Improvement of dietary quality with the aid of a low glycemic index diet in Asian patients with type 2 diabetes mellitus.

This randomized controlled study was conducted to determine the effect of low glycemic index (GI) dietary advice on eating patterns and dietary quality in Asian patients with type 2 diabetes (T2DM). Asian patients with T2DM (N  =  104) were randomized into 2 groups that received either low GI or conventional carbohydrate exchange (CCE) dietary advice for 12 weeks. Nutritional prescriptions were based on the medical nutrition therapy for T2DM, with the difference being in the GI component of the carbohydrates. Dietary intake and food choices were assessed with the use of a 3-day food record. At week 12, both groups achieved the recommendations for carbohydrate (52 ± 4% and 54 ± 4% of energy) and fat (30 ± 4% and 28 ± 5% of energy) intake. There were no significant differences in the reported macronutrient intake in both groups. With the low GI diet, crude fiber and dietary calcium intake increased, while the dietary GI reduced. Subjects in the lowest dietary glycemic index/glycemic load (GI/GL) quartile consumed more parboiled/basmati rice, pasta, milk/dairy products, fruits, and dough, which are foods from the low GI category. There was a significant reduction in the hemoglobin A(1c) level at week 12 for patients in the lowest GI/GL quartile (Δ  =  -0.7 ± 0.1%) compared with those in the highest GI/GL quartile (Δ  =  -0.1 ± 0.2%). These results demonstrate the ability of low GI dietary advice to improve the dietary quality of Asian patients with T2DM

Acute effect of low and high glycemic index meals on post- prandial glycemia and insulin responses in patients with type 2 diabetes mellitus

Introduction:Post-prandial hyperglycemia is an important independent risk factor in the development of cardiovascular disease in diabetes. This randomised cross-over study was conducted to compare the post-prandial glycemic and insulin responses to both high and low glycemic index (GI) meals in patients with type 2 diabetes (T2DM). Methods:A total of 41 patients with established T2DM (16 males, 25 females, Age= 55 + 10 years and BMI= 27 + 4 kg/m2) were randomly given either a High GI or a Low GI meal in a cross-over manner. Both test meals were separated by one week washout periods. The meals contained almost the same amount of energy and macronutrients with the exception of the GI values(High GI=70 vs Low GI= 36). Venous blood was taken through an indwelling catheter periodically at 0, 30, 60, 90, 120, 150 and 180 minutes respectively. The incremental area under the curve (iAUC) was used to calculate the post-prandial glycemia and insulin excursion over the 3-hour period. Results: The low GI meal induced lower glycemic responses at times 30, 60, 90 and 120 minutes (mean+SE; low GI=8.1+0.4, 9.1+0.4, 8.9+0.4 and 8.5 +0.4mmol/l vs high GI= 9.1+0.4, 10.7+0.4, 11.0+0.5 and 9.7 +0.5 mmol/l) and reduced the insulin levels at time 60, 90, 120 and 150 minutes (mean+SE; low GI= 17.1+1.7, 21.1+2.0, 20.4+1.7,18.5+1.8 vs high GI= 25.0+2.5, 31.2+2.9, 29.8 +3.0 and 23.0+2.3 μIU/ml)(p<0.05). The area under the glycemic (mean+SE; low GI= 215.93 + 15.9 mmol.L/minute vs high GI= 419.52 + 32.7 mmol.L/minute) and insulin (mean +SE; low GI= 1439.76 + 226 vs high GI= 2372.76 + 317μ IU.ml/min) curves were lower after the low GI than high GI meal respectively (p<0.05).Conclusion: The low GI meal has the ability to reduce the post-prandial hyperglycemia as well insulin responses in type 2 diabetes patients

A comparison of chemical compositions in Kelulut honey from different regions = Perbandingan komposisi kimia dalam madu kelulut dari kawasan berbeza

Kelulut honey (KH) is honey produced by stingless bees (Trigona spp.) found in Malaysia. This study investigated the difference inherent in the chemical composition of kelulut honey collected from the east coast, and the central and northern regions of Peninsular Malaysia. Total sugar content, individual sugar content, total phenolics, total flavonoids, ascorbic acid, ascorbic acid equivalent antioxidant content (AEAC), and proline content were determined. Sugar analysis revealed that kelulut honey contained 62.33-79.53 g/100g of total sugar, with maltose as the predominant sugar (15.85-37.74 g/100g), followed by fructose (9.91-53.64 g/100g), glucose (10.96-25.04 g/100g), and sucrose (0.54-3.48 g/100g). The results indicate that total flavonoids (78.95±0.70 mg QE/kg) and phenolics (1149.48±40.52 mg GAE/kg) were the highest in honey from the east coast region. The proline and ascorbic acid content were less likely to be affected by geographical factors. Kelulut honey possesses a unique sugar profile that may contribute to its unique taste. In conclusion, the geographical and floral origin of honey are the two most important factors that fundamentally affect the physical-chemical properties of honey samples

