Changes in serum lipids following consumption of coconut oil and palm olein oil: A sequential feeding crossover clinical trial.

BACKGROUND: High incidence of cardiovascular disease (CVD) in South Asia is linked to genetic predisposition and diets high in saturated fatty acids (SFAs). Increased CVD prevalence correlates with rising palm oil consumption in some South Asian countries, where coconut oil and palm olein oil are primary SFA sources. OBJECTIVE: Compare the effects of coconut oil and palm olein oil on serum lipoprotein lipids and biochemical parameters in healthy adults. METHODS: A sequential feeding crossover clinical trial with two feeding periods of 8 weeks each was conducted among 40 healthy adults. Participants were provided palm olein oil in the first feeding period followed by coconut oil with a 16-week washout period in between. The outcomes measured were the difference in serum low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC) and high-density lipoprotein cholesterol (HDL-C), TC/HDL-C ratio, triglycerides (TG), very-low-density lipoprotein cholesterol (VLDL-C), fasting plasma glucose (FPG), and liver enzymes. RESULTS: Thirty-seven participants completed the study. LDL-C decreased by 13.0 % with palm olein oil (p < 0.001) and increased by 5.6 % with coconut oil (p = 0.044), showing a significant difference (p < 0.001). TC decreased by 9.9 % with palm olein oil (p < 0.001) and increased by 4.0 % with coconut oil (p = 0.044). CONCLUSION: Palm olein oil consumption resulted in more favorable changes in lipid-related CVD risk factors (TC, LDL-C, TC:HDL-C, and FPG) compared to coconut oil. Clinical Trial Registry number and website where it was obtained: (SLCTR/2019/034); https://slctr.lk/trials/slctr-2019-034.

Enhancing physical function and activity level in malnourished older adults through oral nutrition supplements: a randomized controlled trial.

BACKGROUND: Malnutrition of older individuals, leads to significant functional decline, reducing their quality of life. Lifestyle interventions; dietary improvements and supplementation are explored to enhance the physical function of older adults. The current study aimed to assess the impact of oral nutritional supplements (ONS) on the functional and activity levels of Sri Lankan older adults. METHODS: This randomized controlled trial included; an intervention group (IG) receiving 200 mL of ONS providing 247 kcal per serving, for 12 weeks and a control group (CG) receiving an equivalent volume of water. Changes in handgrip strength, knee extension strength, gait speed, functional and activity levels were assessed. RESULTS: The IG showed significant improvements in handgrip strength (43.96 ± 18.61 kg vs. 32.81 ± 17.92 kg; p < 0.001) and knee extension strength (23.45 ± 2.29 kg vs. 16.41 ± 2.09 kg; p < 0.001) following 12 weeks compared to the CG. The IG also exhibited significant improvements in gait speed (1.31 ± 0.52 m/s vs. 0.87 ± 0.26 m/s), Barthel index score, (0.30 ± 0.47 vs. -0.18 ± 0.66), PASE score (0.52 ± 17.79 vs. -1.60 ± 21.77) and IPAQ categories. CONCLUSIONS: ONS was found to be effective in improving the functional and physical activity levels of malnourished older adults. TRIAL REGISTRATION: Sri Lanka Clinical Trial Registry SLCTR/2022/021. Registered on 06/10/2022.

Impact of an oral nutritional supplement on the body composition of older adults with or at risk of malnutrition in an institutionalised setting: A randomised controlled trial.

