MJN 2008 Issues
Malaysian Journal of Nutrition
Volume 14 No.1, 2008
Table of Content
Energy and Nutrient Intakes: Findings from the Malaysian
Adult Nutrition Survey (MANS)
Mirnalini K, Zalilah MS, Safiah MY, Tahir A, Siti Haslinda MD, Siti Rohana D, Khairul Zarina MY, Mohd Hasyami S & Normah H
ABSTRACT
Nutrition surveys based on a representative sample of the Malaysian adult population have hitherto not been reported. In 2003, the Ministry of Health, Malaysia, conducted the Malaysian Adult Nutrition Survey (MANS), the first and largest nutrition survey in the country which aimed to provide detailed quantitative information on nutritional status, food and nutrient intakes, and physical activity pattern on a nationwide representative sample of adult subjects between the ages of 18 and 59 years. The survey covered four zones in Peninsular Malaysia (Central, Southern, Northern and East Coast), Sabah and Sarawak. This paper presents the mean and selected percentiles of energy and nutrient intake of 6886 subjects by selected demographic and socioeconomic characteristics. Energy contributions by macronutrients and dietary adequacy in relation to the Recommended Nutrient Intake for Malaysians are also described. Information on dietary intake was collected by trained nutritionists using a one day 24-hour diet recall. Dietary data were analysed using Nutritionist Pro, a diet analysis software and statistical analysis was carried out using the SPSS ver. 13.0. In most of the demographic and socioeconomic groups, males had higher mean energy (1776 kcal) and nutrient intake and percent achievement of RNI than females (1447 kcal). The proportions of calories derived from macronutrients were within the recommendations for a healthy diet. Intake of micronutrients such as iron, calcium and vitamin A was about 50% of RNI particularly in women. Sodium intake of Malaysians, not reported in earlier studies, is also made available. Under-reporting using the EI/BMR ratio was found in half of the population studied. The present study provides the first national estimates of energy and nutrient intake of the Malaysian adult population. Regular nutrition surveys are needed at the national level to provide valuable information on trends in food and nutrient intake, particularly among age and ethnically diverse subgroups of the population.
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Nutrition surveys based on a representative sample of the Malaysian adult population have hitherto not been reported. In 2003, the Ministry of Health, Malaysia, conducted the Malaysian Adult Nutrition Survey (MANS), the first and largest nutrition survey in the country which aimed to provide detailed quantitative information on nutritional status, food and nutrient intakes, and physical activity pattern on a nationwide representative sample of adult subjects between the ages of 18 and 59 years. The survey covered four zones in Peninsular Malaysia (Central, Southern, Northern and East Coast), Sabah and Sarawak. This paper presents the mean and selected percentiles of energy and nutrient intake of 6886 subjects by selected demographic and socioeconomic characteristics. Energy contributions by macronutrients and dietary adequacy in relation to the Recommended Nutrient Intake for Malaysians are also described. Information on dietary intake was collected by trained nutritionists using a one day 24-hour diet recall. Dietary data were analysed using Nutritionist Pro, a diet analysis software and statistical analysis was carried out using the SPSS ver. 13.0. In most of the demographic and socioeconomic groups, males had higher mean energy (1776 kcal) and nutrient intake and percent achievement of RNI than females (1447 kcal). The proportions of calories derived from macronutrients were within the recommendations for a healthy diet. Intake of micronutrients such as iron, calcium and vitamin A was about 50% of RNI particularly in women. Sodium intake of Malaysians, not reported in earlier studies, is also made available. Under-reporting using the EI/BMR ratio was found in half of the population studied. The present study provides the first national estimates of energy and nutrient intake of the Malaysian adult population. Regular nutrition surveys are needed at the national level to provide valuable information on trends in food and nutrient intake, particularly among age and ethnically diverse subgroups of the population.
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Food Consumption Patterns: Findings from the Malaysian
Adult Nutrition Survey(MANS)
Norimah AK, Safiah M, Jamal K, Siti Haslinda, Zuhaida H, Rohida S, Fatimah S, Siti Norazlin, Poh BK, Kandiah M, Zalilah MS, Wan Manan WM, Fatimah S & Azmi MY
ABSTRACT
This study reports the food consumption patterns of adults aged 18 to 59 years in the Malaysian Adults Nutrition Survey (MANS) carried out between October 2002 and December 2003. A total of 6,742 subjects comprising 3,274 men and 3,468 women representing the northern, central , southern and east coast of Peninsular Malaysia as well as Sabah and Sarawak were interviewed. A semi- quantitative food frequency questionnaire (FFQ) which consisted of 126 food items was used to evaluate the food consumption pattern (habitual food intake) of the respondents during the previous one- year period. The results demonstrate that nasi putih (cooked rice) was consumed by 97% of the population twice daily (average 2½ plates per day). Other food items consumed daily were marine fish, (one medium fish per day), green leafy vegetables (one cup per day) and sweetened condensed milk (three teaspoons per day. The mean frequencies for daily intake of rice, leafy vegetables, marine fish, local kuih , anchovy( ikan bilis ) and biscuits were significantly higher among the rural compared to the urban adults. In contrast, more urban dwellers consumed chicken and eggs more frequently than their rural counterparts. More men than women consumed chicken and eggs more frequently. Malaysian adults showed a satisfactory habit of drinking plain water, with 99% drinking at least six glasses of plain water daily. Other beverages such as tea (47%), coffee (28%), chocolate-based drinks (23%) and cordial syrup (11%) were also consumed on daily basis, however, in a smaller proportion of the population. There were differences in the prevalence of daily consumption of foods when comparing urban and rural population, and also between men and women. The prevalence of daily consumption of marine fish among rural and urban adults was 51% and 34% respectively. For sweetened condensed milk, men and women consumed 43% and 28% respectively; however, more women drank full cream milk than men. Between the age groups, 21% of adults below 20 years old consumed chicken at least once a day, while this pattern of intake was not shown in the older age groups. Our findings show that adults, aged 50 to 59 years old, had the highest prevalence of daily consumption of full cream milk with 24% while those aged 18 to 19 years old had the lowest prevalence of daily consumption at 15%. The food consumption pattern of Malaysian adults appears to be satisfactory. However, some changes in food habits are recommended especially in substituting the less wholesome sweetened condensed milk with the more nutritious full cream or skimmed milk.
