Displaying publications 1 - 20 of 49 in total

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  1. Suzana Shahar, Yow, Bee Charn
    MyJurnal
    Poor appetite and inadequate food intake together with depression are associated with malnutrition, that will increase risk of morbidity and mortality among elderly people. Identifying factors associated with these conditions are essential for formulation of preventive strategies. Therefore, a study was conducted to identify factors associated with poor appetite and depression among institutionalised Chinese elderly people in Butterworth, Penang. A total of 100 Chinese elderly (49 men and 51 women) aged 60 years and above, (mean age ± SD of 74.7 ± 9.2 years), with no known terminal and mental illnesses from two nursing homes participated in this study. Subjects were interviewed to gather information on appetite using Council of Nutrition Appetite Questionnaire (CNAQ), depression using Geriatric Depression Scale (GDS) and also socio demographic and health status. Food intake was assessed using a combination of one-day food weighing and 24 hour diet recall. Body weight and height were measured. Results showed that the mean energy and nutrients intake did not achieve the Recommended Nutrient Intake of Malaysia (RNI), with the exception for vitamin C. Only 4% of the subjects were underweight and obese, 65% normal and 31% overweight. A total of 70% and 73% of subjects had poor appetite and depression, respectively. Subjects who had depression (adjusted OR = 2.78, 95% CI = 0.95-8.03), energy intake below RNI (adjusted OR = 2.34, 95% CI = 0.68-6.95) and difficulty to fall asleep at night (insomnia) (adjusted OR = 2.22, 95% CI = 0.72-6.82) were more likely to have poor appetite. Subjects who had poor appetite (adjusted OR = 3.36, 95% CI = 1.19-9.47) and insomnia (adjusted OR = 2.58, 95% CI = 0.83-7.98) were more likely to have depression. In conclusion, although the majority of subjects had normal body weight but the nutrient intake was inadequate. Poor appetite and depression were prevalent and interrelated and also strongly associated with insomnia.
    Device, Scales & Questionnaire: Council of Nutrition Appetite Questionnaire (CNAQ-8); Geriatric Depression Scale (GDS-15)
  2. Suzana Shahar, Nik Nur Izzati
    Jurnal Sains Kesihatan Malaysia, 2018;16(101):237-237.
    MyJurnal
    The term metabolic syndrome (MetS) describes a clustering of risk factors for cardiovascular disease and type 2 diabetes mellitus which include high blood pressure, low fasting high-density lipoprotein cholesterol (HDL-c), high fasting triglyceride (TG), high fasting blood glucose (BG), and abdominal obesity. The aim of this cross sectional study was to determine the dietary patterns (DPs) associated with MetS among 451 older adults in Malaysia. Food intake was determined using validated Diet History. DP was identified based on 40 food groups by using principal component analysis (PCA), and the factors were rotated by varimax rotation. Fasting venous blood samples were taken to determine HDL-c, TaG and BG level. Blood pressure and anthropometric measurements were also performed. Three major dietary patterns have been identified; 1) bread, spreads and oats, 2) Malaysia traditional pancakes and 3) vegetables and healthy cooked dishes. Three models were built to compare the potential confounder such as age, education years, marital status, calorie intakes, ciggarate smoking and body mass indeks (BMI). Only vegetables and healthy cooked dishes DP was associated with MetS. This DP reflects high consumption of various types of vegetables, noodle in soup, healthy cooked fish or seafood and low consumption of all type of high calorie rice, noodles and fried desserts. For all models, subject in the highest tertile of vegetables and healthy cooked dishes DP had a lower odd ratio (OR) for MetS as compared to lowest tertile. As more potential confounders added in new models, the significant values are increased. After adjustment of body mass index, the association for vegetables and healthy cooked dishes DP was attenuated (OR: 0.67, CI: 0.39-1.16, p: 0.156). In conclusion, high consumption of vegetable and healthy cooked dishes may lower the occurance of MetS among Malaysian elderly.
