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  1. Yang WY, Williams LT, Collins C, Siew Swee CW
    JBI Libr Syst Rev, 2012 1 1;10(58):4568-4599.
    PMID: 27820524
    BACKGROUND: The exponential increase in prevalence of childhood obesity has become a global concern. Developing countries in Asia are at particular risk due to their stage in the epidemiological and nutrition transition.

    OBJECTIVES: The review objectives were to summarize the evidence on prevalence of childhood overweight and obesity within developing countries in Asia and to synthesise the best epidemiological association between the dietary patterns of children in the developing countries in Asia and their weight status in terms of obesity.

    INCLUSION CRITERIA: This review considered any studies that included children under 18 years of age who live in developing countries in Asia.This review of epidemiological association considered any analytical observational studies (case-control studies, cohort studies and analytical cross-sectional studies).The focus was to summarise the prevalence of childhood overweight and obesity within developing countries in Asia and synthesise the best available evidence on the relationship between dietary patterns as the exposure variable and childhood overweight and obesity as the outcome.

    SEARCH STRATEGY: A three-step search strategy was utilised, with an initial limited search of MEDLINE, CINAHL and EMBASE to identify search terms. A second search using all identified keywords and index terms was undertaken across all included databases. Thirdly, the reference list of all identified reports and articles were searched for additional studies. Additional electronic databases searched included: ProQuest, Web of Science, and Scopus. Each database was searched from inception to September 2011, with an English language restriction.

    METHODOLOGICAL QUALITY: All papers selected for retrieval were assessed independently by two reviewers using standardised critical appraisal instruments from the Joanna Briggs Institute.

    DATA COLLECTION: Data was extracted from included studies by two reviewers independently using an adapted version of the standardised data extraction form from the Joanna Briggs Institute.

    DATA SYNTHESIS: Meta-analysis was not possible because of the heterogeneity of studies in terms of methodology, statistical analyses and outcomes. A narrative summary of results is provided.

    RESULTS: Fifteen studies were included in the review. The prevalence rates of childhood overweight and obesity in Asian developing countries ranged from 5.1% to 19.9% with no specific trend in age or gender. Several significant but inconsistent statistical associations between dietary patterns and overweight/obesity in children and adolescents were found [high energy diet (OR: 1.80 95%CI 1.10 to 2.90, p<0.05 vs 0.80 95%CI 0.60 to 1.10, p>0.05), low intake of fruit and vegetables (OR: 2.34 95%CI 1.04 to 5.24, p<0.001; 2.00 95%CI 1.10 to 3.40, p<0.05 vs 1.33 95%CI 0.44 to 4.05, p>0.05; 0.70 95%CI 0.50 to 1.00, p>0.05), high meat consumption (RR: 2.40 95%CI 1.00 to 5.60, p<0.05 vs 1.70 95%CI 1.00 to 2.70, p>0.05), eating out (OR: 12.0 95%CI 7.7 to 18.7, p<0.001; 1.70 95%CI 1.04 to 2.90, p<0.05 vs 1.20 95%CI 0.60 to 2.40, p>0.05), fast food intake (OR: 1.50 95%CI 1.12 to 2.02, p<0.05), presence of snacking (OR: 2.34 95%CI 1.01 to 5.54, p=0.05; 1.26 95%CI 1.13 to 1.40, p<0.05 vs 0.80 95%CI 0.48 to 1.32,p=0.377; 0.60 95%CI 0.30 to 0.99, p<0.05; 0.60 95%CI 0.40 to 0.90, p<0.05) and drinking sugar sweetened beverages (OR: 1.60 95%CI 1.02 to 2.50, p<0.05; 1.70 95%CI 1.10 to 2.70, p<0.05 vs 0.93 95%CI 0.82 to 1.05, p>0.05)]. The key limitation was the heterogeneity of studies in terms of measures of dietary patterns and obesity standards.

    CONCLUSIONS: The prevalence rates of childhood overweight and obesity in Asian developing countries ranged from 5.1% to 19.9% with no specific trend in age or gender. From the practice perspective, several significant yet inconsistent statistical associations between dietary patterns and childhood overweight/obesity in children and adolescents were found.This review highlights the need for clinicians to monitor the effects of dietary change on the weight and health status of children in Asian countries.There is a need for valid measures of dietary intake and use of standardised international cut-offs for overweight and obesity, and for future researchers to conduct prospective studies to determine the causal relationship between Asian children's dietary pattern and their weight status.

