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Fulltext Association between TAS1R2 gene polymorphism (rs12033832) and sweet taste perception amongst malay obese and non- obese subjects

Ahmad Riduan Bahauddin, Nazamid Shaari, Zalilah Mohd Shariff, Roselina Karim

Malaysian Journal of Medicine and Health Sciences, 2020;16(4):4-12.
MyJurnal

Introduction: A growing evidence supported that variation of sweet taste perception, mediated by TAS1Rs gene variants could lead to excess sweetened food and beverages intake and also obesity. However, obesity development may also alter individuals' taste sensitivity and perception. Thus, it is best to further investigate whether or not the individuals' sweet taste sensitivity and acceptance are associated with variation in TAS1R2 gene and Body Mass Index (BMI) status. Methods: This comparison cross sectional study comprised of 88 obese and 92 non-obese subjects aged 20-45. All the subjects were genotyped for TAS1R2 gene variant at rs12033832 using polymerase chain reaction – restriction fragment length polymorphism (PCR-RFLP). Suprathreshold sensitivity for sweet taste was assessed using general Labeled Magnitude Scales. Intensity rating and hedonic test were carried out on 2 food samples (tea drink and rose flavoured agar) to examine subject's intensity rating and liking at different sugar contents. Results: Our re- sults showed that rs12033832 of TAS1R2 gene is associated with sweet taste perception among obese and non-obese subjects. No interaction effect between BMI status and TAS1R2 gene variant (rs12022832) was found on sweet taste measures. Overall, non-obese subjects with AA genotype on rs12033832 had the highest sweet taste sensitivity and dislike high sugar content products the most. The effect was reverse among the obese subjects with GG homozygous. Conclusion: These findings suggest that TAS1R2 gene variation plays an important role in sweet taste perception among individuals and may have nutritional implications and obesity.
Fulltext Prevalence of food insecurity and associated factors among freeliving older persons in Selangor, Malaysia

Siti Farhana Mesbah, Norhasmah Sulaiman, Zalilah Mohd Shariff, Zuriati Ibrahim

Malays J Nutr, 2018;24(3):349-357.
MyJurnal

Introduction: Older persons are vulnerable to food insecurity. This study
aimed to determine the prevalence of food security and associated factors
among free-living older persons in Petaling District, Selangor. Methods:
A total of 220 free-living older persons aged 60-87 years were selected by
using the cluster sampling method in this cross-sectional study. Faceto-face interviews were conducted to obtain information concerning the
demographic and socioeconomic background, food security, oral health, and
psychosocial status. Chi-square test and binary logistic regression analysis
were used to analyse the studied variables. Results: The median age of the
respondents was 65.5 years, and 19.5% were found as food insecure. There
were significant associations between marital status (χ2=6.818), education
level (χ2=6.242), occupation status (χ2=7.540), monthly income (χ2=9.940,),
and oral health status (χ2=9.627) with food security status. Those with a low
monthly income (AOR=2.449, 95% CI: 1.046-5.732), poor oral health status
(AOR: 3.306, 95% CI: 1.387-7.889) and living in rented accommodation
(AOR=6.218, 95% CI: 1.458-26.518) were more likely to be food insecure.
Conclusion: Respondents with an income lower than the poverty line
income (PLI), living in rented accommodation and poor oral health status
face increased risk of food insecurity. A nutrition assistance programme is
suggested to improve the socioeconomic and food security status of older
persons. Regular oral check-ups are recommended to improve the oral
health status of the elderly.
Fulltext Overweight and obesity among Orang Asli adults in Krau Wildlife Reserve, Pahang: a four-year follow-up study

