Background: The Indonesian Public Health Care (PHC) of Management Nutrition Therapy (MNT) guideli... more Background: The Indonesian Public Health Care (PHC) of Management Nutrition Therapy (MNT) guidelines describe that individual nutrition education is aimed to improve quality of MNT services. The guidelines were originally developed for non-communicable diseases (NCDs), not specially for type 2 diabetes mellitus (T2DM) purposes. The reluctance of patients with T2DM to attend individual nutrition education is a common public health care issue in Padang (Indonesia). Methods: The presented cross-sectional study aimed to determine the individual nutrition education needs among people with T2DM. A set questionnaire was distributed to 11 PHC selected from 11 districts in Padang and 179 patients with T2DM were recruited and interviewed. Results: Among the 179 patients with T2DM, 76.5% were females and housewives (49.2%), a slight majority (57.8%) were ≤58 years old and 45.9% had graduated from primary school. The highest numbers of patients with T2DM were in PHC Andalas (20.7%). Some 74.9% ...
Background: Weight loss is well-known among head and neck (HNC) patients during radiotherapy and ... more Background: Weight loss is well-known among head and neck (HNC) patients during radiotherapy and could continue after the treatment is completed. Weight monitoring is essential for treatment outcomes and cancer surveillance. The purpose of the study is to evaluate the weight loss during and post-treatment among HNC patients. Methods: A total of 45 out of 50 patients post-treatment were included in this secondary treatment. Data were collected at baseline, at the completion of radiotherapy and one month after completion of radiotherapy. Results: The mean weight loss was 4.53 ± 2.87 kg (7.4%) during treatment and 1.38 ± 2.65 kg (2.1%) post-treatment. There were significant improvements one month after completion of radiotherapy in Patient-Generated Subjective Global Assessment (PGSGA), muscle mass, nutrition impact symptoms (NIS) score, energy and protein from oral intake (p < 0.0001). Energy and protein from oral nutritional supplements (ONS) decreased significantly (p < 0.0001...
Sufficient postoperative dietary intake is crucial for ensuring a better surgical outcome. This s... more Sufficient postoperative dietary intake is crucial for ensuring a better surgical outcome. This study aimed to investigate the postoperative dietary intake achievement and predictors of postoperative dietary intake among gynecologic cancer patients. A total of 118 participants were included in this secondary analysis. Postoperative dietary data was pooled and re-classified into early postoperative dietary intake achievement (EDIA) (daily energy intake (DEI) ≥ 75% from the estimated energy requirement (EER)) and delay dietary intake achievement (DDIA) (DEI < 75% EER) There was a significant difference in postoperative changes in weight (p = 0.002), muscle mass (p = 0.018), and handgrip strength (p = 0.010) between the groups. Postoperative daily energy and protein intake in the EDIA was significantly greater than DDIA from operation day to discharged (p = 0.000 and p = 0.036). Four significant independent postoperative dietary intake predictors were found: preoperative whey protei...
BACKGROUND Malnutrition is common among cancer patients regardless of stage of cancer. Given the ... more BACKGROUND Malnutrition is common among cancer patients regardless of stage of cancer. Given the strong association between malnutrition with prolonged hospitalization, delayed recovery and even higher post-operative complications among gynaecologic cancer (GC) patients, it is important to understand its predictive factors. The current study aimed to determine malnutrition predictors among GC patients before elective operation. METHOD A cross-sectional study was conducted among surgical GC patients who were admitted for elective surgery. Data on socio-demographic characteristics, clinical status (diagnosis, the staging of cancer, comorbidities and family history on cancer), anthropometric measures [ Body Mass Index (BMI), weight changes, the percentage of weight loss past one month, muscle mass, fat mass, fat-free mass and mid-upper arm circumference (MUAC)], biochemical profiles [C-reactive protein, albumin and C-reactive protein (CRP) to albumin ratio (CAR)], handgrip strength, total daily energy and protein intake, and malnutrition status [scored Patient Generated-Subjective Global Assessment (PG-SGA)] were assessed during admission. RESULTS Study recruited 124 participants and 57.2% (n = 71) were malnourished. Mean for age, weight changes past one month, handgrip strength, total daily energy and protein intake, PG-SGA score and CAR of participants were 49.9 ± 12.5 years, -4.9 ± 7.2%, 15.6 ± 6.2 kg, 25±7 kcal/kg/day, 1.0 ± 0.3 g/kg/day, 6.5 ± 5.4 and 0.7 ± 1.9, respectively. Multiple linear regression test revealed that the percentage of weight loss past one month, haemoglobin, CRP and handgrip strength were the significant predictors of malnutrition. CONCLUSION Malnutrition is common among GC patient even before elective operation. The early malnutrition screening following with proper nutritional intervention is crucial to optimize nutritional status among GC patients before elective operation.
