Search results for: dietary behavior

Authors: David Tran, Sina Gallo, Jenny Lin

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The present study investigated two adolescent populations between the ages of 10-14 years of age from two different studies: a dietary assessment validation study conducted at the Georgia 4-H Rock Eagle summer camp (Eatonton, Georgia) and a middle-school diet study at an Alabama middle school (Birmingham, Alabama). Energy intake and meal consumption were recorded via either direct observation of camp lunch or weighing and photography of school lunch trays. Child weight and height were measured to calculate Body Mass Index (BMI) and compared to CDC growth charts to assess percentile or Z-score. Results showed that those participants categorized with higher BMI had a statistically significant and positive correlation with energy intake (kcal). Future research should increase the sample size and include a broader subject size which includes those of a younger childhood population, to assess the effect of age.

Keywords: BMI, adolescent, direct observation, dietary intake

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Authors: Zhidong Zhang, Zhi-Chao Zhang

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This study focuses on early adolescent externalizing behavioral problems which specifically concentrate on rule breaking behavior and aggressive behavior using the instrument of Achenbach System of Empirically Based Assessment (ASEBA). The purpose was to analyze the relationships between the externalizing behavioral problems and relevant background variables such as sports activities, hobbies, chores and the number of close friends. The stratified sampling method was used to collect data from 1975 participants. The results indicated that several background variables as predictors could significantly predict rule breaking behavior and aggressive behavior. Further, a hierarchical modeling method was used to explore the causal relations among background variables, breaking behavior variables and aggressive behavior variables.

Keywords: aggressive behavior, breaking behavior, early adolescence, externalizing problem

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Authors: Eunmi Koh, Bogyoung Choi, Dayeon Ryu, Jee-Yeon Lee, Sungok Kwon, Cho-Il Kim

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Ethyl carbamate(EC) is a probable human carcinogen (Group 2A) found in alcoholic beverages and fermented foods. A total of 351 samples including fermented foods and alcoholic beverages were chosen from 734 foods appeared in the pooled intake data of 2008, 2009, 2010, and 2011 Korea National Health & Nutrition Examination Survey (KNHANES). Sampling was carried out from September 2013 to July 2016 in 18 supermarkets of 9 metropolitan cities in Korea. The samples were pooled, prepared according to various cooking methods, and analyzed. A total of 1245 samples were analyzed using gas chromatograph-mass spectrometer. EC was detected in 13 items (1.0%), which ranged from not-detected to 151 g/kg. Alcoholic beverages (maesilju, whisky, and bokbunjaju) and fermented soy products (soy sauce and soybean paste) were the food items with relatively higher EC levels. Dietary intake of EC in the Korean population was estimated to be 2.11 ng/kg body weight (bw) per day for average population and 8.42 ng/kg bw per day for high consumers (the 97.5th percentile). When the estimated average dietary exposure to EC was compared with the Benchmark Dose Lower Confidence Limit 10% (BMDL10) of 0.3 mg/kg bw per day, margin of exposure (MOE) values of 1420000 to 28000000 were observed. This indicates that there is no health concern for the Korean population.

Keywords: ethyl carbamate, total diet study, dietary exposure, margin of exposure

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Authors: Mohammad Khamoushi, Reza Mirmahdi

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The aim of this research was the effect of sensory integration in reduction of stereotype behaviors in autistic children. The statistical population included 55 children with the age range 2/8 – 14 in Esfahan Ordibehesht autistic center. Purposive sampling was used for selecting the sample group and 20 children with random assignment were designated in two group; experimental and control . Research project was quasi-experimental two-group with pretest and posttest. Data collection tools included repetitive behavior scale-revised with six sub-scales: stereotype behavior, self-injurious behavior, compulsive behavior, ritualistic behavior, sameness behavior, restricted behavior. Analysis of covariance was used for analyzing hypotheses. Result show that sensory integration procedure was effective in reduction of stereotype behavior, compulsive behavior and self-injurious behavior in autistic children. According to the findings, it is suggested that effect sensory integration procedure in stereotype behavior of autism children should be studied and used for treatment of other disabilities of this children.

Keywords: autism, sensory integration procedure, stereotype behavior, compulsive behavior

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Authors: Nasiruddin Khan, Nasser M. Al-Daghri, Dara A. Al-Disi, Asim Al-Fadda, Mohamed Al-Seif, Gyanendra Tripathi, A. L. Harte, Philip G. Mcternan

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For the last few decades, the prevalence of type 2 diabetes mellitus (T2DM) in the Kingdom of Saudi Arabia (KSA) is increasing alarmingly high and is unprecedented at 31.6 %. Preventive measures should be taken to curb down the increasing incidence. In this prospective, 3-month study, we aimed to determine whether dietary modification program would confer favorable affects among overweight and obese adult Saudi women with or without T2DM. A total of 92 Saudi women [18 healthy controls, 24 overweight subjects and 50 overweight or obese patients with early onset T2DM were included in this prospective study. Baseline anthropometrics and fasting blood samples were taken at baseline and after 3 months. Fasting blood sugar and lipid profile were measured routinely. A 500 Kcal deficit energy diet less than their daily recommended dietary allowances were prescribed to all participants. After 3 months of follow-up visit, significant improvements were observed in both the overweight and DMT2 group as compared to baseline with decreased mean BMI [Overweight Group 28.54±1.49 versus 27.95±2.25, p<0.05; DMT2 group 35.24±7.67 versus 35.04±8.07, p<0.05] and hip circumference [Overweight group 109.67±5.01 versus 108.07±4.07, p<0.05; DMT2 group 112.3±13.43 versus 109.21±12.71, p<0.01]. Moreover, in the overweight group, baseline HDL-cholesterol was significantly associated with protein intake and inversely associated with carbohydrate intake in controls. In the DMT2 group, carbohydrate intake at baseline was significantly associated with BMI. A 3-month 500kcal/day deficit dietary modification alone is probably effective among adult overweight or obese Saudi females without or with T2DM. Longer prospective studies are to determine whether the dietary intervention alone can reduce progression of T2DM among high-risk adult Arabs.

