Recognising the epidemic of overweight and obesity among Malaysians, formulation of intervention programmes such as a weight management programme at workplace is essential. This study aimed to determine the effectiveness of a structured weight management programme at workplace among overweight and obese employees. In this quasi-experimental study, sixty-four of overweight and obese adults were recruited and divided into two groups (intervention group, n = 32 and control group, n = 32). Subjects in the intervention group received three months scheduled programme and the control group received a routine weight management consultation from dietitians. Significant group effect was found on waist circumference (WC) in men (p < 0.05) and Body Mass Index (BMI) in women (p < 0.05). Men from the intervention group had reduced their WC by 3.4% (-3.7 cm) as compared to controls of 0.7% (-0.8 cm). Women in the intervention group improved their BMI by 1.4% (-0.4 kg/m2) as compared to controls at 0.3% (-0.1 kg/m2). Total cholesterol and LDL-C reduced among women in both intervention and control group with significant time effect (p < 0.05). As a conclusion a structured weight management programme effectively improved WC in men and BMI in women, and appeared to be as effective as individual diet counselling by dietitians in improving lipid profiles in women.
Obesity

Introduction: Adequacy of fruit intake contributes to an individual’s health including reducing the risk of non-communicable disease. This study aimed to assess consumption of fruits in various forms and to determine associated factors and barriers. Methods: In this cross-sectional study, a total of 300 adults aged 20-39 years were purposely recruited from several urban locations in the Klang Valley. Consumption of fruits in the past 12 months was assessed using a selfadministered food frequency questionnaire (FFQ), assisted with pictures of serving size of fruits. Anthropometric measurements were taken and body mass index and waist circumference computed. Results: Fruit intake among young adults was lower (1.6±1.0 servings/day) than the Malaysian Dietary Guideline 2010 of ≥ 2 servings/day. Only 32.3% consumed fruits as recommended, with women consuming significantly more fruits than men. Preferred fresh fruits were red apple, banana and papaya. Consumption of fruit juice was associated with increase in waist circumference (R2=0.261, p=0.027) after adjustment for age, sex, ethnicity, education level and marital status. Fruit intake showed no significant association with other anthropometric measurements. Sensory appeal, perceived health benefit, easy to prepare and influence of family were the main determinants of fruit intake, whilst affordability and availability were the major barriers. Conclusion: Fruit consumption among young adults in this study was lower than the recommendation for daily fruit intake. Studies with larger sample size are suggested to verify the finding of significant association between fruit juice consumption and risk of abdominal obesity.

Obesity is a risk factor for chronic diseases which can affect work productivity and physical function of employees particularly among those in security sector. The study aimed to determine the association between obesity with total days of sick leave and health related quality of life (HRQoL) among Malay male security officers. A cross-sectional study was conducted among Malay male security officers working in a Malaysian higher learning institution. Subjects were evaluated using anthropometric measurements, quality of life and number of sick leave taken within two months prior to the study. A total of 194 subjects (mean age 40.12 ± 11.41 years) were recruited. A total of 30.4% were obese, 39.7% were pre-obese and only 29.9% had normal body weight or underweight. Central obesity was observed in 57.7% of them and 87.1% shown excessive body fat percentage. Number of sick leave days was positively correlated with Body Mass Index (BMI) (r = 0.162, p = 0.024) and waist circumference (r = 0.181, p = 0.012). Score of the general health component was negatively correlated with BMI (r = -0.161, p = 0.025), waist circumference (r = -0.194, p = 0.007) and body fat percentage (r = -0.191, p = 0.008). Physical functioning score was lowest in obese subjects than normal and pre-obese subjects (p = 0.046). Score of the bodily pain component was positively correlated with waist circumference (r = 0.156, p = 0.030). Obesity is associated with number of sick leave days and quality of life in the studied group. Hence, body weight of the security staff should be monitored and appropriate intervention should be conducted to improve their work attendance and quality of life.
Obesity

