Understanding exposomes and its relation with cancer risk in Malaysia based on epidemiological evidence: a narrative review.

The prevalence of cancer is increasing globally, and Malaysia is no exception. The exposome represents a paradigm shift in cancer research, emphasizing the importance of a holistic approach that considers the cumulative effect of diverse exposures encountered throughout life. The exposures include dietary factors, air and water pollutants, occupational hazards, lifestyle choices, infectious agents and social determinants of health. The exposome concept acknowledges that each individual's cancer risk is shaped by not only their genetic makeup but also their unique life experiences and environmental interactions. This comprehensive review was conducted by systematically searching scientific databases such as PubMed, Scopus and Google Scholar, by using the keywords "exposomes (environmental exposures AND/OR physical exposures AND/OR chemical exposures) AND cancer risk AND Malaysia", for relevant articles published between 2010 and 2023. Articles addressing the relationship between exposomes and cancer risk in the Malaysian population were critically evaluated and summarized. This review aims to provide an update on the epidemiological evidence linking exposomes with cancer risk in Malaysia. This review will provide an update for current findings and research in Malaysia related to identified exposomes-omics interaction and gap in research area related to the subject matter. Understanding the interplay between complex exposomes and carcinogenesis holds the potential to unveil novel preventive strategies that may be beneficial for public health.

Crosstalk Between circRNA and Tumor Microenvironment of Hepatocellular Carcinoma: Mechanism, Function and Applications.

Hepatocellular carcinoma (HCC) is one of the most common aggressive tumors in the world. Despite the availability of various treatments, its prognosis remains poor due to the lack of specific diagnostic indicators and the high heterogeneity of HCC cases. CircRNAs are noncoding RNAs with stable and highly specific expression. Extensive research evidence suggests that circRNAs mediate the pathogenesis and progression of HCC through acting as miRNA sponges, protein modulators, and translation templates. Tumor microenvironment (TME) has become a hotspot of immune-related research in recent years due to its effects on metabolism, secretion and immunity of HCC. Accordingly, understanding the role played by circRNAs in TME is important for the study of HCC. This review will discuss the crosstalk between circRNAs and TME in HCC. In addition, we will discuss the current deficiencies and controversies in research on circRNAs and predict future research directions.

Triple burden of malnutrition among Malaysian children aged 6 months to 12 years: Current findings from SEANUTS II Malaysia.

OBJECTIVE: This paper aims to report South East Asian Nutrition Surveys (SEANUTS) II Malaysia data on nutritional status, dietary intake, and nutritional biomarkers of children aged 6 months to 12 years. DESIGN: Cross-sectional survey conducted in 2019-2020. SETTING: Multistage cluster sampling conducted in Central, Northern, Southern, and East Coast regions of Peninsular Malaysia. PARTICIPANTS: 2989 children aged 0.5-12.9 years. RESULTS: Prevalences of stunting, thinness, overweight, and obesity among children aged 0.5-12.9 years were 8.9%, 6.7%, 9.2%, and 8.8%, respectively. Among children below 5 years old, 11.4% were underweight, 13.8% had stunting, and 6.2% wasting. Data on nutritional biomarkers showed a small proportion of children aged 4-12 years had iron (2.9%) and vitamin A deficiencies (3.1%). Prevalence of anaemia was distinctly different between children below 4 years old (40.3%) and those aged 4 years and above (3.0%). One-fourth of children (25.1%) had vitamin D insufficiency, which was twice as prevalent in girls (35.2% vs. boys: 15.6%). The majority of children did not meet the recommended dietary intake for calcium (79.4%) and vitamin D (94.8%). CONCLUSIONS: Data from SEANUTS II Malaysia confirmed that triple burden of malnutrition co-exists among children in Peninsular Malaysia, with higher prevalence of overnutrition than undernutrition. Anaemia is highly prevalent among children below 4 years old, while vitamin D insufficiency is more prevalent among girls. Low intakes of dietary calcium and vitamin D are also of concern. These findings provide policymakers with useful and evidence-based data to formulate strategies that address the nutritional issues of Malaysian children.

