Dietary fibre and total fluid intakes are inversely associated with risk of constipation in Malaysian adolescents, adults and the elderly

Dietary fibre (DF) and fluid intakes have been reported elsewhere to reduce the risk of constipation. The association of these dietary components on Agachand’s Constipation Score (CS) was investigated in the present study. Methods: A total of 202 Malaysian participants comprising 50 adolescents (aged 12.4 ± 5.3 yrs), 50 adults (aged 46.3 ± 11.3 yrs), 52 women of childbearing age (aged 29.1 ± 9.3 yrs) and 50 elderly persons (aged 70.0 ± 7.4 yrs) were recruited by convenience sampling from five venues - two communities in Cheras, one community in Klang, the IMU campus, Bukit Jalil and a private secondary school in Klang. All participants were interviewed with a previously-evaluated food frequency questionnaire (FFQ) and an Agachand’s Constipation Score (CS) Questionnaire.Results: Mean daily DF intakes were low across all age groups with means ranging from 10.0 – 15.6g. The percentage of subjects with daily DF intakes below the “deficient” cut-off of 20g was alarmingly high; 80% in adolescents, 45% in adults, 85% in women of child-bearing age and 70% in the elderly. About onefifth or 20% of subjects in all age groups had CS values ≥15 which indicated a problem of constipation. Mean daily total fluid consumption (TFC) ranged from 2128 – 5490 ml in the four categories of subjects. Overall, both daily DF intakes and TFC were negatively associated with CS values. This inverse association was significant for DF vs CS scores in adolescents (r = -0.500, p = 0.001), adults (r = -0.351, p = 0.013), the elderly (r = -0.392, p = 0.005) and all subjects combined (r = -0.366, p=0.001). For TFC vs CS scores, the inverse association was only significant for the elderly (r = -0.312, p = 0.027) and all subjects combined (r = -0.245, p = 0.001). Conclusion: The results of this study support the role of dietary fibre intake and TFC in reducing the risk of constipation, as well as reinforcing previous data for low DF intakes among the Malaysian population.

Influence of rice and added sugar intakes on fasting plasma glucose and triacylglycerol levels amongst a population sample of Malaysian adults

Introduction: A recently published meta-analysis showed that each additional serving of rice increased risk of type 2 diabetes mellitus (DM) by an alarming 11%. We investigated whether this phenomenon is seen in the Malaysian population by studying the effect of rice intake and added sugar consumption on fasting plasma glucose (FPG) and fasting triacylglycerol (TAG). Methods: Ninety subjects (60 females, 30 males, aged 30-70 years), adequate to detect a weak-to-moderate Pearson correlation of r=0.26 at a=0.05 and power= 0.80, were recruited by convenience sampling from six communities in the Klang Valley, Malaysia. Fasting blood samples were collected by finger-prick and analysed for FPG (AccuCek, Roche) and TAG (Accutrend, Roche). Macronutrient intakes, including rice, were obtained by a single interview using a previously-evaluated food frequency questionnaire (FFQ) and quantitated as grams by the DietPLUS V2 programme. Added sugar intakes by subjects were estimated using an Added Sugar Intake excel programme. Results: Rice contributed to 85% of dietary carbohydrates, accounting for 41.8 % kcal of the average 1750- kcal diet. Rice intakes or added sugar consumption did not have a significant correlation (p>0.05) with FPG nor fasting TAG. Added sugar consumption, which averaged 44g/person/day (5% kcal) was markedly lower than the 137g/person/day reported elsewhere for the Malaysian population. Conclusion: High consumption of rice as a risk factor of type 2 DM was not indicated in the present study. Since white rice consumption varied 10-fold in the present subjects, the reduction in daily intake of this staple food represents a feasible option for cutting back on calorie intake for overweight or obese individuals.

Omega-6 and omega-3 fatty acid nutrition amongst Malaysians are far from desirable

This paper reviews available reports on the omega-6 (linoleic acid, LA) and omega-3 fatty acid [alpha-linolenic acid (ALA) + eicosapentaenoic acid (EPA) + docosahexaenoic acid) intakes amongst Malaysians against Malaysian Recommended Nutrient Intakes (RNI), focussing particularly on pregnant and lactating women because of the availability of data for these latter vulnerable groups. Overall, the omega-6 and omega-3 fatty acid nutrition amongst Malaysians are poor and far from desirable. The nutritional situation regarding these long-chain polyunsaturated fatty acids (LCPUFA) amongst Malaysian pregnant and lactating women is alarming and warrants urgent attention in nutrition promotion activities/counselling. Daily consumption of LA by these women and other Malaysians studied ranged from 3.69 - 5.61 % kcal with 38-60% of individuals not meeting their RNIs. Daily intakes of omega-3 fatty acids faired worse, averaging 0.21- 0.33 % kcal with as high as 92% of subjects in one study not meeting their RNIs. The omega-6 to omega-3 fatty acid ratios obtained in the studies reviewed are about 20:1, which is way above the World Health Organisationrecommended ratio of 5-10:1. Dietary sources of these omega- fatty acids in the subjects studied are chicken, fish and milk. Since local foods are not particularly rich in LCPUFA such as EPA and DHA, the options to improve EPA/DHA nutrition amongst Malaysians are the greater consumption of omega-3 enriched foods and in the case of pregnant and lactating women, LCPUFA supplementation may warrant serious consideration.