Sufficient postoperative dietary intake is crucial for promoting wound healing and ensuring bette... more Sufficient postoperative dietary intake is crucial for promoting wound healing and ensuring better surgical outcomes. This study aimed to determine the postoperative nutritional achievement and predictors of postoperative dietary intake among gynecologic cancer patients. A total of 118 participants were included in this secondary analysis. Postoperative dietary data were pooled and re-classified into early postoperative dietary intake achievement (EDIA) (daily energy intake (DEI) ≥ 75% from the estimated energy requirement (EER)) and delay dietary intake achievement (DDIA) (DEI
Introduction: This is open label randomised control trial, aimed to identify whether an early (co... more Introduction: This is open label randomised control trial, aimed to identify whether an early (commenced at the time of diagnosis) and intensive nutrition intervention (INI) (individualised dietary counselling, oral nutritional supplements [ONS], telephone, and home visit) can improve weight and dietary intake of gynaecological cancer (GC) patients preoperatively. Methods: Selected GC patients planned for surgery were randomly grouped into control group (CG) (n = 35) and intervention group (IG) (n = 34). Malnutrition screening tool (MST) was used as a screening tool, while Patient-Generated Subjective Global Assessment (PG-SGA) was used as a nutrition assessment tool. IG received an intensive individualised dietary counselling with the supply of ONS at baseline (Day 1). This continued with telephone and home visit follow-up by research dietitian (Day 3 and Day 6). Meanwhile, CG only received general nutritional counselling without supply of ONS. Final assessment was conducted on Day...
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Introduction: Malnutrition is associated with poorer outcomes following treatment for colorectal ... more Introduction: Malnutrition is associated with poorer outcomes following treatment for colorectal cancer (CRC). This study evaluates the relationship between nutritional status using scored Patient Generated-Subjective Global Assessment (PG-SGA) with the validated European Organisation for Research and Treatment of Cancer questionnaire (EORTC-QLQ C30) which consists of five functional scales, three symptoms scales and one item of global health/quality of life (QOL). Methods: A total of 42 CRC patients at oncology outpatient clinics from two hospitals in Malaysia participated in the study from March 2011 to March 2012. The participants were classified as either well-nourished (PG-SGA A) or malnourished (PG-SGA B and C). Results: The majority of patients were Chinese, male, with a mean age of 57.1 ± 9.8 years and had been diagnosed with stage 2 CRC. Well-nourished patients had statistically significantly better QOL scores on symptom scales: fatigue (p<0.001), nausea and vomiting (p&...
This cross-sectional study aimed to determine the association of psychosocial factors with physic... more This cross-sectional study aimed to determine the association of psychosocial factors with physical activity levels among undergraduate students aged 18 to 30 years. A sample of 261 students from Universiti Putra Malaysia (n = 261; 138 males; 123 females) participated in the study. The respondents have been selected through a probability-based cluster sampling. A self-administered questionnaire was used to gather information regarding the socio-demographic characteristics(age, ethnicity, family household number, allowance income, and parent’s monthly income), psychosocial factors (self-efficacy, social support, and perceived benefit), and physical activity levels, which was accessed using Global Physical Activity Questionnaire (GPAQ). Multiple linear regression analysis was performed to determine factors associated with physical activity levels. The highest percentage of respondents (63.2%) were classified as having a moderate physical activity, followed by vigorous (24.9%)and low p...