Chua, Ee Yin, Zalilah Mohd Shariff, Norhasmah Sulaiman, Appannah, Geeta

Malays J Nutr, 2019;25(3):199-207.
MyJurnal

Introduction: Obesity and excess weight gain in adults are linked to an increased
risk of cardiometabolic abnormalities. The changing lifestyle experienced by the
Orang Asli predisposes the population to the risk of obesity and non-communicable
diseases. This study aimed to describe the prevalence of overweight and obesity as
well as body-weight change over a period of four years among Orang Asli adults.
Methods: Data were collected from Orang Asli adults aged ≥18 years, who were
enrolled in the 2011-2012 and 2015-2016 surveys, and who were residing within
the Krau Wildlife Reserve. Weight and height of the adults (N2011-2012=828; N2015-
2016=662) were measured at both time points. Follow-up data were available for 378
adults (male:113; female:265). Results: The prevalence of overweight and obesity
were 18.8% and 7.4% in 2011-2012 and 26.1% and 9.5% in 2015-2016. In the
follow-up group, significant differences in body weight and body mass index (BMI)
were observed in men and women, respectively. More than one-third (35.5%) of the
adults had weight gain of more than 5.0%. The increasing percentage of body weight
change was associated with being female, younger age, more years of schooling and
reduced household income. Conclusion: Obesity is a growing health problem in
the Orang Asli adult population. Weight gain was associated with socioeconomic
indicators and it was more prominent in women. Effective strategies are needed to
address the increasing prevalence of overweight and obesity in this population to
further reduce adverse health outcomes.
Fulltext Association between eating behaviour and weight gain among primary school children in Bandar Baru Bangi, Selangor

Norliza Ahmad, Munn-Sann Lye, Zalilah Mohd Shariff, Firdaus Mukhtar, Lim Poh Ying

Malaysian Journal of Medicine and Health Sciences, 2019;15(104):86-86.
MyJurnal

Introduction: Childhood obesity is increasing in prevalence in Malaysia. Excess in dietary intake and inadequate physical activity contribute to the development of obesity among children. The objective of this study was to de-termine the association between eating behaviour and excess weight among primary school children in an urban community in Malaysia. Methods: This is a baseline data of a randomized control field trial of a family-based inter-vention to reduce adiposity in overweight and obese children. It involved five primary government schools in Bandar Baru Bangi, Selangor. The inclusion criteria include parent-child dyad; children aged 7 to 10 years with body mass index (BMI) z-score of +1 standard deviation or more. Parents completed the validated self-administered Children Eating Behaviour Questionnaire (CEBQ). This questionnaire assessed children’s eating behaviour that includes food responsiveness, enjoyment of food, emotional overeating, desire to drink, slowness in eating, satiety responsiveness, emotional undereating and food fussiness. The children’s weight and height were measured and the BMI z-score was calculated. The association between CEBQ subscales and obesity was assessed using multiple linear regression, adjusted for sex and family income. Results: One hundred and thirty-four parent-child dyads had participated in this study. The food responsiveness was found to be significant with excess weight (β = 0.094, 95% CI: 0.02-0.17, p= 0.014). Conclusion: The food responsiveness subscale was associated with excess weight. This eating behaviour need to be taken into consideration in the development and implementation of health campaign targeted at the re-duction of childhood obesity.
Fulltext Food security status and childhood obesity in Kuantan Pahang

Roselawati Mat Ya, Wan Azdie Mohd Abu Bakar, Aflah Afandi, Jamalludin Ab Rahman, Zalilah Mohd Shariff

International Journal of Allied Health Sciences, 2017;1(2):56-71.
MyJurnal

Food insecurity has become one of the concerning issues in public health. The purpose of this study was to investigate household food security status and its relationship with childhood obesity in Kuantan, Pahang. This comparative cross sectional study was conducted in Kuantan, Pahang among 128 mothers aged 18 to 55 years with the children aged 7 and 13 years. Data on food security status was collected using Radimer/Cornell hunger and food insecurity instrument through telephone survey while children's height and weight as well as socio-demographic data were measured and obtained during schools visits. A total of 23% of the respondents were food secure. However, 77% experienced food insecurity where 52% were household food insecure, 9% women were individual food insecure and 16% fell into the child hunger category. Income (p=0.04), income per capita (p=0.033), household size (p=0.032) and area of living (p=0.001) were the significant risk factors for household food insecurity. The prevalence of overweight and obesity among children were 60.6% in food insecure households which was higher compared to food-secure households (38.4%). However, there were no significant association between childhood obesity and food security status. This study demonstrates that the prevalence of food insecurity and childhood obesity in Kuantan, Pahang is a major concern. The results warrant the need
for further investigation to identify complex interaction between food insecurity and
childhood obesity.
Fulltext A feasibility study of multiple micronutrient supplement for home fortification of foods among Orang Asli children in Negeri Sembilan, Malaysia

