Introduction: Associations between serum adiponectin concentrations and anthropometric and metabolic parameters in obesity and diabetes have been elucidated; however, the relationship between serum adiponectin and cardiovascular risks in patients with metabolic syndrome are less studied. Methods: One hundred and sixty patients with metabolic syndrome (107 men and 54 women) were recruited for this study. Anthropometric indices of weight, height, waist circumference and hip circumference were measured. Serum adiponectin, lipid profile and fasting blood glucose (FBG) were measured by enzyme- linked irnmunosorbent assay method (ELbA). The homeostasis model assessment (HOMA) was used for determination of insulin resistance. Results: BMI was significantly higher and waist-to-hip ratio (WHR) was lower in women compared to men (P < 0.001 and < 0.05 respectively). Serum high density lipoprotein cholesterol (HDL-C) in women was significantly higher than in men (45.98 ± 11.15 versus 39.11 ± 8.43 mg/dl; P < 0.001). Serum adiponectin concentrations were negatively associated with serum triglyceride concentration and waist cfrcumference in men and women respectively. There was also a positive relationship between serum adiponectin and HDL-C concentrations and age in men and women respectively (P < 0.05). Adjusting for the confounding effects of age and BMI using linear regression model, serum TG, LDL-C and WC were significant negative predictors of serum adiponectin concentrations (P < 0.05). Conclusion: Our findings showed that serum adiponectin concentration is related to anthropometric and metabolic parameters in patients with metabolic syndrome. Further studies are warranted to better clarify these associations and underlying mechanisms.

Intrduction: Obesity and chronic diseases have been increasing since the last few decades alongside rapid economic development in developed and developing countries. The alarming increase in the prevalence of childhood obesity had been shown by many epidemiological studies worldwide. The aims of this study were to determine the prevalence of overweight and obesity among Chinese school children in Kota Bharu, Kelantan, and to map the association between dietary practices and their nutritional status. Methods: A cross-sectional study was conducted on 278 school children aged 10 to 12 years old (144 boys and 134 girls) studying in a Chinese primary school in Kota Bharu. Results: The survey revealed that while only 1.4% (n=4) were overweight, 23.4% (n=65) of the children were obese. A total of 67.7% (n=44) of the obese children were boys. The overweight and obese children (n=70) were compared with a randomly selected group of normal weight children (n=70). Dietary assessment showed that protein, fat and total calorie intake were significantly higher among the overweight group (p<0.05). A significantly higher proportion of the normal weight children (85.7%) took breakfast daily or at least 4 days per week compared to the overweight groups (59.4%) (p<0.05). Conclusion: The prevalence of obesity among school children in the study is a matter of concern. These findings may be useful in targeting programmes and strategies for prevention and intervention of childhood obesity.

Introduction: The glycaemic index (GI) concept ranks starchy foods according to the blood glucose responses following ingestion. When considering commonly consumed Sri Lankan meals, only a few can be categorised as low GI. However, a significant negative correlation between the GI of Sri Lankan meals and fibre content has been observed indicating the potential to reduce the GI of meals by incorporating naturally occurring sources of fibre. Thus, the objective of this study was to study the effect of increased edible quantities of fibre on the GI of rice meals consumed in Sri Lanka. Methods: Meal 1 consisted of rice with several meal accompaniments (lentil curry, boiled egg, coconut gravy and Centella asiatica (gotukola) leaves salad). Meal 2 contained similar constituents as meal 1 and a Lasia spinosa (kohila) rhizome salad. The composition of meal 3 was similar to meal 2 but contained Trichosanthes cucumerina (snake gourd) salad instead of Lasia spinosa salad. Meal 3 contained similar fibre contents as meal 1 and similar meal size as meal 2. The glycaemic indices of the three meals were determined with healthy individuals (n=10, age =20-30 yrs, BMI=24±3 kg/m2) using bread as the standard. Results: Meals 1 and 3 contained total dietary fibre (TDF) contents of 15.2g. Meal 2 contained 16.3g TDF. The GI values of the three meals were 63±5, 57±5, 61±5 respectively and were not significantly different from one another (p>0.05). The GI of the rice mixed meal 2 was reduced by 9% when total edible dietary fibre content of the actual meal was increased by 7.2%. Conclusion: The study results show that the GI of rice mixed meals may be reduced by including naturally occurring sources of fibre with starchy staples while fulfilling daily dietary fibre requirement of an adult at low cost.

