Combined Effect of Dietary Acid Load and Cardiometabolic Syndrome on Bone Resorption Marker among Post-Menopausal Women in Malaysia.

Background: This study aimed to investigate factors associated with bone resorption status and determine the independent and interactive effects of dietary acid load (DAL) and cardiometabolic syndrome (CMS) on bone resorption in post-menopausal women. Methods: Overall, 211 community-dwelling post-menopausal women were recruited from the National Council of Senior Citizens Organization, Malaysia. DAL was estimated using the potential renal acid load from the food frequency questionnaire. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) and smoking behaviour was assessed using the Global Adult Tobacco Survey 2011. Serum 25(OH) vitamin D levels were determined using the ADVIA Centaur vitamin D assay and serum C-terminal telopeptides of type I collagen (CTX1) were used as surrogate markers to assess bone resorption. CMS was determined based on the harmonised criteria. Results: Age (ß = -0.145, t = -2.002, P < 0.05) was negatively associated while DAL (ß = 0.142, t = 2.096, P < 0.05) and sleep quality (ß = 0.147, t = 2.162, P < 0.05) were positively associated with CTX1. Height was positively correlated with CTX1 (r = 0.136, P <0.05). Conversely, other variables (CMS traits, CMS, serum 25(OH) vitamin D level, years of menopause, years of education and physical activity) were not significantly associated with CTX1 levels. There was no significant interaction between DAL and CMS on bone resorption. Conclusion: Our findings propose that high DAL, but not CMS, is a potential risk factor for bone resorption. The analysis did not demonstrate the combined effects of DAL and CMS on bone resorption.

Effectiveness of Mediterranean Diet on Daytime Sleepiness among Individuals with Type 2 Diabetes Mellitus in Oman.

Background Sleep disturbance is a major complaint among individuals with diabetes mellitus and may be augmented by dietary interventions. The objective of this randomized controlled trial was to determine the effectiveness of a Mediterranean diet intervention on daytime sleepiness among individuals with type 2 diabetes mellitus (T2DM) in Oman. Methods In total, 134 eligible individuals with T2DM (61 and 73 participants in the intervention and control groups, respectively) were recruited. The intervention participants underwent a 6-month Mediterranean diet intervention consisting of individual dietary counseling, cooking classes, phone calls, and social media messages, while the control group continued with standard diabetes care. Daytime sleepiness was assessed using the Epworth Sleepiness Scale. All data was analyzed using IBM SPSS Statistics for Windows, version 26.0 (IBM Corp., Armonk, NY, USA). Results Daytime sleepiness was evident, with ∼ 30% of the participants experiencing it, with no significant difference between control and intervention participants at baseline. There was a significant reduction in daytime sleepiness in both the intervention and control groups after 6 months, with daytime sleepiness significantly lower in the intervention group, with a modest difference of 42.56% ( p < 0.001). Conclusion Adherence to the Mediterranean diet is effective in reducing daytime sleepiness among individuals with T2DM. Clinical Trial UMIN000041152.

Dietitian-led cluster randomised controlled trial on the effectiveness of mHealth education on health outcomes among pregnant women: a protocol paper.

INTRODUCTION: Nutrition education is the cornerstone to maintain optimal pregnancy outcomes including gestational weight gain (GWG). Nevertheless, default for appointments is common and often lead to suboptimal achievement of GWG, accompanied with unfavourable maternal and child health outcomes. While mobile health (mHealth) usage is increasing and helps minimising barriers to clinic appointments among pregnant mothers, its effectiveness on health outcomes has been inconclusive. Therefore, this study aimed to address the gap between current knowledge and clinical care, by exploring the effectiveness of mHealth on GWG as the primary outcome, hoping to serve as a fundamental work to achieve optimal health outcomes with the improvement of secondary outcomes such as physical activity, psychosocial well-being, dietary intake, quality of life and sleep quality among pregnant mothers. METHODS AND ANALYSIS: A total of 294 eligible participants will be recruited and allocated into 3 groups comprising of mHealth intervention alone, mHealth intervention integrated with personal medical nutrition therapy and a control group. Pretested structured questionnaires are used to obtain the respondents' personal information, anthropometry data, prenatal knowledge, physical activity, psychosocial well-being, dietary intake, quality of life, sleep quality and GWG. There will be at least three time points of data collection, with all participants recruited during their first or second trimester will be followed up prospectively (after 3 months or/and after 6 months) until delivery. Generalised linear mixed models will be used to compare the mean changes of outcome measures over the entire study period between the three groups. ETHICS AND DISSEMINATION: Ethical approvals were obtained from the ethics committee of human subjects research of Universiti Putra Malaysia (JKEUPM-2022-072) and medical research & ethics committee, Ministry of Health Malaysia: NMRR ID-22-00622-EPU(IIR). The results will be disseminated through journals and conferences targeting stakeholders involved in nutrition research. TRIAL REGISTRATION NUMBER: Clinicaltrial.gov ID: NCT05377151.