  3. Suzana Shahar, Chiah, Hui Lin, Hasnah Haron
    MyJurnal
    Polyphenol is a non-nutrient phytochemical compound existed abundantly in plant-based diet which has the properties to prevent age related oxidative damage induced diseases. However, there are difficulties in quantifying its intake and local food frequency questionnaire (FFQ) for the assessment is not available. Therefore, this study aimed to develop and validate FFQ for estimation of dietary polyphenol intake among 93 individuals aged 60 years and above recruited from several senior citizen clubs in Klang Valley. Phase I of the study involved the development of FFQ consisted of 117 items under 9 categories and formation of the database extracted from PHENOL-EXPLORER. In Phase II, the intake of polyphenol estimated using FFQ was compared with reference method consisted of 2-day diet records and diet history questionnaire (DHQ). The mean dietary polyphenol intake estimated from FFQ and the reference method was 2770.7 ± 1552.4 mg/d and 2171.4 ± 898.8 mg/d, respectively. Spearman’s rho and Kendall’s tau-b analysis indicated that there was a significant positive correlation between polyphenol intake estimated from FFQ and reference method (r = 0.41, p < 0.001; r = 0.28, p < 0.001). For Bland-Altman plot, 95.7% of scattered plot fell within ± 1.96 SD limits of agreement revealed that there was good agreement between the two methods used. Cross-classifi cation analysis showed that 36.6% was categorized in the same quartile, 78.5% in identical and contiguous quartiles, with only 3.2% in the opposite quartiles. Regression analysis showed that all categories in FFQ signifi cantly account for the inter-variance for dietary polyphenol intake after controlling for the other variables (R2 = 1.000, p < 0.001). In conclusion, the newly developed FFQ is considered valid and has the potential to be used as a tool to estimate polyphenol intake among elderly individuals in Malaysia.
  4. Hasnah Haron, Chong GL, Suzana Shahar
    Sains Malaysiana, 2014;43:535-542.
    The study was aimed to analyze the physicochemical properties and antioxidant activities in five batches of seeds and oils of Nigella sativa, obtained from Malaysia, Iran and Yemen. Proximate analysis showed that the seeds contained 20.63-28.71% crude fat, 11.35-14.04% crude protein, 5 .37-7 .93% total moisture, 4.15-4.51% total ash contents and 48.69-57.18% total carbohydrate contents. Physicochemical analysis showed a refractive index of 1.4697-1.4730, specific gravity of 1.369-1376 g/cm3, peroxide value of 3.33-21.33 meq 02/kg, 184-220 mg/g in saponification number and unsaponifiable matter of 1.1-1.8% in the oil samples. The seeds showed high mineral content such as Ca (2242 mg/kg), K (6393 mg/kg) and Mg (2234 mg/kg). The oil sample from Kelantan, Malaysia contained the lowest saturated fatty acid (sFA) (1.42±029%) while Sudan, Yemen contained the highest content of polyunsaturated fatty acid (PUFA) (65 .13 ±5 .45%). Monounsaturated fatty acid (MUFA) were found the highest (20 .45 ±2 .61%) in the seed samples originated from Iran. Seeds from Iran showed the highest antioxidant activity (IC50 = 1.49 mg/mL) and total phenolic content (30.84 mg GAE/g) while oil sample from Sudan, Yemen has the highest antioxidant activity (IC50 = 4.48 mg/mL). Seeds from Iran have the highest quality among the seed samples while oil samples from Kelantan, Malaysia was the best among the oil samples in terms of low SFA, high PUFA, MUFA and antioxidant activities.
  5. Rasyidah Mohamad Basiran, Hanis Mastura Yahya, Suzana Shahar
    Malays J Nutr, 2018;24(3):441-453.
    MyJurnal
    Introduction: Nutrient profiling is the science of ranking food based on the nutrient
    content that enables an individual to make healthier food choice without exceeding
    the daily energy recommendation. This study was aimed at developing and validating
    a nutrient profiling model for Malaysian older population. Methods: A total of six
    nutrient profiling models comprising different combinations of nutrients were
    developed. Each model was tested by scoring 94 food items in terms of 100 kcal and
    100 g, and the Recommended Nutrient Intakes for Malaysian (2017) as the reference
    value. The scores in each model were correlated with energy density per 100 g of
    food. The best model to correctly rank food according to nutrient density was chosen
    for validation. Validation was done by comparing the healthiness classification of
    174 food items as determined by Towards Useful Aging Food Nutrient Density Index
    (TUA FNDI) nutrient profiling model and the Malaysian Dietary Guidelines. Results:
    Models with sodium and total fat were better correlated with energy density. All
    six models were inversely correlated with energy density. TUA FNDI 9-2 model was
    chosen as the best model for validation. Overall, there was substantial agreement
    between TUA FNDI 9-2 model and the food-based dietary guidelines (κ=0.644,
    p=0.001). Conclusion: The inverse correlation between nutrient profiling models
    to energy density shows that foods with higher nutrient density contain lower
    energy. The validated TUA FNDI 9-2 model is recommended for older adults to make
    healthier food choices.
