Final maso program b5

MALAYSIAN ASSOCIATION FOR THE STUDY OF OBESITY
Persatuan Kajian Obesiti Malaysia
__________________________________________________
MASO 2009
SCIENTIFIC CONFERENCE ON OBESITY
‘Obesity & Our Environment’
12 – 13 August 2009
Best Western Premier Seri Pacific Hotel
Kuala Lumpur

TABLE OF CONTENTS
1
Page
Message from Minister of Health Malaysia 2
Message from President, MASO 3
Organising Committee 4
Conference Information 5
Opening Ceremony 7
Scientific Programme 8
Keynote Address 15
Biography and abstract
Plenary Lecture 18
Biography and abstract
Abstracts of Papers 20
Symposium Day 1
MASO 2009 Dinner Lecture 36
Abstracts of Papers 37
Symposium Day 2
List of Posters 51
Abstracts for Poster Session 57
Acknowledgements 99

Message from Minister of
2
Health Malaysia

Message from President
It gives me great pleasure to welcome you to Kuala Lumpur for MASO‟s biennial
conference (MASO 2009). We are indeed honoured to have the presence of YB Dato‟
Sri Liow Tiong Lai, Minister of Health Malaysia to grace the official opening of the
conference.
It is most gratifying to note that despite the H1N1 outbreak, several eminent researchers
in the field of obesity and participants from no less than 15 countries have brave the
journey to be with us here today.
The theme of this year conference “ Obesity and our Environment” serve to update our
members and all related professionals of the growing concern our environment plays in
relation to the Obesity epidemic from a broad perspective and to highlight some recent
local and global efforts and actions for their prevention and control.
We have a busy 2-day programme which include 1 Keynote address by Professor Philip
James, President, IASO, 1 Plenary lecture by Professor John Reilly, 31 Symposia
papers and more than 40 Poster presentations that will allow participants to update
themselves of the current state of the art and science of obesity.
MASO would like to express our sincere gratitude to YB Dato‟ Sri Liow TIong Lai for
taking time off his hectic schedule to declare open MASO 2009 and to launch MASO‟s
Pre-diabetic screening campaign. A special thanks goes to all the speakers for
accepting our invitation and all the participants of MASO 2009. We would also like to
acknowledge the support of the sponsors and other contributors and last but not least,
members of the Organising Committee for their undivided support.
May you all have a fruitful meeting and to our foreign colleagues an enjoyable stay in
Malaysia.
Professor Dr Mohd Ismail Noor FASc, FIUNS
3
Chairman, Organizing Committee

Organising Committee
CHAIRMAN
Prof Dr Mohd Ismail Noor
VICE CHAIRMAN
Assoc Prof Dr Nik Mazlan Mamat
SECRETARY
Assoc Prof Dr Norimah A Karim
TREASURER
Dr Roslee Rajikan
SUBCOMMITTEES:
SECRETARIAT
Assoc. Prof. Dr Norimah A Karim
Assoc Prof Dr Nik Mazlan Mamat
Ms Chang Mei Ciu
Ms Noraini Kosnon
SCIENTIFIC
Assoc Prof Dr Poh Bee Koon
Dr Ng Lai Oon
Dr Zawiah Hashim
Ms Wong Jyh Eiin
Ms Ng Boon Koon
PUBLICITY & PUBLICATIONS
Dr Nik Shanita Safii
Ms Lee Ching Li
Ms Tan Sue Yee
Ms Ong Shwu Chen
TECHNICAL
Dr Hamid Jan bin Jan Mohamed
Dr Hazizi Abu Saad
Mr Mahenderan Appukutty
Mr Ong Wei Wen
4

Conference Information
5
Registration Desk
The registration desk will be located at the entrance to Pacific
Ballroom, Level 2, Best Western Premier Seri Pacific Hotel, Kuala
Lumpur. Registration will be open during the following hours:
Wednesday, 12 August 2009 0800-0900, 1000-1100
Thursday, 13 August 2009 0800-0900
All delegates may collect their conference materials at the
registration desk during the hours. Participants and accompanying
persons are required to wear their badges throughout the
conference for identification purposes and for admission to
conference hall and dining room.
Lunch and Tea / Coffee Breaks
Tea/coffee breaks will be served at the Foyer of Pacific Ballroom,
Level 2 while lunch will be served at Bunga Room, Level 3, Best
Western Premier Seri Pacific Hotel, Kuala Lumpur.
Secretariat Room
The Secretariat Room is located at Bunga Lily, Level 3, Best
Western Premier Seri Pacific Hotel, Kuala Lumpur. Oral
presenters may preview their slides at the Secretariat Room from
0900 till 1700 hours on both conference days.
Poster Session
Posters will be displayed throughout the conference days at the
back foyer of the Pacific Ballroom, Level 2, Best Western Premier
Seri Pacific Hotel, Kuala Lumpur. Posters should be put up by
0830 hours on Wednesday, 12 August 2009, and should be taken
down by 1730 hours on Thursday, 13 August 2009. Poster

presenters should be in attendance next to their posters during
the indicated Poster sessions for discussion and interaction with
other participants. Three best posters by student presenters shall
be awarded cash prizes.
6
Opening Ceremony
The Opening Ceremony of MASO 2009 will be held at 0900 hours
on Thursday, 13 August 2009, at Pacific Ballroom, Level 2, Best
Western Premier Seri Pacific Hotel, Kuala Lumpur. Participants
are requested to be seated inside the Ballroom by 0850 hours.
MASO Conference Dinner Lecture
The conference dinner lecture will be held on Wednesday, 12
August 2009, at 8 pm in Bunga Room, Level 2, Best Western
Premier Seri Pacific Hotel, Kuala Lumpur. Please confirm and
collect your ticket to the conference dinner lecture at the
registration desk during registration.
Trade exhibitions
Abbott Laboratories (M) Sdn Bhd
DSM Nutritional Products (M) Sdn Bhd
Nestle Malaysia Berhad
Neucor Alliance (M) Sdn Bhd
Nova Nutritional Supplies Sdn Bhd
Totalife (M) Sdn Bhd
Display of products and services in the trade exhibition and
advertisements in this Souvenir programme, do not necessarily
imply endorsement of these products and services by the
Malaysian Association for the Study of Obesity.

Opening Ceremony
Official Opening by YB Dato’ Sri Liow Tiong Lai,
Hon. Minister of Health Malaysia
Thursday 13th August 2009
0900 hours
Pacific Ballroom, Best Western Premier
Seri Pacific Hotel,
Kuala Lumpur
8.00 a.m. Registration of delegates
8.45 a.m. Arrival of YB Dato’ Sri Liow Tiong Lai,
Honorable Minister of Health Malaysia
9.00 a.m. Welcome address by Professor Dr Mohd Ismail
Noor, President MASO
9.10 a.m. Speech by Professor Dr Phillip James, President,
International Association for the Study of Obesity
(IASO)
9.20 a.m. Speech and Official Opening by YB Dato’ Sri Liow
Tiong Lai, Hon. Minister of Health Malaysia
9.40 a.m. Launching of ‘Pre-diabetic Screening Campaign’
9.50 a.m. Tour of Exhibition / Posters by Guest of Honour
7

Scientific Programme
Day 1 (12 Aug 2009, Wednesday)
8
Time Programme
8.00 a.m. Registration
9.00 a.m. Welcome by
Professor Dr Mohd Ismail Noor, President MASO
9.10 a.m. PLENARY LECTURE
Chair: Professor Dr Fatimah Harun, Universiti Malaya
Treatment of child and adolescent obesity: Present
and future
Professor Dr John Reilly, University of Glasgow, U.K.
10.10 a.m. Coffee break
Posters / Exhibition
10.40 a.m.
SYMPOSIUM 1
Causes and Consequences of Obesity
Chair: Assoc Professor Dr Nik Mazlan Mamat,
International Islamic University, Malaysia
10.40–11.00 a.m.
S1.1 Obesity and metabolic syndrome in Japan
Professor Dr Shuji Inoue, Kiryu University, Japan
11.00–11.15 a.m.
S1.2 Relationships between obesity and abdominal
muscular endurance in an middle-aged female
population
Dr Hsu CH, National Pingtung University of Science
and Technology, Taiwan
11.15–11.30 a.m.
S1.3 Prevalence of obesity, metabolic syndrome
and its components among older adults in rural
areas
Assoc Professor Dr Zaitun Yassin, Universiti Putra
Malaysia

