Dietary patterns and its associations with adipokines (adiponectin and leptin) among adults: a narrative review

To compile and analyse existing scientific evidence regarding the association of dietary patterns with adiponectin and leptin. Medline and PubMed electronic databases were searched for articles related to the association of dietary patterns with adiponectin and leptin from 2005 to 2015. Only full text articles using English as a language of publication were included. Studies were limited to the use of food frequency questionnaires in assessing dietary intake, factor analysis using principal component analysis, cluster analysis or reduced rank regression method in determining dietary pattern. A total of six relevant studies involving a total of 6467 subjects (47% men and 53% women) met the inclusion criteria from 1407 reviewed articles Twelve dietary patterns were extracted i.e. healthy pattern, meat and fat, sweet pattern, potatoes and refined grains, Japanese pattern, westernized pattern, mixed pattern, traditional pattern, vegetables, fruits and lean meat pattern, high alcohol, ‘Izakaya’ pattern and dieting. Two studies showed association with leptin which serum leptin concentration showed significantly higher in vegetables, fruits and lean meat compared to western pattern and lower circulating levels of leptin in westernized breakfast dietary pattern. Adiponectin concentration resulting significant positive relationship with fruits and vegetables, dieting, Japanese and healthy dietary pattern. Adherence to healthy dietary patterns plays an important role on serum adiponectin and leptin concentration. However, in most studies that resulted in a significant relationship, adiponectin, leptin and diet components were evaluated separately. Therefore, further well-designed studies were required to clarify the mechanism mediating relationship between dietary patterns and adipokines

Compliance to Dietary Counselling in Controlling Blood Lipid and its Barriers among Dyslipidemic Individuals

Dyslipidemia is a risk factor causing cardiovascular disease and compliance to dietary counselling results in an improved lipid profile. The present study aimed to assess the compliance to dietary counselling and its barriers among dyslipidemic individuals attending dietary follow-ups counselling in Diet Clinic of Universiti Kebangsaan Malaysia Medical Centre (UKMMC). A cross sectional study using the convenience sampling technique was conducted from May to June 2012. Data on food intake, lifestyle habits, physical activity level and barriers in adhering to dietary counselling were collected using interview-based questionnaires. Anthropometric measurements were conducted, while blood lipid profile and medical information were obtained from medical records. The results showed that non-compliance is prevalent among dyslipidemic patients who received dietary counselling. Most subjects (81%) were unable to achieve at least four of the therapeutic lifestyle change dietary recommendations as outlined by National Cholesterol Education Program Adult Treatment Panel III. Factors such as time, food taste and price have been reported as the main barriers to comply towards dietary counselling. A significantly higher proportion of those in non-compliance group did not meet total fat (p < 0.001) and saturated fat (p < 0.001) recommendations as compared to the compliance group. In conclusion, acknowledgements of barriers while providing dietary education are necessary to improve dyslipidemic patients’ compliance with controlling blood lipid

Factors Associated with Body Weight Changes among Nigerian Postgraduate Students at Universiti Sultan Zainal Abidin (UniSZA), Malaysia

International students usually experience a change in body weight and eating behaviour after migrating to a host country. The aim of this study is to determine the factors associated with body weight changes among Nigerian postgraduate students at Unversiti Sultan Zainal Abidin (UniSZA), Malaysia. A prospective study was conducted for six months to determine the association between body weight changes and socio-demographic, eating behavior, physical activity, dietary intake and quality of life. A total of 82 students (76 male and six females) completed a set of self-administered questionnaires, and their weight and height were measured. Descriptive statistic and paired t-test were carried out to analyze the data (IBM SPSS Version 20.0). Multiple linear regression analysis was conducted to determine the factors. Body weight significantly increased by 2.3 ± 0.5 kg after 6 months. Being an art student (β=1.67, p=0.006), being a female (β=-2.68, p=0.009), consuming breakfast once a week (β=5.10, P=<0.001),  taking morning tea less than once a month or never at all (β= 3.62, p<0.001), consuming lunch one to three times a month (β=-2.57, p= 0.006), taking afternoon tea two to three days a week (β=2.56, P=0.005), skipping meal sometimes (β=1.22, p= 0.049), taking meal at other food stalls, coffee shops or hawkers’ centers less than once a month or never at all (β=-2.31, p= <0.001) were adjusted significant associated factors for body weight changes. Socio-demography and eating behaviour were found to be the significant predicting factors of body weight changes. This paper concludes that the change in environment has an impact on body weight and eating behaviour of Nigerian students.

