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Hydrogen is an energy carrier found from renewable sources such as biomass, geothermal, solar, or wind. Water splitting and dehydrogenation of glycerol is a sustainable process of H2 production from renewables because water is abundant, and the glycerol is formed from the biomass-derived compounds. However, finding a suitable and best catalyst for these processes is challenging. Thus, this paper proposed a theoretical study to find the mechanism of the dissociation of water and dehydrogenation of glycerol using Au metal and PdAu alloy catalysts using the density functional theory (DFT) method. Four PdAu alloys have been constructed with different atomic compositions ranging from 1 to 3 of Pd metal to Au metal. The result showed strong adsorption on the Pd1Au3 catalyst surface, and the water splitting is best on the Pd3Au1 catalyst surface. Simultaneously, the glycerol adsorption on catalyst surfaces is tested before proceeding for the complete dehydrogenation mechanism of glycerol. Strong adsorption was found at the Pd1Au3 catalyst compared to other catalyst surfaces on the glycerol adsorption. The dehydrogenation mechanism was found toward a downhill reaction and removed eight hydrogens from the glycerol compared to Au metal, referring to easy dehydrogenation of glycerol using the alloy PdAu. The final species that adsorbed on the Pd1Au3 surface is the carbon monoxide will be turned later into carbon dioxide.

Background: Increasing physical activity and reducing sitting time was recommended to cancer survivors after cancer treatment for sustained health and to enhance the quality of life. This study aimed to determine the association of physical activity and sitting time with quality of life among the Malay breast and gynaecological cancer survivors. Methods: A cross-sectional study was conducted among 95 breast and gynaecology cancer survivor subjects. The Malay International Physical Activity Questionnaire (IPAQ) was used to assess physical activity and sitting time. Quality of life was assessed using the Malay EORTC QLQ-C30 questionnaire. Sociodemographic, clinical characteristics and anthropometric measurements were also obtained in this study. Results: The mean age of the subject was 51.8 ± 7.7 years old and the duration of survivorship was 4.3 ± 3.4 years. A total of 76.8% of subjects were categorized as having low physical activity level with a mean MET 403.5 ± 332.7 minutes/week and sitting time of 416.9 ± 151.0 minutes/day. Overall, subjects aged 50 years and above (p=0.006), widowed (p=0.032), retired (p=0.029) and had other non-communicable diseases (p=0.005) showed lower levels of physical activity. Increased physical activity had a positive effect on physical function (r=0.2, p=0.038), reduced insomnia (r=-0.3, p

Objective Fear of cancer recurrent, side effects of treatment and belief in food taboos encourage cancer survivors to make changes in their dietary practices after diagnosis of cancer. The objective of this study was to determine the impact of dietary changes on quality of life (QoL) among Malay breast and gynaecological cancer survivors. Methods Questionnaire of dietary changes was modified from WHEL study and adapted to typical Malay's food intake in Malaysia. A total of 23 items were listed and categorized by types of food and cooking methods. Four categories of changes "increased", "decreased", "no changes" or "stopped" were used to determine the changes in dietary practices. Score one (+1) is given to positive changes by reference to WCRF/AICR and Malaysia Dietary Guideline healthy eating recommendations. Malay EORTC QLQ-C30 were used to determine the QoL. Sociodemographic, clinical characteristics and anthropometric measurement were also collected. Results The mean age of the subjects (n=77) was 50.7±7.8 years old with duration of survivorship 4.0±3.1 years. Subjects mean BMI was 27.8±4.9 kg/m2 which indicate subjects were 31.2% overweight and 32.5% obese. The percentage score of positive dietary changes was 34.7±16.4%. Positive dietary changes were increased intake of green leafy vegetable (49.4%), cruciferous vegetable (46.8%) and boiling cooking methods (45.5%). Subjects reduced their intake of red meat (42.9%), sugar (53.2%) and fried cooking method (44.2%). Subjects stopped consuming milk (41.6%), c 2008-5862 heese (33.8%) and sweetened condensed milk (33.8%). With increasing positive dietary changes, there was a significant improvement on emotional function (rs=0.27; p=0.016) and reduced fatigue symptoms (rs=-0.24; p=0.033). Conclusion Positive changes in dietary intake improved emotional function and reduced fatigue symptoms after cancer treatment. By knowing the trend of food changes after cancer treatment, enables the formation of healthy food intervention implemented more effective.

