Introduction: Critical time windows exert profound influences on foetal physiological and metabolic profiles, which predispose an individual to later diseases via a 'programming' effect. Obesity has been suggested to be 'programmed' during early life. Foetuses and infants who experience adverse growth are subjected to a higher risk of obesity. However, the key factors that link adverse foetal growth and obesity risk remain obscure. To date, there is considerable evidence showing that the overall balance between free radical damage and the antioxidative process being challenged occurs throughout gestation. With the view that pregnancy is a pro-inflammatory state confronted with enhanced oxidative stress, which possesses similar characteristics to obesity (a chronic inflammatory state with increased oxidative stress), oxidative stress is thus biologically plausibly be proposed as the underlying mechanism between this causal-disease relationship. Oxidative stress could act as a programming cue for the development of obesity by inducing complex functional and metabolic deregulations as well as inducing the alteration of the adipogenesis process. Thereby, oxidative stress promotes adipose tissue deposition from early life onwards. The enhancement of fat accumulation further exaggerates oxidative derangement and perpetuates the cycle of adiposity. This review focuses on the oxidative stress pathways in prenatal and early postnatal stages, from the aspects of various endogenous and exogenous oxidative insults. Because oxidative stress is a modifiable pathway, this modifiability suggests a potential therapeutic target to fight the obesity epidemic by understanding the causal factors of oxidant induction.

Iron deficiency and anaemia affect millions of children worldwide. This study aimed to investigate the effect of iron deficiency with or without anaemia on cognitive functions, specifically with short-term memory, attention and visualmotor coordination in children. A total of 173 primary school children was enrolled. Cognitive functions were assessed using the Wechsler Intelligence Scale for Children. Three sub-tests were selected to assess processing speed (coding test), immediate auditory memory (digit span test) and visual processing and problem solving ability (maze test). The results showed significant correlation between age and coding test (r =0.38, p<0.001), digit span test (r =0.16,p = 0.028), and maze test scores (r =0.28, p<0.001), and the total sub-test scores (r=0.43, p <.001). After age adjustment of the cognitive function tests, iron deficient children without anaemia scored significantly lower than the healthy children (p<0.001) on coding test, while iron deficient children with anaemia and iron deficient children without anaemia scored significantly lower (p<0.001) than the healthy counterparts on maze test. No significant differences were observed on digit-span score among the groups. This study confirms the negative effect of both iron deficiency and iron deficiency anaemia on processing speed and visualmotor coordination in children.

Introduction: This study aimed to develop and examine the validity and reproducibility of a semi-quantitative food frequency questionnaire (FFQ) among Malay pregnant women in Kelantan, Malaysia. Methods: A total of 177 Malay pregnant women participated in the validation study while 85 of them participated in the reproducibility study which was carried out in the antenatal clinic of Universiti Sains Malaysia Hospital. The newly developed FFQ was validated against two 24-hour dietary recalls (DR). The FFQ was repeated 20 to 28 days apart. Results: Results showed that the FFQ moderately over estimated the nutrient and food intakes compared to the DR. Spearman correlation coefficients for nutrients ranged from 0.24 (fat) to 0.61 (calcium) and for foods, ranged from 0.13 (organ meats, onion and garlic) to 0.57 (malt drink). For nutrients, 72 to 85% of women were classified into the correct quartiles from the FFQ and the DR while for foods, 67 to 85% of women were classified correctly. Bland-Altman plot showed relatively good agreement between these two dietary methods. The intra-class correlation (ICC) was used to estimate reproducibility. It ranged from 0.75 (vitamin C) to 0.94 (phosphorus) for nutrients while it ranged from 0.73 (confectionary) to 0.96 (coffee) for foods. Conclusion: On average, at least 90% of pregnant women were correctly classified into the quartiles for nutrients and foods from the two sets of the FFQ. The FFQ presented acceptable reproducibility and appears to be a valid tool for categorising pregnant women according to dietary intake.

