Physiological Factors and Physical Activity Contribute to the Incidence of Type 2 Diabetes Mellitus in Indonesia

Type 2 diabetes mellitus (T2DM) is the sixth highest cause of death in Indonesia. Thus, it must be prevented and overcome with appropriate management. This study aimed to determine the contribution of physiological factors and physical activities to the incidence of T2DM. The study used a cohort retrospective design using secondary data from the Indonesian Family Life Survey (IFLS) from 2007 to 2014, which included a sample of 14,517 people involved for more than 20 years. Data analysis was performed using multiple logistic regressions. The results revealed a 3.8% incidence of T2DM in Indonesia. Record of hypertension risk increased the likelihood of T2DM by 1.7 times compared to without hypertension. A normal body mass index (BMI) increased the risk by 2.2 times, a higher BMI at 5.5 times, and BMI whose risk obesity was 7 times had greater likelihood of having T2DM compared with respondents with a thin BMI. After controlling for sex, age, marital status, record of parents’ DM, residence, employment, and education, results also indicated that people with less active physical activity were likely to have T2DM compared to those who were very active. Controlling blood pressure, maintaining a normal BMI, and increasing physical activity since adolescence can prevent T2DM

Factors Influencing Adolescents’ Use of Social Media for Nutrition Intervention

Adolescents are the largest population using social media in daily life, and their use is influenced by a wide range of factors. Hence, it is applied in nutrition intervention, which improved their health. However, some intervention lacks participation and engagement. This study identifies factors influencing adolescents’ social media use for nutrition interventions. An in-depth interview was conducted virtually for 30 to 60 minutes focusing on nutrition-related matters with 15 adolescents. Almost all of them were interested to participate in nutrition interventions on social media. User characteristics, environmental factors, and social media features were identified as the factors impacting them. Keywords: Adolescents; Social media; Nutrition; Intervention eISSN: 2398-4287 © 2023. The Authors. Published for AMER & cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), and cE-Bs (Centre for Environment-Behaviour Studies), College of Built Environment, Universiti Teknologi MARA, Malaysia. DOI: https://doi.org/10.21834/ebpj.v8i24.468

The characteristic of obesity intervention studies among school children in Malaysia: a scoping review

Obesity among school children has now reached an alarming level in most developing countries, including Malaysia. Thus, numerous strategies to curb the rising of obesity focusing on school children have been taking place. However, this issue management is complex, and a holistic approach is needed to address it comprehensively. This scoping review aimed to identify the characteristics of obesity interventions conducted among school children in Malaysia as a principal recommendation to develop a comprehensive obesity intervention. Arksey and O'Malley’s framework used to guide the scoping review process. Published articles on intervention studies conducted for school children in Malaysia from 2007 to 2020 retrieved based on keyword using the selected electronic and local databases. The NVivo 12 Plus software used to place findings in the systematic framework matric form and evidence tables. The final results reported in descriptive tables. Eighteen studies only reviewed among 3417 extracted articles. Thirteen aspects of the characteristics of the interventions identified. The influence of environmental intervention (family and school communities) on children lifestyle identified as a research gap. Combined environmental interventions and educational guides with technology application recognised as one of the potential components for future obesity intervention design amongst school children

Glycaemic index of four commercially available breads in Malaysia.

This study was carried out to determine the blood glucose response and glycaemic index (GI) values of four types of commercially available breads in Malaysia. Twelve healthy volunteers (six men, six women; body mass index, 21.9±1.6 kg/m 2; age, 22.9±1.7 years) participated in this study. The breads tested were multi-grains bread (M-Grains), wholemeal bread (WM), wholemeal bread with oatmeal (WM-Oat) and white bread (WB). The subjects were studied on seven different occasions (four tests for the tested breads and three repeated tests of the reference food) after an overnight fast. Capillary blood samples were taken immediately before (0 min) and 15, 30, 45, 60, 90 and 120 min after consumption of the test foods. The blood glucose response was obtained by calculating the incremental area under the curve. The GI values were determined according to the standardized methodology. Our results showed that the M-Grains and WM-Oat could be categorized as intermediate GI while the WM and WB breads were high GI foods, respectively. The GI of M-Grains (56±6.2) and WM-Oat (67±6.9) were significantly lower than the reference food (glucose; GI = 100) (P 0.05). Among the tested breads, the GI values of M-Grains and WM-Oat were significantly lower (P < 0.05) than those of WM and WB. There was no relationship between the dietary fibre content of the bread with the incremental area under the curve (r = 0.15, P = 0.15) or their GI values (r = 0.17, P = 0.12), indicating that the GI value of the test breads were unaffected by the fibre content of the breads. The result of this study will provide useful nutritional information for dieticians and the public alike who may prefer low-GI over high-GI foods

