Social and multimedia influence on endurance athletes’ preferred snack choices

Snacks are required for athletes to fuel their higher demand of energy. Meanwhile, social influences and multimedia can affect the athletes’ choices of snacks. Social influences are divided into three categories: Compliance (sports dietitian/nutritionist & medical officer), Conformity (friend) and Obedience (parent & coach), while multimedia refers to internet, magazines and newspaper. The objective of this study was to investigate the different sources of social influence and multimedia on athletes’ preferred snacks. Out of 26 snack choices, 3 most preferred snacks were chosen by 69 endurance athletes from the National Sports Institute (NSI) through a questionnaire. They are Popiah & Mixed Fruit Jelly, Chicken Salad and Egg & Cheese Sandwich. Out of the 6 choices of beverages, the top 3 preferred beverages were sports drinks, orange smoothie and apple smoothie. Social influence from parent (p = 0.041) has significant effect on the athlete’s most preferred snack choice, followed by influence from dietitian (p = 0.02) on their second preferred snack choice and lastly internet (p = 0.024), has its effect on the third preferred snack. Other social influences such as friends, medical officer and coach show no significance effect on the preferred snack choices. The parent factor also has significant effect on the most preferred beverage choices with p = 0.043. To conclude, parent influence is strongly related to both snack and beverage choices of the athletes, followed by dietitian and internet on the athlete’s preferred snack choices

Comparison of breastfeeding practice using deuterium oxide dose to mother technique with maternal recall breastfeeding practice among mothers in Klang Valley

The assessment of exclusive breastfeeding is important to invest the efforts to promote and support breastfeeding practices. Hence this study was carried out to compare breastfeeding practices among mothers using deuterium dose to mother technique with maternal recall breastfeeding practice. A total of 30 mother-infant pairs from a university hospital and government health clinics in Klang Valley participated and completed the study. Mother-infant pairs were recruited into the study when infants were aged 3 months ± 1 week. Anthropometric measurements (height, weight, waist circumference for mother; length and weight for infant) were carried out. Socio-demographic questionnaire was self-administered while breastfeeding practices were interview administered using maternal recall breastfeeding practice questionnaire (MRBF). This was followed by baseline saliva collection of mother-infant pairs before dose and 6 days after mothers were given 30 ± 0.01 g of D2O. The post dose saliva sample of mother-infant pairs were collected 6 times at day 1,2,3,4,13 and 14.The results showed that majority of mothers (57%) were university graduates but majority were stay at home mothers. Meanwhile, mothers had BMI with mean 25 ± 4 kg/m2. The results from MRBF questionnaire showed that all mothers were practicing exclusive breastfeeding and their infant never received any water sources other than their breast milk. However, the deuterium dose to mother technique revealed only 3% of mothers were actually practicing exclusive breastfeeding. From the isotopic data, the calculated mean intake of milk was 721 ± 243 g/day while the mean non-milk oral intake of 122 ± 22 g/ day. In contrast exclusive breastfeeding infants received only 10 g/day non milk oral intake, demonstrating exclusive breastfeeding practice of mothers. There were different breastfeeding practice reported from mother using deuterium oxide dose to mother technique with maternal recall breastfeeding practice

Juara Sihat™: study design of a school-based childhood obesity nutrition education programme in Kuala Lumpur, Malaysia

The global prevalence of overweight and obesity among children has increased rapidly in the recent decades, including in Malaysia. Thus, development of effective interventions to prevent childhood obesity in Malaysia is urgently needed. This paper describes the study design of a 12-week multi-component, school-based nutrition education programme aimed at managing childhood obesity. The objective of Juara Sihat™ is to determine the effectiveness of a nutrition education programme in improving anthropometric status, knowledge, attitude and practice (KAP) of nutrition, eating habits and physical activity level among overweight and obese children. This quasi-experimental study involves two primary schools in Kuala Lumpur with similar demographic characteristics. Eligibility criteria of research participants are overweight and obese children aged 9 to 11 years. The main components of the Juara Sihat™ intervention are nutrition education classes on healthy eating and active lifestyle; physical activity sessions; and active involvements of parents and teachers. The control school does not receive any interventions. The primary outcome is BMI-for-age z-score, while other outcomes include waist circumference, body fat percentage, KAP of nutrition score, dietary intake, physical activity level, sedentary behaviour and biochemical profile. Outcome measures will be assessed at three intervals: baseline, post-intervention 1 (3-month follow-up), and post-intervention 2 (6-month follow-up). The Juara Sihat™ programme represents a promising approach to examining the effectiveness of a school-based childhood obesity intervention with strong empowerment of Parents’ and Teachers’ Association (PTA). We anticipate that this study may provide insights towards the development of more effective strategies in formulating childhood obesity interventions

A systematic review on the effectiveness of enteral immunonutrition (EIN) on pre- and post-operative outcomes in gastric cancer patients

