Efficacy Of Calcium Supplementation And Weightbearing Exercise On Bone Mineral Density In Postmenopausal Chinese Women

The etiology of age-related bone loss is unclear but both habitually low calcium intake and lack of physical activity have been proposed as its determinants. The objective of this two-year randomized controlled trial was to evaluate the efficacy of increasing calcium intake and weight-bearing exercise on bone mineral density (BMD) in postmenopausal Chinese women who were not on hormone replacement therapy. Bone mineral density at the total body, lumbar spine L2-L4, femoral neck, Ward's triangle, trochanter and total hip were measured using dual energy X-ray absorptionmetry (DEXA) at six month intervals. Information on sociodemographic background, lifestyle factors and reproductive history were assessed using a validated questionnaire. Calcium intake was evaluated by both the three-day food record and food frequency questionnaire at baseline, 1 2 and 24 months. Exercise habits were assessed with an exercise diary and Physical Activity Scale for the Elderly (P ASE) questionnaire

Correlations between anthropometric measurements, biochemical indicators, dietary intake and Dialysis Malnutrition Score among haemodialysis patients in Sibu, Sarawak

Introduction: Malnutrition is a common problem associated with increased risk of morbidity and mortality among haemodialysis (HD) patients. Methods: This study determined the correlation between anthropometric measurements, biochemical indicators, dietary intake and dialysis malnutrition score among HD patients in Sibu, Sarawak. A total of 55 patients were recruited by purposive sampling and their biochemical parameters were retrieved from dialysis records. Anthropometric measurements and dietary intake were determined using standardised protocols while Dialysis Malnutrition Score (DMS) was computed to determine patients’ nutritional status. Results: Mean age of the patients was 53.0±12.2 years. Mean DMS was low, indicating low tendency of malnutrition among the patients. Approximately one-third of the patients had high interdialytic weight gain (IDWG), indicating a poor adherence on fluid recommendation. Mean intakes of dietary energy (DEI) and protein (DPI) were low, with only approximately 15% achieving the recommendations according to Kidney Disease Outcomes Quality Initiative (K/ DOQI). Increase in age (r=0.337, p=0.012) and dialysis vintage (r=0.403, p=0.002) were associated with poorer nutritional status while higher BMI, MUAC, and serum albumin were associated with better nutritional status. Conclusion: This study revealed a high proportion of the HD patients with poor adherence on fluid intake, and the prevalence of inadequate DEI and DPI, indicating the importance of regular dietary counselling for HD patients. In view of their non-invasive nature and close relationship with nutritional status, body mass index, mid-upper arm circumference, and serum albumin should be included as part of the comprehensive periodic nutrition assessment of HD patients

Phosphorus contents of raw chicken meat and processed chicken meat products

Introduction: The per capita consumption of chicken meat and related products has increased steadily in Malaysia, as it is affordable and can be consumed without religious constraints. There is concern for the widespread use of phosphate additives in processed meats, which may lead to hyperphosphatemia, especially among chronic kidney disease (CKD) patients. The objective of this study was to determine and compare the phosphorus content in raw chicken breast meat (RCBM) and selected processed chicken meat products. Methods: Samples of RCBM, chicken frankfurters, chicken patties and chicken nuggets of different brands were studied. The phosphorus content of the samples were determined via the dry ashing method and a Perkin-Elmer 5300DV inductively coupled plasma-optical emission spectrometer (ICP-OES). Results: The mean phosphorus content in RCBM was 209.15±3.13 mg per 100 g. Chicken nuggets contained the highest phosphorus content, followed by RCBM, chicken patties and chicken frankfurters. Compared to the RCBM, the mean phosphorus content of chicken frankfurters and chicken patties were 21.42% and 4.81% respectively lower, whilst that of chicken nuggets was 1.74% higher. The same type of chicken meat products from different brands also differed significantly in their phosphorus content. Conclusion: There were significant differences in the phosphorus content among different types of chicken meat products, and among the same chicken meat products from different brands. Caution should be exercised, especially by CKD patients, in consuming processed chicken meat products due to the risk posed to them by phosphorus content

Correlation of cognitive impairment with constipation and renal failure

The improvement of health care support has greatly extended the average life expectancy over the last 50 years, which has increased the rate of cognitive decline consequently. The avoidance of risk factors such as toxins, stress and somatic diseases can be protective against the reduction of cognitive function in the elderly. This study aimed to determine the effects of socio-demographic factors, constipation and renal failure on cognitive status among 2322 samples who were the non-institutionalized Malaysian elderly. The multiple logistic regression analysis was applied to estimate the risk of such factors on cognitive decline in subjects. Approximately, 77.54% of samples experienced cognitive impairment. The results showed that advanced age (odds ratio (OR) = 1.03), Malay ethnic (OR = 2.15), constipation (OR = 3.31) and renal failure (OR= 4.42), significantly increased the risk of cognitive impairment in subjects (p<0.05). In addition, education (OR = 0.38) significantly reduced the risk. However, we concluded that age, Malay ethnic, constipation and renal failure increased the risk of cognitive impairment in subjects but education reduced the risk

Correlates of physical activity level among hemodialysis patients in Selangor, Malaysia.