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This study reports the food consumption patterns of adults aged 18 to 59 years in the Malaysian Adults Nutrition Survey (MANS) carried out between October 2002 and December 2003. A total of 6,742 subjects comprising 3,274 men and 3,468 women representing the northern, central , southern and east coast of Peninsular Malaysia as well as Sabah and Sarawak were interviewed. A semi- quantitative food frequency questionnaire (FFQ) which consisted of 126 food items was used to evaluate the food consumption pattern (habitual food intake) of the respondents during the previous one- year period. The results demonstrate that nasi putih (cooked rice) was consumed by 97% of the population twice daily (average 2½ plates per day). Other food items consumed daily were marine fish, (one medium fish per day), green leafy vegetables (one cup per day) and sweetened condensed milk (three teaspoons per day. The mean frequencies for daily intake of rice, leafy vegetables, marine fish, local kuih , anchovy( ikan bilis ) and biscuits were significantly higher among the rural compared to the urban adults. In contrast, more urban dwellers consumed chicken and eggs more frequently than their rural counterparts. More men than women consumed chicken and eggs more frequently. Malaysian adults showed a satisfactory habit of drinking plain water, with 99% drinking at least six glasses of plain water daily. Other beverages such as tea (47%), coffee (28%), chocolate-based drinks (23%) and cordial syrup (11%) were also consumed on daily basis, however, in a smaller proportion of the population. There were differences in the prevalence of daily consumption of foods when comparing urban and rural population, and also between men and women. The prevalence of daily consumption of marine fish among rural and urban adults was 51% and 34% respectively. For sweetened condensed milk, men and women consumed 43% and 28% respectively; however, more women drank full cream milk than men. Between the age groups, 21% of adults below 20 years old consumed chicken at least once a day, while this pattern of intake was not shown in the older age groups. Our findings show that adults, aged 50 to 59 years old, had the highest prevalence of daily consumption of full cream milk with 24% while those aged 18 to 19 years old had the lowest prevalence of daily consumption at 15%. The food consumption pattern of Malaysian adults appears to be satisfactory. However, some changes in food habits are recommended especially in substituting the less wholesome sweetened condensed milk with the more nutritious full cream or skimmed milk.
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Daily Energy Intake from Meals and Afternoon Snacks:
Findings from the Malaysian Adults Nutrition Survey(MANS)
Zalilah MS, Mirnalini K, Safiah MY, Tahir A, Siti Haslinda MD, Siti Rohana D, Khairul Zarina MY, Mohd Hasyami S, Normah H & Siti Fatimah A
ABSTRACT
Meal and snack patterns are associated with energy and nutrient intakes and consequently health and nutritional status. The aim of this paper is to describe the percentage of daily energy intake from meals and afternoon snack among Malaysian adults. The study included a representative sample of adults aged 18- 59 years (n=7349) from a nationwide Food Consumption Survey conducted by the Ministry of Health. Information on dietary intake was obtained using a one day 24-hour diet recall (24-HDR). Dietary data on 6886 adults were analysed using Nutritionist ProTM and statistical analysis was carried out using the SPSS 13.0. The median percentage of daily energy intake is reported only for adults consuming meals and afternoon tea and by socio-demographic characteristics as well as body mass index (BMI) status. More than 80% of Malaysian adults consumed morning meals, lunch and dinner and 54% reported having afternoon tea. The median percentage of energy intake from morning meals, lunch, dinner and afternoon tea was 29.9%, 30.5%, 32.4% and 17%, respectively. There were variations in the median percentage of energy from meals and snacks according to the socio-demographic variables and BMI status. It is important to understand the eating patterns of Malaysians as the information can assist in efforts to address obesity and diet-related chronic diseases among adults.
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Meal and snack patterns are associated with energy and nutrient intakes and consequently health and nutritional status. The aim of this paper is to describe the percentage of daily energy intake from meals and afternoon snack among Malaysian adults. The study included a representative sample of adults aged 18- 59 years (n=7349) from a nationwide Food Consumption Survey conducted by the Ministry of Health. Information on dietary intake was obtained using a one day 24-hour diet recall (24-HDR). Dietary data on 6886 adults were analysed using Nutritionist ProTM and statistical analysis was carried out using the SPSS 13.0. The median percentage of daily energy intake is reported only for adults consuming meals and afternoon tea and by socio-demographic characteristics as well as body mass index (BMI) status. More than 80% of Malaysian adults consumed morning meals, lunch and dinner and 54% reported having afternoon tea. The median percentage of energy intake from morning meals, lunch, dinner and afternoon tea was 29.9%, 30.5%, 32.4% and 17%, respectively. There were variations in the median percentage of energy from meals and snacks according to the socio-demographic variables and BMI status. It is important to understand the eating patterns of Malaysians as the information can assist in efforts to address obesity and diet-related chronic diseases among adults.
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Framingham Risk Scores and Anthropometric
Measurements in Predicting Cardiovascular Risks among
Malay Men
Moy FM, Atiya Ab Sallam & Wong ML
ABSTRACT
Framingham Risk Scores is an established method to predict an individual’s 10- year risk for coronary heart disease (CHD). It provides a more precise delineation of risk which might lead to appropriate selection of therapy and opportunities for patient education and motivation. A Healthy Lifestyle Project was initiated to decrease the modifiable risk factors for CHD in a worksite in Kuala Lumpur. The participants were Malay men (n=186) working as security guards in a public university. Their mean age was 46.6 + 6.6 years. The majority had secondary education and were married. The participants’ 10-year risks based on the Framingham Risk Scores were 55.4%, 39.8% and 4.8% respectively for categories of low (< 10%), intermediate (10 to 20%) and high (>20%) risk. Their Framingham Risk Scores were then correlated with anthropometric measurements such as the Body Mass Index (BMI), waist circumference and waist-hip-ratio (WHR). All the anthropometric measurements had weak but significant correlation with the Framingham Risk Scores (WHR: r =0.26; waist circumference: r =0.23; BMI: r =0.16). In conclusion, 44.6% of our participants had more than 10% risk in developing CHD in the coming ten years. Hence, they are suitable target candidates for the promotion of a healthy lifestyle such as smoking cessation, weight control, healthy dietary patterns and increased physical activities. Indicators of abdominal obesity like WHR or waist circumference may be used to complement the Framingham Risk Scores for the prediction of CHD risk in this population.