Introduction: The culture of eating out among Malaysians has substantially increased in recent years due to the urbanisation of the society. Frequent eating out has been linked with reduced quality of diet, reduced intake of micronutrients, and increased weight gain. This study aims to explore specific factors on the perceptions and behaviours related to eating out from the perspective of parents. Methods: A qualitative study was carried out among 27 informants from various ethnicities and locations in Peninsular Malaysia. All sessions were audio-recorded, fully transcribed and analysed using thematic content analysis. Results: The main overarching theme that surfaced from this study was the role of parents in shaping the practice of eating out. Time constraints due to parents’ work commitments, the availability of various food outlets, increase in family bonding time and food preferences were recurring themes revealed by informants as facilitating factors to eating out. Other emerging themes, such as hygiene of food premises and cost of food, posed as barriers to eating out. Conclusion: These findings offered a better understanding on the eating out practices of a family from the parents’ perspective. Information as such could be incorporated in strategies to enhance the promotion of healthy eating and nutrition interventions that aim to inculcate healthy food choices while eating out.

Oxidation reaction of glycerol has the probability of producing intermediate species that may be toxic to the catalyst surface and blocks the catalyst function. Thus this study presents the performance and durability of glycerol fuel cell with novel catalyst, Palladium-Aurum catalysts supported on Vapor Grown Carbon Nanofiber to reduce this effect. The electrochemical behaviour tests indicate that nanoalloy with mole ratio of Palladium to Aurum (1:1) is the best nanocatalyst that can achieve a maximum mass current of 0.17 A m g - 1 based on cyclic voltammetry analysis on glycerol oxidation in alkaline media. Apparently, the cell performance was improved from 0.0058 W cm−2 with Palladium black to 0.007 W cm−2 via Palladium-Aurum/Vapor Grown Carbon Nanofiber. Moreover, the present of Vapor Grown Carbon Nanofiber, as a support, give stability and durability to the catalyst due to unnoticeable deactivation after being used several times. In addition, the influence of the operating conditions (example: temperature and Sodium hydroxide concentration) towards the electrochemical kinetic activity was also studied in detail through the determination of the activation energies.

The assessment of exclusive breastfeeding is important to invest the efforts to promote and support breastfeeding practices. Hence this study was carried out to compare breastfeeding practices among mothers using deuterium dose to mother technique with maternal recall breastfeeding practice. A total of 30 mother-infant pairs from a university hospital and government health clinics in Klang Valley participated and completed the study. Mother-infant pairs were recruited into the study when infants were aged 3 months ± 1 week. Anthropometric measurements (height, weight, waist circumference for mother; length and weight for infant) were carried out. Socio-demographic questionnaire was self-administered while breastfeeding practices were interview administered using maternal recall breastfeeding practice questionnaire (MRBF). This was followed by baseline saliva collection of mother-infant pairs before dose and 6 days after mothers were given 30 ± 0.01g of D 2 O. The post dose saliva sample of mother-infant pairs were collected 6 times at day 1,2,3,4,13 and 14. The results showed that majority of mothers (57%) were university graduates but majority were stay at home mothers. Meanwhile, mothers had BMI with mean 25 ± 4 kg/m 2 . The results from MRBF questionnaire showed that all mothers were practising exclusive breastfeeding and their infant never received any water sources other than their breast milk. However, the deuterium dose to mother technique revealed only 3% of mothers were actually practising exclusive breastfeeding. From the isotopic data, the calculated mean intake of milk was 721 ± 243 g/day while the mean non-milk oral intake of 122 ± 22 g/ day. In contrast exclusive breastfeeding infants received only 10 g/day non milk oral intake, demonstrating exclusive breastfeeding practice of mothers. There were different breastfeeding practice reported from mother using deuterium oxide dose to mother technique with maternal recall breastfeeding practice. DOI : http://dx.doi.org/10.17576/JSKM-2019-1701-14