A randomised trial was carried out to determine the effect of supplementation of fish oil among 5... more A randomised trial was carried out to determine the effect of supplementation of fish oil among 51 children with leukaemia aged 4 to 12 years on appetite level, caloric intake, body weight and lean body mass. They were randomly allocated into the trial group (TG) and the control group (CG). At baseline, 30.8% of TG subjects and 44.0% of CG subjects were malnourished and 7.7% of subject from TG and 28.0% from CG were classified as stunted. The majority of subjects from TG and CG were in the mild malnutrition category for mid upper arm muscle circumference (MUAMC)-for-age. The TG group showed significant increment in MUAMC (0.13 cm vs -0.09 cm) compared with CG at 8 weeks (p<0.001). There was a significant higher increase for appetite level (0.12±0.33) (p<0.05) and an increasing trend on energy and protein intake in the TG group (213±554 kcal; 3.64 ±26.8 g) than in the CG group. In conclusion, supplementation of fish oil has a positive effect on appetite level, caloric intake an...
Introduction: Plate wastage in hospital contributes to malnutrition-related complications includi... more Introduction: Plate wastage in hospital contributes to malnutrition-related complications including longer hospitalization among cancer patients. The objective of this study was to determine the relationship between patients’ experiences of access to food hospital and plate wastage among hospitalized cancer patients. Methods: Two hundred and thirty-one cancer patients in the National Cancer Institute, Malaysia were recruited for this study. All eligible patients were undergoing cancer treatments and provided with informed consent. Data obtained included socio-demographic characteristics and patients’ experiences of access to food hospital which will contribute to plate wastage. Plate wastage was determined by weighing the unwanted food left on the plate. Results: Prevalence of plate wastage among cancer patients was high at approximately 54%. The appearance of food served was associated with higher plate wastage (p<0.01). Conclusion: This finding shows that the prevalence of plat...
Summary Background and aims It is unknown whether dietary modifications during Ramadan could infl... more Summary Background and aims It is unknown whether dietary modifications during Ramadan could influence glycemic control in diabetes. This study assessed dietary intake following structured Ramadan nutrition therapy and determined the association between changes in dietary intake and glycemic control parameters in patients with type 2 diabetes. Methods This was an 8-week, parallel-group, non-randomised study of 60 type 2 diabetes patients who opted for structured Ramadan Nutrition Therapy (sRNT; n = 38) or standard care (SC; n = 22) group. The sRNT group received a structured Ramadan Nutrition Plan incorporated with diabetes-specific formula throughout the study, while SC received standard nutrition care. The 3-day food records assessed dietary intake at three-time points. Results At baseline, dietary characteristics were comparable; both groups had macronutrient intakes within the recommended range, but inadequate intakes of fiber and 11 essential micronutrients. After 8 weeks, the sRNT group significantly reduced intakes of carbohydrate, dietary glycemic index, glycemic load, and increased percentage of total energy intake from protein, fiber, pyridoxine, vitamin C, vitamin D, calcium, and chromium compared with the SC group. In the sRNT group, compliance to diabetes-specific formula predicted changes in HbA1c (p = 0.024), while fiber intake predicted fasting plasma glucose (p = 0.035), after adjusting for age, sex, weight changes and other dietary variables. Conclusion Intakes of certain nutrients improved significantly in sRNT group after 8 weeks of receiving a structured Ramadan Nutrition Plan compared to the standard care. The structured Ramadan Nutrition Plan with the incorporation of diabetes-specific formula significantly improved glycemic control and dietary adequacy during Ramadan fasting.
Background: Perioperative malnutrition is common in patients undergoing gastrointestinal-oncology... more Background: Perioperative malnutrition is common in patients undergoing gastrointestinal-oncology surgical and associated with longer hospital stays, increased post-operative complications, poorer quality of life and lower survival rate. Current practice emphasises the roles of early perioperative nutrition therapy as early intervention in order to combat the post-operative complications of patients and the implementation is now widely adopted. The aim of the study is to determine the effects of intensive perioperative nutrition therapy to overcome the post-operative complications in adult patients undergoing gastrointestinal and oncological surgery. Methods: This is a pragmatic randomised control trial study where elective admitted patients will be randomised into Intervention (SS) or Control (NN) Group. All data will be collected during a face to face interview, anthropometric measurement, blood sampling (albumin, white blood count, haemoglobin and c-reactive protein), handgrip st...