The Effects of 12 Weeks Colostrum Milk Supplementation on the Expression Levels of Pro-Inflammatory Mediators and Metabolic Changes among Older Adults: Findings from the Biomarkers and Untargeted Metabolomic Analysis.

Senescence is a normal biological process that is accompanied with a series of deteriorations in physiological function. This study aimed to investigate the effects of bovine colostrum milk supplementation on metabolic changes and the expression of various biomarkers on inflammation, antioxidant and oxidative damage, nutrient metabolism, and genomic stability among older adults. Older adults (50-69 years old) who participated in the 12-week randomized, double-blinded, placebo-controlled trial were instructed to consume the IgCo bovine colostrum-enriched skim milk or regular skim milk (placebo) twice daily. Following 12 weeks of intervention, participants in the intervention group had lower expression levels in pro-inflammatory mediators (CRP, IL-6, and TNF-α), with significant (p < 0.05) interaction effects of the group and time observed. However, no significant interaction effect was observed in the vitamin D, telomerase, 8-OHdG, MDA, and SOD activities. UPLC-MS-based untargeted metabolomics analysis revealed that 22 metabolites were upregulated and 11 were downregulated in the intervention group compared to the placebo group. Glycerophospholipid metabolism, along with cysteine and methionine metabolism were identified as the potential metabolic pathways that are associated with bovine colostrum milk consumption. In conclusion, consuming bovine colostrum milk may induce metabolic changes and reduce the expression of various pro-inflammatory mediators, thus improving the immune function in older adults.

Upregulation of APOC1 Promotes Colorectal Cancer Progression and Serves as a Potential Therapeutic Target Based on Bioinformatics Analysis.

Background: Approximately 10% of cancer patients worldwide have colorectal cancer (CRC), a prevalent gastrointestinal malignancy with substantial mortality and morbidity. The purpose of this work was to investigate the APOC1 gene's expression patterns in the CRC tumor microenvironment and, using the findings from bioinformatics, to assess the biological function of APOC1 in the development of CRC. Methods: The TCGA portal was employed in this investigation to find APOC1 expression in CRC. Its correlation with other genes and clinicopathological data was examined using the UALCAN database. To validate APOC1's cellular location, the Human Protein was employed. In order to forecast the relationship between APOC1 expression and prognosis in CRC patients, the Kaplan-Meier plotter database was used. TISIDB was also employed to evaluate the connection between immune responses and APOC1 expression in CRC. The interactions of APOC1 with other proteins were predicted using STRING. In order to understand the factors that contribute to liver metastasis from CRC, single-cell RNA sequencing (scRNA-seq) was done on one patient who had the disease. This procedure included sampling preoperative blood and the main colorectal cancer tissues, surrounding colorectal cancer normal tissues, liver metastatic cancer tissues, and normal liver tissues. Finally, an in vitro knockdown method was used to assess how APOC1 expression in tumor-associated macrophages (TAMs) affected CRC cancer cell growth and migration. Results: When compared to paracancerous tissues, APOC1 expression was considerably higher in CRC tissues. The clinicopathological stage and the prognosis of CRC patients had a positive correlation with APOC1 upregulation and a negative correlation, respectively. APOC1 proteins are mostly found in cell cytosols where they may interact with APOE, RAB42, and TREM2. APOC1 was also discovered to have a substantial relationship with immunoinhibitors (CD274, IDO1, and IL10) and immunostimulators (PVR, CD86, and ICOS). According to the results of scRNA-seq, we found that TAMs of CRC tissues had considerably more APOC1 than other cell groups. The proliferation and migration of CRC cells were impeded in vitro by APOC1 knockdown in TAMs. Conclusion: Based on scRNA-seq research, the current study shows that APOC1 was overexpressed in TAMs from CRC tissues. By inhibiting APOC1 in TAMs, CRC progression was reduced in vitro, offering a new tactic and giving CRC patients fresh hope.

Quality of energy intake in Malaysian adolescents: prevalence, characteristics, determinants and impact of implausible reporters.