9
11.30–11.45 a.m.
S1.4 Obesity and hypoventilation syndrome: A
biomechanical prospective
Praveen Jayaprabha Surendran, INTI University
College
11.45–12.00 p.m.
S1.5 Dietary influences on obesity in a rural
population of Tamilnadu, South India
Dr Usha Rani, Bharathiar University, India
12.00–12.15 p.m.
S1.6 Serum adiponectin and central adiposity in
Malay adults
Dr Hamid Jan JM, Universiti Sains Malaysia
12.15 p.m. Poster session / Exhibition
12.45 p.m. LUNCH
2.00 p.m. SYMPOSIUM 2
Epidemiology of Obesity
Chair: Assoc. Professor Dr Zaitun Yassin, Universiti
Putra Malaysia
2.00 – 2.20 p.m.
S2.1 Prevalence and trends of overweight and
obesity in two cross-sectional studies of Malaysian
children, 2002-2008
Professor Dr Mohd Ismail Noor, Universiti Kebangsaan
Malaysia
2.20 – 2.35 p.m.
S2.2 Prevalence of overweight and obesity and
their correlates - A cross sectional study among
medical students of India
Dr M Athar Ansari, Aligarh Muslim University, India
2.35 – 2.50 p.m. S2.3 Cultural and social perception of obesity in
Southeast Asia: A preliminary survey among
overweight adults in Indonesia, the Philippines,
and Thailand
Professor Dr Wan Abdul Manan Wan Muda, Universiti
Sains Malaysia
2.50 – 3.05 p.m.
S2.4 Obesity and metabolic syndrome of a
wellness cohort in Kuala Lumpur
Dr Moy Foong Ming, Universiti Malaya

3.05 – 3.20 p.m. S2.5 Physical activity and sedentary behaviours
among Malaysian schoolchildren
Assoc Professor Dr Poh Bee Koon, Universiti
Kebangsaan Malaysia
10
3.30 p.m.
SYMPOSIUM 3
Childhood Obesity
Chair: Dr Zawiah Hashim, MASO Council Member
3.30 – 3.50 p.m.
S3.1 Why we must prevent childhood obesity in
Malaysia
Professor Dr Fatimah Harun, Universiti Malaya
3.50 – 4.05 p.m.
S3.2 Association of sugar intake and sweetened
beverage consumption with body mass index
among primary school children in Klang Valley
Assoc Professor Dr Norimah A Karim, Universiti
Kebangsaan Malaysia
4.05 – 4.20 p.m.
S3.3 Diet and physical activity profile of the obese
children attending the obesity clinic of Yangon
Children Hospital
Dr Phyu Phyu Aung, Universiti Malaysia Sarawak
4.20 – 4.35 p.m.
S3.4 A case study on snacking frequency amongst
obese male teenagers at regular national school in
Shah Alam, Selangor
Assoc Professor Dr Raja Saidatul Hisan Raja Azam,
Universiti Teknologi MARA
4.35 – 4.50 p.m. S3.5 A randomised controlled trial of childhood
obesity treatment in Malaysia (MASCOT) –
Preliminary results
Sharifah Wajihah Wafa SST Wafa, Universiti
Kebangsaan Malaysia
4.50 – 5.20 p.m. Poster session / Exhibition
5.20 p.m. Tea break

8.00 p.m. Conference Dinner Lecture (Sponsored by Abbott
Malaysia)
Chair: Dr Kumararajah Tambyraja, Medical Director,
Abbott Malaysia
The importance of weight management in
preventing and managing diabetes
Professor Phillip James, President IASO, U.K.
11

Day 2 (13 Aug 2009, Thursday)
12
Time Programme
9.00 a.m.
OPENING CEREMONY
9.40 a.m. Tour of Exhibition / Posters by Guest of Honour
Coffee break
10.30 a.m. KEYNOTE ADDRESS
Chair: Professor Dr Mohd Ismail Noor, President,
MASO
Obesity and its major societal implications
Professor Dr Phillip James, President IASO, U.K.
11.30 a.m.
SYMPOSIUM 4
Behavioural Aspects of Obesity
Chair: Rokiah Don, Ministry of Health Malaysia
11.30–11.50 a.m.
S4.1 Self-esteem, life satisfaction and weight
measures in the Malaysian urban community
Dr Ng Lai Oon, Universiti Kebangsaan Malaysia
11.50–12.05 p.m.
S4.2 The differences in attitudes toward and
beliefs about obese persons among Malaysian
Chinese and Malaysian Indian
Dr Priyadarshini Moharkonda Srinivasan, Sunway
University College
12.05–12.20 p.m.
S4.3 Dietary, exercise and mental attitude
patterns in subjects’ 6-months into a weight
management program
Dr Priya M Miranda, Madras Diabetes Research
Foundation, India
12.20–12.35 p.m.
S4.4 Relationship between weight and mental
health
Cheong Sau Kuan, Sunway University College
12.35–12.50 p.m.
S4.5 Transtheoretical Model of Change and
weight control among Sarawak natives
Chang Ching Thon, Universiti Malaysia Sarawak

12.50 p.m. Poster session / Exhibition
13
1.00 p.m. LUNCH
2.00 p.m.
SYMPOSIUM 5
Management and Treatment of Obesity
Chair: Professor Dr Fatimah Arshad, International
Medical University, Malaysia
2.00 – 2.20 p.m.
S5.1 Can food solutions win the war against
obesity
Dr Peifang Zhang, Nestlé R&D Centre Beijing,
China
2.20 – 2.35 p.m.
S5.2 A successful dieting through avoiding
high-fat diets and performing light-resistance
exercise to prevent metabolic syndromes and
sarcopenia
Professor Masashige Suzuki, Waseda University,
Japan
2.35 – 2.50 p.m.
S5.3 Paediatric obesity: Outpatient management
in a district general hospital Dr Chinyelu
Menakaya, Fairfeld General Hospital, UK
2.50 – 3.05 p.m.
S5.4 Promoting weight loss among obese
participants through a community-based
behavioural intervention program in Kelantan
Wan Suriati Wan Nik, Universiti Sains Malaysia
3.05 – 3.20 p.m.
S5.5 Balance in obesity – Rehabilitation
perspective
Rajkumar KV, Kuala Lumpur Metropolitan University
College

14
3.30 p.m.
SYMPOSIUM 6
Emerging issues & technologies related to
Obesity
Chair: Assoc. Professor Datin Dr Safiah Mohd
Yusof, Universiti Teknologi MARA, Malaysia
3.30 – 4.00 p.m.
S6.1 Feeding regulation and energy metabolism
in brain – Novel GPCR ligands
Professor Dr Shioda Seiji, Showa University School
Medicine, Japan
4.00 – 4.15 p.m.
S6.2 BMI, a better predictor of hypertension
among a tribe of Sikkim, India: Evidence of
gene-lifestyle interaction
Dr Sovanjan Sarkar, Vivekananda College for
Women, India
4.15 – 4.30 p.m.
S6.3 Obesity screening for young Japanese
males and females using skin fold
measurements: The classification revisited
Dr Masaharu Kagawa, Queensland University of
Technology, Australia
4.30 – 4.45 p.m.
S6.4 A framework of web-mobile intelligence
monitoring system in the management of
obesity for Malaysian community
Dr Nasriah Zakaria, Universiti Sains Malaysia
4.45 – 5.00 p.m. S6.5 Body mass index, waist hip ratios and
novel phenotypic markers: A triad for detecting
diabesity in a population of Tamilnadu, South
India
Shajithanoop Selvakumar, Bharathiar University,
India
5.00 p.m. Poster Prize Presentation
Closing Ceremony
5.20 p.m. Tea break
5.30 p.m. End of Conference