Effectiveness of acupuncture as adjunctive therapy in type 2 diabetic: Study protocol for a randomized controlled trial.

INTRODUCTION: The incidence of type 2 diabetes mellitus is increasing worldwide. The literature suggests that acupuncture is a possible complementary therapy for type 2 diabetes mellitus. This study aims to determine the effectiveness of acupuncture as an adjunctive therapy on homeostasis model assessment-insulin resistance (HOMA-IR), and health-related quality of life (HRQoL) in patients with type 2 diabetes mellitus. MATERIALS AND METHODS: This randomized, double-blind, placebo controlled, and parallel design trial will be carried out in a public university teaching hospitals in Malaysia. Eligible type 2 diabetes mellitus subjects will be randomly assigned to receive either acupuncture (n = 30) or a placebo (n = 30). The intervention is carried out using press needle or press placebo on abdomen area (10 sessions of treatment). Both groups will continue with their routine diabetes care. Primary outcome of HOMA-IR will be measured at the time of recruitment (-week 0), and after completion of 10 sessions (week 7) of the treatment. Additionally, secondary outcome of HRQoL will be measured at the time of recruitment (-week 0), after completion of 5 sessions (week 3/4), and 10 sessions (week 7) of the treatment. Any adverse event will be recorded at every visit. DISCUSSION: The findings of this study will provide important clinical evidence for the effect of acupuncture as adjunctive therapy on HOMA-IR, adiposity and HRQoL of type 2 diabetes mellitus. TRIAL REGISTRATION NUMBER: NCT04829045.

Effects of tai chi on postural balance and quality of life among the elderly with gait disorders: A systematic review.

BACKGROUND: Tai Chi is good for improving the physical fitness of older adults. But few studies have reported the effects of Tai Chi on the postural balance and quality of life of older adults with gait disorders. OBJECTIVE: This review aimed to assess the influence of tai chi on postural stability and quality of life in older adults with abnormal gait. METHOD: According to the literature retrieval principles, the works published from the inception date to May 2023 were retrieved, including the following databases: PubMed, Scopus, Web of Science, China National Knowledge Infrastructure, EBSCOhost, and Google Scholar. Subsequently, literature screening and quality assessment were performed. RESULTS: A total of 16 randomized controlled trials were included in this study, Tai Chi intervention can affect populations with Parkinson's disease (PD), no exercise, mild cognitive impairment (MCI), chronic stroke, sedentary, fear of falling, or history of falling. Postural instability is associated with balance, gait, the Unified Parkinson's Disease Rating Scale Motor Subscale 3 (UPDRS III), mobility, lower body strength, and falls. Only two articles looked at quality of life. The Yang style is the most commonly used in the intervention. Nonetheless, most studies were performed on female participants, hence, more research on older male populations is needed. CONCLUSION: Tai Chi intervention benefits postural balance in patients with gait disorders. 12 weeks is the most common intervention period for patients with gait disorders. The frequency of intervention is seven articles twice a week, and the intervention time is about 60 minutes. The Tai Chi intervention methods in this study involve Yang Style, Sun Style, Taoist Tai Chi, and Health Qigong Tai Chi, but the Yang Style Tai Chi intervention is the most widely used.

Interactions of genetic and macronutrient intake with abdominal obesity among middle-aged vegetarians in Malaysia.