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

Dietetic practices in the management of childhood obesity in Malaysia

Introduction: Dietitians play an essential role in the management of childhood obesity and consistency in dietetic practices is required to ensure the effectiveness of treatment. This study assessed dietitians' current practices in the management of childhood obesity, compared the practices with nutrition practice guidelines used by dietitians in other countries and identified practice components for the development of nutrition practice guidelines for the management of childhood obesity in Malaysia. Methods: A cross-sectional study was conducted among 40 dietitians in 16 Ministry of Health hospitals and three teaching hospitals. Information on current dietetic practices in the management of childhood obesity was obtained through a mailed survey questionnaire. The practices included nutritional assessment, determination of energy requirement, dietary prescription and physical activity modification. Emails were sent to 31 dietetic associations in other countries to obtain information on practice guidelines used by dietitians. Results: Frequently used dietary intervention and physical activity modification approaches were high fibre diet (65%), low fat diet (40%), reduction of sedentary pursuits and screen times (67.5%) and an increase in duration of current physical activities (60%). In comparison to other dietetic practice guidelines, the current dietetic practices in Malaysia do not usually include waist circumference, biochemical and blood pressure data. However, similar to other guidelines, the current dietetic practices included low dietary fat, high fibre diet, decreased sedentary activity and increased physical activity level. Conclusions: The dietetic practices in the management of childhood obesity in Malaysia are diverse. A comprehensive nutrition practice guideline for management of childhood obesity is urgently needed for standardisation of dietetic practices in Malaysia

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

Penilaian media bercetak untuk pendidikan pemakanan kanak-kanak berlebihan berat badan dan obes

Media pendidikan bercetak merupakan saluran komunikasi yang utama dalam pendidikan kesihatan awam. Namun, kajian tempatan yang menilai penerimaan media pendidikan bercetak masih terhad di Malaysia. Maka, kajian ini dilakukan untuk menilai media pendidikan bercetak sedia ada yang mensasarkan obesiti di kalangan kanak-kanak untuk kegunaan dalam program pendidikan atau promosi pemakanan. Kajian ini melibatkan dua peringkat. Peringkat pertama merupakan tinjauan keperluan iaitu tinjauan terhadap media pendidikan bercetak sedia ada yang mensasarkan kanakkanak yang mengalami masalah berlebihan berat badan dan obes dan kajian rintis terhadap borang soal selidik yang dibentuk. Manakala peringkat kedua adalah penilaian penerimaan subjek kajian terhadap media pendidikan bercetak dan perubahan tahap pengetahuan mereka selepas membaca media pendidikan bercetak yang diberikan. Skala Likert digunakan dalam penilaian ini iaitu daripada 1 (sangat tidak memuaskan) hingga 5 (sangat memuaskan). Jumlah subjek dalam kajian ini adalah seramai 67 orang yang terdiri daripada golongan profesional dalam bidang pendidikan dan kesihatan (n = 7), subjek dewasa (n = 30) dan subjek kanak-kanak (n = 30). Di dalam kajian ini, subjek dewasa diberi satu buku kecil yang mengandungi maklumat berkenaan pencegahan dan pengurusan masalah obesiti di kalangan kanak-kanak seperti komplikasi masalah obesiti dan penyediaan makanan. Subjek kanak-kanak pula menerima satu buku kecil yang mengandungi maklumat berkenaan piramid makanan, kepentingan sarapan, aktiviti fi zikal dan sebagainya di samping satu poster yang mengandungi maklumat berkenaan pemilihan makanan sihat. Manakala golongan profesional menerima semua media pendidikan bercetak ini. Kajian ini mendapati penerimaan subjek terhadap isi kandungan, gambar, jadual dan rajah, warna, susun atur gambar, susun atur kandungan, bahasa dan saiz huruf bagi ketiga-tiga media pendidikan bercetak adalah pelbagai, iaitu daripada sangat tidak memuaskan hingga sangat memuaskan. Min skor penilaian keseluruhan terhadap buku kecil yang mensasarkan populasi dewasa adalah 3.9 ± 0.5 manakala min skor penilaian keseluruhan terhadap buku kecil yang mensasarkan populasi kanak-kanak adalah 4.3 ± 0.4 dan poster adalah 3.9 ± 0.9. Skor pengetahuan pemakanan golongan profesional meningkat dari 88.6 ± 11.2% kepada 95.5 ± 3.2% selepas membaca media tersebut. Skor pengetahuan pemakanan subjek dewasa juga meningkat secara signifi kan (p < 0.001) daripada 67.7 ± 13.6% kepada 84.8 ± 15.9%; bagi subjek kanak-kanak, skor pengetahuan pemakanan juga meningkat secara signifi kan (p < 0.001) daripada 65.3 ± 14.4% kepada 84.0 ± 11.4%. Kesimpulannya, media pendidikan bercetak sedia ada mendapat penerimaan yang baik dan dapat meningkatkan tahap pengetahuan kumpulan sasaran. Oleh itu, media pendidikan bercetak tersebut sesuai digunakan dalam mana-mana program pendidikan pemakanan yang berkaitan dengan obesiti kanak-kanak

