MJN 1996 Issues
Malaysian Journal of Nutrition
Volume 02 No.1, 1996
Table of Content
Changes in body weight, dietary intake and activity pattern of adolescents during Ramadan
Poh BK, Zawiah H, Ismail MN & Henry CJK
ABSTRACT
A study was carried out on 117 schoolchildren comprising 51 boys and 66 girls between the ages of 10 and 13 years to evaluate the effect of Ramadan-fasting on body weight. The results revealed that more than 90% of the subjects experienced a decrease in body weight during Ramadan. The initial mean body weight of the boys and girls were 35.7 ± 6.7 kg and 35.2 ± 6.1 kg respectively. After four weeks' fast, the boys and girls significantly lost (p<0.001) an average of 4.2% and 3.7% of their initial body weight respectively. Dietary intake and activity pattern were also assessed in a subgroup of 20 boys and 30 girls during the same period. The mean daily energy intake during Ramadan-fasting {boys 1230 ± 363 kcal (5.15 ± 1.52 MJ), girls 1034 ± 290 kcal (4.33 ± 1.21 MJ)} was significantly lower (p<0.001) than intake assessed before Ramadan {boys 1520 ± 463 kcal (6.36 ± 1.94 MJ), girls 1344 ± 428 kcal (5.62 ± 1.79 MJ)}. Both values were found to be below the suggested daily dietary intake for Malaysians of similar sex and age group recommended by Teoh (1975). Both boys and girls significantly decreased their intakes of fat, carbohydrate and thiamine during Ramadan. However, intakes of protein, niacin, vitamins A and C were found to be comparable to non-fasting values. During Ramadan, the mean intake of all nutrients analysed except protein were lower than recommended values. The boys spent significantly more (p<0.05) time sitting and significantly less (p<0.05) time standing and in moderately active pursuits during Ramadan. During this period, the boys spent more time in prayers compared with the girls. Time spent on all other activities did not differ between the fasting and non-fasting months. The findings suggest that the decrease in body weight during Ramadan may be primarily due to the reduction in energy intake since activity pattern remain fairly constant. The nutrient intake pattern of the adolescents studied may be of great concern in the long-term, as it does not meet the requirements for the normal growth of adolescents.
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A study was carried out on 117 schoolchildren comprising 51 boys and 66 girls between the ages of 10 and 13 years to evaluate the effect of Ramadan-fasting on body weight. The results revealed that more than 90% of the subjects experienced a decrease in body weight during Ramadan. The initial mean body weight of the boys and girls were 35.7 ± 6.7 kg and 35.2 ± 6.1 kg respectively. After four weeks' fast, the boys and girls significantly lost (p<0.001) an average of 4.2% and 3.7% of their initial body weight respectively. Dietary intake and activity pattern were also assessed in a subgroup of 20 boys and 30 girls during the same period. The mean daily energy intake during Ramadan-fasting {boys 1230 ± 363 kcal (5.15 ± 1.52 MJ), girls 1034 ± 290 kcal (4.33 ± 1.21 MJ)} was significantly lower (p<0.001) than intake assessed before Ramadan {boys 1520 ± 463 kcal (6.36 ± 1.94 MJ), girls 1344 ± 428 kcal (5.62 ± 1.79 MJ)}. Both values were found to be below the suggested daily dietary intake for Malaysians of similar sex and age group recommended by Teoh (1975). Both boys and girls significantly decreased their intakes of fat, carbohydrate and thiamine during Ramadan. However, intakes of protein, niacin, vitamins A and C were found to be comparable to non-fasting values. During Ramadan, the mean intake of all nutrients analysed except protein were lower than recommended values. The boys spent significantly more (p<0.05) time sitting and significantly less (p<0.05) time standing and in moderately active pursuits during Ramadan. During this period, the boys spent more time in prayers compared with the girls. Time spent on all other activities did not differ between the fasting and non-fasting months. The findings suggest that the decrease in body weight during Ramadan may be primarily due to the reduction in energy intake since activity pattern remain fairly constant. The nutrient intake pattern of the adolescents studied may be of great concern in the long-term, as it does not meet the requirements for the normal growth of adolescents.
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Nutrient intake among elderly in southern Peninsular Malaysia
Suriah AR, Zainorni MJ, Shafawi S, Mimie Suraya S, Zarina N, Wan Zainuddin WA & Zalifah MK
ABSTRACT
Studies were conducted in selected areas in three states namely Johor (n=117, male=55, female=62), Negeri Sembilan (n=130, male=52, female=78) and Malacca (n=97, male=33, female=64) involving free living elderly (age range from 60 to 93 years old). Respondents were divided into three age cohort groups that is 60 to 69 years, 70 to 79 years and above 80 years old. Assessment of macro and micronutrients were obtained from 24-hour diet recall for three consecutive days. Household measurements were used to estimate the amount of food consumed. Mean energy intake for both sexes were lower than the Malaysian RDA. Mean energy intake were also found to decline with age increment. The percentage of carbohydrate from total calories is higher compared to fat and protein. No respondents were found to consume less than 1/3 RDA for protein. Although no significant difference in nutrient intake was noted among age cohort groups, there was a decline in the intake of protein, fat and carbohydrate. Significantly (p < 0.05) lower carbohydrate intake was noted in cohort group above 80 years. As for vitamins and minerals consumption, more than 50% of the elderly population studied consumed less than 2/3 RDA for vitamin A, thiamine, riboflavin, niacin and calcium. Very low intake of nutrient may lead to many health problems. Overall mean energy intake indicate the respondents consume less than the Malaysian RDA for all three age cohort groups. Total mean energy intake were also found to decline with age increment for both sexes. Due to the low energy intake, higher percentage of elderly were found consuming less than 2/3 RDA for thiamine (65%), riboflavin (63%) and niacin (90%). Other nutrients which were also being consumed less than 2/3 RDA by the respondents are vitamin A (67%) and calcium (65%). The intake of calcium which was found to be extremely low (ranged from 277 to 303 mg) could lead to problems like osteoporosis.