  2. Akit H, Collins C, Fahri F, Hung A, D'Souza D, Leury B, et al.
    Animals (Basel), 2016;6(6).
    PMID: 27338483 DOI: 10.3390/ani6060038
    The purpose of this study was to investigate the effect of dietary lecithin on skeletal muscle gene expression of collagen precursors and enzymes involved in collagen synthesis and degradation. Finisher gilts with an average start weight of 55.9 ± 2.22 kg were fed diets containing either 0, 4, 20 or 80 g/kg soybean lecithin prior to harvest for six weeks and the rectus abdominis muscle gene expression profile was analyzed by quantitative real-time PCR. Lecithin treatment down-regulated Type I (α1) procollagen (COL1A1) and Type III (α1) procollagen (COL3A1) mRNA expression ( p < 0.05, respectively), indicating a decrease in the precursors for collagen synthesis. The α-subunit of prolyl 4-hydroxylase (P4H) mRNA expression also tended to be down-regulated ( p = 0.056), indicating a decrease in collagen synthesis. Decreased matrix metalloproteinase-1 (MMP-1) mRNA expression may reflect a positive regulatory response to the reduced collagen synthesis in muscle from the pigs fed lecithin ( p = 0.035). Lecithin had no effect on tissue inhibitor metalloproteinase-1 (TIMP-1), matrix metalloproteinase-13 (MMP-13) and lysyl oxidase mRNA expression. In conclusion, lecithin down-regulated COL1A1 and COL3A1 as well as tended to down-regulate α-subunit P4H expression. However, determination of muscle collagen content and solubility are required to support the gene functions.
  3. Yang WY, Burrows T, MacDonald-Wicks L, Williams LT, Collins CE, Chee WS
    J Hum Nutr Diet, 2016 08;29(4):441-8.
    PMID: 26879748 DOI: 10.1111/jhn.12356
    BACKGROUND: Childhood obesity is becoming more common as Malaysia experiences rapid nutrition transition. Current evidence related to parental influences on child dietary intake and body weight status is limited. The present study aimed to report, among Malay families, the prevalence of energy mis-reporting and dietary relationships within family dyads.

    METHODS: The cross-sectional Family Diet Study (n = 236) was conducted at five primary schools in central of Peninsular Malaysia. Each family consisted of a Malay child, aged 8-12 years, and their main caregiver(s). Information on socio-demographics, dietary intake and anthropometry were collected. Correlations and regression analyses were used to assess dietary relationships within family dyads.

    RESULTS: Approximately 29.6% of the children and 75.0% parents were categorised as being overweight or obese. Intakes of nutrients and food groups were below the national recommended targets for majority of children and adults. A large proportion of energy intake mis-reporters were identified: mothers (55.5%), fathers (40.2%) and children (40.2%). Children's body mass index (BMI) was positively associated with parental BMI (fathers, r = 0.37; mothers, r = 0.34; P < 0.01). For dietary intakes, moderate-to-strong (0.35-0.72) and weak-to-moderate (0.16-0.35) correlations were found between mother-father and child-parent dyads, respectively. Multiple regression revealed that maternal percentage energy from fat (β = 0.09, P < 0.01) explained 81% of the variation in children's fat intake.

    CONCLUSIONS: Clear parental dietary relationships, especially child-mother dyads, were found. Despite a significant proportion of families with members who were overweight or obese, the majority reported dietary intakes below recommended levels, distorted by energy mis-reporting. The findings of the present study can inform interventions targeting parent-child relationships to improve family dietary patterns in Malaysia.

  4. Akit H, Collins CL, Fahri FT, Hung AT, D'Souza DN, Leury BJ, et al.
    Meat Sci, 2014 Mar;96(3):1147-51.
    PMID: 24334033 DOI: 10.1016/j.meatsci.2013.10.028
    The influence of dietary lecithin at doses of 0, 4, 20 or 80 g/kg fed to finisher gilts for six weeks prior to slaughter on growth performance, carcass quality and pork quality was investigated. M. longissimus lumborum (loin) was removed from 36 pig carcasses at 24h post-mortem for Warner-Bratzler shear force, compression, collagen content and colour analyses. Dietary lecithin increased dressing percentage (P=0.009). Pork chewiness and collagen content were decreased by dietary lecithin (P<0.05, respectively), suggesting that improved chewiness may be due to decreased collagen content. However, dietary lecithin had no effect on shear force, cohesiveness or hardness (P>0.05, respectively). Dietary lecithin reduced loin muscle L* values and increased a* values (P<0.05, respectively) but no changes on b* values (P=0.56). The data showed that dietary lecithin improved dressing percentage and resulted in less chewy and less pale pork.
  5. Prazeres F, Jamoulle M, Kareli A, Collins C, Móczár C, Wong MCS, et al.
    Fam Pract, 2024 Nov 19.
    PMID: 39561247 DOI: 10.1093/fampra/cmae061
    INTRODUCTION: The evolving landscape of general practice (GP)/family medicine (FM) in the post-COVID-19 era, focussing on integrating telemedicine and remote consultations requires a new definition for this specialty. Hence, a broader consensus-based definition of post-COVID-19 GP/FM is warranted.

    METHODS: This study involved a modified electronic Delphi technique involving 27 specialists working in primary care recruited via convenient and snowball sampling. The Delphi survey was conducted online between August 2022 and April 2023, utilizing the Google Forms platform. Descriptive statistics were employed to analyse consensus across Delphi rounds.

    RESULTS: Twenty-six international experts participated in the survey. The retention rate through the second and third Delphi rounds was 96.2% (n = 25). The broader consensus definition emphasizes person-centred care, collaborative patient-physician partnerships, and a holistic approach to health, including managing acute and chronic conditions through in-person or remote access based on patient preferences, medical needs, and local health system organization.

    CONCLUSION: The study highlights the importance of continuity of care, prevention, and coordination with other healthcare professionals as core values of primary care. It also reflects the role of GP/FM in addressing new challenges post-pandemic, such as healthcare delivery beyond standard face-to-face care (e.g. remote consultations) and an increasingly important role in the prevention of infectious diseases. This underscores the need for ongoing research and patient involvement to continually refine and improve primary healthcare delivery in response to changing healthcare landscapes.

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