Nur Dayana Shaari, Zalilah Mohd Shariff, Gan, Wan Ying, Loh, Su Peng

Malays J Nutr, 2019;25(1):69-77.
MyJurnal

Introduction: The prevalence of child undernutrition and micronutrient deficiencies
are higher in the Orang Asli (OA) than the general Malaysian population. The World
Health Organization recommends the use of multiple micronutrient supplement
(MMS) that is a blend of micronutrients in powder form that can be sprinkled onto
foods for home fortification to prevent undernutrition among children. This pilot
study aimed to assess the feasibility of using MMS among OA children. Methods: A
total of 25 OA children (14 boys and 11 girls) aged 6-31 months (mean±SD = 15.7±7.2
months) in Negeri Sembilan were given three sachets of MMS weekly for 5 weeks.
Caregivers were instructed to add MMS to three types of food from the same food
group per week varying with a different food group weekly. Written instruction for
using MMS in simple language was given prior to the supplementation. Caregivers
were interviewed for information on socio-demographics, compliance, acceptance,
preference and adverse effect of MMS. Results: A high level of compliance was
observed (85%). All caregivers reported that the instructions for use were easy to read.
No noticeable changes to the foods mixed with MMS were observed and no adverse
effects were reported. Conclusion: This study demonstrated feasibility of the use of
MMS for future trials among OA children. The easy to read information that comes
with the MMS, frequent monitoring of MMS use and support to caregivers were
required to ensure compliance. Cultural feeding practices and financial constraints
may limit the types of food that can be mixed with MMS.
Fulltext Factors associated with stunting among Orang Asli preschool children in Negeri Sembilan, Malaysia

Wan, Ying Gan, Siti Fatihah Murtaza, Norhasmah Sulaiman, Zalilah Mohd Shariff

Malays J Nutr, 2018;24(2):215-226.
MyJurnal

Introduction: Childhood stunting is recognised as one of the most significant
barriers to human development. This cross-sectional study aimed to determine the
factors associated with stunting among Orang Asli (OA) preschool children in Negeri
Sembilan, Malaysia.

Methods: A total of 264 children (50.9% boys and 49.1%
girls) aged 2-6 years (M=4.04, SD=1.21 years) including their mothers from 14 OA
villages in Negeri Sembilan participated in this study. Mothers were interviewed to
obtain information regarding socioeconomic status, sanitation facility and personal
hygiene. The height of the children and their mothers were measured. Venous
blood samples were drawn from the children to estimate haemoglobin level, and
stool samples were collected to screen for intestinal parasitic infections.

Results:
Approximately one third of the children (35.6%) and 7.8% of the mothers were
stunted. One in five of the children were anaemic (21.6%), while one- third had
intestinal parasitic infections (35.0%). Low birth weight (AOR=2.526, 95% CI: 1.310-
4.872; p=0.006), anaemia (AOR=2.742, 95% CI: 1.265-5.945; p=0.011), presence
of intestinal parasitic infections (AOR=2.235, 95% CI: 1.310-3.813, p=0.003), not
wearing shoes (AOR=2.602, 95% CI: 1.453-4.660; p=0.001), absence of piped water
at home (AOR=2.395, 95% CI: 1.047-5.476; p=0.039), dirty nails (AOR=1.956, 95%
CI: 1.163-3.289, p=0.011), and stunted mothers (AOR=3.443, 95% CI: 1.334-8.890;
p=0.011) were identified as significant factors for childhood stunting.