BACKGROUND: Malnutrition often manifests as a body weight (BW) reduction and unhealthy alteration in body composition. The present study aimed to assess the efficacy of an oral nutritional supplement (ONS) in improving BW and body composition among older adults with malnutrition. METHODS: An open-label randomised controlled, parallel-group study was conducted among older adults (age ≥ 60 years) with/at risk of malnutrition (mini nutrition assessment-short form score ≤ 11). In total, 50 participants were randomly assigned to the intervention (IG) and control (CG) groups (1:1 ratio). The IG received the ONS (57 g/day; 247 kcal/serving, 12 g protein) before bedtime for 12 weeks. CG received 200 mL of water. Anthropometric measurements, body composition analysis, and dietary and physical activity assessments were performed at the beginning and end of the study. RESULTS: Forty-two participants (IG: 20, CG: 22) completed the study. The mean ± SD ages of the IG and CG were 75.4 ± 6.1 and 74.8 ± 5.2 years, respectively (p = 0.73). The IG had a significant increase in BW (+1.68 ± 1.16 vs. -0.46 ± 0.95 kg; p < 0.001), lean mass (+1.23 ± 0.93 vs. -0.45 ± 0.90 kg; p < 0.001) and fat mass (+0.54 ± 0.82 vs. -0.06 ± 0.82 kg; p = 0.02) compared to the CG. One-quarter of the IG (n = 5) achieved a weight gain > 5% of BW, whereas none in the CG did (p = 0.01). No significant changes were observed in bone mineral content in either group. CONCLUSIONS: For malnourished older adults, supplementing with an ONS, along with regular food intake, significantly increased BW, lean mass and fat mass compared to control following the regular diet without supplementation.

A low-calorie meal replacement improves body composition and metabolic parameters in shift workers with overweight and obesity: a randomized, controlled, parallel group trial.

BACKGROUND: Shift work has been identified as a risk factor for several chronic health conditions including obesity. This study evaluated the impact of a low-calorie meal replacement (MR) as a dinner substitute on body composition and metabolic parameters in shift workers with overweight and obesity. METHODS: An 8-week parallel, randomized controlled trial was conducted on overweight and obese shift workers in a large hospital. An intervention group (IG) (n = 25) was provided with a low-calorie MR shake (∼200 kcal) as a replacement for dinner, every day for 8 weeks, while the control group (CG) (n = 25) continued their habitual diet. Anthropometric measurements, body composition, biochemical, and lifestyle data were assessed at the first and last visits. Analyses were done per protocol (PP) and by intention to treat (ITT). RESULTS: Over the study duration, both groups displayed moderate changes in anthropometric measurements and body composition, although these were not statistically significant according to the PP analysis. In the ITT analysis, apart from the hip circumference (HC), all other anthropometric parameters demonstrated significant group and time interactions, suggesting the advantageous effects of the meal replacement over the study period (P < 0.05). HDL and VLDL cholesterol measures showed significant main effects, influenced by both group (P = 0.031) and time (P = 0.050) respectively. The most pronounced dietary shift in the IG was a reduction in carbohydrate consumption and an increase in protein intake. Throughout the study, the meal replacement was well-tolerated, with no adverse events reported. CONCLUSIONS: The meal replacement dietary intervention appears to offer beneficial health effects over time. Extended research is crucial to understand the broader implications of meal replacements across diverse populations. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12622000231741. Registered on 09 February 2022. https://www.anzctr.org.au/ACTRN12622000231741.aspx .

The Colombo Twin and Singleton Study (COTASS): Piloting the Feasibility of Collecting Nutritional Data and Extension of the Sample to Include Children of Twins.

Nutrition and diet are key modifiable risk factors for the rising burden of non-communicable diseases like cardio-vascular diseases and diabetes in low- and middle- income countries (LMICs). The nutritional transition in dietary behaviours in LMICs has most likely contributed to this problem. Although traditionally assumed to be environmental, dietary choices are also genetically influenced. Twin study designs can be used to investigate the relative influence of genes and environment on nutrition intake, eating behaviours and associated psychological health. The overall aim of this project is to: provide proof-of-concept for the feasibility of using dietary (biomarker) data within the Children-of-Twin design in nutrition studies, develop laboratory skills and statistical genetic skills and establish a Sri Lankan-specific food composition database. Currently, a pilot study is being conducted with 304 individuals (38 Monozygotic twin pairs, 38 Dizygotic twin pairs and their male or female adult offspring). Questionnaire data on nutritional intake, eating behaviours, psychological well-being, physical health, and bio-specimens are being collected. A Sri Lankan-specific food composition database was developed, training sessions on macro and micro element analysis in biological samples and statistical genetics skills development were conducted and Community Engagement and Involvement programs were carried out in two districts of Sri Lanka.