Platinum group metal (PGM) is the common catalyst used in cathode side of Direct Methanol Fuel Cell (DMFC), however, problem arise because of the competitive reaction between methanol oxidation and oxygen reduction. Besides, using a PGM catalyst makes the DMFC expensive. Many non-platinum catalysts were developed but most of them produce hydrogen peroxide that is toxic to the cathode and membrane that reduces the performances of the fuel cell. Thus, this study proposes a novel non-platinum catalyst that produced water as main product instead of hydrogen peroxide. CoPc/C-W18O49 is prepared via pyrolysis and they demonstrate as a promising catalyst to replace PGM in acidic media. As a semiconductor metal oxide, W18O49 has interesting properties and is used as a catalyst support to enhance the reactivity of the oxygen reduction reaction. W18O49 were synthesized first through a solvo-thermal process and then mixed with CoPc/C via pyrolysis at 700 °C, and they were also synthesized in the reverse order. The catalyst was physically characterized by Field Emission Scanning Electron Microscopy (FESEM), Transmission Electron Microscopy (TEM) and X-ray Diffraction (XRD) and chemically characterized by Cyclic Voltammetry (CV) and Rotating Ring-Disc Electrode (RRDE) analysis for the oxygen reduction reaction (ORR). The results showed that the supported Nanowires (W18O49) are not transformed to WO3 after the pyrolysis process. The prepared catalyst, which is inert in the methanol environment electrolyte, has shown catalytic activity towards oxygen reduction in acidic media and has a 3.81-electron transfer, which produces water as the main product. The catalyst has comparable performance with other macrocycle catalysts with modified structures.

Currently, platinum is used as the cathode catalyst in direct methanol fuel cells (DMFCs). However, platinum reduces the number of active sites for the oxygen reduction reaction (ORR) due to the reaction between platinum and methanol and the strong adsorption of carbon monoxide molecules on the platinum surface, and in addition, platinum is very expensive. Hence, this study proposes cobalt phthalocyanine/carbon-tungsten oxide nanowires (W18O49) as a non-platinum catalyst for the cathode side of a DMFC. We determined the kinetic parameters of the catalyst and investigated the factors affecting the reaction. The factors involved in the examination of the significant parameters were the synthetic method, the pyrolysis temperature, the mass ratio of CoPc to carbon, the mass ratio of CoPc/C to tungsten hexachloride and the molarity of tungsten hexachloride. The optimum parameters were determined to be a pyrolysis temperature of 600 °C and a mass ratio of CoPc/C:WCl6 of 1.90. These conditions produced a peak potential at 0.63 V vs. RHE, a mass activity of 1.76 A gcatalyst−1 at 0.65 V, an average electron transfer number of 3.9 with water as the main product, and an electron transfer number of 3.9 at 0.65 V. Finally, the results showed that the non-platinum catalyst (which is less expensive than platinum) has similar characteristics to platinum. The single cell performance test showed that the power density is 9.0 mW cm−2. The catalyst has comparable performance with other macrocycle catalysts with modified structures.

Two nationwide studies, namely the South East Asian Nutrition Survey (SEANUTS Malaysia) and MyBreakfast study showed that 13-17% of children aged between 6 and 12 years were either overweight or obese. From dietary assessment, the majority of children achieved the Malaysian recommended nutrient intake (RNI) for energy and protein, but more than 50% did not fulfill the RNI for calcium and vitamin D. The majority of children consumed breakfast regularly; however, 20-30% of children skipped breakfast. The MyBreakfast study showed that 17.7% of the children consumed ready-to-eat cereal (RTEC) at breakfast, while among non-RTEC consumers, bread (44.2%), eggs (31.8%), and nasi lemak (23.9%) were the most common foods consumed. RTEC was the major contributor of whole grain (68.6%), followed by hot cereal (18.6%), biscuits (8.7%), and bread (1.8%). In the SEANUTS Malaysia, among children aged 7-9 years, 13.4 and 9.5% met the Malaysian Dietary Guideline (MDG) for fruits and vegetables while among children aged 10-12 years, only 19.6 and 16.1%, respectively, met the MDG for fruits and vegetables. For the milk group, only 5.5% of 7- to 9-year-old children and 3.7% of those 10-12 years old met the MDG for milk/dairy products per day.

Two nationwide studies, namely the South East Asian Nutrition Survey (SEANUTS Malaysia) and MyBreakfast study showed that 13-17% of children aged between 6 and 12 years were either overweight or obese. From dietary assessment, the majority of children achieved the Malaysian recommended nutrient intake (RNI) for energy and protein, but more than 50% did not fulfill the RNI for calcium and vitamin D. The majority of children consumed breakfast regularly; however, 20-30% of children skipped breakfast. The MyBreakfast study showed that 17.7% of the children consumed ready-to-eat cereal (RTEC) at breakfast, while among non-RTEC consumers, bread (44.2%), eggs (31.8%), and nasi lemak (23.9%) were the most common foods consumed. RTEC was the major contributor of whole grain (68.6%), followed by hot cereal (18.6%), biscuits (8.7%), and bread (1.8%). In the SEANUTS Malaysia, among children aged 7-9 years, 13.4 and 9.5% met the Malaysian Dietary Guideline (MDG) for fruits and vegetables while among children aged 10-12 years, only 19.6 and 16.1%, respectively, met the MDG for fruits and vegetables. For the milk group, only 5.5% of 7- to 9-year-old children and 3.7% of those 10-12 years old met the MDG for milk/dairy products per day.