Conclusion:
It is suggested that the factors identified associated with childhood stunting be
included in future intervention programmes that address stunting among OA
children.
Fulltext Dietary characteristics of women with gestational diabetes mellitus

Farah Yasmin Hasbullah, Heng Yaw Yong, Zalilah Mohd Shariff, Zulida Rejali

Malaysian Journal of Medicine and Health Sciences, 2019;15(201):69-76.
MyJurnal

Introduction: The role of dietary intake on maternal glucose is uncertain. This study described the dietary charac- teristics of women with gestational diabetes mellitus (GDM) and examined the differences in dietary characteristics based on GDM diagnosis. Methods: This study recruited GDM women (n =45; age =31.1±5.1 years old) from health clinics in Seremban. Dietary intake, glycemic index (GI) and glycemic load (GL) were assessed using a semi-quanti- tative food frequency questionnaire (SFFQ) during first and second trimester of pregnancy. GDM diagnosis was made at 28 weeks gestation with the following cut-off for FPG  5.1 or 2hPG  7.8 mmol/L following oral glucose toler- ance test. Results: Women with GDM had a reasonable intake of protein and fat but consumed high-carbohydrate at second trimester and high-sugar diet at both trimesters. Fibre, iron and calcium from the food sources did not meet the recommended nutrient intakes for pregnancy. About 75.6% (n = 34) GDM women had high 2hPG (9.3 ± 1.5 mmol/L) with a normal FPG (4.7 ± 0.7 mmol/L). While dietary characteristics were not significantly different, women with a higher 2hPG tended to take a higher proportion of protein at first trimester and a higher dietary GI, serving of rice, and sugars and creamer at second trimester than high FPG. Conclusion: Suboptimal maternal nutrition in women with GDM are of particular concern. Dietary characteristics of women with high fasting and 2-hour glucose were comparable but not optimal. The needs of tailored nutritional intervention are evident in women known to be at high risk of GDM.
Fulltext Factors associated with poor nutritional status among hemodialysis patients in Malaysia

Chan Yoke Mun, Zalilah Mohd Shariff, Christopher Lim Thiam Seong, Goh Bak Leong

Malaysian Journal of Medicine and Health Sciences, 2019;15(201):77-83.
MyJurnal

Introduction: Poor nutritional status is prevalent among hemodialysis patients, with limited studies available on how it is being influenced by other factors in the local context. The current study aimed to determine the nutritional sta- tus and its associated factors among hemodialysis patients. Methods: This was a study undertaken in a total of 455 hemodialysis patients (256 men and 199 women). The main outcome measure was Malnutrition Inflammation Score (MIS), which was utilized to identify nutritional and inflammatory status of the hemodialysis patients. Other evalu- ation tools included anthropometry and biochemical measurements as well as dietary assessment. Results: A high proportion of hemodialysis patients were malnourished (64.4%) and presented with inflammation (67.5%). Using multiple linear regression analysis, factors contributing to malnutrition were older age, lower lean body mass, higher interdialytic weight gain (IDWG), inadequate intakes of energy and protein, as well as presence of comorbidities and inflammation. Conclusion: The presence of malnutrition and inflammation were prevalent among hemodialysis patients. Several determinants of poor nutritional status of hemodialysis patients were modifiable and should be rec- ognized while formulating and implementing appropriate intervention plans for this vulnerable group.
Fulltext Insulin resistance, inflammation and metabolic syndrome in normal weight and overweight/obese primary school children in Kuala Lumpur

Mohd Nasir Mohd Taib, Chin, Yit Siew, Zalilah Mohd Shariff, Tung, Serene En Hui, Yim, Hip Seng, Zubaidah Jamil Osman

Malays J Nutr, 2018;24(2):153-161.
MyJurnal

Introduction: Studies on metabolic syndrome (MetS) of children are important
in view of rising prevalence of childhood obesity worldwide. This study compares
the risks of insulin resistance, inflammation and metabolic syndrome between
overweight/obese (OW/OB) and normal weight (NW) children in Kuala Lumpur.

Methods: A cross-sectional study was conducted in 12 primary schools selected
using multi-stage stratified random sampling. Height and weight were taken of a
total of 1971 children aged 10-11 years. Based on BMI-for-age, 235 OW/OB children
matched for age, sex and ethnicity with 226 NW children were selected for the study.
Overnight fasting blood samples were collected to determine insulin, high-sensitivity
C-reactive protein (hsCRP), glucose and lipid profiles. Logistic regression analysis
was conducted to estimate associations between weight status and metabolic risk
factors.