Adequate nutrition is important for mothers and their offspring during and after birth. This cross sectional study was conducted to determine nutritional status and nutritional knowledge of pregnant women from two selected private hospitals in Klang Valley, Malaysia. A total of 236 Malay pregnant women aged between 20 to 45 years old (mean age 31+5 years) were recruited through convenient sampling method. Socio-demographic data, nutritional knowledge and a 24-hours diet recall were obtained through a self-administered questionnaire. Anthropometric and haemoglobin data were obtained from the antenatal records in the respective hospitals. The percentages of participants who were underweight, normal, overweight and obese before pregnancy were 12.7%, 55.1%, 25.0% and 7.2% respectively. Among those who were obese before pregnancy, a total of 59.7% had inadequate weight gain, 24.6% gained adequate weight and 15.7% gained excessive gestational weight. About 33.5% of subjects were anaemic (Hb < 11.0g/dL). The mean daily energy intake of the participants was 1748 ± 526 kcal which was 76% of RNI. Calcium (73% of RNI), folic acid (36% of RNI), niacin (89% of RNI) and vitamin D (40% of RNI). The nutritional knowledge level of subjects was moderate (51.9 ± 13.8%). Lower monthly household income (p < 0.001), educational level (p < 0.001) and gestational stage (p < 0.05) of participants were associated with a lower nutritional knowledge level. Nutritional knowledge score was positively correlated with gestational weight gain (r = 0.166, p < 0.05) and haemoglobin level (r = 0.200, p < 0.05). Subjects who claimed practising food taboos had higher nutritional knowledge score (54.9 ± 12.5%) than those who did not (49.9 ± 14.4%)(p < 0.05). A comprehensive nutrition education should be integrated in the antenatal classes to improve nutritional status of pregnant women

Peer-reviewed articles on the usage of mobile applications in the management of diabetes were reviewed. Studies using mobile device applications for diabetes interventions published between January 2007 and March 2013 were included in this review. Studies related to the developmental processes of the mobile applications were excluded. The characteristics of these studies and the outcomes of the methods used in the management of diabetes were gathered. We retrieved a total of 372 articles from ACM Digital library, PubMed and Proquest Medical Library. After applying the inclusion and exclusion criteria, 8 articles were eligible for further review. Most of the studies included in this review showed the effectiveness of mobile applications in diabetes management. Their major contribution comes from feedback functions of the systems that assist participants in the self-monitoring of their blood glucose and dietary intake. However, the majority of the studies showed the limited use of the mobile phone as a tool to input information into systems which would in turn convey a reminder message to the patient. In conclusion, with its features of portability and convenience, mobile application used in the management of diabetes has the potential to improve glycaemic control, resulting in significant clinical and financial benefits.
Diabetes Mellitus

Introduction: Lack of healthy food choices at the worksite is associated with unhealthy eating habits and poor diet quality. This study aimed to conduct a two weeks pilot study to assess the diet quality of lunch-meals delivered to worksites. Methods: Using a crossover study design, a total of 50 adults were purposely recruited from among university and hospital staffs in Selangor. Participants were randomised into two groups, whereby in week one, Group A was provided with the study’s “healthy lunch-meals” (RD4U©) for 3 work days/week, while Group B consumed their usual lunch. In week two, the groups switched over with Group B receiving RD4U© lunch-meals for three days. Diet quality of the lunch meals was assessed using the Healthy Eating Index for Malaysian (HEI-M). Participant satisfaction for RD4U© service was determined using SERVQUAL. Results: Mean protein consumption was significantly higher (27±4 g/day) while fat consumption was significantly lower (18±5 g/day) for the RD4U© lunch-meals, compared to the respective levels (24±11 g/day; 22±12 g/day) for the usual lunch meals. Total HEI score of the RD4U© meals (61.9±9.2) was higher than that for the usual lunch meals (56.1±11.2). Nonetheless, the overall diet quality scores indicate that both RD4U© and usual lunch meals were in the “need improvement” category. Generally, participants were satisfied with the RD4U© lunch-meal service. Conclusion: The RD4U© lunch-meals showed potential in delivering healthy lunch to worksites, and feasibility studies to expand the RD4U© delivery service is recommended.