Background: Quality of life (QOL) is an essential part of health outcomes for diabetes patients . Methods: This cross-sectional study aimed to evaluate the quality of life among 100 Iranian type 2 diabetes patients aged 37 to 66 years, attending the outpatient diabetes clinic at Golestan Hospital, Ahvaz, Iran, from August to October 2013. Diabetes quality of life (DQoL) questionnaire was used to determine quality of life of diabetes patients. Body weight, height, waist circumference, clinical parameters, including glycated hemoglobin A1c level (HbA1c) were also measured. Results: The mean age of men and women was 56±6.1 and 53.4± 6.7 years respectively. Sixty one present of patients were female and 39 % were male with 4.05 ± 1.4 mean years duration of diabetes. The mean total DQOL was 54.6± 2.4, a moderate quality of life and was associated with diabetes care and treatment adherence. The mean for diabetes-related worry was 77.5 ±7.05. Conclusions: Male diabetic patients in comparison with female diabetic patients, non-insulin-treated patients compared with insulin-treated patients had better quality of life. HbA1c higher than 7%, was associated with higher probabilities of worse quality of life among patients. More studies are needed to include larger study populations among Iranian type 2 diabetes patients in order to help health care providers develop proper health care programs for diabetic patients in Iran.

Countries in South East Asia are undergoing a nutrition transition, which typically involves a dietary shift from plant to animal proteins. To explore the main drivers of protein consumption, the SCRiPT (Socio Cultural Research in Protein Transition) study recruited a population sample in Malaysia (N = 1604). Participants completed in-person 24 h dietary recalls and socio-demographic surveys. Energy and nutrient intakes were estimated using Nutritionist Pro. A novel recipe-based frequency count coded protein sources as meat (chicken, beef, pork, and mutton), fish, eggs, dairy, and plants (cereals, pulses, tubers). Dietary intakes and frequencies were examined by gender, age, income, education, ethnicity, religion, and family status, using ANOVAs and general linear models. Energy intakes were 1869 kcal/d for men and 1699 kcal/d for women. Protein intakes were 78.5 g/d for men and 72.5 g/d for women. Higher energy and protein intakes were associated with Chinese ethnicity, higher education and incomes. Frequency counts identified plant proteins in 50% of foods, followed by meat (19%), fish (12%), eggs (12%), and dairy (7%). Most frequent source of meat was chicken (16%) rather than pork or beef (1.5% each). In bivariate analyses, animal protein counts were associated with younger age, higher education and incomes. In mutually adjusted multivariate regression models, animal proteins were associated with education and ethnicity, plant proteins were associated with ethnicity and religion. Protein choices in Malaysia involve socio-cultural as well as economic variables.

ObjectiveThe present study aimed to determine the prevalence of anaemia, iron deficiency (ID) and iron-deficiency anaemia (IDA) among female adolescents in the Gaza Strip, Palestine, as well as the risk factors involved in these conditions.DesignThe study was conducted using the quantitative descriptive method with a cross-sectional design. Data were collected using an FFQ and sociodemographic, sedentary behaviour and physical activity questionnaires. Anthropometric measurements and blood analyses were also conducted.SettingThe study population included all Palestinian female adolescents enrolled in secondary schools in the academic years 2015–2016. Five female secondary schools were selected randomly from five governorates of the Gaza Strip.SubjectsFemale adolescents (n330) aged 15–19 years in the selected secondary schools were enrolled randomly.ResultsPrevalence of anaemia, ID and IDA among female adolescents in the Gaza Strip, Palestine, was 35·8, 40·3 and 26·0 %, respectively. A significant association (PConclusionsThe study shows that there is an alarming problem of anaemia and IDA in the Gaza Strip, Palestine. This may indicate that there are insufficient nutrition education programmes, particularly inside schools or by the mass media.