  6. Suzana Shahar, Kim, Tiu Teng, Nor Fadilah Rajab, Fatimah Arshad
    MyJurnal
    A preliminary study was conducted to determine the level of oxidative DNA damage, fruits and vegetables intake among 50 breast cancer patients (cases) as compared to 50 healthy women (controls) with no known medical history of breast cancer in Klang Valley. Both groups were matched for age and ethnicity. Data on socio-demographic, health status and medical history, fruits and vegetables intake, and supplements intake were obtained through an interviewbased questionnaire. Anthropometry measurements included weight, height, and waist and hip circumference were also carried out on subjects. A total of 3mL fasting venous blood was drawn to assess lymphocytes oxidative DNA damage using Alkaline Comet Assay. Results indicated that the mean intake of fruits and vegetables was lower in cases (4.09 ± 1.17 servings/d) than controls (4.77 ± 0.90 servings/d)(p < 0.05) The intake of fruits and vegetables from family groups of solanaceae, myrtaceae, caricaceae, apiaceae, brinjal, rutaceae, broccoli, orange, carrot, watermelon were 0.5 - 1 servings/week significantly higher among controls as compared to cases (p < 0.05 for all parameters). However, the intake of fruits from rosaceae family and apple was higher among controls than cases (p < 0.05). The estimated intake of ß-carotene, carotenoids, vitamin A, vitamin C (p < 0.001), a-carotene and lycopene (p < 0.05) from fruits and vegetables were higher among controls than cases. Mean DNA damage level of cases (4.55 ± 1.78 % DNA in tail, %TD; 0.35 ± 0.21 tail moment, TM) were 3.5 and 3.9 times higher than the value of controls (1.3 ± 0.70% TD; 0.09 ± 0.09 TM) (p < 0.001) and the damage increased with higher values of waist hip ratio (% TD, r = 0.396, p < 0.05; TM, r = 0.349, p < 0.05) and waist circumference (% TD, r = 0.334, p < 0.05; TM, r = 0.360, p < 0.05). There was an inverse relationship between oxidative DNA damage with intake of total fruits and vegetables, cauliflowers and water convolvulus and also consumption from rutaceae and solanaceae families. Similar trend was noted for estimated intake of vitamin A, carotenoids, vitamin C, ß-carotene and lycopene. In conclusion, the intake of fruits and vegetables of five servings/d and the consumption of specific families and types of fruits and vegetables might protect against oxidative DNA damage and further reduce breast cancer risk.
  7. Hanisah Rosli, Suzana Shahar, Normah Che Din, Hasnah Haron
    MyJurnal
    Literature review suggests that polyphenols in particular flavonoids, are beneficial for mental health during aging process. This review examines the effect of consumption of all polyphenols groups on mental health and cognitive status during aging process. The keywords searched were “mental health,” “depression,” “anxiety,” “stress” and “cognitive” combined with “dietary,” and “polyphenols.” The databases including PubMed, Web of Science and CAB Abstracts were searched for a period of 10 years. A total of 11 studies were identifi ed to fulfi ll the inclusion criteria. From this review, polyphenols may confer beneficial effects towards mental health, in particular the decline in cognitive functions during aging process, however, some studies showed contradictory results. Polyphenols have been proven to improve language and verbal ability, which is among the main vulnerable aspects in cognitive decline in pathological brain aging. In contrast, polyphenols intake did not seem to affect executive functioning. The effects of polyphenols towards cognitive status were more prominent among the elderly as compared to young and middle-aged adults. This review also shows that flavonoids is the main type of polyphenols that confer positive effects towards cognitive status during aging. This review provides evidence that consumption of polyphenols may lead to cognitive and mental health benefits. Further clinical trials involving human subjects are required with carefully designed methodology to elucidate the potential mechanisms underlying the relationship between polyphenols consumption and improvement in cognitive and mental health status.