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Studies were conducted in selected areas in three states namely Johor (n=117, male=55, female=62), Negeri Sembilan (n=130, male=52, female=78) and Malacca (n=97, male=33, female=64) involving free living elderly (age range from 60 to 93 years old). Respondents were divided into three age cohort groups that is 60 to 69 years, 70 to 79 years and above 80 years old. Assessment of macro and micronutrients were obtained from 24-hour diet recall for three consecutive days. Household measurements were used to estimate the amount of food consumed. Mean energy intake for both sexes were lower than the Malaysian RDA. Mean energy intake were also found to decline with age increment. The percentage of carbohydrate from total calories is higher compared to fat and protein. No respondents were found to consume less than 1/3 RDA for protein. Although no significant difference in nutrient intake was noted among age cohort groups, there was a decline in the intake of protein, fat and carbohydrate. Significantly (p < 0.05) lower carbohydrate intake was noted in cohort group above 80 years. As for vitamins and minerals consumption, more than 50% of the elderly population studied consumed less than 2/3 RDA for vitamin A, thiamine, riboflavin, niacin and calcium. Very low intake of nutrient may lead to many health problems. Overall mean energy intake indicate the respondents consume less than the Malaysian RDA for all three age cohort groups. Total mean energy intake were also found to decline with age increment for both sexes. Due to the low energy intake, higher percentage of elderly were found consuming less than 2/3 RDA for thiamine (65%), riboflavin (63%) and niacin (90%). Other nutrients which were also being consumed less than 2/3 RDA by the respondents are vitamin A (67%) and calcium (65%). The intake of calcium which was found to be extremely low (ranged from 277 to 303 mg) could lead to problems like osteoporosis.
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Obesity among years 1 and 6 primary school children in Selangor Darul Ehsan
Bong ASL & Safurah Jaafar
ABSTRACT
A study was conducted from March to June 1991 to determine the prevalence of obesity among primary school children in the State of Selangor. One School Health Team in each of the 9 Districts of Selangor participated in the collection of data, the whole project being coordinated by the Selangor State Health Department. A total of 28 rural and 24 urban schools were selected for the study, involving a total of 2,688 pupils in Standard 1 and Standard 6. The prevalence of obesity, using >120% of the reference weight-for-height as the criteria, varied considerably in the different districts, with an overall prevalence of 7.8% in the State. The proportion of boys affected (66.7%) was twice that among girls (33.3%). The prevalence of obesity of 9.8% in the urban schools was significantly higher than the 6.1% found for rural schools (p<0.0001). 151 (11.1%) were from Standard 6 and 59 (4.4%) were from Standard 1 (p<0.0001). It was also found that there was a significantly higher prevalence of obesity amongst primary 6 children (p<0.0001). Whilst the problem may not be as serious as that found in developed countries, the findings of this study should serve as an early warning to health authorities of the seriousness of the problem.
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A study was conducted from March to June 1991 to determine the prevalence of obesity among primary school children in the State of Selangor. One School Health Team in each of the 9 Districts of Selangor participated in the collection of data, the whole project being coordinated by the Selangor State Health Department. A total of 28 rural and 24 urban schools were selected for the study, involving a total of 2,688 pupils in Standard 1 and Standard 6. The prevalence of obesity, using >120% of the reference weight-for-height as the criteria, varied considerably in the different districts, with an overall prevalence of 7.8% in the State. The proportion of boys affected (66.7%) was twice that among girls (33.3%). The prevalence of obesity of 9.8% in the urban schools was significantly higher than the 6.1% found for rural schools (p<0.0001). 151 (11.1%) were from Standard 6 and 59 (4.4%) were from Standard 1 (p<0.0001). It was also found that there was a significantly higher prevalence of obesity amongst primary 6 children (p<0.0001). Whilst the problem may not be as serious as that found in developed countries, the findings of this study should serve as an early warning to health authorities of the seriousness of the problem.
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Kandungan laktoferin dalam susu ibu dan kaitan dengan pengambilan kalori, protein dan ferum
Maznah Ismail & Rodziah Abd Razak
ABSTRACT
Kajian ini bertujuan untuk menentukan kandungan laktoferin dalam susu ibu dan menguji perkaitannya dengan pengambilan kalori, protein dan ferum dalam diet ibu. Kajian telah dilakukan ke atas 35 orang ibu yang baru melahirkan sehingga hari ke-30 kelahiran di kawasan Serdang. Sampel susu ibu dipungut sebanyak tiga kali iaitu pada peringkat kolostrum (hari ke-2), transisi (hari ke-7) dan matang (hari ke30). Maklumat kajian diperolehi melalui penggunaan borang soal selidik yang mengandungi makiumat latar belakang subjek, Ingatan Diet 24 Jam dan Kekerapan Pengambilan Makanan. Maklumat Ingatan Diet 24 Jam dianalisis menggunakan DEMETER bagi menentukan pengambilan kalori, protein dan ferum ibu-ibu. Teknik ELISA sandwic tak bersaing telah digunakan untuk menentukan kandungan laktoferin dalam susu ibu. Hasil analisis yang dijalankan mendapati bahawa kandungan laktoferin menurun mengikut tempoh penyusuan dengan min laktoferin di dalam kolostrum sebanyak 7.0 ± 0.3 mg/ml (6.2 - 7.6 mg/ml), susu transisi sebanyak 3.5 ± 0.2 mg/ml (2.6-4.1 mg/ml) dan susu matang sebanyak 1.5 ± 0.2 mg/ml (1.2-1.9 mg/ml. Data pengambilan diet diet subjek kajian menunjukkan bahawa purata pengambilan nutrien ibu-ibu pada hari ke-30 meningkat berbanding hari ke-7. Purata pengambilan kalori pada hari ke7 ialah sebanyak 2540 ± 325 kcal dan meningkat kepada 2698 ± 364 kcal pada hari ke-30 sementara bagi protein pula sebanyak 65.0 ± 26.8 g pada hari ke-7 dan meningkat kepada 74.9 ± 32.1 g pada hari ke-30. Demikian juga bagi ferum, pada hari ke-7 didapati pengambilan sebanyak 11.5 ± 6.9 mg dan pada hari ke-30, ia meningkat kepada 14.4 ± 8.9 mg. Pekali Korelasi Pearson menunjukkan bahawa tiada perkaitan yang signifikan di antara pengambilan kalori, protein dan ferum dengan kandungan laktoferin pada p<0.05 (r=0.1258, 0.0878, 0.2056). Kajian ini mendapati bahawa kandungan laktoferin menurun sepanjang tempoh penyusuan, paling tinggi pada peringkat kolostrum dan aras laktoferin tidak dipengaruhi oleh pengambilan kalori, protein dan ferum ibu.