Background: The purpose of this study is to evaluate changes in nutrition impact symptoms (NIS) a... more Background: The purpose of this study is to evaluate changes in nutrition impact symptoms (NIS) and nutritional and functional status that occur throughout radiotherapy in head and neck cancer (HNC) patients. Methods: A prospective observational study of HNC inpatients who underwent radiotherapy with or without chemotherapy were recruited to participate. Fifty patients were followed for the periods before, in the middle and at the end of radiotherapy. Nutritional parameters were collected throughout radiotherapy. Results: According to Patient-Generated Subjective Global Assessment (PG-SGA), there was an increase from a baseline of 56% malnourished HNC patients to 100% malnourished with mean weight loss of 4.53 ± 0.41kg (7.39%) at the end of radiotherapy. Nutritional parameters such as muscle mass, fat mass, body mass index, dietary energy and protein intake decrease significantly (p < 0.0001) while NIS score, energy and protein intake from oral nutritional supplements (ONS) incre...
Introduction: Malnutrition is common among cancer patients and it is reported in a significant pr... more Introduction: Malnutrition is common among cancer patients and it is reported in a significant proportion of patients with gynaecological cancer (GC). The aim of this study was to determine the association between quality of life (QOL) and hand grip strength (HGS) among malnourished GC outpatients in the National Cancer Institute (NCI). Methods: This study was carried out in a Multidisciplinary Clinic of NCI. HGS was measured using Jamar Hand Dynamometer. Nutritional status was assessed using the scored Patient-Generated Subjective Global Assessment (PG-SGA). QOL was measured using the validated European Organisation for Research and Treatment of Cancer Questionnaire (EORTC-QLQ C30). Results: A total of 69 patients were selected for the study. Fifty eight (84.1%) were classified as moderately malnourished or at risk of malnutrition (PG-SGA B) and 11 (15.9%) were classified as severely malnourished (PG-SGA C). There was a moderate, significant positive relationship between HGS and functional status (r s =0.275, p=0.022) observed in this study. Besides, in malnourished GC patients with low HGS, results indicated that they had problems with social functioning as well (r=0.255, p=0.035). Appetite was suggested as a predicting factor for low HGS among malnourished GC patients (F=12.253, p=0.001). Conclusion: HGS is a simple objective indicator of functionality and is, therefore, a valid item to be measured when assessing QOL of malnourished GC outpatients.
(1) Background: Structured nutrition therapy (NT) is essential for the management of type 2 diabe... more (1) Background: Structured nutrition therapy (NT) is essential for the management of type 2 diabetes (T2D), but the optimal delivery during Ramadan fasting remains unclear. The present study aimed to evaluate the effect of structured NT program versus standard care in patients with T2D during Ramadan. (2) Methods: The present study was an 8-week, parallel, non-randomized study with patients' preference design involving 64 patients with T2D. The participants were asked to choose their preferred group, i.e., structured NT (Structured Ramadan NT, sRNT) or standard care (SC). The participants in the sRNT group received a Ramadan-focused nutrition plan, including a diabetes-specific formula throughout the study, whereas the patients in the SC group received standard nutrition care. Study outcomes included clinical outcomes and quality of life (QoL). Data was analyzed using two-way repeated-measures ANOVA and linear mixed-effects model. (3) Results: More than half of the participants (n = 38, 63%) chose sRNT as their preferred group. Both groups had comparable baseline characteristics. After 8-weeks of the respective intervention, participants in the sRNT group had lower levels of fasting plasma glucose (−0.9 ± 0.3 mmol/L vs. 0.2 ± 0.3 mmol/L, p < 0.05), triglycerides (−0.21 ± 0.08 mmol/L vs. 0.20 ± 0.17 mmol/L, p < 0.05), and self-monitoring glucose at pre-dawn (6.9 mmol/L vs. 7.8 mmol/L, p < 0.05) and pre-bedtime (7.6 mmol/L vs. 8.6 mmol/L, p < 0.05) than participants in the SC group. Although not different between groups, HbA1c levels decreased significantly in the sRNT (−0.72 ± 0.16%, p < 0.001) but not in the SC group (−0.35 ± 0.24%, p = 0.155). QoL and satisfaction scores improved significantly in sRNT group, but not in SC group. (4) Conclusions: The structured NT regimen for Ramadan is a feasible and beneficial program for T2D patients observing Ramadan fasting as it showed an improvement in clinical outcomes and QoL.