  8. Sa’ida Munira Johari, Suzana Shahar, Roslee Rajikan, Safiyyah A. Aziz
    MyJurnal
    Mild cognitive impairment (MCI) is a common disorder among elderly and may worsen to dementia. The aim of this study is to develop a nutrition and lifestyle booklet to implement better lifestyle modification, as an effort to delay cognitive decline. A series of discussions with a research group comprising of dieticians, nutritionists, a geriatrician and a public health physician were conducted to ascertain the content of the booklet. There were seven guidelines in the booklet including; eat more fish, eat more foods rich in folic acid, eat more fruits and vegetables, exercise regularly, do activities to stimulate memory, stop smoking and alcohol drinking and stay cheerful and positive. Evaluation of acceptance for the booklet was carried out which comprised of assessment on content, graphic and design among elderly and health staff at health clinic in Cheras. The assessment involved 15 Malay elderly subjects aged 60 to 81 years (mean age 66.1 ±6.6 years), with 60.0% men and 40.0% women and 10 health staff aged 36.6 ± 12.0 years, with range of 27 to 58 years, consists of 20.0% men and 80.0% women also participated. Most of elderly subjects (80.0%, n = 12) indicated they understood information in the booklet. Meanwhile, 20.0% (n = 3) of elderly expressed they did not fully understand the content of the booklet in particular on sentence and terminology. All health staff (100.0%) understood the information in the booklet. This booklet was well accepted by elderly subjects and health staff, however adding more graphics, simplifying sentence structures and minimizing scientific terminologies to improve understanding were suggested. The booklet has the potential to increase the nutritional and health knowledge of elderly specifically with MCI. This would motivate them to adopt healthy eating and lifestyle, thus reducing cognitive decline and prevent dementia.
    Keywords: Cognitive, education, booklet, elderly, lifestyle
  9. Nurul Nurliana Baharudin, Suzana Shahar, Zulkifli Md. Zainuddin
    Jurnal Sains Kesihatan Malaysia, 2017;15(1):113-130.
    MyJurnal
    Nutrition has been widely recognized to have certain levels of influence on the risk of kidney stone formation. Thus,
    this case-control study was conducted to determine the association of dietary intake and lifestyles factors with kidney
    stone disease. Sociodemographic data, dietary intake, supplements intake, smoking and alcohol habit, medical history,
    physical activity and anthropometric data were obtained using interviewer-administered pre-tested questionnaires
    among 81 patients who had been diagnosed with kidney stone disease and 81 patients without kidney stone disease at
    Universiti Kebangsaan Malaysia Medical Centre. The results indicated that body mass index and hip circumference
    were higher among cases as compared to controls in both men and women (p < 0.05). Energy, macronutrients and
    micronutrients intake were higher for case subjects compared to control subjects for all significant parameters (p < 0.05).
    Results showed positive association of kidney stone with consumption of nuts (≥1 time/week) for men and women while
    consumption of eggs (1-3 times/month) and beans (1-6 times/week) showed positive association for women. Analysis
    of multivariate found the risk factor among women was diabetes mellitus [Adjusted OR = 27.6 (95% CI = 1.43-53.3)]
    (p < 0.05). Whilst, plain water intake of at least 6 glasses [Adjusted OR = 0.001 (95% CI = 0.000-0.08)] (p < 0.05) and
    8 glasses per day [Adjusted OR = 0.001 (95% CI = 0.000-0.02)] (p < 0.05) reduced the risk among women. The risk
    factors for men were smoking habits [Adjusted OR = 16.2 (95% CI = 1.29-203)] (p < 0.05), consumption of carbonated
    drink 1-3 times per month [Adjusted OR = 6.25 (95% CI = 1.04-40.7)] (p < 0.05) and 1-6 times per week [Adjusted OR =
    12.5 (95% CI = 1.41-111)] (p < 0.05). Unhealthy dietary and lifestyles factors increased the risk of kidney stone disease
    and various risk factors were found for different sexes.
  10. Rohida Saleh Hudin, Suzana Shahar, Norhayati Ibrahim, Hanis Mastura Yahaya
    MyJurnal
    Food insecurity is associated with an inadequate nutrient intake among older adults. Therefore, this study aimed
    to determine the food intake among older adults with food insecurity in an agricultural settlement, i.e. Felda Land
    Development Authority (FELDA) settlers at Lubuk Merbau, Kedah. A total of 70 older adults were selected as a subsample
    to record data on food supply for a week, from an original study (n = 289: mean age= 69.2 ± 7.4 years). This study was
    conducted through a house to house visit of which respondent was interview to get information on sociodemographic
    and food insecurity. Food intake was recorded for a week using food supply questionnaire. Food insecurity was assessed
    using Food Security Tool For the Elderly. Results indicated that 19.7% respondents had food insecurity. Energy intake
    was found to be higher among women with food insecurity (2329.0 ± 814 kcal/day) compared to respondents with food
    secured (1836 ± 447 kcal/day) (p < 0.05). However, after removing over reporters, the energy intake among both groups
    did not differ significantly (1890 ± 208 kcal/day and 1643 ± 233 kcal/day). Total intake from food groups of fat, oil, sugar
    and salt was higher among respondents with food insecurity (106.6 ± 60.0 g/day) as compared to those who were food
    secured (80.3 ± 30.1 g/day)(p < 0.05). In conclusion, food insecurity affected approximately a fifth of the respondents and
    associated with unhealthy diet with high in fat, oil, sugar and salt. There is a need to formulate intervention programme
    to improve the quality of diet of older adults at high risk of food insecurity.