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Framingham Risk Scores is an established method to predict an individual’s 10- year risk for coronary heart disease (CHD). It provides a more precise delineation of risk which might lead to appropriate selection of therapy and opportunities for patient education and motivation. A Healthy Lifestyle Project was initiated to decrease the modifiable risk factors for CHD in a worksite in Kuala Lumpur. The participants were Malay men (n=186) working as security guards in a public university. Their mean age was 46.6 + 6.6 years. The majority had secondary education and were married. The participants’ 10-year risks based on the Framingham Risk Scores were 55.4%, 39.8% and 4.8% respectively for categories of low (< 10%), intermediate (10 to 20%) and high (>20%) risk. Their Framingham Risk Scores were then correlated with anthropometric measurements such as the Body Mass Index (BMI), waist circumference and waist-hip-ratio (WHR). All the anthropometric measurements had weak but significant correlation with the Framingham Risk Scores (WHR: r =0.26; waist circumference: r =0.23; BMI: r =0.16). In conclusion, 44.6% of our participants had more than 10% risk in developing CHD in the coming ten years. Hence, they are suitable target candidates for the promotion of a healthy lifestyle such as smoking cessation, weight control, healthy dietary patterns and increased physical activities. Indicators of abdominal obesity like WHR or waist circumference may be used to complement the Framingham Risk Scores for the prediction of CHD risk in this population.
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Prevalence of Metabolic Syndrome among Malaysians using
the International Diabetes Federation, National Cholesterol
Education Program and Modified World Health Organization
Definitions
Bee Ying Tan, Haresh Kumar Kantilal & Rajbans Singh
ABSTRACT
The World Health Organization (WHO), National Cholesterol Education Program Adults Treatment Panel III (NCEP ATP III) and International Diabetes Federation (IDF) have proposed different criteria to diagnose metabolic syndrome (MetS). However, there is no single definition to accurately diagnose MetS. The objective of this study is to estimate the prevalence of MetS using WHO, NCEP ATP III and IDF in the Malaysian community, and to determine the concordance between these definitions for MetS. 109 men and women aged > 30 years participated in the study, and the prevalence of MetS was determined according to the three definitions. Weight, height, body mass index (BMI), waist-hip circumference, blood pressure, blood lipid profile and plasma fasting glucose were measured. In order to determine the concordance between IDF and the other two definitions, the kappa index ( κ -test) was used. The prevalence of MetS (95% confidence interval) was 22.9% (22.8-23.1) by IDF definition, 16.5% (16.3-16.9) by NCEP ATP III definition and 6.4% (6.2-6.6) by modified WHO definition. The sensitivity and specificity of IDF against NCEP ATP III were 88.9% and 90.1% respectively, IDF against WHO definition were 85.7% and 81.4%. The κ statistics for the agreement of the IDF definition was 68.3 ± 0.1 with the NCEP ATP III, and 30.5 ± 0.1 with the modified WHO definition. The prevalence of the MetS among respondents using the IDF definition was highest, followed by NCEP ATP III, and finally modified WHO definition. There was a good concordance between the IDF and NCEP ATP III definitions, and a low concordance between IDF and modified WHO definitions.
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The World Health Organization (WHO), National Cholesterol Education Program Adults Treatment Panel III (NCEP ATP III) and International Diabetes Federation (IDF) have proposed different criteria to diagnose metabolic syndrome (MetS). However, there is no single definition to accurately diagnose MetS. The objective of this study is to estimate the prevalence of MetS using WHO, NCEP ATP III and IDF in the Malaysian community, and to determine the concordance between these definitions for MetS. 109 men and women aged > 30 years participated in the study, and the prevalence of MetS was determined according to the three definitions. Weight, height, body mass index (BMI), waist-hip circumference, blood pressure, blood lipid profile and plasma fasting glucose were measured. In order to determine the concordance between IDF and the other two definitions, the kappa index ( κ -test) was used. The prevalence of MetS (95% confidence interval) was 22.9% (22.8-23.1) by IDF definition, 16.5% (16.3-16.9) by NCEP ATP III definition and 6.4% (6.2-6.6) by modified WHO definition. The sensitivity and specificity of IDF against NCEP ATP III were 88.9% and 90.1% respectively, IDF against WHO definition were 85.7% and 81.4%. The κ statistics for the agreement of the IDF definition was 68.3 ± 0.1 with the NCEP ATP III, and 30.5 ± 0.1 with the modified WHO definition. The prevalence of the MetS among respondents using the IDF definition was highest, followed by NCEP ATP III, and finally modified WHO definition. There was a good concordance between the IDF and NCEP ATP III definitions, and a low concordance between IDF and modified WHO definitions.
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Weight Status and Dietary Intake among Female Children
and Adolescents Aged 6-17 Years in a Welfare Home,
Kuala Lumpur
Chee YF, Roseline Yap WK & Siti Sabariah B
ABSTRACT
A cross-sectional study was conducted among 13 female children and 40 adolescents residing in a welfare home. The objectives of this study were to determine underweight, overweight rates and body fat percentages as well as assess the dietary intake of energy, selected macro- and micro-nutrients among the subjects aged 6-17 years. The anthropometric measurements collected were Body Mass Index (BMI) and skinfold thickness of five body sites - triceps, subscapular, abdomen, suprailiac, and thigh. Dietary intake was assessed using a 24-hour dietary recall. This study indicated that the majority (75%) of the subjects were of normal weight, 21% were underweight and 4% were overweight. BMI and body fat percentages of the adolescents were found to be significantly higher than those of the children (t=- 3.083, p=0.003; t=-7.321, p<0.001). A positive correlation between BMI and body fat percentage was also significant (r=0.791, p<0.001). In terms of dietary assessment, there were significant differences in percentage of RNI attainment between children and adolescents for energy, protein, iron, and folate (p<0.05). In conclusion, the majority of the children and adolescents had normal weight and average body fat percentages. Besides, all the children met the RNI requirements for all the studied nutrients while the adolescents met the RNI requirements for energy, protein, iron, and zinc with dietary calcium and folate slightly below the RNI requirements.