Introduction: The increasing prevalence of adiposity is associated with the development of type 2 diabetes mellitus (T2DM). The two most popular methods to measure adiposity are body mass index (BMI) and waist-hip-ratio (WHR), which measure the overall and abdominal adiposity, respectively. The aim of this study was to determine whether BMI or WHR was more strongly associated with macronutrient intakes and lipid profiles in T2DM patients. Methods: In this cross-sectional study, a total of 210 T2DM patients, mean age of 56.73(SD 10.23) years, were recruited from Penang. Information on socio-demographic, body measurements (height, weight, waist circumference and hip circumference)and macronutrient intakes (three 24-hour dietary recalls) were recorded. Routine laboratory tests (fasting blood glucose, HbA1c, LDL, HDL, triglyceride and total cholesterol) were performed according to standard procedure. Results:Among the respondents, 84% had abdominal and 63% had overall adiposity respectively.There was a significant correlation between WHR and the total calorie(r=0.27; p<0.001), carbohydrate (r=0.30; p<0.001) and protein intakes(r=0.18; p=0.009). WHR was significantly associated with serum triglycerides(r=0.18; p=0.011) and the HDL levels (r=-0.20; p=0.003). On the other hand, neither lipid profiles nor dietary intakes showed significant correlation with BMI. Conclusion: In T2DM, WHR is more strongly associated with macronutrient intakes, HDL and triglyceride compared with BMI. Hence, WHR is a better anthropometric indicator of plasma lipids in T2DM.

Introduction: The aim of this study was to investigate the relationship between gender, birth weight, nutritional status, and iron status of children with their academic performance and cognitive function. Methods: Two hundred and fortynine children, seven to nine years of age, were recruited by systematic sampling from six primary schools in a rural area in Malaysia. Cognitive function was assessed by using Raven’s Coloured Progressive Matrices (R-CPM). Academic performance of the children was recorded from their school final examination results in four subjects including Malay language, English, Mathematics, and Science. Birth weight was recorded from the birth certificate, and nutritional status was determined by weight-for-age z score and height-for-age z score. Results: Girls had a significantly higher score in all the academic tests, but a lower cognitive score compared to boys. Nutritional status was found to be correlated significantly with academic performance. Academic and cognitive function scores were also found to be correlated significantly with birth weight, parents’ education, and family income. In a multivariate analysis, gender remained the significant predictor of academic function, and iron status and haemoglobin were the significant predictors of cognitive function, after controlling for other variables. Conclusion: The study showed that girls performed better academically than boys in rural Malaysia. Nutritional status, parents’ education and family income could be additional modifiable factors to improve academic performance of the children. More attention is needed to improve academic achievements of boys at their early school years.

Introduction: A cross-sectional study was carried out to investigate accelerometerdetermined physical activity level of 233 Malay government employees (104 men, 129 women) working in the Federal Government Building Penang,Malaysia. Methods: Body weight, height, waist and hip circumference, body fat percentage and blood pressure were measured for each respondent. All the respondents were asked to wear an accelerometer for 3 days. Body mass index (BMI) and waist-hip ratio (WHR) were calculated using a standard formulas. Fasting blood sample was obtained to determine the lipid profile and glucose levels of the respondents. Results: Based on the accelerometer-determined physical activity level, almost 65% of the respondents were categorised as sedentary. Approximately 50.2% of the respondents were overweight or obese. There were negative but significant relationships between body mass index (BMI) (r=-0.353, p<0.05), body fat percentage (r=-0.394, p<0.05), waist circumference (WC) (r=-0.198, p<0.05) and physical activity level. Sedentary individuals had a higher risk than moderate to active individuals of having a BMI more than or equal to 25 kg/m2 (OR= 2.80, 95% CI 1.55-5.05), an-risk classified WC (OR= 1.79, 95% CI 1.01-3.20), and a body fat percentage classified as unhealthy (OR= 3.01, 95% CI 1.41-6.44). Conclusion: The results of this study suggest that accelerometer-determined physical activity level is a significant factor associated with obesity in this study. The high prevalence of physical inactivity and obesity found among respondents of this study indicate a need for implementing intervention programmes among this population.