing outside meals about 3-4 times and >4 times a week. Normal weight students had significantly higher restrained eating behaviour score [3.0(1.1)] than those in the obese group [2.9(1.1)]. Household income had no association with frequency of purchasing outside meals.
Conclusion: Eating behaviour affected BMI and the frequency of purchasing outside meals during COVID-19 lockdown. COVID-19 lockdown has resulted in tremendous changes in the eating behaviour and physical activity pattern of university students. Future studies should focus on increasing the nutrition knowledge of university students, especially on the aspect of eating out.
Key words:
body mass index, COVID-19, eating behaviour, household income, purchasing meals
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Effect of adherence to follow-up on recovery from moderate acute malnutrition among under-fives in a supplementary feeding programme
Ekong Emmanuel Udoh1, Rosemary Augustine Umoh, Kevin Bassey Edem, Frances Samue Okpokowuruk, Ekemini Nsikan Udo, Blessing Njideka Nwazuluoke & Olugbemi Oluseyi Motilewa

doi: https://doi.org/10.31246/mjn-2021-0040

ABSTRACT

Introduction: Supplementary feeding programme is a strategy for managing underfives with moderate acute malnutrition (MAM). This study aimed to determine the effect of adherence to follow-up on recovery from MAM among under-fives.
Methods: A clinical trial to evaluate the effectiveness of daily supplementary rations of a standardised milk-based formulation (SMBF), standardised non-milk-based formulation (SNMBF), and hospital-based formulation (HBF) on recovery from MAM over a four months period was conducted among eligible children aged 6 – 59 months. Recovery from MAM among participants was determined based on their status of adherence to follow-up at week 16. It was deemed statistically significant if p-value was <0.05.
Results: Of the 157 children evaluated, 41/54 (75.9%) who received the SMBF, 32/57 (56.1%) who received the SNMBF, and 22/46 (47.8%) who received the HBF had good adherence. Adherence to follow-up was significantly higher with SMBF than SNMBF and HBF (χ²=8.923; p=0.012). In all, 95/157 (60.5%) had good adherence to follow-up with 73/95 (76.8%) recovery from MAM against 42/62 (67.7%) recovery in those with poor adherence (p=0.208).
Conclusion: The status of adherence to scheduled follow-up was not significantly associated with recovery from MAM among under-fives enrolled in the supplementary feeding programme. Nevertheless, efforts at promoting adherence to scheduled follow-up visits should be sustained.
Key words: adherence, clinical, follow-up, malnutrition, nutrition, trial

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