Search

Background and Aim: The gut microbiota in irritable bowel syndrome (IBS) is known to vary with diet. We aim to (i) analyze the gut microbiota composition of IBS patients from a multi‐ethnic population and (ii) explore the impact of a low FODMAP diet on gastrointestinal symptoms and gut microbiota composition among IBS patients. Methods: A multi‐center study of multi‐ethnic Asian patients with IBS was conducted in two phases: (i) an initial cross‐sectional gut microbiota composition study of IBS patients and healthy controls, followed by (ii) a single‐arm 6‐week dietary interventional study of the IBS patients alone, exploring clinical and gut microbiota changes. Results: A total of 34 adult IBS patients (IBS sub‐types of IBS‐D 44.1%, IBS‐C 32.4%, and IBS‐M 23.5%) and 15 healthy controls were recruited. A greater abundance of Parabacteroides species with lower levels of bacterial fermenters and short‐chain fatty acids producers were found among IBS patients compared with healthy controls. Age and ethnicity were found to be associated with gut microbiota composition. Following a low FODMAP dietary intervention, symptom and quality of life improvement were observed in 24 (70.6%) IBS patients. Symptom improvement was associated with adherence to the low FODMAP diet (46.7% poor adherence vs 92.9% good adherence, P = 0.014), and gut microbiota patterns, particularly with a greater abundance of Bifidobacterium longum, Anaerotignum propionicum, and Blautia species post‐intervention. Conclusion: Gut microbiota variation in multi‐ethnic IBS patients may be related to dietary intake and may be helpful to identify patients who are likely to respond to a low FODMAP diet. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to explore the dietary practices and factors affecting Malaysian breast cancer survivors' dietary behaviours. Methods: We conducted an in‐depth qualitative interview on 20 participants from a cohort study. An ecological framework was used to construct the semi‐structured topic guide. The interviews were audio‐recorded and transcribed verbatim. Thematic analysis with theoretical saturation was used in data analysis. Results: The participants were found to have variable dietary practices that either followed or did not follow dietary recommendations. The social environment was critical as most women relied on family and friends for food choices; additionally, individuals in charge of food preparation had to prepare food based on their family member preferences. Furthermore, individuals had difficulty sustaining healthy dietary changes during the acute survivorship phase due to a lack of health consciousness and difficulty in healthy food access. Notably, there was a lack of dietary guidance from health care professionals, especially dietitians, in long‐term survivorship care. Conclusion: This study highlights the lack of breast cancer survivors' healthy diet and lifestyle knowledge. A holistic multidisciplinary approach involving individual, social, physical, and macro‐level environmental elements are crucial to influencing healthy eating behaviours. [ABSTRACT FROM AUTHOR]

Background: Radiation therapy is the treatment of pelvic cancers, with diarrhea often being the most frequent acute side effect. This study aimed to determine the efficacy of partially hydrolyzed guar gum (PHGG) usage in reducing radiotherapy‐induced diarrhea and improving bacterial count, nutrition status, and quality of life (QoL) among cancer patients. Methods: Adult patients undergoing pelvic radiation were recruited and randomly assigned to receive supplementation of either 10 g of PHGG or placebo (maltodextrin) twice daily, 14 days prior and 14 days during pelvic radiation. Diarrhea frequency, fecal samples, nutrition status, and QoL were assessed at baseline and days 14, 28 (2 weeks after pelvic radiation), and 45 (at the completion of pelvic radiation, 2 weeks' postsupplementation). Results: A total of 30 patients (mean age 56.5 ± 10.8 years, 75% malnourished) participated. The mean of diarrhea frequency in the intervention group (IG) was higher compared with the control group (CG) from days 14 and 28 but reduced at day 45. There was a significant intervention effect after controlling for confounders (ie, baseline diarrhea, age, nutrition status) (P <.05). Bifidobacterium count increased by double among the IG at 14 days of PHGG supplementation, whereas such trend was not observed in the CG. Conclusion: Supplementation of PHGG potentially increased the bifidobacterial count and seemed to have post‐supplementation effects by reducing the frequency of diarrhea upon the completion of pelvic radiation treatment. [ABSTRACT FROM AUTHOR]

Objectives: The main aims of the study were to identify barriers to seeking help for cancer, appraise demographic and socio‐economic differences in relation to barriers and evaluate the association between barriers and cancer symptoms awareness and delayed help‐seeking. Methods: A total of 2,360 adults (18 years and above) from randomly selected households in metropolitan Kuala Lumpur completed face‐to‐face interviews with trained research assistants that incorporated the validated Malay version of the Cancer Awareness Measure (CAM). Logistic regression was the main statistical technique that was used to investigate the study objectives and relationships (noted above). Results: The most commonly reported barriers to help‐seeking were emotional barriers. The probability of delaying seeking help was 49% higher in participants who reported emotional barriers (OR = 1.49; CI: 1.32–1.68; p <.001); and each unit rise in the cancer symptom awareness score was associated with a reduced likelihood of 29% in help‐seeking delay (OR = 0.71; 95% CI: 0.68–0.74; p <.001). Conclusions: Our study presents clear evidence of the relationship between cancer awareness and help‐seeking; and the need for, and potential positive impact of, providing cancer awareness‐raising programmes. Cancer health education campaigns or programme should address emotional barriers and encourage early seeking help. [ABSTRACT FROM AUTHOR]

