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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 Reliability and factor structure of the General Health Questionnaire-12 among university students

Normala Ibrahim, Zubaidah Jamil Osman, Khin Ohmar Naing Noor Jan, Siti Irma Fadhilah Ismail, Phang Cheng Kar, Firdaus Mukhtar, et al.

Malaysian Journal of Medicine and Health Sciences, 2014;10(2):53-60.
MyJurnal

The 12- item General Health Questionnaire (GHQ-12) has been translated into many languages and widely used in different settings and countries. Its reliability and psychometric properties were extensively studied in many population groups which suggested that it measures psychological distress in multidimensional construct. Objective: The objective of this study was to assess the reliability and factor structure of the Bahasa Malaysia version of the GHQ-12 among university students attending a health program at a Malaysian public university. Method: The cross sectional survey was conducted on 306 undergraduate students aged between 18 to 27 years old who visited the booth set up for mental health screening at a health program. The screening was conducted using a self-administered, validated Bahasa Malaysia version of GHQ-12 questionnaire. Results: Using exploratory factor analysis, the Bahasa Malaysia version of GHQ-12 was found to have a three factor structures namely depressive symptoms, self-esteem and perceived abilities which accounted for 58% of the item variance. The overall Cronbach’s alpha coefficient of the scale was found to be high (0.84) with each factor having acceptable inter-item consistency ranging from 0.61 to 0.82. Conclusion: The findings of the study show that the Bahasa Malaysia version GHQ-12 is reliable and has good structural characteristics. It can assess a few domains of the psychological status of university students. It also helps in providing more information
on the domain which may become a focus target of intervention in the prevention of mental illness.
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 Fluid intake, hydration status and its association with cognitive function among adolescents in Petaling Perdana, Selangor, Malaysia

Tung SEH, Ch'ng YZ, Karnan TV, Chong PN, Zubaidah JO, Chin YS

Nutr Res Pract, 2020 Oct;14(5):490-500.
PMID: 33029289 DOI: 10.4162/nrp.2020.14.5.490

BACKGROUND/OBJECTIVES: A cross-sectional study was undertaken to evaluate fluid intake and hydration status in association with cognitive function among 230 adolescents (10-14 years of age) in Petaling Perdana, Selangor, Malaysia.
SUBJECTS/METHODS: Urine color was used to measure hydration status, while fluid intake was assessed using the 15-item beverage intake questionnaire. Cognitive function was assessed using the Wechsler Intelligence Scale for Children, Fourth Edition.
RESULTS: More than half of the adolescents were mildly or moderately dehydrated (59.6%) and only one-third (33.0%) were well hydrated. Among the daily fluid types, intakes of soft drinks (r = -0.180; P = 0.006), sweetened tea (r = -0.184; P = 0.005) and total sugar-sweetened beverages (SSBs) (r = -0.199; P = 0.002) were negatively correlated with cognitive function. In terms of hydration status, cognitive function score was significantly higher (F-ratio = 4.102; P = 0.018) among hydrated adolescents (100.38 ± 12.01) than in dehydrated (92.00 ± 13.63) counterparts. Hierarchical multiple linear regression analysis, after adjusting for socio-demographic factors, showed that soft drinks (β = -0.009; P < 0.05) and sweetened tea (β = -0.019; P < 0.05) negatively predicted cognitive function (ΔR2 = 0.044). When further control for sources of fluid, hydration status (β = -2.839; P < 0.05) was shown to negatively predict cognitive function (ΔR2 = 0.021). The above variables contributed 20.1% of the variance in cognitive function.
CONCLUSIONS: The results highlight the links between fluid intake (soft drinks, sweetened tea, total SSBs) and hydration status with cognitive function in adolescents. Interventions aimed at decreasing the consumption of SSBs and increasing hydration status through healthy fluid choices, such as water, could improve cognitive performance in adolescents.