OBJECTIVE: Misreporting of energy intake (EI) in nutritional epidemiology is common and even severe among adolescents. Thus, the current study aims to examine the presence, bias and impact introduced by implausible reporters. DESIGN: Cross-sectional. SETTING: Central and eastern regions of Peninsular Malaysia. PARTICIPANTS: A stratified random sampling was employed to select 917 secondary school-going adolescents (aged 15-17 years). RESULTS: The prevalence of under-reporters was 17·4 %, while no over-reporters were identified. Under-reporters had higher body composition and lower dietary intakes (except for vitamin C, Cr and Fl) compared with plausible reporters (P < 0·05). Adolescents with overweight and obesity had a higher odds of under-reporting compared with under-/normal weight adolescents (P < 0·001). In model 3, the highest regression coefficient (R2 = 0·404, P < 0·001) was obtained after adjusting for reporting status. CONCLUSIONS: Overweight and obese adolescents were more likely to under-report their food intake and consequently affect nutrient intakes estimates. Future analyses that include nutrient intake data should adjust for reporting status so that the impact of misreporting on study outcomes can be conceded and consequently improve the accuracy of dietary-related results.

Results from the Malaysia 2022 report card on physical activity for children and adolescents.

Background: The Malaysia 2022 Report Card on Physical Activity for Children and Adolescents provides evidence-based assessment across 12 indicators of physical activity-related behaviors, individual characteristics, settings and sources of influence, and strategies and investments for children and adolescents. Methods: The development process follows the systematic steps recommended by the Active Healthy Kids Global Alliance was used. Nationally representative data from 2016 to 2021, government reports and unpublished data were reviewed and consolidated by a panel of experts. Letter grades were assigned based on predefined benchmarks to 12 indicators including 10 core physical activity indicators that are common to Global Matrix 4.0 and two additional indicators (Diet and Weight Status). The current grading was then compared against those obtained in 2016. Results: Four of six indicators in the Daily Behaviors category received D- or C grades [Overall Physical Activity, Active Transportation and Diet (D-); Sedentary Behaviors (C)], which remains poor, similar to the 2016 report card. School indicator was graded for the Settings and Sources of Influence category, which showed an improvement from grade B (2016) to A- (2022). As for the Strategies and Investments category, B was again assigned to the Government indicator. Two new indicators were added after the 2016 Report Card, and they were graded B (Physical Fitness) and B- (Weight Status). Four indicators (Organized Sports and Physical Activity, Active Play, Family and Peers, and Community and Environment) were again graded Incomplete due to a lack of nationally representative data. Conclusion: The 2022 Report Card revealed that Malaysian children and adolescents are still caught in the "inactivity epidemic". This warrants more engagement from all stakeholders, public health actions, and timely research, to comprehensively evaluate all indicators and drive a cultural shift to see Malaysian children and adolescents moving more every day.

Lifestyle indices of body composition and obesity risk and prevalence among multi-ethnic adolescents in Malaysia.

The prevalence of childhood obesity in Malaysia has doubled in less than a decade. Moreover, being overweight and obese have been associated with immediate and later comorbidities, thus emphasizing the need to prevent obesity from an early age. This cross-sectional study involved 923 multi-ethnic Malaysian adolescents aged between 15 and 17 years old. Body composition was estimated using bioelectrical impedance analysis. Body mass index (BMI) classification was based on the World Health Organization (WHO) growth reference and the International Obesity Task Force (IOTF) cut-off. Meanwhile, the Child Growth Foundation (CGF) body fat reference was used to classify adolescents' adiposity. Lifestyle indices including physical activity, sedentary behavior, supplement intake, smoking and alcohol status were assessed via questionnaires. A high prevalence of overweight/obesity among the adolescents was observed according to the CGF (26%), followed by that of the WHO (24%) and then the IOTF (23%) cut-off, with high concordance values between each pair. After adjustment, a significant association was found between physical activity (PAQ score) and lean mass (p = 0.027). No lifestyle determinant was found to be a significant predictor of fat percentage. A high sedentary level increased the likelihood of obesity (OR 3.0, p < 0.01), while antioxidant-rich supplements were found to protect against obesity (OR 0.4, p < 0.05). The lifestyle predictors identified in this study may be considered when designing interventions that integrate lifestyle modifications targeting adolescents.

Efficacy of zinc carnosine in the treatment of colorectal cancer and its potential in combination with immunotherapy in vivo.