Perceptions of the importance of sports nutrition knowledge and barriers in implementing them: a qualitative study among track and field stakeholders in Sri Lanka.

BACKGROUND: Integrating the core aspects of sports nutrition knowledge [SNK] into the multidisciplinary team is critical to improving an athlete's performance and well-being. Conducting in-depth interviews with members of the sports-related team is a comprehensive method of gathering information on various aspects of SNK. This qualitative study aimed to examine the opinions and beliefs of stakeholders in athletics regarding the importance of SNK. METHODS: Fifteen professional track and field athletes and stakeholders were recruited into the study. Separate in-depth interviews were conducted to collect information within four key themes. Practical difficulties in getting an appropriate meal were included in an additional theme. Thematic analysis was performed using NVIVO v10.0. RESULTS: All participants were mindful of the importance of proper food habits for overall athletic outcomes and reported different opinions on meal timing and composition. The opinions on supplements were heterogeneous and both positive and negative claims were reported. Beliefs regarding hydration demonstrated that the cohort was well aware of the significance of adequate hydration plus the signs and consequences of dehydration with many reporting experiences of the negative consequences of dehydration. All respondents reported that both alcohol and smoking may have an adverse impact on performance and health. CONCLUSIONS: All respondents emphasized the importance of proper food habits for sports performance and well-being, but also identified barriers to optimizing nutrition.

The effect of coconut oil and palm oil on anthropometric parameters: a clinical trial.

BACKGROUND: During recent years several studies have investigated the impact of different dietary oils on body weight. They have shown differential positive and negative effects on anthropometry. We investigated the effects of palm and coconut oils on body weight and other anthropometric parameters, considering their importance as a primary source of saturated fat, controlling for other confounding variable such as total energy intake. METHODS: The study was conducted as a sequential feeding clinical trial with 40 healthy men and women divided into two feeding periods of initial palm oil (8 weeks) and subsequent coconut oil (8 weeks), with a 16-week washout period in between. Each participant received a pre-determined volume of each oil, which were integrated into their routine main meals and snacks during the respective study periods. Changes in body weight, body mass index (BMI), waist circumference (WC), hip circumference (HC), and waist-to-hip ratio (WHR) were evaluated. Physical activity levels and dietary intake were also evaluated as potential confounding factors. RESULTS: Thirty-seven participants completed both oil treatment periods. The mean (± SD) age of the participants was 39 (± 13.1) years. There were no significant differences in any of the anthropometric parameters between the initial point of feeding coconut oil and the initial point of feeding palm oil. Following both oil treatment phases, no significant changes in the subjects' body weight, BMI, or other anthropometric measurements (WC, HC, and WHR) were observed. CONCLUSION: Neither coconut oil nor palm oil significantly changed anthropometry-related cardiovascular risk factors such as body weight, BMI, WC, HC, and WHR. TRIAL REGISTRATION: Sri Lankan Clinical Trial Registry: SLCTR/2019/034 on 4th October 2019 ( https://slctr.lk/trials/slctr-2019-034 ).

The impact of an oral nutritional supplement on body weight gain in older adults with malnutrition: an open-label randomized controlled trial.