Background: The Indonesian Public Health Care (PHC) of Management Nutrition Therapy (MNT) guideli... more Background: The Indonesian Public Health Care (PHC) of Management Nutrition Therapy (MNT) guidelines describe that individual nutrition education is aimed to improve quality of MNT services. The guidelines were originally developed for non-communicable diseases (NCDs), not specially for type 2 diabetes mellitus (T2DM) purposes. The reluctance of patients with T2DM to attend individual nutrition education is a common public health care issue in Padang (Indonesia). Methods: The presented cross-sectional study aimed to determine the individual nutrition education needs among people with T2DM. A set questionnaire was distributed to 11 PHC selected from 11 districts in Padang and 179 patients with T2DM were recruited and interviewed. Results: Among the 179 patients with T2DM, 76.5% were females and housewives (49.2%), a slight majority (57.8%) were ≤58 years old and 45.9% had graduated from primary school. The highest numbers of patients with T2DM were in PHC Andalas (20.7%). Some 74.9% ...
Background: Weight loss is well-known among head and neck (HNC) patients during radiotherapy and ... more Background: Weight loss is well-known among head and neck (HNC) patients during radiotherapy and could continue after the treatment is completed. Weight monitoring is essential for treatment outcomes and cancer surveillance. The purpose of the study is to evaluate the weight loss during and post-treatment among HNC patients. Methods: A total of 45 out of 50 patients post-treatment were included in this secondary treatment. Data were collected at baseline, at the completion of radiotherapy and one month after completion of radiotherapy. Results: The mean weight loss was 4.53 ± 2.87 kg (7.4%) during treatment and 1.38 ± 2.65 kg (2.1%) post-treatment. There were significant improvements one month after completion of radiotherapy in Patient-Generated Subjective Global Assessment (PGSGA), muscle mass, nutrition impact symptoms (NIS) score, energy and protein from oral intake (p < 0.0001). Energy and protein from oral nutritional supplements (ONS) decreased significantly (p < 0.0001...
Sufficient postoperative dietary intake is crucial for ensuring a better surgical outcome. This s... more Sufficient postoperative dietary intake is crucial for ensuring a better surgical outcome. This study aimed to investigate the postoperative dietary intake achievement and predictors of postoperative dietary intake among gynecologic cancer patients. A total of 118 participants were included in this secondary analysis. Postoperative dietary data was pooled and re-classified into early postoperative dietary intake achievement (EDIA) (daily energy intake (DEI) ≥ 75% from the estimated energy requirement (EER)) and delay dietary intake achievement (DDIA) (DEI < 75% EER) There was a significant difference in postoperative changes in weight (p = 0.002), muscle mass (p = 0.018), and handgrip strength (p = 0.010) between the groups. Postoperative daily energy and protein intake in the EDIA was significantly greater than DDIA from operation day to discharged (p = 0.000 and p = 0.036). Four significant independent postoperative dietary intake predictors were found: preoperative whey protei...
BACKGROUND Malnutrition is common among cancer patients regardless of stage of cancer. Given the ... more BACKGROUND Malnutrition is common among cancer patients regardless of stage of cancer. Given the strong association between malnutrition with prolonged hospitalization, delayed recovery and even higher post-operative complications among gynaecologic cancer (GC) patients, it is important to understand its predictive factors. The current study aimed to determine malnutrition predictors among GC patients before elective operation. METHOD A cross-sectional study was conducted among surgical GC patients who were admitted for elective surgery. Data on socio-demographic characteristics, clinical status (diagnosis, the staging of cancer, comorbidities and family history on cancer), anthropometric measures [ Body Mass Index (BMI), weight changes, the percentage of weight loss past one month, muscle mass, fat mass, fat-free mass and mid-upper arm circumference (MUAC)], biochemical profiles [C-reactive protein, albumin and C-reactive protein (CRP) to albumin ratio (CAR)], handgrip strength, total daily energy and protein intake, and malnutrition status [scored Patient Generated-Subjective Global Assessment (PG-SGA)] were assessed during admission. RESULTS Study recruited 124 participants and 57.2% (n = 71) were malnourished. Mean for age, weight changes past one month, handgrip strength, total daily energy and protein intake, PG-SGA score and CAR of participants were 49.9 ± 12.5 years, -4.9 ± 7.2%, 15.6 ± 6.2 kg, 25±7 kcal/kg/day, 1.0 ± 0.3 g/kg/day, 6.5 ± 5.4 and 0.7 ± 1.9, respectively. Multiple linear regression test revealed that the percentage of weight loss past one month, haemoglobin, CRP and handgrip strength were the significant predictors of malnutrition. CONCLUSION Malnutrition is common among GC patient even before elective operation. The early malnutrition screening following with proper nutritional intervention is crucial to optimize nutritional status among GC patients before elective operation.