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A cross-sectional study was conducted among 13 female children and 40 adolescents residing in a welfare home. The objectives of this study were to determine underweight, overweight rates and body fat percentages as well as assess the dietary intake of energy, selected macro- and micro-nutrients among the subjects aged 6-17 years. The anthropometric measurements collected were Body Mass Index (BMI) and skinfold thickness of five body sites - triceps, subscapular, abdomen, suprailiac, and thigh. Dietary intake was assessed using a 24-hour dietary recall. This study indicated that the majority (75%) of the subjects were of normal weight, 21% were underweight and 4% were overweight. BMI and body fat percentages of the adolescents were found to be significantly higher than those of the children (t=- 3.083, p=0.003; t=-7.321, p<0.001). A positive correlation between BMI and body fat percentage was also significant (r=0.791, p<0.001). In terms of dietary assessment, there were significant differences in percentage of RNI attainment between children and adolescents for energy, protein, iron, and folate (p<0.05). In conclusion, the majority of the children and adolescents had normal weight and average body fat percentages. Besides, all the children met the RNI requirements for all the studied nutrients while the adolescents met the RNI requirements for energy, protein, iron, and zinc with dietary calcium and folate slightly below the RNI requirements.
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Nutritional Status of Adult Men from the Oraon Tribe in
Ranchi District of Jharkhand, India
Sudip Datta Banik
ABSTRACT
A cross-sectional study was undertaken to investigate anthropometric characteristics and nutritional status among adult male (18 years and above) Oraons (n = 290), a tribe in the Ranchi District of the state of Jharkhand in India. The anthropometric characteristics (stature, body weight and mid upper arm circumference or MUAC) were categorised into three age-groups (18-39 years, 40- 59 years and 60 years and above). This particular investigation recorded a low (18.48Kg/m 2 ) body mass index (BMI) and a high frequency of under-nutrition (53.10% chronic energy deficiency or CED) among the adult Oraons. BMI and CED of the adult Oraons were also compared with some populations of eastern India. It is noted that 38.28% of adult Oraons suffer from under-nutrition when the nutritional status of their population is evaluated by the standard cut-off points of MUAC. Pearson correlations of BMI and MUAC with age exhibited significantly (p< 0.001) negative correlations among the Oraons. Correlations between BMI and MUAC in their population showed a high significance ( p < 0.0001). Significant age-related variations (tested by one-way ANOVA) in anthropometric parameters were observed in the Oroan population. Linear regression analyses revealed more or less significant negative impacts of age on BMI and MUAC in the population.
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A cross-sectional study was undertaken to investigate anthropometric characteristics and nutritional status among adult male (18 years and above) Oraons (n = 290), a tribe in the Ranchi District of the state of Jharkhand in India. The anthropometric characteristics (stature, body weight and mid upper arm circumference or MUAC) were categorised into three age-groups (18-39 years, 40- 59 years and 60 years and above). This particular investigation recorded a low (18.48Kg/m 2 ) body mass index (BMI) and a high frequency of under-nutrition (53.10% chronic energy deficiency or CED) among the adult Oraons. BMI and CED of the adult Oraons were also compared with some populations of eastern India. It is noted that 38.28% of adult Oraons suffer from under-nutrition when the nutritional status of their population is evaluated by the standard cut-off points of MUAC. Pearson correlations of BMI and MUAC with age exhibited significantly (p< 0.001) negative correlations among the Oraons. Correlations between BMI and MUAC in their population showed a high significance ( p < 0.0001). Significant age-related variations (tested by one-way ANOVA) in anthropometric parameters were observed in the Oroan population. Linear regression analyses revealed more or less significant negative impacts of age on BMI and MUAC in the population.
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Physical Growth and Nutritional Status of the Shabar Tribal
Adolescents of Orissa, India: a Cross-sectional Study
Suman Chakrabarty & Premananda Bharati
ABSTRACT
The aim of the study is to assess the growth and nutritional status of adolescents of the Shabar tribe of Orissa, India. There are no studies on the growth pattern of the Shabar tribe, one of the largest tribal communities of Orissa. Studies of other tribes have shown poor health status of their members. This cross-sectional study was carried out on 328 adolescents (149 boys and 179 girls), aged 10 to 18 years from Khurda and Cuttack districts of Orissa. Anthropometric measurements were taken to assess growth and nutritional status. Means, standard deviation and percentile curves were used to examine the pattern of growth, while t -test and 50th percentile values were used to compare the nutritional status with other studies. Values of <5th percentile of body mass index (BMI) for age were considered as indicators of under-nutrition. Most of the body measurements showed high rates of increase between 14 to 15 years among boys and 12 to 13 years among girls, which correspond to the adolescent growth spurt. The Shabar adolescents were significantly (p<0.01) shorter and lighter than the NCHS (National Center for Health Statistics) 50th percentile curves. There was high prevalence of chronic under-nutrition (<5th percentile of BMI for age). It is noted that the nutritional status of the Shabar children is generally better than that of other tribes. These findings may be attributed to various nutritional programmes for children. However, poor socio-economic status of this tribe remains an important factor for the high prevalence of chronic under-nutrition and poor growth pattern. In-depth studies are necessary for identifying other factors that lead to growth retardation and under-nutrition among the adolescents of the Shabar population.
