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  1. Akhtar MT, Bin Mohd Sarib MS, Ismail IS, Abas F, Ismail A, Lajis NH, et al.
    Molecules, 2016 Aug 09;21(8).
    PMID: 27517894 DOI: 10.3390/molecules21081026
    Andrographis paniculata is an annual herb and widely cultivated in Southeast Asian countries for its medicinal use. In recent investigations, A. paniculata was found to be effective against Type 1 diabetes mellitus (Type 1 DM). Here, we used a non-genetic out-bred Sprague-Dawley rat model to test the antidiabetic activity of A. paniculata against Type 2 diabetes mellitus (Type 2 DM). Proton Nuclear Magnetic Resonance (¹H-NMR) spectroscopy in combination with multivariate data analyses was used to evaluate the A. paniculata and metformin induced metabolic effects on the obese and obese-diabetic (obdb) rat models. Compared to the normal rats, high levels of creatinine, lactate, and allantoin were found in the urine of obese rats, whereas, obese-diabetic rats were marked by high glucose, choline and taurine levels, and low lactate, formate, creatinine, citrate, 2-oxoglutarate, succinate, dimethylamine, acetoacetate, acetate, allantoin and hippurate levels. Treatment of A. paniculata leaf water extract was found to be quite effective in restoring the disturbed metabolic profile of obdb rats back towards normal conditions. Thisstudy shows the anti-diabetic potential of A. paniculata plant extract and strengthens the idea of using this plant against the diabetes. Further classical genetic methods and state of the art molecular techniques could provide insights into the molecular mechanisms involved in the pathogenesis of diabetes mellitus and anti-diabetic effects of A. paniculata water extract.
    Matched MeSH terms: Obesity/blood; Obesity/drug therapy*
  2. Majid HA, Keow LP, Islam T, Su TT, Cantwell M, Taib NA, et al.
    J Acad Nutr Diet, 2018 04;118(4):705-713.
    PMID: 28756991 DOI: 10.1016/j.jand.2017.05.024
    BACKGROUND: Lifestyle factors, such as diet, body weight, and physical activity, are linked to better survival after breast cancer (BC) diagnosis. A high percentage of the Malaysian population is overweight or obese. In addition, studies have shown a disparity in survival among Malaysian women compared with other higher-income countries. The Malaysian Breast Cancer Survivorship Cohort (MyBCC) study aims to study lifestyle factors that affect survival in BC survivors. These are the preliminary findings on the nutritional status of Malaysian BC survivors.

    OBJECTIVE: Our aim was to evaluate the nutritional status of BC survivors at 1 year after diagnosis.

    DESIGN: This was a cross-sectional study of 194 participants from the MyBCC study, recruited within 1 year of their diagnosis. Participants completed a 3-day food diary.

    PARTICIPANTS: Malaysian women (aged 18 years and older) who were newly diagnosed with primary BC, managed at the University Malaya Medical Center, and able to converse either in Malay, English, or Mandarin were included.

    MAIN OUTCOME MEASURES: Dietary intake and prevalence of overweight or obesity among participants 1 year after diagnosis were measured.

    STATISTICAL ANALYSES PERFORMED: Student's t test and analysis of variance or its equivalent nonparametric test were used for association in continuous variables.

    RESULTS: About 66% (n=129) of participants were overweight or obese and >45% (n=86) had high body fat percentage 1 year after diagnosis. The participants' diets were low in fiber (median=8.7 g/day; interquartile range=7.2 g/day) and calcium (median=458 mg/day; interquartile range=252 mg/day). Ethnicity and educational attainment contributed to the differences in dietary intake among participants. Higher saturated fat and lower fiber intake were observed among Malay participants compared with other ethnic groups.

    CONCLUSIONS: Overweight and obesity were highly prevalent among BC survivors and suboptimal dietary intake was observed. Provision of an individualized medical nutrition therapy by a qualified dietitian is crucial as part of comprehensive BC survivorship care.