BACKGROUND: A complex of Zn and carnosine, called Zinc-L-carnosine (ZnC), enjoys a wide application as part of a Zn supplement therapeutic method as well as in treating peptic ulcers. However, researches fail to confirm the biological functions possessed by ZnC as well as tumor immune microenvironment in colorectal cancer (CRC). METHODS: Cell counting kit 8(CCK8), 5-ethynyl-2'-deoxyuridine (EdU), transwell and wound healing assays were conducted to study the influence of ZnC in the proliferating, invading and migrating processes of CRC cell lines (HCT116, LOVO) in vitro. The antitumor activity ZnC as well as its effects on tumor immune microenvironment were then assessed using CRC subcutaneous tumors in the C57BL/6 mouse model. RESULTS: According to CCK8, EdU, transwell and wound healing assays, ZnC inhibited CRC cell lines in terms of proliferation, invasion and migration. ZnC could inhibit miR-570 for up-regulating PD-L1 expression. In vivo experiments showed that gavage (100 mg/kg, once every day) of ZnC inhibited the tumor growth of CRC, and the combination of ZnC and anti-PD1 therapy significantly improved the efficacy exhibited by anti-PD1 in treating CRC. In addition, mass cytometry results showed that immunosuppressive cells including regulatory T cells (tregs), bone marrow-derived suppressor cells (MDSC), and M2 macrophages decreased whereas CD8+ T cells elevated after adding ZnC. CONCLUSIONS: The present study reveals that ZnC slows the progression of CRC by inhibiting CRC cells in terms of proliferation, invasion and migration, meanwhile up-regulating PD-L1 expression via inhibiting miR-570. The ZnC-anti-PD1 co-treatment assists in synergically increasing anti-tumor efficacy in CRC therapy.

Higher Lead and Lower Calcium Levels Are Associated with Increased Risk of Mortality in Malaysian Older Population: Findings from the LRGS-TUA Longitudinal Study.

The main objective of this study is to determine the association of various trace elements' status with the 5-year mortality rate among community-dwelling older adults in Malaysia. This study was part of the Long-term Research Grant Scheme­Towards Useful Ageing (LRGS-TUA). The participants were followed up for five years, and their mortality status was identified through the Mortality Data Matching Service provided by the National Registration Department, Malaysia. Of the 303 participants included in this study, 34 (11.2%) participants had died within five years after baseline data collection. As compared to the survivors, participants who died earlier were more likely (p < 0.05) to be men, smokers, have a lower intake of total dietary fiber and molybdenum, higher intake of manganese, lower zinc levels in toenail samples, lower calcium and higher lead levels in hair samples during baseline. Following the multivariate Cox proportional hazard analysis, lower total dietary fiber intake (HR: 0.681; 0.532−0.871), lower calcium (HR: 0.999; 95% CI: 0.999−1.000) and higher lead (HR: 1.309; 95% CI: 1.061−1.616) levels in hair samples appeared as the predictors of mortality. In conclusion, higher lead and lower calcium levels are associated with higher risk of mortality among community-dwelling older adults in Malaysia. Our current findings provide a better understanding of how the trace elements' status may affect older populations' well-being and mortality rate.

Zinc carnosine: Frontiers advances of supplement for cancer therapy.

Zinc (Zn) has an existence within large quantities in the human brain, while accumulating within synaptic vesicle. There is growing evidence that Zn metabolic equilibrium breaking participates into different diseases (e.g., vascular dementia, carcinoma, Alzheimer's disease). Carnosine refers to an endogenic dipeptide abundant in skeletal muscle and brains and exerts a variety of positive influences (e.g., carcinoma resistance, crosslinking resistance, metal chelation and oxidation limitation). A complex of Zn and carnosine, called Zinc-L-carnosine (ZnC), has been extensively employed within Zn supplement therapeutic method and the treating approach for ulcers. ZnC has been shown to play a variety of roles in the body, including inhibiting intracellular reactive oxygen species(ROS) and free radical levels, inhibiting inflammation, supplementing zinc enzymes and promoting wound healing and mucosal cell repair. The present study conducting a reviewing process for the advances of ZnC in tumor adjuvant therapy.

Dietary Risk Factors and Odds of Colorectal Adenoma in Malaysia: A Case Control Study.