Sufficient postoperative dietary intake is crucial for promoting wound healing and ensuring bette... more Sufficient postoperative dietary intake is crucial for promoting wound healing and ensuring better surgical outcomes. This study aimed to determine the postoperative nutritional achievement and predictors of postoperative dietary intake among gynecologic cancer patients. A total of 118 participants were included in this secondary analysis. Postoperative dietary data were pooled and re-classified into early postoperative dietary intake achievement (EDIA) (daily energy intake (DEI) ≥ 75% from the estimated energy requirement (EER)) and delay dietary intake achievement (DDIA) (DEI
Introduction: This is open label randomised control trial, aimed to identify whether an early (co... more Introduction: This is open label randomised control trial, aimed to identify whether an early (commenced at the time of diagnosis) and intensive nutrition intervention (INI) (individualised dietary counselling, oral nutritional supplements [ONS], telephone, and home visit) can improve weight and dietary intake of gynaecological cancer (GC) patients preoperatively. Methods: Selected GC patients planned for surgery were randomly grouped into control group (CG) (n = 35) and intervention group (IG) (n = 34). Malnutrition screening tool (MST) was used as a screening tool, while Patient-Generated Subjective Global Assessment (PG-SGA) was used as a nutrition assessment tool. IG received an intensive individualised dietary counselling with the supply of ONS at baseline (Day 1). This continued with telephone and home visit follow-up by research dietitian (Day 3 and Day 6). Meanwhile, CG only received general nutritional counselling without supply of ONS. Final assessment was conducted on Day...
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Introduction: Malnutrition is associated with poorer outcomes following treatment for colorectal ... more Introduction: Malnutrition is associated with poorer outcomes following treatment for colorectal cancer (CRC). This study evaluates the relationship between nutritional status using scored Patient Generated-Subjective Global Assessment (PG-SGA) with the validated European Organisation for Research and Treatment of Cancer questionnaire (EORTC-QLQ C30) which consists of five functional scales, three symptoms scales and one item of global health/quality of life (QOL). Methods: A total of 42 CRC patients at oncology outpatient clinics from two hospitals in Malaysia participated in the study from March 2011 to March 2012. The participants were classified as either well-nourished (PG-SGA A) or malnourished (PG-SGA B and C). Results: The majority of patients were Chinese, male, with a mean age of 57.1 ± 9.8 years and had been diagnosed with stage 2 CRC. Well-nourished patients had statistically significantly better QOL scores on symptom scales: fatigue (p<0.001), nausea and vomiting (p&...
This cross-sectional study aimed to determine the association of psychosocial factors with physic... more This cross-sectional study aimed to determine the association of psychosocial factors with physical activity levels among undergraduate students aged 18 to 30 years. A sample of 261 students from Universiti Putra Malaysia (n = 261; 138 males; 123 females) participated in the study. The respondents have been selected through a probability-based cluster sampling. A self-administered questionnaire was used to gather information regarding the socio-demographic characteristics(age, ethnicity, family household number, allowance income, and parent’s monthly income), psychosocial factors (self-efficacy, social support, and perceived benefit), and physical activity levels, which was accessed using Global Physical Activity Questionnaire (GPAQ). Multiple linear regression analysis was performed to determine factors associated with physical activity levels. The highest percentage of respondents (63.2%) were classified as having a moderate physical activity, followed by vigorous (24.9%)and low p...