Original Research Improvement of Dietary Quality with the Aid of a Low Glycemic Index Diet in Asian Patients with Type 2 Diabetes Mellitus

Objectives: This randomized controlled study was conducted to determine the effect of low glycemic index (GI) dietary advice on eating patterns and dietary quality in Asian patients with type 2 diabetes (T2DM). Methods: Asian patients with T2DM (N 5 104) were randomized into 2 groups that received either low GI or conventional carbohydrate exchange (CCE) dietary advice for 12 weeks. Nutritional prescriptions were based on the medical nutrition therapy for T2DM, with the difference being in the GI component of the carbohydrates. Dietary intake and food choices were assessed with the use of a 3-day food record. Results: At week 12, both groups achieved the recommendations for carbohydrate (52 6 4% and 54 6 4% of energy) and fat (30 6 4% and 28 6 5% of energy) intake. There were no significant differences in the reported macronutrient intake in both groups. With the low GI diet, crude fiber and dietary calcium intake increased, while the dietary GI reduced. Subjects in the lowest dietary glycemic index/glycemic load (GI/GL) quartile consumed more parboiled/basmati rice, pasta, milk/dairy products, fruits, and dough, which are foods from the low GI category. There was a significant reduction in the hemoglobin A 1c level at week 12 for patients in the lowest GI/GL quartile (D 5 20.7 6 0.1%) compared with those in the highest GI/GL quartile (D 5 20.1 6 0.2%). Conclusions: These results demonstrate the ability of low GI dietary advice to improve the dietary quality of Asian patients with T2DM

Randomized controlled trial of a good practice approach to treatment of childhood obesity in Malaysia: Malaysian childhood obesity treatment trial (MASCOT)

Context. Few randomized controlled trials (RCTs) of interventions for the treatment of childhood obesity have taken place outside the Western world. Aim. To test whether a good practice intervention for the treatment of childhood obesity would have a greater impact on weight status and other outcomes than a control condition in Kuala Lumpur, Malaysia. Methods. Assessor-blinded RCT of a treatment intervention in 107 obese 7- to 11-year olds. The intervention was relatively low intensity (8 hours contact over 26 weeks, group based), aiming to change child sedentary behavior, physical activity, and diet using behavior change counselling. Outcomes were measured at baseline and six months after the start of the intervention. Primary outcome was BMI z-score, other outcomes were weight change, health-related quality of life (Peds QL), objectively measured physical activity and sedentary behavior (Actigraph accelerometry over 5 days). Results. The intervention had no significant effect on BMI z score relative to control. Weight gain was reduced significantly in the intervention group compared to the control group (+1.5 kg vs. +3.5 kg, respectively, t-test p &lt; 0.01). Changes in health-related quality of life and objectively measured physical activity and sedentary behavior favored the intervention group. Conclusions. Treatment was associated with reduced rate of weight gain, and improvements in physical activity and quality of life. More substantial benefits may require longer term and more intensive interventions which aim for more substantive lifestyle changes

From ToyBox Study to eToyBox : Advancing Childhood Obesity Reduction in Malaysian Kindergartens

Prevention and treatment of childhood obesity is a global concern, and in Malaysia, it is considered a national public health priority. Determinants of childhood obesity are multifactorial and include factors that directly and indirectly influence energy balance-related behaviours, including energy intake and energy expenditure. Interventions to address childhood obesity that have multiple components at different levels have been shown to be the most influential. The ToyBox-study is a childhood obesity intervention aimed at preschool-aged children and their families that had been shown to be effective in several European countries and so was chosen for adaption for the Malaysian setting. Materials were translated and adjusted for the Malaysian context and audience and implemented in kindergartens in Peninsular Malaysia and Sarawak. However, during the COVID-19 pandemic and lockdown, teaching transitioned to being online. This brought an opportunity to reach a wider audience and consider the long-term sustainability of the intervention, and thus eToybox was born. eToybox aims to bring support for healthy energy balance behaviours directly to the teachers, into kindergartens and homes, to encourage families to be active and eat healthily, and prevent or reduce obesity. Through online innovation, the Toybox Study Malaysia programme has been expanded to enhance its potential to impact the promotion of healthy lifestyles among preschoolers and their families, highlighting the importance of a holistic approach to preventing and treating childhood obesity in Malaysia