Biography of Keynote Speaker
W Philip T James
CBE, MD, DSc, FRCP, FRSE
Professor of Nutrition, London School of Hygiene & Tropical Medicine
President, International Association for the Study of Obesity, London,
UK
Professor James, after science and medical qualifications in London, worked in
Jamaica and Harvard before returning to head the teaching program for global
nutritional problems at the London School of Hygiene and Tropical Medicine.
He then became the Assistant Director for the Medical Research Council's
Dunn Nutrition Unit in Cambridge before, in 1982, becoming Director of the
Rowett Research Institute in Scotland.
He wrote the first UK government and Royal College reports on obesity before
developing for WHO the first nutritional strategies for the multiple problems of
diseases throughout the European Region in 1986. He then chaired and wrote
the WHO's first global analysis of the integrated food and nutritional needs for
combating chronic diseases in malnourished populations in 1990(WHO
technical report 797). He has since chaired and written for the UK Government
and WHO the first reports on obesity as a public health problem and its
prevention and management. Tony Blair asked him to propose a solution to
the BSE and the E Coli food safety crisis in the UK: his proposals for
restructuring government were implemented by Tony Blair as Prime Minister.
He then advised the European Commission on the formation of a Health Policy
Directorate and produced their global strategy for dealing with the risk of BSE
and other food borne diseases. He was the author for the EU Commission's
"Three Wise Men" report on the need to develop a Food and Public Health
Authority in Europe before being asked to chair the United Nations Millennium
Report on global nutrition and health challenges.
He established in 1996 the International Obesity TaskForce which drafted a)
the first WHO report on obesity, b) produced the current global classification of
childhood obesity, c) the report highlighting the intrinsic societal drivers in the
development and control of obesity, d) specified the Asian susceptibility to
obesity, e) established with WHO the remarkable burden of weight gain for
global disability and premature death and f) has proposed to numerous
governments appropriate strategies for combating the epidemic. He currently
chairs the Presidential Council of the WHO-linked Global Prevention Alliance
involving the World Heart Federation, the International Diabetes Federation, the
International Union of Nutritional Sciences, the International Paediatric
Association and IASO. He also Chairs the Executive Steering Committee of
the SCOUT trial of weight management in high risk cardiology patients.
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Keynote Address
Obesity and Its Major Societal Implications
W Philip T James
CBE, MD, DSc, FRCP, FRSE
Professor of Nutrition, London School of Hygiene & Tropical Medicine
President, International Association for the Study of Obesity, London,
UK
Malaysia has the highest obesity rates in Asia but since this is a recent
development the full health and societal impact of the problem is not yet
manifest. The importance of the emerging childhood obesity epidemic
has also not yet been properly recognised. The three main ethnic
groups, however, provide a further major clinical and public health
challenge because the Malays, Indians and Chinese may have different
susceptibilities to the co-morbidities of weight gain. New World Bank,
CDC/WHO analyses reveal the escalating importance of obesity as the
epidemic progresses with obesity being the third biggest risk factor for
disability and premature death now in affluent countries. Furthermore
the UK government's recent Foresight analyses highlight obesity as a
normal "passive" biological response to overwhelming environmental
factors which have to be altered before the normal human physiological
controls of food intake can possibly cope. The major findings that as
people become overweight there is a hypothalamic adaptation which
"resets" the normal responsiveness of both intake and activity to
maintain the excess weight means that major preventive measures are
needed for both children and adults. Combating childhood obesity alone
is not an option for overwhelmed medical services - only a substantial
reduction in adult obesity will save much money in the next two decades.
The susceptibility to weight gain in different ethnic groups may be
genetic but recent studies from several low income countries including
India, Philippines and China show that early nutritional and other
influences during pregnancy and the first two years of life are
particularly detrimental if followed by weight gain: DM and hypertension
are then much more likely complications. Thus prevalent low birth
weights in Malaysia 40-70 years ago mean that the whole middle aged
population's vulnerability to diabetes may relate to their early childhood
experience. Those of Indian origin are particularly susceptible to
abdominal obesity with greater fat/lean proportions, insulin resistance
and a propensity to hypertension. Epigenetic changes, particularly
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linked to the one carbon pool metabolism with distortions in the
folate/B12 availability in Indian vegetarians are probably causal.
However, the intrinsic lack of animal protein in many Indian diets
parallels all the animal studies which show the induction of diabetes in
offspring who had restricted protein intakes during pregnancy. Therefore
a fundamental lack of essential and limited amino acids e.g. glycine may
have profound implications for the susceptibility of the Indian ethnic
group in Malaysia. Combating this with better low fat milk supplies may
turn out to be the simplest way of combating these deficiencies and will
have a marked beneficial effect on the still prevalent rates of stunting. In
Malaysia the secular changes in physical activity and particularly in diet
have been profound with two major features: the marked increases in
sugar and fat consumption driven by immense industrial forces and fast
food chains within Malaysia. This is occurring when Malays should be
eating much less as a result of their physical inactivity. How to combat
this societal challenge requires novel and courageous approaches but
without them the impact of obesity on the Malaysian economy is bound
to increase progressively.
17

Biography of Plenary Speaker
John J Reilly
Personal Professor, University of Glasgow Division of Developmental
Medicine
Professor Reilly, BSc PhD, is Personal Professor in Paediatric Energy
Metabolism at the University of Glasgow and Yorkhill Hospitals,
Glasgow, Scotland. He leads a large Research Group focused on a
number of aspects of childhood obesity: diagnosis; consequences;
aetiology; prevention; treatment. He has published over 140 peer-reviewed
papers. He is on the Editorial Board of the British Journal of
Nutrition, and is Associate Editor of the International Journal of Pediatric
Obesity. He has won a number of awards for his research, notably the
Sir David Cuthbertson Medal from the UK Nutrition Society in 2001 and
the Royal Society of Edinburgh Personal Research Fellowship in 2003.
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Plenary Lecture
Treatment of Child and Adolescent Obesity: Present
and Future
John J Reilly
Personal Professor, University of Glasgow Division of Developmental
Medicine
Child and adolescent obesity are now very common across the
developed and developing world. In the UK for example approximately
one third of adolescents are obese, and prevalence of obesity is even
higher among some sub-groups of the population. Obesity in childhood
and adolescence has many adverse effects, both for the obese child
and for the adult who was obese as a child. High prevalence of obesity,
combined with adverse consequences, makes treatment interventions a
high priority for health services. The presentation will take an evidence-based
approach to several aspects of paediatric obesity treatment:
diagnosis; screening for co-morbidities; the issues of when and who to
treat; choosing appropriate behavioural targets of treatment; methods of
ensuring that behavioural changes are made; what are the appropriate
aims of treatment ?; promising treatment approaches. The presentation
will be based on recent systematic reviews and evidence-based
guidelines, as well as recent randomised controlled trials of child and
adolescent obesity treatment interventions. The generalisability to
Malaysia of current evidence on the treatment of paediatric obesity-evidence
obtained largely from the USA and Europe- will also be
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considered.

