MJN 2002 Issues
Malaysian Journal of Nutrition
Volume 08 No.1, 2002
Table of Content
Antioxidants in Dietary Oils: Their Potential Role in Breast Cancer Prevention
Paul W Sylvester & Sumit Shah
Edible oils contain variable amounts of natural antioxidants such as vitamin E. Antioxidants act not only to prevent lipid peroxidation and free-radical production, but also display potent anticancer activity. The vitamin E family of compounds is divided into two subgroups called tocopherols and tocotrienols, but only tocotrienols display potent anticancer activity at treatment doses that have little or no effect on normal cell growth or viability. Palm oil contains the highest concentrations of natural tocotrienols. Tocotrienols induced apoptosis or programmed cell death in breast cancer cells. Morphological and biochemical characteristics of apoptosis, such as nuclear and cytoplasmic condensation and DNA fragmentation, are mediated by the activation of cysteine proteases called caspases. Apoptosis is triggered by the activation of initiator caspases (caspase-8 or 9) that subsequently activate effector caspases (caspase-3, 6, and 7). Studies were conducted using the highly malignant +SA mouse mammary epithelial cell line to determine if tocotrienol-induced programmed cell death is mediated through the caspase-8 or caspase-9 pathway. Treatment with cytotoxic doses of tocotrienol resulted in a large increase in caspase-8 and caspase-3, but not caspase-9 activity. Combined treatment of tocotrienol with selective caspase-8 or caspase-3 inhibitors completely blocked tocotrieno-linduced apoptosis and activation of caspase-8 and caspase-3, respectively. These findings demonstrate that tocotrienol-induced apoptosis in highly malignant mammary epithelial cells is mediated through caspase-8 activation, and may provide essential information necessary for understanding the potential health benefits of these compounds in preventing and/or reducing the risk of breast cancer in women.
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Nutritional Assessment of Pre-School Children in Rural Villages of the Family Dynamics, Lifestyles and Nutrition Study (1997-2001) I. Socio-Economic Status of Households
Chee Heng Leng, Khor Geok Lin, Fatimah Arshad and Wan Abdul Manan Wan Muda, Ahmad Affendi Shabdin, Asnarulkhadi Abu Samah, Rohani Abdullah, Siti Jamilah Bidin, Zahid Emby & Zamaliah Mohd Marjan
This paper presents the socio-economic profile of households in the Family Dynamics Study (FDS) (1997-2001) and makes comparisons with the earlier Functional Groups Study (FGS) (1992-1996). For the current study, FGS villages with a high prevalence of child malnutrition were purposively selected. In each village selected, all households were included, and interviews with a structured questionnaire were conducted in April-May 1998. Incomes were generally low and incidence of poverty was high; 49.6% of the households were under the poverty line income, of which 37.2% were poor and 12.4% were hard core poor. Overall, only 23.2% of heads of households were in agricultural occupations, others being primarily waged workers and petty traders. Livestock rearing was widespread (57.8%), and most households (90.4%) owned at least one motorised vehicle, the most common being the motorcycle. The majority of households had refrigerators (73.6%), washing machines (58.8%), and televisions (91.1%); but telephones (42.2%), mobile phones (6.1%) and computers (2.3%) were less common. Although 99.7% of households had electricity supply and 95.1% had either a flush or pour flush latrine, only 57.4% had piped water supply. In comparison to the FGS, poverty in the current study is lower (49.6% of FDS households are poor compared to 55.2% of FGS households), the proportion of household heads in agricultural occupations is also lower (26.9% compared to 55.3%), while all other socioeconomic indicators were better, except for piped water supply, which remains inadequate for households in the current study.