Functional bowel disorders, including irritable bowel syndrome (IBS), are a chronic condition that can significantly reduce patients' quality of life. Therefore, this paper will review the roles of a low fermentable oligosaccharides, disaccharides, monosaccharides, and polypols (FODMAP) diet in treating IBS, particularly in an Asian setting. About 20% of the general population is diagnosed with IBS. However, there are limited effective medical therapies available for treating IBS. Therefore, IBS presents a major challenge to the health‐care providers. Recently, there is an increasing interest in the use of a diet low in FODMAP for the treatment of IBS. A low FODMAP diet can decrease the delivery of readily fermentable substrates to the small intestine and colon, thereby improving functional gastrointestinal symptoms. [ABSTRACT FROM AUTHOR]

Background: The efficacy and acceptance of a low fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) diet in Asian adults with irritable bowel syndrome (IBS) remain uncertain. We aimed to describe our early experience in a single center with a dedicated gastroenterology dietetic service. Methods: Consecutive patients with IBS referred to our dedicated Dietetic Gastroenterology Clinic between February 2016 and May 2016 were screened. A low FODMAP diet was instituted as per standard protocol. Data on demographic and clinical variables were obtained from patients' records and prospective telephone interviews. Results: A total of 16 patients, with a median age of 67 ± 13.57 years; female gender n = 10 (62.5%); ethnicity: Chinese n = 8 (50%), Indian n = 5 (31.25%), and Malay n = 3 (18.75%) with IBS, were included in the study. Compliance with the low FODMAP diet was complete in 8 of 16 (50%) patients, partial in 4 of 16 (25%), and 4 of 16 (25%) could not comply with the diet at all. Improvement in symptoms were reported in 11 of 16 (68.8%) patients. Among patients who complied (complete/partial) with the low FODMAP diet, predominant symptom improvement was reported as follows: abdominal pain 3 of 5 (60%), abdominal bloating/distension 7 of 10 (70%), and flatulence 7 of 8 (87.5%). Patients with the IBS‐D subtype appeared to have the greatest improvement in stool consistency (87.5% IBS‐D vs 12.5% non‐IBS‐D, P = 0.009). Conclusion: Based on our pilot observational study of a relatively small sample of Asian IBS patients, compliance with a low FODMAP diet appears to be low. Further larger studies are required to verify our observation. The efficacy and acceptance of a low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diet in Asian adults with irritable bowel syndrome (IBS) remain uncertain. Based on our pilot observational study of a relatively small sample of Asian IBS patients, compliance with a low FODMAP diet appears to be low. Patients with the IBS‐D subtype appeared to have the greatest improvement in stool consistency. [ABSTRACT FROM AUTHOR]

We aimed to predict the ten-year cardiovascular disease (CVD) risk among low-income urban dwellers of metropolitan Malaysia. Participants were selected from a cross-sectional survey conducted in Kuala Lumpur. To assess the 10-year CVD risk, we employed the Framingham risk scoring (FRS) models. Significant determinants of the ten-year CVD risk were identified using General Linear Model (GLM). Altogether 882 adults (≥30 years old with no CVD history) were randomly selected. The classic FRS model (figures in parentheses are from the modified model) revealed that 20.5% (21.8%) and 38.46% (38.9%) of respondents were at high and moderate risk of CVD. The GLM models identified the importance of education, occupation, and marital status in predicting the future CVD risk. Our study indicated that one out of five low-income urban dwellers has high chance of having CVD within ten years. Health care expenditure, other illness related costs and loss of productivity due to CVD would worsen the current situation of low-income urban population. As such, the public health professionals and policy makers should establish substantial effort to formulate the public health policy and community-based intervention to minimize the upcoming possible high mortality and morbidity due to CVD among the low-income urban dwellers. [ABSTRACT FROM AUTHOR]

Objectives. This study aims to compare various body composition indices and their association with a predicted cardiovascular disease (CVD) risk profile in an urban population in Kuala Lumpur, Malaysia. Methods. A cross-sectional survey was conducted in metropolitan Kuala Lumpur, Malaysia, in 2012. Households were selected using a simple random-sampling method, and adult members were invited for medical screening. The Framingham Risk Scoring algorithm was used to predict CVD risk, which was then analyzed in association with body composition measurements, including waist circumference, waist-hip ratio, waist-height ratio, body fat percentage, and body mass index. Results. Altogether, 882 individuals were included in our analyses. Indices that included waist-related measurements had the strongest association with CVD risk in both genders. After adjusting for demographic and socioeconomic variables, waist-related measurements retained the strongest correlations with predicted CVD risk in males. However, body mass index, waist-height ratio, and waist circumference had the strongest correlation with CVD risk in females. Conclusions. The waist-related indicators of abdominal obesity are important components of CVD risk profiles. As waist-related parameters can quickly and easily be measured, they should be routinely obtained in primary care settings and population health screens in order to assess future CVD risk profiles and design appropriate interventions. [ABSTRACT FROM AUTHOR]