Binge eating (BE) behaviour is associated with obesity and eating disorders. This cross-sectional study investigates BE behaviour and its relationship with nutrition-related factors among university students. A total of 170 (69% females) university students in Malaysia aged 19 to 24 years participated in this study. BE behaviour was assessed with the use of Binge Eating Scale (BES) questionnaire. Socio-demographic background and nutritional status (anthropometric measurements, body mass index (BMI) and dietary intake) were also measured. BE behaviour reported by 10% percent of the participants. BE behaviour was associated with increased energy intake, elevated BMI and sex (Adjusted R2 = 0.116, p < 0.001). Differences in sex-specific factors in predicting the risk of BE behaviour were evident. In male participants, an increased in energy intake, elevated BMI and had a higher waist circumference associated with the risk of BE behaviour (Adjusted R2 = 0.411, p < 0.001). In female participants, only a higher waist circumference associated with BE behaviour (Adjusted R2 = 0.028, p < 0.05). The finding suggests that understanding sex-specific factors are necessary to prevent BE. These are the potential targets for tailored eating behaviour intervention among university students.

This study aimed to investigate the effect of saffron extract and crocin on blood biomarkers associated with obesity using the rat model. Methods: Obesity was induced by feeding a high-fat diet to 42 male Sprague-Dawley rats for 12 weeks, after which they were equally distributed into seven groups. Three groups served as controls namely, normal diet (ND), high-fat diet (HFD), and high-fat diet plus orlistat (HFD + ORL), while the remaining four treatment groups consisted of HFD added low or high dose (40 and 80 mg/kg/day) of either saffron extract or crocin in the food. At the end of 8 weeks, blood samples were collected by cardiac puncture for biochemical analysis. Results: Obese rats treated with a high dose of saffron extract and crocin showed significantly lower plasma glucose levels (5.26 and 5.67 mmol/L respectively) than the HFD rats (6.92 mmol/L). Saffron extract and crocin at a high dose showed significantly lower levels of plasma insulin (3.97 and 3.88 ng/mL respctively) compared to HFD control (5.41 ng/mL). Adiponectin levels significantly increased in obese rats fed saffron extract and crocin at high doses (7.44 and 7.92 µg/mL respectively) compared to HFD control (5.34 µg/mL). Ghrelin level significantly increased from 419.10 to 284.10 pg/mL,while leptin level significantly decreased from 8.08 to 5.68 ng/mL for the high dose crocin groups compared to HFD control. No significant differences in plasma serotonin levels were found among the groups. Conclusion: Saffron extract and crocin show potential in reducing blood biomarkers associated with obesity as well as anti-inflammatory and regulatory potential of adipocytokines in an animal model.

White and whole meal breads have been classified as high glycemic index (GI) foods which in turn produce the greatest rise in blood glucose. One of the commercial bread products in Malaysia known as Brown breads (BB) has been recently marketed as a healthy choice for diabetics due to its low GI value. This study was conducted to examine the effect of BB when eaten with different fillings on blood glucose response among healthy individuals and to describe the influences of these fillings in reducing blood glucose response. Five test meals using BB (BB eaten with baked beans, BB eaten with vegetable, BB eaten with apple, BB eaten with roast chicken and BB eaten with seaweeds) had been prepared for this study. Postprandial blood glucose response was determined for each test meal and reference food (glucose) that contained 50 g carbohydrate respectively. A total of 21 healthy subjects were recruited by advertisement to participate. Only 20 subjects (15 males, 5 females, Mean + SD Age : 24.4 + 3.7 years; BMI 23.4 + 3.0 kgm-2) completed this study. After an overnight fast, subjects consumed BB eaten with fillings according to the assigned group given and three repeated tests of reference food (glucose). Fasting capillary blood glucose samples were taken at time 0 and at 15, 30, 45, 60, 90 and 120 min respectively after the meal began. The blood glucose response was obtained by calculating the incremental area under the curve (AUC). Blood glucose response after consuming reference food (251.8 + 12.1 mmol.min/L) was significantly higher than all the test meals (p < 0.05). Among the test meals, BB eaten with baked beans produced the highest rise in blood glucose (97.0 + 16.9 mmol.min/L) whereas BB eaten with seaweeds demonstrated the lowest response in blood glucose (33.3 + 6.5 mmol.min/L) and the difference was statistically significant (p < 0.05). The postprandial blood glucose response after ingestion of BB when eaten with vegetable was 73.3 + 19.1 mmol.min/L followed by BB eaten with apple (58.9 + 12.2 mmol.min/L) and BB eaten with roast chicken (56.5 + 10.1 mmol.min/ L). Generally, BB when eaten with fillings produced a slow rise in blood glucose response than the reference food. Combining this BB with fillings had the effect of reducing the postprandial blood glucose further.