    Matched MeSH terms: Obesity/complications; Obesity/epidemiology*
  3. Loganathan R, Vethakkan SR, Radhakrishnan AK, Razak GA, Kim-Tiu T
    Eur J Clin Nutr, 2019 04;73(4):609-616.
    PMID: 29946115 DOI: 10.1038/s41430-018-0236-5
    BACKGROUND/OBJECTIVES: The consumption of antioxidant-rich cooking oil such as red palm olein may be cardioprotective from the perspective of subclinical inflammation and endothelial function.

    SUBJECTS/METHODS: Using a crossover design, we conducted a randomised controlled trial in 53 free-living high-risk abdominally overweight subjects, comparing the effects of incorporating red palm olein (with palm olein as control) in a supervised isocaloric 2100 kcal diet of 30% en fat, two-thirds (45 g/day) of which were derived from the test oil for a period of 6 weeks each.

    RESULTS: We did not observe a significant change in interleukin-6 (IL-6), in parallel with other pro-inflammatory (tumour necrosis factor-β, interleukin-1β, IL-1β, high sensitivity C-reactive protein, hsCRP) and endothelial function (soluble intercellular adhesion molecules, sICAM, soluble intravascular adhesion molecules, sVCAM) parameters. Interestingly, we observed a significant reduction in oxidised LDL levels (P 

    Matched MeSH terms: Obesity, Abdominal/blood; Obesity, Abdominal/therapy*
  4. Ahmad N, Shariff ZM, Mukhtar F, Lye MS
    Nutr J, 2018 08 02;17(1):74.
    PMID: 30071855 DOI: 10.1186/s12937-018-0379-1
    BACKGROUND: Social media may be an effective medium by which parents could be trained to promote healthy eating behaviour and physical activity for their children. This trial evaluates the effectiveness of a family-based intervention using social media in combination with face-to-face sessions - the REDUCE (REorganise Diet, Unnecessary sCreen time and Exercise) programme - on adiposity of Malay children.
    METHODS: Five primary schools in an urban area in Selangor, Malaysia participated in this two-arm randomized controlled field trial. Participants were parents (n = 134) and their primary school-going children 8-11 years of age who were either overweight or obese. These parent-child dyads were randomly allocated to intervention and wait-list control groups and were blinded to group assignment. The intervention was a four-week training programme using two face-to-face sessions and two Facebook sessions followed by weekly booster sessions over a three-month period using WhatsApp. The primary outcome was body mass index (BMI) z-score. Height, body weight, waist circumference and percentage of body fat were measured by blinded assessors. Data were collected at baseline (T1), immediately post-training (T2) and at three- (T3) and six-month post training (T4) and were analysed using generalized linear mixed modelling adjusted for covariates to estimate the intervention effects. Subgroup analysis was conducted for overweight and obese children.
    RESULTS: Ninety-one percent of parents completed the study, 64 in intervention group and 58 in wait-list group. At the sixth month post-training, BMI z-scores were significantly reduced in the intervention group compared to the wait-list group, for the all children (overweight and obese children) and within the obese subgroup ((F(6, 517) = 2.817, p = 0.010) and (F(6, 297) = 6.072, p 
    Matched MeSH terms: Pediatric Obesity/physiopathology; Pediatric Obesity/therapy*
  5. Alagappan M, Rampal L, Zalilah MS
    Med J Malaysia, 2019 12;74(6):513-520.
    PMID: 31929478
    INTRODUCTION: This cross-sectional study aimed to determine the prevalence of overweight and obesity and factors associated among secondary school students in Batang Padang District, Perak, Malaysia.

    METHODS: Out of the 7247 students in the ten selected schools studied, a total of 6248 students (2928 males, 3320 females) took part. A validated self-administered questionnaire was used. Data was analysed using SPSS version 22. Multivariable logistic regression was used to determine the adjusted odd ratio.