INTRODUCTION: There is mounting evidence demonstrating the importance of adequate physical activity to promote better well-being among hemodialysis patients. Available data pertaining to the levels of physical activity and its determinants among hemodialysis patients is, however, scarce in Malaysia. The objectives of this study are hence to determine the levels of physical activity and it associated factors among hemodialysis patients. METHODOLOGY: A total of 70 subjects were recruited from three dialysis centres in Selangor. A face-to-face interview was conducted to obtain socio-demographic data and subjects' knowledge on dietary sources. Medical history, biochemical parameters and weight status were obtained from medical records. Physical activity level (PAL) was assessed using the Global Physical Activity Questionnaire (GPAQ). RESULTS: A total of 81.4% and 18.6% of the respondents had low and moderate PALs, respectively. Thus, none of the respondents had high PAL. Serum creatinine, education level, personal income and knowledge score on potassium-related medical complications were factors found to correlate significantly with PAL. Multiple linear regression analysis showed that higher PAL was predicted by a lower knowledge score on dietary sodium source, higher education and higher serum creatinine. CONCLUSION: Despite consistent documentation of the potential positive impact of physical exercise on hemodialysis outcomes, the level of physical activity remains low among these patients. It is hoped that these findings can add to the existing body of knowledge and serve as a supporting document for the formulation of appropriate interventions to improve the status of physical activity among hemodialysis patients in Malaysia

The trans fatty acid content in human milk and its association with maternal diet among lactating mothers in Malaysia

Excessive intake of trans fatty acids (TFA) could reduce the fat density of human milk and impair the desaturation of essential fatty acids. Because the mammary glands are unable to synthesize TFA, it is likely that the TFA in human milk come from dietary intake. Thus, the aim of this study was to investigate the sources of TFA intake for lactating mothers in one of the urban areas in Selangor. In this cross-sectional study, anthropometric measurements, FFQ including 7 food groups and dietary consumption data were collected from 101 lactating mothers. Five major TFA isomers (palmitoelaidic acid (16:1t9), petroselaidic acid (18:1t6), elaidic acid (18:1t9), vaccenic acid (18:1t11) and linoelaidic acid (18:2t9,12) in human milk were measured by gas chromatography (GC). The relationship between food consumption and TFA levels was assessed using the non-parametric Spearman's rho test. The TFA content in human milk was 2.94±0.96 (SEM) % fatty acid; this is considered low, as it is lower than 4%. The most abundant TFA isomer was linoelaidic acid (1.44±0.60% fatty acid). A sub-experiment (analyzing 3 days of composite food consumption) was conducted with 18 lactating mothers, and the results showed that linoelaidic acid was the most common TFA consumed (0.07±0.01 g/100 g food). Only 10 food items had an effect on the total TFA level and the isomers found in human milk. No association was found between TFA consumption and the TFA level in human milk

Prevalence of metabolic syndrome in type 2 diabetic patients: a comparative study using WHO, NCEP ATP III, IDF and Harmonized definitions

To determine the prevalence of metabolic syndrome (MetS) in Malaysian type 2 diabetic patients using WHO, NCEP ATP III, IDF and the new Harmonized definitions, and the concordance between these definitions. This study involved 313 patients diagnosed with type 2 diabetes mellitus (T2DM) at two Malaysian tertiary hospitals. Socio-demographic data were assessed using a pre-tested interviewer-administered structured questionnaire. Anthropometric measurements were carried out according to standard protocols. Clinical and laboratory characteristics were examined. Kappa (k) statistics were used for the agreement between the four MetS definitions. The overall prevalence rates of MetS (95% CI) were 95.8% (93.6-98.1), 96.1% (94.0-98.3), 84.8% (80.8-88.9) and 97.7% (96.1-99.4) according to the WHO, NCEP ATP III, IDF and the Harmonized definitions, respectively. The Kappa statistics demonstrated a slight to substantial agreement between the definitions (k = 0.179-0.875, p < 0.001), where the WHO criteria revealed the highest concordance with the NCEP ATP III definition (k = 0.875, p < 0.001). The WHO against NCEP ATP III criteria evinced the highest sensitivity (99.66%) whereas Harmonized criteria against all the other three definitions showed the highest specificity (100%) in identifying MetS. In conclusion, the new Harmonized criteria established the highest prevalence of MetS among the four definitions applied. There was a very good concordance between the WHO and NCEP ATP III criteria. The extremely high prevalence of MetS observed in type 2 diabetic patients indicates an impending pandemic of CVD risk in Malaysia. Aggressive treatment of MetS components is required to reduce cardiovascular risk in T2DM

