Calcium supplementation amongst postmenopausal women: effect on serum calcium, phosphorus and magnesium level

This study assessed the effect of calcium supplementation towards the change in serum calcium, phosphorus and magnesium level. We carried out a randomized controlled trial of calcium supplementation in 113 postmenopausal women for 24 months period study. Subjects were randomly assigned into two groups. Subjects in Calcium Supplemented Group (CSG) were to take calcium supplement (1200 mg/day) while the Control Group were not given any placebo and advised to continue with their regular diet. The study showed that calcium supplementation helps to increased daily intake of calcium amongst the subject which in results helping to maintain the serum calcium level within normal range. The serum magnesium and phosphorus level in this study were kept at a normal range although there is a slight decrease in serum phosphorus levels may be due to a reduction in the daily intake of the mineral

Diabetes Care in Malaysia: Problems, New Models, and Solutions

Background: Diabetes is a major public health concern in Malaysia, and the prevalence of type 2 diabetes(T2D) has escalated to 20.8% in adults above the age of 30, affecting 2.8 million individuals. The burden of managing diabetes falls on primary and tertiary health care providersoperating in various settings. Objectives: This review focuses on the current status of diabetes in Malaysia, including epidemiology, complications, lifestyle, and pharmacologic treatments, as well as the use of technologies in its management and the adoption of the World Health Organization chronic care model in primary care clinics. Methods: A narrative review based on local available health care data, publications, and observations from clinic experience. Findings: The prevalence of diabetes varies among the major ethnic groups in Malaysia, with Asian Indians having the highest prevalence of T2D, followed by Malays and Chinese. The increase prevalence of overweight and obesity has accompanied the rise in T2D. Multidisciplinary care is available in tertiary and primary care settings with integration of pharmacotherapy, diet, and lifestyle changes. Poor dietary adherence, high consumption of carbohydrates, and sedentary lifestyle are prevalent in patients with T2D. The latest medication options are available with increasing use of intensive insulin regimens, insulin pumps, and continuous glucose monitoring systems for managing glycemic control. A stepwise approach is proposed to expand the chronic care model into an Innovative Care for Chronic Conditions framework to facilitate implementation and realize better outcomes in primary care settings. Conclusions: A comprehensive strategy and approach has been established by the Malaysian government to improve prevention, treatment, and control of diabetes as an urgent response to this growing chronic disease

Transcultural Diabetes Nutrition Algorithm: A Malaysian Application

Glycemic control among patients with prediabetes and type 2 diabetes mellitus (T2D) in Malaysia is suboptimal, especially after the continuous worsening over the past decade. Improved glycemic control may be achieved through a comprehensive management strategy that includes medical nutrition therapy (MNT). Evidence-based recommendations for diabetes-specific therapeutic diets are available internationally. However, Asian patients with T2D, including Malaysians, have unique disease characteristics and risk factors, as well as cultural and lifestyle dissimilarities, which may render international guidelines and recommendations less applicable and/or difficult to implement. With these thoughts in mind, a transcultural Diabetes Nutrition Algorithm (tDNA) was developed by an international task force of diabetes and nutrition experts through the restructuring of international guidelines for the nutritional management of prediabetes and T2D to account for cultural differences in lifestyle, diet, and genetic factors. The initial evidence-based global tDNA template was designed for simplicity, flexibility, and cultural modification. This paper reports the Malaysian adaptation of the tDNA, which takes into account the epidemiologic, physiologic, cultural, and lifestyle factors unique to Malaysia, as well as the local guidelines recommendations

Gender Differences in the Relationships between Perceived Stress, Eating Behaviors, Sleep, Dietary Risk, and Body Mass Index

Background: Obesity is a growing epidemic among university students, and the high levels of stress reported by this population could contribute to this issue. Singular relationships between perceived stress; engagement in restrained, uncontrolled, and emotional eating; sleep; dietary risk; and body mass index (BMI) have been reported in the current body of literature; however, these constructs interact with each other, and the complex relationships among them are infrequently examined. Therefore, the aim of the present study was to explore the complex relationships between these constructs using mediation and moderation analyses stratified by gender. Methods: A cross-sectional study, enrolling university students from the United States (U.S.), the Netherlands, South Korea, Malaysia, Ireland, Ghana, and China, was conducted between October 2020 and January 2021 during the COVID-19 pandemic. Perceived stress; maladaptive eating behaviors including restrained, uncontrolled, and emotional eating; sleep duration and quality; dietary risk; and BMI were assessed using validated questionnaires, which were distributed through an online platform. Results: A total of 1392 students completed the online survey (379 male, 973 female, and 40 who self-identified as “other”). Uncontrolled and emotional eating mediated the relationship between perceived stress and dietary risk for both males and females; higher sleep quality weakened this relationship among female students but not males. Emotional eating mediated the relationship between perceived stress and BMI for both males and females, but higher sleep quality weakened this relationship only among females. Conclusions: Our findings suggest that students in higher education are likely to benefit from interventions to reduce uncontrolled and emotional eating. Programs that improve sleep quality, especially during highly stressful periods, may be helpful

Defining the Practice of Dietitians in Malaysia Using the Nutrition Care Process in Patients with Type 2 Diabetes Mellitus