BACKGROUND AND OBJECTIVES: Evidence for gene-diet interactions is lacking among individuals with specific dietary practices including vegetarians. This study aimed to determine the interactions of rs174547 in the fatty acid desaturase 1 (FADS1) gene with macronutrient such as carbohydrate (particularly fibre), protein and fat intakes on abdominal obesity among middle-aged Malaysian vegetarians of Chinese and Indian ethnicity. METHODS AND STUDY DESIGN: The present cross-sectional study was conducted among 163 vegetarians in Kuala Lumpur and Selangor, Malaysia. Dietary intakes of vegetarians were assessed by using a food frequency questionnaire. Waist circumference of vegetarians was measured by using a Lufkin tape W606PM. Genotypes of the rs174547 of vegetarians were determined by using Agena® MassARRAY. A multiple logistic regression model was used to determine the interactions of the rs174547 with macronutrient on abdominal obesity. RESULTS: About 1 in 2 vegetarians (51.5%) had abdominal obesity. Individuals with CT and TT genotype at T3 intake of carbohydrates, protein, fat and fibre as well as individuals with TT genotype at T2 intake of carbohydrates and protein had higher odds of abdominal obesity (pinteration <0.05). The gene-diet interaction remained significant for fibre intake (OR: 4.71, 95% CI: 1.25-17.74, pinteraction=0.022) among vegetarians with TT genotype at T2 intake of fibre after adjusting for age and sex and considering the effects of ethnicity and food groups. CONCLUSIONS: The rs174547 significantly interacted with fibre intake on abdominal obesity. A specific dietary fibre recommendation based on genetics is needed among Chinese and Indian middle-aged vegetarians.

Social and Health Determinants of Quality of Life of Community-Dwelling Older Adults in Malaysia.

Quality of life (QOL) of older adults is a complex issue that requires an understanding of the intersection between socioeconomic and health factors. A poor quality of life (QOL) is frequently reported as sub-optimal among older adults whereby concerted and collective actions are required through an evidence-based approach. Hence, this cross-sectional study aims to determine the social and health predictors of the QOL of a community-dwelling older adult Malaysian population through a quantitative household survey using multi-stage sampling. A total of 698 respondents aged 60 years old and older were recruited and the majority of them had a good quality of life. Risk of depression, disability, living with stroke, low household income, and lack of social network were identified as the predictors of a poor QOL among the community-dwelling older Malaysians. The identified predictors for QOL provided a list of priorities for the development of policies, strategies, programmes, and interventions to enhance the QOL of the community-dwelling older Malaysians. Multisectoral approaches, especially collective efforts from both social and health sectors, are required to address the complexities of the ageing issues.

Factors predicting health-related quality of life of the Malaysian B40 school-aged children living in urban-poor flats in the central region of Malaysia.

BACKGROUND AND OBJECTIVES: Health-related quality of life (HRQoL) is a multidimensional concept that indicated an individual's holistic health, whereby the urban-poor community are susceptible to low HRQoL due to their high vulnerability. This study aimed to determine factors that predicted the HRQoL among the urban-poor school-aged children. METHODS AND STUDY DESIGN: This is a cross-sectional study and a total of 408 primary school-aged children (male: 72.3%; female: 27.7%), with a mean age of 9.68±1.48 years, were recruited from 10 urban-poor flats through cluster sampling at the central region of Malaysia. Their anthropometry, nutrition knowledge, attitude and practice, physical activity, dietary practices, and HRQoL were assessed. RESULTS: A quarter (24.5%) of the urban-poor children were either overweight or obese in the present study. The HRQoL total score among the urban-poor children was 65.0±18.5. The result of multiple linear regression analysis shown that higher nutrition attitude (B=0.34, p=0.001) and practices (B=0.39, p=0.001), higher physical activity (B=3.73, p=0.004), higher lunch intake (B=1.35, p<0.001), lower supper intake (B=-1.35, p<0.001), and lower fast-food intake (B=-1.61, -1.17, p<0.001) are the significant predictors of better HRQoL among the urban-poor children (R2=0.32, F(8,399)=23.72, p<0.001). CONCLUSIONS: Future studies should focus on these predictors to formulate interventions that could enhance the HRQoL among the Malaysian urban-poor children.

Associations of alkaline water with metabolic risks, sleep quality, muscle strength: A cross-sectional study among postmenopausal women.

