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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.

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.

Epitheliotropic intestinal T-cell lymphoma (EITL, also known as type II enteropathy-associated T-cell lymphoma) is an aggressive intestinal disease with poor prognosis and its molecular alterations have not been comprehensively characterized. We aimed to identify actionable easy-to-screen alterations that would allow better diagnostics and/or treatment of this deadly disease. By performing whole-exome sequencing of four EITL tumor-normal pairs, followed by amplicon deep sequencing of 42 tumor samples, frequent alterations of the JAK-STAT and G-protein-coupled receptor (GPCR) signaling pathways were discovered in a large portion of samples. Specifically, STAT5B was mutated in a remarkable 63% of cases, JAK3 in 35% and GNAI2 in 24%, with the majority occurring at known activating hotspots in key functional domains. Moreover, STAT5B locus carried copy-neutral loss of heterozygosity resulting in the duplication of the mutant copy, suggesting the importance of mutant STAT5B dosage for the development of EITL. Dysregulation of the JAK-STAT and GPCR pathways was also supported by gene expression profiling and further verified in patient tumor samples. In vitro overexpression of GNAI2 mutants led to the upregulation of pERK1/2, a member of MEK-ERK pathway. Notably, inhibitors of both JAK-STAT and MEK-ERK pathways effectively reduced viability of patient-derived primary EITL cells, indicating potential therapeutic strategies for this neoplasm with no effective treatment currently available.

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.

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。.

The consumption of beverages contributes to diet quality and overall nutrition. Studies on malted drinks, one of the widely consumed beverage choices among children in Asia, however, have received limited attention. This study aimed to examine the prevalence of malted drink consumption and explored associations of sociodemographic characteristics, nutrient intakes, weight status and physical activity levels with malted drink consumption among primary school children in Malaysia. Data for this analysis were from the MyBreakfast Study, a national cross-sectional study conducted from April to October 2013 throughout all regions in Malaysia. A total of 2065 primary school children aged 6 to 12 years were included in the present analysis. Data on two days 24-h dietary recall or record, anthropometry, physical activity and screen time were recorded. Associations between malted drink consumption and related factors were examined using binary logistic regression, adjusting for region, area, gender, ethnicity and household income. Among children aged 6 to12 years, 73.5 % reported consuming malted drinks for at least once per week. Consumption of malted drinks was significantly associated with region (χ 2 = 45.64, p

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.

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.

Background Physical inactivity has been acknowledged as a public health issue and has received increasing attention in recent years. This cross-sectional study was conducted to determine the barriers to physical activity among Malaysian men. These barriers were analyzed with regards to sociodemographic factors, physical activity level, BMI and waist circumference. Methods Subjects in this study included 308 Malay men and 422 Chinese men aged 20 years and older. Subjects completed the International Physical Activity Questionnaire (IPAQ) and a questionnaire on barriers to physical activity, categorized into personal and psychological, physical and social environment barriers. Weight, height and waist circumference were also measured and BMI was calculated. Results Descriptive analyses showed that 79.3% of subjects were married, 52.1% had secondary educational level, 68.8% were still working, and 39.7% had household income between RM1500 to RM3500. The perception that other recreational activities with family and friends were more fun was the most frequently reported barrier, followed by weather, lack of discipline, lack of free time, lack of money, and lack of friends. Marriage status, educational level, household income, BMI, and physical activity status were shown to be associated with perceived barriers. Conclusions To increase participation in physical activity, policy makers should consider significant personal, social and environmental barriers when developing appropriate intervention programmes. Health-promoting strategies that increase awareness, knowledge, skills and motivation related to physical activity are required.