Keywords: diet, lipid, obesity, T2DM

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Authors: Muntanavadee Maytapattana

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This research aims to study the effects of the Parent Training Program for Obesity Reduction (PTPOR) on child waist circumference and health behaviors of pre-school children at the Samut-Songkhram kindergarten school, Samut-Songkhram province, Thailand. The objective of this research is to evaluate the effectiveness of the PTPOR on child waist circumference and health behaviors of the pre-school children. The conceptual framework of this study is developed on the basis of the Ecological Systems Theory (EST), not only do the individual factors such as child characteristics and child risk factors contribute to the child’s weight status, but also other factors such as parenting style and family characteristics, as well as community and demographic factors. This research is a quasi-experimental study. Participants were pre-school overweight and obese children and their parents. Forty-one parent-child dyads were recruited into the program. Parents participated in two sessions including an educational session and a group discussion session. Research methodology uses Paired-Samples t-test to determine the difference between groups in the mean scores of the outcome variables of the children and parents. The research results show that there was significant difference between child waist circumferences mean score at the baseline and finishing the program at the 0.01 level (p = 0.001), mean score of the child waist circumference was decrease after finishing the program. And there was no significant difference between child exercise health behaviors mean score at the baseline and finishing the program at the 0.05 level; however, mean score of the child exercise behavior was increase after finishing the program. Meanwhile, there was significant difference between child dietary health behavior mean score at the baseline and finishing the program at the 0.01 level (p = 0.001), mean score of the child dietary was increase after finishing the program.

Keywords: PTPOR, child waist circumference, child health behaviors, pre-school children

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Authors: Tagel Gebrehiwot, Carolina Castilla

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Food insecurity and child malnutrition are among the most critical issues in Ethiopia. Accordingly, different reform programs have been carried to improve household food security. The Food Security Program (FSP) (among others) was introduced to combat the persistent food insecurity problem in the country. The FSP combines a safety net component called the Productive Safety Net Program (PSNP) started in 2005. The goal of PSNP is to offer multi-annual transfers, such as food, cash or a combination of both to chronically food insecure households to break the cycle of food aid. Food or cash transfers are the main elements of PSNP. The case for cash transfers builds on the Sen’s analysis of ‘entitlement to food’, where he argues that restoring access to food by improving demand is a more effective and sustainable response to food insecurity than food aid. Cash-based schemes offer a greater choice of use of the transfer and can allow a greater diversity of food choice. It has been proven that dietary diversity is positively associated with the key pillars of food security. Thus, dietary diversity is considered as a measure of household’s capacity to access a variety of food groups. Studies of dietary diversity among Ethiopian rural households are somewhat rare and there is still a dearth of evidence on the impact of PSNP on household dietary diversity. In this paper, we examine the impact of the Ethiopia’s PSNP on household dietary diversity and child nutrition using panel household surveys. We employed different methodologies for identification. We exploit the exogenous increase in kebeles’ PSNP budget to identify the effect of the change in the amount of money households received in transfers between 2012 and 2014 on the change in dietary diversity. We use three different approaches to identify this effect: two-stage least squares, reduced form IV, and generalized propensity score matching using a continuous treatment. The results indicate the increase in PSNP transfers between 2012 and 2014 had no effect on household dietary diversity. Estimates for different household dietary indicators reveal that the effect of the change in the cash transfer received by the household is statistically and economically insignificant. This finding is robust to different identification strategies and the inclusion of control variables that determine eligibility to become a PSNP beneficiary. To identify the effect of PSNP participation on children height-for-age and stunting we use a difference-in-difference approach. We use children between 2 and 5 in 2012 as a baseline because by then they have achieved long-term failure to grow. The treatment group comprises children ages 2 to 5 in 2014 in PSNP participant households. While changes in height-for-age take time, two years of additional transfers among children who were not born or under the age of 2-3 in 2012 have the potential to make a considerable impact on reducing the prevalence of stunting. The results indicate that participation in PSNP had no effect on child nutrition measured as height-for-age or probability of beings stunted, suggesting that PSNP should be designed in a more nutrition-sensitive way.

Keywords: continuous treatment, dietary diversity, impact, nutrition security

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Authors: Amelia Tero-Vescan, Camil-Eugen Vari, Laura Ciulea, Cristina Filip, Silvia Imre

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A HPLC –UV method for the identification of ephedrine (EPH), sibutramine (SB), yohimbine (Y) and caffeine (CF) was developed. Separation was performed on a Kromasil 100-RP8, 150 mm x 4.6 mm, 5 mm column equipped with a precolumn Kromasil RP 8. Mobile phase was a gradient of 80-35 % sodium dihydrogen phosphate pH=5 with NH4OH and acetonitrile over 15 minutes time of analysis. Based on the responses of 113 athletes about dietary supplements (DS) consumed for "fat burning" and weight loss which have a legal status in Romania, 28 supplements have been selected and investigated for their content in CF, Y, legal substances, and SB, EPH (prohibited substances in DS). The method allows quantitative determination of the four substances in a short analysis time and with minimum cost. The presence of SB and EPH in the analyzed DS was not detected while the content in CF and Y considering the dosage recommended by the manufacturer does not affect the health of the consumers. DS labeling (plant extracts with CF and Y content) allows manufacturers to avoid declaring correct and exact amounts per pharmaceutical form (pure CF or equivalent and Y, respectively).

Keywords: dietary supplements, sibutramine, ephedrine, yohimbine, caffeine, HPLC

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Authors: Mardiana Madjid, Nurpudji Astuti Taslim, Suryani As'ad, Haerani Rasyid, Agussalim Bukhari

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The high level of Urine Urea Nitrogen (UUN) indicates hypercatabolism occurs in hospitalized patients. High levels of Total Lymphocyte Count (TLC) indicates the immune system condition, adequate wound healing, and limit complication. Adequate dietary intake affects to decrease of hypercatabolism status in treated patient’s hospitals. Nitrogen Balance (NB) is simply the difference between nitrogen (N₂) intake and output. If more N₂ intake than output, then positive NB or anabolic will occur. This study aims to evaluate the effect of dietary intake in influencing balance nitrogen and total lymphocyte count. Method: A total of 43 patients admitted to a Wahidin Sudirohusodo Hospital between 2018 and 2019 for 10 days' treats are included. The inclusion criteria were patients who were treated for 10 days and receives food from the hospital orally. Patients did not experience gastrointestinal disorders such as vomiting and diarrhea and experience impair kidney function and liver function and expressed approval to participate in this study. During hospitalization, food intake, UUN, albumin serum, balance nitrogen, and TLC was assessed twice on day 1 and day 10. There is no Physician Clinical Nutritional intervention to correct food intake. UUN is 24 hours of urine collected on the second day after admission and the tenth day. Statistical analysis uses SPSS 24 with observational cohort methods. Result: The Forty-three participants completed the follow-up (27 men and 18 women). The age of fewer than 4 years is 22 people, 45 to 60 years is 16 people, and over 60 years is 4 people. The result of the study on day 1 obtained SGA score A, SGA score B, SGA score C are 8, 32, 3 until day 10 are 8, 31, 4, respectively. According to 24h dietary recalls, the energy intake during observation was from 522.5 ± 400.4 to 1011.9 ± 545.1 kcal/day P < 0.05, protein intake from 20.07 ± 17.2 to 40.3 ± 27.3 g/day P < 0.05, carbohydrates from 92.5 ± 71.6 to 184.8 ± 87.4 g/day, and fat from 5.5 ± 3.86 to 13.9 ± 13.9 g/day. The UUN during the observation was from 6.6 ± 7.3 to 5.5 ± 3.9 g/day, TLC decreased from 1622.9 ± 897.2 to 1319.9 ± 636.3/mm³ value target 1800/mm³, albumin serum from 3.07 ± 0.76 to 2.9 ± 0.57 g/day, and BN from -7.5 ± 7.2 to -3.1 ± 4.86. Conclusion: The high level of UUN needs to correct adequate dietary intake to improve NB and TLC status on hospitalized patients.