  11. Roszanadia Rusali, Suzana Shahar, Lee, Xiao Wen, Zahara Abdul Manaf
    MyJurnal
    Recognising the epidemic of overweight and obesity among Malaysians, formulation of intervention programmes such as
    a weight management programme at workplace is essential. This study aimed to determine the effectiveness of a structured
    weight management programme at workplace among overweight and obese employees. In this quasi-experimental
    study, sixty-four of overweight and obese adults were recruited and divided into two groups (intervention group,
    n = 32 and control group, n = 32). Subjects in the intervention group received three months scheduled programme and the
    control group received a routine weight management consultation from dietitians. Significant group effect was found on
    waist circumference (WC) in men (p < 0.05) and Body Mass Index (BMI) in women (p < 0.05). Men from the intervention
    group had reduced their WC by 3.4% (-3.7 cm) as compared to controls of 0.7% (-0.8 cm). Women in the intervention
    group improved their BMI by 1.4% (-0.4 kg/m2
    ) as compared to controls at 0.3% (-0.1 kg/m2
    ). Total cholesterol and LDL-C
    reduced among women in both intervention and control group with significant time effect (p < 0.05). As a conclusion a
    structured weight management programme effectively improved WC in men and BMI in women, and appeared to be as
    effective as individual diet counselling by dietitians in improving lipid profiles in women.
  12. Resshaya Roobini Murukesu, Devinder Kaur Ajit Singh, Suzana Shahar
    Jurnal Sains Kesihatan Malaysia, 2018;16(101):227-227.
    MyJurnal
    Urinary incontinence (UI) is a common disorder among older adults, with a global prevalence between 2% to 58%. UI has been associated with social isolation, increased morbidity and reduced quality of life (QoL). The aim of this study was to investigate the sociodemographic, clinical, cognitive and physical function risk factors of UI among Malaysian community dwelling older adults. This study is part of a larger scale population based longitudinal study on neuroprotective model for healthy longevity among older adults (LRGS TUA). A total of 1560 Malaysian community dwelling older adults aged 60 years and above were screened in this phase III LRGS study. Participants sociodemographic and clinical history were obtained. Mini Mental State Examination (MMSE), Rey Auditory Verbal Learning Test (RAVLT) and Digit Span tested cognitive function. Timed Up and Go Test (TUG), Hand Grip Strength Test, Chair Stand Test and Lawton Instrumental Activities of Daily Living tested physical function. The overall prevalence of UI was 15.7% (n = 245) in this study, with 11.8% (n = 88) in men and 19.3% (n = 157) in women. Logistic regression analysis showed that TUG (Adjusted odds ratio [OR], 1.071; 95% confidence interval [CI], 1.02-1.13), MMSE (OR, 0.93; CI, 0.90-0.97), weight (OR, 1.02; CI, 1.00-1.03), and constipation (OR 0.60; CI, 0.46-0.78) (p < 0.005) were significant risk factors of UI. The results indicate, decreased physical and cognitive function; increase in weight and having constipation increased the risk of UI. Maintaining optimum mobility, cognitive function, body weight and constipation prevention are vital in the prevention and management of UI among older adults.
  13. Suzana Shahar, Rajwinder Kaur Hardev Singh, Devinder Kaur Ajit Singh
    Jurnal Sains Kesihatan Malaysia, 2018;16(101):221-222.