Type 2 diabetes is a chronic illness which can be managed by patients' commitment to self-care and self-efficacy behaviors.A randomized controlled intervention study was carried out to determine the impact of self-efficacy education based on the Health Belief Model (HBM) in 240 patients with type 2 diabetes at the Golestan Hospital, Ahvaz, Iran between October 2014 and August 2015. The education duration was three months followed by a 24-week follow-up visit to determine the progress of the subjects. In this study, reliable and validated diabetes educational booklet and questionnaires based on knowledge, health beliefs and quality of life were used. The participants were randomly allocated to either the intervention group (n=120) or to the conventional dietary counseling group as controls (n=120), and assessed at the baseline, week 12 and week 36. The study was divided into primary outcome measurements consisting of glycated hemoglobin A1c (HbA1c), fasting blood glucose, lipid profile, and anthropometric levels. Secondary outcome measures were related to nutrition knowledge, health beliefs and quality of life.The results showed that subjects in the intervention group had significantly better metabolic and glycemic profiles compared with those in the control group. It also showed that knowledge, health belief and quality of life significantly increased in the intervention group.Findings indicate that through tailored self-efficacy education, the quality of life and metabolic profile of diabetes patients can be improved.

Platinum (Pt) is the common catalyst used in a direct methanol fuel cell (DMFC). However, Pt can lead towards catalyst poisoning by carbonaceous species, thus reduces the performance of DMFC. Thus, this study focuses on the fabrication of a new composite TiO2 carbon nanofiber anodic catalyst support for direct methanol fuel cells (DMFCs) via electrospinning technique. The distance between the tip and the collector (DTC) and the flow rate were examined as influencing parameters in the electrospinning technique. To ensure that the best catalytic material is fabricated, the nanofiber underwent several characterizations and electrochemical tests, including FTIR, XRD, FESEM, TEM, and cyclic voltammetry. The results show that D18, fabricated with a flow rate of 0.1 mLhr−1 and DTC of 18 cm, is an ultrafine nanofiber with the smallest average diameter, 136.73 ± 39.56 nm. It presented the highest catalyst activity and electrochemical active surface area value as 274.72 mAmg−1 and 226.75m2 g−1 PtRu, respectively, compared with the other samples.

Platinum is the most effective electro-catalyst for oxidation and reduction processes in direct methanol fuel cells (DMFCs). Although platinum and its alloys show desirable electrochemical activities, these catalysts are expensive and make the commercialization of DMFC less attractive. Beside, literature reviews show that tremendous improvements of the activity and stability of non-platinum cathode catalysts have been achieved over the past few years. However, problems including low reaction rates, high over-potentials and low stabilities that remain unsolved particularly for cathode catalyst are discussed in this paper. This paper also describes the various types of non-platinum materials that can potentially substitute for platinum cathode catalysts in DMFC like macrocyclic molecules such as porphyrins and phthalocyanines, transition metal oxides, transition metal sulfides, amorphous transition metal sulfides, and transition metal-based catalysts. Finally, this paper also summarizes the preparation procedure and the performance of various potential cathode catalysts for DMFC operated in acidic and alkaline media as compared with platinum.

Sleep deprivation and coffee caffeine consumption have been shown to affect glucose homeostasis separately, but the combined effects of these two variables are unknown.Forty-two healthy Iranian men, aged 20-40 years old, were assigned to three groups in a randomised crossover trial involving three treatments with two-week washout periods. Subjects were moderate coffee consumers (=3 cups/day), and had a Pittsburgh Sleep Quality Index=5. Each treatment involved three nights of deprived sleep (4 hrs. in bed) plus 3×150 cc/cup of boiled water (BW treatment), decaffeinated coffee (DC treatment, without sugar, 99.9% caffeine-free), and caffeinated coffee (CC treatment, without sugar, 65 mg caffeine/ cup). DC and CC treatments were blinded. At the end of each treatment, fasting serum glucose (using enzyme assays) and insulin (using electrochemiluminescence immunoassay) were measured and, again, two hours after an oral glucose tolerance test (OGTT). Insulin resistance was quantified with the homeostasis model.Repeated measures ANOVA indicated no significant difference between the treatments in fasting serum glucose (p=0.248) or insulin resistance (p=0.079). However, ANOVA demonstrated differences between treatments in fasting serum insulin (p=0.004) and glucose, as well as insulin after OGTT (p0.001). Pairwise comparisons test (within subjects) showed that the CC treatment yielded higher serum glucose and insulin after OGTT (p0.001), higher fasting serum insulin (p=0.001), and increased insulin resistance (p=0.039) as compared to the DC treatment.Thus caffeinated coffee was more adverse for glucose homeostasis compared to decaffeinated coffee in individuals who were simultaneously sleep deprived.背景与目的：睡眠剥夺和咖啡中咖啡因的摄入对葡萄糖稳态的影响已分别被证 明，但这两个变量的综合效果尚不知道。方法与研究设计：42 名年龄在20-40 岁之间的伊朗男性在本随机交叉试验中被分配到3 个试验组，试验组间有两周 的洗脱期。研究对象为中度咖啡消费者（=3 杯/天），并且匹兹堡睡眠质量指 数=5。每种试验包括3 晚上的睡眠剥夺（在床上4 小时），加3 杯开水（BW 试验，每杯150 毫升）、无咖啡因的咖啡（DC 试验，不加糖，99.9%无咖啡 因）或含咖啡因的咖啡（CC 试验，不加糖，每杯含65 毫克咖啡因）。DC 和 CC 处理采用盲法。每种试验结束后，测量空腹血糖（采用酶法测定）和胰岛 素（采用电化学发光免疫分析法测定），口服葡萄糖耐量试验（OGTT）两个 小时后再次测量血糖和胰岛素。胰岛素抵抗采用稳态模型量化。结果：重复测 量方差分析表明各试验组间的空腹血糖（p=0.248）和胰岛素抵抗（p=0.079） 没有显著差异。然而，方差分析表明各试验组间空腹血清胰岛素、血糖和 OGTT 后的胰岛素有差异。配对比较（研究对象间）表明：与DC 试验组相 比，CC 试验组OGTT 后血糖和胰岛素较高（p0.001），空腹血清胰岛素 （p=0.001）和胰岛素抵抗（p=0.039）也增加。结论：对睡眠被剥夺的人，含 咖啡因的咖啡比不含咖啡因的咖啡更不利于葡萄糖稳态。.