BACKGROUND: The global aging population is expanding rapidly and many individuals have a particularly higher risk of malnutrition. Malnutrition can lead to impaired body function, morbidity, and mortality. Meeting nutritional requirements is a key strategy to minimize multiple debilitating adverse outcomes associated with malnutrition in the elderly. Oral nutritional supplements (ONS) have been widely used as a dietary intervention for malnutrition in older adults. These supplements provide additional nutrients and calories to support nutritional requirements and have been shown to improve nutritional status, physical function, and quality of life in malnourished older adults. METHODS: This is an open-label, randomized controlled, parallel-group study including 50 institutionalized older adults (aged > 60 years) with malnutrition or at risk of malnutrition, living in a selected elderly care institution in Colombo, Sri Lanka. The aim is to assess improvement in healthy body weight gain and body composition in older adults with malnutrition at risk of malnutrition by using an ONS. Older adults will be screened for malnutrition using the Mini Nutrition Assessment (MNA) tool and eligible participants randomized using the simple random sampling technique to intervention and control groups (1:1 allocation ratio). The intervention group will consume 200 mL of ONS before bed continuously for 12 weeks. The primary outcome is the percentage who achieved at least 5% weight gain in the intervention group compared to the control group. Nutritional status (anthropometric, biochemical, clinical, and dietary), body composition (dual-energy X-ray absorptiometry), frailty, functional capacity (hand grip strength, knee extension, and Barthel index) cognitive status (Montreal Cognitive Assessment), and physical activity will be assessed as secondary outcomes at baseline and at the end of the 12-week intervention. Some measurements (anthropometry, dietary, and functional assessments) will also be performed at the end of the 4th week. Data will be analyzed using SPSS V-23. DISCUSSION: This study will determine whether the use of an ONS is effective in promoting healthy weight gain in older adults with malnutrition or at risk of malnutrition. In addition, investigating the impact of an ONS on multiple outcomes via clinical, nutritional, functional, and cognitive function will provide a more comprehensive understanding of the potential benefits of these supplements. TRIAL REGISTRATION: Sri Lanka Clinical Trail Registry SLCTR/2022/021. Oct. 6, 2022.

Sports Nutrition Knowledge Questionnaires Developed for the Athletic Population: a Systematic Review.

PURPOSE OF REVIEW: Sports nutrition (SN) is pivotal in aiding athletes to reach peak performance, minimize sport-related injuries, enhance career longevity, and improve general health. An accurate assessment of athletes' sports nutrition knowledge (SNK) is required to design targeted nutrition education programs aimed at enhancing both nutritional knowledge and dietary practices. This review systematically evaluates studies that use questionnaires to assess the SNK of athletes engaged in athletics. RECENT FINDINGS: The literature search was conducted in PubMed®, Web of Science®, and Scopus®, and 375 potentially relevant articles were identified. The total number of articles included in the present review is 11, with eight studies involving only athletic disciplines and three involving athletics and other sports. The majority (n = 8) of the questionnaires included general and SN aspects, with SN covering endurance athletes' knowledge of competition carbohydrate guidelines, gastrointestinal symptoms associated with exercise, and ultra-endurance athletes' sodium beliefs and practices. Questionnaires were either delivered online (n = 7) or self-administered in hard copy (n = 1). The three major strategies identified for developing questionnaires were based on previous literature and recent SN guidelines (n = 6), consultation with a panel of experts (n = 7), and the use of a previously developed sports nutrition knowledge questionnaires (SNKQ) (n = 4), with more than one approach used in five studies. Similarly, up to three validation approaches were used, including content, face, and construct validity. Seven studies used a test-retest procedure to ensure external reliability, and eight used Cronbach's alpha or kappa coefficient to assess internal consistency. Endurance and ultra-endurance athletes are the populations of interest for the majority of questionnaires developed for athletics, with most questionnaires incorporating general and SNK topics.

A qualitative exploration of the experiences of shift workers participated in a low-calorie meal replacement dietary intervention.