Results: Prevalence of MetS among OW/OB children was 3.8% compared to
0% in the NW. Prevalence of insulin resistance among OW/OB was 45.5% compared
to 18.6% among NW children. High risk of inflammation was found in 28.1% of the
OW/OB children compared to 12.4% in the NW. The odds ratio of having insulin
resistance, inflammation and metabolic risk factors among OW/OB were 3.66 (95%
CI: 2.40-5.59), 2.76 (95% CI: 1.69-4.50), 4.93 (95% CI: 3.42-7.10), respectively
compared to the NW.

Conclusion: The OW/OB children in this study showed higher
risks of developing insulin resistance, inflammation and MetS compared to the NW
counterparts. Further studies are suggested to better understand the relationships
between insulin resistance, inflammation and MetS in children.
Fulltext Determinants of compliance behaviours among patients undergoing hemodialysis in Malaysia

Chan YM, Zalilah MS, Hii SZ

PLoS One, 2012;7(8):e41362.
PMID: 22870215 DOI: 10.1371/journal.pone.0041362

BACKGROUND: Patients with end stage renal disease often fail to follow prescribed dietary and fluid regimen, leading to undesirable outcomes. This study aimed to examine and identify factors influencing dietary, fluid, medication and dialysis compliance behaviours in patients undergoing hemodialysis.
METHODS: This was a cross-sectional study which employed purposive sampling design. A total of 188 respondents were recruited from 14 dialysis centres in Malaysia between 2008-2011. Self-reported compliance behaviours and biochemical measurements were used as evaluation tools.
RESULTS: Compliance rates of dietary, fluid, medication and dialysis were 27.7%, 24.5%, 66.5% and 91.0%, respectively. Younger, male, working patients and those with longer duration on hemodialysis were found more likely to be non-compliant. Lacks of adequate knowledge, inadequate self-efficacy skills, forgetfulness and financial constraints were the major perceived barriers towards better compliance to fluid, dietary, medication and dialysis, respectively.
CONCLUSIONS: Healthcare professionals should recognise the factors hindering compliance from the patients' perspective while assisting them with appropriate skills in making necessary changes possible.
Fulltext Evaluation of dietary quality using Malaysian healthy eating index and its relationships with cardiometabolic risk factors in Malaysian adolescents

Geeta Appannah, Nor Aishah Emi, Nur Athira Ahmad Yusin, Wan Ying Gan, Zalilah Mohd Shariff, Nurainul Hana Shamsuddin, et al.

Malaysian Journal of Medicine and Health Sciences, 2020;16(106):46-55.
MyJurnal

Introduction: This cross-sectional study aimed to investigate relationships between diet quality assessed by Malay- sian Healthy Eating Index (HEI) and cardiometabolic risk factors in adolescents aged 13 years. Methods: 336 ado- lescents from various public secondary schools provided information on sociodemography and their anthropometric measurements including height (cm), weight (kg) and waist circumference (cm) were measured. Body mass index (BMI) was estimated thereafter. Dietary intakes assessed using a validated adolescent food frequency questionnaire (FFQ) was used to estimate Malaysian HEI. Biomarker parameters including lipid profile, fasting glucose, insulin and insulin resistance were also assessed. Associations of diet quality indicators to cardiometabolic risk factors were examined using regression models. Results: The overall diet quality of the adolescents was rather poor (49%), with a greater percentage of males were found to have low dietary quality score compared to females (56% vs. 39%; p
Fulltext Maternal hemoglobin change from early pregnancy to second trimester is associated with risk of gestational diabetes mellitus: a retrospective cohort study