Gastric cancer is one of the most common upper gastrointestinal malignancies. To date, enteral immunonutrition (EIN) has gained increasing attention as it is found to effectively enhance the host’s immunity and improve the metabolic status of gastric cancer patients undergoing gastrectomy. The health-boosting effects of EIN are believed to originate from a number of nutritional elements such as omega-3 fatty acids, glutamine, arginine and nucleic acid precursors that help reduce the incidences of post-operative complications and shorten the length of hospital stay among the aforementioned patients. However, little was known about the consistency of health-boosting benefits conferred by EIN. Hence, according to PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) protocol, this systematic review was carried out using nine meticulously and specifically selected full-length articles focusing on the pre- and post-operative effects of EIN including physical, biochemical, clinical and immunological outcomes on gastric cancer patients. Among the selected articles, seven of them focused on post-operative EIN while the remaining two concentrated on pre-operative EIN. In most of the selected studies, more than one immunonutritional components (arginine, glutamine, omega-3 fatty acid, RNA) were integrated. Patients receiving EIN showed significantly improved immunity, for example, increase in CD4+ T and NK cell counts that are responsible for fighting pathogens. In addition to that, individuals receiving EIN also showed increased levels of inflammatory biomarkers in their sera such as pre-albumin and transferrin. This results in shorter period of post-operative hospital stay that in turn permits progressive healing process and increases the survival rate due to minimal frequency of post-operative infections. Conclusively, our systematic review acknowledges that regardless of the initiation timing (pre-operative or post-operative) of immunonutrition, EIN can improve the overall health status of gastric cancer patients including infection complications and the length of hospital stay through regulation of immune responses

Metabolic syndrome, abnormal glucose tolerance and high sensitivity-C-reactive protein among women with a history of Gestational Diabetes Mellitus

Background: Gestational Diabetes Mellitus (GDM) is a risk factor for diabetes and cardiovascular diseases. Early detection of cardio-metabolic risks is recommended for management. This study evaluated the associations between Metabolic Syndrome (MetS), abnormal glucose tolerance and cardiovascular risk factors in Malaysian women with prior GDM. Method: Seventy-seven, non-diabetic women post-GDM, aged 20-40 years (mean BMI: 26.4 ± 4.6kg/m2) with high type 2 diabetes risks, were evaluated at a median of four months postpartum. Their anthropometric and biochemical measurements were obtained. Results: The overall prevalence of MetS and dysglycaemia were 22% and 29% respectively. Dysglycaemic was predominantly impaired glucose tolerance (IGT: 77%).MetS was higher among dysglycaemic subjects although also detected in 13% of normo glycaemic subjects. Eighty percent of IGT subjects did not have MetS. Sixty-eight percent of subjects had intermediate or high CVD risks (hsCRP>1mg/L). hscRP increased with obesity and was not associated with glycaemic status. Infant birth weight, maternal age and triglycerides were independent predictors of dysglycaemia (p<0.05). Conclusion: Despite the low prevalence of MetS, elevated levels of hsCRP among these women with prior- GDM was highly prevalent. Normoglycaemic subjects with MetS demonstrated intermediate to high risk hsCRP levels. The findings also emphasize the importance of performing OGTT mainly in older post-GDM women, with higher triglycerides and infants who are large for gestational age

Malay version of the mhealth app usability Questionnaire (M-MAUQ): translation, adaptation, and validation study

Background: Mobile health (mHealth) apps play an important role in delivering education, providing advice on treatment, and monitoring patients’ health. Good usability of mHealth apps is essential to achieve the objectives of mHealth apps efficiently. To date, there are questionnaires available to assess the general system usability but not explicitly tailored to precisely assess the usability of mHealth apps. Hence, the mHealth App Usability Questionnaire (MAUQ) was developed with 4 versions according to the type of app (interactive or standalone) and according to the target user (patient or provider). Standalone MAUQ for patients comprises 3 subscales, which are ease of use, interface and satisfaction, and usefulness. Objective: This study aimed to translate and validate the English version of MAUQ (standalone for patients) into a Malay version of MAUQ (M-MAUQ) for mHealth app research and usage in future in Malaysia. Methods: Forward and backward translation and harmonization of M-MAUQ were conducted by Malay native speakers who also spoke English as their second language. The process began with a forward translation by 2 independent translators followed by harmonization to produce an initial translated version of M-MAUQ. Next, the forward translation was continued by another 2 translators who had never seen the original MAUQ. Lastly, harmonization was conducted among the committee members to resolve any ambiguity and inconsistency in the words and sentences of the items derived with the prefinal adapted questionnaire. Subsequently, content and face validations were performed with 10 experts and 10 target users, respectively. Modified kappa statistic was used to determine the interrater agreement among the raters. The reliability of the M-MAUQ was assessed by 51 healthy young adult mobile phone users. Participants needed to install the MyFitnessPal app and use it for 2 days for familiarization before completing the designated task and answer the M-MAUQ. The MyFitnessPal app was selected because it is one among the most popular installed mHealth apps globally available for iPhone and Android users and represents a standalone mHealth app. Results: The content validity index for the relevancy and clarity of M-MAUQ were determined to be 0.983 and 0.944, respectively, which indicated good relevancy and clarity. The face validity index for understandability was 0.961, which indicated that users understood the M-MAUQ. The kappa statistic for every item in M-MAUQ indicated excellent agreement between the raters (