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Kajian ini bertujuan untuk menentukan kandungan laktoferin dalam susu ibu dan menguji perkaitannya dengan pengambilan kalori, protein dan ferum dalam diet ibu. Kajian telah dilakukan ke atas 35 orang ibu yang baru melahirkan sehingga hari ke-30 kelahiran di kawasan Serdang. Sampel susu ibu dipungut sebanyak tiga kali iaitu pada peringkat kolostrum (hari ke-2), transisi (hari ke-7) dan matang (hari ke30). Maklumat kajian diperolehi melalui penggunaan borang soal selidik yang mengandungi makiumat latar belakang subjek, Ingatan Diet 24 Jam dan Kekerapan Pengambilan Makanan. Maklumat Ingatan Diet 24 Jam dianalisis menggunakan DEMETER bagi menentukan pengambilan kalori, protein dan ferum ibu-ibu. Teknik ELISA sandwic tak bersaing telah digunakan untuk menentukan kandungan laktoferin dalam susu ibu. Hasil analisis yang dijalankan mendapati bahawa kandungan laktoferin menurun mengikut tempoh penyusuan dengan min laktoferin di dalam kolostrum sebanyak 7.0 ± 0.3 mg/ml (6.2 - 7.6 mg/ml), susu transisi sebanyak 3.5 ± 0.2 mg/ml (2.6-4.1 mg/ml) dan susu matang sebanyak 1.5 ± 0.2 mg/ml (1.2-1.9 mg/ml. Data pengambilan diet diet subjek kajian menunjukkan bahawa purata pengambilan nutrien ibu-ibu pada hari ke-30 meningkat berbanding hari ke-7. Purata pengambilan kalori pada hari ke7 ialah sebanyak 2540 ± 325 kcal dan meningkat kepada 2698 ± 364 kcal pada hari ke-30 sementara bagi protein pula sebanyak 65.0 ± 26.8 g pada hari ke-7 dan meningkat kepada 74.9 ± 32.1 g pada hari ke-30. Demikian juga bagi ferum, pada hari ke-7 didapati pengambilan sebanyak 11.5 ± 6.9 mg dan pada hari ke-30, ia meningkat kepada 14.4 ± 8.9 mg. Pekali Korelasi Pearson menunjukkan bahawa tiada perkaitan yang signifikan di antara pengambilan kalori, protein dan ferum dengan kandungan laktoferin pada p<0.05 (r=0.1258, 0.0878, 0.2056). Kajian ini mendapati bahawa kandungan laktoferin menurun sepanjang tempoh penyusuan, paling tinggi pada peringkat kolostrum dan aras laktoferin tidak dipengaruhi oleh pengambilan kalori, protein dan ferum ibu.
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Development of a HPLC method for the simultaneous determination of several B-vitamins and ascorbic acid
Khor Swan-Choo & Tee E-Siong
ABSTRACT
In cognizance of the difficulties involved in the colorimetric and titrimetric methods for the determination of individual vitamins, this laboratory has been carrying out a series of studies into the use of HPLC for improved analysis of these nutrients. Preliminary studies have been carried out for the determination of four B-vitamins. The present paper reports on further improvements made to enable the simultaneous determination of eight vitamins i.e. B1, B2, B6, B12, C, niacin, niacinamide and folic acid. Trials were carried out to determine the most suitable chromatographic system include changing the proportion of methanol in the mobile phase, the use of different ion-pairing reagents and other additives such as triethylamine and ammonia. Three sets of HPLC mobile phase systems are proposed to enable successful separation of all eight vitamins in less than 20 minutes, varying slightly with the type of ion-pairing reagent and mobile phase additive. This laboratory is currently carrying out trials to determine if the developed methods could be used for the determination of pharmaceutical products and food samples.
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In cognizance of the difficulties involved in the colorimetric and titrimetric methods for the determination of individual vitamins, this laboratory has been carrying out a series of studies into the use of HPLC for improved analysis of these nutrients. Preliminary studies have been carried out for the determination of four B-vitamins. The present paper reports on further improvements made to enable the simultaneous determination of eight vitamins i.e. B1, B2, B6, B12, C, niacin, niacinamide and folic acid. Trials were carried out to determine the most suitable chromatographic system include changing the proportion of methanol in the mobile phase, the use of different ion-pairing reagents and other additives such as triethylamine and ammonia. Three sets of HPLC mobile phase systems are proposed to enable successful separation of all eight vitamins in less than 20 minutes, varying slightly with the type of ion-pairing reagent and mobile phase additive. This laboratory is currently carrying out trials to determine if the developed methods could be used for the determination of pharmaceutical products and food samples.
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Kandungan makronutrien di dalam makanan yang terdapat di kantin sekolah rendah
Wan Nudri Wan Daud1 dan Aminah Abdullah
ABSTRACT
Tiga buah sekolah rendah yang mempunyai corak pengendalian makanan yang berbeza di Kuala Selangor telah dipilih untuk kajian. Semua contoh makanan yang disediakan semasa lima hari persekolahan telah diambil dan dianalisa kandungan kalori, protein, lemak dan karbohidrat. Kebanyakan daripada makanan yang disediakan adalah berasaskan nasi seperti nasi lemak, nasi ayam, mee dan kuih-kuih tradisional. Kandungan kalori dan protein per hidangan makanan adalah masing-masing di antara julat 77-274 kcal dan 0.9-3.6 g. Makanan yang disediakan di bawah Rancangan Makanan Tambahan mengandungi kalori yang lebih tinggi berbanding dengan makanan yang dijual di kantin sekolah. Walau bagaimanapun kandungan protein dan kalori masih rendah berbanding dengan yang disarankan oleh Kementerian Pendidikan Malaysia, yang mana berdasarkan menu sepatutnya menyediakan sekurang-kurangnya 10 g protein dan 290-390 kcal. Peratus sumbangan tenaga daripada protein di dalam makanan yang disediakan di kantin sekolah juga adalah lebih rendah daripada yang disarankan.