Bioactive compounds in Cucumis melo L. and its beneficial health effects: a scoping review

Cucumis melo L. possesses numerous medicinal and nutritive functions due to the rich sources of biological active compounds. However, Cucumis melo L. processing generate by-products that threaten the environment. This study aims to explore the bioactive compounds present in different melon parts and the fruit’s beneficial health effects. A methodological framework proposed by Arksey and O’Malley was used to conduct the scoping review. An electronic database search for English academic articles was conducted using PubMed, Scopus and ScienceDirect encompassing years between 1999 and 2019. All types of studies, excluding systematic review or review papers were eligible for inclusion. Out of 602 studies identified, a total of 18 studies were included. Both peels and seeds were rich in phenolic compounds. The seed oil contained rich sources of tocopherols, while β-carotene and vitamin C were found in the flesh. Next, the main beneficial health effects included antioxidant, anti-inflammatory, anti-ulcer, anti-angiogenic, anti-diabetic, anti-bacterial and anti-hypothyroidism activities, which were attributable to the presence of bioactive compounds. In summary, Cucumis melo L., particularly its seeds and peels exhibited various health benefits. This was an indicative of the potential of incorporating these by-products into various food and nutraceutical applications to create novel functional food or dietary supplements

Nutrient Profiling Model Towards Recommendation of A Healthy Diet: A Scoping Review

The objective of this study is to identify the availability of Nutrient Profiling (NP) models worldwide and discuss their application. This scoping review is based on the Preferred Reporting Items for Systematic Review and Meta-Analyses Extension for the Scoping Review (PRISMA-ScR) and the Arksey and O’Malley framework. Articles related to NP among adults published from 2012 to 2022, written in English, were retrieved from the Web of Science, Science Direct, Scopus, and Pubmed databases. Mendeley software was used for database acquisition and MS Excel for the syntesis process. Only 17 articles out of 2,019 article titles identified met the inclusion criteria for the review. This review discovers that the applications of NP in nutrition policies include food labelling, Front-Of-Pack (FOP), and regulations on food marketing, health, and nutrition. Fibre is the nutrient that needs to be included in the NP application compared to saturated fats, fatty acids, sodium, and total sugar. This scoping review demonstrates the scientific basis of the NP model’s development in public health policy, leading to advocacy and the recommendation of healthy diets

Clinical Study A 10-Week Multimodal Nutrition Education Intervention Improves Dietary Intake among University Students: Cluster Randomised Controlled Trial

The aim of the study was to evaluate the effectiveness of implementing multimodal nutrition education intervention (NEI) to improve dietary intake among university students. The design of study used was cluster randomised controlled design at four public universities in East Coast of Malaysia. A total of 417 university students participated in the study. They were randomly selected and assigned into two arms, that is, intervention group (IG) or control group (CG) according to their cluster. The IG received 10-week multimodal intervention using three modes (conventional lecture, brochures, and text messages) while CG did not receive any intervention. Dietary intake was assessed before and after intervention and outcomes reported as nutrient intakes as well as average daily servings of food intake. Analysis of covariance (ANCOVA) and adjusted effect size were used to determine difference in dietary changes between groups and time. Results showed that, compared to CG, participants in IG significantly improved their dietary intake by increasing their energy intake, carbohydrate, calcium, vitamin C and thiamine, fruits and 100% fruit juice, fish, egg, milk, and dairy products while at the same time significantly decreased their processed food intake. In conclusion, multimodal NEI focusing on healthy eating promotion is an effective approach to improve dietary intakes among university students

Changes in health‑related lifestyles and food insecurity and its association with quality of life during the COVID‑19 lockdown in Malaysia