Keywords: adequate dietary intake, balance nitrogen, total lymphocyte count, urine urea nitrogen

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Authors: Marlene Yu Lilin Wätzold, Wisnu Harto Adiwijoyo, Meike Wollni

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Land-use conversion from tropical forests to cash crop production in the form of monocultures has drastic consequences for biodiversity. Meanwhile, high dependence on cash crop production is often associated with a decrease in other food crop production, thereby affecting household dietary diversity. Additionally, deforestation rates have been found to reduce households’ dietary diversity, as forests often offer various food sources. Agroforestry systems are seen as a potential solution to improve local biodiversity as well as provide a range of provisioning ecosystem services, such as timber and other food crops. While a number of studies have analyzed the effects of agroforestry on biodiversity, as well as household livelihood indicators, little is understood between potential trade-offs or synergies between the two. This interdisciplinary study aims to fill this gap by assessing cacao agroforestry’s role in enhancing local bird diversity, as well as farm household dietary diversity. Additionally, we will take a landscape perspective and investigate in what ways the landscape composition, such as the proximity to forests and forest patches, are able to contribute to the local bird diversity, as well as households’ dietary diversity. Our study will take place in two agro-ecological zones in Ghana, based on household surveys of 500 cacao farm households. Using a subsample of 120 cacao plots, we will assess the degree of shade tree diversity and density using drone flights and a computer vision tree detection algorithm. Bird density and diversity will be assessed using sound recordings that will be kept in the cacao plots for 24 hours. Landscape compositions will be assessed via remote sensing images. The results of our study are of high importance as they will allow us to understand the effects of agroforestry and landscape composition in improving simultaneous ecosystem services.

Keywords: agroforestry, biodiversity, landscape composition, nutrition

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Authors: Zahra Esmaeily, Zahra Tajari, Shahrzad Daei, Mahshid Rezaei, Atefeh Eyvazkhani, Marjan Mansouri Dara, Ahmad Reza Dorosty Motlagh, Andriko Palmowski

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Objective: Sarcopenia (SPA) is associated with frailty and disability in the elderly. Adherence to current dietary guidelines in addition to physical activity could play a role in the prevention of muscle wasting and weakness. The Healthy Eating Index-2015 (HEI) is a tool to assess diet quality as recommended in the U.S. Dietary Guidelines for Americans. This study aimed to investigate whether there is a relationship between HEI scores and the probability of SPA (PS) among the Tehran elderly. Method: A previously validated semi-quantitative food frequency questionnaire was used to assess HEI and the dietary intake of randomly selected elderly people living in Tehran, Iran. Handgrip strength (HGS) was measured to evaluate the PS. Statistical evaluation included descriptive analysis and standard test procedures. Result: 201 subjects were included. Those probably suffering from SPA (as determined by HGS) had significantly lower HEI scores (p = 0.02). After adjusting for confounders, HEI scores and HGS were still significantly associated (adjusted R2 = 0.56, slope β = 0.03, P = 0.09). Elderly people with a low probability of SPA consumed more monounsaturated and polyunsaturated fatty acids (P = 0.06) and ingested less added sugars and saturated fats (P = 0.01 and P = 0.02, respectively). Conclusion: In this cross-sectional study, HEI scores are associated with the probability of SPA. Adhering to current dietary guidelines might contribute to ameliorating muscle strength and mass in aging individuals.

Keywords: aging, HEI-2015, Iranian, sarcopenic

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Authors: Rani Abro, Ali Ata Moazzami, Jan Erik Lindberg, Torbjörn Lundh

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The effect of dietary starch level on liver metabolism in Arctic charr (Salvelinus alpinus) and tilapia (Oreochromis mossambicus) was studied using 1H-NMR based metabolomics. Fingerlings were fed iso-nitrogenous diets containing 0, 10 and 20 % starch for two months before liver samples were collected for metabolite analysis. Metabolite profiling was performed using 600 MHz NMR Chenomx software. In total, 48 metabolites were profiled in liver extracts from both fish species. Following the profiling, principal component analysis (PCA) and orthogonal partial least square discriminant analysis (OPLC-DA) were performed. These revealed that differences in the concentration of significant metabolites were correlated to the dietary starch level in both species. The most prominent difference in metabolic response to starch feeding between the omnivorous tilapia and the carnivorous Arctic charr was an indication of higher anaerobic metabolism in Arctic charr. The data also indicated that amino acid and pyrimidine metabolism was higher in Artic charr than in tilapia.

Keywords: arctic charr, metabolomics, starch, tilapia

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Authors: Olufemi Samuel Shola, Oladapo Adenike Adesola

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Inadequate dietary intake has increased the susceptibility of under five children to malnutrition and infections. This study, therefore, assessed the feeding practices of children of 0-23 months of age among mothers in urban areas of Akure, Ondo State, Nigeria. Simple random sampling technique was used to select four hundred (400) mothers out of 710 mothers from 7 primary health care centres in Akure metropolis for the study. Data were collected using modified WHO 2003 Questionnaire on child feeding practices. Data were analyzed using descriptive statistics, while chi-square was used to determine the association between variables. Results showed that 52.0% of the children were males, with 47.5% in the 6-8 months age group. More than half (57.0%) of the mothers were between the ages of 20-29 years, and 45.0% had secondary education. Majority (94.3%) of the mothers breastfed their children in the last 24 hours preceding the survey. The feeding practices history of mothers showed that 28.0% and 53.7% of the mothers initiated breastfeeding less than 30 minutes and between 30 minutes to 1 hour after delivery, respectively. Also, 52.0% of mothers practiced exclusive breastfeeding for six months, while 26.2% breastfed from 6 months up to 2 years of age. Dietary diversity of the children age 6-23 months revealed that 68.7% of the children attained the minimum dietary diversity by consuming 4 or more food groups in the last 24 hours. There was a significant association (P < 0.05) between mothers’ education (n=180), occupation(n=41) and dietary diversity (n= 150) and meal frequency (n=209). Therefore, the study concluded that the duration of breastfeeding and time of introduction of complementary food did not meet WHO recommended guidelines. There is urgent need to launching more programmes.