Current evidence suggests that dietary and lifestyle factors may play an important role in colorectal cancer risk but there are only a few studies that investigated their relationship with colorectal adenomas (CRA), the precursors for colorectal cancer. A case-control study was conducted to determine the relationship between dietary and lifestyle factors associated with CRA risk among 125 subjects with CRA and 150 subjects without CRA at Hospital Canselor Tuanku Muhriz UKM (HCTM), Malaysia. We used dietary history questionnaire (DHQ) and International Physical Activity Questionnaire-Short Form (IPAQ) to estimate the diet and physical activity. The findings of this study showed that male gender [OR = 2.71 (95% CI= 1.01-7.27)], smoking [OR = 6.39 (95% CI= 1.04-39.30)], family history of cancer [OR = 6.39 (95% CI= 1.04-39.30)], high body fat percentage [OR = 1.25 (95% CI= 1.04-1.51)], high calorie and fat intake [OR = 1.03 (95% CI= 1.01-1.06)], [OR = 1.01 (95% CI= 0.95-1.09)] and red meat intake more than 100 g per day [OR = 1.02 (95% CI= 1.01-1.04)] increased CRA risk. High fiber [OR = 0.78 (95% CI= 0.64-0.95)] and calcium intake [OR = 0.78 (95% CI= 0.98-1.00)] was found to decrease CRA risk. Some of these modifiable risk factors could be advocated as lifestyle interventions to reduce risk of CRA.

Dietary Pattern, Genomic Stability and Relative Cancer Risk in Asian Food Landscape.

The incidence of cancer globally is increasing, partly due to lifestyle factors. Despite a better understanding of cancer biology and advancement in cancer management and therapies, current strategies in cancer treatment remain costly and cause socioeconomic burden especially in Asian countries. Hence, instead of putting more efforts in searches for new cancer cures, attention has now shifted to understanding how to mitigate cancer risk by modulating lifestyle factors. It has been established that carcinogenesis is multifactorial, and the important detrimental role of oxidative stress, chronic inflammation, and genomic instability is evident. To date, there is no study linking dietary pattern and genomic stability in cancer risk in the Asian food landscape. Thus, this present review article discusses recent literature on dietary pattern and genomic stability and its relationship with cancer risk in Asia.

Association between Diet-related Behaviour and Risk of Colorectal Cancer: A Scoping Review.

Individual dietary patterns may be influenced by diet-related behaviours, which may eventually play a significant role in contributing to colorectal cancer risk. As nearly half of colorectal cancer cases can be prevented through diet and lifestyle modification, in this study, we aimed to present an overview of the literature on diet-related behaviour and its effect on colorectal cancer risk among adults. Articles published from 2011 until July 2021 were selected. Out of the 1,198 articles retrieved, 25 were analyzed. There were 16 case-control studies, and nine of them were cohort studies. As a finding, the instruments used in this review were food frequency questionnaires (n = 23), followed by a semi-structured interview (n = 1), and diet records (n = 1). We demonstrated that unhealthy diet-related behaviours are linked to an increased risk of colorectal cancer in adults and those food frequency questionnaires or food records are common instruments used to collect diet-related behaviours. This article imparts the research trends and directions of colorectal cancer risk factors and shows that diet-related behaviour varies and changes over time.

Multidimensional Risk Factors of Age-Related Hearing Loss Among Malaysian Community-Dwelling Older Adults.