OBJECTIVES: Shift work is associated with various health challenges, including obesity and metabolic disturbances. To address these concerns, a randomised controlled clinical trial was conducted to evaluate the efficacy of a low-calorie meal replacement (MR) dietary intervention for dinner among shift workers with obesity. This study focuses on the qualitative aspects of this intervention, aiming to explore the experiences and perceptions of shift workers who participated in the trial. DESIGN: Following the completion of the intervention, semi-structured face-to-face or telephone interviews were conducted with a purposive sample of trial participants. Data analysis was inductive, thematic using NVivo V.10 software. SETTING: The intervention was conducted among shift workers with obesity in a private hospital in Sri Lanka and resulted in a modest decrease in weight. PARTICIPANTS: Using purposeful maximum variation sampling, we recruited eight healthcare shift workers who took part in a weight loss intervention. RESULTS: All participants expressed satisfaction with the MR meal for dinner, highlighting its positive impact on their well-being. Despite initial difficulties, strong determination and motivation by results supported adherence. Some participants suggested that the MR could be improved with sweeter taste and more flavour options. Few reported mild bloating at the beginning, but no serious side effects were noted. Participants felt lighter in their bodies due to weight loss. The method's simplicity was the most frequently reported benefit, making it feasible even during busy night shifts. Overall, participants highly recommended the intervention to others in need. CONCLUSION: Participants experienced weight loss by replacing their dinner with the MR. This study offers valuable insights for tailoring future workplace-based dietary interventions for this vulnerable population. TRIAL REGISTRATION NUMBER: ACTRN12622000231741.

The effect of shift work on different hematological parameters among healthcare workers.

Shift workers frequently experience alterations in their circadian rhythms, which are correlated with variations in hematological parameters. Changes in blood cells may be related to an individual's health status. Therefore, this study aimed to compare the relationship between shift work and changes in blood cells among a group of healthcare workers in Sri Lanka. A comparative cross-sectional study was conducted among healthcare workers, recruited by a stratified random sampling technique. Socio-demographic data were collected using a structured questionnaire. Venous blood samples were obtained and analyzed for the determination of total and differential blood cell counts. Descriptive statistics were used for the analysis of sociodemographic and hematological parameters. A sample of 37-day workers and 39 shift workers were included in the analysis. The mean ages (years) were not significantly different between the groups (36.8 ± 10.8 vs 39.1 ± 12.0; P = 0.371). Shift employees showed a significantly higher total mean white blood cell count (WBC) of 7548.75 mm-3 compared to day workers' 6869.19 mm-3 (P = 0.027). They also had higher mean absolute counts for all different WBC types (Neutrophils: 3949.2 vs 3557.7 , Lymphocyte: 2756.5 vs 2614.2 , Eosinophil: 317.6 vs 233.4 , Monocytes: 491.63 vs 432.51 , Basophils: 31.68 vs 29.22 ). Shift employees exhibited higher WBC counts than day workers at the same level of work experience. The length of shift work exposure revealed a positive link with neutrophil (r = 0.225 ) and eosinophil counts (r = 0.262 ), whereas these correlations were negative for day workers. Shift workers were associated with higher WBC counts in healthcare workers compared to their day-working counterparts.

Impact of the economic crisis on food consumption of Sri Lankans: An online cross-sectional survey.

AIMS: This study investigated how the economic crisis has changed Sri Lankans' food consumption. METHODS: A web-based cross-sectional survey was carried out in the month of July 2022, using an e-questionnaire based on Google Forms. The questionnaire assessed respondents' socio-demographics, food consumption, and dietary patterns before and during the economic crisis. The changes were compared using descriptive statistics and inferential statistics. RESULTS: A total of 1095 respondents, aged ≥18 years were included in the survey. There was a significant reduction in the average consumption of main meals per day during the economic crisis (pre: 3.09 ± 0.42, post: 2.82 ± 0.47; P < 0.001). The intake of food items such as rice, bread, and snacks also reduced significantly (P < 0.001). The average daily milk intake frequency decreased from 1.41 ± 1.07 to 0.57 ± 0.80 meals/day (P < 0.001). On contrary, the intake of non-dairy beverages such as malted milk and "plain tea" has increased by several folds. Consumption of fruit and vegetables showed a significant reduction in both frequency and portion size. The consumption of meat, fish, eggs and dhal also decreased in around three-quarters of the study sample. During this period majority (81%) used food coping mechanisms and the most adopted strategy was buying less expensive food. CONCLUSION: Sri Lankans' food consumption have been adversely altered due to the country's economic crisis. There has been an overall reduction in the amount and frequency of intake of many common food items.