    RESULTS: The prevalence of overweight and obesity was 16.0% and 11.5% respectively. Obesity/overweight was significantly (p<0.05) associated with gender, age, ethnicity, education level of father, education level of mother, physical activity, disordered eating, smoking status, body size perception and body part satisfaction. The multivariable analysis results showed that the odds of being overweight/obesity were higher in males compared to females (OR 1.56, 95%CI: 1.37, 1.77). The results also showed that the odds of being overweight/obesity were highest among those in age group 12 and 13 years and among Malay ethnicity. The odds of overweight/obesity were higher in those who was dissatisfied with their body parts, (OR 1.96, 95%CI: 1.71, 2.25), dissatisfied with their body size (OR: 4.25, 95%CI: 3.60, 5.02), low physical activity (OR 1.23, 95%CI: 1.06, 1.44), current smokers (OR 1.38, 95%CI: 1.07, 1.78) and at risk of having eating disorder (OR: 1.39, 95%CI 1.22, 1.59).

    CONCLUSION: The overall prevalence of overweight and obesity is high. The findings from this study can be used by policy makers to plan an integrated intervention program in schools.

    Matched MeSH terms: Pediatric Obesity/epidemiology*; Pediatric Obesity/physiopathology
  6. Mitra SR, Tan PY
    Br J Nutr, 2019 05;121(9):1002-1017.
    PMID: 30761964 DOI: 10.1017/S0007114519000345
    The aim of this study was to investigate the effectiveness of the Hipcref (high-protein, energy-restricted, high-vitamin E and high-fibre) diet in Malaysian adults on body composition and metabolic parameters after an intervention period of 6 months. Overweight/obese Malaysian adults (n 128; BMI≥23 kg/m2) were randomised to the Hipcref (n 65) or control diet (n 63). The intervention group received Hipcref diet charts based on their personal preferences. The control group followed a generalised dietary advice based on Malaysian Dietary Guidelines, 2010. All participants were responsible for preparing their own meals. There was a significant treatment group×time effect on anthropometric parameters (P<0·05) on an intention-to-treat basis. Pairwise comparisons revealed that Hipcref diet participants had significant reduction in weight, BMI, waist circumference, fat mass and percentage body fat at months 3 and 6 compared with baseline (P<0·001). The control group had significant increase in weight and BMI at months 3 and 6 compared with baseline (P<0·05). The Hipcref diet group had higher reduction in fasting insulin, insulin resistance and C-reactive protein levels compared with the control group at month 6 (P<0·05). Post-intervention, compared with the control group, the Hipcref diet group was found to consume significantly higher percentage energy from protein, and PUFA, higher energy-adjusted vitamin E (mg) and fibre (g), and lower total energy, lower percentage energy from fat and carbohydrate (P<0·05). The success of the Hipcref diet on overweight/obese Malaysian adults may be due to the combined effect of the nutrient composition of the Hipcref diet.
    Matched MeSH terms: Obesity/diet therapy*; Obesity/physiopathology
  7. Rosli TI, Chan YM, Kadir RA, Hamid TAA
    BMC Public Health, 2019 Jun 13;19(Suppl 4):547.
    PMID: 31196031 DOI: 10.1186/s12889-019-6867-1
    BACKGROUND: Poor oral health has an impact on food choices and intake of important nutrients among older population. The use of oral health-related quality of life instruments along with the clinical dental indicators can help to assess the oral problems that lead to nutritional problems in this group. This study aims to determine the association between oral health-related quality of life (OHRQoL) and nutritional status among a group of older adults in Kuala Pilah district, Malaysia.

    METHODS: A cross-sectional study was carried out on 446 older adults aged 50 years and above from 20 randomly selected villages. Respondents were interviewed to collect information on their demographic characteristics and oral health perception, followed by physical examination to measure height, weight and body mass index (BMI) of respondents. The validated Malay version of General Oral Health Assessment Index (GOHAI) was used to measure OHRQoL.