A randomised trial was carried out to determine the effect of supplementation of fish oil among 5... more A randomised trial was carried out to determine the effect of supplementation of fish oil among 51 children with leukaemia aged 4 to 12 years on appetite level, caloric intake, body weight and lean body mass. They were randomly allocated into the trial group (TG) and the control group (CG). At baseline, 30.8% of TG subjects and 44.0% of CG subjects were malnourished and 7.7% of subject from TG and 28.0% from CG were classified as stunted. The majority of subjects from TG and CG were in the mild malnutrition category for mid upper arm muscle circumference (MUAMC)-for-age. The TG group showed significant increment in MUAMC (0.13 cm vs -0.09 cm) compared with CG at 8 weeks (p<0.001). There was a significant higher increase for appetite level (0.12±0.33) (p<0.05) and an increasing trend on energy and protein intake in the TG group (213±554 kcal; 3.64 ±26.8 g) than in the CG group. In conclusion, supplementation of fish oil has a positive effect on appetite level, caloric intake an...
Introduction: Plate wastage in hospital contributes to malnutrition-related complications includi... more Introduction: Plate wastage in hospital contributes to malnutrition-related complications including longer hospitalization among cancer patients. The objective of this study was to determine the relationship between patients’ experiences of access to food hospital and plate wastage among hospitalized cancer patients. Methods: Two hundred and thirty-one cancer patients in the National Cancer Institute, Malaysia were recruited for this study. All eligible patients were undergoing cancer treatments and provided with informed consent. Data obtained included socio-demographic characteristics and patients’ experiences of access to food hospital which will contribute to plate wastage. Plate wastage was determined by weighing the unwanted food left on the plate. Results: Prevalence of plate wastage among cancer patients was high at approximately 54%. The appearance of food served was associated with higher plate wastage (p<0.01). Conclusion: This finding shows that the prevalence of plat...
Summary Background and aims It is unknown whether dietary modifications during Ramadan could infl... more Summary Background and aims It is unknown whether dietary modifications during Ramadan could influence glycemic control in diabetes. This study assessed dietary intake following structured Ramadan nutrition therapy and determined the association between changes in dietary intake and glycemic control parameters in patients with type 2 diabetes. Methods This was an 8-week, parallel-group, non-randomised study of 60 type 2 diabetes patients who opted for structured Ramadan Nutrition Therapy (sRNT; n = 38) or standard care (SC; n = 22) group. The sRNT group received a structured Ramadan Nutrition Plan incorporated with diabetes-specific formula throughout the study, while SC received standard nutrition care. The 3-day food records assessed dietary intake at three-time points. Results At baseline, dietary characteristics were comparable; both groups had macronutrient intakes within the recommended range, but inadequate intakes of fiber and 11 essential micronutrients. After 8 weeks, the sRNT group significantly reduced intakes of carbohydrate, dietary glycemic index, glycemic load, and increased percentage of total energy intake from protein, fiber, pyridoxine, vitamin C, vitamin D, calcium, and chromium compared with the SC group. In the sRNT group, compliance to diabetes-specific formula predicted changes in HbA1c (p = 0.024), while fiber intake predicted fasting plasma glucose (p = 0.035), after adjusting for age, sex, weight changes and other dietary variables. Conclusion Intakes of certain nutrients improved significantly in sRNT group after 8 weeks of receiving a structured Ramadan Nutrition Plan compared to the standard care. The structured Ramadan Nutrition Plan with the incorporation of diabetes-specific formula significantly improved glycemic control and dietary adequacy during Ramadan fasting.
Background: Perioperative malnutrition is common in patients undergoing gastrointestinal-oncology... more Background: Perioperative malnutrition is common in patients undergoing gastrointestinal-oncology surgical and associated with longer hospital stays, increased post-operative complications, poorer quality of life and lower survival rate. Current practice emphasises the roles of early perioperative nutrition therapy as early intervention in order to combat the post-operative complications of patients and the implementation is now widely adopted. The aim of the study is to determine the effects of intensive perioperative nutrition therapy to overcome the post-operative complications in adult patients undergoing gastrointestinal and oncological surgery. Methods: This is a pragmatic randomised control trial study where elective admitted patients will be randomised into Intervention (SS) or Control (NN) Group. All data will be collected during a face to face interview, anthropometric measurement, blood sampling (albumin, white blood count, haemoglobin and c-reactive protein), handgrip st...