Much has been claimed on the health benefits of alkaline water including metabolic syndrome (MetS) and its features with scarcity of scientific evidence. Methods: This cross-sectional comparative study was conducted to determine whether regular consumption of alkaline water confers health advantage on blood metabolites, anthropometric measures, sleep quality and muscle strength among postmenopausal women. A total of 304 community-dwelling postmenopausal women were recruited with comparable proportion of regular drinkers of alkaline water and non-drinkers. Participants were ascertained on dietary intake, lifestyle factors, anthropometric and biochemical measurements. Diagnosis of MetS was made according to Joint Interim Statement definition. A total of 47.7% of the participants met MS criteria, with a significant lower proportion of MetS among the alkaline water drinkers. The observed lower fasting plasma glucose (F(1,294) = 24.20, p = 0.025, partial η2 = 0.435), triglyceride/high-density lipoprotein concentration ratio (F(1,294) = 21.06, p = 0.023, partial η2 = 0.360), diastolic blood pressure (F(1,294) = 7.85, p = 0.046, partial η2 = 0.258) and waist circumference (F(1,294) = 9.261, p = 0.038, partial η2 = 0.263) in the alkaline water drinkers could be considered as favourable outcomes of regular consumption of alkaline water. In addition, water alkalization improved duration of sleep (F(1,294) = 32.05, p = 0.007, partial η2 = 0.451) and handgrip strength F(1,294) = 27.51, p = 0.011, partial η2 = 0.448). Low density lipoprotein cholesterol concentration (F(1,294) = 1.772, p = 0.287, partial η2 = 0.014), body weight (F(1,294) = 1.985, p = 0.145, partial η2 = 0.013) and systolic blood pressure (F(1,294) = 1.656, p = 0.301, partial η2 = 0.010) were comparable between the two different water drinking behaviours. In conclusion, drinking adequate of water is paramount for public health with access to good quality drinking water remains a critical issue. While consumption of alkaline water may be considered as a source of easy-to implement lifestyle to modulate metabolic features, sleep duration and muscle strength, further studies are warranted for unravelling the precise mechanism of alkaline water consumption on the improvement and prevention of MetS and its individual features, muscle strength and sleep duration as well as identification of full spectrum of individuals that could benefit from its consumption.

Application of Mediterranean Diet in Cardiovascular Diseases and Type 2 Diabetes Mellitus: Motivations and Challenges.

OBJECTIVE: Cardiovascular disease (CVD) is the leading cause of disability and death in many countries. Together with CVD, Type 2 diabetes mellitus (T2DM) accounts for more than 80% of all premature non-communicable disease deaths. The protective effect of the Mediterranean diet (MedDiet) on CVD and its risk factors, including T2DM, has been a constant topic of interest. Notwithstanding, despite the large body of evidence, scientists are concerned about the challenges and difficulties of the application of MedDiet. This review aims to explore the motivations and challenges for using MedDiet in patients with CVD and T2DM. DESIGN: An electronic search was conducted for articles about MedDiet published in PubMed, ScienceDirect, Scopus, and Web of Science up to December 2021, particularly on CVD and T2DM patients. From a total of 1536 studies, the final eligible set of 108 studies was selected. Study selection involved three iterations of filtering. RESULTS: Motivation to apply MedDiet was driven by the importance of studying the entire food pattern rather than just one nutrient, the health benefits, and the distinct characteristics of MedDiet. Challenges of the application of MedDiet include lacking universal definition and scoring of MedDiet. Influences of nutritional transition that promote shifting of traditional diets to Westernized diets further complicate the adherence of MedDiet. The challenges also cover the research aspects, including ambiguous and inconsistent findings, the inexistence of positive results, limited evidence, and generalization in previous studies. The review revealed that most of the studies recommended that future studies are needed in terms of health benefits, describing the potential benefits of MedDiet, identifying the barriers, and mainly discussing the effect of MedDiet in different populations. CONCLUSIONS: In general, there is consistent and strong evidence that MedDiet is associated inversely with CVD risk factors and directly with glycemic control. MedDiet is the subject of active and diverse research despite the existing challenges. This review informs the health benefits conferred by this centuries-old dietary pattern and highlights MedDiet could possibly be revolutionary, practical, and non-invasive approach for the prevention and treatment CVD and T2DM.

Dietary Quality, Sleep Quality and Muscle Mass Predicted Frailty among Chinese Postmenopausal Women in Malaysia.

