1.Lowering Dietary Glycaemic Index through NutritionEducation among Malaysian Women with a History of Gestational Diabetes Mellitus
Sangeetha-Shyam ; Fatimah A ; Rohana AG ; Norasyikin AW ; Karuthan C ; Nik Shanita S ; Mohd Yusof BN ; Nor Azmi K
Malaysian Journal of Nutrition 2013;19(1):9-23
Introduction: Gestational diabetes mellitus (GDM) increases risks for type 2
diabetes and cardiovascular diseases. Low glycaemic index (GI) diets improve
cardio-metabolic outcomes in insulin-resistant individuals. We examined the
feasibility of lowering GI through GI-based-education among Asian post-GDM
women. Methods: A 3-month investigation was carried out on 60 Malaysian
women with a mean age of 31.0±4.5 years and a history of GDM. Subjects were
randomised into two groups: LGIE and CHDR. The CHDR group received
conventional healthy dietary recommendations only. The LGIE group received
GI based-education in addition to conventional healthy dietary recommendations.
At baseline and after 3-months, dietary intake of energy and macronutrient
intakes including GI diet and glycaemic load was assessed using 3-day food
records. Diabetes-Diet and GI-concept scores and physical activity levels were
assessed using a questionnaire. Adherence to dietary instructions was measured
at the end of 3 months. Results: At the end of 3 months, the LGIE group had
significant reductions in energy intake (241.7±522.4Kcal, P=0.037, ES=0.463), total
carbohydrate (48.7±83.5g, P=0.010, ES=0.583), GI (3.9±7.1, P=0.017, ES=0.549) and
GL (39.0±55.3, P=0.003, ES=0.705) and significant increases in protein (3.7±5.4g,
0.003, ES=0.685) and diet fibre (4.6±7.3g, P=0.06). The CHDR group had a significant
reduction in fat only (5.7±9.4g, P=0.006, ES=0.606). There was a 30% increase in
GI-concept scores in the LGIE group (p< 0.001). Changes in GI-concept scores
correlated significantly to the reduction in dietary GI (r = -0.642, P=0.045). Dietary
adherence was comparable in both groups. Conclusion: GI-education improves
GI-concept knowledge and helps lower dietary glycaemic index among women
with a history of GDM.
2.Effect of Two Different Meal Compositions on 1-hour Plasma Ghrelin Levels in Young Men
Brinnell Annette Caszo ; Sangeetha Shyam ; Purushotham Krishnappa ; Justin Vijay Gnanou
Malaysian Journal of Medicine and Health Sciences 2023;19(No.5):185-189
Introduction: Calorie restriction is the main strategy for loosing body weight in obese individuals. However, persistence to this strategy is a major challenge. Ghrelin, a hormone that influences an individual to consume food by
modulating the feelings of hunger. This effect may be influenced by the % fat composition of a meal. Materials and
Methods: Twelve young male participants with normal BMI, were administered in random order one of 2 isocaloric
meals after an overnight fast. The 2 meals contained either 31 or 52% fat. After a 7 day gap, cross-over of the participants was carried out and they consumed the other meal similarly. Ghrelin levels were measured after fasting and
1 hour after diet consumption. An appetite rating on a visual analogue scale (VAS) was used to measure perceived
hunger and satiety before and after the meal. Results: When compared to the baseline values, an average of 34% and
20% decrease in ghrelin levels were noted after the high-fat meal (p<0.025), and low-fat meal respectively. Analysis
of the VAS showed that feelings of hunger decreased, while feelings of satiety increased after the meal, however there
was no difference between the two meals. Conclusion: Thus, within this study group, though the feelings of hunger
and satiety was comparable, consumption of isocaloric high fat caused ghrelin levels to decrease within one hour
post meal. This shows that manipulation of % fat of the diet can achieve lower post-meal ghrelin levels.
3.Salivary amylase and adiponectin as potential non-invasive markers of glycaemic control in Malaysian type 2 diabetes mellitus participants
Helen Thong ; Sangeetha Shyam ; Ammu Radhakrishnan ; Cheong Lieng Teng
International e-Journal of Science, Medicine and Education 2020;14(1):8-21
Introduction:
Serum amylase and adiponectin levels have shown promise as markers of cardio-metabolic diseases. However, the levels of these markers in saliva and their association with glycaemic management in diabetes mellitus (DM) are not well documented. Therefore, we investigated the correlation of salivary amylase and adiponectin concentrations with measures of glycaemic control in type 2 diabetes mellitus (T2DM) participants.
Methods:
We conducted a cross-sectional study involving 80
T2DM participants of Indian and Malay ethnicity. Saliva
was collected, and salivary amylase and adiponectin
concentrations were analysed. Recent fasting blood
sugar and HbA1c of the participants was obtained form
their medical records. The correlations of salivary
amylase and adiponectin with fasting blood sugar and
HbA1c were calculated using Spearman’s correlation
Results:
There was a weak positive correlation between salivary
adiponectin and HbA1c (rho = 0.221, p = 0.051). The
salivary adiponectin levels was significnalty lower among
participants with good glycaemic control (HbA1c ≤
7.0%) compared to those with poor glycaemic control
(HbA1c > 7.0%,) (1.13 (1.75) vs. 2.34 (3.54) ng/ml,
p = 0.039).
Conclusion
Salivary adiponectin weakly correlated with HbA1c,
while salivary amylase showed no correlation with
the glycaemic parameters studied. Therefore, salivary
adiponectin may warrant further investigation as a
potential non-invasive biomarker of T2DM.
Diabetes Mellitus, Type 2
;
Glycated Hemoglobin
4.Prevalence of malnutrition among patients with breast cancer and colorectal cancer in Hospital Tuanku Ja’afar, Seremban
Wei Xiang Wong ; Ting Xuan Wong ; Shu Hwa Ong ; Sangeetha Shyam ; Seong Ting Chen ; Winnie Siew Swee Chee
International e-Journal of Science, Medicine and Education 2022;16(1):16-29
Background:
Malnutrition is common among cancer patients, and it can impact the surgical outcomes of the patients undergoing elective surgery. Addressing malnutrition at the early stage of treatment will enhance the recovery process of the patients after anti-cancer treatments. Our study aimed to assess the nutritional status among breast and colorectal cancer patients who were scheduled for elective surgery and treatment.
Methods:
A total of 89 patients, 46 breast cancer patients and 43 colorectal cancer patients participated in the study. Sociodemographic information and medical history were collected using a questionnaire. Body weight and height were measured using a weighing scale and stadiometer. Body composition data were collected using an 8-point bioimpedance analysis machine. Dietary intake was collected using a 7-day diet history. Handgrip strength was evaluated using a dynamometer. The prevalence of malnutrition was determined based on the AND/ASPEN malnutrition clinical characteristics. The differences between groups were analysed using independent sample t-test, Mann Whitney U test and chi-square test.
Results:
Out of 89 patients, 51.7% were diagnosed as being malnourished based on the AND/ASPEN characteristics. The most common malnutrition characteristic observed among the breast and colorectal cancer patients was reduced handgrip strength (56.2%), followed by experience of muscle loss (43.8%) and reduced food intake (42.7%).
Conclusion
There was a high prevalence of patients at risk of malnutrition among breast and colon cancer patients undergoing surgery. Early detection of malnutrition in cancer patients allows healthcare professionals to provide prompt intervention and improve their prognosis.
Malnutrition
;
nutrition assessment
;
hospitals
;
Breast Neoplasms
;
Colorectal Neoplasms