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.