    RESULTS: About one-third (35.8%) of the respondents had normal BMI. Majority of the respondents were overweight (40.4%) and obese (19.9%), while only a small proportion was underweight (3.9%). Mean GOHAI score was 53.3 (SD = 4.7), indicating low perception of oral health. About 81.6% respondents had moderate to low perception of oral health. Logistic regression analysis showed a statistically significant association between the GOHAI and BMI scores (OR = 2.3; p 

    Matched MeSH terms: Obesity/epidemiology; Obesity/psychology
  8. Wafa SW, Ghazalli R
    PLoS One, 2020;15(4):e0232000.
    PMID: 32330177 DOI: 10.1371/journal.pone.0232000
    With the on-going interest in implementing school policies to address the problem of childhood obesity in Malaysia, there is urgent need for information about the association between school environment and children's weight status. This study aims to investigate the association between school environmental factors (physical, economic, political and sociocultural) with BMI of school children in Terengganu. The school environment factors were assessed using a set of validated whole-school environmental mapping questionnaires, consisting of 76 criteria with four domains; physical environment (41 criteria), economic environment (nine criteria), political environment (nine criteria) and sociocultural environment (17 criteria). This involved face-to-face interview sessions with 32 teachers from 16 schools (eight rural and eight urban). In addition, 400 school children aged between 9 and 11 years of the selected schools were assessed for BMI (WHO 2007 reference chart), dietary intake (food frequency questionnaire (FFQ)) and physical activity level (physical activity questionnaire for children (PAQ-C)). Multiple regression was used to examine the association between school environment factors and BMI of the school children. Seven school environment criteria were found to be associated with BMI of school children when it was adjusted for calorie intake and physical activity level. About 33.4% of the variation in BMI of school children was explained by health professional involvement, simple exercise before class, encouragement to walk/ride bicycle to/from school, no high-calorie food sold, healthy options of foods and drinks at tuck shop, availability of policy on physical activity and training teacher as a role model. Policy makers should make urgent actions to address the obesogenic features of school environments. It should strive towards setting up healthy school environment and improving school curricula to promote healthy behaviours among the school children.
    Matched MeSH terms: Pediatric Obesity/etiology*; Pediatric Obesity/psychology*
  9. Chang Y, Jung HS, Cho J, Zhang Y, Yun KE, Lazo M, et al.
    Am J Gastroenterol, 2016 08;111(8):1133-40.
    PMID: 27185080 DOI: 10.1038/ajg.2016.178
    OBJECTIVES: The risk of nonalcoholic fatty liver disease (NAFLD) among obese individuals without obesity-related metabolic abnormalities, a condition referred to as metabolically healthy obese (MHO), is largely unexplored. Therefore, we examined the association between body mass index (BMI) categories and the development of NAFLD in a large cohort of metabolically healthy men and women.

    METHODS: A cohort study was conducted in 77,425 men and women free of NAFLD and metabolic abnormalities at baseline, who were followed-up annually or biennially for an average of 4.5 years. Being metabolically healthy was defined as not having any metabolic syndrome component and having a homeostasis model assessment of insulin resistance <2.5. The presence of fatty liver was determined using ultrasound.

    RESULTS: During 348,193.5 person-years of follow-up, 10,340 participants developed NAFLD (incidence rate, 29.7 per 1,000 person-years). The multivariable adjusted hazard ratios (95% confidence intervals) for incident NAFLD comparing overweight and obese with normal-weight participants were 2.15 (2.06-2.26) and 3.55 (3.37-3.74), respectively. In detailed dose-response analyses, increasing baseline BMI showed a strong and approximately linear relationship with the incidence of NAFLD, with no threshold at no risk. This association was present in both men and women, although it was stronger in women (P for interaction <0.001), and it was evident in all clinically relevant subgroups evaluated, including participants with low inflammation status.

    CONCLUSIONS: In a large cohort of strictly defined metabolically healthy men and women, overweight and obesity were strongly and progressively associated with an increased incidence of NAFLD, suggesting that the obese phenotype per se, regardless of metabolic abnormalities, can increase the risk of NAFLD.