The effect of low glycemic index bread eaten with different dillings on blood glucose response in healthy individuals

White and whole meal breads have been classified as high glycemic index (GI) foods which in turn produce the greatest rise in blood glucose. One of the commercial bread products in Malaysia known as Brown breads (BB) has been recently marketed as a healthy choice for diabetics due to its low GI value. This study was conducted to examine the effect of BB when eaten with different fillings on blood glucose response among healthy individuals and to describe the influences of these fillings in reducing blood glucose response. Five test meals using BB (BB eaten with baked beans, BB eaten with vegetable, BB eaten with apple, BB eaten with roast chicken and BB eaten with seaweeds) had been prepared for this study. Postprandial blood glucose response was determined for each test meal and reference food (glucose) that contained 50 g carbohydrate respectively. A total of 21 healthy subjects were recruited by advertisement to participate. Only 20 subjects (15 males, 5 females, Mean + SD Age : 24.4 + 3.7 years; BMI 23.4 + 3.0 kgm-2 ) completed this study. After an overnight fast, subjects consumed BB eaten with fillings according to the assigned group given and three repeated tests of reference food (glucose). Fasting capillary blood glucose samples were taken at time 0 and at 15, 30, 45, 60, 90 and 120 min respectively after the meal began. The blood glucose response was obtained by calculating the incremental area under the curve (AUC). Blood glucose response after consuming reference food (251.8 + 12.1 m m o l . m i n / L ) w a s s i g n i f i c a n t l y h i g h e r t h a n a l l t h e t e s t m e a l s (p < 0.05). Among the test meals, BB eaten with baked beans produced the highest rise in blood glucose (97.0 + 16.9 mmol.min/L) whereas BB eaten with seaweeds demonstrated the lowest response in blood glucose (33.3 + 6.5 mmol.min/L) and the difference was statistically significant (p < 0.05). The postprandial blood glucose response after ingestion of BB when eaten with vegetable was 73.3 + 19.1 mmol.min/L followed by BB eaten with apple (58.9 Jurnal Sains Kesihatan Malaysia 6 (1) 2008: 1-102 + 12.2 mmol.min/L) and BB eaten with roast chicken (56.5 + 10.1 mmol.min/ L). Generally, BB when eaten with fillings produced a slow rise in blood glucose response than the reference food. Combining this BB with fillings had the effect of reducing the postprandial blood glucose further

Abdominal obesity in Malaysian adults: National Health and Morbidity Survey III (NHMS III, 2006)

Abdominal obesity (AO) is an independent risk factor for cardiovascular disease, hypertension and diabetes mellitus in adults. There is a lack of data on the magnitude and socio-demographic profile of AO among Malaysian adults at the national level. In the Third National Health and Morbidity Survey (NHMS III) conducted in 2006, AO of adults aged 18 years and above was determined based on the waist circumference as part of the nutritional status assessment. This article reports the prevalence of AO in relation to socio-economic factors and demographic characteristics of adult subjects. Out of a total of 33,465 eligible individuals 18 years and above, waist circumference was measured in 32,900 (98.3%) individuals. The prevalence of AO was assessed using the cut-off points recommended by World Health Organization. The mean waist circumference in men and women was 84.0cm [95% confidence interval (95% CI): 83.8, 84.3] and 80.3cm (95% CI: 80.1, 80.6) respectively. The national prevalence of AO was 17.4% (95% CI: 16.9, 17.9). The identified risks of AO were women (OR: 4.2, 95% CI: 3.8, 4.6), aged 50-59 years (OR: 5.6, 95% CI: 4.0, 7.7), Indians (OR: 3.0, 95% CI: 2.4, 3.8), housewives (OR: 1.4, 95% CI: 1.1, 1.7), subjects with primary education (OR: 1.3, 95% CI: 1.1, 1.5) and ever married (OR: 1.4, 95% CI: 1.2, 1.6). Being the largest population-based study on AO among Malaysians, these findings have important public health implications. There is an urgent need to revise public health policies and programmes aimed at prevention of abdominal obesity especially in the groups at risk