Background: The purpose of this study is to evaluate changes in nutrition impact symptoms (NIS) a... more Background: The purpose of this study is to evaluate changes in nutrition impact symptoms (NIS) and nutritional and functional status that occur throughout radiotherapy in head and neck cancer (HNC) patients. Methods: A prospective observational study of HNC inpatients who underwent radiotherapy with or without chemotherapy were recruited to participate. Fifty patients were followed for the periods before, in the middle and at the end of radiotherapy. Nutritional parameters were collected throughout radiotherapy. Results: According to Patient-Generated Subjective Global Assessment (PG-SGA), there was an increase from a baseline of 56% malnourished HNC patients to 100% malnourished with mean weight loss of 4.53 ± 0.41kg (7.39%) at the end of radiotherapy. Nutritional parameters such as muscle mass, fat mass, body mass index, dietary energy and protein intake decrease significantly (p < 0.0001) while NIS score, energy and protein intake from oral nutritional supplements (ONS) incre...
Introduction: Malnutrition is common among cancer patients and it is reported in a significant pr... more Introduction: Malnutrition is common among cancer patients and it is reported in a significant proportion of patients with gynaecological cancer (GC). The aim of this study was to determine the association between quality of life (QOL) and hand grip strength (HGS) among malnourished GC outpatients in the National Cancer Institute (NCI). Methods: This study was carried out in a Multidisciplinary Clinic of NCI. HGS was measured using Jamar Hand Dynamometer. Nutritional status was assessed using the scored Patient-Generated Subjective Global Assessment (PG-SGA). QOL was measured using the validated European Organisation for Research and Treatment of Cancer Questionnaire (EORTC-QLQ C30). Results: A total of 69 patients were selected for the study. Fifty eight (84.1%) were classified as moderately malnourished or at risk of malnutrition (PG-SGA B) and 11 (15.9%) were classified as severely malnourished (PG-SGA C). There was a moderate, significant positive relationship between HGS and functional status (r s =0.275, p=0.022) observed in this study. Besides, in malnourished GC patients with low HGS, results indicated that they had problems with social functioning as well (r=0.255, p=0.035). Appetite was suggested as a predicting factor for low HGS among malnourished GC patients (F=12.253, p=0.001). Conclusion: HGS is a simple objective indicator of functionality and is, therefore, a valid item to be measured when assessing QOL of malnourished GC outpatients.
(1) Background: Structured nutrition therapy (NT) is essential for the management of type 2 diabe... more (1) Background: Structured nutrition therapy (NT) is essential for the management of type 2 diabetes (T2D), but the optimal delivery during Ramadan fasting remains unclear. The present study aimed to evaluate the effect of structured NT program versus standard care in patients with T2D during Ramadan. (2) Methods: The present study was an 8-week, parallel, non-randomized study with patients' preference design involving 64 patients with T2D. The participants were asked to choose their preferred group, i.e., structured NT (Structured Ramadan NT, sRNT) or standard care (SC). The participants in the sRNT group received a Ramadan-focused nutrition plan, including a diabetes-specific formula throughout the study, whereas the patients in the SC group received standard nutrition care. Study outcomes included clinical outcomes and quality of life (QoL). Data was analyzed using two-way repeated-measures ANOVA and linear mixed-effects model. (3) Results: More than half of the participants (n = 38, 63%) chose sRNT as their preferred group. Both groups had comparable baseline characteristics. After 8-weeks of the respective intervention, participants in the sRNT group had lower levels of fasting plasma glucose (−0.9 ± 0.3 mmol/L vs. 0.2 ± 0.3 mmol/L, p < 0.05), triglycerides (−0.21 ± 0.08 mmol/L vs. 0.20 ± 0.17 mmol/L, p < 0.05), and self-monitoring glucose at pre-dawn (6.9 mmol/L vs. 7.8 mmol/L, p < 0.05) and pre-bedtime (7.6 mmol/L vs. 8.6 mmol/L, p < 0.05) than participants in the SC group. Although not different between groups, HbA1c levels decreased significantly in the sRNT (−0.72 ± 0.16%, p < 0.001) but not in the SC group (−0.35 ± 0.24%, p = 0.155). QoL and satisfaction scores improved significantly in sRNT group, but not in SC group. (4) Conclusions: The structured NT regimen for Ramadan is a feasible and beneficial program for T2D patients observing Ramadan fasting as it showed an improvement in clinical outcomes and QoL.
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