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Tiga buah sekolah rendah yang mempunyai corak pengendalian makanan yang berbeza di Kuala Selangor telah dipilih untuk kajian. Semua contoh makanan yang disediakan semasa lima hari persekolahan telah diambil dan dianalisa kandungan kalori, protein, lemak dan karbohidrat. Kebanyakan daripada makanan yang disediakan adalah berasaskan nasi seperti nasi lemak, nasi ayam, mee dan kuih-kuih tradisional. Kandungan kalori dan protein per hidangan makanan adalah masing-masing di antara julat 77-274 kcal dan 0.9-3.6 g. Makanan yang disediakan di bawah Rancangan Makanan Tambahan mengandungi kalori yang lebih tinggi berbanding dengan makanan yang dijual di kantin sekolah. Walau bagaimanapun kandungan protein dan kalori masih rendah berbanding dengan yang disarankan oleh Kementerian Pendidikan Malaysia, yang mana berdasarkan menu sepatutnya menyediakan sekurang-kurangnya 10 g protein dan 290-390 kcal. Peratus sumbangan tenaga daripada protein di dalam makanan yang disediakan di kantin sekolah juga adalah lebih rendah daripada yang disarankan.
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The effect of cellulose on crystal formation in the kidneys of guinea pigs fed diet rich in calcium and sodium
Syed Shamsuddin Syed Hussain, Tan Kah Ooi & Mohd Azman Abu Bakar
ABSTRACT
Our earlier report showed that diet rich in calcium and sodium fed to guinea pigs can be urolithogenic. In this study, we investigated the effect of adding 3% or 15% cellulose as a source of fiber into similar diet to asses the formation of kidney calculus. From the result, animals fed diet with 3% cellulose showed a relatively high concentration of urinary oxalate, urate and large number of crystals in the kidneys. When the cellulose level was raised to 15%, the concentrations of urinary calcium, urate and the number of crystals formed in the kidneys were lowered. We therefore, conclude that high fiber diet may be beneficial in reducing the incidence of kidney stones of calcium origin.
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Our earlier report showed that diet rich in calcium and sodium fed to guinea pigs can be urolithogenic. In this study, we investigated the effect of adding 3% or 15% cellulose as a source of fiber into similar diet to asses the formation of kidney calculus. From the result, animals fed diet with 3% cellulose showed a relatively high concentration of urinary oxalate, urate and large number of crystals in the kidneys. When the cellulose level was raised to 15%, the concentrations of urinary calcium, urate and the number of crystals formed in the kidneys were lowered. We therefore, conclude that high fiber diet may be beneficial in reducing the incidence of kidney stones of calcium origin.
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Hurdles and hopes in the management of human obesity
AG Dulloo
ABSTRACT
A population shift towards obesity is a major side-effect of changes in lifestyle that accompany economic prosperity, and a high risk factor for many chronic degenerative diseases including non-insulin-dependent diabetes mellitus (NIDDM), coronary heart disease and hypertension. According to current WHO population statistics, 40% of obese patients eventually develop NIDDM, 80% of individuals with NIDDM are obese and the incidence of hypertension in obesity and NIDDM could be as high as 50%. Of particular concern for developing countries is the strong epidemiological evidence indicating that the prevalence of obesity and diabetes often increase in epidemic proportions in communities emerging from lifestyles of subsistence into affluence. Even modest increase in prosperity seem to be associated with the most marked increases in the proportion of these chronic diseases. Indeed, obesity and its pathophysiological complications have become health priorities among American Indians, Australian Aborigines, Pacific Islanders, and are rapidly becoming major concerns among many other developing countries. For example, the prevalence of obesity (BMI >30) for the middle-age group is 32% in women living in Urban Trinidad, 16.4% in Nicaragua, 14% in Costa Rica, values which are higher than for the USA (12-15%) or in the UK (8-9%). Even more spectacular are the health statistics about the middle-aged Pima Indians in Arizona and inhabitants of the South Pacific Island of Nauru, showing that more than 80% are obese, and 50-70% have NIDDM. These grim figures must be weighed against the hard fact that there is at present no effective cure for obesity, and judging from the outcome of health policies in countries with a long experience in dealing with this problem, the management of obesity has a long and disappointing history. In fact, for the past decades, a wide array of treatment has been available to their public (low-calorie regimes, low-fat or high fibre foods, anorectic drugs, exercise and behavioural therapy, etc), but in the vast majority of cases, the result is a transient phase of weight loss, followed by a return to the obese condition within a few years. Despite the poor prognosis of treating obesity by reducing food intake (by dieting alone or with the help of anorectic drugs), thi approach will continue to be the most common form of treatment in the foreseeable future. However, there is growing realisation that in response to reduced food intake, the accompanying fall in energy expenditure is a major factor that limits weight loss and contributes to obesity relapse. After an analysis of the various approaches to reduce energy intake, this paper will examine the extent to which re-adjustments in the various compartments of energy expenditure contribute to this apparent adaptation to reduced food intake. It will then analyze the rationale, applicability and effectiveness of various approaches (behavioural, dietary, and pharmacological) that could conceivably stimulate the metabolic rate and thus counteract such adaptive changes in energy expenditure in order to improve the efficacy of obesity management.