The older adult population is growing faster than any age group, which increases their risk of frailty. Studies conducted among older adult are relatively scarce in Malaysia, especially among Chinese postmenopausal women, who have the longest life expectancy. Thus, the present study aimed to determine the prevalence of frailty and its associated factors among Chinese postmenopausal women. A total of 220 eligible respondents were recruited, with information on sociodemographic background, comorbidities, dietary intake and lifestyle behaviour were obtained using a structured questionnaire, while anthropometry indicators were assessed according to standard protocol. Fasting blood was withdrawn for the analysis of serum 25(OH)D. Multinomial logistic regression was used to determine factors that predict pre-frailty and frailty. Prevalence of pre-frailty and prevalence of frailty were 64.5 and 7.3%, respectively, and most of the respondents presented with weak handgrip strength. Pre-frailty was prevalent among the younger population. Dietary quality was unsatisfactory among the respondents, and the majority of them presented with a high percentage of body fat. An increased dietary quality index (DQI), poor sleep and low muscle mass were factors that contributed to frailty. In conclusion, nutritional factors should be considered in developing health-related policies and programs in reducing and delaying the onset of frailty.

The impact of Movement Control Order during the COVID-19 pandemic on lifestyle behaviours and body weight changes: Findings from the MyNutriLifeCOVID-19 online survey.

BACKGROUND: The COVID-19 pandemic lockdowns have affected daily lives of the communities worldwide. This study aims to determine the lifestyle behaviours and their associations with body weight changes among Malaysian adults during the Movement Control Order (MCO) due to COVID-19 pandemic. METHODS: A total of 1319 Malaysian adults participated in this cross-sectional online survey. Information on anthropometric data including body weight and height, and lifestyle behaviours including eating pattern, physical activity, and sleep pattern were self-reported by the respondents. A multivariable generalised linear mixed model was used to assess the associations between lifestyle behaviours and body weight changes with adjustment of confounding factors; namely, age, sex, ethnicity, and body weight status before MCO. RESULTS: During MCO, 41.2% of the respondents perceived that their eating patterns were healthier, but 36.3% reduced their physical activities, and 25.7% had a poorer sleep quality. Further, the proportion of adults who reported having lose weight (32.2%) was almost similar to those who reported having gained weight (30.7%). Lifestyle behaviours including less frequent practice of healthy cooking methods and lunch skipping were associated with weight gain, while less frequent consumption of high fat foods, more frequent physical activity, and good sleep latency were associated with lower risk of weight gain. In contrast, practicing healthy eating concept, skipped lunch, and more frequent physical activity were significantly associated with weight loss. CONCLUSION: Lifestyle behaviours were associated with body weight changes during MCO. While the COVID-19 pandemic lockdown is necessary to prevent further spread of the disease, promoting healthy lifestyle practices during lockdown should be implemented for a healthy weight and better health.

Dietary Factors and Sleep Quality Among Hemodialysis Patients in Malaysia.

OBJECTIVES: Poor sleep quality is a commonly seen problem in hemodialysis patients. This study investigated the associations between dietary factors and sleep quality among hemodialysis patients. DESIGN AND METHODS: This is a cross-sectional study conducted among 184 eligible hemodialysis patients at four dialysis units in Malaysia. Three days dietary recall were used in the analysis of dietary intake and behavior. Sleep quality was assessed through Pittsburgh Sleep Quality Index. RESULTS: More than half of the patients were poor sleepers. Among the sleep components, sleep latency affected patients the most, with the use of sleep medications was relatively low. A majority of the patients had inadequate dietary intake of energy (88%) and protein (75%). Dietary protein, potassium adjusted for body weight, and sodium intake were significantly increased in poor sleepers. Lower percentage of energy from carbohydrates; higher percentage of energy from fats; higher intakes of dietary protein, fat, phosphorus, and sodium were correlated with poorer sleep quality and its components. Skipping dinner on non-dialysis days and having supper on dialysis days were associated with poor sleep quality. CONCLUSION: Poor sleep is prevalent among hemodialysis patients. Sleep quality of hemodialysis patients was highly associated with certain dietary factors. Periodical assessment of sleep quality and dietary intake is necessary to identify poor sleepers with inappropriate dietary intake to allow effective clinical and nutritional interventions to improve the sleep quality and nutritional status of these patients.

Bioelectrical Impedance Analysis Derived-Phase Angle as a Pragmatic Tool to Detect Protein Energy Wasting among Multi-Ethnic Hemodialysis Patients.