Keywords: breastfeeding, mothers, child feeding, urban areas, ondo state, nigeria

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Authors: T. Vijay Bhasker, N. K. S Gowda, P. Krishnamoorthy, D. T. Pal, A. K. Pattanaik, A. K. Verma

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Boron (B) is a newer trace element and its biological importance and dietary essentiality is unclear in animals. The available literature suggests its putative role in bone mineralization, antioxidant status and steroid hormone synthesis. A feeding trial was conducted in Wister strain (Rattus norvegicus) albino rats for duration of 90 days. A total of 84 healthy weaned (3-4 weeks) experimental rats were randomly divided into 7 dietary groups (4 replicates of three each) viz., A (Basal diet/ Control), B (Basal diet + 5 ppm B), C (Basal diet + 10 ppm B), D (Basal diet + 20 ppm B), E (Basal diet + 40 ppm B), F (Basal diet-Ca 50%), G (Basal diet-Ca 50% + 40 ppm B). Dietary level of calcium (Ca) was maintained at two levels, 100% and 50% of requirement. Sodium borate was used as source of boron along with other ingredients of basal diet while preparing the pelletized diets. All the rats were kept in proper ventilated laboratory animal house maintained at temperature (23±2º C) and humidity (50 to 70%). At the end of experiment digestibility trial was conducted for 5 days to estimate nutrient digestibility and gut absorption of minerals. Eight rats from each group were sacrificed to collect the vital organs (liver, kidney and spleen) to study histopathology. Blood sample was drawn by heart puncture to determine biochemical profile. The average daily feed intake (g/rat/day), water intake (ml/rat/day) and body weight gain (g/rat/day) were similar among the dietary groups. The digestibility (%) of organic matter and crude fat were significantly improved (P < 0.05) was by B supplementation. The gut absorption (%) Ca was significantly increased (P < 0.01) in B supplemented groups compared to control. However, digestibility of dry matter and crude protein, gut absorption of magnesium and phosphorus showed a non-significant increasing trend with B supplementation. The gut absorption (%) of B (P < 0.01) was significantly lowered (P<0.05) in supplemented groups compared to un-supplemented ones. The serum level of triglycerides (mg/dL), HDL-cholesterol (mg/dL) and alanine transaminase (IU/L) were significantly lowered (P < 0.05) in B supplemented groups. While serum level of glucose (mg/dL) and alkaline phosphatase (KA units) showed a non-significant decreasing trend with B supplementation. However the serum levels of total cholesterol (mg/dL) and aspartate transaminase (IU/L) were similar among dietary groups. The histology sections of kidney and spleen revealed no significant changes among the dietary groups and were observed to be normal in anatomical architecture. However, the liver histology revealed cell degenerative changes with vacuolar degeneration and nuclear condensation in Ca deficient groups. But the comparative degenerative changes were mild in 40 ppm B supplemented Ca deficient group. In conclusion, dietary supplementation of graded levels of boron in rats had a positive effect on metabolism and health by improving nutrient digestibility and gut absorption of Ca. This indicates the beneficial role of dietary boron supplementation.

Keywords: boron, calcium, nutrient utilization, histopathology

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Authors: Justina Ijeoma Ezebuwa, Catherine C. Ikewuchi, Eka B. Essien, Francis C. Anacletus

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Iron deficiency anemia (IDA) is a significant problem in Nigeria, especially in children under five. Intervention options for treating anemia in under-five children have also been the subject of research. This study aims to synthesize the evidence on dietary interventions for managing iron deficiency anemia in under-five children in Nigeria. This study uses a systematic review method to collect relevant studies to answer the research questions and a narrative synthesis to analyze and synthesize the findings of this study. Cochrane, PubMed, and ScienceDirect databases were thoroughly searched, and five (5) articles were selected for this study. The results show that dietary interventions, such as daily multi-nutrient fortified dairy-based drinks, biofortified (yellow/ white) cassava rich in pro-vitamin A, iron supplementation in foods, and ready-to-use therapeutic food (RUTF) may be relevant to the management of iron deficiency anemia in under-five children in Nigeria. The study also shows that daily multi-nutrient fortified dairy-based drinks may be more effective, feasible, and culturally acceptable for managing anemia in under-5 children in Nigeria. In addition, daily multi-nutrient fortified dairy-based drinks and ready-to-use therapeutic food (RUTF) were reported to have the potential to improve the growth, cognitive development, and overall health outcomes of under-five children with iron deficiency anemia in Nigeria. Recommendations for future studies in this research area and for public health practitioners and policymakers were provided.

Keywords: dietary intervention, iron deficiency anemia, under-five children, Nigeria

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Authors: Cristian Baldini

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‘Diabesity’ is a term for diabetes occurring in the context of obesity. The positive effect of LCHF diets (low-carb, high-fat diets) is well documented: LCHF diets are at least as effective as other dietary strategies for reducing body weight, improving glycaemic control, and reducing both hyperinsulinaemia and blood glucose (reduction of HbA1c) in type 2 diabetes and have unique positive effects on blood lipid concentrations and cardiovascular risk factors. Also, in obese insulin-resistant women, food fried in extra-virgin olive oil significantly reduced both insulin and C-peptide responses after a meal. This case study shows that if combined, both dietary strategies produce a strong effect on blood glucose, resulting in a “forced” reduction of exogenous insulin injection to avoid the problem of hypoglycaemia. Blood tests after three months of this dietary treatment show how HbA1c, triglycerides, and blood lipid profile (LDL, HDL, Total Cholesterol) are improved despite the reduction of exogenous insulin injection of 80% with a parallel body weight decrease of 15%. For continuous glucose monitoring (CGM), the patient used FreeStyle Libre before and after the dietary treatment. In order to check general body functions and glycosuria, the patient used the urine test Multistix 10 SG Siemens.