The effects of pyridoxine (vitamin B6) supplementation in nausea and vomiting during pregnancy: a systematic review and meta-analysis.

PURPOSE: Nausea and vomiting during pregnancy (NVP) are common symptoms in pregnancy. Although no definitive treatment option for NVP, pyridoxine (Vitamin B6) supplementation has been used widely. The present study aims to systematically evaluate the current evidence regarding pyridoxine for the treatment of NVP. METHODS: Data were obtained using a stepwise search process using keywords in the following online medical databases; PubMed®, Web of Science®, and Scopus® for studies published before 1st May 2021. Studies reporting intervention with pyridoxine supplementation alone and/or with other active substances were included. A meta-analysis was performed on the PUQE score and Rhode's score for nausea and vomiting. FINDINGS: Initial database searching indicated 548 potentially eligible articles, of which 18 studies satisfying the inclusion criteria were selected. Eight studies showed beneficial effects with pyridoxine alone as the supplementation, while six others found that the supplementation of pyridoxine in combination with another active substance had favourable effects. Supplementation of pyridoxine alone as well as combined treatment of pyridoxine with an active ingredient as the intervention significantly improved the symptoms of nausea according to Rhode's score [0.78 [95% CI: 0.26, 1.31; p = 0.003; I2 = 57%, p = 0.10)] and PUQE score [0.75 (95% CI: 0.28, 1.22; p = 0.002; I2 = 0%, p = 0.51)], respectively. CONCLUSION: Supplementation of pyridoxine alone as well as with an active ingredient demonstrated beneficial effects for women suffering from NVP.

COVID-19 vaccine hesitancy in Sri Lanka: A national level survey.

Objective: It is important to understand the factors associated with vaccination hesitancy for a given population for successful coronavirus disease-2019 (COVID-19) immunization program. This survey aimed to examine the prevalence of vaccine hesitancy and associated sociodemographic factors. Methods: A cross-sectional online survey was undertaken by circulating through social media platforms. Survey questions included sociodemographics and vaccination acquisition-related questions. Results: The study comprised a total of 3621 respondents. Over one-fifth of the unvaccinated population were identified as vaccine hesitancy group. Ethnicity and district indicated significant associations with vaccine hesitancy (P < 0.05). Indian Tamils (Odds Radio [OR] 2.222; 95%Confidence interval [CI], 1.150-4.294; P = 0.018), Sri Lankan Tamils (OR 1.714; 95% CI, 1.181-2.488; P = 0.005), and Sri Lankan Moors (OR 1.913; 95% CI, 1.316-2.781; P = 0.001) had significantly higher odds of vaccine hesitancy when compared to the Sinhalese. People in rural areas also had greater odds of vaccine hesitancy (OR 1.339; 95% CI, 1.000-1.793; P = 0.05) compared to municipal council areas. Conclusion: Vaccine hesitancy was considerably high in this survey population. Our results emphasize the need of the Sri Lankan government taking appropriate efforts to establish a targeted COVID-19 vaccination campaign plan for rural and Colombo district residents. Attention should also be given to ethnic minority groups.

Coconut oil consumption and bodyweight reduction: a systematic review and meta-analysis.