Diabetes in pregnancy is associated with risks to the woman and her developing fetus. Management of the condition at the primary care level includes pre-conception care, screening, diagnosis, as well as antenatal and postpartum care. A multidisciplinary approach is essential in ensuring its holistic management.

This study aims to determine the association between obesity-related behaviors (dietary practices, physical activity and body image) and body weight status among adolescents. A total of 382 adolescents (187 males and 195 females) aged 13 to 15 years in Kajang, Selangor participated in this study. Majority of the respondents were Malays (56.0%), followed by Chinese (30.1%) and Indians (13.9%). Dietary practices, physical activity and body image of the adolescents were assessed through the eating behaviors questionnaire, two-day dietary record, two-day physical activity record and multi-dimensional body image scale (MBIS), respectively. Body weight and height were measured by trained researchers. The prevalence of overweight and obesity (19.5%) was about twice the prevalence of underweight (10.5%). About two-thirds of the respondents (72.3%) skipped at least one meal and half of them (56.2%) snacked between meals with a mean energy intake of 1,641 +/- 452 kcal/day. More than half of the respondents (56.8%) were practicing sedentary lifestyle with a mean energy expenditure of 1,631 +/- 573 kcal per day. Energy intake (r = 0.153, P < 0.05), physical activity (r = 0.463, P < 0.01) and body image (r = 0.424, P < 0.01) were correlated with BMI. However, meal skipping, snacking and energy expenditure per kg body weight were not associated with body weight status. Multiple linear regression analysis showed that body image, physical activity and energy intake contributed significantly in explaining body weight status of the adolescents. In short, overweight and obesity were likely to be associated not only with energy intake and physical activity, but also body image. Hence, promoting healthy eating, active lifestyle and positive body image should be incorporated in future obesity prevention programmes in adolescents.
Adolescent ; Aged ; Asian Continental Ancestry Group ; Body Image ; Body Weight ; Diet Records ; Eating ; Energy Intake ; Energy Metabolism ; Feeding Behavior ; Humans ; Life Style ; Linear Models ; Male ; Meals ; Motor Activity ; Obesity ; Overweight ; Prevalence ; Surveys and Questionnaires ; Sedentary Lifestyle ; Snacks ; Thinness

The ultimate purpose of diabetes care is achieving the outcomes that patients regard as important throughout the life course. Despite advances in pharmaceuticals, nutraceuticals, psychoeducational programs, information technologies, and digital health, the levels of treatment target achievement in people with diabetes mellitus (DM) have remained suboptimal. This clinical care of people with DM is highly challenging, complex, costly, and confounded for patients, physicians, and healthcare systems. One key underlying problem is clinical inertia in general and therapeutic inertia (TI) in particular. TI refers to healthcare providers’ failure to modify therapy appropriately when treatment goals are not met. TI therefore relates to the prescribing decisions made by healthcare professionals, such as doctors, nurses, and pharmacists. The known causes of TI include factors at the level of the physician (50%), patient (30%), and health system (20%). Although TI is often multifactorial, the literature suggests that 28% of strategies are targeted at multiple levels of causes, 38% at the patient level, 26% at the healthcare professional level, and only 8% at the healthcare system level. The most effective interventions against TI are shorter intervals until revisit appointments and empowering nurses, diabetes educators, and pharmacists to review treatments and modify prescriptions.

