Mohd Razif Shahril

Healthy eating index and breast cancer risk among Malaysian women

Healthy Eating Index-2005 (HEI-2005), an index-based dietary pattern, has been shown to predict the risk of chronic diseases among Americans. This study aims to examine the ability of HEI-2005 in predicting the probability for risk of premenopausal and postmenopausal breast cancer among Malaysian women. Data from a case–control nutritional epidemiology study among 764 participants including 382 breast cancer cases and 382 healthy women were extracted and scored. Multivariate odds ratios (OR) with 95% confidence intervals (CI) were used to evaluate the relationship between the risk of breast cancer and quartiles (Q) of HEI-2005 total scores and its component, whereas the risk prediction ability of HEI-2005 was investigated using diagnostics analysis. The results of this study showed that there is a significant reduction in the risk of breast cancer, with a higher HEI-2005 total score among premenopausal women (OR Q1 vs. Q4=0.34, 95% CI; 0.15–0.76) and postmenopausal women (OR Q1 vs. Q4=0.20, 95% CI; 0.06–0.63). However, HEI-2005 has a sensitivity of 56–60%, a specificity of 55–60%, and a positive predictive value and negative predictive value of 57–58%, which indicates a moderate ability to predict the risk of breast cancer according to menopausal status. The breast cancer incidence observed poorly agrees with risk outcomes from HEI-2005 as shown by low &kgr; statistics (&kgr;=0.15). In conclusion, although the total HEI-2005 scores were associated with a risk of breast cancer among Malaysian women, the ability of HEI-2005 to predict risk is poor as indicated by the diagnostic analysis. A local index-based dietary pattern, which is disease specific, is required to predict the risk of breast cancer among Malaysian women for early prevention.

Dietary Carbohydrate, Fiber and Sugar and Risk of Breast Cancer According to Menopausal Status in Malaysia

BACKGROUND Dietary carbohydrate, fiber and sugar intake has been shown to play a role in the etiology of breast cancer, but the findings have been inconsistent and limited to developed countries with higher cancer incidence. OBJECTIVE To examine the association of premenopausal and postmenopausal breast cancer risk with dietary carbohydrate, fiber and sugar intake. MATERIALS AND METHODS This population based case-control study was conducted in Malaysia with 382 breast cancer patients and 382 controls. Food intake pattern was assessed via an interviewer-administered food frequency questionnaire. Logistic regression was used to compute odds ratios (OR) with 95% confidence intervals (CI) and a broad range of potential confounders were included in analysis. RESULTS A significant two fold increased risk of breast cancer among premenopausal (OR Q4 to Q1=1.93, 95%CI: 1.53-2.61, p-trend=0.001) and postmenopausal (OR Q4 to Q1=1.87, 95%CI: 1.03-2.61, p-trend=0.045) women was observed in the highest quartile of sugar. A higher intake of dietary fiber was associated with a significantly lower breast cancer risk among both premenopausal (OR Q4 to Q1=0.31, 95%CI: 0.12-0.79, p-trend=0.009) and postmenopausal (OR Q4 to Q1=0.23, 95%CI: 0.07-0.76, p-trend=0.031) women. CONCLUSIONS Sugar and dietary fiber intake were independently related to pre- and postmenopausal breast cancer risk. However, no association was observed for dietary carbohydrate intake.

Measuring the Daily Activity of Lying Down, Sitting, Standing and Stepping of Obese Children Using the ActivPALTM Activity Monitor.

This study describes the patterns of objectively measured sitting, standing and stepping in obese children using the activPALTM and highlights possible differences in sedentary levels and patterns during weekdays and weekends. Sixty-five obese children, aged 9-11 years, were recruited from primary schools in Terengganu, Malaysia. Sitting, standing and stepping were objectively measured using an activPALTM accelerometer over a period of 4-7 days. Obese children spent an average of 69.6% of their day sitting/lying, 19.1% standing and 11.3% stepping. Weekdays and weekends differed significantly in total time spent sitting/lying, standing, stepping, step count, number of sedentary bouts and length of sedentary bouts (p < 0.05, respectively). Obese children spent a large proportion of their time sedentarily, and they spent more time sedentarily during weekends compared with weekdays. This study on sedentary behaviour patterns presents valuable information for designing and implementing strategies to decrease sedentary time among obese children, particularly during weekends.