    Matched MeSH terms: Obesity, Metabolically Benign/metabolism; Obesity, Metabolically Benign/epidemiology*
  10. Chakraborty C, Das S
    Mini Rev Med Chem, 2016;16(15):1258-1268.
    PMID: 27145852 DOI: 10.2174/1389557516666160505115512
    The incidence of diabetes in developing countries in Asia has increased over the last few years. The economic development is radically changing the lifestyle of the younger generation who prefer to embrace the western lifestyle of eating high calorie fast food with minimal physical exercise. Previously, the rate of diabetes was very low but it is increasing at an alarming rate in the developing countries in Asia. Admittedly, there is paucity of literature on the prevalence of patients with type-1 diabetes in Asian developing countries due to lower field surveys and lack of quantitative data. Few contributing factors such as body mass index (BMI) and its relation with obesity and diabetes, energy dense diet, excessive caloric intake, sedentary behaviors, lifestyle and family history, gene and genomewide association of diabetes, genes and gene polymorphisms are being discussed especially with regard to the Asian population. Dynamics of the diabetes and obesity was depicted for the population of Asian developing countries with special emphasis on China and India. Diabetes has become widespread among the low-income communities. Hence, it is necessary to develop appropriate healthcare policies in order to mitigate this rampant epidemic before it is too late.
    Matched MeSH terms: Obesity/epidemiology*; Obesity/prevention & control
  11. Yong RY, Mustaffa SB, Wasan PS, Sheng L, Marshall CR, Scherer SW, et al.
    Hum Mutat, 2016 Jul;37(7):669-78.
    PMID: 27068483 DOI: 10.1002/humu.22996
    The human amylase gene locus at chromosome 1p21.1 is structurally complex. This region contains two pancreatic amylase genes, AMY2B, AMY2A, and a salivary gene AMY1. The AMY1 gene harbors extensive copy number variation (CNV), and recent studies have implicated this variation in adaptation to starch-rich diets and in association to obesity for European and Asian populations. In this study, we showed that by combining quantitative PCR and digital PCR, coupled with careful experimental design and calibration, we can improve the resolution of genotyping CNV with high copy numbers (CNs). In two East Asian populations of Chinese and Malay ethnicity studied, we observed a unique non-normal distribution of AMY1 diploid CN genotypes with even:odd CNs ratio of 4.5 (3.3-4.7), and an association between the common AMY2A CN = 2 genotype and odd CNs of AMY1, that could be explained by the underlying haplotypic structure. In two further case-control cohorts (n = 932 and 145, for Chinese and Malays, respectively), we did not observe the previously reported association between AMY1 and obesity or body mass index. Improved methods for accurately genotyping multiallelic CNV loci and understanding the haplotype complexity at the AMY1 locus are necessary for population genetics and association studies.
    Matched MeSH terms: Obesity/ethnology; Obesity/genetics*
  12. Ramli NS, Ismail P, Rahmat A
    BMC Complement Altern Med, 2016 Jul 26;16:243.
    PMID: 27456968 DOI: 10.1186/s12906-016-1200-3
    Red pitaya (Hylocereus polyrhizus) or known as buah naga merah in Malay belongs to the cactus family, Cactaceae. Red pitaya has been shown to give protection against liver damage and may reduce the stiffness of the heart. Besides, the beneficial effects of red pitaya against obesity have been reported; however, the mechanism of this protection is not clear. Therefore, in the present study, we have investigated the red pitaya-targeted genes in obesity using high-carbohydrate, high-fat diet-induced metabolic syndrome rat model.
    Matched MeSH terms: Obesity/genetics*; Obesity/metabolism
  13. Zulkipli MS, Dahlui M, Jamil N, Peramalah D, Wai HVC, Bulgiba A, et al.
    PLoS Negl Trop Dis, 2018 02;12(2):e0006263.
    PMID: 29415036 DOI: 10.1371/journal.pntd.0006263
    BACKGROUND: Severe dengue infection often has unpredictable clinical progressions and outcomes. Obesity may play a role in the deterioration of dengue infection due to stronger body immune responses. Several studies found that obese dengue patients have a more severe presentation with a poorer prognosis. However, the association was inconclusive due to the variation in the results of earlier studies. Therefore, we conducted a systematic review and meta-analysis to explore the relationship between obesity and dengue severity.

    METHODS: We performed a systematic search of relevant studies on Ovid (MEDLINE), EMBASE, the Cochrane Library, Web of Science, Scopus and grey literature databases. At least two authors independently conducted the literature search, selecting eligible studies, and extracting data. Meta-analysis using random-effects model was conducted to compute the pooled odds ratio with 95% confidence intervals (CI).