Abstracts of Papers
Symposium Day 1
Symposium 1: Causes and Consequences of Obesity
S1.1 Obesity and Metabolic Syndrome in Japan
20
Inoue S
Dept of Clinical Nutrition, Kiryu, University Gumma, Japan
Obesity is originally defined as excessive body fat accumulation now
assessed by BMI. Two other types of obesity are defined in the respect
of risks for obesity-associated diseases (lifestyle-related disease): upper
body obesity or abdominal obesity and visceral obesity. It had been
recognized that obesity as a disease should be treated and 5-10%
reduction of body weight is enough to normalize obesity-associated
abnormalities, while simple obesity itself is not necessarily to be treated
from a view point of medical problems. After concept of metabolic
syndrome appeared, the situation has changed and it is considered that
it should be treated although it is not a disease. Metabolic syndrome is a
cluster of high blood glucose, high blood pressure, and dyslipidemia
(hypertriglyceridemia and hypoHDL-cholesterolemia) based on
abdominal obesity or visceral obesity, and is proposed to be a high risk
syndrome for coronary heart disease and diabetes mellitus. Utilizing the
concept of metabolic syndrome, national task force for preventing
lifestyle-related diseases especially diabetes mellitus have initiated last
year in Japan. 3 kg of body weight reduction with 3 cm of waist
circumference reduction is targeting for the purpose of this task force.
This paper discusses how these three obesities and obesity as a
disease were defined in Japan, and recent status of the Japanese
national task force.

S1.3 Prevalence of Obesity, Metabolic Syndrome and Its
Components among Older Adults in Rural Areas
Zaitun Y1,2, Hazizi AS2, Norimah AK3, Fatimah A4, Rokiah MY2,
Nawalyah AG2 & Abdul Rashid AR5
1Medical Gerontology Laboratory, Institute of Gerontology, UPM,
Serdang, Selangor
2Dept of Nutrition & Dietetics, Faculty of Medicine & Health Sciences,
UPM, Serdang, Selangor
3Dept of Nutrition & Dietetics, Faculty of Allied Health Sciences, UKM,
Kuala Lumpur
4Nutrition & Dietetics, School of Pharmacy & Health Sciences, IMU,
Kuala Lumpur
5Cyberjaya University College of Medical Sciences, Cyberjaya
The purpose of this paper is to present the distribution of obesity,
metabolic syndrome and its components among older adults (50+ years)
from selected rural areas. Data from the study on “Development and
Validation of CVD Risk Calculator for Malaysian Population” carried out
in 2004-2006 were used (n=2696; men=1148; women=1548).
Information on demographics and health-related characteristics were
collected using a questionnaire during face-to-face interviews. Height,
weight, waist circumference (WC), hip circumference (HC) and blood
pressure were measured using standard procedures and appropriate
instruments. Blood samples were collected after 8 to 10 hours of
overnight fasting and analysed using the Chemical Analyser (Hitachi
902). Respondents were classified as having MS based on the
International Diabetes Federation (IDF) consensus worldwide definition
that is central obesity plus any two of the other four diagnostic criteria
(high triglycerides, low HDL-cholesterol, high blood pressure and
impaired fasting glucose). The results showed that the distribution of
overweight and obesity were 36.3% and 16.7%, respectively. Metabolic
syndrome was present in 56.4% of the respondents representing almost
equal proportion of the males (53.2%) and females (58.8%). The most
common metabolic abnormality was high blood pressure in 68.7% of the
respondents. About 3% of the respondents did not have any of the
components of MS, while 54.8% had three or more. The study revealed
a high distribution of overweight, obesity, dyslipidemia, high blood
pressure and metabolic syndrome among the older adults. Strategies
and actions need to be initiated to prevent and treat the components of
metabolic syndrome. Older adults diagnosed with MS should receive
increased attention with the aim of reducing the risk for CVD and Type 2
diabetes. Prevention of modifiable risk factors, such as obesity and
22

other lifestyle risk factors should be the key approach. Appropriate
promotive and preventive programmes, including dietary and lifestyle
intervention should be targeted at those at high risk.
S1.4 Obesity and Hypoventilation Syndrome (OHS) – A
Biomechanical Prospective
Praveen JS, Sunitha C Nair, Nagarajan M & Aravind K Kannan
School of Physiotherapy, Faculty of Medical & Health Sciences, INTI
University College, Nilai, N. Sembilan
An extensive literature review was carried out using Ovid, Science direct,
Pubmed and Proquest to find the baseline biomechanical alterations
leading to Hypoventilation Syndrome in obesity. The World Health
Organization (WHO) estimates that, by 2015, nearly 2.3 billion adults
will be overweight and more than 700 million will be obese. Obesity
impairs health-related quality of life and is a major cause of morbidity
and premature mortality because of an increased risk of developing
cardiovascular as well as metabolic complications and now recognized
as an important risk factor for developing several respiratory diseases.
This alteration in respiratory mechanics causes major respiratory
compromises and increasing susceptibility for respiratory disorders.
Obesity–hypoventilation syndrome (OHS) is characterized by a triad of
obesity, daytime hypoxemia, and diurnal hypoventilation, as defined by
PaCO2 > 45 mmHg in the absence of other causes of hypoventilation.
Total respiratory system resistance is elevated in OHS 100% during
inspiration when compared to simple obesity which is only 30%. This
further reduces the lung volumes, but FEV1 /FVC ratio remains normal.
There is increased pulmonary loading and further reduction in FRC.
Studies show reduced lung, chest wall, and total respiratory system
compliance due to increased pulmonary blood volume and closure of
dependent airways, excess elastic load posed by excess weight on the
thorax and abdomen, as well as by an enhanced threshold load,
wherein a greater (more negative) pleural pressure must be generated
by the respiratory muscles to initiate airflow. In people OHS have 25%
greater respiratory rate and 25% lower VT causing impaired alveolar
ventilation leading to abnormal ventilatory control/drive. Studies showed
blunted mouth occlusion pressure responses to CO2 and by the ability to
correct PaCO2 during a voluntary hyperventilation maneuver.
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S1.6 Serum Adiponectin and Central Adiposity in Malay Adults
Hamid Jan JM, Nur Firdaus I, Laila Ruwaida MZ & Wan Manan WM
Nutrition Programme, School of Health Sciences, USM Health
Campus, Kubang Kerian, Kelantan
Adiponectin protein is proposed to play an important role in obesity. Low
level of serum adiponectin is associated with low physical activity, high
caloric diet intake and increased risk of type 2 diabetes mellitus. Several
studies have shown the above mentioned associations and also its
variations between ethnicity such as in European and Japanese. Hence,
the aim of this study was to investigate the level of serum adiponectin
and its association with adiposity in Malay population. A total of 156
Malay adults (71 male, 85 females) were randomly recruited from four
rural villages in Kelantan, Malaysia. Socio-demography information,
anthropometry measurements, body composition (TANITA, Japan) and
fasting blood samples were collected for serum adiponectin analysis.
Serum adiponectin was measured using a commercial human
adiponectin ELISA kit (Millipore, USA). Serum adiponectin concentration
ranged from 0.1 g/ml to 42.6 g/ml with the mean of 9.9 g/ml.
Adiponectin level was significantly higher (P<0.001) in female (12.3
g/ml) compared to male (6.9 g/ml) subjects. Serum adiponectin was
moderately and significantly correlated with body weight (r=-0.3,
P<0.001), waist circumference (r=-0.3, P<0.001), waist-hip-ratio (r=-0.3,
P<0.001) and visceral fat (r=-0.4, P<0.001). However no significant
correlation was found between serum adiponectin with body mass index
and percentage body fat. This study shows sexual dimorphism
characteristic of adiponectin which is lower in males suggesting higher
susceptibility for type 2 diabetes. It also shows that adiponectin is
associated with measures of central obesity and it could be proposed as
a good biological marker for central adiposity in adults.
25