Keywords: diabetes, obesity, diabesity, fat, fried foods

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Authors: R. B. B. Samantha Ramachandra, L. D. J. Upul Senarath, S. H. Padmal De Silva

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Dietary pattern largely differs over countries and even within a country, it shows cultural differences. The dietary pattern changes the energy consumption and micronutrient intake, directly affects the pregnancy outcome. The dietary diversity was used as an indirect measure to assess micronutrient adequacy for pregnant mothers in this study. The study was conducted as a baseline survey with the objective of designing an intervention to improve the dietary diversity of pregnant mothers in Sri Lanka. The survey was conducted in Kalutara district of Sri Lanka in 2015 among 769 pregnant mothers at different gestational ages. Dietary diversity questionnaire developed by Food and Agricultural Organization’s (FAO) Food and Nutrition technical Assistance (FANTA) II project, recommended for cross-country use with adaptations was used for data collection. Trained data collectors met pregnant mothers at field ante-natal clinic and questioned on last 24hr dietary recall with portion size and coded food items to identify the diversity. Pregnant mothers were identified from randomly selected 21 clusters of public health midwife areas. 81.5% mothers (n=627) in the sample had been registered at Public Health Midwife (PHM) before 8 weeks of gestation. 24.4% of mothers were with low starting BMI and 22.7% mothers were with high starting BMI. 47.6% (n=388) mothers had abstained from at least one food item during the pregnancy. The food group with the highest consumption was rice (98.4%) followed by sugar (89.9%). 76.1% mothers had consumed milk, 73% consumed fish and sea foods. Consumption of green leaves was 52% and Vit A rich foods consumed only by 49% mothers. Animal organs, flesh meat and egg all showed low prevalence as 4.7%, 21.6% and 20% respectively. Consumption of locally grown roots, nut, legumes all showed very low prevalence. Consumption of 6 or more food groups was considered as good dietary diversity (DD), 4 to 5 food groups as moderate diversity and 3 or less food groups as poor diversity by FAO FANTA II project. 42.1% mothers demonstrated good DD while another 42.1% recorded moderate diversity. Working mothers showed better DD (51.6%, n=82/159) compared to housewives in the sample (chi = 10.656a,. df=2, p=0.005). The good DD showed gradual improvement from 43.1% to 55.5% along the poorest to richest wealth index (Chi=48.045, df=8 and p=0.000). DD showed significant association with the ethnicity and Moors showed the lowest DD. DD showed no association with the home gardening even though where better diversity expected among those who have home gardening (p=0.548). Sri Lanka is a country where many food items can be grown in the garden and semi-urban setting have adequate space for gardening. Many Sri Lankan mothers do not add homegrown items in their meal. At the same time, their consumption of animal food shows low prevalence. The DD of most of the mothers being either moderate or low (58%) may result from inadequate micro nutrient intake during pregnancy. It is recommended that adding green leaves, locally grown vegetables, roots, nuts and legumes can help increasing the DD of Sri Lankan mothers at low cost.

Keywords: dietary diversity, pregnant mothers, micro-nutrient, food groups

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Authors: Maryam Ghavam Sadri, Kimia Moiniafshari

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Objectives: The prevalence of Autism in the world has taken on a growing trend. Autism is a neuro-developmental disorder that is identified at the age of three. Studies have been shown that nutritional management can control nutritional deficiencies in Autism. This review study aimed to assess the role of nutritional management strategies for Autism in children has been made. Methods: This review study was accomplished by using the keywords related to the topic, 68 articles were found (2000-2015) and finally 15 articles with criteria such as including dietary pattern, nutritional deficiencies and Autism controlling were selected. Results: The studies showed that intake of vitamins D, E, and calcium because of restricted diet (casein and gluten free) in autistic children is less than typically developing children (TYP) (p value ≤ 0.001) and as a result of restrictions on the consumption of fresh fruits and vegetables, vitamin C and magnesium intake is less than TYP children (p value ≤ 0.001). Autistic children also get omega-3 less than TYP children. Studies have shown that food sources rich in omega-3 can improve behavioral indicators, especially in reducing hyperactivity (95% CI = -2.2 - 5.2). Zinc deficiency in these children leads to a high serum level of mercury, lead and cadmium. As a result of the repetitive dietary pattern, Sodium intake in autistic children is more than TYP children (p value < 0.001).Because of low food variety in autistic children, healthy eating index (HEI) is less than TYP children (p value = 0.008).Food selectivity in Autism due to repetitive and restricted dietary pattern and nutritional deficiencies. Conclusion: Because of restricted (casein and gluten free) and repetitive dietary pattern, the intake of some micronutrients are denied in autistic children. The nutritional strategy programs appear to help controlling of Autism.

Keywords: autism, food selectivity, nutrient intake, nutritional strategies

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Authors: Vaishali P. Joshi, Pallav Joshi

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The objective of this study is to examine the differences fashion innovators and non-fashion innovators in their fashion consumption behavior in terms of their pre-purchase behavior, purchase behavior and post purchase behavior. The questionnaire was distributed to a female college student for data collection for achieving the objective of the first part of the study. Question-related to fashion innovativeness and fashion consumption behavior was asked. The sample was comprised of 81 college females ages 18 through 30 who were attending Business Management degree. A series of attitude questions was used to categorize respondents on the Innovativeness Scale. 32 respondents with a score of 21 and above were designated as Fashion innovators and the remainder (49) as Non-fashion innovators. Findings showed that there exist significant differences between innovators and non-innovators in their fashion consumption behavior. Data was analyzed through frequency distribution table. Many differences were found in the behavior of innovators and non-innovators in terms of their pre-purchase, actual purchase, and post-purchase behavior.

Keywords: fashion, innovativeness, consumption behavior, purchase

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Authors: A. F. Agboola, B. R. O. Omidiwura, A. Oyeyemi, E. A. Iyayi, A. S. Adelani