PURPOSE: This study evaluates the prevalence of and the multidimensional risk factors associated with age-related hearing loss (ARHL) among community-dwelling older adults in Malaysia. PATIENTS AND METHODS: A total of 253 participants aged 60 years and above participated in this cross-sectional study. The participants were subjected to pure tone audiometric assessment. The hearing threshold was calculated for the better ear and classified into pure-tone average (PTA) for the octave frequencies from 0.5 to 4 kHz and high-frequency pure-tone average (HFA) for the octave from 2 to 8kHz. Then, the risk factors associated with PTA hearing loss (HL) and HFAHL were identified by using multivariate logistic regression analysis. RESULTS: The prevalence of ARHL based on PTA and HFA among the community-dwelling older adults was 75.5% and 83.0%, respectively. Following multifactorial adjustments, being older (OR: 1.239; 95% CI: 1.062-1.445), having higher waist circumference (OR: 1.158; 95% CI: 1.015-1.322), lower intake of niacin (OR: 0.909; 95% CI: 0.831-0.988) and potassium (OR: 0.998; 95% CI: 0.996-1.000), and scoring lower in RAVLT T5 (OR: 0.905; 95% CI: 0.838-0.978) were identified as the risk factors of PTAHL. Meanwhile, being older (OR: 1.117; 95% CI: 1.003-1.244), higher intake of carbohydrate (OR: 1.018; 95% CI: 1.006-1.030), lower intake of potassium (OR: 0.998; 95% CI: 0.997-0.999), and lower scores on the RAVLT T5 (OR: 0.922; 95% CI: 0.874-0.973) were associated with increased risk of having HFAHL. CONCLUSION: Increasing age, having higher waist circumference, lower intake of niacin and potassium, higher intake of carbohydrates and having lower RAVLT T5 score were associated with increased risk of ARHL. Modifying these risk factors may be beneficial in preventive and management strategies of ARHL among older persons.

Higher levels of lead and aluminium are associated with increased risk of falls among community-dwelling older adults: An 18-month follow-up study.

AIM: The present study aims to determine the association of trace elements and oxidative and DNA damage biomarkers with fall incidence among community-dwelling older adults. METHODS: This study is part of the Long-term Research Grant Scheme - Towards Useful Ageing cohort study in Malaysia. Of a total of 174 participants with complete trace elements and oxidative and DNA damage data during baseline, only 147 (84.5%) were successfully followed up after 18 months. Participants who experienced any fall events in the previous 18 months during the follow-up were categorized as fallers. RESULTS: Thirty participants (20.4%) reported at least one fall in the previous 18 months. The mean concentrations of aluminium, lead and zinc were significantly higher (P < 0.05) in fallers than non-fallers. However, in comparison with the non-faller group, the percentage of DNA in tail (11.43 ± 4.10% vs. 13.22 ± 5.24%) and tail moment (1.19 ± 0.54 AU vs. 1.59 ± 0.78 AU) was significantly (P < 0.05) lower in the faller group. No significant difference in serum superoxide dismutase activities and malondialdehyde level was observed between non-fallers and fallers. Following multifactorial adjustments, higher aluminium (odds ratio [OR]: 1.007; 95% confidence interval [CI]: 1.002-1.011) and lead (OR: 1.162; 95% CI: 1.010-1.336) levels and lower tail moment scores (OR: 0.313; 95% CI: 0.138-0.709) appeared significant in the final hierarchical binary logistic regression model. CONCLUSIONS: Higher levels of lead and aluminium were associated with increased risk of falls among community-dwelling older adults. Geriatr Gerontol Int 2021; 21: 1026-1032.

Multidomain Intervention for Reversal of Cognitive Frailty, Towards a Personalized Approach (AGELESS Trial): Study Design.

BACKGROUND: Cognitive frailty (CF) is identified as one of the main precursors of dementia. Multidomain intervention has been found to delay or prevent the onset of CF. OBJECTIVE: The aim of our present study is to determine the effectiveness of a comprehensive, multidomain intervention on CF; to evaluate its cost effectiveness and the factors influencing adherence toward this intensive intervention. METHODS: A total of 1,000 community dwelling older adults, aged 60 years and above will be screened for CF. This randomized controlled trial involves recruitment of 330 older adults with CF from urban, semi-urban, and rural areas in Malaysia. Multidomain intervention comprised of physical, nutritional, cognitive, and psychosocial aspects will be provided to participants in the experimental group (n = 165). The control group (n = 165) will continue their usual care with their physician. Primary outcomes include CF status, physical function, psychosocial and nutritional status as well as cognitive performance. Vascular health and gut microbiome will be assessed using blood and stool samples. A 24-month intensive intervention will be prescribed to the participants and its sustainability will be assessed for the following 12 months. The effective intervention strategies will be integrated as a personalized telerehabilitation package for the reversal of CF for future use. RESULTS: The multidomain intervention developed from this trial is expected to be cost effective compared to usual care as well as able is to reverse CF. CONCLUSION: This project will be part of the World-Wide FINGERS (Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability) Network, of which common identifiable data will be shared and harmonized among the consortia.