Introduction: Malnutrition among under-five children is a chronic problem in developing countries. This study explores the socio-economic determinants of severe and moderate stunting among under-five children of rural Bangladesh. Methods: The study used data from the 2007 Bangladesh Demographic and Health Survey. Cross-sectional and multinomial logistic regression analyses were used to assess the effect of the socio-demographic variables on moderate and severe stunting over normal among the children. Results: Findings revealed that over two-fifths of the children were stunted, of which 26.3% were moderately stunted and 15.1% were severely stunted. The multivariate multinomial logistic regression analysis yielded significantly increased risk of severe stunting (OR=2.53, 95% CI=1.34-4.79) and moderate stunting (OR=2.37, 95% CI=1.47-3.83) over normal among children with a thinner mother. Region, father’s education, toilet facilities, child’s age, birth order of children and wealth index were also important determinants of children’s nutritional status. Conclusion: Development and poverty alleviation programmes should focus on the disadvantaged rural segments of people to improve their nutritional status.

Introduction: In experiencing epidemiologic transition, Indonesia faces emerging nutrition problems. Methods: Among the dietary lifestyle changes over the years is the rising consumption of fats and oils, including trans fatty acids. Intake of these fatty acids from ruminant meats, hydrogenated vegetable oils and fried foods is known to have detrimental effects on serum lipoprotein cholesterol levels. The purpose of this study was to determine the effects of trans fatty acid intake on blood lipid profile. A prospective cohort study was conducted on 388 workers at an on-shore oil company in East Kalimantan. Results: The mean intake of trans fatty acid was 0.48% of the total dietary calories. Fried foods contributed most to the total trans fatty acid consumed at 0.20% of the total calories. Trans fatty acid intake from ruminant products, and margarine/ hydrogenated vegetable oil products were 0.09% and 0.06% of calories, respectively. The high consumption of fried foods is associated with risks of hypertriglyceridemia (RR: 1.41, 95%CI 1.06; 1.86), high ratio of total cholesterol/ HDL-C (RR: 1.98, 95%CI 1.00; 3.98) and dyslipidemia (RR: 1.35, 95%CI 1.00;1.84). Every additional one percent of saturated fatty acid intake is associated with an increase in trans fatty acids amounting to 0.03% of total calories (r = 0.320, p = 0.000). Conclusion: These results suggest that a reduction in consumption of fried foods will be of benefit as it will reduce intake of both saturated and trans fatty acids. Further studies are recommended to determine the intake of trans fatty acids and their health effects on other population groups in Indonesia.

Introduction: The Philippines’ Cebu Longitudinal Health and Nutrition Survey (CLHNS) is one of the longest running birth cohort studies in Southeast Asia. This paper illustrates the pathways through which maternal and infant nutrition influence later health outcomes using selected CLHNS findings. Methods: The CLHNS initially examined the determinants and consequences of low birth weight and early nutrition on child growth and development. It has since expanded to study other health, nutrition, and demographic issues in the life course of the cohort participants such as the consequences of early nutrition on adult health. Results: CLHNS findings have documented important effects of poor maternal nutrition beyond impaired foetal growth (manifested through low birth weight). Mothers who had lower energy intakes and poorer nutritional status during pregnancy had offsprings who were at risk of having higher blood pressure measurements in adolescence. Infants born small at birth were not only more likely to be stunted through adolescence, but were also at greater risk of cardiovascular disease later in life. Among the males, those born thin at birth and have high BMI in adulthood had increased risk of elevated systolic blood pressure. Early infant feeding also had long-term effects on health. Breastfeeding not only protected against morbidity and stunting in childhood, but also lowered the risk of insulin resistance and high triglyceride levels in adulthood among the males. Delayed complementary feeding was associated a with lower risk of overweight in young adulthood. An intergenerational matrilineal effect was also observed among the participants, with maternal birth weight being positively associated with offspring birth weight. Conclusion: The CLHNS findings support the WHO recommendations for exclusive breastfeeding until six months, timely introduction of complementary foods, and continued breastfeeding until two years. Since child nutrition begins in utero, programs should focus on improving maternal nutrition during pregnancy to minimise the risk of low birth weight.

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.