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The aim of the study is to assess the growth and nutritional status of adolescents of the Shabar tribe of Orissa, India. There are no studies on the growth pattern of the Shabar tribe, one of the largest tribal communities of Orissa. Studies of other tribes have shown poor health status of their members. This cross-sectional study was carried out on 328 adolescents (149 boys and 179 girls), aged 10 to 18 years from Khurda and Cuttack districts of Orissa. Anthropometric measurements were taken to assess growth and nutritional status. Means, standard deviation and percentile curves were used to examine the pattern of growth, while t -test and 50th percentile values were used to compare the nutritional status with other studies. Values of <5th percentile of body mass index (BMI) for age were considered as indicators of under-nutrition. Most of the body measurements showed high rates of increase between 14 to 15 years among boys and 12 to 13 years among girls, which correspond to the adolescent growth spurt. The Shabar adolescents were significantly (p<0.01) shorter and lighter than the NCHS (National Center for Health Statistics) 50th percentile curves. There was high prevalence of chronic under-nutrition (<5th percentile of BMI for age). It is noted that the nutritional status of the Shabar children is generally better than that of other tribes. These findings may be attributed to various nutritional programmes for children. However, poor socio-economic status of this tribe remains an important factor for the high prevalence of chronic under-nutrition and poor growth pattern. In-depth studies are necessary for identifying other factors that lead to growth retardation and under-nutrition among the adolescents of the Shabar population.
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Effect of Sodium Metavanadate Supplementation on Lipid
and Glucose Metabolism Biomarkers in Type 2 Diabetic
Patients
Mohammad Afkhami-Ardekani, Mahdi Karimi, Seid Mohammad Mohammadi &
Forough Nourani
ABSTRACT
Type 2 diabetes mellitus is a chronic, progressive illness that causes considerable morbidity and premature mortality. Vanadium is a trace mineral that has been claimed to be effective in controlling blood glucose levels in diabetic patients. A randomised placebo-controlled study was conducted to evaluate the effect of sodium metavanadate on selected biochemical markers in type 2 diabetic patients. Forty patients were enrolled and half of them received 100 mg sodium metavanadate daily for 6 weeks while the other half were placebo subjects. The mean age of the patients was 53.1 ± 8.5 years. Body mass index (BMI), blood pressure(BP), fasting blood sugar (FBS), 2-h postprandial glucose, glycated hemoglobin (HbA1C), triglyceride(TG), total cholesterol (TC), low-density lipoproteins (LDL), high-density lipoproteins (HDL) were determined before the start and at the end of the study. Levels of FBS, HbA1C, TC and LDL in the diabetic subjects decreased after six weeks on sodium metavanadate, but the differences were not statistically significant on comparing between pre- and post- trial levels. Based on the results, this study did not find sodium metavanadate of beneficial use as a form of vanadium supplementation among patients with type 2 diabetes.
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Type 2 diabetes mellitus is a chronic, progressive illness that causes considerable morbidity and premature mortality. Vanadium is a trace mineral that has been claimed to be effective in controlling blood glucose levels in diabetic patients. A randomised placebo-controlled study was conducted to evaluate the effect of sodium metavanadate on selected biochemical markers in type 2 diabetic patients. Forty patients were enrolled and half of them received 100 mg sodium metavanadate daily for 6 weeks while the other half were placebo subjects. The mean age of the patients was 53.1 ± 8.5 years. Body mass index (BMI), blood pressure(BP), fasting blood sugar (FBS), 2-h postprandial glucose, glycated hemoglobin (HbA1C), triglyceride(TG), total cholesterol (TC), low-density lipoproteins (LDL), high-density lipoproteins (HDL) were determined before the start and at the end of the study. Levels of FBS, HbA1C, TC and LDL in the diabetic subjects decreased after six weeks on sodium metavanadate, but the differences were not statistically significant on comparing between pre- and post- trial levels. Based on the results, this study did not find sodium metavanadate of beneficial use as a form of vanadium supplementation among patients with type 2 diabetes.
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Malaysian Journal of Nutrition
Volume 14 No.2, 2008
Table of Content
Editorial
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Abdominal Obesity in Malaysian Adults: National Health and
Morbidity Survey III (NHMS III, 2006)
Kee CC, Jamaiyah H, Noor Safiza MN, Geeta A, Khor GL, Suzana S, Jamalludin AR, Rahmah R, Ahmad AZ, Ruzita AT, Wong NF & Ahmad Faudzi Y
ABSTRACT
Abdominal obesity (AO) is an independent risk factor for cardiovascular disease, hypertension and diabetes mellitus in adults. There is a lack of data on the magnitude and socio-demographic profile of AO among Malaysian adults at the national level. In the Third National Health and Morbidity Survey (NHMS III) conducted in 2006, AO of adults aged 18 years and above was determined based on the waist circumference as part of the nutritional status assessment. This article reports the prevalence of AO in relation to socio-economic factors and demographic characteristics of adult subjects. Out of a total of 33,465 eligible individuals 18 years and above, waist circumference was measured in 32,900 (98.3%) individuals. The prevalence of AO was assessed using the cut-off points recommended by World Health Organization. The mean waist circumference in men and women was 84.0cm [95% confidence interval (95% CI): 83.8, 84.3] and 80.3cm (95% CI: 80.1, 80.6) respectively. The national prevalence of AO was 17.4% (95% CI: 16.9, 17.9). The identified risks of AO were women (OR: 4.2, 95% CI: 3.8, 4.6), aged 50-59 years (OR: 5.6, 95% CI: 4.0, 7.7), Indians (OR: 3.0, 95% CI: 2.4, 3.8), housewives (OR: 1.4, 95% CI: 1.1, 1.7), subjects with primary education (OR: 1.3, 95% CI: 1.1, 1.5) and ever married (OR: 1.4, 95% CI: 1.2, 1.6). Being the largest population-based study on AO among Malaysians, these findings have important public health implications. There is an urgent need to revise public health policies and programmes aimed at prevention of abdominal obesity especially in the groups at risk.
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Abdominal obesity (AO) is an independent risk factor for cardiovascular disease, hypertension and diabetes mellitus in adults. There is a lack of data on the magnitude and socio-demographic profile of AO among Malaysian adults at the national level. In the Third National Health and Morbidity Survey (NHMS III) conducted in 2006, AO of adults aged 18 years and above was determined based on the waist circumference as part of the nutritional status assessment. This article reports the prevalence of AO in relation to socio-economic factors and demographic characteristics of adult subjects. Out of a total of 33,465 eligible individuals 18 years and above, waist circumference was measured in 32,900 (98.3%) individuals. The prevalence of AO was assessed using the cut-off points recommended by World Health Organization. The mean waist circumference in men and women was 84.0cm [95% confidence interval (95% CI): 83.8, 84.3] and 80.3cm (95% CI: 80.1, 80.6) respectively. The national prevalence of AO was 17.4% (95% CI: 16.9, 17.9). The identified risks of AO were women (OR: 4.2, 95% CI: 3.8, 4.6), aged 50-59 years (OR: 5.6, 95% CI: 4.0, 7.7), Indians (OR: 3.0, 95% CI: 2.4, 3.8), housewives (OR: 1.4, 95% CI: 1.1, 1.7), subjects with primary education (OR: 1.3, 95% CI: 1.1, 1.5) and ever married (OR: 1.4, 95% CI: 1.2, 1.6). Being the largest population-based study on AO among Malaysians, these findings have important public health implications. There is an urgent need to revise public health policies and programmes aimed at prevention of abdominal obesity especially in the groups at risk.