Sulhariza HZ, Zalilah MS, Geeta A

Front Nutr, 2023;10:1197485.
PMID: 37396129 DOI: 10.3389/fnut.2023.1197485

INTRODUCTION: The accrual of iron that is reflected in high maternal hemoglobin (Hb) status is increasingly recognized as a risk factor for gestational diabetes mellitus (GDM). Changes in maternal Hb level could also implicate glycemic status in pregnancy. This study aimed to determine the associations between maternal Hb levels and their changes with GDM.
METHODS: In this retrospective cohort study, a total of 1,315 antenatal records of mothers with singleton pregnancies from eight health clinics of a district in the northern region of Peninsular Malaysia who delivered between 1st January 2016-31st December 2017 were analyzed. Data extracted from the records were socio-demographic, anthropometric, obstetrical, and clinical data. Hb levels were extracted at booking (<14 weeks) and second trimester (14-28 weeks). Change in Hb was determined by subtracting the Hb level in the second trimester from the booking Hb level and was categorized as decreased, unchanged, and increased Hb. The associations between maternal Hb levels and their changes with GDM risk were analyzed using multiple regression, adjusting for covariates in four different models. Model 1: maternal age and height. Model 2: covariates of Model 1 added with parity, history of GDM, and family history of diabetes. Model 3: covariates of Model 2 added with iron supplementation at booking. Model 4: covariates of Model 3 added with Hb level at booking.
RESULTS AND DISCUSSIONS: Unchanged Hb level from booking to second trimester was significantly associated with GDM risk in Model 1 (AOR: 2.55; 95% CI: 1.20, 5.44; p
Psychological distress as a mediator in the relationships between biopsychosocial factors and disordered eating among Malaysian university students

Gan WY, Mohd Nasir MT, Zalilah MS, Hazizi AS

Appetite, 2012 Dec;59(3):679-87.
PMID: 22885453 DOI: 10.1016/j.appet.2012.08.002

The mechanism linking biopsychosocial factors to disordered eating among university students is not well understood especially among Malaysians. This study aimed to examine the mediating role of psychological distress in the relationships between biopsychosocial factors and disordered eating among Malaysian university students. A self-administered questionnaire measured self-esteem, body image, social pressures to be thin, weight-related teasing, psychological distress, and disordered eating in 584 university students (59.4% females and 40.6% males). Body weight and height were measured. Structural equation modeling analysis revealed that the partial mediation model provided good fit to the data. Specifically, the relationships between self-esteem and weight-related teasing with disordered eating were mediated by psychological distress. In contrast, only direct relationships between body weight status, body image, and social pressures to be thin with disordered eating were found and were not mediated by psychological distress. Furthermore, multigroup analyses indicated that the model was equivalent for both genders but not for ethnic groups. There was a negative relationship between body weight status and psychological distress for Chinese students, whereas this was not the case among Malay students. Intervention and prevention programs on psychological distress may be beneficial in reducing disordered eating among Malaysian university students.
Direct and indirect effects of sociocultural influences on disordered eating among Malaysian male and female university students. A mediation analysis of psychological distress

Gan WY, Mohd Nasir MT, Zalilah MS, Hazizi AS

Appetite, 2011 Jun;56(3):778-83.
PMID: 21435366 DOI: 10.1016/j.appet.2011.03.005

This study aimed to examine the role of psychological distress in the relationships between sociocultural influences (social pressure to be thin and weight teasing) and disordered eating. Data were collected from 584 university students (59.4% females and 40.6% males), aged 18-24 years old (M=20.6, SD=1.4), selected from four universities in the Klang Valley, Malaysia. Participants completed four standardized questionnaires which measured social pressure to be thin, weight-related teasing, psychological distress and disordered eating. A good fit structural equation modeling (SEM) model was developed for both sexes. For males, the SEM model revealed that sociocultural influences showed an indirect effect on disordered eating through psychological distress. For females, the model showed an indirect effect of sociocultural influences on disordered eating through psychological distress, as well as a direct effect of sociocultural influences on disordered eating. In conclusion, psychological distress mediated the relationships between sociocultural influences and disordered eating in both males and females. Our results suggest that disordered eating intervention programs on reducing psychological distress in university students may be beneficial.
Fulltext Estimates and distribution of body mass index in a sample of Malaysian adolescents

