A structured weight management programme at a workplace may help in reducing the prevalence of overweight and obesity.
Therefore, this intervention study was to determine the effectiveness of weight loss programmes including face-to-face,
online and control group at workplace among employees who are overweight and obese. A total of 108 overweight and
obese adults were recruited and randomly divided into three groups (face-to-face group (FT), n=38; online group (OG),
n=31; control group (CG), n=39). In the FT group, the participants took part in health talks, interactive activities and
counselling; the OG group was given access to an online weight management program and the CG group was provided
with educational booklets on weight loss. All information given was related to nutrition, physical activity and motivation
to reduce weight. Body weight, body mass index (BMI), waist circumference (WC), body fat percentage, dietary intake,
fasting lipid profile and glucose levels were assessed at baseline and 4 months. The FT group showed greater reduction
in body weight (-5.80 kg) compared to OG (-1.12 kg) and CG (-1.82 kg). Significant interaction effects were found for BMI,
WC, fasting serum triglycerides, HDL-cholesterol and total cholesterol/HDL-cholesterol ratio (all p<0.05), with the FT
group showing the biggest improvements, compared to the other groups. The face-to-face weight management program
offered in the workplace showed to be the most effective at improving anthropometric profile, fasting serum triglycerides,
HDL-C, total cholesterol/HDL-C ratio, and dietary intake among overweight and obese employees.
Introduction: This study aimed to identify dietary patterns (DPs) and their
association with successful aging (SA). Methods: A comparative cross-sectional
study was conducted among 579 elderly subjects recruited from four states in
Malaysia through a multistage random sampling method. SA was defined as having
no chronic illnesses, no functional limitation, normal global function, no depression,
a good quality of life and good self-perceived health. Information on dietary intake was
obtained using a diet history questionnaire. Cognitive functions were assessed using
the Mini Mental State Examination (MMSE), depressive symptoms using Geriatric
Depression Score-15 items (GDS-15) and a question regarding their perceived health
and quality of life. Activities of Daily Living (ADL) and Instrumental Activities of Daily
Living (IADL) questionnaires were used to determine functional status. DPs were
obtained using the principal component analysis (PCA) approach. An ordinal logistic
regression model was used to examine associations between DP scores and SA.
Results: Five DPs were identified namely ‘sweet foods-beverages’, ‘meat-vegetablesrice and noodles’, ‘local snacks-fish and seafood-high salt foods’, ‘fruits-legumes’, and
‘tropical fruits-oats’. A higher score for ‘tropical fruits-oats’ DP was associated with
SA [Adjusted OR=1.59 (95% CI: 1.08-2.32)]. However, the association diminished
when the model was adjusted for education level. Further analysis indicated that
this DP increased the chance of SA among those with secondary education and above
[Adjusted OR=2.43 (95% CI: 1.09–5.42)]. Conclusion: ‘Tropical fruits-oats’ DP is
associated with SA among elderly with secondary education and above. There is a
need to investigate DPs among those with lower education.
A case control study to determine the association of dietary fibre and cancer among Malaysians. It was conducted among 100 newly-diagnosed cancer patients admitted to the Radiotherapy and Oncology Ward, Hospital Kuala Lumpur. A total of 100 controls matched with the cases for age, sex and ethnic origin were selected from the Outpatient Health Clinic in Sentul. The subjects were interviewed to obtain information on their habitual dietary intakes and lifestyles. Family history of cancer, smoking habits, and alcohol consumption were found to be significant risk factors for cancer (p<0.05 for all parameters). The mean intake of total energy was higher among men with nasopharyngeal cancer and women with gastrointestinal cancer as compared to their controls (p<0.05 for both parameters). The percentage of energy contribution from fat was higher among cases (35%) than controls (32.1%). The mean dietary fibre intake among cases (10.86 ± 8.90 g/d) was apparently lower than the controls (13.22 ± 5.99 g/d), with significant differences noted for breast cancer and also nasopharyngeal cancer. Women with low fibre intake (<10g/d) had a 2.2 times higher risk of getting breast cancer. There is a need to educate the public to adhere to a wholesome diet, in particular to increase the consumption of high-fibre food for disease prevention.