Protein-energy wasting (PEW) is a devastating metabolic derangement that leads to increased morbidity and mortality in hemodialysis (HD) patients. This study aimed to determine the diagnostic test accuracy of bioelectrical impedance analysis derived-phase angle (PhA) in detecting PEW among HD patients. This was a multi-centre, cross-sectional study conducted amongst 152 multi-ethnic HD patients in Klang Valley, Malaysia. PEW was assessed using the International Society of Renal Nutrition and Metabolism criteria as the reference method. PhA was measured using a multi-frequency bioelectrical impedance spectroscopy at 50 kHz. Multiple and logistic regressions were used to determine factors associated with PhA and PEW diagnosis, respectively. A receiver operating characteristics curve analysis was used to establish the gender-specific PhA cut-offs to detect PEW. PEW existed in 21.1% of the HD patients. PhA was found as an independent predictor of PEW (adjOR = 0.308, p = 0.001), with acceptable to excellent discriminative performance (adjAUCmale = 0.809; adjAUCfemale = 0.719). Male patients had higher PhA cut-off compared to female patients (4.26° vs. 3.30°). We concluded that PhA is a valid and pragmatic biomarker to detect PEW in multi-ethnic Malaysian HD patients and a gender-specific cut-off is necessary, attributed to the gender differences in body composition.

Dietary Acid Load and Its Interaction with IGF1 (rs35767 and rs7136446) and IL6 (rs1800796) Polymorphisms on Metabolic Traits among Postmenopausal Women.

The objective of this study was to explore the effects of dietary acid load (DAL) and IGF1 and IL6 gene polymorphisms and their potential diet-gene interactions on metabolic traits. A total of 211 community-dwelling postmenopausal women were recruited. DAL was estimated using potential renal acid load (PRAL). Blood was drawn for biochemical parameters and DNA was extracted and Agena® MassARRAY was used for genotyping analysis to identify the signalling of IGF1 (rs35767 and rs7136446) and IL6 (rs1800796) polymorphisms. Interactions between diet and genetic polymorphisms were assessed using regression analysis. The result showed that DAL was positively associated with fasting blood glucose (FBG) (ß = 0.147, p < 0.05) and there was significant interaction effect between DAL and IL6 with systolic blood pressure (SBP) (ß = 0.19, p = 0.041). In conclusion, these findings did not support the interaction effects between DAL and IGF1 and IL6 single nucleotide polymorphisms (rs35767, rs7136446, and rs1800796) on metabolic traits, except for SBP. Besides, higher DAL was associated with higher FBG, allowing us to postulate that high DAL is a potential risk factor for diabetes.

No Interaction Effect between Interleukin-6 Polymorphisms and Acid Ash Diet with Bone Resorption Marker in Postmenopausal Women.

BACKGROUND: Evidence is growing that a high-acid diet might accelerate the rate of bone loss, and gene polymorphisms such as Interleukin 6 (IL6) -174G/C and -572G/C are related to bone deterioration. However, no study of the interaction between diet and IL6 polymorphisms has been conducted among Asians. Thus, the objective of this study was to determine whether IL6 gene polymorphisms modified the association between dietary acidity and the rate of bone resorption. METHODS: This cross-sectional study recruited 203 postmenopausal women (age ranged from 51 to 85 years old) in community settings. The dietary intakes of the participants were assessed using a validated interviewer-administered semi-quantitative food frequency questionnaire (FFQ), while dietary acid load (DAL) was estimated using net endogenous acid production (NEAP). Agena® MassARRAY genotyping analysis and serum collagen type 1 cross-linked C-telopeptide (CTX1) were used to identify the IL6 genotype and as a bone resorption marker, respectively. The interactions between diet and single-nucleotide polymorphisms (SNPs) were assessed using linear regressions. RESULTS: A total of 203 healthy postmenopausal women aged between 51 and 85 years participated in this study. The mean BMI of the participants was 24.3 kg/m2. In IL6 -174 G/C, all the participants carried the GG genotype, while the C allele was absent. Approximately 40% of the participants had a high dietary acid load. Dietary acid load (B = 0.15, p = 0.031) and the IL6 -572 CC genotype group (B = 0.14, p = 0.044) were positively associated with a higher bone resorption. However, there was no moderating effect of the IL6 genetic polymorphism on the relationship between and acid ash diet and bone resorption markers among the postmenopausal women (p = 0.79). CONCLUSION: High consumption of an acid ash diet and the IL6 -572 C allele seem to attribute to high bone resorption among postmenopausal women. However, our finding does not support the interaction effect of dietary acidity and IL6 (-174G/C and -572G/C) polymorphisms on the rate of bone resorption. Taken together, these results have given scientific research other candidate genes to focus on which may interact with DAL on bone resorption, to enhance planning for preventing or delaying the onset of osteoporosis among postmenopausal women.