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Dietary cholesterol has elicited the most public interest as it relates with coronary heart disease. Thus, humans have been paying more attention to health, thereby reducing consumption of cholesterol enriched food. Egg is considered as one of the major sources of human dietary cholesterol. However, an alternative way to reduce the potential cholesterolemic effect of eggs is to modify the fatty acid composition of the yolk. The effect of palm oil (PO), soybean oil (SO), sesame seed oil (SSO) and fish oil (FO) supplementation in the diets of layers on egg yolk fatty acid, cholesterol, egg production and egg quality parameters were evaluated in a 42-day feeding trial. One hundred and five Isa Brown laying hens of 34 weeks of age were randomly distributed into seven groups of five replicates and three birds per replicate in a completely randomized design. Seven corn-soybean basal diets (BD) were formulated: BD+No oil (T1), BD+1.5% PO (T2), BD+1.5% SO (T3), BD+1.5% SSO (T4), BD+1.5% FO (T5), BD+0.75% SO+0.75% FO (T6) and BD+0.75% SSO+0.75% FO (T7). Five eggs were randomly sampled at day 42 from each replicate to assay for the cholesterol, fatty acid profile of egg yolk and egg quality assessment. Results showed that there were no significant (P>0.05) differences observed in production performance, egg cholesterol and egg quality parameters except for yolk height, albumen height, yolk index, egg shape index, haugh unit, and yolk colour. There were no significant differences (P>0.05) observed in total cholesterol, high density lipoprotein and low density lipoprotein levels of egg yolk across the treatments. However, diets had effect (P<0.05) on TAG (triacylglycerol) and VLDL (very low density lipoprotein) of the egg yolk. The highest TAG (603.78 mg/dl) and VLDL values (120.76 mg/dl) were recorded in eggs of hens on T4 (1.5% sesame seed oil) and was similar to those on T3 (1.5% soybean oil), T5 (1.5% fish oil) and T6 (0.75% soybean oil + 0.75% fish oil). However, results revealed a significant (P<0.05) variations on eggs’ summation of polyunsaturated fatty acid (PUFA). In conclusion, it is suggested that dietary oils could be included in layers’ diets to produce designer eggs low in cholesterol and high in PUFA especially omega-3 fatty acids.

Keywords: dietary oils, egg cholesterol, egg fatty acid profile, egg quality parameters

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Authors: Khalid Ahmed Abdoun, Mohamed Abdulwahid Alsoufi, Ibrahim Abdullah Alhidary

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The intention of this study was to evaluate the effect of dietary Cr supplementation on haematological parameters in camel calves reared under hot summer conditions. Fifteen male camel calves (5 – 6 months old) were randomly allotted to three dietary treatments (n = 5) for a period of 84 days. Camel calves were fed ad libitum on basal diet without Cr supplementation (control), basal diet supplemented with 0.5 mg Cr/kg DM (Cr 0.5) or basal diet supplemented with 1.0 mg Cr/kg DM (Cr 1.0). During this, blood samples were collected every four weeks for hematological examination. The obtained results revealed that dietary Cr supplementation to camel calves reared under hot summer did not show significant effects (P> 0.05) on hematological variables. However, the neutrophil to lymphocytes ratio (N: L ratio) was significantly (P < 0.05) reduced in camel calves fed on diets supplemented with chromium. In conclusion, Chromium supplementation to the diet of camel calves did not show any significant effects on hematological variables. Whereas, the neutrophil to lymphocytes ratio (N: L ratio) was reduced in camel calves fed diets supplemented with chromium.

Keywords: camel calves, chromium, haematological, immune response

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Authors: Allioua Meryem

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Similar to much of the developing world, Algeria is currently undergoing an epidemiological transition. While mal- and under-nutrition and infectious diseases used to be the main causes of poor health, today there is a higher proportion of chronic, non-communicable diseases (NCDs), including cardiovascular disease, diabetes mellitus, cancer, etc. According to estimates for Algeria from the World Health Organization (WHO), NCDs accounted for 63% of all deaths in 2010. The objective of this study was the assessment of eating habits and anthropometric characteristics in a group of youth aged 15 to 19 years in Tlemcen. This study was conducted on a total effective of 806 youth enrolled in a descriptive cross-sectional study; the classification of nutritional status has been established by international standards IOTF, youth were defined as obese if they had a BMI ≥ 95th percentile, and youth with 85th ≤ BMI ≤ 95th percentile were defined as overweight. Wc is classified by the criteria HD, Wc with moderate risk ≥ 90th percentile and Wc with high risk ≥ 95th percentile. The dietary assessment was based on a 24-hour dietary recall assisted by food records. USDA’S nutrient database for Nutrinux® program was used to analyze dietary intake. Nutrients adequacy ratio was calculated by dividing daily individual intake to dietary recommended intake DRI for each nutrient. 9% of the population was overweight, 3% was obese, 7.5% had abdominal obesity, foods eaten in moderation are chips, cookies, chocolate 1-3 times/day and increased consumption of fried foods in the week, almost half of youth consume sugary drinks more than 3 times per week, we observe a decreased intake of energy, protein (P < 0.001, P = 0.003), SFA (P = 0.018), the NAR of phosphorus, iron, magnesium, vitamin B6, vitamin E, folate, niacin, and thiamin reflecting less consumption of fruit, vegetables, milk, and milk products. Youth surveyed have eating habits at risk of developing obesity and chronic disease.

Keywords: food intake, health, anthropometric characteristics, Algeria

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Authors: Zeiler M., Stadler D., Schmaderer C.

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Over the years of dialysis treatment, most patients experience significant weight loss. The primary emphasis in earlier research was the underlying mechanism of protein energy wasting and the subsequent malnutrition inflammation syndrome. In the interest to provide an effective and rapid solution for the patients, the aim of this study is identifying individual influences of their assumed reduced dietary intake, such as nausea, appetite loss and taste changes, and to determine whether the patients adhere to their nutrition guidelines. A prospective, controlled study with 38 end-stage renal disease patients was performed using a questionnaire to reflect their diet within the last 12 months. Thereby, the daily intake for the most important macro-and micronutrients was calculated to be compared with the individual KDQOI-guideline value, as well as controls matched in age and gender. The majority of the study population did not report symptoms commonly associated with dialysis, such as nausea or inappetence, and denied any change in dietary behavior since receiving renal replacement therapy. The patients’ daily intake of energy (3080kcal ± 1266) and protein (89,9g [53,4-142,0]) did not differ significantly from the controls (energy intake: 3233kcal ± 1046, p=0,597; protein intake: 103,7g [90,1-125,5], p=0,120). The average difference to the individual calculated KDQOI-guideline was +176,0kcal ± 1156 (p=0,357) for energy intake and -1,75g ± 45,9 (p=0,491) for protein intake. However, there was an observed imbalance in the distribution of macronutrients, with a preference for fats over proteins. The patients’ daily intake of sodium (5,4g [ 2,95-10,1]) was higher than in the controls (4,1g [2,04-5,99], p= 0,058) whereas both values for potassium (3,7g ± 1,84) and phosphorous (1,79g ± 0,91) went significantly below the controls’ values (potassium intake: 4,89g ± 1,74, p=0,014; phosphorous intake: 2,04g ± 0,64, p=0,038). Thus, the values exceeded the calculated KDQOI-recommendation by + 3,3g [0,63-7,90] (p<0,001) for sodium, +1,49g ± 1,84 (p<0,001) for potassium and +0,89g ± 0,91 (p<0,001) for phosphorous. Contrary to the assumption, the patients did not under-eat. Nevertheless, their diets did not align with the recommended values. These findings highlight the need for intervention and education among patients and that regular dietary monitoring could prevent unhealthy nutrition habits. The elaboration of individual references instead of standardized guidelines could increase the compliance to the advised diet so that interdisciplinary comorbidities do not develop or worsen.