    FINDINGS: We obtained a total of 13,333 articles from the searches. For the final analysis, we included a total of fifteen studies among pediatric patients. Three cohort studies, two case-control studies, and one cross-sectional study found an association between obesity and dengue severity. In contrast, six cohort studies and three case-control studies found no significant relationship between obesity and dengue severity. Our meta-analysis revealed that there was 38 percent higher odds (Odds Ratio = 1.38; 95% CI:1.10, 1.73) of developing severe dengue infection among obese children compared to non-obese children. We found no heterogeneity found between studies. The differences in obesity classification, study quality, and study design do not modify the association between obesity and dengue severity.

    CONCLUSION: This review found that obesity is a risk factor for dengue severity among children. The result highlights and improves our understanding that obesity might influence the severity of dengue infection.

    Matched MeSH terms: Obesity/complications*; Obesity/immunology
  14. Sayem ASM, Arya A, Karimian H, Krishnasamy N, Ashok Hasamnis A, Hossain CF
    Molecules, 2018 Jan 28;23(2).
    PMID: 29382104 DOI: 10.3390/molecules23020258
    Diabetes is associated with obesity, generally accompanied by a chronic state of oxidative stress and redox imbalances which are implicated in the progression of micro- and macro-complications like heart disease, stroke, dementia, cancer, kidney failure and blindness. All these complications rise primarily due to consistent high blood glucose levels. Insulin and glucagon help to maintain the homeostasis of glucose and lipids through signaling cascades. Pancreatic hormones stimulate translocation of the glucose transporter isoform 4 (GLUT4) from an intracellular location to the cell surface and facilitate the rapid insulin-dependent storage of glucose in muscle and fat cells. Malfunction in glucose uptake mechanisms, primarily contribute to insulin resistance in type 2 diabetes. Plant secondary metabolites, commonly known as phytochemicals, are reported to have great benefits in the management of type 2 diabetes. The role of phytochemicals and their action on insulin signaling pathways through stimulation of GLUT4 translocation is crucial to understand the pathogenesis of this disease in the management process. This review will summarize the effects of phytochemicals and their action on insulin signaling pathways accelerating GLUT4 translocation based on the current literature.
    Matched MeSH terms: Obesity/metabolism*; Obesity/pathology
  15. Goonasegaran AR, Nabila FN, Shuhada NS
    Singapore Med J, 2012 Jun;53(6):403-8.
    PMID: 22711041
    Body mass index (BMI) has limited diagnostic performance due to its inability to discriminate between fat and lean mass. This study was conducted to compare the effectiveness of body fat percentage (BFP) against BMI in defining body composition.
    Matched MeSH terms: Obesity/complications; Obesity/diagnosis
  16. Nasta AM, Goel R, Singhal R, Lemmens L, Baig S, Seki Y, et al.
    Obes Res Clin Pract, 2024;18(3):195-200.
    PMID: 38955573 DOI: 10.1016/j.orcp.2024.06.001
    INTRODUCTION: Revisional bariatric surgery (RBS) for insufficient weight loss/weight regain or metabolic relapse is increasing worldwide. There is currently no large multinational, prospective data on 30-day morbidity and mortality of RBS. In this study, we aimed to evaluate the 30-day morbidity and mortality of RBS at participating centres.

    METHODS: An international steering group was formed to oversee the study. The steering group members invited bariatric surgeons worldwide to participate in this study. Ethical approval was obtained at the lead centre. Data were collected prospectively on all consecutive RBS patients operated between 15th May 2021 to 31st December 2021. Revisions for complications were excluded.