Anaemia and iron deficiency are very common worldwide among female adolescents. There is a dearth of literature concerning the knowledge, attitude and practice (KAP) regarding iron deficiency anaemia (IDA). The magnitude of anaemia as a health problem is enormous and can be engaged by increasing awareness and the promotion of correct attitudes and practices. The study aims to evaluate the effectiveness of a nutrition education intervention in iron deficiency anaemia on the knowledge, attitude, and practice (KAP) among iron-deficient female adolescents in the Gaza Strip. In this intervention study, 89 female adolescents aged 15–19 were recruited and randomly divided into intervention and control groups. Both of the groups received iron supplementation (ferrous fumarate 200 mg) weekly for three months. The intervention group attended nutrition education sessions for 3 months, while the control group did not. The two groups completed KAP questionnaires at baseline and after six months. The nutrition education intervention consisted of lectures, presentations, interactive discussions using posters, and the distribution of information booklets and brochures about proper nutrition, and was conducted for three months. KAP and overall scores before and after the intervention were compared using the Wilcoxon signed ranks test, as the scores did not show normal distribution. Our findings revealed that overall, the female adolescents’ knowledge improved significantly after a nutrition education intervention, as the percentage of good knowledge (≥50 %) was 22.7% pre-nutrition educational intervention, and increased to 90.9% post intervention (p

A nutritional status study was carried out among a group of young Chinese adults, aged between 19 and 25, in Kuala Lumpur, Malaysia. Subjects comprised 108 young adults (55 women, 53 men) who were students at two institutes of higher learning. Physical characteristics were evaluated by anthropometric measurements while food intake was determined with a 3-day food record. Blood cholesterol and triglyceride were assessed using the Reflotron analyser. Birthweight was obtained from birth certificates or by proxy. The results showed that the mean body mass index (BMI) for men and women was 21.4 ± 3.3 and 20.0 ± 2.0, respectively, indicating normal weight. Further analysis of BMI classification demonstrated that 28% of men and 39% of women were underweight, 11% of men and 2% of women were overweight while 2% of men were obese. Mean waist-to-hip ratio showed that the subjects had a low risk of developing cardiovascular disease (0.72 ± 0.03 women; 0.81 ± 0.05 men). Mean energy intake was 8841 ± 1756 kJ per day for men and 6426 ± 1567 kJ per day for women. Closer analysis of energy intake of the subjects showed that 86% of men and 91% of women were consuming below the Malaysian recommendation for energy. Nutrients found to be deficient in at least one third of women were calcium, vitamin A, niacin and iron. Mean cholesterol intake in the diet was 278.7 ± 108.7 mg in men and 207.0 ± 82.5 mg in women and there was a significant difference between genders. Blood cholesterol and triglyceride levels were 3.88 ± 0.76 mmol/L and 1.08 ± 0.33 mmol/L, respectively in men, while these levels were lower in women, 3.87 ± 0.80 mmol/L for cholesterol and 0.99 ± 0.29 mmol/L for triglyceride. A general trend of higher mean blood cholesterol and triglyceride levels was shown in adults who were born with lower birthweights.