Nutritional Assessment of Pre-School Children in Rural Villages of the Family Dynamics, Lifestyles and Nutrition Study (1997-2001) II. Prevalence of Undernutrition and Relationship to Household Socio-Economic Indicators

This paper describes the nutritional status of pre-school children and analyzes its relationship to various household socio-economic indicators. Padi, rubber and fishing villages from the Functional Groups Study (1992-1996) were selected for having a high prevalence of child undernutrition, and all children between the ages of 12 and 72 months were measured for their weights and heights in April-May 1998. The NCHS reference values were used to calculate z-scores, which were categorised according to WHO (1983) recommendations. Children between minus 2SD and minus 1SD of reference median were classified as mildly malnourished. Prevalence of underweight was higher (30.5%) than stunting (22.3%), while wasting was only 9.7%. Padi villages had the highest prevalence of undernutrition, followed by fishing, and then rubber villages. Mean household incomes were found to be significantly lower for children with worse nutritional status, and undernutrition was higher in households below the poverty line income. The odds ratios for having stunted children were significantly higher for households whose heads were agricultural own-account workers (OR 3.66, 95% CI = 1.37-9.79), agricultural waged workers (OR 2.75, 95% CI = 1.06-7.10), and non-agricultural manual workers (OR 2.49, 95% CI = 1.04-6.00) compared to non-manual workers. Various household socio-economic indicators showed significantly higher odds ratios for underweight, stunting and wasting. After adjusting for confounding effects by logistic regression analysis, however, only mother’s education was found to be a significant predictor for stunting, while poverty level and access to piped water supply were significant predictors for both underweight and stunting. Households without livestock were significant predictors for wasting. Thus, this study identified specific socio-economic factors that should be prioritized for policy and research towards the amelioration of childhood malnutrition in rural areas

iDietScoreTM: Meal recommender system for athletes and active individuals

Individualized meal planning is a nutrition counseling strategy that focuses on improving food behavior changes. In the sports setting, the number of experts who are sports dietitians or nutritionists (SD/SN) is small in number, and yet the demand for creating meal planning for a vast number of athletes often cannot be met. Although some food recommender system had been proposed to provide healthy menu planning for the general population, no similar solution focused on the athlete's needs. In this study, the iDietScoreTM architecture was proposed to give athletes and active individuals virtual individualized meal planning based on their profile, includes energy and macronutrients requirement, sports category, age group, training cycles, training time and individual food preferences. Knowledge acquisition on the expert domain (the SN) was conducted prior to the system design through a semistructured interview to understand meal planning activities' workflow. The architecture comprises: (1) iDietScoreTM web for SN/SD, (2) mobile application for athletes and active individuals and (3) expert system. SN/SD used the iDietScoreTM web to develop a meal plan and initiate the compilation meal plan database for further use in the expert system. The user used iDietScoreTM mobile app to receive the virtual individualized meal plan. An inference-based expert system was applied in the current study to generate the meal plan recommendation and meal reconstruction for the user. Further research is necessary to evaluate the prototype

Penentuan kandungan makronutrien dalam tiga jenis kuih manis tempatan: pengiraan berbanding analisis

Kajian ini bertujuan untuk membandingkan kandungan makronutrien dalam tiga jenis kuih manis tempatan iaitu kuih seri muka (SM), kuih bakar (B) dan kuih wajik (W) yang mana resepinya telah dibentuk secara pengiraan nutrien yang berdasarkan Jadual Komposisi Makanan Malaysia (JKMMM) dengan kaedah analisis secara proksimat. Penentuan kandungan makronutrien secara spesifik ditentukan menggunakan kaedah analisis proksimat manakala penentuan tenaga dan karbohidrat total dijalankan melalui pengiraan. Hasil analisis proksimat menunjukkan W mengandungi karbohidrat total tertinggi (61.5 ± 1.6%) secara signifikan (p < 0.05), berbanding B (39.3 ± 1.5%) dan SM (38.7 ± 1.5%). SM mempunyai kandungan air yang lebih tinggi (46.7 ± 1.6%) secara signifikan (p < 0.05) berbanding B (42.5 ± 6.6 %) dan W (30.2 ± 0.4%). B mengandungi kandungan protein tertinggi (6.1 ± 0.9%) secara signifikan berbanding dengan W (3.0 ± 0.3%). Tiada perbezaan yang signifikan bagi kandungan lemak di antara B (12.8 ± 1.8%), SM (9.9 ± 0.2%) dan W (8.2 ± 2.6%). Jumlah kalori untuk W adalah tertinggi (332 kcal/100g) diikuti oleh B (299 kcal/100g) dan SM (262 kcal/100g). Secara umumnya, nilai kandungan makronutrien dari analisis proksimat adalah lebih rendah berbanding secara pengiraan kandungan makronutrien menggunakan JKMMM. Ini disebabkan pengiraan berdasarkan JKMMM adalah berdasarkan bahan mentah manakala analisis proksimat berdasarkan sampel kuih yang telah disediakan