Facilitators and Barriers to Implementing Healthy School Canteen Intervention among Malaysian Adolescents:A Qualitative Study

This study evaluated implementing a school-based intervention to promote healthier dietary habits in the school environment among Malaysian adolescents using qualitative methods. This qualitative study was conducted in four secondary schools in Perak and Selangor (two urban and two rural schools) that received the intervention (either training or training and food subsidy). A total of eight focus groups (68 students aged 15 years old) and 16 in-depth interviews were conducted with canteen operators, school convenience shop operators, school teachers and school principals in each school. Thematic analysis was used to analyse the qualitative data to identify suitable themes. We found several initiatives and changes by the schools’ stakeholders to change to a healthy school canteen programme. The stakeholders also noticed the students’ food preferences that influence healthy food intake in canteens and convenience shops. The food vendors and school administrators also found that subsidising healthy meals might encourage healthy eating. Among barriers to implementing healthy school initiatives were the student’s perception of healthy food and their eating habits, which also affect the food vendors’ profit if they want to implement a healthy canteen. The school-based intervention has the potential to promotes healthier eating among school adolescents. Continuous training and monitoring of canteen operators and convenience shops are needed, including building partnerships and educating the students on healthy eating to cultivate healthy eating habits

High-intensity interval training improves physical performance without C-reactive protein (CRP) level alteration in overweight sedentary women

A sedentary lifestyle is associated with an unhealthy diet and lack of physical activity. This study aimed to analyze the effect of high-intensity interval training (HIIT) on changes in VO2max and C-reactive protein (CRP) levels in overweight young adult women with a sedentary lifestyle. The subjects included 20 women who were 21–30 years old and divided into 2 groups, a treatment group (performed HIIT) and a control group. Physical exercise (bicycle) included an intensity of 90% of the maximum heart rate (HRmax) with intervals. The exercise was carried out by pedaling an ergocycle for 10 s at a speed of 100 rpm and 50 s at a speed of 50 rpm intermittently for a total of 20 min. Exercise was performed 3×/week or 8 sessions in 3 weeks. The measured variables included VO2max and CRP level. These were taken before (pre) and after (post) treatment. VO2max was measured by the Astrand–Rhyming Test with a bicycle ergometer, and CRP was analyzed using the ELISA method. In addition, the changes in VO2max and CRP levels were also calculated. These results showed that the VO2max after treatment with HIIT (35.2±2.12 ml/kg/min) was significantly higher (p<0.05) compared to the control (28.9±2.58 ml/kg/min). The CRP levels (ng/mL) in the control was increased, and it tended to decrease with HIIT; however, this difference was not significant (p≥0.05). This study concludes that bicycling HIIT can improve the VO2max and decrease the serum CRP level in overweight young adult women who lead a sedentary lifestyle

Cardiometabolic Risk Factors and Physical Activity Patterns Maximizing Fitness and Minimizing Fatness Variation in Malaysian Adolescents:A Novel Application of Reduced Rank Regression

Patterns of physical activity (PA) that optimize both fitness and fatness may better predict cardiometabolic health. Reduced rank regression (RRR) was applied to identify combinations of the type (e.g., football vs. skipping), location and timing of activity, explaining variation in cardiorespiratory fitness (CRF) and Body Mass Index (BMI). Multivariable regressions estimated longitudinal associations of PA pattern scores with cardiometabolic health in n = 579 adolescents aged 13–17 years from the Malaysian Health and Adolescent Longitudinal Research Team study. PA pattern scores in boys were associated with higher fitness (r = 0.3) and lower fatness (r = −0.3); however, in girls, pattern scores were only associated with higher fitness (r = 0.4) (fatness, r = −0.1). Pattern scores changed by β = −0.01 (95% confidence interval (CI) −0.04, 0.03) and β = −0.08 (95% CI −0.1, −0.06) per year from 13 to 17 years in boys and girls respectively. Higher CRF and lower BMI were associated with better cardiometabolic health at 17 years, but PA pattern scores were not in either cross-sectional or longitudinal models. RRR identified sex-specific PA patterns associated with fitness and fatness but the total variation they explained was small. PA pattern scores changed little through adolescence, which may explain the limited evidence on health associations. Objective PA measurement may improve RRR for identifying optimal PA patterns for cardiometabolic health. © 2019 by the authors. Licensee MDPI, Basel, Switzerland

Effect of platelet-rich plasma treatment on antioxidant enzymes’ activity following hamstring injury among Malaysian athletes

The objective of the present preliminary study was to investigate the effect of platelet-rich plasma (PRP) treatment alongside rehabilitation programme compared with rehabilitation programme alone on antioxidant enzymes’ (superoxide dismutase, SOD; catalase, CAT) activity and time to return to play (RTP) following hamstring injury among Malaysian athletes. Participants diagnosed with grade-2 acute hamstring injury (n=10) were randomised into 2 groups of PRP treatment and rehabilitation programme (PRP-T) and rehabilitation programme alone (CON). Blood samples were collected at baseline and 2 fortnightly (week-2, W2; week-4, W4) for the biochemical assessments. Participants were certified to have recovered upon fulfilling RTP criteria. PRP-T group showed a significantly lower CAT activity compared to CON group (47.55% lower at W2, 37% lower at W4, p<0.05), while there was no significant difference in SOD activity between the groups. Although PRP-T group benefited from an earlier (~15 days) time to RTP compared to the CON group, no statistically significant difference was noted; however, the effect size was large (Cohen’s d=0.9). These findings suggested that PRP treatment alongside rehabilitation potentially reduces the degree of secondary tissue damage and facilitates muscle recovery through regulation of antioxidant enzymes, which subsequently hastens time to RTP. Athletes and coaches could consider PRP as viable treatment for hamstring injury

Musculoskeletal Corticosteroid Injection during COVID-19 Pandemic in Sabah: Is It Safe?