A food habits and health status study was carried out among 100 Malay adults aged 40 years and above. The study protocol incorporated anthropometric measurements, evaluation of food habits and determination of blood glucose, cholesterol and blood pressure. Mean body mass index (BMI) for men and women were 27.2 ± 4.2 kg/m2 and 27.0 ± 5.2 kg/m2 respectively, which on average showed that the subjects were overweight. Food habits evaluation indicated that rice, fish and vegetables were the foods consumed almost everyday by the majority of the subjects. Meat, dairy products and fruits were eaten once to three times per week. Food intake score for sugar and salt demonstrated that a majority of men and women consumed moderate amounts of these foods. Most subjects exercised twice to three times a week for 15 min per session. Blood glucose tests revealed a mean of 5.04 ± 1.60 mmol/l in men and 4.86 ± 2.10 mmol/l for women. Mean cholesterol for men was 5.06 ± 1.22 mmol/l while it was 4.90 ± 1.34 mmol/l in women. Mean systolic and diastolic blood pressure in men was normal of 127.69 ± 13.60 mm Hg dan 85.87 ± 7.97 mm Hg, while in women it was 127.42 ± 17.54 mm Hg, 83.53 ± 9.50 mm Hg. The mean value for glucose, cholesterol and blood pressure increased with age. The food habits of these adults were satisfactory; however blood test for the nutrients of interest exhibited an increasing trend towards blood pressure, blood cholesterol and glucose with age. Middle-aged adults should adapt to a more active lifestyle and be more cautious of their food habits. This is to ensure a healthy well being throughout their life span.

AIMS The aim of this study is to compare the efficacy of low glycaemic index (GI) vs. conventional carbohydrate exchange (CCE) dietary advice on glycaemic control and metabolic parameters in patients with type 2 diabetes. METHODS A total of 104 patients with type 2 diabetes were randomly assigned to either a low GI (GI) or CCE dietary advice over a 12-week period. The primary end-point was glycaemic control as assessed by glycated haemoglobin A1c (HbA1c), fructosamine level and plasma glucose. The secondary end-points were anthropometric measurements and metabolic parameters that include blood pressure, lipid profile and insulin levels. The oral antidiabetic medications remained unchanged throughout the duration of the study. RESULTS A low-GI diet was associated with significant changes in the fructosamine level (DeltaGI = -0.20 +/- 0.03; DeltaCCE = -0.08 +/- 0.03 mmol/l, p < 0.01) and waist circumference (DeltaGI group = -1.88 +/- 0.30 cm; DeltaCCE group: -0.36 +/- 0.4 cm, p < 0.05) at week 4. At week 12, the changes in fasting glucose (DeltaGI = -0.03 +/- 0.3; DeltaCCE = 0.7 +/- 0.3 mmol/l; p < 0.05) and waist circumference (DeltaGI = -2.35 +/- 0.47 cm; DeltaCCE group = -0.66 +/- 0.46 cm; p < 0.05) in the GI group was significantly lower than the CCE group. With the low-GI diet, the changes in postprandial glycaemia at time 0, 60, 150 and 180 min after consuming the standard test meal was lower than with the CCE diet (p < 0.05). No significant differences were found between the groups for the remaining parameters that were measured. CONCLUSIONS Use of a low-GI diet resulted in significant changes of serum fructosamine level, plasma glucose and waist circumference in Asian patients with type 2 diabetes over a 12-week period compared with those following a CCE diet. The effect on HbA1c and other metabolic parameters was not significantly different between the two study groups but the improvement within the GI group was more pronounced and of clinical benefit.