Introduction: The use of email and website as channels for workplace health information delivery is not fully explored. This study aims to describe the rationale, design, and baseline findings of an email-linked website intervention to improve modifiable cancer risk factors. Methods: Employees of a Malaysian public university were recruited by systematic random sampling and randomised into an intervention (n=174) or control group (n=165). A website was developed for the intervention and educational modules were uploaded onto the website. The intervention group received ten consecutive weekly emails with hypertext links to the website for downloading the modules and two individual phone calls as motivational support whilst the control group received none. Diet, lifestyle, anthropometric measurements, psychosocial factors and stages of change related to dietary fat, fruit and vegetable intake, and physical activity were assessed. Results: Participants were predominantly female and in non-academic positions. Obesity was prevalent in 15% and 37% were at risk of co-morbidities. Mean intake of fats was 31%, fruit was ~1 serving/day and vegetable was <1 serving/day. Less than 20% smoked and drank alcohol and about 40% were physically inactive. The majority of the participants fell into the Preparation stage for decreasing fat intake, eating more fruit and vegetables, and increasing physical activity. Self-efficacy and perceived benefits were lowest among participants in the Precontemplation/Contemplation stage compared to the Preparation and Action/Maintenance stages. Conclusion: Baseline data show that dietary and lifestyle practices among the employees did not meet the international guidelines for cancer prevention. Hence the findings warrant the intervention planned.

Introduction: Medicinal plants, believed to possess hypoglycemic and hypolipidemic potential namely, Gymnema sylvestre, Momorodica charantia, Murraya koenigii, Terminalia arjuna and Trigonella foenum graecum, were analysed for nutritional composition. Methods: Proximate analysis was done following the methods of AOAC. Available carbohydrate, β-carotene and minerals were analysed using spectrophotometer and atomic absorption spectrophotometer, respectively. One-way variance analysis was used to statistically analyse the variations in nutrient contents among the plants. Results: Moisture, crude protein, crude fibre, crude fat, ash, carbohydrate and energy content ranged between 10.86 - 91.81 , 2.81-25.60, 6.22-13.63, 0.48-7.41, 3.27-19.40, 52.87- 68.20 g/100 g and 292.78-400.17 Kcal/100 g on dry weight basis, respectively. Total soluble, reducing, non-reducing sugar and starch varied from 3.02-7.74, 1.74-4.78, 0.65-5.49 and 1.99-19.38 g/100 g, respectively. Neutral detergent fibre, acid detergent fibre, hemicellulose, cellulose and lignin ranged between 22.82-39.68, 1.98-20.69, 8.98- 31.19, 1.21-8.93, 0.72-12.50 g/100 g, respectively. Gymnema sylvestre had the highest concentration of β-carotene (7950 + 0.45 mg/100 g) and iron (37.21 + 0.50 mg/100 g), while Murraya koenigii had the highest copper (2.71 + 0.09 mg/100 g) and calcium concentration (42.76 + 0.43 mg/100 g). Chromium and zinc were highest in Momorodica charantia (2.93 + 0.22 mg/100 g) and Trigonella foenum graecum (3.61 + 0.46 mg/100 g), respectively. Significant difference was observed in the crude protein, crude fat, carbohydrate, energy, acid detergent fibre and lignin content of the medicinal plants.Conclusion: These medicinal plants can be considered as potential sources of protein, fat, dietary fibre, β-carotene and minerals for diabetic and dyslipidemic patients.

Introduction: Diet and lifestyle modification is commonly used in constipation management. As there is a dearth of studies on this topic in Malaysia, we aim to elucidate the relations between stool patterns, dietary intake and physical activity levels among adults with functional constipation. Methods: From a database collected via surveys at public events, a convenience sample of 100 adults diagnosed with Rome II-defined functional constipation was enrolled in this cross-sectional study. After severity assessment using the Chinese Constipation Questionnaire, subjects completed 2-week bowel movement diaries to determine stool frequency, consistency and output. Dietary intake and physical activity levels were assessed twice using three-day 24-hour diet recalls and International Physical Activity Questionnaire, respectively. Ninety subjects who completed the study were included in the analysis. Results: Mean weekly stool frequency was 3.9±1.9 times, consistency score was 2.6±0.6 (range 1.0-4.0), output was 11.0±6.3 balls (40 mm diameter) and severity score was 10.3±3.3 (range 5.0-22.0). Mean daily dietary intakes were: energy 1,719±427kcal, dietary fibre 15.0±4.9g and fluid 2.5±0.8L. The majority of subjects were physically inactive. Stool frequency and output were positively associated with dietary fibre (rs=0.278, P<0.01; rs=0.226, P<0.05) and fluid intake (rs=0.257, P<0.05; OR=3.571, 95% CI [1.202-10.609]). Constipation severity was associated with higher physical activity levels (OR=2.467, 95% CI [1.054-5.777]). Conclusion: Insufficient intake of dietary fibre and fluid are associated with aggravated constipation symptoms. Further studies are necessary to confirm usefulness of dietary intervention in treatment of constipation as dietary factors alone may not influence overall severity and stool consistency, an integral element of constipation.