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Nutritional Assessment of Pre-School Children in Rural Villages of the Family Dynamics, Lifestyles and Nutrition Study (1997-2001) II. Prevalence of Undernutrition and Relationship to Household Socio-Economic Indicators
Chee Heng Leng, Khor Geok Lin, Fatimah Arshad, Wan Abdul Manan Wan Muda, Mohd Nasir Mohd Taib, Nik Shanita Safii, Norimah Abdul Karim, Norlela Mohd Husin, Normah Hashim, Pob Bee Koon, Rokiab Mohd Yusof
This paper describes the nutritional status of pre-school children and analyzes its relationship to various household socio-economic indicators. Padi, rubber and fishing villages from the Functional Groups Study (1992-1996) were selected for having a high prevalence of child undernutrition, and all children between the ages of 12 and 72 months were measured for their weights and heights in April-May 1998. The NCHS reference values were used to calculate z-scores, which were categorised according to WHO (1983) recommendations. Children between minus 2SD and minus 1SD of reference median were classified as mildly malnourished. Prevalence of underweight was higher (30.5%) than stunting (22.3%), while wasting was only 9.7%. Padi villages had the highest prevalence of undernutrition, followed by fishing, and then rubber villages. Mean household incomes were found to be significantly lower for children with worse nutritional status, and undernutrition was higher in households below the poverty line income. The odds ratios for having stunted children were significantly higher for households whose heads were agricultural own-account workers (OR 3.66, 95% CI = 1.37-9.79), agricultural waged workers (OR 2.75, 95% CI = 1.06-7.10), and non-agricultural manual workers (OR 2.49, 95% CI = 1.04-6.00) compared to non-manual workers. Various household socio-economic indicators showed significantly higher odds ratios for underweight, stunting and wasting. After adjusting for confounding effects by logistic regression analysis, however, only mother’s education was found to be a significant predictor for stunting, while poverty level and access to piped water supply were significant predictors for both underweight and stunting. Households without livestock were significant predictors for wasting. Thus, this study identified specific socio-economic factors that should be prioritized for policy and research towards the amelioration of childhood malnutrition in rural areas.
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A Prospective Study on Malnutrition and Duration of Hospitalisation among Hospitalised Geriatric Patients Admitted to Surgical and Medical Wards of Hospital Universiti Kebangsaan Malaysia
Suzana Shahar, Wong Sun Fun & Wan Chak Pa’ Wan Chik
Elderly people are known to be at a greater risk of malnutrition, particularly those having diseases or illnesses. A prospective study was undertaken on 92 hospitalised geriatric patients (45.6% males), aged 60 to 89 years old, admitted to surgical and medical wards at Hospital Universiti Kebangsaan Malaysia (HUKM). The study aimed to assess malnutrition at admission, day 3 and day 7 of hospitalisation, and its relation with length of stay in the wards. Malnutrition was assessed using anthropometrics and biochemical indicators. Although the majority of subjects had a normal Body Mass Index (BMI), 10.9% had Chronic Energy Deficiency (CED) and 38% were overweight. A total of 10% subjects had muscle wasting as assessed by Mid-upper Arm Circumference (MUAC). Biochemical tests indicated that women subjects were more likely to have hypoalbuminaemia (p <0.05) whilst, men were at risk of anaemia (p < 0.05). Throughout hospitalisation, there was a significant reduction in body weight, biceps skinfold thickness, calf circumference, MUAC, percentage of body fat and body mass index (BMI) in both males and females (p < 0.05 for all parameters). Biochemical tests on a sub sample of subjects indicated that 71.4% had hypoalbuminaemia and 39.6% were anaemic. Subjects diagnosed with cancer, had loss of appetite or had poor nutritional status as assessed by BMI or MUAC on admission were more likely to be hospitalised longer than or equal to 7 days (p < 0.05 for all parameters). Serum albumin levels at admission correlated positively with MUAC values both on admission (r = 0.608, p <0.01) and at clay seven of hospitalisation (r = 0.906, p < 0.05). There is a need to screen elderly patients at high risk of malnutrition at admission in order to reduce the length of stay and increase their health and nutritional status.