BACKGROUND/OBJECTIVES: This study aims to determine contribution of meal frequency, self-efficacy for healthy eating, and availability of healthy foods towards diet quality of adolescents in Kuala Lumpur, Malaysia. SUBJECTS/METHODS: This study was conducted among 373 adolescents aged from 13 to 16 years old. Diet quality of the respondents was assessed using the Healthy Eating Index for Malaysians. Meal frequency, self-efficacy for healthy eating, and availability of healthy foods were assessed through the Eating Behaviours Questionnaire (EBQ), self-efficacy for healthy eating scale, and availability of healthy foods scale, respectively. RESULTS: The majority of the respondents (80.7%) were at risk of poor diet quality. Males (mean = 34.2 +/- 8.2%) had poorer diet quality than females (mean = 39.9 +/- 9.0%) (t = -5.941, P < 0.05). Malay respondents (mean = 36.9 +/- 8.7%) had poorer diet quality than Indian respondents (mean = 41.3 +/- 10.0%) (F = 2.762, P < 0.05). Age (r = 0.123, P < 0.05), self-efficacy for healthy eating (r = 0.129, P < 0.05), and availability of healthy foods (r = 0.159, P < 0.05) were positively correlated with the diet quality of the respondents. However, meal frequency was not correlated with the diet quality of the respondents. Multiple linear regression analysis showed that being a male, being a Malay, low self-efficacy for healthy eating, and low availability of healthy foods contributed significantly towards poor diet quality among respondents. CONCLUSIONS: In short, sex, ethnicity, self-efficacy for healthy eating, and availability of healthy foods were associated with diet quality among adolescents. Health practitioners should take into consideration of differences in sex and ethnicity during implementation of nutrition-related intervention programs. Self-efficacy for healthy eating and availability of healthy foods should be included as important components in improving diet quality of adolescents.
Adolescent* ; Surveys and Questionnaires ; Diet* ; Eating ; Female ; Humans ; Linear Models ; Malaysia* ; Male ; Meals

BACKGROUND/OBJECTIVES: Diet plays an important role in growth and development of children. However, dietary intakes of children living in either rural or urban areas can be influenced by household income. This cross-sectional study examined energy, nutrient and food group intakes of 749 urban children (1-10 years old) by household income status. SUBJECTS/METHODS: Children's dietary intakes were obtained using food recall and record for two days. Diet adequacy was assessed based on recommended intakes of energy and nutrients and food group servings. RESULTS: For toddlers, all nutrients except dietary fiber (5.5 g) exceeded recommended intakes. Among older children (preschoolers and school children), calcium (548 mg, 435 mg) and dietary fiber (7.4 g, 9.4 g) did not meet recommendations while percentage of energy from total fat and saturated fats exceeded 30% and 10%, respectively. The mean sodium intakes of preschoolers (1,684 mg) and school children (2,000 mg) were relatively high. Toddlers in all income groups had similar energy and nutrient intakes and percentages meeting the recommended intakes. However, low income older children had lowest intakes of energy (P < 0.05) and most nutrients (P < 0.05) and highest proportions that did not meet recommended energy and nutrient intakes. For all food groups, except milk and dairy products, all age groups had mean intakes below the recommended servings. Compared to middle and high income groups, low income preschoolers had the lowest mean intake of fruits (0.07 serving), meat/poultry (0.78 serving) and milk/dairy products (1.14 serving) while low income toddlers and school children had the least mean intake of fruits (0.09 serving) and milk/dairy products (0.54 serving), respectively. CONCLUSION: Low socioeconomic status, as indicated by low household income, could limit access to adequate diets, particularly for older children. Parents and caregivers may need dietary guidance to ensure adequate quantity and quality of home food supply and foster healthy eating habits in children.
Calcium ; Caregivers ; Child ; Cross-Sectional Studies ; Dairy Products ; Diet ; Dietary Fiber ; Eating ; Family Characteristics* ; Fats ; Food Supply ; Fruit ; Growth and Development ; Humans ; Milk ; Parents ; Social Class ; Sodium