Keywords: compliance, dialysis, end-stage renal disease, KDQOI, malnutrition, nutrition guidelines, questionnaire, salt intake

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Authors: Muhammad Atif Randhawa, Adnan Amjad

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Assessment of insecticides used for growing vegetables in comparison with their safety status was the main purpose of this study. A total of 180 samples of okra (Abelmoschus esculentus L.) and brinjal (Solanum melongena L.) comprising 30 samples of each vegetable were collected from the peri-urban farming system of Multan, Faisalabad and Gujranwala. The mean value for imidacloprid residues found in brinjal (0.226 mg kg-1) and okra (0.176 mg kg-1) from Multan region were greater than the residues reported from Gujranwala and Faisalabad, showing excessive application of imidacloprid in Multan. Out of total 180 samples analysed for imidacloprid and acetamaprid residues, (90 samples for each of okra and brinjal), 104 (58%) and 117 (65%) samples contained detectable imidacloprid and acetamiprid residues, respectively. Whereas 10% and 15% samples exceeded their respective MRLs for imidacloprid and acetamiprid residues. Dietary intake assessment for imidacloprid and acetamiprid was calculated according to their MPI values 3.84 and 4.48 mg person-1day-1, respectively. The dietary intake assessment data revealed that although a reasonable proportion of samples exceeded the MRLs in studied areas but their consumption was found within safe limit in comparison to values obtained for MPI.

Keywords: Acceptable Daily Intake (ADI), insecticides, Maximum Residual Limits (MRLs), risk assessment, vegetables

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Authors: G. S. Sumanasekara, A. Balasuriya

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Introduction: In Sri Lanka studies reveal higher trend in prevalence of diabetes. The office employees have sedentary life style and their eating patterns changed due to nutritional transition. Further overall, urban and rural pre diabetes is also increasing. Objectives - Study the general food pattern of office employees and its relation to overweight/obesity and prevalence of diabetes among them. Method: The data was collected from office employees between 30-60 years (n-400).Data analyzed using SPSS 16 version.The Study design was a descriptive cross sectional study. The study setting was Ministry of Economic Development. Anthropometric measurements and blood glucose assessed by trained nurses. Dietary pattern was studied through a food frequency questionairre thereby calculated daily nutrient intakes. Results: Mean age of office employees were 38.98 SD (7.033) CI=95%) and 245 females (61.2%) 155 males (38.8 %) ,Nationality includes Sinhala (67.5%), Tamil(20%), and Muslims (12.5%).Owerweight(7,1.8%), obese male(36,9%), obese female(66,16%)/ diabetes/obese(18,4.5%) out of 127(31.8%) who were above the normal BMI whereas 273(68.2) were within the normal. Mean BMI was 24.1593.Mean Blood sugar level was 104.646,SD(16.018).12% consume tobacco products,17.8 consumed alcohol.15.8% had nutrition training. Two main dietary patterns identified who were vegetarians and non vegetarians .Mean energy intake 1727.1, (SD 4.97), Mean protein consumption(11.33, SD 1.811), Mean fat consumption(24.07, SD 4.131),Mean CHO consumption (64.56, SD 4.54), Mean Fibre (30.05, SD 17.9), Mean cholesterol(16.85, SD 17.22), Energy intake was higher in non vegetarians and larger propotion of energy derived from proteins , and fat. Their carbohydrate and cholesterol intake was also higher. Tamils were mostly vegetarians. Mainly BMI were within normal range(18.5-23.5) whereas Muslims who had higher energy intakes showed BMI above the normal. Conclusion: Two distinct dietary patterns identified. Different ethnic groups consume different diets with different nutrient composition. Dietary pattern has a relation to overweight. Overweight related to high blood glucose levels but some overweight subjects do not show any relation.

Keywords: obesity, overweight, diabetes, dietary pattern, nutrition, BMI, non communicable disease

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Authors: Yu Du, Jian-Guo Wang

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Green consumption is a key link to develop the ecological economy, and consumers are vital to carry out green consumption. With environmental awareness gradually being aroused, consumers often fail to turn their positive attitude into actual green consumption behavior. According to behavior reasoning theory, reasons for adoption have a direct (positive) influence on consumers’ attitude while reasons against adoption have a direct (negative) influence on consumers’ adoption intentions, the incongruous coexistence of which leads to the attitude-behavior gap of green consumption. Based on behavior reasoning theory, this research integrates reasons for adoption and reasons against adoption into a proposed model, in which reasons both for and against green consumption mediate the relationship between consumer’ values, attitudes, and behavioral intentions. It not only extends the conventional theory of reasoned action but also provides a reference for the government and enterprises to design the repairing strategy of green consumption attitude-behavior gap.

Keywords: green product, attitude-behavior gap, behavior reasoning theory, green consumption, SEM

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Authors: Atiya Mahmood, Mubasharah Hanif, Ghazala Butt, Mehwish Zahoor Ahmed

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Acne vulgaris affects millions of adults.Despite extensive research, its food related etiology remains elusive. Objective:To assess the correlation between dietary intake and acne through a case-control survey of 300,15-25 year old respondents living in Pakistan. 50 acne patients and 150 age-and ethnicity-matched controls completed a questionnaire.Cases and controls were separated using SPSS-22 and univariate analysis was performed using the chi-square test. p value < 0.05 was considered statistically significant. We used adjusted odds ratios to assess the strength of associations with 95% confidence intervals. Most of the respondents were females(91.3%).Most(48.7%)acne patients were 20-25 yearsold.Acne severity was mild in 50%,moderate in 34%,severe in14%and very severe in 2%.Frequent low-fat foods(p<0.001)(OR=3.22),fat intake(p=0.03)(OR = 1.629),sweet snacks i.e. biscuits and candies etc. (p=0.013) (OR=1.9254), soft drinks(p= 0.045)(OR= 1.9091),butter(p<0.001) (OR= 1.8185),dairy products(p=0.043)(OR=0.624),salty foods(p= 0.011)(OR=1.961),chocolate (p=0.028)(OR=1.669), were associated with increased acne risk.No association was found with consumption of fried foods, desserts, fruit juices, raw fruit, fast food, vegetables, cheese, soy products, salt, and corn. Increased butter and chocolate consumption were linked to more severe forms of acne(p=0.049 and p=0.005 respectively).Most respondents (n=218) considered themselves to have healthy eating habits, indicating they were not educated about the nutritional aspects of acne treatment.Certain food item intake was significantly higher in acne patients to give an association between the two. Further studies must be conducted to develop a causative relationship. Nutrition aawareness is critical to reduce acne.