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Anthropometry and Dietary Intake of Type 2 Diabetes Patients Attending an Outpatient Clinic
Moy Foong Ming & Suriah A Rahman
A cross sectional study on Type 2 diabetes patients seeking treatment in the Primary Health Care outpatient clinic of the University Malaya Medical Centre, Kuala Lumpur was undertaken. Two hundred and thirty-three subjects participated. They were asked questions on biodata and dietary intake using face-to-face interview techniques. Dietary intake was assessed using the 24-hour dietary recall. Anthropometric measurements including weight and height were taken and Body Mass Index (BMI) was computed to establish the extent of obesity. Of the 196 subjects, 66.8% were overweight (BMI ³25 kg/m2) with 15.8% obese (BMI ³30 kg/m2). The mean BMI of males and females were 25.9±4.3 kg/m2 and 27.2±4.7 kg/m2 respectively. The findings from the dietary survey showed that the mean energy intake of the subjects only achieved about 72% of the Recommended Daily Allowance (RDA) for Malaysia while protein intake of all subjects was adequate. The macronutreint contribution to the total calorie was consistent with the recommendation of the Malaysian Diabetic Association for a healthy diet for diabetes patients. The male subjects were found to meet the RDA requirements for all nutrients while the female subjects did not have sufficient intake of calcium, vitamin A and niacin. No consistent pattern in energy and nutrient intake was observed among different age groups. On the other hand, the Malay subjects seemed to have lower energy and all nutrient intake (except vitamin A and vitamin C) compared to the Chinese and Indian subjects. The Indian subjects seemed to have the highest intake of calcium compared to the others. Advice needs to be given to those who did not have adequate nutrient intake as well as those who need to reduce their weight.
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Gender Differences in Eating Behavior and Social Self Concept among Malaysian University Students
Khor Geok Lin, Lynne Cobiac & Grace Skrzypiec
University students may encounter personal, family, social, and financial stresses while trying to cope with their academic challenges. Such constraints could affect their eating behavior and health status which, in turn may have negative effects on their studies. In light of little information in Malaysia on this subject, this study was undertaken on a sample of 180 students pursuing different academic programs in a Malaysian university. The study objectives were to determine the students’ eating behavior including body weight control and the extent of fear of being fat, their social self concept that reflects the five selves namely, the psychological self, the social self, the sexual self, the family self and the physical self. Eating behavior and social self concept were determined based on various methods previously validated in studies on young adults in Asia and Australia. This article focuses on gender comparisons for these determinants. The results showed that psychological and emotional factors have a significant bearing on the eating behavior of university students. Uninhibited eating behavior of both the males and females showed significant and negative correlations with feelings pertaining to personal worth, the physical self, and their relationships with peers and families. Gender differences were manifested for some determinants. The females showed more restrained eating behavior than the males; the females have a significantly higher score for family relationship, which appears to be a significant factor on male students’ eating behavior. Future studies on a larger sample size may help to unravel the extent to which psychological factors influence eating behavior of students, and the underlying psychosocial basis for some of the gender differences reported in this study.
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INVITED REVIEWS
The Role of Partnership in Capacity Building in Public Health Nutrition - Experience of Malaysia
Narimab Awin
Public Health emphasizes the plurality of the determinants of health of individuals, families and communities. Nutrition, as a major determinant of health, is itself influenced by a multitude of determinants that are under the purview of several agencies. Thus, inter-sectoral collaboration among the relevant agencies is imperative for promoting optimal health and nutrition such a partnership is manifested in the development and implementation of the National Plan of Nutrition (NPAN) of Malaysia pursuant to the International Conference on Nutrition (ICN) held in 1992. While the overall coordination of NPAN is at the Family Development Division in the Ministry of Health, the body that sees to the coordination is again a multi-agency group in the form of the National Coordinating Committee for Food and Nutrition (NCCFN). The NCCFN has representation for the nine thrust areas of NPAN that cut across various sectors including health, agriculture, education, community development and economic planning. Capacity building is a central strategy in the NPAN through the creation of positions and special budgetary allocations, and the implementation of activities including research, training, development of dietary guidelines and the National Nutrition Policy. This policy will be a major driving force for strengthening and building of capacity for nutrition-related activities, and more importantly it will facilitate a coordinated and coherent approach to capacity building, including sharing of resources.
