Body Mass Index (BMI) is the most established anthropometric indicator used for assessment of nutritional status. Other anthropometric indicators which are related closely to BMI are waist hip ratio (WHR) and waist circumference. In this paper, receiver operating characteristics (ROC) curves were constructed to assess the value of waist circumference and waist hip ratio as a screening measure for the need of weight management using BMI as the reference test. Sensitivity and specificity were calculated at several cut-offs. The areas under the ROC curve calculated by comparing waist circumference with BMI were high (0.70 - 0.86) while the areas calculated for WHR were low (0.46 - 0.67). Sensitivities of 0.745 and 0.800 were observed at cut-off points of waist circumference at 90cm and 80cm for males and females respectively, while the false positive rates were 0.233 for males and 0.250 for females. These cut-off points could be considered as a fair trade-off. Therefore it is concluded that waist circumference performed better than WHR as a screening test. It is indicative that waist circumference could be used as a tool in raising awareness of weight management in this population.
Aim: Research on patient-reported outcomes in colorectal cancer are scarce in Malaysia. We aimed to determine pattern of health-related quality of life and its associations among patients with colorectal cancer.Methods: A cross-sectional study of 324 patients. Data were drawn from patient’s records and interviews. Research tools included the locally validated European Organization for Research and Treatment of Cancer (EORTC) core QLQ-C30 and colorectal-cancer specific QLQ-CR29 questionnaires.Results: The mean (±standard deviation) age of patients was 62.5 (±13.6) years. Majority of them were Chinese (62.3%) followed by Malays (19.8%), Indians (14.8%) and others (3.1%). Colon cancer was 7-fold more common than rectal cancer (87% vs 13%). Majority of them were presented at Stage II (29.6%) and III (28.1) of TNM Staging. The mean (±SD) score for global health status/quality of life (GHS/QOL) was 73.13 (±14.19). Good overall functionality (mean scores ≥80) was observed for physical, emotional, role, cognitive and social/family for QLQ-C30; body image, anxiety and weight for QLQ-CR29. The mean score for sexual functioning in men (32.95±28.81) and women (17.56±25.60) were low. Commonest symptoms were fatigue (22.29±17.40), urinary frequency (21.96 ± 24.22) and insomnia (18.42 ± 23.32). Those with lower GHS/QOL had stoma (p=0.044) and were of Chinese ethnicity (p<0.001). On multivariate analysis, ethnicity was the only independent predictor of GHS/QOL (95% confidence interval, 2.589 to 6.139, p<0.001). Conclusion: Our results suggest that there is decrease in sexual functioning despite good overall GHS/QOL among our colorectal cancer survivors. Fatigue, sleep loss and urinary frequency were the common symptoms after cancer treatment. Chinese patients had the poorest quality of life.
Background Diet monitoring has been linked with improved eating habits and positive health outcomes such as prevention of obesity. However, this is often unsustainable as traditional methods place a high burden on both participants and researchers through pen and paper recordings and manual nutrient coding respectively. The digitisation of dietary monitoring has greatly reduced these barriers. This paper proposes a diet application with a novel food recognition feature with a usability study conducted in the real world. Methods This study describes the development of a mobile diet application (MyDietCam) targeted at healthy Malaysian adults. Focus group discussions (FGD) were carried out among dietitians and potential users to determine ideal features in a diet application. Thirty participants were recruited from a local university to log their meals through MyDietCam for six days and submit the Malay mHealth Application Usability Questionnaire (M-MAUQ) at the end of the study. Results The findings from the FGD led to the implementation of the main features: individualised recommendations, food logging through food recognition to reduce steps for data entry and provide detailed nutrient analyses through visuals. An average overall usability score of 5.13 out of a maximum of seven was reported from the M-MAUQ which is considered acceptable. Conclusion The development of a local (Malaysian) mobile diet application with acceptable usability may be helpful in sustaining the diet monitoring habit to improve health outcomes. Future work should focus on improving the issues raised before testing the effectiveness of the application for improving health outcomes.
Background: Malnutrition among elderly is a multi-dimensional problem which predisposes them to increased risks of disability, hospitalisation and mortality. This study aimed to investigate the prevalence of and associated factors for malnutrition in communitydwelling elderly.
Background Patients with diabetes have increased risks of cardiovascular diseases (CVD), and their LDL-cholesterol (LDL-C) has to be treated to target to prevent complications. We aim to determine the LDL-C trend and its predictors among patients with type 2 diabetes (T2D) in Malaysia. Methods This was a retrospective open cohort study from 2013 to 2017 among T2D patients in public primary health care clinics in Negeri Sembilan state, Malaysia. Linear mixed-effects modelling was conducted to determine the LDL-C trend and its predictors. The LDL-C target for patients without CVD was <2.6 mmol/L, whereas <1.8 mmol/L was targeted for those with CVD. Results Among 18,312 patients, there were more females (55.9%), adults ≥60 years (49.4%), Malays (64.7%), non-smokers (93.6%), and 45.3% had diabetes for <5 years. The overall LDL-C trend reduced by 6.8% from 2.96 to 2.76 mmol/L. In 2017, 16.8% (95% CI: 13.2–21.0) of patients without CVD and 45.8% (95% CI: 44.8–46.8) of patients with CVD achieved their respective LDL-C targets. The predictors for a higher LDL-C trend were younger adults, Malay and Indian ethnicities, females, dyslipidemia, and diabetes treatment with lifestyle modification and insulin. Longer diabetes duration, obesity, hypertension, retinopathy, statin therapy, achievement of HbA1c target and achievement of BP target were independent predictors for a lower LDL-C trend. Conclusions The LDL-C trend has improved, but there are still gaps between actual results and clinical targets. Interventions should be planned and targeted at the high-risk populations to control their LDL-C.
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