BACKGROUND/OBJECTIVES: Little is known about the dietary patterns (DPs) of women during pregnancy. The present study aimed to identify the DPs of pregnant Malaysian women and their associations with socio-demographic, obstetric, and anthropometric characteristics. SUBJECTS AND METHODS: This prospective cohort study included 737 participants enrolled in Seremban Cohort Study between 2013 and 2015. Food consumption was assessed using a validated 126-food item semi-quantitative food frequency questionnaire (SFFQ) at four time-points, namely, pre-pregnancy and at each trimester (first, second, and third). Principal component analysis (PCA) was used to identify DPs. RESULTS: Three DPs were identified at each time point and designated DP 1–3 (pre-pregnancy), DP 4–6 (first trimester), DP 7–9 (second trimester) and DP 10–12 (third trimester). DP 1, 4, and 7 appeared to be more prudent diets, characterized by higher intakes of nuts, seeds & legumes, green leafy vegetables, other vegetables, eggs, fruits, and milk & dairy products. DP 2, 5, 8, and 11 had greater loadings of condiments & spices, sugar, spreads & creamer, though DP 2 had additional sweet foods, DP 5 and 8 had additional oils & fats, and DP 11 had additional tea & coffee, respectively. DP 3 and 6 were characterized by high protein (poultry, meat, processed, dairy, eggs, and fish), sugars (mainly as beverages and sweet foods), and energy (bread, cereal & cereal products, rice, noodles & pasta) intakes. DP 9 had additional fruits. However, DP 12 had greater loadings of energy foods (bread, cereal & cereal products, rice, noodles & pasta), sugars (mainly as beverages, and sweet foods), and good protein sources (eggs, nuts, seeds & legumes). Malays were more likely to have lower adherence (LA) for DP 1 and 10 than non-Malays. DP 2, 8, and 11 were more prevalent among Malays than non-Malays. Women with a higher education were more likely to have LA for DP 10, and women with a greater waist circumference at first prenatal visit were more likely to show LA for DP 11. CONCLUSIONS: DPs observed in the present study were substantially different from those reported in Western populations. Information concerning associations between ethnicity, waist circumference and education with specific DPs before and throughout pregnancy could facilitate efforts to promote healthy dietary behavior and the overall health and well-being of pregnant women.
Beverages ; Carbohydrates ; Coffee ; Cohort Studies ; Condiments ; Dairy Products ; Diet ; Edible Grain ; Education ; Eggs ; Fabaceae ; Fats ; Female ; Fruit ; Humans ; Meat ; Milk ; Nuts ; Oils ; Ovum ; Pregnancy ; Pregnant Women ; Principal Component Analysis ; Prospective Studies ; Spices ; Tea ; Vegetables ; Waist Circumference

BACKGROUND/OBJECTIVES: Low early pregnancy serum 25-hydroxy vitamin D (25[OH]D) levels can increase gestational diabetes mellitus (GDM) risk, although inconsistent findings related to that association have been reported. This study examined the association of serum vitamin D with GDM and the possible influencers on this association. SUBJECTS/METHODS: This study included 259 pregnant women within the Seremban Cohort Study (SECOST). Blood samples at < 14 weeks of gestation were drawn to determine serum 25(OH)D levels. GDM diagnosis was made at 24 to 32 weeks of gestation using a standard procedure. Association between serum vitamin D and GDM was tested using binary logistic regression. RESULTS: Nearly all women (90%) had mild (68.3%) or severe (32.2%) vitamin D deficiency (VDD). Non-GDM women with mild VDD had a significantly higher mean vitamin D intake than GDM women with mild VDD (t = 2.04, p < 0.05). Women with higher early pregnancy serum vitamin D levels had a greater risk of GDM. However, this significant association was only identified among those with a family history of type 2 diabetes mellitus (T2DM) and in women with a body mass index indicating overweight or obese status. CONCLUSIONS The high prevalence of VDD in this sample of pregnant women underscores the need for effective preventive public health strategies. Further investigation of this unexpected association between serum vitamin D level and GDM risk in predominantly VDD pregnant women and the potential effects of adiposity and family history of T2DM on that association is warranted.