INTRODUCTION: Due to the composition and biological properties of coconut oil, there is still considerable debate regarding potential benefits for the management of obesity, including the specific impact on body weight (BW) reduction. This systematic review and meta-analysis of clinical trials aims to assess the impact of coconut oil on BW reduction in comparison to other oils and fats. EVIDENCE ACQUISITION: The databases, PubMed®, Web of Science®, EMBASE®, and SciVerse Scopus® were systematically searched. A combination of medical subject headings and words linked to coconut oil and obesity parameters were utilized. Any clinical trials comparing coconut oil to any other form of oil or fat, with more than one month feeding period among adults were considered. EVIDENCE SYNTHESIS: From the 540 potentially relevant papers, 9 were included. The period of coconut oil intake varied from four to twelve weeks, apart from one long-term trial where coconut oil was consumed for two years. When compared to other oils and fats, coconut oil substantially decreased BW (N.=546), Body Mass Index (BMI) (N.=551), and percentage of fat mass (FM%) (N.=491) by 0.75 kg (P=0.04), 0.28 kg/m2 (P=0.03), and 0.35% (P=0.008), respectively. Coconut oil consumption did not result in any significant alteration in waist circumference (WC) (N.=385) (-0.61 cm; P=0.30), waist-to-hip ratio (WHR) (N.=330) (-0.01; P=0.39) and FM (N.=86) (-0.25 kg; P=0.29). CONCLUSIONS: Results indicate a small statistically significant reduction in BW, BMI, and FM% in the coconut oil group. In contrast, consumption of coconut oil had no statistically significant effect on WC, WHR, or FM.

Shift Work is Associated with an Elevated White Blood Cell Count: A Systematic Review and Meta-Analysis.

The white blood cell (WBC) count increases significantly in reaction to infections and certain chronic diseases. Shift employment increases the risk for chronic low-grade inflammation and the progression of several chronic diseases. The objective of this study was to systematically evaluate the evidence from studies on total and differential WBC counts in shift employees. A literature search was performed in PubMed®, Web of Science, and Scopus databases using keywords for research published before March 1, 2022. A meta-analysis was conducted for total and differential WBC counts using a random-effects approach. A total of 25 studies covering a sample of 37,708 day and shift employees were included in this review. The studies represented America, Europe, East Asia, and Middle East. A significant increase in the total counts (×109/L) of WBC [mean difference (MD) = 0.43; 95% confidence interval (CI): 0.34-0.52; P < 0.001], lymphocytes (MD = 0.16; 95% CI: 0.02-0.30; P = 0.02), monocytes (MD = 0.04; 95% CI: 0-0.07; P = 0.03), and eosinophils (MD = 0.01; 95% CI: 0-0.01; P = 0.03) was observed in shift workers compared to the day counterparts. However, neutrophils and basophils were not significantly different between the groups. Shift work significantly increases the total and differential blood counts in peripheral circulation. Therefore, total and differential WBC counts represent a relatively inexpensive biomarker for diagnostics and prognostics of diseases in shift workers.

The impact of the Sri Lankan economic crisis on medication adherence: An online cross-sectional survey.

Background: The economic crisis in Sri Lanka has disarrayed the country's healthcare services, posing a challenge to people with chronic diseases on routine care. This study investigated the changes in medication adherence during the economic crisis. Methods: A web-based cross-sectional survey was undertaken in July-August 2022. It assessed socio-demographics, diseases, medication adherence, and reasons for changes in compliance of respondents and their family members during the economic crisis. Descriptive statistics and multivariable logistic regression analysis were used. Findings: A total of 1214 respondents, aged ≥18 years were included in the survey. The majority were females (60%). The main finding was that 39%, 41%, and 37% of participants, their family members, or children respectively have changed medication use during the crisis. Among those who changed their medication practices, the most significant change was the change in the brand, reported by 44.7% of the respondents. A similar pattern was observed among other family members, with 61.3% of adults and 53.8% of children switching brands. Respondents who lived outside the Colombo district had a significantly increased risk of changing medication (OR = 1.425, 95% CI = 1.020-1.992, P = 0.038). Respondents with monthly incomes of less than 100,000 LKR had a twofold greater risk of medication nonadherence compared to participants who earned more than 100,000 LKR per month (OR = 2.278, 95% CI = 1.37-3.78, P = 0.001). The most stated reason for changing medication among adults was the high cost of drugs, whereas among, children, the lack of access to drugs in the public or private sector was the leading cause of non-compliance. Interpretation: The population's adherence to medication is negatively impacted by the economic crisis in Sri Lanka.

