Risk factors of vitamin D deficiency and the effects of sunlight exposure and vitamin D supplementation on serum vitamin D level, adiponectin, cardiometabolic risk factors and metabolic syndrome among adults in Kelantan

In spite of abundant sunshine for cutaneous vitamin D (VD) synthesis, low levels of VD have been documented among Malaysian population. However, the effects of occupational sunlight exposure and monsoon seasons on VD are not well established. Besides, low VD levels has been associated with several non-bone or calcium-related outcomes including metabolic syndrome (MetS), which may mediated by adiponectin. This study was divided into two phases. Phase 1, a comparative crosssectional study was conducted to characterize the effect of occupational sunlight exposure and monsoon season on serum 25-hydroxyvitamin D (25(OH)D) and identify factors modifying the serum 25(OH)D levels. Besides, the relationship between 25(OH)D levels with high molecular weight (HMW) adiponectin and cardiometabolic risk factors were also observed. Phase 2, a quasi-experimental study was carried out for 12 weeks to evaluate the effects of moderate sunlight exposure (sunlight exposure group; 15 minutes sunlight exposure biweekly on face, arms, hands and feet; n=19), VD supplementation (VD supplement group, 50 000 IU cholecalciferol weekly, n=15] and placebo (placebo group, n=15) on serum 25(OH)D, HMW adiponectin and cardiometabolic risk factors in women with VD deficiency (serum 25(OH)D < 50 nmol/l). Both phases were carried out among Malay working adults in Kelantan from 2012 to 2015. Outcome measures comprises of anthropometric measurements (height, weight and waist circumference), body fat percentage and blood pressure assessment, fasting blood test (25(OH)D, HMW adiponectin, lipid profile, glucose, insulin and hs- CRP) and questionnaire (socio-demographic, medical history, sunlight exposure and sun protection use, physical activity assessment and VD intake). In phase 1, two-point data were collected in 138 outdoor and 143 indoor workers, first in non-monsoon (May-June 2012) and second in monsoon season (Jan-Feb 2013). Results of phase 1 study revealed that serum 25(OH)D levels were significantly higher in outdoor workers compared to indoor workers irrespective of season and sex (p<0.001). Furthermore, significant association between VD status and occupation was observed (p<0.001). Monsoonal differences of 25(OH)D was observed only in male outdoor workers (mean difference, MD = 10.39 nmol/l, p<0.001). However, in overall, no significant association was found between VD status and monsoon season (χ2(1)=0.076, p=0.783). Serum 25(OH)D level was directly predicted by hours of sunlight exposure (β=0.38, p=0.010) and inversely by sun protection score (β=-4.64, p=0.001), body mass index (β=-1.02, p=0.002), indoor occupation (β=-42.72, p<0.001) and female sex (β=-19.46, p<0.001). No significant relationship between VD with HMW adiponectin and cardiometabolic risk factors were found in this study (p>0.05). Considering the results of determinants of VD in Phase 1, female indoor workers with VD deficiency in both monsoon and non-monsoon seasons were recruited for phase 2 study. In phase 2, after 12 week of intervention, serum 25(OH)D increased significantly in sunlight exposure (MD = 14.27 nmol/l, p<0.001) and VD supplement group (MD = 14.30 nmol/l, p<0.001) but not in placebo group (MD = 1.63 nmol/l, p=0.067). Significant increase in HMW adiponectin was observed only in VD supplement group (MD=0.43 ng/ml, p=0.024). Among the MetS components, only glucose decreased significantly after 12 weeks of sunlight exposure (MD=-0.27 mmol/l, p<0.001) but no changes seen in the other groups. No significant changes were found in waist circumference, blood pressure, triglycerides and other cardiometabolic risk factors in all groups after 12 weeks. However, HDL-C was found increased significantly in all groups after the intervention (p<0.05). In conclusion, both moderate sunlight exposure and VD supplement interventions improved the VD levels, but the effects of VD on HMW adiponectin and cardiometabolic risk factors are still inconclusive

Nutritional status and physical activity of users and non-users of dietary supplements in Kota Kinabalu