    RESULTS: A total of 65 global centres submitted data on 750 patients. Sleeve gastrectomy (n = 369, 49.2 %) was the most common primary surgery for which revision was performed. Revisional procedures performed included Roux-en-Y gastric bypass (RYGB) in 41.1 % (n = 308) patients, One anastomosis gastric bypass (OAGB) in 19.3 % (n = 145), Sleeve Gastrectomy (SG) in 16.7 % (n = 125) and other procedures in 22.9 % (n = 172) patients. Indications for revision included weight regain in 615(81.8 %) patients, inadequate weight loss in 127(16.9 %), inadequate diabetes control in 47(6.3 %) and diabetes relapse in 27(3.6 %). 30-day complications were seen in 80(10.7 %) patients. Forty-nine (6.5 %) complications were Clavien Dindo grade 3 or higher. Two patients (0.3 %) died within 30 days of RBS.

    CONCLUSION: RBS for insufficient weight loss/weight regain or metabolic relapse is associated with 10.7 % morbidity and 0.3 % mortality. Sleeve gastrectomy is the most common primary procedure to undergo revisional bariatric surgery, while Roux-en-Y gastric bypass is the most commonly performed revision.

    Matched MeSH terms: Obesity, Morbid/mortality; Obesity, Morbid/surgery
  17. Lee YY, Kamarudin KS, Wan Muda WAM
    BMC Public Health, 2019 May 22;19(1):621.
    PMID: 31118019 DOI: 10.1186/s12889-019-6971-2
    BACKGROUND: For the past decades, Malaysia has seen an increased prevalence of overweight and obesity which leads to significant health threats. Physical activity is beneficial in maintaining healthy body weight. The objective of this study was to measure physical activity of adults in Malaysia using objective measurement (accelerometer) and self-reported methods, as well as to determine their associations with (body mass index (BMI) and waist circumference (WC) measurements.

    METHODS: Four-hundred and ninety Malaysian adults (n = 490) aged 20 to 65 years old participated in this cross-sectional study. Their body weight, height, and WC measurements were measured according to standard procedures. Physical activity was assessed objectively with accelerometers for five to seven consecutive days. The International Physical Activity Questionnaire (IPAQ) was used to estimate the amount of time spent on various domains of physical activity. Mixed models were used to determine the associations between physical activity variables and both BMI and WC.

    RESULTS: The mean value of objectively measured moderate-to-vigorous physical activity (MVPA) was 13.5 min per day, in which male participants recorded a significantly higher amount of time compared to females. On the other hand, the mean self-reported total physical activity was 380 min per week; male participants reported a significantly higher amount of time on physical activity in the occupation/work and leisure/recreation domains while female participants spent significantly more time in the domestic/household chores domain. We also observed that the mean values of objectively measured total MVPA, self-reported time spent on walking for leisure/recreation, and total time amount of time spent on MVPA for leisure/recreation were significantly higher among participants with BMI of less than 25 kg/m2. The final statistical model yielded a significant negative association between objectively measured total MVPA and BMI, but not with WC measurement. No significant association was reported between self-reported total physical activity with BMI and WC measurement.

    CONCLUSIONS: Objectively measured MVPA was inversely associated with BMI, but not WC measurement. No significant association was observed between self-reported total physical activity and physical activity time measures across domains with both BMI and WC measurement.

    Matched MeSH terms: Obesity/epidemiology*; Obesity/psychology
  18. Azman M, Sani A, Kamaruddin NA
    Ann Saudi Med, 2014;34(6):476-81.
    PMID: 25971819 DOI: 10.5144/0256-4947.2014.476
    BACKGROUND AND OBJECTIVES: Obstructive sleep apnea (OSA) is a common disease affecting middle-aged patients and is associated with significant cardiovascular, cerebrovascular, and metabolic complications. Current evidences show inconclusive association between OSA and insulin resistance (IR). This study aims to examine the possible correlation between OSA parameters and IR.

    DESIGN AND SETTINGS: This was a cross-sectional study to examine the association between OSA parameters and IR using homeostasis model assessment (HOMA) on patients who underwent polysomnogram (PSG) in a tertiary center between March 2011 and March 2012 (1 year).

    PATIENTS AND METHODS: A total of 62 patients underwent PSG within the study period, of which 16 patients were excluded due to abnormal fasting blood sugar. Information on patients' medical illnesses, medications, and Epworth sleepiness scale (ESS) was obtained. Patients' body mass index (BMI), neck circumference, and waist circumference (WC) were measured. Blood samples were collected after 8 hours of fasting to measure HOMA-IR value. Overnight PSG was performed for all patients. Data was recorded and analyzed using SPSS, version 12.0 (SPSS Inc, Chicago, USA).