    MyJurnal
    Physical performance in older adults is known to decline with ageing. However, there is limited information about physical performance difference among older adults with; successful (SA), usual ageing (UA) and mild cognitive impairment (MCI). The purpose of this study was to compare the differences in physical performance among older adults in these three categorised groups. This study is part of a larger scale population based longitudinal study on neuroprotective model for healthy longevity among older adults (LRGS TUA). Physical performance was assessed using hand grip (HGT; upper limb strength), 2 minutes step (2MST; endurance), sit to stand (STS; lower limb strength), sit and reach (SRT; lower body flexibility), timed up and go (TUG; mobility and balance), back scratch (BST; upper body flexibility) and gait speed (GS; walking speed) tests. Cognitive status was measured using Mini Mental Status Examination (MMSE) for global function, Digit Span for attention and working memory; Rey Auditory Verbal Learning Test (RAVLT) for verbal memory. Participants were categorised in three groups; SA, UA and MCI. SA group were those without diabetes, hypertension, chronic lung disease, cancer, heart diseases and stroke, had normal scores in MMSE (score of >22), optimum self-rated health and no functional limitations measured using Instrumental Activities of Daily Living questionnaire (IADL). Participants with MCI had subjective information of cognitive impairment from caretakers, minimum or low functional limitation, global function with ≤ 19 score on MMSE and 1 SD from below the normal mean of the group for Digit Span and RAVLT. Older adults with UA had minimal or no functional limitation and average scores of MMSE, Digit Span and RAVLT which were between the scores of SA and MCI group. Data was collected among 1291 participants in Phase three of LRGS TUA study. Data was analysed for differences among the three groups using one way ANOVA test. The results showed that majority of older adults was categorized as UA group (71.14%), followed by SA (15.19% ) and MCI (12.72%). Higher performance in physical performance measures except in SRT were demonstrated in SA group compared to MCI and UA groups. Post hoc Sheffe test showed that there was a significant difference (p < 0.05) in the SA and UA group for all tests except for HGT and SRT. MCI and UA groups were significantly different (p < 0.05) in STS, TUG and GST tests. The results suggested that UA and MCI groups had reduced physical performance in lower limb muscle strength, mobility, balance and walking speed compared SA group. Promoting optimum physical performance is important among older adults for successful ageing.
  14. Muhammad Iqbal Shaharudin, Devinder Kaur Ajit Singh, Suzana Shahar
    Jurnal Sains Kesihatan Malaysia, 2018;16(101):223-224.
    MyJurnal
    Falls is a global health concern due to its many negative consequences in older adults. Early falls screening and prevention is important among older adults. We developed Falls Screening Mobile Application (FallSA) as a self falls screening tool among older adults. FallSA was developed using data of physical performance test, demographic information and questions to inform falls risk from a larger population based longitudinal study on neuroprotective model for healthy longevity among older adults (LRGS TUA). The aim of this study was to determine validity and reliability of FallSA as a self-screening tool to inform falls risk among Malaysian older adults. This cross sectional study was conducted among 91 community dwelling older adults aged 60 years and above. FallSA was validated against Physiological Profile Assessments (PPA), a comprehensive falls risk assessment tool. Participants used FallSA to test their falls risk by repeating the test twice between an hour. Validity and test–retest reliability of FallSA was examined by using Spearman correlation, Kappa, Sensitivity and Specificity, Intra correlation coefficient (ICC), Cronbach alpha and Bland-Altman. Concurrent validity test was significant with moderate correlation rs = 0.518, p < 0.001, moderate agreement K = 0.516, p < 0.001 and acceptable Sensitivity: 80.4% and Specificity: 71.1%. Reliability of FallSA was shown to be good (ICC: 0.948, CI: 0.921-0.966), good internal consistency α = 0.948, p < 0.001 and good agreement was indicated by small mean differences and narrow limits of agreement (LoA). The results of this study suggest that FallSA was a valid and reliable tool to inform falls risk among Malaysian older adults. Further prospective studies are required to determine the accuracy of FallSA to correctly classify older adults into fallers and non-faller groups.
  15. Asheila Meramat, Razinah Sharif, Suzana Shahar, Nor Fadilah Rajab
    Jurnal Sains Kesihatan Malaysia, 2018;16(101):213-214.
    MyJurnal
    Nutritional diet plays an important roles in the health of an individual. One of the simplest and suitable approach followed by certain individual especially older adults are Sunnah fasting. Sunnah fasting is reported to have a positive impact in maintaining public health and aids to prolong the life span of older adults. This study aimed to examine the relationship of Sunnah fasting in repairing DNA damage of older adults who suffer from mild cognitive impairment (MCI). The study design was comparative cross sectional study that comparing two phases (baseline and 36 months). A total of 99 subjects of MCI aged ≥ 60 years and have no terminally ill diseases involved in the study. Ten ml of whole blood, socio-demographic and cognitive assessment data was taken. The blood collected is used to determine DNA damage using the Alkaline Comet Assay. MMSE, IADL, ADL and GDS was conducted to determine the cognitive function. The study found that the percentage of DNA in tail (TD) for the subjects who practice Sunnah fasting for both phases is significantly lower than in subjects who did not practice Sunnah fasting (Baseline, TD: 12.49 ± 0.24% vs 17.40 ± 0.43%; 36 months, TD: 8.21 ± 0.43% vs 15.23 ± 1.16%). The percentage of tail moment (TM) for the subjects who practice Sunnah fasting for both phases is significantly lower than in subjects who did not practice Sunnah fasting (Baseline, TM: 0.92 ± 0.05% vs 1.46 ± 0.08%; 36 months, TM: 0.4 ± 0.03% vs 1.32 ± 0.13%). In conclusion, this shows the Sunnah fasting can reduce DNA damage among the older adult of MCI subjects. Thus, further research is warranted to determine the metabolomes in MCI subjects that related with Sunnah fasting to produce a predictive model of healthy diet to be used in the future.