The use of dietary supplements to improve nutritional status or health has become a trend and the increasing use of dietary supplements has also been reported. However, studies on dietary supplements in the context of food intake is limited in Kota Kinabalu. Here, we aimed to compare nutritional status and physical activity between users and non-user of dietary supplements. Crosssectional study was conducted in an area with a working women population in Kota Kinabalu, Sabah and IBM SPSS 26 was performed to analyze the data. A total of 276 participants involved in this study. Results of this study found that 32.2% were dietary supplement users and most of them took Vitamin C (27.9%) supplements. There were no significant differences between users and non-users in their anthropometry, dietary intake of calories, fat, carbohydrates, protein and iron before supplements were added in their food but intake of vitamin C, protein and calcium were more significant among users after supplement were added. Dietary supplement users also were more active compared to non-users. It is shown that users and non-users of dietary supplement varied in their physical activity and intake of certain nutrients. This provides more evidence of the importance of taking these factors into consideration when interpreting study participants’ self-reported dietary intake information

Counting Footsteps with a Pedometer to Improve HMW Adiponectin and Metabolic Syndrome among Young Female Adults in the United Arab Emirates

Introduction. Physical activity (PA) may improve cardiometabolic fitness and increase high-molecular-weight adiponectin (HMW-Adip). The pedometer is an effective, user-friendly device to monitor PA with the aim of improving health. This study examined how counting footsteps, using a pedometer, might affect HMW-Adip and MetS components among young females. Methods. Fifty-two females (21.43 ± 4.8 years) were divided into “normal” (BMI = 18–24.9 kg/m2) and “high” (BMI ≥ 25 kg/m2) BMI groups. Participants wore pedometers throughout the day for nine weeks. Pre-post intervention tests performed on anthropometric, biochemical, and nutrient intake variables were tested at p≤0.05. Results. Participants walked 7056 ± 1570 footsteps/day without a significant difference between normal (7488.49 ± 1098) and high (6739.18 ± 1793) BMI groups. After week 9, the normal BMI group improved significantly in BMI, body fat mass (BFM), and waist-hip ratio (WHR). Additionally, percent body fat, waist circumference (WC), and visceral fat area also reduced significantly in the high BMI group. A significant decrease in triglycerides (TG) (71.62 ± 29.22 vs. 62.50 ± 29.16 mg/dl, p=0.003) and insulin (21.7 ± 8.33 µU/l vs. 18.64 ± 8.25 µU/l, p=0.046) and increase in HMW-Adip (3.77 ± 0.46 vs. 3.80 ± 0.44 μg/ml, p=0.034) were recorded in the high BMI group. All participants exhibited significant inverse correlations between daily footsteps and BMI (r=−0.33,  p=0.017), BFM (r=−0.29,  p=0.037), WHR (r=−0.401,  p=0.003), and MetS score (r=−0.49,  p<0.001) and positive correlation with HMW-Adip (r=0.331,  p=0.017). A positive correlation with systolic (r=0.46,  p=0.011) and diastolic (r=0.39,  p=0.031) blood pressures and inverse correlation with the MetS score (r=−0.5,  p=0.005) were evident in the high BMI group. Conclusion. Counting footsteps using a pedometer is effective in improving MetS components (obesity, TG) and increasing HMW-Adip levels

Association of birth weight with risk of diabetes mellitus in adolescence and early adulthood: analysis of the Indonesian Family Life Survey

Purpose We aimed to investigate the association of birth weight with the risk of diabetes mellitus in adolescence and early adulthood in the Indonesian population. Methods This study analyzed data from the Indonesian Family Life Survey, a longitudinal study of the Indonesian population with repeated measurements at 3 time points (1997, 2007, and 2014). The subjects observed were children aged 0–59 months in 1997, who were 10–15 years old in 2007, and 17–22 years in 2014. We performed a generalized linear model to investigate the association between birth weight at baseline and the level of hemoglobin A1c (HbA1c) at the 2 follow-up periods. We adjusted the association for the characteristics of the children, parents, and household. Results The mean±standard deviation level of HbA1c was 7.35%±0.95% in 2007 and decreased to 5.30%±0.85% in 2014. The crude β (95% confidence interval [CI]) of the association between birth weight and HbA1c was 0.150 (-0.076, 0.377) in 2007 and 0.146 (-0.060, 0.351) in 2014. After adjustment for the sociodemographic characteristics of the children, parents, and confounding factors, the adjusted β (95% CI) was 1.12 (0.40–1.85) in 2007 and 0.92 (0.35–1.48) in 2014. The HbA1c of the parents, father’s employment status, percentage of food expenditure, and underweight were the covariates that had significant associations with HbA1c. Conclusions HbA1c level was higher in adolescence than in early adulthood. Birth weight was associated with HbA1c level in both periods. The HbA1c of the parents, father’s employment, percentage of food expenditure, and underweight partly explained the association between birth weight and the HbA1c level