Comparisons of conventional and novel anthropometric obesity indices to predict metabolic syndrome among vegetarians in Malaysia.

Our study aimed to compare the ability of anthropometric obesity indices to predict MetS and to determine the sex-specific optimal cut-off values for MetS among Malaysian vegetarians. Body weight, height, waist circumference (WC), blood pressure (BP), fasting venous blood sample were collected from 273 vegetarians in Selangor and Kuala Lumpur, Malaysia. The abilities of body mass index (BMI), body fat percentage (BF%), waist to height ratio (WHtR), lipid accumulation product (LAP), visceral adiposity index (VAI), a body shape index (ABSI), and body roundness index (BRI) to identify MetS were tested using receiver operating characteristic (ROC) curve analyses. MetS was defined according to the Joint Interim Statement 2009. The ROC curve analyses show that BMI, BF%, WHtR, LAP and VAI were able to discriminate MetS in both sexes. LAP was a better predictor to predict MetS, followed by WHtR for male and female vegetarians. The suggested WHtR's optimal cut-offs and LAP's optimal cut-offs for MetS for male and female vegetarians were 0.541, 0.532, 41.435 and 21.743, respectively. In conclusion, LAP was a better predictor to predict MetS than other anthropometric obesity indices. However, WHtR could be an alternative obesity index in large epidemiology survey due to its convenient and cost-effective characteristics.

Frailty Intervention through Nutrition Education and Exercise (FINE). A Health Promotion Intervention to Prevent Frailty and Improve Frailty Status among Pre-Frail Elderly-A Study Protocol of a Cluster Randomized Controlled Trial.

The ageing process has been associated with various geriatric issues including frailty. Without early prevention, frailty may cause multiple adverse outcomes. However, it potentially may be reversed with appropriate interventions. The aim of the study is to assess the effectiveness of nutritional education and exercise intervention to prevent frailty among the elderly. A 3-month, single-blind, two-armed, cluster randomized controlled trial of the frailty intervention program among Malaysian pre-frail elderly will be conducted. A minimum of total 60 eligible respondents from 8 clusters (flats) of Program Perumahan Rakyat (PPR) flats will be recruited and randomized to the intervention and control arm. The intervention group will receive a nutritional education and a low to moderate multi-component exercise program. To date, this is the first intervention study that specifically targets both the degree of frailty and an improvement in the outcomes of frailty using both nutritional education and exercise interventions among Malaysian pre-frail elderly. If the study is shown to be effective, there are major potential benefits to older population in terms of preventing transition to frailty. The findings from this trial will potentially provide valuable evidence and serve as a model for similar future interventions designed for elderly Malaysians in the community.

Maternal Vitamin D Levels during Late Pregnancy and Risk of Allergic Diseases and Sensitization during the First Year of Life-A Birth Cohort Study.

Allergic diseases are the most common chronic illness in childhood. Findings from developed countries have reported associations between Vitamin D levels during pregnancy and offspring allergy risk. This prospective cohort study aimed to determine the associations between maternal Vitamin D levels during late pregnancy and allergic diseases in Malaysian infants during the first year of life. Serum 25(OH)D concentrations of 380 pregnant women in the third trimester were measured using a chemiluminescent immunoassay. Children's allergic outcomes were assessed at 3, 6, and 12 months based on parental reports. Specific IgE antibodies against food and inhalant allergens were measured in infants at 12 months of age. A total of 43.2% pregnant women were Vitamin D deficient (<30 nmol/L) and 56.8% were nondeficient (≥30 nmol/L). A total of 27.6% of the infants had eczema, 6.1% had wheeze, 27.4% had food sensitization, 10.8% had inhalant allergen sensitization, and 3.8% had IgE-mediated food allergy during the first year of life. Compared with the nondeficient group, maternal Vitamin D deficiency in late pregnancy was not associated with any allergic outcomes after adjustment for potential confounding factors. In conclusion, the present study does not support an association between maternal Vitamin D levels in late pregnancy and allergic outcomes during the first year of life.