Study site: Radiotherapy and Oncology Ward, Hospital Kuala Lumpur and Outpatient Health Clinic in Sentu
Aging is associated with increased risk of frailty and malnutrition. However, food insecurity has rarely been highlighted
in the elderly population, especially among the low income group. Thus, a cross-sectional study was conducted to
determine the association between nutritional status, food insecurity and frailty among elderly in low income residences
in Klang Valley. A total of 72 elderly individuals aged 60 years and above was selected (mean age 66 ± 6 years) through
convenient sampling. Participants were interviewed to obtain information on socio-demographic, health status, food
insecurity and cognitive status. Anthropometrics parameters and frailty assessments was measured using standard
criteria. Results showed that 75.0% of the participants had abdominal obesity. Nearly half of the participants were
overweight (41.7%), followed by normal (43.0%) and underweight (15.3%). With respect to food insecurity, most of them
reported that they had enough food (93.1%). There were significant correlation (p < 0.05) between food insecurity with
height (r = -0.263, p = 0.026). Most of the participants were pre-frail (58.3%), frail (27.8%) and followed by non-frail
(13.9%). Calcium intake is inversely associated with frailty (t = -2.62, p = 0.011). In conclusion, food insecurity was not
a problem, however, half of the subjects were overweight and pre-frail. Three out four subjects had abdominal obesity.
There is a need to investigate further the pathogenesis of fat frail in this low income elderly population and formulate
effective intervention strategies.
Mild cognitive impairment (MCI) is associated with significant morbidity, especially in the development of Alzheimer’s disease and also related to nutritional factors. A pilot study was carried out to determine antioxidant intake and its relation with MCI among elderly people aged between 60 and 74 years in Klang Valley. Subjects were interviewed to obtain socio-demography data and functional status was evaluated using the Instrumental Activities of Daily Living (IADL). Data on food intake was assessed using the diet history questionnaire and food frequency questionnaire, whilst the Geriatric Depression Scale (GDS) was used to assess depression level. A combination of tests was used to assess cognitive decline, which are Mini-mental State Examination (MMSE), Clock Drawing Test (CDT), and Dementia Rating Scale (DRS). Out of 84 elderly recruited, 70 completed all parts of the study (response rate 83.3%). Mean vitamin E intake was less than the Malaysian RNI (50.0% of RNI for men and 43.0% for women). The incidence of amnestic-MCI (aMCI) was 15.7% among the respondents, while 32.8% were depressed. After adjustment for educational background, beta-carotene intake was found to be significantly (β = 0.325, p<0.05) correlated to cognitive impairment based on CDT scores. The intake levels of antioxidants among subjects were unsatisfactory and beta-carotene intake was related to poor cognitive status based on CDT.
In thalassaemic patients, the impact of the disease especially on quality of life (QOL) of the caregivers in Malaysia has not been established. This study was conducted to assess the health-related quality of life (HRQOL) of thalassaemia patients and their caregivers in order to explore factors affecting their QOL. A cross-sectional study was conducted on 75 thalassaemic children and adolescents aged between 7 and 18 years old and their caregivers. The PedsQLTM 4.0
generic core scales questionnaire was administered to both thalassaemic children and their caregivers while the health questionnaire EQ 5D was given to caregivers only. The subjects were recruited from Hospital Kuala Lumpur (HKL) and Universiti Kebangsaan Malaysia Medical Centre (UKMMC). The results revealed that the mean of psychosocial HRQOL score in patients (63.91±14.65) was significantly lower than parent proxy reports (67.14±10.48) (p=0.008). The
school functioning score (50.59±15.31) was the lowest of the psychosocial measure, followed by emotional functioning (59.92±16.83) and social functioning (78.01±13.92) score. The patients’ pre-transfusion haemoglobin concentration was significantly associated with their QOL (p=0.02). Having more children, higher numbers of thalassaemic children and lower educational level of caregivers were associated with poorer QOL. In conclusion, caregivers underestimated
the QOL of their thalassaemic children. The school functioning domain was affected the most domain. There is a need to improve the QOL of thalassaemic children and their caregivers.