This study was carried out to determine the blood glucose response and glycaemic index (GI) values of four types of commercially available breads in Malaysia. Twelve healthy volunteers (six men, six women; body mass index, 21.9±1.6 kg/m(2); age, 22.9±1.7 years) participated in this study. The breads tested were multi-grains bread (M-Grains), wholemeal bread (WM), wholemeal bread with oatmeal (WM-Oat) and white bread (WB). The subjects were studied on seven different occasions (four tests for the tested breads and three repeated tests of the reference food) after an overnight fast. Capillary blood samples were taken immediately before (0 min) and 15, 30, 45, 60, 90 and 120 min after consumption of the test foods. The blood glucose response was obtained by calculating the incremental area under the curve. The GI values were determined according to the standardized methodology. Our results showed that the M-Grains and WM-Oat could be categorized as intermediate GI while the WM and WB breads were high GI foods, respectively. The GI of M-Grains (56±6.2) and WM-Oat (67±6.9) were significantly lower than the reference food (glucose; GI = 100) (P0.05). No significant difference in GI value was seen between the reference food and the GI of WM (85±5.9) and WB (82±6.5) (P0.05). Among the tested breads, the GI values of M-Grains and WM-Oat were significantly lower (P0.05) than those of WM and WB. There was no relationship between the dietary fibre content of the bread with the incremental area under the curve (r = 0.15, P = 0.15) or their GI values (r = 0.17, P = 0.12), indicating that the GI value of the test breads were unaffected by the fibre content of the breads. The result of this study will provide useful nutritional information for dieticians and the public alike who may prefer low-GI over high-GI foods.

Following fast increase in the incidence of type 2 diabetes among Iranians, diabetes self-care activities are important. This cross-sectional study was carried out to evaluate the knowledge, attitude and practices regarding diabetes among 100 Iranian type 2 diabetics (61 female, 39 male) aged between 37 to 66 years, attending the out-patient Diabetes Clinic at Golestan Hospital, Ahvaz, Iran. A face-to-face interview was done and a validated knowledge, attitude and practice (KAP) questionnaire was used to determine knowledge, attitude and practices of diabetes patients. The mean duration of diabetes among patients was 4.05 ± 1.4 years. Fifty three percent of patients had good glycemic control (HbA1c level (=

Introduction: This cross sectional study was conducted to assess the quality of life (QoL) of primary school children in Kuala Lumpur. Method: As much as 124 children (75 normal weight, 23 overweight and 26 obese) aged between 8 and 11 years old were participated in this study. Result: Mean for physical characteristics of the subjects were 35.5± 12.8 kg for body weight, 134.8± 9.1 cm for height, 19.2± 5.1 kg/m2 for BMI and 1.2± 2.1 for BMI z-score. QoL was assessed using the Pediatric Quality of Life Inventory version 4.0. It was self-administered and completed by both parent-proxy and child self-report. This questionnaire assessed physical, emotional, social, and school functioning from which total, physical and psychosocial health summary scores were derived. There was no significant difference (p > 0.05) in QoL mean score of normal weight, overweight and obese children in all domains including physical health, psychosocial health and total score either for child self report or parent-proxy report. However, this study found that overall children self-report QoL mean score was higher among normal weight children (71.2± 12.9) than overweight (69.9± 11.0) and obese children (66.7± 10.9). For parent-proxy, parents of obese children reported higher QoL (69.7± 15.7) than normal weight (68.6± 14.1) and overweight children parents (63.9± 16.0). This study indicated that higher BMI associated with lower quality of life (r =−0.13, p > 0.05 for total score) reported by the children. Conclusion: Higher BMI contributes to lower quality of life and the trend shows that the overweight and obese children have lower quality of life.

BACKGROUND Coronary heart disease (CHD) is the leading cause of death in Malaysia, despite its status as a developing country. The rural population is thought to be at low risk. OBJECTIVE To investigate the prevalence of risk factors and global risk profile among rural Malays in Malaysia. METHODS We studied 609 rural Malay subjects (346 females, 263 males; age range 30-65 years). Blood pressure (BP), body mass index (BMI), waist-hip ratio (WHR), smoking habits and family history of premature CHD were documented. Fasting blood samples were analysed for serum lipids, lipoprotein (a), plasma glucose and fibrinogen. Oral glucose tolerance tests were performed using 75 g anhydrous glucose. RESULTS The prevalence of hypercholesterolaemia for total cholesterol concentrations of > or = 5.2, > or =6.5 and > or =7.8 mmol/l were 67.3, 30.5 and 11.8% respectively. There was a high prevalence of low serum high-density lipoprotein cholesterol (13.1%), hypertension (30.3%), smokers (24.4%), diabetes (6.4%), impaired fasting glucose or glucose tolerance (13.9%), overweight or obesity (44.7%) and increased WHR (48.5%). Global risk assessment showed that 67.3% of the study population were at risk, with 15.9, 18.9 and 32.5% in the mild, moderate and high risk categories respectively. CONCLUSION Prevalence of risk factors was high in the rural population. Global risk assessment showed a high-risk profile with two-thirds being at risk, and one-third being categorized into the high-risk group. Although rural communities were considered at low risk of developing CHD, this is changing fast, possibly due to the rapid socio-economic development, in addition to underlying genetic predisposition.