Background: The pandemic of SARS CoV2 virus has severely impacted the entire world population. The lockdown imposed during the pandemic has created enormous challenges particularly on the health, economic and social life of most individuals. This study aimed to investigate the changes in health-related lifestyle and food security during the lockdown and how they influenced the quality of life (QoL) of Malaysian adults. Methods: An online survey using a structured questionnaire consisting of sociodemographic, body weight, diet quality, physical activity, sleep quality, food insecurity, and QoL was conducted among adult respondents across Malaysia. Multivariate linear regression analyses were conducted to assess the associations between the changes in each component and QoL based on the total score before and during the lockdown. Results: A total of 759 valid responses were included in the final analysis (75% female and 24.5% male). There was a significant improvement in diet quality during the lockdown while sleep quality and food insecurity worsened significantly. As for physical activity, metabolic equivalents (METs) in moderate activity increased significantly, whilst there was a significant decrease in the METs in walking and total minutes spent on physical activity during the lockdown. Overall, independent of age, gender, ethnicity, and religion, there were significant associations between QoL during lockdown and changes in BMI, METs of moderate activity, sleep quality, and food insecurity. Conclusions: The unprecedented COVID-19 outbreak and the lockdown measure during the pandemic have caused significant negative changes in health-related lifestyles and affected the QoL of Malaysian adults. Despite the new norms and rules to prevent disease transmission, efforts to maintain a healthy lifestyle and food security among the population must be rolled out to improve the QoL and prevent further adverse mental and physical health outcomes

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

Higher Parental Age and Lower Educational Level are Associated with Underweight among Preschool Children in Terengganu, Malaysia

This cross-sectional study aimed to investigate the determinants of underweight among preschool children. A total of 218 preschool children were enrolled. Their sociodemographic data were collected using self-reported questionnaires whilst body weight and height were measured, recorded and the BMI for-age z-score was calculated using WHO AnthroPlus software. Of all preschool children participants, 47.7% were male and 53.3% were female. Most of them were Malays (99.5%), aged 4 to <5 years (40.8%) and came from low-income household (92.7%). Overall, the prevalence of underweight, normal, overweight and obese was 17.9%, 73.8%, 4.6% and 3.7% respectively. The underweight prevalence was higher than the national prevalence (13.7%). Of all parent participants, 12.4% were male and 87.6% were female. Most of them aged 30−39 years (55.5%) and did not hold a degree (89.4%). Multivariate logistic regression showed that parental age and their level of education were the determinants of childhood underweight. The risk of being underweight increased with the age of parents (p=0.033) and lower level of education of parents (p=0.042). In conclusion, this study found that underweight among preschool children was mainly associated with parental factors. Hence, designing a special nutritional intervention program involving older parents and lower education levels could overcome this problem

'Energy-Dense, High-SFA and low-fiber’ dietary pattern lowered Adiponectin but not leptin concentration of breast cancer survivors

Dietary pattern (DP) and its relationship with disease biomarkers have received recognition in nutritional epidemiology investigations. However, DP relationships with adipokines (i.e., adiponectin and leptin) among breast cancer survivors remain unclear. Therefore, we assessed relationships between DP and high-molecular weight (HMW) adiponectin and leptin concentration among breast cancer survivors. This cross-sectional study involved 128 breast cancer survivors who attended the oncology outpatient clinic at two main government hospitals in the East Coast of Peninsular Malaysia. The serum concentration of HMW adiponectin and leptin were measured using enzyme-linked immunosorbent assay (ELISA) kits. A reduced rank regression method was used to analyze DP. Relationships between DP with HMW adiponectin and leptin were examined using regression models. The findings show that with every 1-unit increase in the ‘energy-dense, high-SFA, low-fiber’ DP z-score, there was a reduction by 0.41 μg/mL in HMW adiponectin which was independent of age, BMI, education level, occupation status, cancer stage, and duration since diagnosis. A similar relationship with leptin concentration was not observed. In conclusion, the ‘energy-dense, high-saturated fat and low-fiber’ DP, which is characterized by high intake levels of sugar-sweetened drinks and fat-based spreads but low intake of fruits and vegetables, is an unhealthy dietary pattern and unfavorable for HMW adiponectin concentration, but not for leptin. These findings could serve as a basis in developing specific preventive strategies that are tailored to the growing population of breast cancer survivors