Falls are a public health concern among older adults. There is a need to take significant measures such as screening for the risk of a fall as a means of prevention and management. A cross-sectional study was conducted to determine discriminative and predictive ability of physical performance measures in identifying the risk of fall among Malaysian community dwelling older adults. Three hundred twenty-five Malaysian community dwelling older adults aged 60 years and above (67.67+ 5.5 years) participated in this study. This study was a part of a larger longitudinal study ‘LRGS TUA’. Physiological Profile Assessment (PPA), a comprehensive tool for quantifying risk of fall was used as a standard measure of comparison to 6 Meter Gait Speed (GS), Timed Up and Go (TUG) and Walking While Talking (WWT) tests to establish discriminative and predictive ability. Participants recorded incidence of falls in a ‘falls diary’ over a span of six months. To determine the optimum cut off scores of the test identified to classify fall risk, receiver operator curves (ROC) were used and its sensitivity and specificity were calculated. A significant mean difference between fallers and non-fallers was demonstrated only with TUG test (p<0.05). TUG test cut off score in discriminating older adults at risk of fall was established at eight seconds, with a sensitivity and specificity of 83.95% and 32.4%, respectively, in this study. Eighty-four percent older adults who experienced a fall in our study were identified to be at risk of fall when screened using this TUG cut off score. Our study results suggested TUG test to be an optimal screening tool for risk of fall among community dwelling older adults.
Lo, Adeline Li Ching, Muhammad Rabbani Abdul Malek, Nurshahirah Zulkifli, Siti Nur Fatihah Shaifol Akmar, Suzana Shahar, Chong, Elizabeth Gar Mit, et al.
Compliance rate towards consumption of oral nutritional supplement (ONS) is low among geriatric patients. Thus, this study aimed to examine factors affecting low compliance of ONS intake among a sample of geriatric patients. A cross-sectional survey was carried out involving 30 geriatric patients being prescribed with ONS during their stay in Hospital Kuala Lumpur. Information on compliance rate and influencing factors were collected through interview and observation. Nutritional status was assessed using anthropometry and Patient Generated Subjective Global Assessment (PG-SGA). 50.0% subjects were underweight and 70.0% and 30.0% were moderate and severely malnourished, respectively. A total of 43.3% were categorised as low, 53.4% medium and 3.3% high compliance towards consumption of ONS. Most of the subjects with low compliance agreed expressed that they need more nursing support (53.8%). Less than half perceived they had been given the needed nursing support (44.4%), and with respect to ONS: knowledgeable (38.5%), timely given (37.5%), understood the importance (35.7%), were able to finish it (35.0%), well-aware of the reasons of prescription (33.3%), satisfied with its taste (33.3%), received suitable volume (33.3%), satisfied with the texture (31.6%), and received suitable frequency (28.6%). In conclusion, approximately 40% of subjects had low compliance towards ONS. Awareness and nursing support were important factors associated with low compliance. There is a need to ensure adequate nursing support and education been given to patients prescribed with ONS in order to increase the compliance rate.
A cross-sectional study was carried out to evaluate the nutritional status of 51 subjects with leukemia aged 4 to 12 years from the Haematology and Oncology Paediatric Ward, Universiti Kebangsaan Malaysia Medical Centre (PPUKM) and the Paediatric Institute of Kuala Lumpur. Nutritional status was assessed using anthropometric measurements, biochemical and haematological parameters. Subjects comprised 32 (62.7%) males and 19 (27.3%) females. Most of the subjects (41.2%) were in the age group of 4 to 6 years. More than half of the children were Malays (70.6%) followed by Indians (15.7%) and Chinese (13.7%). The subjects were diagnosed as acute lymphoblastic leukemia (ALL) (84.3%) followed by acute myelogenous leukemia (AML) (13.7%) and chronic myelogenous leukemia (CML) (2.0%) respectively. Most of the children were in remission status (54.9%). Underweight (