The association of metabolic syndrome risk factors with serum high-molecular weight adiponectin and urinary metabolites among the orang asli in Malaysia

Orang Asli (OA) are the indigenous people of Peninsular Malaysia. Overall, there are 18 subtribes of OA which are categorised under three main tribes namely Senoi, Proto Malay, and the Negrito. The association of metabolic syndrome (MetS) risk factors with serum high-molecular weight (HMW) adiponectin and urinary metabolites among OA tribes are scantly reported. The purpose of this study was to determine the association of MetS risk factors with serum HMW adiponectin and urinary metabolites among the OA population in Peninsular Malaysia. This crosssectional study was conducted according to the geographical locations of OA subtribes namely Che Wong, Kensiu, Semai, Orang Kanaq, Lanoh, and Bateq by simple random sampling method. The purposive and snow-ball sampling methods were used to select 185 respondents aged 18 years and above. The respondents were measured for their weight, height, waist circumference (WC), and blood pressure. Overnight fasting venous blood samples were analysed for lipid profiles, plasma glucose, and HMW adiponectin while urine samples were analysed for metabolite profiles using metabolomics approach. The overall prevalence of MetS was 29.7% (55/185). MetS prevalence was significantly higher in female (36.2%) compared to male (21.3%) respondents. MetS was also higher among the suburban Orang Kanaq (81.8%) and Kensiu (36.4%) subtribes and lower among rural Semai (23.8%) andBateq (8.0%) subtribes (p<0.001). Females had significantly higher rates of high WC (45.7% vs. 2.5%, p<0.001) and low HDL-C (69.5% vs. 31.3%, p<0.001) compared to males. Area under ROC curve (AUROC) analysis showed that 22 metabolites were determined as potential urinary metabolite biomarkers of MetS with area under the curve (AUC) of at least 0.7. Multiple linear regression models revealed that HMW adiponectin were negatively associated with WC (β=-0.07; p=0.001) and sex (β=-1.53; p<0.001) but positively associated with age (β=0.05; p=0.004). Besides, urinary 3-ethyl-3-methyl-tridecanoic acid (C16H32O2) level was positively associated with systolic blood pressure (β=0.06; p=0.031). This urinary metabolite was not associated with HMW adiponectin in multiple linear regression models but it was correlated with HMW adiponectin in Spearman correlation analysis. This study could provide clues and additional insight into the pathogenic mechanism of MetS among OA population

Validity and Reproducibility of Malaysian Food Frequency Questionnaire for Dietary Intake Related to Colorectal Cancer

This study aims to report on the validity and reproducibility of a 142-food item Food Frequency Questionnaire (FFQ) for dietary factors related to colorectal cancer among Malaysians. Population aged 30 to 70 years from two cities of Peninsular Malaysia were recruited through voluntary participation. A semi-quantitative FFQ was modified from an established FFQ used in the national survey. It includes specific questions to measure the consumption of food sources related to colorectal cancer development. FFQ was administered two times in two weeks to evaluate reproducibility (FFQ1 and FFQ2). Then the validity was assessed by comparing FFQ against the 3-day Food Record method (FR). A total of 100 respondents (mean age 50.6 years) provided data for both validity and reproducibility. The FFQ had significantly higher estimates of most nutrients and food groups’ intake than the FR. The Spearman correlation showed moderate agreement between FFQ and FR while moderate to strong correlation between FFQs. The limit of agreement between both methods using Bland Altman plot was acceptable or both validity and reproducibility. The classification into the same and adjacent quartiles was between 62 to 75% for validity and 77 to 89% for reproducibility assessment. Overall, the validity was satisfactory and reproducibility of the FFQ was good for estimating absolute nutrient and food group intakes. Hence, the FFQ could be used as a valid tool for assessing dietary intake among Malaysians to study dietaryfactors related to colorectal cancer risk

Dietary patterns associated with colorectal cancer risk in the Malaysian population: a case–control study with exploratory factor and regression analysis

Abstract Background Studies on the relationship between diet and colorectal cancer (CRC) risk using single food or nutrient approach are widely conducted as opposed to dietary pattern approach. Therefore, this study aimed to determine the major dietary patterns and their association with CRC risk among Malaysians. Methods Patients aged between 18 and 80 years old from two teaching hospitals in Peninsular Malaysia were recruited through purposive sampling. Socio-demographic information and anthropometry data were assessed before the colonoscopy procedure, and dietary intake was also recorded using a validated semi-quantitative food frequency questionnaire (FFQ). Cases were those patients having histopathologically proven CRC, while controls were those without. Results Four major dietary patterns were identified: the allergenic diet, plant-based diet, processed diet, and energy-dense diet pattern. After adjusting for potential covariates, the processed diet pattern was consistently associated with CRC (OR = 3.45; 95% CI = 1.25–9.52; P = 0.017) while the plant-based diet, energy-dense diet, and allergenic diet were not associated with CRC risk. Conclusions The processed diet pattern attributed to a diet high in confectionaries and fast foods was associated with an increased risk of CRC in the Malaysian population. In order to give prevention measures through lifestyle change, more research could be done on the effect of food patterns on faecal microbiota associated with CRC