Meal replacement as a weight loss strategy for night shift workers with obesity: a protocol for a randomized controlled trial.

BACKGROUND: Shift work is considered a risk factor for a number of chronic health conditions including obesity. Weight reduction in obese patients lowers the risk for cardiovascular disease, diabetes, certain cancers, and mortality. Achieving a negative energy balance by providing low-calorie meal replacements is widely used for weight management. This study aims to evaluate the impact of a low-calorie "meal-replacement" on the weight and metabolic parameters of shift workers with obesity. METHODS: This trial will be conducted in a parallel, randomized controlled design for a period of 8 weeks. A total of 44 shift workers with body mass index over 25 kg/m2 will be recruited after assessing eligibility. Participants will be randomly assigned to the test and control groups on a 1:1 ratio. The intervention group (N = 22) will be provided with a low-calorie (~200 kcal) meal replacement shake as dinner, and the control group (N = 22) will continue their habitual diets. The visits and the evaluations will be done as follows: screening (visit 0), 4 weeks (visit 1), and 8 weeks (visit 2). Anthropometric measurements will be taken at 0, 4, and 8 weeks. Body composition, biochemical parameters, dietary intake, and physical activity will be assessed during the first and the last visit. OUTCOMES: The primary outcome will be the proportion of participants that had a 5% body weight loss from baseline. The secondary outcomes will be post-intervention changes in other metabolic parameters. DISCUSSION: To our knowledge, this is one of the first randomized controlled trials evaluating the effects of a meal replacement as the night meal for weight loss in shift workers with obesity. Moreover, improvement of metabolic parameters in shift workers will be an added benefit to this high-risk group. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12622000231741 . Registered on 09 February 2022.

The Effect of Shiftwork on Body Composition: A Comparative Cross-sectional Study Among Health Care Workers.

OBJECTIVE: This study compared the body composition parameters between shiftworkers and nonshiftworkers in a hospital setting in Sri Lanka. METHODS: A comparative cross-sectional study was carried out among a sample of 78 health care workers, recruited by a stratified random sampling technique. Subjects underwent anthropometric and bioimpedentiometric analysis for body composition parameters. RESULTS: The mean (SD) body fat percentage (BF%) of shiftworking women (40.8 [SD, 6.8%]) was significantly higher than day-working women (36.7% [SD, 5.9%]) ( P < 0.05). Mean BF% between day and shift groups did not significantly differ (33.0% [SD, 6.9%] vs 32.4% [SD, 10.7%]). Body mass index and waist circumference were significantly higher among shiftworking women ( P < 0.05), whereas male workers showed the opposite trend. CONCLUSION: Prolonged exposure to shiftwork was associated with a higher BF%. Therefore, interventions for shiftworkers must be addressed, focusing on improving body composition.

Chronotype and Sleep Quality in Obesity: How Do They Change After Menopause?

PURPOSE OF REVIEW: This review primarily provides an overview of the current evidence on chronotype (which reflects an individual's preference for the timing of sleeping, eating, and activity in a 24-h period) and sleep quality changes in obesity in postmenopausal women. It also explores possible nutritional strategies to manage these changes in this phase of a woman's life. RECENT FINDINGS: Menopause is a life stage frequently associated with sleep disturbances and changes in circadian rhythms. Sleep disturbances are one of the main symptoms of menopause and are caused by several factors such as hormonal changes, obesity, and melatonin reduction. In addition, the chronotype also changes following menopause. Nutritional strategies are essential because they could help manage menopausal sleep disturbances and circadian misalignment, particularly by tackling obesity and overweight. In the management of postmenopausal women, especially those experiencing obesity, careful assessment of sleep disturbances and chronotype and subsequent development of the most appropriate treatment, including nutritional management, should be part of the treatment routine.