Zalilah MS, Mirnalini K, Khor GL, Merlin A, Bahaman AS, Norimah K

Med J Malaysia, 2006 Mar;61(1):48-58.
PMID: 16708734 MyJurnal

The purpose of this study was to report on the estimates and distribution of body mass index in a sample of Malaysian adolescents. The study utilized a cross-sectional design and multi-stage random sampling of secondary schools to select 5 urban and 9 rural schools in Kedah and Penang. A total of 6555 male and female adolescents (11-15 years old) of Malay, Chinese and Indian ethnic groups were measured for weights and heights for body mass index calculation. Information on household demographic and socioeconomic were obtained from parents through self-administered questionnaires. Analyses of body mass index distribution by location, ethnicity, gender and age were conducted using Chi-square test of SPSS 11.5. More of the rural (12.1%) and urban (19.4%) adolescents were underweight and overweight, respectively. While in all ethnic, gender and age groups, rural adolescents were more likely to be underweight, more of the urban adolescents were overweight. The prevalence of underweight was highest among the Indians (19.2%) and lowest in Chinese (7.2%). The prevalence of overweight in the three ethnic groups was in the range of 18-19%. More male than female adolescents were underweight (15% vs 7.8%) and overweight (19.5% vs 16.7%). Consistent patterns were also observed across location, ethnic and age groups. As age increased, the prevalence of overweight decreased across the ethnic and gender groups. The reported findings can serve as current reference on body mass index distribution of Malaysian adolescents and a basis for future efforts in health and nutrition interventions for Malaysian children and adolescents.
Dietary patterns and cognitive ability among 12- to 13 year-old adolescents in Selangor, Malaysia

Nurliyana AR, Mohd Nasir MT, Zalilah MS, Rohani A

Public Health Nutr, 2015 Feb;18(2):303-12.
PMID: 24507623 DOI: 10.1017/S1368980014000068

OBJECTIVE: The present study aimed to identify dietary patterns and determine the relationship between dietary patterns and cognitive ability among 12- to 13 year-old Malay adolescents in the urban areas of Gombak district in Selangor, Malaysia.
DESIGN: Data on sociodemographic background were obtained from parents. Height and weight were measured and BMI-for-age was determined. Adolescents were interviewed on their habitual dietary intakes using a semi-quantitative FFQ. Cognitive ability was assessed using the Wechsler Nonverbal Scale of Ability in a one-to-one manner. Dietary patterns were constructed using principal component analysis based on thirty-eight food groups of the semi-quantitative FFQ.
SETTING: Urban secondary public schools in the district of Gombak in Selangor, Malaysia.
SUBJECTS: Malay adolescents aged 12 to 13 years (n 416).
RESULTS: The mean general cognitive ability score was 101·8 (sd 12·4). Four major dietary patterns were identified and labelled as 'refined-grain pattern', 'snack-food pattern', 'plant-based food pattern' and 'high-energy food pattern'. These dietary patterns explained 39·1 % of the variance in the habitual dietary intakes of the adolescents. The refined-grain pattern was negatively associated with processing speed, which is a construct of general cognitive ability. The high-energy food pattern was negatively associated with general cognitive ability, perceptual reasoning and processing speed. Monthly household income and parents' educational attainment were positively associated with all of the cognitive measures. In multivariate analysis, only the high-energy food pattern was found to contribute significantly towards general cognitive ability after controlling for socio-economic status.
CONCLUSIONS: Consumption of foods in the high-energy food pattern contributed towards general cognitive ability after controlling for socio-economic status. However, the contribution was small.
Fulltext Obesity indices predict hypertension among indigenous adults in Krau Wildlife Reserve, Peninsular Malaysia

Chua EY, Zalilah MS, Haemamalar K, Norhasmah S, Geeta A

J Health Popul Nutr, 2017 05 25;36(1):24.
PMID: 28545536 DOI: 10.1186/s41043-017-0102-4

BACKGROUND: The disease burden of indigenous peoples has been augmented by the rising prevalence of obesity and hypertension in this population. This study assessed the ability of obesity indices to predict hypertension among indigenous adults of Peninsular Malaysia.
METHODS: In this cross-sectional study, 482 adults (223 men, 259 women) aged ≥18 years old were measured for body mass index (BMI), waist circumference (WC), waist-height ratio (WHtR), waist-hip ratio (WHR), and blood pressure. Receiver operating characteristic (ROC) analysis was used to determine the predictive ability of obesity indices for hypertension in men and women. Gender-specific logistic regression analyses were done to examine the association between obesity, defined by BMI, WC, WHtR and WHR, and hypertension.
RESULTS: Prevalence of hypertension was 25.5%. Overall, WHtR was the best predictor of the presence of hypertension, in both men and women. The optimal WHtR cut-off values for hypertension were 0.45 and 0.52 in men and women, respectively. Obese adults with WHtR ≥0.5 had about two times increased odds of having hypertension compared to non-obese adults.
CONCLUSIONS: WHtR may serve as a simple and inexpensive screening tool to identify individuals with hypertension in this relatively difficult to reach population.
Psychological Factors and Cardiovascular Disease Risk Factors as Mediators of the Relationship between Overweight/Obesity and Cognitive Function among School Children in Kuala Lumpur, Malaysia