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The Shift in Stages of the Nutrition Transition in the Developing World Differs from Past Experiences!
Barry M Popkin
This paper explores the unique nutrition transition shifts in diet and activity patterns from the period termed the receding famine pattern to one dominated by nutrition-related noncommunicable diseases (NR-NCDs). The paper examines the speed and timing of these changes; unique components, such as the issue of finding both under- and over-nutrition in the same household; potential exacerbating biological relationships that contribute to differences in the rates of change; and political issues. The focus is on lower and middle income countries of Asia, Africa, the Middle East and Latin America. These changes are occurring at great speed and at earlier stages of these countries’ economic and social development. There are some unique issues that relate to body composition and potential genetic factors. The significance of the high number of persons exposed to heavy insults during pregnancy and infancy (fetal origins hypothesis) and the subsequent rapid shifts in energy imbalance remains to be understood. Countries that are still addressing major concerns of under-nutrition are not ready to address these NR-NCDs. These finding indicate that the developing world needs to give far greater emphasis to addressing the prevention of the adverse health consequences of this shift to the nutrition transition stage of the degenerative diseases.
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Malaysian Journal of Nutrition
Volume 08 No.2, 2002
Table of Content
Effects of Feeding Fat During Pregnancy and Lactation on Growth Performance, Milk Composition and Very Low Density Lipoprotein Composition in Ratstc "Density Lipoprotein Composition in Rats"
Loh Teck Chwen, Foo Hooi Ling, Zurina Abdul Wahab & Tan Bee Koon
The effects of dietary fat during pregnancy and lactation on growth performance of pups, milk composition and very low density lipoprotein composition in rats were studied. A total of 33 dams were used in this study and each litter was adjusted to 8 pups per dam. The dams were fed on high fat (150 g fat/kg diet, HF), medium fat (75 g fat/kg of diet, MF) and low fat (2.5 g fat/kg diet, LF) diets. The body weights of dams increased during pregnancy and decreased after pregnancy. The HF pups had a higher body weight and higher weight gain than those of LF pups. The amount of feed intake of HF dams was significantly higher than LF and MF dams. The HF dams had significantly higher milk fat and water concentrations than LF dams. The milk protein was not significantly different among the treatment groups. All dams showed hypertriacylglycerolaemia in their very low density lipoprotein (VLDL) in late pregnancy. The VLDL-protein concentrations increased during the first week after parturition. The HF dams showed a greater response to the dietary fat than that of LF and MF dams. The findings suggest that addition of fat in the diet during pregnancy and lactation may improve the milk quality through modifying the composition of VLDL contents, leading to better growth of pups.
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The Effect of Increased Consumption of Edible Palm Oil on the Nutritional Status, Lipid Profiles and Lipid Peroxidation Among Malaysian Aboriginestc
Iskandar Zulkarnain Alias, Zaleha Md. Isa, Khalid Abdul Kadir & Osman Ali
This study was conducted to determine the effects of increased edible palm oil consumption on community health status in the aboriginal communities in Tual Post (treatment group) and Sinderut Post (control group), Kuala Lipis, Pahang. Nutritional status, blood pressure, lipid profiles, fasting blood glucose (FBG), vitamin E (alpha-tocopherol) levels and lipid peroxidation product (malonaldehyde) levels were taken as indicators of health status. This is a pre-and post-controlled community trial in which similar variables were measured in each group. Every family of 2–6 household members was given 2–5 kg cooking palm oil per month for a period of 18 months. All subjects were measured for height (cm), weight (kg) and waist-hip ratio (WHR). For calorie intake measurement, house-to-house interviews were conducted using 24-hour dietary recall method. Blood pressure, percent body fat, lipid profiles, namely total cholesterol, high density lipoprotein cholesterol, triglyceride and fasting blood glucose (FBG) were also measured. Vitamin E (alpha-tocopherol) levels and lipid peroxidation products (MDA) were also determined. There was a significant increase (p<0.05) in percent body fat (28.1%) and calorie intake (17.2%) following palm oil consumption. The proportion of fat intake as an energy source also increased from 4.6% to 33.9%. There was a reduction in the systolic blood pressure following consumption (p<0.05). However, diastolic blood pressure did not change. A significant decrease (p<0.05) was observed in total cholesterol, low density lipoprotein and triglyceride. No particular pattern in fasting blood glucose levels was observed among the indigenous inhabitants following palm oil consumption. There was a significant increase in alpha-tocopherol levels (p<0.0001) and a decrease in MDA levels (p<0.0001) following consumption. In conclusion, high consumption of edible palm oil for 18 months was found to be not harmful to health. For the Malaysian aborigines, it serves as a good source of fat and energy.
