Improvement in body composition of adult postbariatric surgery patients at one-year follow-up at a public hospital in United Arab Emirates

Background: Data on postoperative follow-ups and bariatric surgery (BS) outcomes performed in the United Arab Emirates (UAE) are crucial for registry. This study assessed the one-year postoperative changes in body composition and metabolic profiles in BS patients. Methods: The medical and dietetics records of 51 adult patients who underwent BS in the largest public hospital in Sharjah, UAE were reviewed. Data on body weight and composition, as well as metabolic profile (blood glucose and lipid levels) from the initial until the last hospital visit were recorded. Results: The median (interquartile range) follow-up period was 6.0 (8.0) months. The patients had significant total weight loss [19.3 (12.6)%] and reduction in body mass index (BMI) [18.0 (13.6)%] of approximately 7 BMI points. Moreover, the patients’ body composition improved significantly; loss was the highest in fat mass [–30.9 (22.1)%] and the least in lean body mass [–8.6 (8.4)%]. There was a steady decline in all body composition variables with a longer duration of follow-up visits from 1–3 months to 10–12 months. The fat mass (–40.3%):lean body mass (–10.7%) loss ratio was 3.8:1 at 10–12 months. The patients’ metabolic status was normal during the last postoperative visit. Conclusions: Incremental improvements in body composition of patients were evident with longer follow-up visits up to one year after BS. Hence, patients should attend regular follow-up visits after BS. Moreover, accurate and complete documentations of medical and dietetics visits are mandated.

The in vivo glycaemic response of different rice varieties in Sri Lanka

Introduction: Diabetes poses a heavy economic burden in Sri Lanka. High glycaemic index (GI) diets are known to promote a higher risk of diabetes. This study was aimed to determine the GI values of nine improved and three traditional rice varieties of Sri Lanka including Bg406, H.H.Z.36, Ld368, Bw367, Bg94-1, At405, At362, Bg300, Bg352, Sudu heenati, Madathawalu, and Pachchaperumal. Furthermore, comparisons of GI values between improved and traditional varieties, as well as the effect of subject gender and colour of pericarp on GI were described. Methods: Fourteen healthy subjects consisting of seven males and seven females were fed with a reference food and cooked rice varieties containing 50 g available carbohydrate; GI were calculated. Results: The GI of 12 rice varieties varied from 40-69. All traditional varieties including Sudu heenati, Madathawalu and Pachchaperumal were in the low GI category presenting GI values of 51, 54, and 41, respectively. Rice with red pericarp obtained significantly lower GI compared to those with white pericarp. Yet, GI values obtained in males were significantly higher than females. Conclusion: The result of this study suggested that all traditional varieties and improved rice H.H.Z 36, Ld368, and Bg406 could have beneficial effects on lowering the glycaemic response in healthy subjects. Glycaemic index can be predicted from the colour of the rice grain. Gender should be considered in the determination of GI.

Translation and validation of Food Insecurity Experience Scale (FIES)

Introduction: Food insecurity has a complex and multifaceted concept and definition, thus assessing it has been an ongoing challenge for researchers, health practitioners, and policy makers. Previous studies reported inconsistent findings on the prevalence and severity of food insecurity, depending on the measuring tools used. To overcome this limitation, this study aimed to translate and validate the Food Insecurity Experience Scale (FIES) for Malaysians, which has been used as a standard measurement by Food and Agriculture Organization (FAO). Methods: Two forward and backward translations involving experts in food insecurity studies and experts in language were done, as well as the pre-test and cognitive interview stipulated in World Health Organization (WHO) translation guidelines. Content and face validity were conducted as part of the validation process. Content Validity Index (CVI) was done to analyse content validity. Results: The harmonised Malay version of FIES was produced with 1.0 CVI, which was above the 0.8 criteria. Face validity showed good understandability and clarity of FIES. Conclusion: The translated Malay version of FIES had good acceptability, as well as good face validity when tested among the target audience. Thus, a full validation study of the Malay version FIES should be done before it is widely used to measure food insecurity in the population, specifically the Malaysian population.

The correlations between gut microbiota of Muslim Thai lactating women and their dietary intake and gut microbiota of breastfed infants