Tung SEH, Mohd Nasir MT, Chin YS, Zalilah MS, Zubaidah JO, Yim HS

Child Obes, 2019 01;15(1):56-62.
PMID: 30339034 DOI: 10.1089/chi.2018.0066

BACKGROUND: Recent research suggests that a negative relationship exists between adiposity and cognitive function in children. However, limited information is known on how they are related. This study aimed to examine the mediators of the relationship between overweight/obesity and cognitive function among school children in Kuala Lumpur, Malaysia.
METHODS: This is a cross-sectional comparison study whereby 225 overweight/obese children matched for age, sex, and ethnicity with 225 normal weight children participated in this study. Body image dissatisfaction, disordered eating, and depressive symptoms were assessed through a self-administered questionnaire. Blood pressure was measured, whereas blood was drawn to determine insulin, high-sensitivity C-reactive protein (hs-CRP), glucose, and lipid profiles. Homeostasis model assessment-estimated insulin resistance (HOMA-IR) was calculated using glucose and insulin levels. Wechsler's Intelligence Scale for Children-Fourth Edition (WISC-IV) was used to assess cognitive function in children. Ordinary least square regression analysis was conducted to determine the direct and indirect relationships between weight status and cognitive function.
RESULTS: A negative relationship was found between overweight/obesity with cognitive function. Overweight/obese children were on average 4.075 units lower in cognitive function scores compared to normal weight children. Such difference was found through mediators, such as body image dissatisfaction, disordered eating, depression, systolic blood pressure, triglycerides, HOMA-IR, and hs-CRP, contributing 22.2% of the variances in cognitive function in children.
CONCLUSION: Results highlight the important mediators of the relationship between overweight/obesity and cognitive function. Consequently, future interventions should target to improve psychological well-being and reduce cardiovascular disease risk for the prevention of poorer cognitive performance in overweight/obese children.
Fulltext Dietary Acid Load, IGF-1 Single Nucleotide Polymorphism and Bone Resorption among Postmenopausal Chinese Women

Lim SY, Zalilah MS, Chin YS, Ramachandran V, Chan YM

Nutrients, 2018 Jul 17;10(7).
PMID: 30018240 DOI: 10.3390/nu10070915

The interaction of dietary and genetic factors may affect the development of bone deterioration. This study investigated whether the effects of dietary acid load (DAL) on bone loss in postmenopausal Chinese women were moderated by the insulin-like growth factor-1 (IGF-1) single nucleotide polymorphism, a known gene that plays a role in the regulation of bone formation and bone remodeling. A total of 217 healthy participants were recruited from the National Council of Senior Citizens Organizations Malaysia. Serum collagen type 1 cross-linked C-telopeptide was used as a surrogate bone marker to assess bone resorption and Agena® MassARRAY genotyping analysis was used to identify the signaling of IGF-1 rs35767. The dietary acid load was measured by potential renal acid load score while physical activity was ascertained using the Global Physical Activity Questionnaire. Hierarchical regression was applied to test the main and interaction effects of DAL and IGF-1 genotypes in bone resorption. The result supported the diet-dependent acid-base balance theory that higher DAL was positively associated with bone resorption (β = 0.152, p = 0.031, F(6,207) = 2.11, sig-F = 0.036, R² = 0.079). However, the results indicated that there was no significant correlation between IGF-1 and bone resorption, or any significant interaction between DAL and IGF-1. In conclusion, there was no moderating effect of IGF-1 on the relationship between DAL and bone resorption.

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