    RESULTS: The prevalence of IR in OSA patients was 64.3%. There was significant correlation between OSA parameters (apnea-hypopnea index, ESS, BMI, and WC) and HOMA-IR with correlation coefficient of 0.529, 0.224, 0.261, and 0.354, respectively.

    CONCLUSION: A linear correlation exists between OSA parameters and IR concluding a definite causal link between OSA and IR. IR screening is recommended in severe OSA patients.

    Matched MeSH terms: Obesity/complications; Obesity/metabolism*
  19. Pell C, Allotey P, Evans N, Hardon A, Imelda JD, Soyiri I, et al.
    BMC Public Health, 2016 10 13;16(1):1082.
    PMID: 27737680
    BACKGROUND: Malaysians have become increasingly obese over recent years. The transition from adolescence to early adulthood is recognized as critical for the development of eating and activity habits. However, little obesity-related research focuses on this life stage. Drawing on data from a health and demographic surveillance site in Malaysia, this article describes obesity and overweight amongst adolescents and young adults in a multi-ethnic population.

    METHODS: Data were collected at the South East Asia Community Observatory (SEACO) in Segamat District, Johor. In this dynamic cohort of approximately 40,000 people, 5,475 were aged 16-35 in 2013-2014. The population consists of Malay, Chinese, Indian and Indigenous (Orang Asli) families in proportions that reflect the national ethnic diversity. Data were collected through health profiles (Body Mass Index [BMI] measurements in homes) and self-report questionnaires.

    RESULTS: Age and ethnicity were associated with overweight (BMI 25.0-29.9Kg/m2) and obesity (BMI ≥ 30Kg/m2). The prevalence of overweight was 12.8 % at ages 16-20 and 28.4 % at ages 31-35; obesity was 7.9 % and 20.9 % at the same age groups. The main ethnic groups also showed varied patterns of obesity and overweight at the different age groups with Chinese at lowest and Orang Asli at highest risk. Level of education, employment status, physical activity and frequency of eating out were poorly predictive of overweight and obesity.

    CONCLUSION: The pattern of overweight and obesity in the 16-35 age group further highlights this as a significant period for changes in health-related behaviours. Further longitudinal research is however needed to confirm the observed pattern and investigate causal factors.
    Matched MeSH terms: Obesity/etiology; Obesity/epidemiology*
  20. Ahmad A, Zulaily N, Shahril MR, Syed Abdullah EFH, Ahmed A
    PLoS One, 2018;13(7):e0200577.
    PMID: 30044842 DOI: 10.1371/journal.pone.0200577
    The epidemic of obesity in developed countries is commonly associated with poor dietary habit and sedentary lifestyle. However, other determinants, including education background and family income, may contribute towards the problem especially in developing countries. This study aimed to determine the influence of socioeconomic status (SES) on obesity among 12-year-old school adolescents in Terengganu, Malaysia. Body weight and height were measured and BMI was categorised based on WHO z-score cut-off points. Information was obtained from self-reported questionnaire on parents' education background, family income and occupation. A total of 3,798 school adolescents aged 12 years (44% boys and 56% girls) were recruited. There was no significant difference in BMI status between boys and girls, or between rural and urban participants. There were significant differences between BMI categories and gender, household income and SES level within rural areas. In the urban areas, significant differences were found between BMI categories and gender, parents' occupational and educational level, household income and size, and SES level. A logistic regression model found several SES factors to be predictors of obesity in this population, namely, gender, household size, father's occupation level, household income level and SES level. Each component of SES has been significantly associated with the BMI category of school adolescents, particularly in the urban areas. This suggests the requirement of multifaceted approaches, including the role of family, society and authorities, in the effort to curtail adolescent obesity.
    Matched MeSH terms: Pediatric Obesity/epidemiology*; Pediatric Obesity/prevention & control
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