Symposium 2: Epidemiology of Obesity
S2.1 Prevalence and Trends of Overweight and Obesity in Two
Cross-sectional Studies of Malaysian Children, 2002-2008
Ismail MN1, Ruzita AT1, Norimah AK1, Poh BK1, Nik Shanita S1, Nik
Mazlan M1, Roslee R1, Nurunnajiha N1, Wong JE1, Nur Zakiah MS2 &
Raduan S3
Kuala Lumpur
2Dept of Biomedical Sciences, Faculty of Allied Health Sciences, UKM,
Kuala Lumpur
3Dept of Mass Communication, Faculty of Creative Industries, UTAR,
Kuala Lumpur
Childhood obesity previously thought as an unusual condition
associated with genetic disorders has, since the late 1990‟s, been
recognized as an emerging public health concern with increasing
worldwide prevalence. The estimation of the prevalence and secular
trends in childhood obesity, both within and between countries has been
severely restricted by the wide range of different definitions and cut-off
points for overweight and obesity in different populations of children.
Cross-sectional studies can often be useful in providing a “snapshot”
view of the prevalence of obesity at a given time. This paper reports
prevalence and trends of overweight and obesity among primary school
children aged 6 to 12 years old in four regions of Peninsular Malaysia in
two separate studies – survey I (2001/02) involving 11,264 children and
survey II (2007-08) involving 9987 children. The prevalence was
estimated using both the Cole et al. (2000) cut-off points and the
recently introduced WHO (2007) growth reference. The prevalence of
overweight children increased by 5% using the Cole et al. (2000) as
compared to only 1.8% using WHO (2007). Obesity prevalence among
the children recorded an increase of 2.5% (Cole et al. 2000) as
compared to 3.9% (WHO 2007). Overall, the increase in prevalence of
overweight and obesity using Cole et al. (2000) was 1.8% higher as
compared to (WHO 2007). However, the study also revealed that the
percentage of obesity in both surveys increased markedly using the
WHO (2007) growth reference. This paper will also highlight differences
between region, sex, ethnic and urban and rural settings. In conclusion,
there is an apparent trend of a steady rise in prevalence of overweight
and obesity among children aged 6-12 years from 16.4% to 24% using
(Cole et al. 2007) and from 20.7% to 26.4% using (WHO 2007),
26

between 2002 and 2008. Further studies to compare trends in childhood
obesity using appropriate reference cut-off points are still required.
27

S2.3 Cultural and Social Perception of Obesity in Southeast Asia:
A Preliminary Survey among Overweight Adults in Indonesia, the
Philippines and Thailand
28
Wan Abdul Manan Wan Muda
Dept of Community Medicine, School of Medical Sciences, Health
Campus USM, Kubang Kerian, Kelantan
Once associated exclusively with rich industrialized countries, obesity is
now a serious problem throughout the developing world, including
Southeast Asia. The growing double burden of under-nutrition and
obesity will be the major challenge in the near future in all Southeast
Asian countries. The modern phase of globalization as an important
determinant of global eating pattern interacts directly on population
through the fast food globalizing processes. The presence of fast food
also is linked to the increasing availability of foods high in fats, sugar
and salts is changing diets globally which in turn is linked to changes in
the production, retailing and marketing of foods. The objective of this
project is to examine perceptions about obesity in relation to
globalization and changing lifestyles in Southeast Asia. A survey was
carried out in Indonesia, the Philippines and Thailand to solicit the
perception regarding obesity and quality of life. A total of 350
respondents from both urban and rural population participated in the
study. Results of the survey revealed that self-perception regarding
obesity among Southeast Asian show common similarities, particularly
in self reporting on health, dietary habit and also the concept of beauty
and a beautiful body. Character and behavior are highly regarded in
evaluating a person‟s self-worth in society. The findings also show that
Filipinos frequented fast food outlets more than respondents from
Indonesia and Thailand. In terms of quality of life among respondents,
respondents in Thailand have a better quality of life than in the
Philippines and Indonesia.

S2.4 Obesity and Metabolic Syndrome of a Wellness Cohort in
Kuala Lumpur
29
Moy FM & Awang Bulgiba AM
Dept of Social & Preventive Medicine, Faculty of Medicine, Universiti
Malaya, Kuala Lumpur
A worksite wellness program was initiated in a public university in Kuala
Lumpur. All employees aged 40 years and above were invited to
participate. Ethics approval and informed consent were obtained from
the employees who participated. Baseline measurements included
weight, height, waist and hip circumference, blood pressure, fasting
blood glucose, uric acid and lipid profile were collected by trained staff.
All health indicators were categorised into normal or abnormal groups.
Following the NCEP ATP III, Metabolic Syndrome (MetS) was defined
when three of the relevant parameters were abnormal. A total of 1278
employees aged 40 years and above participated in the programme.
Using the WHO cut off criteria, the overall prevalence of overweight
(BMI: 25 – 29 kgm2) and obesity (BMI > 30kgm2) was 41.8% (95% CI:
39.1, 44.5) and 23.1% (95% CI: 20.9, 25.5) respectively, while
abdominal obesity was 65.3% (95% CI: 62.4, 67.6). The overall
prevalence of MetS was 42.0% (95% CI: 39.3, 44.7). There were more
males (49.2%) with MetS compared to females (36.2%). In the
multivariate logistic model: sex, race, age, BMI and uric acid were found
to be significant predictors of MetS (p<0.05). Males had the odds of 1.69
(95% CI: 1.35, 2.11) times more of having MetS than females. Malay
and Indian participants had two to three times higher risks for MetS than
Chinese. As age, level of uric acid and BMI increased, the odds of
getting MetS increased significantly too. The area under the curve of the
Receiver Operating Characteristic (ROC) was 0.768. The prevalence of
obesity and MetS among this study population was high. They were at
high risk for Type 2 Diabetes Mellitus and Cardiovascular Disease. A
worksite wellness program targeting the above predictors is urgently
required.

S2.5 Physical Activity and Sedentary Behaviours among Malaysian
Schoolchildren
Poh BK, Ruzita AT, Nurunnajiha N, Wong JE, Norimah AK, Raduan
S & Ismail MN
Dept of Nutrition & Dietetics, Faculty of Allied Health Sciences, UKM,
Kuala Lumpur
Lack of physical activity is becoming a global concern as it is a major
factor influencing health and weight status. This paper reports the
physical activity pattern of primary school-aged children in Malaysia
from a recent survey carried out in year 2008. Anthropometric
measurements included body weight and height, and body mass index
(BMI) was calculated. Body fat levels were estimated using the Tanita
Body Composition Analyser (TBF-300). Physical activity and inactivity
pattern was assessed using a set of questionnaire. Subjects comprised
5678 boys and 5671 girls aged between 6 and 12 years studying at
primary schools in all regions of Malaysia. Mean BMI were 17.5 ± 4.3
and 16.9 ± 3.9, respectively, for boys and girls. The most commonly
reported physical activity during Physical Education classes were
running or jogging. Less than one-fifth of children walked or cycled to
school. During leisure time, most of the children preferred sedentary
activities, such as watching television, reading, and doing homework or
revision. However, boys were more likely to be active than girls after
school hours. Boys also preferred sports and outdoor games while girls
preferred indoor games and more sedentary activities. Mean time spent
on sedentary and active activities were not significantly different
between normal weight and overweight/obese groups, except for
overweight girls who spent significantly (p<0.01) more time in sedentary
activities. Significant but low positive correlation was found between BMI
of boys (r=0.102, p<0.01) and girls (r=0.131, p<0.001) with the amount
of time spent on sedentary activities. Percentage body fat of girls was
also positively correlated (r=0.150, p<0.001) with amount of time spent
on sedentary activities. We conclude that the children were generally
sedentary, with the girls being more so than boys. It is suggested that
intervention to increase physical activity in schools and the community
should be implemented to prevent the trend towards increasing
prevalence of overweight and obesity over the long term.
30