(1) Background: The quality of dietetic care is crucial to improve patient outcomes. The aim of this study was to measure the current practices regarding the provision of nutrition care in type 2 diabetes mellitus (T2DM) among dietitians in Malaysia. (2) Methods: A 49-item online survey was distributed via Malaysian Dietitians’ Association and Ministry of Health Malaysia social media platforms. Self-reported dietetic practices in the management of T2DM were evaluated against practice guidelines. (3) Results: A total of 173 dietitians completed the survey, with a response rate of 62%. Three-quarters of dietitians in the public sector consulted patients within two to three weeks or more than four weeks versus less than two weeks (86.3%) among private dietitians (p-value < 0.001). More than 95% of private dietitians spent 31–60 min or more than 60 min on new cases versus 71% among public dietitians (p-value < 0.001). Group counseling was only practiced among public dietitians (36.0%). Different practice settings led to the current findings. A limited use of behavioral counseling theories and strategies was observed among dietitians from both sectors. Limited adherence to nutrition-related recommendations (62.8%) and lack of readiness for diet/lifestyle changes (45.5%) were the key challenges faced by dietitians when managing T2DM. (4) Conclusions: The survey indicates that there is a need for the development of comprehensive training to increase the utilization of behavioral counselling. Practice setting is an element to consider when designing training

The relationship between dietary patterns and overweight and obesity in children of Asian developing countries: A systematic review

Background: The exponential increase in prevalence of childhood obesity has become a global concern. Developing countries in Asia are at particular risk due to their stage in the epidemiological and nutrition transition. Objectives: The review objectives were to summarize the evidence on prevalence of childhood overweight and obesity within developing countries in Asia and to synthesise the best epidemiological association between the dietary patterns of children in the developing countries in Asia and their weight status in terms of obesity. Inclusion criteria Types of participants This review considered any studies that included children under 18 years of age who live in developing countries in Asia. Types of studies This review of epidemiological association considered any analytical observational studies (case-control studies, cohort studies and analytical cross-sectional studies). Types of outcomes The focus was to summarise the prevalence of childhood overweight and obesity within developing countries in Asia and synthesise the best available evidence on the relationship between dietary patterns as the exposure variable and childhood overweight and obesity as the outcome. Search strategy A three-step search strategy was utilised, with an initial limited search of MEDLINE, CINAHL and EMBASE to identify search terms. A second search using all identified keywords and index terms was undertaken across all included databases. Thirdly, the reference list of all identified reports and articles were searched for additional studies. Additional electronic databases searched included: ProQuest, Web of Science, and Scopus. Each database was searched from inception to September 2011, with an English language restriction. Methodological quality All papers selected for retrieval were assessed independently by two reviewers using standardised critical appraisal instruments from the Joanna Briggs Institute. Data collection Data was extracted from included studies by two reviewers independently using an adapted version of the standardised data extraction form from the Joanna Briggs Institute. Data synthesis Meta-analysis was not possible because of the heterogeneity of studies in terms of methodology, statistical analyses and outcomes. A narrative summary of results is provided. Results Fifteen studies were included in the review. The prevalence rates of childhood overweight and obesity in Asian developing countries ranged from 5.1% to 19.9% with no specific trend in age or gender. Several significant but inconsistent statistical associations between dietary patterns and overweight/obesity in children and adolescents were found [high energy diet (OR: 1.80 95%CI 1.10 to 2.90, p0.05), low intake of fruit and vegetables (OR: 2.34 95%CI 1.04 to 5.24, p0.05; 0.70 95%CI 0.50 to 1.00, p>0.05), high meat consumption (RR: 2.40 95%CI 1.00 to 5.60, p0.05), eating out (OR: 12.0 95%CI 7.7 to 18.7, p0.05), fast food intake (OR: 1.50 95%CI 1.12 to 2.02, p0.05)]. The key limitation was the heterogeneity of studies in terms of measures of dietary patterns and obesity standards. Conclusions: The prevalence rates of childhood overweight and obesity in Asian developing countries ranged from 5.1% to 19.9% with no specific trend in age or gender. From the practice perspective, several significant yet inconsistent statistical associations between dietary patterns and childhood overweight/obesity in children and adolescents were found

Relationship between Body Composition and Bone Mineral Density in Healthy Postmenopausal Chinese Wowen in Malaysia

Bone loss is known to be accelerated during menopause. The postmenopausal period with advancing age has also been associated with a decrease in learn body mass, an increase in body fat mass and increase in body weight. This study investigated the relative contribution of lean body mass and body fat mass to bone mineral density (BMD) in 139 healthy postmenopausal Chinese women in Kuala Lumpur. Total body, lumbar spine (L2-L4), femoral neck and total hip BMD were measured using dual-energy X-ray absorptiometry (DXA). Findings revealed that 80% of the Chinese postmenopausal women had low bone mass (osteopenia) and 8% were osteoporotic at the lumbar spine and/or femoral neck. Overall, body fat mass showed a positive correlation with BMD at all sites (total body, r = 0.265, p<0.001; total hip r =0.332, p<0.001). Similarly, lean body mass was positively correlated with BMD at most sites (Total body r = 0.239, p < 0.001; femoral neck r = 0.365, p<0.001; total hip r = 0.352, p<0.001) except the lumbar spine. In a multiple stepwise regression analysis body fat mass was a significant predictor for BMD for total body (p<0.0001) and lumbar spine (p<0.005) BMD, while lean body mass was the major determinant of BMD at the femoral neck and total hip (p<0.0001). These data suggested that both fat and lean mass were significant determinants of BMD, the former playing a greater role than lean mass in postmenopausal women. Therefore, postmenopausal women need to avoid being too underweight (and thus having too low body fat) and to maintain lean body mass to protect against osteoporosi