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Dose-Dependent cholesterolemic Activity of tocotrienols
Khor Hun Teik, Ng Theng Theng & Raajeswari Rajendran
Tocotrienols and tocopherols are isoforms of vitamin E. Vitamin E may exhibit antioxidant, prooxidant and non-antioxidant activities depending upon circumstances. In this study, the effect of tocotrienols and a-tocopherol on the activities of HMG CoA reductase and cholesterol 7 a-hydroxylase was investigated. Pure tocotrienols were isolated from palm fatty acid distillate and pure a-tocopherol was obtained commercially. Guinea pigs were treated with different dosages of tocotrienols and a-tocopherol. After the treatment period, animals were sacrificed and liver microsomes were prepared. HMG CoA reductase and cholesterol 7a-hydroxylase were assayed using tracer techniques. Our results showed that the effects of tocotrienols and a-tocopherol on the activities of both the enzymes were dose-dependent. At low dosages, both tocotrienols and a-tocopherol exhibited an inhibitory effect on both the enzymes. Moreover, tocotrienols were a much stronger inhibitors than a-tocopherol. at high dosages, on the other hand, tocotrienols and a-tocopherol showed opposite effects on the enzymes. While tocotrienols continued to exhibit an inhibitory effect, a-tocopherol actually exhibited a stimulatory effect on both the enzymes. A possible explanation for this observation is suggested.
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Antioxidant Activity of Selected Commercial Seaweeds
Amin Ismail & Tan Siew Hong
This study aims to evaluate the antioxidant activity (total antioxidant and free radical scavenging activities) of seaweeds commercially available in the Malaysian supermarket. Four types of seaweeds namely Nori (Porphyra sp.), Kumbu (Laminaria sp.), Wakame (Undaria sp.) and Hijiki (Hijikia sp.) were used in the study. The extracts were prepared with water and ethanol, respectively. The β-carotene bleaching and 1,1-diphenyl-2-picrylhydrazyl (DPPH) assays were used to determine antioxidant properties of seaweeds by measuring the decrease in absorbance at 470 and 517 nm. In water extract, Kumbu showed the highest total antioxidant activity of 63% compared with other samples. Kumbu, Nori and Hijiki exhibited higher radical scavenging activity than Wakame when extracted with water. Wakame exhibited the highest antioxidant and free radical scavenging activities in ethanolic extract with 58% and EC50 = 0.42 mg/ml respectively. The results of ANOVA analysis show significant differences (p<0.05) in the means of total antioxidant and free radical scavenging activities of the seaweeds. The results showed that processed commercial seaweeds exhibited varying degrees of antioxidant properties.
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Antioxidant Activity of Commonly Consumed Vegetables in Yemen
Mohammed Ali Al-Mamary
INVITED REVIEWS
Infectious Diseases and Malnutrition Status in Nepal: An Overview
Shiba Kumar Rai, Kazuko Hirai, Ayako Abe & Yoshimi Ohno
Malaysian Journal of Nutrition
Volume 08 No.3, 2002
Table of Content
REVIEW
SHORT COMMUNICATIONS