Symposium 3: Childhood Obesity
S3.1 Why We Must Prevent Childhood Obesity in Malaysia
31
Fatimah Harun
Universiti Malaya, Kuala Lumpur
(Abstract not received at the time of publication)
S3.2 Association of Sugar Intake and Sweetened Beverage
Consumption with Body Mass Index among Primary School
Children in Klang Valley
Norimah AK & Toh SM
Kuala Lumpur
The increasing prevalence of obesity among children is one of the
nutritional problems occurring in many countries including Malaysia.
This cross sectional study was carried out to determine the association
between sugar and sweetened beverage intake with body mass index
among primary school children. 198 children of Malay, Chinese and
Indian ethnic groups (100 boys, 98 girls) were randomly selected from
five schools in Subang Jaya in Klang Valley. Body mass index was
determined using WHO classification. Sweetened beverage
consumption and sugar intake was determined using two-days 24 hour
recall (a weekday and a weekend) by interview while sweetened
beverage drinking habits was evaluated using a guided self
administered food frequency questionnaire. Mean BMI for girls was
19.3+3.8 kg/m2 while for boys 18.8+4.1 kg/m2. The top three favourite
sweetened beverage were chocolate malted drink (21.3%), carbonated
drinks (13.7%) and fruit juice (12.7%). The consumption of flavoured
drinks and energy drinks were higher especially during lunch time,
afternoon tea and dinner among overweight/obese children than their
normal counterparts. Sweetened beverages were mainly consumed at
home. Malay children had significantly higher mean sugar intake from
beverages (59.0+30.0/day) followed by Indian (51.8+18.4g/day) and
Chinese (30.9+20.8g/day) children. Overweight /obese children also
showed higher mean sugar intake than their normal counterparts
although this was not significant. There was a weak association
between sugar intake and BMI status (r=0.26, p<0.05). This study

showed that there was a need to monitor sweetened beverage
consumption at meal times among children. The consumption of plain
water should be encouraged during meal times as consumption of
sweetened beverage could be a contributing factor in the increasing
prevalence of obesity among children.
S3.3 Diet and Physical Activity Profile of the Obese Children
Attending the Obesity Clinic of Yangon Children Hospital
Phyu Phyu Aung1, Ei Ei Khin2, Moh Moh Haling3, Myint Myint Zin4,
Mya Ohnmar3, Sandar
Tun3 & Thein Aung2
1Basic Medical Sciences Dept, UNIMAS, Sarawak
2Pediatrics Dept, University of Medicine 1, Yangon, Myanmar
3Nutrition Research Division, Dept of Medical Research, Yangon,
Myanmar
4Nutrition Unit, Dept of Health, Ministry of Health, Myanmar
The aim of the study was to investigate the diet and physical activity
profile of the obese children attending the obesity clinic of the Yangon
Children‟s hospital. Seventy five obese children who attended the clinic
during the period from September 2004 to October 2005 were included.
Anthropometric measurements of the children were taken from which
body mass index (BMI) was calculated. Those with BMI against the
growth chart of more than 85th centile were taken as obese. Structured
questionnaire was used as a data collection tool. Among the children,
89.4% of boys and 86%of girls were severely obese with BMI centile of
more than 97%. For both sexes, 74.9% of the children were having
calories more than RDA. Eighty four percent of obese children ate main
meals 3 times a day while 15.3% ate 4 times a day. Majority of them
took snacks once or twice a day. More than half of the children viewed
television 2-4 hours a day. Playing computer games was practiced in
18.8% of boys and 16.7% of girls. Although most of them played at
schools the duration was very short and at homes only 26% of boys and
17.2% of girls played. Most of the children (84.6% of boys and 72.3% of
girls) came to the schools by cars/other vehicles while the rest came on
foot. Mean television viewing, studying, and sleeping times of the
respondents were 9+1.5 hours, 6+1.7 hours, and 9+09 hours
respectively. The results of the present study would provide effective
input for the further management of obese children in the obesity clinic.
32

S3.4 A Case Study on Snacking Frequency amongst Obese Male
Teenagers at Regular National School in Shah Alam, Selangor
Raja Saidatul Hisan RA1, Abd Razak AK & Mazni M
1Faculty of Hotel & Tourism Management, Shah Alam, Selangor
Faculty of Information Technology & Science Quantitative, Shah Alam,
Selangor
Obesity has become a major public health issue and an epidemic
worldwide. This epidemic affects developed and developing countries
society including adult, and children. In numbers, the alarming increase
of obese people in recent decades, worldwide, including teenagers
indicates that there is no sign of this trend to end. In fact, the World
Health Organization (WHO) considered teenagers‟ obesity as an
epidemic of global proportion and if no intervention is made, there is a
thought that they possibility will stay obese as adults. Undoubtedly, the
prevalence of obesity also appears among Malaysian people, based on
research by Ministry of Health, the prevalence of overweight is 21
percent and 6.2 percent is obese in Malaysia (Ismail, 2000). On the
other hand, an estimation was made by World Health Organization
towards the prevalence of obesity in Malaysia, indicated that in 2005,
8.2 percent of females and 1.6 percent of males were found obese from
age between 15 to 100 years old. In addition, this percentage mounting
as the WHO estimates for 2015 as females increase higher up to 14.3
percent while males just increase slightly to 1.7 percent will find obese.
In line with the statistical evidences, many studies related to teenagers
snacking behavior and obesity have been conducted. Unfortunately,
from all studies undertaken, little evidence on the provision of snacking
frequency towards young obese particularly male teenagers is identified
particularly in the context of Malaysia. Realizing such limitation, a case
study at a small setting in Shah Alam has been conducted by the
researchers to investigate the snacking frequency amongst obese male
teenagers at school. Result revealed that most respondents eat snacks
more than three meals per day (162, 68%), compared to 57
respondents or 24% mentioned “less than twice a day” and about 19
respondents or 8% were said, “I never ate snack”. Therefore, local
health and education authorities need to work in close collaboration in
order to address the problems. Besides, a provision should be made for
parental education, a healthy school canteen policy, and a supportive
school environment.
33

S3.5 A Randomised Controlled Trial of Childhood Obesity
Treatment in Malaysia: The Preliminary Findings of MASCOT
Sharifah Wajihah Wafa SSTW 1, Ruzita AT2, Roslee R2, Ng LO3,
Ayeisah R4 & Reilly JJ1
1Division of Developmental Medicine Human Nutrition, Faculty of
Medicine, University of Glasgow, Glasgow, United Kingdom
Kuala Lumpur
3Health Psychology Unit, Faculty of Allied Health Sciences, UKM, Kuala
Lumpur
4Physiotheraphy Unit, Faculty of Allied Health Sciences, UKM, Kuala
Lumpur
A study was carried out to determine whether a MASCOT (Malaysian
Childhood Obesity Treatment) weight management program reduced
BMI z-score relative to no treatment among obese children. The study
design consisted of an assessor-blinded, randomised, controlled trial
involving 107 obese children (54 boys, 53 girls; BMI >95th percentile
relative to CDC reference) aged between 7 and 11 years who were
randomly assigned to a MASCOT program (intervention) or no
treatment (control) organised between November 2008 and April 2009.
The intervention used family-based group and behavioural strategies to
modify diet, physical activity and sedentary behaviour. BMI z-score,
weight, objectively measured physical activity and sedentary behaviour,
and quality of life (QoL) were recorded at baseline and at 6 months.
There were significant differences between groups for indicators of
height, weight and BMI (p=0.01, p=0.02, p=0.04, respectively) at
baseline. The mean BMI z score at baseline were 3.1+0.5kg/m2 and
2.8+0.8kg/m2 for intervention and control groups, respectively. The
intervention had no significant effect on BMI z score from baseline to 6
months (p=0.93). However, the BMI z-score significantly increased in
control group from baseline to 6 months (p<0.05). Weight significantly
increased in both groups from baseline to 6 months (p<0.00,
respectively). At baseline, the proportion of monitored time spent in
sedentary behavior was high and participation in moderate-vigorous
physical activity (MVPA) was extremely low in both groups (intervention:
0.7+0.6%; control: 0.7+0.7%, respectively). There were significant
between-group differences for the total activity (mean count per minutes)
and percentage of time spent in light-intensity physical activity at
baseline in favour of the intervention (p<0.00, p<0.05, respectively).
Percentage of time spent in MVPA significantly increased from baseline
to 6 months in intervention group (p=0.01). There is no significant
34

between-group differences were found for changes in QoL scores for
the child self-report from baseline to 6 months. However, there were
significant between-group differences in parent-proxy report for
psychosocial sub-score (p<0.05) and total score (p<0.05) at 6 months.
Children-reported QoL scores for psychosocial sub-score and total
score significantly improved from baseline to 6 months in intervention
group (p<0.05, respectively). In conclusion, the MASCOT weight
management programme that was tested in this study had modest
benefits for BMI z-score, for objectively measured physical activity and
for QoL.
35