Predictors of cardiovascular disease in patients with type 2 diabetes mellitus

Aims: Cardiovascular disease (CVD) is the leading cause of mortality and morbidity in patients with type 2 diabetes mellitus (T2DM). Although patients with T2DM and CVD share common risk factors, the link between these diseases remains unclear. This study intends to identify the predicting risk factors of CVD in Malaysian T2DM patients. Methods: We conducted an analytical cross-sectional study on 313 patients diagnosed withT2DM at selected tertiary hospitals upon prior ethical approvals. Systematic random sampling method was applied in patient selection. Socio-demographic data was assessed using a pre-tested interviewer-administered structured questionnaire. Diet (by 24-hour dietary recall), physical activity level [via International Physical Activity Questionnaire (IPAQ)], smoking andalcohol consumption status were ascertained. Anthropometric and blood pressure measurements were performed according to standard procedures. Clinical and laboratory characteristics on cardiovascular risk factors (medical history, treatments, glycaemic control,and lipid profile) were collected from medical records, clinical examination and face-to-face interview. All statistical analyses were performed by using SPSS Statistics Version 21.0. Results: The mean age of study subjects was 55.7±9.2 years, with a mean diabetes duration of 10.1±8.1 years (CVD patients 11.5±8.7 years, non-CVD patients 9.2±7.6 years); 52.1%subjects were females; and 47.0% were Malays. Approximately one third (36.1%) of thesubjects were suffering from CVD. Multivariate logistic regression analysis showed age(B=0.056, adjusted OR 95% CI=1.058, p=0.004), lower HDL-C level (B=-1.466, adjusted OR 95% CI =0.231, p=0.003), working status of self-employment (B=1.381, adjusted OR 95% CI=3.978, p=0.002) in comparison to retirement, low (B=1.164, adjusted OR 95% CI=3.203, p<0.001) andmoderate physical activity levels (B=1.172, adjusted OR 95% CI=3.227, p<0.001) compared tohigh physical activity level were significantly associated with higher CVD risk, uponadjustment for potential covariates. Conclusion: Increased age, lower HDL-C, low and moderate physical activity levels, andworking status appeared to be significant predictive factors of CVD among the T2DM patients studied

Factors associated with quality of life among hemodialysis patients in Malaysia

Although hemodialysis treatment has greatly increased the life expectancy of end stage renal disease patients, low quality of life among hemodialysis patients is frequently reported. This cross-sectional study aimed to determine the relationship between medical history, hemodialysis treatment and nutritional status with the mental and physical components of quality of life in hemodialysis patients. Respondents (n=90) were recruited from Hospital Kuala Lumpur and dialysis centres of the National Kidney Foundation of Malaysia. Data obtained included socio-demography, medical history, hemodialysis treatment and nutritional status. Mental and physical quality of life were measured using the Mental Composite Summary (MCS) and Physical Composite Summary (PCS) of the Short-Form Health Survey 36-items, a generic core of the Kidney Disease Quality of Life Short Form. Two summary measures and total SF-36 was scored as 0–100, with a higher score indicating better quality of life. Approximately 26 (30%) of respondents achieved the body mass index (24 kg/m2) and more than 80% (n=77) achieved serum albumin level (>35.0 mg/dL) recommended for hemodialysis patients. The majority of respondents did not meet the energy (n=72, 80%) and protein (n=68,75%) recommendations. The total score of SF-36 was 54.1±19.2, while the score for the mental and physical components were 45.0±8.6 and 39.6±8.6, respectively. Factors associated with a higher MCS score were absence of diabetes mellitus (p=0.000) and lower serum calcium (p=0.004), while higher blood flow (p=0.000), higher serum creatinine (p=0.000) and lower protein intake (p=0.006) were associated with a higher PCS score. To improve the overall quality of life of hemodialysis patients, a multidisciplinary intervention that includes medical, dietetic and psychosocial strategies that address factors associated with mental and physical quality of life are warranted to reduce further health complications and to improve quality of life

Prevalence of obesity and factors associated with it in a worksite setting in Malaysia

Socio-economic status, lifestyle behaviors, and psychosocial factors have been implicated in the development of overweight and obesity. This study aims to observe the prevalence of overweight and obesity in an academic worksite and to examine the possible association between variables such as socio-economic characteristics, work factors, psychosocial factors, and weight control behaviors and obesity. In this study, the target population were full-time academic and non-academic staff. Body mass index (BMI) and waist circumference (WC) were computed to determine obesity. A pretested self-administered questionnaire was used to obtain information on socio-demographic factors, work related factors, psychosocial factors, and weight control behaviors. Data were obtained on 367 adults of whom 39.2% were males and 60.8% females. Overweight was seen in 31.9% of males and 26.5% of females while 16.1% of them were obese, irrespective of gender. Central obesity was noted in about 37% of males and 39% of females. The results showed that socio-demographic factors (age, gender, and education) and psychosocial factors (perceived health status, body weight perception, and weight-control goals) were significantly associated with BMI. Working hours were also significantly associated with BMI. However, weight control practices (diet-control practices and physical activity practices) were not significantly associated with BMI. In conclusion, this study found a higher prevalence of overweight and obesity among employees of a selected public university in comparison to the general population. Socio-demographic, psychosocial factors, and working hours were found to contribute to obesity in this sample of adults