Dietary patterns associated with colorectal cancer risk in the Malaysian population: a case–control study with exploratory factor and regression analysis

Background: Studies on the relationship between diet and colorectal cancer (CRC) risk using single food or nutrient approach are widely conducted as opposed to dietary pattern approach. Therefore, this study aimed to determine the major dietary patterns and their association with CRC risk among Malaysians. Methods: Patients aged between 18 and 80 years old from two teaching hospitals in Peninsular Malaysia were recruited through purposive sampling. Socio-demographic information and anthropometry data were assessed before the colonoscopy procedure, and dietary intake was also recorded using a validated semi-quantitative food frequency questionnaire (FFQ). Cases were those patients having histopathologically proven CRC, while controls were those without. Results: Four major dietary patterns were identified: the allergenic diet, plant-based diet, processed diet, and energy-dense diet pattern. After adjusting for potential covariates, the processed diet pattern was consistently associated with CRC (OR = 3.45; 95% CI = 1.25-9.52; P = 0.017) while the plant-based diet, energy-dense diet, and allergenic diet were not associated with CRC risk. Conclusions: The processed diet pattern attributed to a diet high in confectionaries and fast foods was associated with an increased risk of CRC in the Malaysian population. In order to give prevention measures through lifestyle change, more research could be done on the effect of food patterns on faecal microbiota associated with CRC

Dietary Inflammatory Index, Obesity, and the Incidence of Colorectal Cancer: Findings from a Hospital-Based Case-Control Study in Malaysia

Obesity-mediated inflammation represents a key connection between the intake of foods with high inflammatory potential and colorectal cancer (CRC) risk. We aimed to explore the association between energy-adjusted dietary inflammatory index (E-DII) in relation to CRC risk in both obese and non-obese subjects. This study included 99 histopathologically confirmed CRC cases, 73 colonic polyps cases, and 141 healthy controls from tertiary medical centres in both urban and suburban areas in Peninsular Malaysia. The subjects were categorised into body mass index (BMI) < 25 kg/m2 and BMI ≥ 25 kg/m2 groups. E-DII scores were computed based on dietary intake assessed using a validated food frequency questionnaire (FFQ). Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs), adjusted for potential cofounders. The mean dietary energy intake and mean BMI values of the subjects tended to increase as the E-DII scores increased (p for trend < 0.001). E-DII was significantly related to CRC risk only in obese subjects (OR = 1.45; 95% CI = 1.30-1.77; p < 0.001 for trend). Stratified analyses of risk factors showed significant associations between E-DII and CRC risk by age group (p for interaction = 0.030), smoking status (p for interaction = 0.043), and anthropometric indices for both males and females (p for interaction < 0.001) in the most pro-inflammatory E-DII quartile vs. the lowest E-DII quartile. Overall, pro-inflammatory diets were associated with an increased incidence of CRC in the Malaysian population, particularly in obese subjects

Increased risks of cardiovascular diseases and insulin resistance among the Orang Asli in Peninsular Malaysia

Abstract Background Despite the strategic development plan by the authorities for the Orang Asli, there are six subtribes of which their population numbers are small (less than 700). These minorities were not included in most of the health related studies published thus far. A comprehensive physiological and biomedical updates on these small subtribes in comparison to the larger subtribes and the urban Malay population is timely and important to help provide appropriate measures to prevent further reduction in the numbers of the Orang Asli. Methods A total of 191 Orang Asli from different villages in Peninsular Malaysia and 115 healthy urban Malays were recruited. Medical examinations and biochemical analyses were conducted. Framingham risk scores were determined. Data was analyzed using IBM SPSS Statistics, Version 20.0. Results A higher percentage of the Orang Asli showed high insulin levels and hsCRP compared to the healthy Malays denoting possible risk of insulin resistance. High incidences of low HDL-c levels were observed in all the Orang Asli from the six subtribes but none was detected among the urban Malays. A higher percentage of inlanders (21.1 % of the males and 4.2 % of the females) were categorized to have high Framingham Risk Score. Conclusions Orang Asli staying both in the inlands and peripheries are predisposed to cardiovascular diseases and insulin resistance diabetes mellitus. The perception of Orang Asli being healthier than the urban people no longer holds. We believed that this information is important to the relevant parties in strategizing a healthier community of the Orang Asli to avoid the vanishing of the vulnerable group(s)