MASO Dinner Lecture
The Importance of Weight Management in Preventing
and Managing Diabetes
W Philip T James
London School of Hygiene & Tropical Medicine
President, International Association for the Study of Obesity (IASO)
Type 2 diabetes is a remarkable problem in Malaysia but the
implications of having such high levels of glucose intolerance have also
not been fully recognised. The continuing escalation of diabetes predicts
a huge medical burden affecting not only general clinical and
cardiovascular services but also the demands on the relatively scarce
ophthalmic and renal dialysis facilities. Weight gain with its associated
dietary contributors and physical inactivity is the principal determinant of
why individuals develop type 2 diabetes; those with a family history of
diabetes are particularly vulnerable. However, the markedly increased
sensitivities of the whole population to developing type 2 diabetes has
not yet been taken on board in terms of major changes in clinical
practice. Three approaches are going to be required: first in those with
newly diagnosed diabetes the role of immediate and appreciable weight
loss has not yet been fully understood partly because of the poor
experience of the UK PDS studies where dietetic advice was incoherent
and often misleading. The dramatic impact of bariatric surgery is a vivid
proof of the extreme value of weight loss. Secondly there needs to be a
new approach to identifying those with glucose intolerance with
immediate measures to combat the problem and prevent the
development of diabetes. Thirdly a new approach to prenatal,
pregnancy and post natal care could potentially limit the susceptibility of
children to developing diabetes. The benefits of weight management in
patients with diabetes will be illustrated by the use of sibutramine and/or
orlistat in promoting improvements in fasting glucose, insulin resistance
and HbA1c values. The critical role of reducing fat and increasing
physical fitness will also be considered and how best to do this. The
preliminary results form the SCOUT cardiovascular trial will also be
used to show the potential impact of weight management on
cardiovascular morbidity and mortality.
36

Abstracts of Papers
Symposium Day 2
Symposium 4: Behavioural Aspects of Obesity
S4.1 Self-esteem, Life Satisfaction and Weight Measures in the
Malaysian Urban Community
37
Ng LO
Health Psychology Unit, Faculty of Allied Health Sciences, UKM, Kuala
Lumpur
Studies in obesity and mental health have shown a relationship between
increased body mass index and the risk of psychological disorder. Apart
from an increased risk of suffering from physical problems related to
obesity, people who are overweight and obese are also often viewed in
a negative light, leading to prejudice and discrimination. As such the
quality of life in the overweight and obese is at risk of being negatively
affected due to physical and psychological problems. This study
investigates the relationship between weight measures and
psychological health measures, namely body mass index (BMI), and
waist circumference against self-esteem and general life satisfaction
scales. A total of 332 participants were surveyed at random from
shopping centres around the Klang Valley in Malaysia. They were
surveyed for sociodemographic information, anthropometric details with
regards to height, weight and waist circumference, as well as on the
Rosenberg Self-esteem Scale and the Satisfaction with Life Scale. This
survey only included participants with normal BMI and above, leaving
out underweight individuals for the purpose of controlling for related
confounds. Results revealed that the average person studied in this
survey is overweight based on the Asian classification of BMI. There
was also a significant negative correlation between waist circumference
and life satisfaction. Life satisfaction was highly correlated with self-esteem
although self-esteem was not significantly correlated with waist
circumference, or BMI. As such, this study concludes that while there is
a trend of smaller waistlines leading to better life satisfaction, self-esteem
seems to be independent of either measures of weight among
people in urban Malaysia.

S4.2 The Differences in Attitudes toward and Beliefs about Obese
Persons among Malaysian Chinese and Malaysian Indian
Priyadarshini MS, Lai YJ & Jacqueline Hoe M
Dept of Psychology, School of Health & Natural Sciences, Sunway
University College, Bandar Sunway, Selangor
Obesity refers to an excess of body fat, which normally accounts for
about 25% of weight in women and 18% in men (Wadden, Brownell, &
Foster, 2002). Obesity can be formally defined as abnormal or
excessive fat accumulation that presents risk to health (WHO 2009).
Researchers have shown that the stigma of obesity is widespread.
Obese people are less liked and viewed less favorably when compared
with people of normal weight. In this present research study, the interest
of the investigation was whether Malaysian Indians, as compared with
Malaysian Chinese, have a more positive attitude toward obese persons
and stronger beliefs that obesity is not within the control of the obese
individual themselves. To investigate this, a survey was conducted on
60 Malaysians (30 Chinese and 30 Indians, mean age = 21.35 years)
who were required to answer a set of questionnaire that consists of the
demographic sheet, the Attitudes Toward Obese Persons (ATOP), and
Beliefs About the Obese Persons ( BAOP). The results found that, only
the Chinese males have significantly positive attitudes towards obese
persons. The implications of this study affect policies which relate to the
effect of globalization and acculturation, which are reflected in the
attitudes and beliefs of races in a multi-cultural society.
S4.3 Dietary, Exercise and Mental Attitude Patterns in Subjects’ 6-
months into a Weight Management Program
Priya MM, Vandana S & Kavitha R
Research Associate, Dept of Epidemiology, INDIAB, Madras Diabetes
Research Foundation [MDRF], Gopalapuarm, Chennai 600 086, India
The purpose of this study is to observe dietary, exercise and mental
attitude patterns in subjects‟ 6-months into a weight management
program. Among study subjects [n=155] who had participated in a 6-
week weight loss competition at a tertiary obesity care centre, 55 were
lost to follow-up; the remaining 100 were recruited for the present study
and were followed-up for 6 months. A general questionnaire captured
the demographic details, physical activity, personal habits, and exercise
38

and health profile. Nutritional profiling included dietary habits, a food
frequency questionnaire and a 24-hour diet recall. Mental attitude was
captured via the body shape questionnaire [BSQ], life effectiveness
questionnaire [LEQ] and resilience questionnaire. The mean age was
38.511.7 years. 79 individuals maintained/lost weight [Geometric mean
1.806 kg, Maximum=18 kg]; the remaining 18 individuals gained weight
[1.367 kg, Maximum=8.9 kg]. Females exercised more frequently than
males [p-value<0.001]. Among study subjects 52% were non-vegetarian
and the protein: carbohydrate: fat ratio was 19:73:16 [n=100];
comparable to a “very low fat and a very high carbohydrate diet”. Except
when coping with stress, >85% of the subjects were effective in most
areas of their lives and resilient irrespective of gender. Females have a
significantly lower body image than males [p-value<0.001] with a higher
mean BSQ scores at age intervals ≤ 20 years (43.8±16.5) [Males=16±0,
p-value=0.05], 21-40 years (41.8±13.9) [Males=28±13.5, p-value<0.005]
and 41-60 years (34.0±10.3) [Males=20.4± 8.6, p-value<0.001].
However at age ≥61 years an inversion in pattern was observed with
males being less accepting of their body image [Males=42.5±23.3,
Females=20.5±2.1], although the difference did not reach significance.
We observed that individuals, who showed a steady decline in their
anthropometric indices and had higher life effectiveness scores,
managed their weight more effectively over the 6-months period.
S4.4 Relationship between Weight and Mental Health
39
Cheong SK, Teoh HJ & Woo PJ
Dept of Psychology, Sunway University College, Bandar Sunway,
Selangor
A total of 431 youths consisting of 216 males and 215 females were
studied to ascertain the relationship between weight and mental health
issues amongst youth. Measures of mental health were assessed based
on Depression-Anxiety-Stress Scale (Lovibond & Lovibond, 1995) and
Multidimensional Scale of Perceived Social Support (Zimet, Dahlem,
Zimet & Farley, 1988) and the weight was measured based on
calculated Body Mass Index (BMI). In addition to standardised
questionnaires, the participants were also required to answer questions
about perception of weight and daily eating habits. The results indicated
a positive relationship between BMI towards depression, anxiety and
stress while a negative relationship was observed between BMI and
perceived family social support. With regards to overall weight
perception, more than half of the female participants reported to