The stingless bee honey protects against hydrogen peroxide-induced oxidative damage and lipopolysaccharide-induced inflammation in vitro.

Oxidative stress, DNA damage, and unresolved inflammation are the predisposing factors of many chronic and degenerative diseases, including cancer. Stingless bee honey (SBH) is recognized to have high medicinal value by traditional medicine practitioners and has been used to treat various illnesses traditionally. This study aimed to determine the antioxidant, anti-inflammatory, and genoprotective effects of SBH by using in vitro cell culture models. The sugar content, total phenolic content, radical scavenging activity, and ferric reducing antioxidant power (FRAP) of SBH were determined in this study. Then, the protective effect of SBH against hydrogen peroxide (H2O2)-induced cell death and DNA damage was studied by using WIL2-NS human lymphoblastoid cell line, while the lipopolysaccharide (LPS)-induced RAW 264.7 murine macrophages cell line was used to study the anti-inflammatory effects of SBH. Results from this present study showed that the major sugar contents of SBH were fructose (19.39 + 0.01%) and glucose (14.03 ± 0.03%). Besides, the total phenolic content, the radical scavenging activity, and the FRAP value of SBH were 15.38 ± 0.02 mg GAE/100 g of honey, 34.04 ± 0.21%, and 206.77 + 1.76 µM AAE/100 g honey respectively. Pretreatment with SBH protected WIL2-NS cells from H2O2-induced cell death and DNA damage (p < 0.001). Moreover, SBH was also able to attenuate the production of nitric oxide by inhibiting the expression of inducible nitric oxide synthase in LPS-induced RAW 264.7 cells (p < 0.001). In conclusion, SBH is rich in total phenolic content and possesses strong antioxidant, anti-inflammatory, and genoprotective properties. Our current findings suggest that SBH might be useful in the prevention and treatment of many diseases caused by oxidative stress and inflammation assuming the observed effects are also achievable in vivo.

Incidence and multidimensional predictors of occasional and recurrent falls among Malaysian community-dwelling older persons.

BACKGROUND: Falls incidence rate and comprehensive data on factors that predict occasional and repeated falls from large population-based studies are scarce. In this study, we aimed to determine the incidence of falls and identify predictors of occasional and recurrent falls. This was done in the social, medical, physical, nutritional, biochemical, cognitive dimensions among community-dwelling older Malaysians. METHODS: Data from 1,763 Malaysian community-dwelling older persons aged ≥ 60 years were obtained from the LRGS-TUA longitudinal study. Participants were categorized into three groups according to the presence of a single fall (occasional fallers), ≥two falls (recurrent fallers), or absence of falls (non-fallers) at an 18-month follow-up. RESULTS: Three hundred and nine (17.53 %) participants reported fall occurrences at an 18-month follow-up, of whom 85 (27.51 %) had two or more falls. The incidence rate for occasional and recurrent falls was 8.47 and 3.21 per 100 person-years, respectively. Following multifactorial adjustments, being female (OR: 1.57; 95 % CI: 1.04-2.36), being single (OR: 5.31; 95 % CI: 3.36-37.48), having history of fall (OR: 1.86; 95 % CI: 1.19-2.92) higher depression scale score (OR: 1.10; 95 % CI: 1.02-1.20), lower hemoglobin levels (OR: 0.90; 95 % CI: 0.81-1.00) and lower chair stand test score (OR: 0.93; 95 % CI: 0.87-1.00) remained independent predictors of occasional falls. While, having history of falls (OR: 2.74; 95 % CI: 1.45-5.19), being a stroke survivor (OR: 8.57; 95 % CI: 2.12-34.65), higher percentage of body fat (OR: 1.04; 95 % CI: 1.01-1.08) and lower chair stand test score (OR: 0.87; 95 % CI: 0.77-0.97) appeared as recurrent falls predictors. CONCLUSIONS: Having history of falls and lower muscle strength were predictors for both occasional and recurrent falls among Malaysian community-dwelling older persons. Modifying these predictors may be beneficial in falls prevention and management strategies among older persons.