Introduction: Foods and nutrients are essential not only for human health, but also for the balance of gut microbiota. This research aimed to correlate the gut microbiota of lactating women with their food/ nutrient intakes, as well as with their infants’ gut microbiota. Methods: A cross-sectional study was conducted in 27 pairs of mothers and their exclusively breastfed infants. For lactating women, the dietary assessment was conducted by 24-hour recall, and food groups were assessed following the Food and Agriculture Organization’s guidelines, while nutrient intake was analysed using INMUNCAL V3 programme. Gut microbiota of mothers and infants were measured in stool samples using fluorescent in situ hybridisation technique. Results: It was found that energy intake of mothers was only 66% of the recommended Thai Dietary Reference Intakes (DRIs). Most micronutrient and dietary fibre intakes were below the Thai DRIs. Vitamin A (VA)-rich fruits and vegetables food group correlated positively with Lactobacillus species (spp). The association between gut microbiota and nutrient intake of lactating women showed that total protein, phosphorus, and VA were positively correlated with Bifidobacterium spp.; while β-carotene and vitamin C were also positively correlated with Lactobacillus spp. In contrast, consumption of eggs and calcium correlated negatively with Clostridium spp./ Enterobacter spp. Bifidobacterium spp. and Lactobacillus spp. of lactating women and breastfed infants showed strong correlations. Conclusion: Food and nutrient intakes of lactating women were correlated with their Clostridium spp./Enterobacter spp., Bifidobacterium spp. and Lactobacillus spp. Furthermore, Bifidobacterium spp. and Lactobacillus spp. of mothers and breastfed infants showed strong correlations.

Association between stress and eating behaviour among nurses in Hospital Universiti Sains Malaysia

Introduction: Stress is a factor that may affect dietary behaviour among nurses, which can contribute to a risk of overweight or obesity in the future. The aim of this study was to determine the association between stress and eating behaviour among nurses at Hospital Universiti Sains Malaysia, Kelantan, Malaysia. Methods: A cross-sectional analysis was performed among 105 nurses (30-50 years of age; 84.8% females and 15.2% males) and participants were assessed using a selfadministered questionnaire consisting of socio-demographic data, body mass index (BMI), Perceived Stress Scale-10 (PSS-10), and the Dutch Eating Behaviour Questionnaire (DEBQ). Data were analysed using descriptive statistics and the associations were determined by Kruskal-Wallis Test. Results: Based on descriptive data, 73.3% of nurses (n=77) were moderately stressed and 49.5% had normal BMI (n=52). Furthermore, according to three eating domains, the emotional eating score was the highest (30.0±16.0). An association was found between emotional eating [χ2(2)=10.305, p=0.006], while external eating [χ2(2)=5.103, p=0.078], and restrained eating [χ2(2)=2.335, p=0.311] did not display a significant difference. The Bonferroni test was further used and there was a significant difference between low and moderate stress levels only (p<0.01), while others were not significantly different (low-high and moderate-high) (p>0.05). The results showed that nurses in the low stress group had lower scores of emotional eating behaviour than nurses with moderate stress levels. Conclusion: Stress has an impact on emotional eating behaviour and more research is needed to fully understand this link.

Relationship between maternal characteristics and stunting in children aged 0 to 23 months in the Philippines

Introduction: Stunting is the most prevalent form of child malnutrition worldwide, and is the best overall indicator of growth. This study aimed to determine the relationship between maternal characteristics and nutritional status of children aged 0-23 months based on their length/height-for-age. Method: The study used data from the 2015 Updating Survey conducted by the Philippines’ Food and Nutrition Research Institute – Department of Science and Technology. It employed a stratified multi-stage sampling technique covering all regions in the Philippines. Mothers (n=5,254) of sampled children 0-23 months were the respondents of the Maternal Health and Nutrition survey. The length-for-age z-scores (LAZ) of children and maternal characteristics were analysed. Rao-Scott Chi-square test was used for association analysis. Logistic regression was performed for model fitting. Results: A quarter (25.2%) of children aged 0-23 months in the Philippines at the time of the survey were stunted, with the highest prevalence (36.2%) observed among 12-23 months. Children being stunted or normal in height was associated with prenatal services, maternal nutritional status, education, and duration of lactation. Maternal education (OR: 0.39; p=0.012), age-appropriate breastfeeding (OR: 0.63; p=0.042), and prenatal services like tetanus toxoid vaccination (OR: 0.67; p=0.011) and ultrasound (OR: 0.71; p=0.025) lowered the likelihood of a child being stunted. Conclusion: It is recommended to strengthen and intensify service delivery among pregnant and lactating women because of the implication of maternal factors to the length-for-age status of children 0-23 months.

Improving maternal nutrition in public health facilities by strengthening the dietary component of Janani Shishu Suraksha Karyakram – A government of India programme

Introduction: The Janani Shishu Suraksha Karyakram (JSSK) is a government of India initiative for all pregnant women visiting public health facilities, with many free entitlements – free diet being one. After an in-depth study of existing dietary provisions in all community health centres, an elaborate cyclic-weekly nutritious menu was designed taking into consideration the latest recommendations (2019) by the Ministry of Family and Child Welfare, India to improve maternal health nutrition. Methods: The health functionaries from all ten community health centres of rural Vadodara were chosen for an in-depth estimation of the different meals served in the facilities. Standard measuring cups and spoons were used to measure the exact serving sizes for each person. Each meal served was supervised, checked and quantified in triplicate, while macro- and micronutrients were calculated using the Indian Food Composition Tables 2017 (Longvah et al. 2017). To bridge the gap in service delivery, two new models of cyclic-weekly menu were developed, keeping in mind the amount per mother per day as one hundred Indian rupees. Results: On average the foods served in the community health centres provided 69% of recommended energy intake, while mean recommended dietary allowance met for protein was 51%, calcium 18%, iron 50%, and fat 267%. Conclusion: The recommendations specified in this paper would improve the nutritional status of all pregnant and lactating women availing the services in rural health facilities, which would go a long way in ensuring safe and healthy motherhood.