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A population shift towards obesity is a major side-effect of changes in lifestyle that accompany economic prosperity, and a high risk factor for many chronic degenerative diseases including non-insulin-dependent diabetes mellitus (NIDDM), coronary heart disease and hypertension. According to current WHO population statistics, 40% of obese patients eventually develop NIDDM, 80% of individuals with NIDDM are obese and the incidence of hypertension in obesity and NIDDM could be as high as 50%. Of particular concern for developing countries is the strong epidemiological evidence indicating that the prevalence of obesity and diabetes often increase in epidemic proportions in communities emerging from lifestyles of subsistence into affluence. Even modest increase in prosperity seem to be associated with the most marked increases in the proportion of these chronic diseases. Indeed, obesity and its pathophysiological complications have become health priorities among American Indians, Australian Aborigines, Pacific Islanders, and are rapidly becoming major concerns among many other developing countries. For example, the prevalence of obesity (BMI >30) for the middle-age group is 32% in women living in Urban Trinidad, 16.4% in Nicaragua, 14% in Costa Rica, values which are higher than for the USA (12-15%) or in the UK (8-9%). Even more spectacular are the health statistics about the middle-aged Pima Indians in Arizona and inhabitants of the South Pacific Island of Nauru, showing that more than 80% are obese, and 50-70% have NIDDM. These grim figures must be weighed against the hard fact that there is at present no effective cure for obesity, and judging from the outcome of health policies in countries with a long experience in dealing with this problem, the management of obesity has a long and disappointing history. In fact, for the past decades, a wide array of treatment has been available to their public (low-calorie regimes, low-fat or high fibre foods, anorectic drugs, exercise and behavioural therapy, etc), but in the vast majority of cases, the result is a transient phase of weight loss, followed by a return to the obese condition within a few years. Despite the poor prognosis of treating obesity by reducing food intake (by dieting alone or with the help of anorectic drugs), thi approach will continue to be the most common form of treatment in the foreseeable future. However, there is growing realisation that in response to reduced food intake, the accompanying fall in energy expenditure is a major factor that limits weight loss and contributes to obesity relapse. After an analysis of the various approaches to reduce energy intake, this paper will examine the extent to which re-adjustments in the various compartments of energy expenditure contribute to this apparent adaptation to reduced food intake. It will then analyze the rationale, applicability and effectiveness of various approaches (behavioural, dietary, and pharmacological) that could conceivably stimulate the metabolic rate and thus counteract such adaptive changes in energy expenditure in order to improve the efficacy of obesity management.
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Malaysian Journal of Nutrition
Volume 02 No.2, 1996
Table of Content
Anthropometry, dietary patterns and nutrient intakes of Malaysian estate workers
Chee SS, Zawiah H, Ismail MN, and Ng KK
ABSTRACT
Studies were carried out in two estates in Kedah and Johor to characterize the anthropometry and dietary patterns of 334 (169 females, 165 males) Malaysian estate workers. Subjects were Malay and Indian adults (aged 18 to 60 years) engaged in various work activities including rubber tappers, palm fruit harvesters, field supervisors and workers in the estate factories. Anthropometric results showed that the prevalence of overweight (26% in men, 25% in women) and obesity (5% in men, 11% in women) were higher compared to prevalence of underweight (11% in men, 9% in women) in these workers despite being engaged in moderate to heavy activities. The dietary intake pattern revealed that the main sources of calories in the diet were rice, cooking oil and sugar. Major sources of protein in the Malay diet were anchovies and fish whilst in the Indian diet protein was provided by salted fish, anchovies, eggs, fish, and pulses. The consumption of poultry, meat and dairy products were low for both ethnic groups. The dietary intakes of a subsampel of 108 normal weight subjects (56 females, 52 males) were recorded for 3 days. The results showed that the mean energy intake was 8.44 ± 2.12 MJ in males and 6.48 ± 1.29 MJ in females. The contribution of calories from protein, fat and carbohydrate were 13%, 22% and 60% in males and 12%, 23% and 65% in females, respectively. Alcohol intake was found to contribute five percent of energy in the diet of the Indian male subjects. Calcium, iron, vitamin A, thiamin, riboflavin and niacin intake were below 66% of the Malaysian RDA, particularly amongst the women. Income appeared to have a significant correlation with energy and iron intakes of the female workers as well as thiamin, niacin and riboflavin intakes of the male workers. There is a need for improving the quality of the dietary intakes of these workers as well as nutrition education on the prevention of obesity and its consequences.
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Studies were carried out in two estates in Kedah and Johor to characterize the anthropometry and dietary patterns of 334 (169 females, 165 males) Malaysian estate workers. Subjects were Malay and Indian adults (aged 18 to 60 years) engaged in various work activities including rubber tappers, palm fruit harvesters, field supervisors and workers in the estate factories. Anthropometric results showed that the prevalence of overweight (26% in men, 25% in women) and obesity (5% in men, 11% in women) were higher compared to prevalence of underweight (11% in men, 9% in women) in these workers despite being engaged in moderate to heavy activities. The dietary intake pattern revealed that the main sources of calories in the diet were rice, cooking oil and sugar. Major sources of protein in the Malay diet were anchovies and fish whilst in the Indian diet protein was provided by salted fish, anchovies, eggs, fish, and pulses. The consumption of poultry, meat and dairy products were low for both ethnic groups. The dietary intakes of a subsampel of 108 normal weight subjects (56 females, 52 males) were recorded for 3 days. The results showed that the mean energy intake was 8.44 ± 2.12 MJ in males and 6.48 ± 1.29 MJ in females. The contribution of calories from protein, fat and carbohydrate were 13%, 22% and 60% in males and 12%, 23% and 65% in females, respectively. Alcohol intake was found to contribute five percent of energy in the diet of the Indian male subjects. Calcium, iron, vitamin A, thiamin, riboflavin and niacin intake were below 66% of the Malaysian RDA, particularly amongst the women. Income appeared to have a significant correlation with energy and iron intakes of the female workers as well as thiamin, niacin and riboflavin intakes of the male workers. There is a need for improving the quality of the dietary intakes of these workers as well as nutrition education on the prevention of obesity and its consequences.
