Browsing by Author "Stephen Ambu"
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- PublicationAssociation between dietary patterns and overweight risk among Malaysian adults: evidence from nationally representative surveys(2019)
;Sangeetha Shyam ;Geok-Lin Khor ;Rashidah Ambak ;Balkish Mahadir ;Mohamad Hasnan ;Stephen Ambu ;Wan-Loy ChuTahir ArisObjective: To investigate the association between dietary patterns (DP) and over weight risk in the Malaysian Adult Nutrition Surveys (MANS) of 2003 and 2014. Design: DP were derived from the MANS FFQ using principal component analysis. The cross-sectional association of the derived DP with prevalence of overweight was analysed. Setting: Malaysia. Participants: Nationally representative sample of Malaysian adults from MANS (2003, n 6928; 2014, n 3000). Results: Three major DP were identified for both years. These were ‘Traditional’ (fish, eggs, local cakes), ‘Western’ (fast foods, meat, carbonated beverages) and ‘Mixed’ (ready-to-eat cereals, bread, vegetables). A fourth DP was generated in 2003, ‘Flatbread & Beverages’ (flatbread, creamer, malted beverages), and 2014, ‘Noodles & Meat’ (noodles, meat, eggs). These DP accounted for 25·6 and 26·6 % of DP variations in 2003 and 2014, respectively. For both years, Traditional DP was significantly associated with rural households, lower income, men and Malay ethnicity, while Western DP was associated with younger age and higher income. Mixed DP was positively associated with women and higher income. None of the DP showed positive association with overweight risk, except for reduced adjusted odds of overweight with adherence to Traditional DP in 2003. Conclusions: Overweight could not be attributed to adherence to a single dietary pattern among Malaysian adults. This may be due to the constantly morphing dietary landscape in Malaysia, especially in urban areas, given the ease of availabil ity and relative affordability of multi-ethnic and international foods. Timely surveys are recommended to monitor implications of these changes - PublicationAssociation between long-term exposure to ambient air pollution and prevalence of diabetes mellitus among Malaysian adults(2020)
;Shew Fung Wong ;Poh Sin Yap ;Joon Wah Mak ;Wan Ling Elaine Chan ;Geok Lin Khor ;Stephen Ambu ;Wan Loy Chu ;Maria Safura Mohamad ;Norazizah Ibrahim Wong ;Nur Liana Ab. Majid ;Hamizatul Akmal Abd. Hamid ;Wan Shakira Rodzlan Hasani ;Muhammad Fadhli bin Mohd Yussoff ;Hj. Tahir bin Aris ;Ezahtulsyahreen Bt. Ab. RahmanZaleha Bt. M. RashidBackground: Malaysia has the highest rate of diabetes mellitus (DM) in the Southeast Asian region, and has ongoing air pollution and periodic haze exposure. Methods: Diabetes data were derived from the Malaysian National Health and Morbidity Surveys conducted in 2006, 2011 and 2015. The air pollution data (NO x, NO 2, SO 2, O 3 and PM 10) were obtained from the Department of Environment Malaysia. Using multiple logistic and linear regression models, the association between long-term exposure to these pollutants and prevalence of diabetes among Malaysian adults was evaluated. Results: The PM 10 concentration decreased from 2006 to 2014, followed by an increase in 2015. Levels of NO x decreased while O 3 increased annually. The air pollutant levels based on individual modelled air pollution exposure as measured by the nearest monitoring station were higher than the annual averages of the five pollutants present in the ambient air. The prevalence of overall diabetes increased from 11.4% in 2006 to 21.2% in 2015. The prevalence of known diabetes, underdiagnosed diabetes, overweight and obesity also increased over these years. There were significant positive effect estimates of known diabetes at 1.125 (95% CI, 1.042, 1.213) for PM 10, 1.553 (95% CI, 1.328, 1.816) for O 3, 1.271 (95% CI, 1.088, 1.486) for SO 2 , 1.124 (95% CI, 1.048, 1.207) for NO 2, and 1.087 (95% CI, 1.024, 1.153) for NO x for NHMS 2006. The adjusted annual average levels of PM 10 [1.187 (95% CI, 1.088, 1.294)], O 3 [1.701 (95% CI, 1.387, 2.086)], NO 2 [1.120 (95% CI, 1.026, 1.222)] and NO x [1.110 (95% CI, 1.028, 1.199)] increased significantly from NHMS 2006 to NHMS 2011 for overall diabetes. This was followed by a significant decreasing trend from NHMS 2011 to 2015 [0.911 for NO 2, and 0.910 for NO x]. Conclusion : The findings of this study suggest that long-term exposure to O 3 is an important associated factor of underdiagnosed DM risk in Malaysia. PM 10 NO 2 and NO may have mixed effect estimates towards the risk of DM, and their roles should be further investigated with other interaction models. Policy and intervention measures should be taken to reduce air pollution in Malaysia.