Current treatment for inflammatory bowel disease (IBD) includes the application of anti-inflammatory agents for the induction and remission of IBD. However, prolonged use of anti-inflammatory agents can exert adverse effects on patients. Recently, formulated dietary approach in treating IBD patients is utilized to improve clinical activity scores. An alteration of gastrointestinal microbiota through dietary therapy was found to reduce IBD and is recognized as a promising therapeutic strategy for IBD. One of the recommended formulated diets is an anti-inflammatory diet (AID) that restricts the intake of carbohydrates with modified fatty acids. This diet also contains probiotics and prebiotics that can promote balanced intestinal microbiota composition. However, scientific evidences are limited to support this specific dietary regime in maintaining the remission and prevention relapse of IBD. Therefore, this review aimed to summarize available data from various studies to evaluate the AID diet effectiveness which will be useful for clinicians to manage their IBD patients by application of improved dietary therapy.

Introduction: Malnutrition among cancer patients is associated with a higher risk of gastrointestinal toxicity which develops during treatment and may affect quality of life (QOL). Thus, this cross-sectional study aimed to determine the nutritional status and QOL of 30 oncology patients (mean age 50.0+10.7 years) prior to pelvic radiotherapy at Hospital Sultan Ismail, Johor Bahru. Methods: Patients were assessed for anthropometry measurements, 24-h diet recall and nutritional status using Scored Patient-Generated Subjective Global Assessment (PG-SGA) questionnaire while the European Organization for Research and Treatment of Cancer Care Quality of Life Questionnaire (EORTC QLQ-C30) was used to assess QOL two weeks prior to the initiation of pelvic radiotherapy. Results: Mean Body Mass Index (BMI) of patients was 23.3+3.3kg/m2 and 33% of patients experienced weight loss prior to pelvic radiotherapy. The PG-SGA rating indicated that 63% of patients were at Stage A (well-nourished) and 37% were in Stage B (moderate malnutrition). The PG-SGA numerical score was a significant predictor of QOL, after adjusting for socio-demographic factors (R2=0.861, p<0.05). Conclusion: In general, the low nutritional status of the patients indicates the need for early nutritional assessment, education and intervention in ensuring optimal nutritional status throughout the pelvic radiotherapy treatment.

Current treatment for inflammatory bowel disease (IBD) includes the application of anti-inflammatory agents for the induction and remission of IBD. However, prolonged use of anti-inflammatory agents can exert adverse effects on patients. Recently, formulated dietary approach in treating IBD patients is utilized to improve clinical activity scores. An alteration of gastrointestinal microbiota through dietary therapy was found to reduce IBD and is recognized as a promising therapeutic strategy for IBD. One of the recommended formulated diets is an anti-inflammatory diet (AID) that restricts the intake of carbohydrates with modified fatty acids. This diet also contains probiotics and prebiotics that can promote balanced intestinal microbiota composition. However, scientific evidences are limited to support this specific dietary regime in maintaining the remission and prevention relapse of IBD. Therefore, this review aimed to summarize available data from various studies to evaluate the AID diet effectiveness which will be useful for clinicians to manage their IBD patients by application of improved dietary therapy.

Background/Aims: Ulcerative colitis (UC) is a chronic, relapsing and remitting inflammation of the gastrointestinal tract. Little is known about the link between dietary intake, food avoidance, and beliefs among UC patients of different disease severity. Therefore, this study aimed to assess the dietary intake, food avoidance, and beliefs among active and inactive UC patients. Methods: A cross-sectional study was conducted among UC patients from a tertiary medical center in Kuala Lumpur, Malaysia. Demographic, anthropometric, dietary intake, food avoidance and beliefs were assessed. Disease activity of UC patients was evaluated using the Powell Tuck Index. Results: UC patients were recruited (64.1% inactive UC and 35.9% active UC). As compared to inactive UC patients, active UC patients were likely to lose weight (75.0% vs. 0%), possess certain food beliefs (95.7% vs. 39.0%), and frequently practiced dietary avoidance (95.7% vs. 43.9%). The dietary intake among inactive UC patients was higher than active UC patients. However, neither of them met the standard nutrients recommendation for protein, calcium, iron, folate, zinc, vitamin D, vitamin B12, and vitamin E. Conclusions Active UC patients had poorer dietary intake, were more prone to practicing food avoidance and exhibited certain food beliefs as compared to inactive UC patients. Both macro- and micronutrients intakes were inadequate regardless of patient’s disease status. These findings emphasized the importance for patients to be provided with the nutrition-related knowledge as part of strategies to avoid nutritional inadequacies.