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Body mass index and fat patterning of adults in rural Sarawak
Ulijaszek SJ and Strickland SS
ABSTRACT
Body fatness distribution is a useful epidemiological and clinical marker of health risk among European and other populations. Prevalence of obesity among adults is rising in many parts of Malaysia, and it is important to understand the extent to which fat patterning is robust across different age groups and between the sexes. This analysis examines fatness and fat distribution in rural Sarawakian adults aged 20 to 80 years to determine the extent to which fat patterning varies by sex and age. Principal component analysis of five skinfolds (biceps, triceps, subscapular, suprailiac and medial calf) shows upper body-lower body fat distribution as contributing most to within-group variation in the sum of five skinfolds for both males and females. When divided into younger and older age groups, clear differences were identified. For the males, while absolute fatness does not change with age, there is a change in fat patterning, with a trunk-extremity component disappearing, and a trunk-lower body pattern persisting. Females experience a decline in subcutaneous fatness across age groups, and while the most important component of fat distribution, trunk to lower body subcutaneous fatness, the same for younger and older women, the second component is different, with upper limb-lower body distribution in the younger age group being replaced with upper to lower trunk distribution. The similarities in fat patterning among males and females suggest that the use of fat patterning indices in this Malaysian population need not be sex-specific, but age group- and sex-dependent differences in the second principal component indicate that they should be used with caution, since the relationships between fat patterning and mortality are still poorly understood among Malaysian populations.
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Body fatness distribution is a useful epidemiological and clinical marker of health risk among European and other populations. Prevalence of obesity among adults is rising in many parts of Malaysia, and it is important to understand the extent to which fat patterning is robust across different age groups and between the sexes. This analysis examines fatness and fat distribution in rural Sarawakian adults aged 20 to 80 years to determine the extent to which fat patterning varies by sex and age. Principal component analysis of five skinfolds (biceps, triceps, subscapular, suprailiac and medial calf) shows upper body-lower body fat distribution as contributing most to within-group variation in the sum of five skinfolds for both males and females. When divided into younger and older age groups, clear differences were identified. For the males, while absolute fatness does not change with age, there is a change in fat patterning, with a trunk-extremity component disappearing, and a trunk-lower body pattern persisting. Females experience a decline in subcutaneous fatness across age groups, and while the most important component of fat distribution, trunk to lower body subcutaneous fatness, the same for younger and older women, the second component is different, with upper limb-lower body distribution in the younger age group being replaced with upper to lower trunk distribution. The similarities in fat patterning among males and females suggest that the use of fat patterning indices in this Malaysian population need not be sex-specific, but age group- and sex-dependent differences in the second principal component indicate that they should be used with caution, since the relationships between fat patterning and mortality are still poorly understood among Malaysian populations.
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Anthropometric measurements and body composition of selected national athletes
Wan Nudri WD, Ismail MN and Zawiak H
ABSTRACT
This study was conducted to determine the anthropometric measurements and body composition of selected national athletes. A total of 84 male athletes from 10 different types of sports and 24 female athletes from 5 types of sports were studied. The height and body weight of subjects were measured using the SEGA weighing balance with height attachment. Skinfold thickness measurements were taken using the Harpenden Calipers at 4 sites (biceps, triceps, subscapular and suprailiac). Percentage of body fat was calculated from the sum of 4 measurements of skinfold thickness. Based on body mass index (BMI), most of the male (68 subjects or 81%) and female (19 subjects or 79%) athletes were classified as normal. The percentage average body fat for both male and female athletes were 13.8 ± 4.5% and 24.7 ± 5.3%, respectively. The male and female athletes also had lower percentage of body fat when compared to non-athletes, however these athletes had slightly higher percentage of body fat when compared to those in selected countries.
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This study was conducted to determine the anthropometric measurements and body composition of selected national athletes. A total of 84 male athletes from 10 different types of sports and 24 female athletes from 5 types of sports were studied. The height and body weight of subjects were measured using the SEGA weighing balance with height attachment. Skinfold thickness measurements were taken using the Harpenden Calipers at 4 sites (biceps, triceps, subscapular and suprailiac). Percentage of body fat was calculated from the sum of 4 measurements of skinfold thickness. Based on body mass index (BMI), most of the male (68 subjects or 81%) and female (19 subjects or 79%) athletes were classified as normal. The percentage average body fat for both male and female athletes were 13.8 ± 4.5% and 24.7 ± 5.3%, respectively. The male and female athletes also had lower percentage of body fat when compared to non-athletes, however these athletes had slightly higher percentage of body fat when compared to those in selected countries.
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Breastfeeding and weaning practices in rural communities of Kelantan
Zulkjfli Ahmad, Daw Win Kyi and Abdul Rahman Isa
ABSTRACT
A survey of infant-feeding and weaning practices of 566 mothers, systematically sampled from 15 rural villages, randomly selected in the district of Tumpat, Kelantan was carried out. Almost all mothers (97.3%) breastfed their children, reinforcing the previously reported high incidence of breast-feeding among rural Malaysian mothers. One hundred and seventeen (21.3%) of the 551 children breastfed were also given mixed feeding with infant fomulae as well. Weaning started before 4 months of age in 28.3% of the children and after 6 months of age in 12.8% of the children. The 3 most common type of food used in weaning were Nestum (45.0%), rice porridge or paste (42.6%) and wheat porridge or cakes (11.5%). Forty eight children (12.1%) discontinued breastfeeding once weaning was initiated. The main reasons for initiating weaning was mothers’ perception that there was insufficient milk and that the child was always hungry (55.7%). Most mothers were also given advice by the health clinic staff on weaning, including the timing and the suitable weaning foods to give. All of the mothers were able to name at least one commercial weaning food product available in their community.
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A survey of infant-feeding and weaning practices of 566 mothers, systematically sampled from 15 rural villages, randomly selected in the district of Tumpat, Kelantan was carried out. Almost all mothers (97.3%) breastfed their children, reinforcing the previously reported high incidence of breast-feeding among rural Malaysian mothers. One hundred and seventeen (21.3%) of the 551 children breastfed were also given mixed feeding with infant fomulae as well. Weaning started before 4 months of age in 28.3% of the children and after 6 months of age in 12.8% of the children. The 3 most common type of food used in weaning were Nestum (45.0%), rice porridge or paste (42.6%) and wheat porridge or cakes (11.5%). Forty eight children (12.1%) discontinued breastfeeding once weaning was initiated. The main reasons for initiating weaning was mothers’ perception that there was insufficient milk and that the child was always hungry (55.7%). Most mothers were also given advice by the health clinic staff on weaning, including the timing and the suitable weaning foods to give. All of the mothers were able to name at least one commercial weaning food product available in their community.