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Reliability and Technical Error of Calf Circumference and
Mid-half Arm Span Measurements for Nutritional Status
Assessment of Elderly Persons in Malaysia
Jamaiyah H, Geeta A, Safiza MN, Wong NF, Kee CC, Ahmad AZ, Suzana S, Rahmah R, Khor GL, Ruzita AT, Chen WS, Rajaah M & Faudzi A
ABSTRACT
This study sought to examine the reliability of two measurements; Calf Circumference (CC) and Mid-half Arm Span (MHAS). A sample of 130 elderly persons aged 60 years and above seen consecutively in the Kuala Lumpur Hospital outpatient clinic during the period of December 2005 to January 2006, upon consent, were recruited to the study. There was a high degree of reliability for both inter- and intra-examiner (r close to 1). For inter-examiner, on average the CC measurements taken by the first examiner were 0.3 cm lower than that of the second examiner. The upper and lower limit of the differences were +0.4 to –0.9 cm respectively. Inter-examiner MHAS measurements on average by the first examiner were 0.2 cm lower than that of the second examiner. The limits were +1.7 to –2.1 cm. By comparison, the inter-examiner CC measurements were more reliable than the MHAS measurements. For intra-examiner, on average the CC measurements at Time 1 were consistent with Time 2 (mean difference=0) with limits of the difference at + 0.5 cm. MHAS measurements at Time 1 were on average 0.1 cm less than at Time 2 with limits at +1.7 and –1.8 cm. The technical error of measurement (TEM) and coefficient of variation of CC and MHAS for both inter- examiner and intra-examiner measurements were within acceptable limits with the exception of MHAS TEM. This study suggests that CC and MHAS measured in elderly persons 60 years and above, using Seca Circumference Tape ® 206, Germany (0.05 cm) are reliable and can be used in a community survey.
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This study sought to examine the reliability of two measurements; Calf Circumference (CC) and Mid-half Arm Span (MHAS). A sample of 130 elderly persons aged 60 years and above seen consecutively in the Kuala Lumpur Hospital outpatient clinic during the period of December 2005 to January 2006, upon consent, were recruited to the study. There was a high degree of reliability for both inter- and intra-examiner (r close to 1). For inter-examiner, on average the CC measurements taken by the first examiner were 0.3 cm lower than that of the second examiner. The upper and lower limit of the differences were +0.4 to –0.9 cm respectively. Inter-examiner MHAS measurements on average by the first examiner were 0.2 cm lower than that of the second examiner. The limits were +1.7 to –2.1 cm. By comparison, the inter-examiner CC measurements were more reliable than the MHAS measurements. For intra-examiner, on average the CC measurements at Time 1 were consistent with Time 2 (mean difference=0) with limits of the difference at + 0.5 cm. MHAS measurements at Time 1 were on average 0.1 cm less than at Time 2 with limits at +1.7 and –1.8 cm. The technical error of measurement (TEM) and coefficient of variation of CC and MHAS for both inter- examiner and intra-examiner measurements were within acceptable limits with the exception of MHAS TEM. This study suggests that CC and MHAS measured in elderly persons 60 years and above, using Seca Circumference Tape ® 206, Germany (0.05 cm) are reliable and can be used in a community survey.
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Changes in Nutritional, Functional Status and Quality of Life
of COPD Out-patients after a Pulmonary Rehabilitation
Programme in HUKM: a Pilot Study
Suzana S, Hanis MY, Tang SY, Ayiesah R & Roslina AM
ABSTRACT
This quasi-experimental study was carried out to evaluate the effectiveness of an eight-week multi-disciplinary pulmonary rehabilitation programme in improving nutritional and functional status and quality of life of COPD out patients at Hospital Universiti Kebangsaan Malaysia. A total of 9 COPD outpatients aged 40 years and above (6 men and 3 women) completed at least 50% of 16 sessions of an eight-week pulmonary rehabilitation programme. Their nutritional and functional status and rating of quality of life were measured at baseline (0 day) and after 8 weeks and these were compared to those of the control group matched for age, comprising 13 subjects (11 men and 2 women). Nutritional status was determined using anthropometry, body composition (Bioelectrical Impedance Analysis) and three-day food record. Assessment of appetite for food was also carried out using the Simplified Nutritional Assessment Questionnaire (SNAQ). Functional status was assessed using the Pulmonary Functional Status and Dyspnea Questionnaire-modified version (PFSDQ-M). The handgrip strength was also measured using handgrip dynamometer. The SF36 questionnaire was used to measure the quality of life of the subjects. There was a reduction in dyspnea (-49.0%, p<0.05) and fatigue (- 47.8%, p<0.05) in men after the intervention programme, as compared to their controls (dyspnea -2.9% and fatigue 8.9%). Quality of life in this group was also significantly improved by 31.8% (p<0.05) as compared to their controls (-3.0%, p>0.05). Similar trends were noted for the women, although the difference was not significant. No significant changes were seen in nutritional status assessed by anthropometry, dietary intake and appetite. However, there was a trend of increased nutrient intake and SNAQ score in the intervention group as compared to control. An eight-week pulmonary rehabilitation programme was effective in improving the functional status particularly in men, by reducing dyspnea and fatigue; and also improving their quality of life, but was not effective in changing the nutritional status.