  16. Yeexing You, Suzana Shahar, Hasnah Haron, Hanis Mastura Yahya
    Sains Malaysiana, 2018;47:2713-2729.
    Ulam is the South East Asian traditional vegetables which contains high total phenolic content and exhibits antioxidant
    activity. Several studies have reported the potential of neuroprotective effect of ulam. The objective of this review article
    was to highlight the total phenolic content (TPC) and antioxidant activity of ulam and the roles of phenolic content that
    can contribute to attenuation of cognitive decline. The review includes randomized controlled trial and experimental
    studies from year 2007 to 2017. In this review, PRISMA method was used to report the results (n=15). Phenolic compounds,
    ie plants’ second metabolites of selected ulam in South East Asia were also discussed in this review, with respect to its
    potential for health promotion which and reducing the risk of cognitive disease. Oenanthe javanica (selom), Ocimum
    basilicum (daun selasih) and Anacardium occidentale L. (pucuk gajus) were ranked in the top three highest TPC among
    all the selected ulam. In general, Polygonum minus (kesum), Anacardium occidentale L. (pucuk gajus) and Cosmos
    caudatus (ulam raja) exhibited high DPPH radical scavenging activity whereas Anacardium occidentale L. (pucuk gajus)
    exhibited highest ferric ion reducing potential (FRAP) among all the selected ulam in South East Asia countries. Overall,
    some studies had shown Centella asiatica (pegaga), Oenanthe javanica (selom), Polygonum minus (kesum), Ocimum
    basilicum (daun selasih) and Murraya koenigii (daun kari) are beneficial in improving cognitive status and mood. The
    bioactive compounds in ulam may exhibit neuroprotective effects but human studies are still lacking in exploring the
    relationship between ulam consumption and cognitive status.
  17. Nabilah Rosney, Maihiza Salleh, Hasnah Haron, Suzana Shahar
    Sains Malaysiana, 2018;47:1819-1826.
    Increased the consumption of polyunsaturated (PUFA) and omega-3 fatty acid may be one of the strategies to prevent
    morbidity and mortality among elderly. This study aimed to identify the plasma fatty acid profile and intake among
    older adults who aged successfully (SA) as compared to the usual agers (UA). This cross-sectional comparative study
    was conducted among 48 SA (mean age 66.4+4.7 years old) and 42 UA (mean age 68.4+4.8 years old). The plasma fatty
    acid profile was determined using gas chromatography. Fatty acid intake was measured by using the validated Fatty
    Acid Omega-3 intake food frequency questionnaire. The percentage of saturated fatty acids (SFA) in blood plasma of
    UA (men 62.2+6.4%, women 62.9+7.0%) were significantly higher (p<0.05) compared to SA (men 53.7+15.8%, women
    57.1+9.5%). On the other hand, the percentage of monounsaturated (MUFA), polyunsaturated (PUFA) omega-3 and
    omega-6 fatty acids were the opposites. Fatty acids intake among SA was higher compared to UA. SFA (SA=5.0+2.5%,
    UA=4.6+2.9%) and total omega-3 (SA=0.5+0.4%, UA=0.4+0.3%) intakes met the recommended nutrient intake (RNI).
    However, mean intakes of MUFA (SA=5.3+2.4%, UA=4.7+2.7%) and linoleic acid (LA) (SA=0.5+0.7%, UA=0.3+0.5%)
    were below than the RNI. Percentages of subjects who did not meet the RNI for omega-3 and MUFA were 44.2% and 97.7%
    for SA and 47.4% and 95% for UA, respectively. SA had a higher level of plasma PUFA and MUFA, but lower in SFA when
    compared to UA. MUFA and LA were more likely to be inadequate in the diet of older adults, particularly the UA.
  18. Normah Che Din, Suzana Shahar, Baitil Husna Zulkifli, Rosdinom Razali, Chyn AV, Azhadi Omar
    Sains Malaysiana, 2016;45:1337-1343.