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Mother’s health card: A simple technology for use in primary health care
Husaini MA, Husaini YK, Sandjaja, Gunawan N, Hudono T, Odang R and Karyadi D
ABSTRACT
The incidence of low birth weight in Indonesia as well as other developing countries is high. This can be reduced, if at risk pregnant women can be identified and their risks lowered. A 2-year cohort prospective study of 1,281 pregnant women found that maternal nutrition, including height and weight during pregnancy affected the birth weight of infants. On the basis of these findings, a Mother’s Health Card was developed to monitor maternal weight during pregnancy and to observe factors affecting low birth weight. The validation study of the use of this card in four different ethnic and geographic areas found that the prediction values for identifying women who were at risk of delivering low birth weight infants was adequately high. The card proved simple, usable by village cadres, action oriented, and facilitated health nutrition education as well as persuading women to use available health care services. It also promoted better maternal and foetal nutrition by increasing the level of awareness of the women, the cadres, and the health personnel.
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The incidence of low birth weight in Indonesia as well as other developing countries is high. This can be reduced, if at risk pregnant women can be identified and their risks lowered. A 2-year cohort prospective study of 1,281 pregnant women found that maternal nutrition, including height and weight during pregnancy affected the birth weight of infants. On the basis of these findings, a Mother’s Health Card was developed to monitor maternal weight during pregnancy and to observe factors affecting low birth weight. The validation study of the use of this card in four different ethnic and geographic areas found that the prediction values for identifying women who were at risk of delivering low birth weight infants was adequately high. The card proved simple, usable by village cadres, action oriented, and facilitated health nutrition education as well as persuading women to use available health care services. It also promoted better maternal and foetal nutrition by increasing the level of awareness of the women, the cadres, and the health personnel.
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Energy requirements of Malaysian soldiers in a base camp
Ismail MN, Isa M and Janudin A
ABSTRACT
The energy intake and expenditure of 20 healthy soldiers (mean age, 25 years, weight 61 kg and height 1.67 m) was assessed. Trained personnel stayed in the camp throughout the 5 weeks study period. Each soldier was subjected to a 7-day comprehensive protocol involving anthropometric, food intake, activity pattern and energy expenditure measurements. The mean change in body weight and fat content was minimal, -0.2kg and -0.25%, respectively. Body fat and BMI ranges from 10.0-21.6% and 19.8-24.9, respectively. The mean energy intake of 2190 ± 197 kcal was well below (81%) the recommended allowance of 2700 kcal for the Malaysian Armed Forces. The ration scale analysed chemically provides 2900 kcal thus suggesting a 24% wastage of daily ration. Contribution of protein (15%), fat (25%) and carbohydrate (60%) to energy intake appears to be in line to healthy dietary guidelines. Energy cost of standardised activities were found to be lower in Malaysian soldiers as compared to British soldiers studied under similar environment in the tropics. The mean total daily energy expenditure (TDEE) for soldiers were 2886 ± 222 kcal with a negative energy balance of about 700 kcal. The results suggested that there is a need to review the current provision with regard to food supply and preparation in army camps, to ensure that the menu provided are appealing as well as nutritious for the soldiers.
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The energy intake and expenditure of 20 healthy soldiers (mean age, 25 years, weight 61 kg and height 1.67 m) was assessed. Trained personnel stayed in the camp throughout the 5 weeks study period. Each soldier was subjected to a 7-day comprehensive protocol involving anthropometric, food intake, activity pattern and energy expenditure measurements. The mean change in body weight and fat content was minimal, -0.2kg and -0.25%, respectively. Body fat and BMI ranges from 10.0-21.6% and 19.8-24.9, respectively. The mean energy intake of 2190 ± 197 kcal was well below (81%) the recommended allowance of 2700 kcal for the Malaysian Armed Forces. The ration scale analysed chemically provides 2900 kcal thus suggesting a 24% wastage of daily ration. Contribution of protein (15%), fat (25%) and carbohydrate (60%) to energy intake appears to be in line to healthy dietary guidelines. Energy cost of standardised activities were found to be lower in Malaysian soldiers as compared to British soldiers studied under similar environment in the tropics. The mean total daily energy expenditure (TDEE) for soldiers were 2886 ± 222 kcal with a negative energy balance of about 700 kcal. The results suggested that there is a need to review the current provision with regard to food supply and preparation in army camps, to ensure that the menu provided are appealing as well as nutritious for the soldiers.
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Simultaneous determination of B-vitamins and ascorbic acid in multi-vitamin preparations by reversed-phase HPLC
Tee E-Siong and Khor Swan-Choo
ABSTRACT
The tedious and time consuming methods employed for the analysis of individual B-vitamins can now be replaced by ion-pair reversed-phase high-performance liquid chromatographic (HPLC) methods. This laboratory has previously reported the simultaneous determination of eight water-soluble vitamin standards that is, B1, B2, B6, B12, C, niacin, niacinamide and folic acid. The proposed isocratic HPLC method, employing 3 channels of detection, adequately separated all eight vitamins in less than 20 minutes. This study reports another phase of the project whereby the method was employed for the analysis of pharmaceutical preparations. Different extraction procedures were first evaluated, namely acid, acid plus enzyme and alkaline hydrolysis methods, using vitamin standards, individual vitamin tablets and multivitamin preparations. The amounts obtained from the analysis were compared with the declared values. Recovery studies were also carried out. The method of acid hydrolysis with 0.1N sulphuric acid was found suitable for use and was thus adopted as the extraction procedure for the analysis of 10 multivitamin preparations obtained from various pharmaceutical outlets. For most of these preparations, the amount obtained were close to the declared values, except for folic acid and cyanocobalamin. Further trials on folic acid showed that the problem could be resolved by omitting the filtration step in the final extract after acid hydrolysis and diluting with 0.01N sodium hydroxide before processing for chromatography. Vitamin B12 was not detectable using the present chromatography system probably because of its low concentration in the samples studied.