Association between socioeconomic status and obesity among 12-year-old Malaysian adolescents

The epidemic of obesity in developed countries is commonly associated with poor dietary habit and sedentary lifestyle. However, other determinants, including education background and family income, may contribute towards the problem especially in developing countries. This study aimed to determine the influence of socioeconomic status (SES) on obesity among 12-year-old school adolescents in Terengganu, Malaysia. Body weight and height were measured and BMI was categorised based on WHO z-score cut-off points. Information was obtained from self-reported questionnaire on parents’ education background, family income and occupation. A total of 3,798 school adolescents aged 12 years (44% boys and 56% girls) were recruited. There was no significant difference in BMI status between boys and girls, or between rural and urban participants. There were significant differences between BMI categories and gender, household income and SES level within rural areas. In the urban areas, significant differences were found between BMI categories and gender, parents’ occupational and educational level, household income and size, and SES level. A logistic regression model found several SES factors to be predictors of obesity in this population, namely, gender, household size, father’s occupation level, household income level and SES level. Each component of SES has been significantly associated with the BMI category of school adolescents, particularly in the urban areas. This suggests the requirement of multifaceted approaches, including the role of family, society and authorities, in the effort to curtail adolescent obesity.

Influence of School Location within Districts of Terengganu on Body Weight Status among School Adolescents

Rapid development in the urbanisation process is linked to a shift in dietary intake and lifestyle. The locality may also determine the differences in socio-demographic and environmental factors related to nutrition between the rural and urban populations. The present study aimed to determine prevalence of obesity and to compare the body weight status on body weight status among school adolescents aged 10 to 17 years within districts of Terengganu. A cross sectional survey involving school adolescents aged 10 to 17 years from all government school in seven districts in Terengganu were carried out. Anthropometrics data were obtained from National Fitness Standard (SEGAK) assessment which was uploaded into specific developed database Health Monitoring System (HEMS) and BMI were classified using WHO BMI-for-age zscore. A total of 62,567 school adolescents were involved in this study. Girls had significantly higher BMI than boys in age groups of 13 to 15 and 16 to 17 years old. There were significant differences in mean BMI between rural and urban school locations school adolescents in all age groups (P <0.001) among boys and girls. Significant differences were also found between rural and urban school location in 10 to 12 years old in Dungun and Marang, whilst Kemaman and Kuala Terengganu districts had significant difference between rural and urban in 16 to 17 years old age group. Marang had the highest obesity prevalence within urban 15.3% school location whilst rural school location within Kuala Terengganu had the highest prevalence of obesity (14.1%). The obesity prevalence increased substantially regardless of school locations International Journal of Academic Research in Business and Social Sciences 2017, Vol. 7, No. 6

Data Mining Techniques for Classification of Childhood Obesity Among Year 6 School Children

Today, data mining is broadly applied in many fields, including healthcare and medical fields. Obesity problem among children is one of the issues commonly explored using data mining techniques. In this paper, the classification of childhood obesity among year six school children from two districts in Terengganu, Malaysia is discussed. The data were collected from two main sources; a Standard Kecergasan Fizikal Kebangsaan untuk Murid Sekolah Malaysia/National Physical Fitness Standard for Malaysian School Children (SEGAK) Assessment Program and a set of distributed questionnaire. From the collected data, 4,245 complete data sets were promptly analyzed. The data preprocessing and feature selection were implemented to the data sets. The classification techniques, namely Bayesian Network, Decision Tree, Neural Networks and Support Vector Machine (SVM) were implemented and compared on the data sets. This paper presents the evaluation of several feature selection methods based on different classifiers.