Prevalence and factors associated with undernutrition among Dayak children in rural areas of Sarawak, Malaysia

Background: Undernutrition among children has become a major public health issue due to the high risk of morbidity and mortality involving this vulnerable age group. This study focused on the rural population, especially among the Dayak children in Sarawak, Malaysia. Methodology: This community-based cross-sectional study was conducted in Sarawak’s rural areas using a multistage stratified cluster sampling technique. Data were collected through face-to-face interviews using an interviewer-guided questionnaire. The nutritional status of the under-five children was measured according to the World Health Organization guidelines. The nutritional indicators were calculated as z-scores. Multivariate logistic regression analyses were performed using SPSS to identify the factors associated with nutritional status. Results: The prevalence of undernutrition among the under-five Dayak children in the rural areas of Sarawak was 39.6%. The analysis suggested that wasting was predominantly associated with parental education levels of primary and below, poor wealth index, environmental and sanitation issues, children with history of low birth weight, shorter duration of exclusive breastfeeding, and poor appetite. Stunting was high within the age group of <3 years old and was associated with parents’ occupation and household wealth index. Low parental education, poor wealth index, environmental and sanitation issues, poor appetite, and the children’s recent illness predicted underweight. Conclusion: These findings imply that a multi-sectoral and multi-dimensional approach is essential to address undernutrition in rural settings. Improvement on households’ socioeconomy, environment and sanitation should be emphasised to reduce undernutrition among the children.

Survey on salt content in selected food products of fast food restaurants and determination of salt intake awareness among fast food consumers in Klang Valley

Introduction: Malaysians are exposed to a high salt diet, which is one of the contributors to the prevalence of hypertension among them. This study aimed to identify the salt content in selected food products of fast food restaurants and to determine the salt intake awareness among fast food consumers. Methods: Salt content data were collected through online survey from the official websites of selected restaurants (Kentucky Fried Chicken, McDonald’s, Subway® and Texas Chicken). The food products were classified into eight food categories (chickenbased, potato-based, rice-based, sandwich, salad, bread, dessert, and sauce). The cross-sectional study on salt intake awareness was conducted among 108 Malaysian adults from these restaurants. A knowledge, attitude and practice (KAP) questionnaire was disseminated online. The salt content and the consumers’ salt intake awareness were analysed using Statistical Products and Service Solution (SPSS) software version 25.0. Results: A total of 105 food products were surveyed in this study. Sauce products contained the highest salt content (1.9±0.8 g/100g), followed by bread (1.2±0.3 g/100g), potato-based (1.2±0.4 g/100g), chicken-based (1.2±0.3 g/100g), sandwich (1.1±0.6 g/100g), rice-based (0.7±0.3 g/100g), salad (0.4±0.2 g/100g), and dessert (0.3±0.4 g/100g). For the KAP study, a total of 108 consumers had participated and mostly (48.2%) had a fair level of salt intake awareness. Conclusion: Most food products of fast food restaurants contained high salt content and majority of fast food consumers had a fair level of salt intake awareness. More strategic interventions are needed to control the salt intake among adults in Malaysia

Content identification for the development of a nutrition resource kit for malnourished and at-risk elderly: A review

Introduction: Elderly population is more likely to suffer from malnutrition, thereby requiring appropriate nutrition education as part of nutrition intervention to overcome this issue. This review aims to identify content suitable for developing a nutrition resource kit that provides nutritional guidance to combat malnutrition among malnourished and at-risk elderly in health clinics setting, particularly in Malaysia. Methods: A literature search was conducted up to 15th December 2019 in four databases: PubMed, Scopus, COCHRANE, and ProQuest Health & Medical Collection. Potential literature on nutrition education, suitable dietary guidelines and existing educational materials for elderly in the community, in English and Malay languages, were searched to identify suitable content for the nutrition resource kit. All relevant documents were included based on inclusion and exclusion criteria. Data were extracted and analysed according to the PRISMA-ScR guidelines. Results: A total of 27 documents consisting of articles, printed materials and guidelines were included for analysis. Suitable content included information related to malnutrition such as definition, signs and symptoms, cause-consequences, and nutrition management, which included food plate, serving size, menu suggestion, examples of recipes, tips to increase energy and protein intakes through food or drink, texture modification, a guide to using oral nutritional supplements, tips for maintaining nutrient content in food and drink, tips to encourage to eat, and oral health. Conclusion: A nutrition resource kit tailored for malnourished and at-risk elderly would be a beneficial nutrition intervention. There is a need to incorporate these information in the development of a nutrition resource kit to improve their dietary intake.