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This quasi-experimental study was carried out to evaluate the effectiveness of an eight-week multi-disciplinary pulmonary rehabilitation programme in improving nutritional and functional status and quality of life of COPD out patients at Hospital Universiti Kebangsaan Malaysia. A total of 9 COPD outpatients aged 40 years and above (6 men and 3 women) completed at least 50% of 16 sessions of an eight-week pulmonary rehabilitation programme. Their nutritional and functional status and rating of quality of life were measured at baseline (0 day) and after 8 weeks and these were compared to those of the control group matched for age, comprising 13 subjects (11 men and 2 women). Nutritional status was determined using anthropometry, body composition (Bioelectrical Impedance Analysis) and three-day food record. Assessment of appetite for food was also carried out using the Simplified Nutritional Assessment Questionnaire (SNAQ). Functional status was assessed using the Pulmonary Functional Status and Dyspnea Questionnaire-modified version (PFSDQ-M). The handgrip strength was also measured using handgrip dynamometer. The SF36 questionnaire was used to measure the quality of life of the subjects. There was a reduction in dyspnea (-49.0%, p<0.05) and fatigue (- 47.8%, p<0.05) in men after the intervention programme, as compared to their controls (dyspnea -2.9% and fatigue 8.9%). Quality of life in this group was also significantly improved by 31.8% (p<0.05) as compared to their controls (-3.0%, p>0.05). Similar trends were noted for the women, although the difference was not significant. No significant changes were seen in nutritional status assessed by anthropometry, dietary intake and appetite. However, there was a trend of increased nutrient intake and SNAQ score in the intervention group as compared to control. An eight-week pulmonary rehabilitation programme was effective in improving the functional status particularly in men, by reducing dyspnea and fatigue; and also improving their quality of life, but was not effective in changing the nutritional status.
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Food
Intake and Energy Protein Adequacy of Children from
an Urban Slum in Mysore, India – a Qualitative Analysis
Kulsum A, Lakshmi JA & Prakash J
ABSTRACT
The objective of the investigation was to analyse energy protein adequacy of the diets of Indian children residing in an urban slum. The subjects numbering 271 between the ages of 4-14 years resided in a slum in Mysore city in South India. Nutritional status of children and mothers were determined by standard procedures. Background information was obtained using questionnaire method. Dietary intake data was collected using the 24-hour recall method and analysed for adequacy of food intake, energy protein ratio of diet, sources of protein in diet and associated factors. Results indicate that intake of cereals and pulses is inadequate in younger children but improves with age. Intake of other vegetables is higher than the recommended levels, but that of green leafy vegetables is extremely low. Consumption of fats, oils and milk is very low while protein is derived from plant sources for the majority of the children. Only 22% of children enjoyed a diet adequate in protein and calories. Protein calorie adequacy is influenced by age and gender of children and significantly by literacy or economic status of mothers. Mother’s nutritional status influenced protein energy adequacy of diets significantly. Thus, intervention efforts should not only aim at improving the socio-economic conditions of slum dwellers in general, but should also address nutritional needs of mothers and children.
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The objective of the investigation was to analyse energy protein adequacy of the diets of Indian children residing in an urban slum. The subjects numbering 271 between the ages of 4-14 years resided in a slum in Mysore city in South India. Nutritional status of children and mothers were determined by standard procedures. Background information was obtained using questionnaire method. Dietary intake data was collected using the 24-hour recall method and analysed for adequacy of food intake, energy protein ratio of diet, sources of protein in diet and associated factors. Results indicate that intake of cereals and pulses is inadequate in younger children but improves with age. Intake of other vegetables is higher than the recommended levels, but that of green leafy vegetables is extremely low. Consumption of fats, oils and milk is very low while protein is derived from plant sources for the majority of the children. Only 22% of children enjoyed a diet adequate in protein and calories. Protein calorie adequacy is influenced by age and gender of children and significantly by literacy or economic status of mothers. Mother’s nutritional status influenced protein energy adequacy of diets significantly. Thus, intervention efforts should not only aim at improving the socio-economic conditions of slum dwellers in general, but should also address nutritional needs of mothers and children.
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Biological Properties of
Tinospora crispa
(
Akar Patawali
) and
Its Antiproliferative Activities on Selected Human Cancer Cell
Lines
Zulkhairi A, Abdah MA, M Kamal NH, Nursakinah I, Moklas MAM, Hasnah B, Fazali F, Khairunnur FA, Kamilah KAK, Zamree MS & Shahidan MMA
ABSTRACT
The antioxidant and anti-proliferative activity of the aqueous crude extract of Tinospora crispa stem was investigated. The proximate composition of its stem and leaves was determined. Proximate analysis revealed that T. crispa contains - protein: leaves = 4.7%, stem = 1.2%; fat: leaves = 1.5%, stem = 0.43%; carbohydrate: leaves = 11.8%, stem = 19.4%; ash: leaves = 2.7%, stem = 1.1%; moisture: leaves = 79.3%, stem = 77.9%; fibre: leaves = 1.59%, stem = 0.65%; and energy: leaves = 1.59%, stem = 0.65%. The antioxidant activity of the extract prepared at various temperatures and incubation time was evaluated to determine the optimum extraction procedure. Based on DPPH and TBA tests, the preparation of the extract at 60o C for 6 hours was established as the best possible method as it demonstrated the highest inhibition percentage. The extract was tested against brine shrimp to evaluate its toxicity and n o significant toxicity was recorded since the IC50 value was more than 1000 μ g/ml. The extract produced moderate anti-proliferative activity on selected human cancer cell lines (IC50 MCF-7: 107 μ g/ml, HeLa: 165 μ g/ml, Caov-3: 100 μ g/ml, and HepG2: 165 μ g/ml). The findings from this study suggest that T. crispa has the potential to be a source of natural antioxidants and nutrients, besides having a moderate anti-proliferative effect on selected human cancer cell lines.