Keywords: correlation between dietary components and acne, dietary components, acne, nutrition

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Authors: Dagem Alemayehu, Samson Gebersilassie, Jan Frank

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Climate change is impacting nutrition through reducing food quantity and access, limiting dietary diversity, and decreased nutritional food content as well as strongly affecting seasonal rainfall in Ethiopia. Nevertheless, only a few data is available on the impacts of seasonality in Infant, and Young Child Feeding (IYCF) practices undernutrition among 6-23 months old children in different agro-ecological zones of poor resource settings of Ethiopia. Methods: Socio-demographic, anthropometry, and IYCF indicators were assessed in the harvest and lean seasons among children aged 6–23 months of age randomly selected from rural villages of lowland and midland agro-ecological zones. Results: Child stunting and underweight increased from prevalence of 32.8 % and 23.9 % (lowland &midland respectively) in the lean season to 36.1% and 33.8 % harvest seasons, respectively. The biggest increase in the prevalence of stunting and underweight between harvest and lean seasons was noted in the lowland zone. Wasting decreased from 11.6% lean to 8.5% harvest, with the biggest decline recorded in the midland zone. Minimum meal frequency, minimum acceptable diet, and poor dietary diversity increased considerably in harvest compared to a lean season in the lowland zone. Feeding practices and maternal age were predictors of wasting, while women's dietary diversity and children's age was a predictor of child dietary diversity in both seasons. Conclusion: There is seasonal variation in undernutrition and IYCF practices among children 6-23 months of age with more pronounced effect lowland agro-ecological zone.

Keywords: agroecology, seasonality, stunting, wasting

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Authors: Beruk Berhanu Desalegn, Kebede Awgechew, Addisalem Mesfin

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Introduction: This study aimed to investigate and compare the energy and selected nutrient intakes of sport science and non-sport science University students of Southern Ethiopia. Method: Multiple-day dietary data were collected from 166 university students (76 sport science and 90 non-sport sciences). Average daily energy and nutrient intake, and inadequate intakes were calculated using NutriSurvey (NS). Results: There were significant differences (p < 0.05) in the median intakes of energy, total carbohydrate, and vitamin B1 between female students from the sport science and non-sport science groups, but only the median intake of iron was significantly different (p < 0.05) between the male sport and non-sport science students’ group. The prevalence of inadequate intake of vitamin B1 were significantly (p<0.05) higher in the male and female from the non-sport science groups compared to the male and female students’ groups in the sport science, respectively. Whereas, the prevalence of inadequate iron intake by the male sport science students’ group was significantly (p<0.05) higher compared to their counterparts. Similarly, the prevalence of inadequate energy among the females from the sport science group was significantly (p<0.05) higher compared to the female students from the non-sport science department group. The prevalence of inadequate intakes of dietary energy, and the majority of the nutrients (protein, fat, vitamin A, B1, B2, and magnesium) were high (>50%) in selected University students. Conclusion: The energy and majority of nutrient intakes by the students in the selected universities of southern Ethiopia were sub-optimal. Therefore, activities that will improve the dietary intake of University students should include weekly meal plan revision considering their average recommended nutrient intake (RNI).

Keywords: dietary intake, sport science, University students, Ethiopia

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Authors: Abdullah S. Alghamdi, Khaled Alghamdi, Richard O. Jenkins, Parvez I. Haris

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Background: Unhealthy diet is one of the modifiable risk factors for developing type 2 diabetes mellitus (T2DM). Improvement in diet can be beneficial for countering diabetes. For example, HbA1c, an important biomarker for diabetes, can be reduced by 1.1% through only alteration in diet. Ramadan fasting has been reported to provide positive health benefits. However, optimal benefits are not achieved, often due to poor dietary habits and lifestyle. There is a need to better understand the dietary habits of people fasting during Ramadan, so that necessary improvements can be made to develop this form of fasting as a non-pharmacological strategy for management and prevention of T2DM. Aim: This study aimed to assess the dietary patterns of Saudi adult patients with T2DM over three different periods (before, during, and after Ramadan) and relate this to HbA1c levels. Methods: This study recruited 82 Saudi with T2DM, who chose to fast during Ramadan, from the Endocrine and Diabetic Centre of Al Iman General Hospital, Riyadh, Saudi Arabia. Ethical approvals for the study were obtained from De Montfort University and Saudi Ministry of Health. Dietary patterns were assessed by a self-administered questionnaire in each period. This assessment included the diet type and frequency. Blood samples were collected in each period for determination of HbA1c. Results: The number of meals per day for the participants significantly decreased during Ramadan (P < 0.001). The consumption of fruit and vegetables significantly increased during Ramadan (P = 0.017). However, the consumption of sugary drinks significantly increased during and after Ramadan (P = 0.005). Approximately 60% of the patients indicated that they ate sugary foods at least once per week. The consumption of bread and rice was reported to be at least two times per week. The consumption of rice significantly reduced during Ramadan (P = 0.002). The mean HbA1c significantly varied between periods (P = 0.001), with lowest level during Ramadan compared to before and after Ramadan. The increase in the consumption of fruits and vegetables had a medium effect size on the reduction in HbA1c during Ramadan. There was a variance of 7.7% in the mean difference in HbA1c levels between groups (who changed their fruit and vegetable consumption) which can be accounted for by the increase in the consumption of fruits and vegetables. Likewise, 9.3% of the variance in the mean HbA1c difference between the groups was accounted for by a decrease in the consumption of rice. Conclusion: The increase in the frequency of fruit and vegetables intake, and especially the reduction in the frequency of rice consumption, during Ramadan produce beneficial effects in reducing HbA1c level. Therefore, further improving the dietary habits of patients with T2DM, such as reducing their sugary drinks intake, may help them to obtain greater benefits from Ramadan fasting in the management of their diabetes. It is recommended that dietary guidance is provided to the public to maximise health benefits through Ramadan fasting.

Keywords: Diabetes, Diet, Fasting, HbA1c, Ramadan

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