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The tedious and time consuming methods employed for the analysis of individual B-vitamins can now be replaced by ion-pair reversed-phase high-performance liquid chromatographic (HPLC) methods. This laboratory has previously reported the simultaneous determination of eight water-soluble vitamin standards that is, B1, B2, B6, B12, C, niacin, niacinamide and folic acid. The proposed isocratic HPLC method, employing 3 channels of detection, adequately separated all eight vitamins in less than 20 minutes. This study reports another phase of the project whereby the method was employed for the analysis of pharmaceutical preparations. Different extraction procedures were first evaluated, namely acid, acid plus enzyme and alkaline hydrolysis methods, using vitamin standards, individual vitamin tablets and multivitamin preparations. The amounts obtained from the analysis were compared with the declared values. Recovery studies were also carried out. The method of acid hydrolysis with 0.1N sulphuric acid was found suitable for use and was thus adopted as the extraction procedure for the analysis of 10 multivitamin preparations obtained from various pharmaceutical outlets. For most of these preparations, the amount obtained were close to the declared values, except for folic acid and cyanocobalamin. Further trials on folic acid showed that the problem could be resolved by omitting the filtration step in the final extract after acid hydrolysis and diluting with 0.01N sodium hydroxide before processing for chromatography. Vitamin B12 was not detectable using the present chromatography system probably because of its low concentration in the samples studied.
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Dietary zinc treatment for chronic copper intoxication in palm kernel cake (PKC) fed sheep
Hair-Bejo M, Alimon A R, Maria J, Hass M Y and Moonafizad M
ABSTRACT
Thirty, 4 month-old male Maim x Polled Dorset crossbred sheep were allocated into 6 groups of 5 animals each. Four groups of animals were stall-fed with basal diet of 90% palm kernel cake (PKC) and 10% grass (G) for 16 weeks. One group of the animal was slaughtered at the end of the 16 weeks feeding trial (PKC group), whilst the other three groups were further fed with either the same diet (PKC+PKC group) or fed with a new diet consisting of 30% corn and 10% fish meals (CF) and grass (60%) either with (PKC+CF+Zn group) or without (PKC+CF group) zinc supplementation (500 mg/g Zn as zinc sulfate) for another 16 weeks and were slaughtered at the end of the feeding trial, The other two groups which act as controls were fed with corn (30%) and fish meals (10%) and grass (60%), and were slaughtered at weeks 16 (CF group) and 32 (CF+CF group) of the trial. The blood, right and left liver, renal cortex and medulla, pancreas, bile and urine of all animals were analysed for copper and zinc contents using an atomic absorption spectrophotometer. The liver and kidney were also fixed in 10% buffered formalin for histopathological examination. The study showed that neither clinical signs nor gross lesions of copper or zinc toxicity were observed throughout the trial. However, the copper concentration in both the right and left liver of PKC fed sheep at weeks 16 and 32 rose to about 3 times that of the controls and remained high in both the PKC+CF and PKC+CF+Zn groups. A similar pattern of copper concentration was observed in the blood. The copper and zinc contents in the renal cortex and medulla, pancreas, bile and urine remained low in all groups. The zinc content in the liver of PKC+CF+Zn group was significantly increased. Histologically, moderate hepatic lesions were observed in the PKC fed sheep at week 32. The lesions were milder in the other groups especially in the PKC+CF+Zn group. No significant renal lesions was recorded in all groups. It was concluded that the usage of dietary zinc supplementation (500 mg/g) in the treatment of PKC toxicity in sheep was unsatisfactory. The ability of Malin x Polled Dorset crossbred sheep to tolerate the high copper content in PKC at least during the first 16 weeks of the feeding trial may provide more avenue in the utilization of PKC as a major feed ingredient in sheep.
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Thirty, 4 month-old male Maim x Polled Dorset crossbred sheep were allocated into 6 groups of 5 animals each. Four groups of animals were stall-fed with basal diet of 90% palm kernel cake (PKC) and 10% grass (G) for 16 weeks. One group of the animal was slaughtered at the end of the 16 weeks feeding trial (PKC group), whilst the other three groups were further fed with either the same diet (PKC+PKC group) or fed with a new diet consisting of 30% corn and 10% fish meals (CF) and grass (60%) either with (PKC+CF+Zn group) or without (PKC+CF group) zinc supplementation (500 mg/g Zn as zinc sulfate) for another 16 weeks and were slaughtered at the end of the feeding trial, The other two groups which act as controls were fed with corn (30%) and fish meals (10%) and grass (60%), and were slaughtered at weeks 16 (CF group) and 32 (CF+CF group) of the trial. The blood, right and left liver, renal cortex and medulla, pancreas, bile and urine of all animals were analysed for copper and zinc contents using an atomic absorption spectrophotometer. The liver and kidney were also fixed in 10% buffered formalin for histopathological examination. The study showed that neither clinical signs nor gross lesions of copper or zinc toxicity were observed throughout the trial. However, the copper concentration in both the right and left liver of PKC fed sheep at weeks 16 and 32 rose to about 3 times that of the controls and remained high in both the PKC+CF and PKC+CF+Zn groups. A similar pattern of copper concentration was observed in the blood. The copper and zinc contents in the renal cortex and medulla, pancreas, bile and urine remained low in all groups. The zinc content in the liver of PKC+CF+Zn group was significantly increased. Histologically, moderate hepatic lesions were observed in the PKC fed sheep at week 32. The lesions were milder in the other groups especially in the PKC+CF+Zn group. No significant renal lesions was recorded in all groups. It was concluded that the usage of dietary zinc supplementation (500 mg/g) in the treatment of PKC toxicity in sheep was unsatisfactory. The ability of Malin x Polled Dorset crossbred sheep to tolerate the high copper content in PKC at least during the first 16 weeks of the feeding trial may provide more avenue in the utilization of PKC as a major feed ingredient in sheep.
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Malaysian Journal of Nutrition
Volume 02 No.3, 1996
Table of Content
REVIEW
SHORT COMMUNICATIONS