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The antioxidant and anti-proliferative activity of the aqueous crude extract of Tinospora crispa stem was investigated. The proximate composition of its stem and leaves was determined. Proximate analysis revealed that T. crispa contains - protein: leaves = 4.7%, stem = 1.2%; fat: leaves = 1.5%, stem = 0.43%; carbohydrate: leaves = 11.8%, stem = 19.4%; ash: leaves = 2.7%, stem = 1.1%; moisture: leaves = 79.3%, stem = 77.9%; fibre: leaves = 1.59%, stem = 0.65%; and energy: leaves = 1.59%, stem = 0.65%. The antioxidant activity of the extract prepared at various temperatures and incubation time was evaluated to determine the optimum extraction procedure. Based on DPPH and TBA tests, the preparation of the extract at 60o C for 6 hours was established as the best possible method as it demonstrated the highest inhibition percentage. The extract was tested against brine shrimp to evaluate its toxicity and n o significant toxicity was recorded since the IC50 value was more than 1000 μ g/ml. The extract produced moderate anti-proliferative activity on selected human cancer cell lines (IC50 MCF-7: 107 μ g/ml, HeLa: 165 μ g/ml, Caov-3: 100 μ g/ml, and HepG2: 165 μ g/ml). The findings from this study suggest that T. crispa has the potential to be a source of natural antioxidants and nutrients, besides having a moderate anti-proliferative effect on selected human cancer cell lines.
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Determination of Daidzein and Genistein Contents in
Mangifera
Fruit
Khoo HE & Ismail A
ABSTRACT
The aim of this study was to determine the daidzein and genistein contents in Mangifera fruits. Three Mangifera species namely ‘bacang’ ( Mangifera foetida) , ‘kuini’ ( M. odorata ) and ‘bambangan’ ( M. pajang ) each from two different locations were selected. The extraction of isoflavones was carried out at 80 o C for 30, 60 and 90 min. HPLC method was performed with a flow rate of 1.00 ml/min using three different separation columns to determine isoflavone contents. The Zorbax Eclipse RP C18 reverse-phase column was found to give the best resolution for isoflavone separation in Mangifera fruits. Moreover, extraction time of 90 min was found to increase the isoflavone aglycone contents. At optimised condition, ‘kuini’ had relatively high daidzein (9.4-10.5 mg/100 g) and genistein (1.6-1.7 mg/100 g) contents. Daidzein content of ‘bambangan’ (8.3-8.7 mg/100 g) was higher than ‘bacang’, but the genistein content of ‘bambangan’ (0.4-0.6 mg/100 g) was similar to that of ‘bacang’ (0.4-0.8 mg/100 g). However, there was a variation in daidzein and genistein contents in Mangifera fruits between two geographical locations.
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The aim of this study was to determine the daidzein and genistein contents in Mangifera fruits. Three Mangifera species namely ‘bacang’ ( Mangifera foetida) , ‘kuini’ ( M. odorata ) and ‘bambangan’ ( M. pajang ) each from two different locations were selected. The extraction of isoflavones was carried out at 80 o C for 30, 60 and 90 min. HPLC method was performed with a flow rate of 1.00 ml/min using three different separation columns to determine isoflavone contents. The Zorbax Eclipse RP C18 reverse-phase column was found to give the best resolution for isoflavone separation in Mangifera fruits. Moreover, extraction time of 90 min was found to increase the isoflavone aglycone contents. At optimised condition, ‘kuini’ had relatively high daidzein (9.4-10.5 mg/100 g) and genistein (1.6-1.7 mg/100 g) contents. Daidzein content of ‘bambangan’ (8.3-8.7 mg/100 g) was higher than ‘bacang’, but the genistein content of ‘bambangan’ (0.4-0.6 mg/100 g) was similar to that of ‘bacang’ (0.4-0.8 mg/100 g). However, there was a variation in daidzein and genistein contents in Mangifera fruits between two geographical locations.
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In vitro
Starch Hydrolysis Rate, Physico-chemical Properties and
Sensory Evaluation of Butter Cake Prepared Using Resistant Starch
Type III Substituted for Wheat Flour
Pongjanta J, Utaipattanaceep A, Naivikul O & Piyachomkwan K
ABSTRACT
Resistant starch type III (RS III) derived from enzymatically debranched high amylose rice starch was prepared and used to make butter cake at different levels (0, 5, 10, 15 and 20%) in place of wheat flour. Physico-chemical properties, sensory evaluation, and in vitro starch hydrolysis rate of the developed butter cake were investigated. This study showed that the content of resistant starch in butter cake increased significantly (P <0.05) as the level of substitution with RS III increased from 2.1 to 4.4% of resistant starch content. The butter cake with RS III replacement had a significantly lower in vitro starch hydrolysis rate compared to the control cake (0% RS III). The rates of starch hydrolysis from 0 to 180 min digestion time for 0, 5, 10 15, and 20% RS III in place of wheat flour in butter cakes were 3.70 to 67.65%, 2.97 to 64.86%, 2.86 to 59.99%, 2.79 to 55.96 and 2.78 to 53.04% respectively. The physico-chemical properties of 5 to 10% RS III substituted with wheat flour in the butter cake were not significantly different from the control cake and were moderately accepted by panellists in the sensory evaluation test.
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Resistant starch type III (RS III) derived from enzymatically debranched high amylose rice starch was prepared and used to make butter cake at different levels (0, 5, 10, 15 and 20%) in place of wheat flour. Physico-chemical properties, sensory evaluation, and in vitro starch hydrolysis rate of the developed butter cake were investigated. This study showed that the content of resistant starch in butter cake increased significantly (P <0.05) as the level of substitution with RS III increased from 2.1 to 4.4% of resistant starch content. The butter cake with RS III replacement had a significantly lower in vitro starch hydrolysis rate compared to the control cake (0% RS III). The rates of starch hydrolysis from 0 to 180 min digestion time for 0, 5, 10 15, and 20% RS III in place of wheat flour in butter cakes were 3.70 to 67.65%, 2.97 to 64.86%, 2.86 to 59.99%, 2.79 to 55.96 and 2.78 to 53.04% respectively. The physico-chemical properties of 5 to 10% RS III substituted with wheat flour in the butter cake were not significantly different from the control cake and were moderately accepted by panellists in the sensory evaluation test.
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Supplement
Abstracts of the 23rd Scientific Conference of the Nutrition Society of Malaysia, 2008
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Acknowledgements
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Malaysian Journal of Nutrition
Volume 14 No.3, 2008
Table of Content
REVIEW
SHORT COMMUNICATIONS