Use of Instagram® to Educate Adolescents on Nutrition Labelling: A Feasibility Study in Selangor, Malaysia

This study was undertaken to assess the demand and acceptance of an Instagram-based nutrition labelling education (Info-Nutriteen®) among adolescents. In this quasi-experimental study, a series of educational messages was developed and was uploaded on Instagram for 12 weeks. Participants were recruited and randomized into the intervention group or control group. Feasibility was assessed through participants' demand and acceptance of the program. Changes in nutrition knowledge and Knowledge, Attitudes, and Practices (KAP) on nutrition labels were measured at pre- and post-intervention. A total of 125 participants completed the program. Overall, 92.7% of the participants reported positive acceptance towards Info-Nutriteen®. In terms of demand, they suggested using current and trending songs for the videos and bright colours for the info-graphics. The study showed good demand and acceptance of the Instagram based education for adolescents. The Info-Nutriteen® program also effective to improve their attitude and practice on nutrition labels. Thus, this approach is feasible. Nevertheless, Info-Nutriteen®should be improved further to enhance its impact on nutrition labels knowledge and usage among adolescents

Impak program fit, eat, active, training (F.E.A.T) terhadap status pemakanan dan aktiviti fizikal dalam kalangan dewasa berlebihan berat badan

Intervensi perubahan tingkah laku bagi penurunan berat badan didapati efektif dalam jangka masa yang pendek, namun keberkesanannya dalam jangka masa panjang masih menjadi persoalan. Objektif kajian ini adalah untuk menilai keberkesanan program F.E.A.T iaitu intervensi perubahan tingkah laku pemakanan sihat dan aktiviti fizikal bagi penurunan berat badan selama 36 minggu. Kajian quasi-ekperimental dalam kalangan dewasa berlebihan berat badan ini dijalankan di Melaka. Seramai 53 subjek (min umur 47.4±7.2 tahun) telah berjaya melengkapkan program yang dijalankan dalam tiga peringkat. Pada peringkat pertama (T1: minggu 1-12), kumpulan intervensi (n=28) telah mengikuti aktiviti program F.E.A.T, manakala kumpulan kawalan (n=25) tidak menerima intervensi tersebut. Peringkat kedua (T2: minggu 13-24), aktiviti diteruskan dan dipantau oleh kumpulan sokongan rakan sebaya. Kemampanan aktiviti pula diukur pada peringkat ketiga (T3: minggu 25-36). Keberkesanan program diukur berdasarkan perubahan pada pengambilan makanan, skor aktiviti fizikal, berat badan, indeks jisim tubuh (IJT), ukur lilit pinggang (ULP) dan peratus lemak tubuh pada T0 (pra-intervensi), T1, T2 dan T3. Semua parameter menunjukkan kesan interaksi (masa*kumpulan) yang signifikan kecuali bagi pengambilan tenaga. Kumpulan intervensi menunjukkan penurunan yang signifikan dari T0 hingga T3 bagi pengambilan tenaga (-14.3%), berat badan (-4.3%), IJT (-4.2%), ULP (-10.5%) dan peratus lemak tubuh (-3.6%). Manakala tahap aktiviti fizikal meningkat sebanyak 109.6% bagi kumpulan intervensi. Tiada perbezaan yang signifikan bagi semua parameter tersebut dalam kumpulan kawalan. Hasil kajian menunjukkan keberkesanan program F.E.A.T terhadap perubahan status pemakanan dan aktviti fizikal yang efektif bagi tempoh 36 minggu intervensi