    The goal of this study was to examine the reliability and validity of the Bahasa Malaysia version of the Montreal cognitive assessment (MoCA-BM) and to determine its optimal cut-off score among older adults with mild cognitive impairment (MCI), after adjustments for age, gender, levels of education, physical functioning and depressive symptoms. A total of 2237 community dwelling older adults aged 60 years and above were randomly selected for the study, excluding those with MMSE score below 14. Instruments administered were the MoCA-BM, the Malay Mini-Mental State Examination (MMMSE), the Rey Auditory Verbal Learning Test (RAVLT), the Digit Span and the Digit Symbol subtests of the Wechsler Adult Intelligence Scale (WAIS), activities of daily living (ADL) and the Geriatric Depression Scale (GDS). MCI were determined using the Petersen’s 2014 criteria as the gold standard. SPSS version 22 was used for reliability and validity analysis and optimal cut-off score detection. Cronbach’s α of the MoCA-BM was 0.691 and concurrent validity was high between MoCA-BM and MMMSE scores (r=0.741). Optimal cut-off point for MoCA-BM to detect MCI among older adults in Malaysia was 17/18, with sensitivity of 68.2% and specificity of 61.3%. Using this cut-off, 38.9% of participants were detected to be at risk of MCI. In conclusion, MoCA-BM is a reliable and valid screening instrument for MCI among Malaysian elderly community. The newly derived optimal cut-off for MCI is much lower than the original MoCA with modest ability to discriminate between normal and MCI older adults in the community.
  19. Mohd Khairuddin Noor Khalib, Zahara Abdul Manaf, Suzana Shahar, Arimi Fitri Mat Ludin
    Malays J Nutr, 2018;24(4):575-585.
    MyJurnal
    Introduction: Lack of healthy food choices at the worksite is associated with
    unhealthy eating habits and poor diet quality. This study aimed to conduct a two
    weeks pilot study to assess the diet quality of lunch-meals delivered to worksites.
    Methods: Using a crossover study design, a total of 50 adults were purposely
    recruited from among university and hospital staffs in Selangor. Participants were
    randomised into two groups, whereby in week one, Group A was provided with
    the study’s “healthy lunch-meals” (RD4U©) for 3 work days/week, while Group B
    consumed their usual lunch. In week two, the groups switched over with Group
    B receiving RD4U© lunch-meals for three days. Diet quality of the lunch meals
    was assessed using the Healthy Eating Index for Malaysian (HEI-M). Participant
    satisfaction for RD4U© service was determined using SERVQUAL. Results: Mean
    protein consumption was significantly higher (27±4 g/day) while fat consumption
    was significantly lower (18±5 g/day) for the RD4U© lunch-meals, compared to the
    respective levels (24±11 g/day; 22±12 g/day) for the usual lunch meals. Total HEI
    score of the RD4U© meals (61.9±9.2) was higher than that for the usual lunch
    meals (56.1±11.2). Nonetheless, the overall diet quality scores indicate that both
    RD4U© and usual lunch meals were in the “need improvement” category. Generally,
    participants were satisfied with the RD4U© lunch-meal service. Conclusion: The
    RD4U© lunch-meals showed potential in delivering healthy lunch to worksites, and
    feasibility studies to expand the RD4U© delivery service is recommended.
  20. Bibi Nabihah Abdul Hakim, Hanis Mastura Yahya, Suzana Shahar, Zahara Abdul Manaf
    Malays J Nutr, 2018;24(4):567-574.
    MyJurnal
    Introduction: Adequacy of fruit intake contributes to an individual’s health
    including reducing the risk of non-communicable disease. This study aimed to
    assess consumption of fruits in various forms and to determine associated factors
    and barriers. Methods: In this cross-sectional study, a total of 300 adults aged
    20-39 years were purposely recruited from several urban locations in the Klang
    Valley. Consumption of fruits in the past 12 months was assessed using a selfadministered food frequency questionnaire (FFQ), assisted with pictures of serving
    size of fruits. Anthropometric measurements were taken and body mass index
    and waist circumference computed. Results: Fruit intake among young adults
    was lower (1.6±1.0 servings/day) than the Malaysian Dietary Guideline 2010 of
    ≥ 2 servings/day. Only 32.3% consumed fruits as recommended, with women
    consuming significantly more fruits than men. Preferred fresh fruits were red apple,
    banana and papaya. Consumption of fruit juice was associated with increase in
    waist circumference (R2=0.261, p=0.027) after adjustment for age, sex, ethnicity,
    education level and marital status. Fruit intake showed no significant association
    with other anthropometric measurements. Sensory appeal, perceived health benefit,
    easy to prepare and influence of family were the main determinants of fruit intake,
    whilst affordability and availability were the major barriers. Conclusion: Fruit
    consumption among young adults in this study was lower than the recommendation
    for daily fruit intake. Studies with larger sample size are suggested to verify the
    finding of significant association between fruit juice consumption and risk of
    abdominal obesity.
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