Musculoskeletal corticosteroid injection is commonly used as an adjunct to help patients in pain management. In this current COVID-19 pandemic, many clinicians would differ from this treatment as steroid is considered an immunosuppressive drug and could risk the patient of developing severe adverse effects if contracting COVID-19. This is a retrospective study based in Sabah, Malaysia, examining the prevalence of COVID-19 infection following musculoskeletal corticosteroid injection from 1 December 2019 until 30 June 2020 in the sports medicine clinic and the orthopedic clinic. Patients who received musculoskeletal corticosteroid injection were called by telephone and asked about visits to the emergency department or government health clinic for influenza-like illness symptoms or severe acute respiratory infection that would require screening of COVID-19. Thirty-five patients who responded to the call were included, with mean ages of 47.9 years ± 15.1. 52% were male respondents, while 48% were female. 25% of them were diabetics, and 2.9% of them had a history of lymphoproliferative disorders. The mean pain score before injection was 6.74 ± 1.03 and after injection pain was 2.27 ± 1.63. In this study, there were 11.4% (n = 4) with minor complications of steroid injection, that is, skin discoloration. Nonetheless, there were no severe complications due to corticosteroids reported. There were no reported cases of COVID-19 among the respondents following corticosteroid injection. Musculoskeletal pain would affect a person’s well-being and activities; thus, its management requires that careful consideration with risk-benefit analysis be made before administering musculoskeletal corticosteroid injection during COVID-19 pandemic

Effectiveness of a Group Support Lifestyle Modification (GSLiM) Programme among Obese Adults in Workplace: A Randomised Controlled Trial

<div><p>Background</p><p>There was an increasing trend in the prevalence of obesity and its comorbidities over the past decades in Malaysia. Effective intervention for obesity remains limited. This study aimed to compare the effectiveness of a group based lifestyle modification programme amongst obese individuals with an existing dietary counseling programme.</p><p>Methods</p><p>We recruited one hundred and ninety four overweight and obese (BMI>27.5 kg/m2) employees from a local university. They were randomly allocated to either Group Support Lifestyle Modification (GSLiM) (intervention)(n = 97) or dietary counseling (comparison)(n = 97). The GSLIM activities included self monitoring, cognitive-behaviour sessions, exercise as well as dietary change advocacy, which were conducted through seminars and group sessions over 24 weeks. The comparison group was given dietary counselling once in 12 weeks. Both groups were followed up for additional 12 weeks to check for intervention effect sustenance. Anthropometric and biochemical parameters were measured at baseline, 12, 24 and 36 weeks; while dietary intake, physical activities, psychological measures and quality of life measured at baseline, 24 and 36 weeks. Data analysis was conducted using ANOVA repeated measures with intention to treat principle.</p><p>Results</p><p>The participants were predominantly women with mean (standard deviation) age of 40.5 (9.3) years. A total of 19.6% of the participants in GSLiM achieved 6% weight loss compared to 4.1% in the comparison group (Risk Ratio 4.75; 95% CI: 1.68, 13.45). At 24 weeks, the retention rate was 83.5% for GSLiM and 82.5% for comparison group. GSLiM participants also achieved significant improvement in total weight self-efficacy score, negative emotions and physical discomfort subscales, MDPSS friend subscale and all domains in quality of life. Participants in the comparison group experienced reduction in negative self-thoughts.</p><p>Conclusion</p><p>The GSLiM programme proved to be more effective in achieving targeted weight loss, improving weight self-efficacy, friend social support, and quality of life compared to dietary counseling.</p><p>Trial Registration</p><p>Iranian Registry of Clinical Trials <a href="http://www.irct.ir/IRCT201104056127N1" target="_blank">IRCT201104056127N1</a></p></div

Vitamin D and Calcium Intakes, Physical Activity, and Calcaneus BMC among School-Going 13-Year Old Malaysian Adolescents

Background: Dietary calcium and vitamin D are essential for bone development. Apart from diet, physical activity may potentially improve and sustain bone health. Objective: To investigate the relationship between the dietary intake of calcium and vitamin D, physical activity, and bone mineral content (BMC) in 13-year-old Malaysian adolescents. Design: Cross-sectional. Setting: Selected public secondary schools from the central and northern regions of Peninsular Malaysia. Participants: The subjects were from the Malaysian Health and Adolescents Longitudinal Research Team Cohort study (MyHeARTs). Methods: The data included seven-day diet histories, anthropometric measurements, and the BMC of calcaneal bone using a portable broadband ultrasound bone densitometer. Nutritionist Pro software was used to calculate the dietary calcium and vitamin D intakes from the diet histories, based on the Nutrient Composition of Malaysian Food Database guidance for the dietary calcium intake and the Singapore Energy and Nutrient Composition of Food Database for vitamin D intake. Results: A total of 289 adolescents (65.7% females) were recruited. The average dietary intakes of calcium and vitamin D were 377 ± 12 mg/day and 2.51 ± 0.12 µg/day, respectively, with the majority of subjects failing to meet the Recommended Nutrient Intake (RNI) of Malaysia for dietary calcium and vitamin D. All the subjects had a normal Z-score for the BMC (−2.00 or higher) with a mean of 0.55 ± 0.01. From the statistical analysis of the factors contributing to BMC, it was found that for those subjects with a higher intake of vitamin D, a higher combination of the intake of vitamin D and calcium resulted in significantly higher BMC quartiles. The regression analysis showed that the BMC might have been influenced by the vitamin D intake. Conclusions: A combination of the intake of vitamin D and calcium is positively associated with the BMC