perceive themselves as overweight. The implication of this study can be
useful in the development of youth health/wellness programme which
takes into account of the mental health needs of youth.
S4.5 Transtheoretical Model of Change and Weight Control among
Sarawak Natives
Chang CT1, Hong KS2 & Chang KH3
1,3Dept of Nursing, Faculty of Medicine & Health Sciences, UNIMAS,
Sarawak
2Faculty of Cognitive Science & Human Development, UNIMAS,
Sarawak
This study was conducted to determine the applicability of
Transtheoretical Model of Change to examine the Stages of Change,
the Decisional Balance and the self efficacy in weight control among
Bidayuh, Malay and Iban in Sarawak. A total of 271 respondents
participated in this cross-sectional study. Interview using structured
questionnaires was used to collect data. Findings showed that 60.5% of
these respondents were in the Precontemplation, while around 20.7%
were in the Contemplation Stages of Change for weight control.
Education level, household income and age had significant influence on
stage distribution in which higher percentage of respondents with higher
education, higher income and younger age took action to lose weight.
Confirmatory factor analyses failed to replicate the original subscales of
Weight Efficacy Lifestyle Questionnaire and Decisional Balance Scale of
this model of change. Exploratory factor analyses were performed to
determine the factorial structure of these measurements. Two con and
one pro subscales were determined for Decisional Balance Scale. Three
subscales were determined for self-efficacy questionnaire. The
relationship between self efficacy, decisional balance and Stages of
Change were tested using non-parametric tests which showed statistical
significant difference between groups. Findings showed that
Transtheoretical of Change could be applicable to study natives‟ weight
control intention, self efficacy and their decisional balance pattern in
weight control. The findings also indicated that stage determination was
crucial to ensure stage-match weight control intervention. In addition,
findings suggested the use of self efficacy questionnaire and decisional
balance scale to evaluate the intermediate outcomes of weight loss
interventions implemented in Malaysia especially among the rural
natives of Sarawak.
40

Symposium 5: Management and Treatment of Obesity
S5.1 Can Food Solutions Win the War Against Obesity?
41
Zhang P
Nestlé R&D Centre Beijing Ltd., Beijing, China
Obesity is a complex issue. Although the pathophysiology which
underlines the initiation and chronic nature of this disorder remains
largely unknown, the basic reason is clear: energy intake is more than
energy expended over an extended period of time. Food manufacturers
invest in the innovation and renovation of its portfolio of products to
provide practical food solutions for weight management. Scientific
approach is multidisciplinary, focusing on understanding the interactions
between genetics, food selection, and psychological factors. A few
examples of key finding include: the ingestion of fast-absorbable
proteins, like whey proteins, results in a greater postprandial
aminoacidemia and a higher beta-cell secretion than the ingestion of a
“slow” protein; modulation of gut microflora ameliorates glucose
tolerance of mice by altering the expression of hepatic and intestinal
genes in inflammation and metabolism; consumption of a beverage
containing green tea catechins and caffeine increase energy
expenditure by 106±31 kcal/24 hours; certain naturally occurring
flavonoids act as inhibitors of human α-amylase, which could help to
control blood glucose; exposure to a greater food variety at weaning
facilitated greater acceptance of new food. The effects of repeated
exposure appear to be long lasting as 63% of the infants were still
eating and liking the initially-disliked vegetable after nine months post-study.
The research findings will be used to develop food and beverage
applications that satisfy specific consumer preferences that meet
individual nutritional needs. Food manufacturers‟ goal is to promote a
healthy and active life and make it easier for people to maintain a
healthy weight while still getting essential pleasure from their food.

S5.2 A Successful Dieting through Avoiding High-fat Diets and
Performing light-Resistance Exercise to Prevent Metabolic
Syndromes and Sarcopenia
42
Suzuki M
School of Sport Sciences, Waseda University Tokorozawa, Saitama,
Japan
Habitual exercise and food restriction are the most popular therapies for
obese individuals. Although food restriction using low calorie diets has
the most immediate weight reduction effect, it will result in the loss of
muscle mass due to decline resting metabolic rate (RMR), leading to
sarcopenia in old age. Decline in RMR may inhibit subsequent weight
loss and its maintenance; in addition they enhance the development of
metabolic syndromes. Apart from positive energy balance as the main
contributing factor to obesity, the difference in dietary energy
composition can alter body fat deposition, even if energy intake remains
the same. The diet-induced thermogenesis (DIT) is much lower in a
high-fat diet than in a low-fat/high-carbohydrate diet. In addition to the
percentage of fat in total energy consumption, the simultaneous intake
of fat and sugars from sweet foods and drinks is another important
reason for the enhanced efficiency of body fat deposition from dietary fat.
This has been clearly demonstrated by rat study that a more efficient
body fat accumulation occurs when fat is ingested together with
insulinogenic sugar as compared with the separate ingestion of fat and
sugar. This is due to activation of lipoprotein lipase in adipose tissue by
insulinogenic sugar concurrently with the increased supply of TG into
the blood. Feeding on high-fat diet feeding over generations can have
an effect on the efficiency of body-fat accumulation in the offspring. We
have investigated the effect of a parental high-fat diet on body-fat
accumulation in the offspring. The results suggest that a parental high-fat
diet before intrauterine developmental stage may increase body-fat
accumulation in the offspring, suggesting parental diet may influence the
lifelong health of offspring and epigenetic inheritance may be occurred.
In terms of increase in energy expenditure, aerobic exercise is generally
recommended because they result in a greater utilization of fat stores
and greater energy consumption than does anaerobic or resistance
exercise. However, aerobic exercise such as jogging, swimming or
aerobic dancing sometimes causes fat free mass (FFM) loss and is
difficult for many obese people to develop the habit of aerobic exercise
because of mental stress or orthopaedic lesions. Dumbbell exercise
(aerobic-resistance exercise with light dumbbells) is much easier to instil
as a habit as compared to general aerobic exercise. This exercise could

successfully reduce body weight and body fat without reducing FFM,
contrary could increase RMR and DIT. About three hours after a meal
both plasma glucose and TG significantly decreased. When the
dumbbell exercise was applied after a high-protein snack, the muscle
mass and strength were significantly increased with a marked reduction
of body fat. Thus enhancement of energy expenditure in RMR (BMR)
and DIT by the light-resistance exercise with low-fat diets may produce
a successful dieting favoring of the prevention of metabolic syndromes
and sarcopenia.
S5.3 Paediatric Obesity: Outpatient Management in a District
General Hospital
43
Menakaya C, Lee C & Puttha R
Dept of Paediatrics, Fairfield General Hospital, Bury, Lancashire, United
Kingdom
Obesity is a hot topic which has a major impact on physical, social,
emotional well being of an individual including huge financial impact on
a country‟s economy. It increases morbidity and mortality particularly
when linked with disease, notably diabetes, dyslipidaemia and
hypertension. Because of the rising prevalence among the paediatric
population, we carried out a prospective audit to identify the percentage
of children attending clinics who were overweight or obese and how
medical staff managed these children. We conducted a prospective
audit over a period of three months on children attending outpatient
clinics in a district general hospital. 136 cases were selected randomly
but only 105 children were studied. Children under the age of 1.5 years
were excluded from the study. Subjects had anthropometric
measurements taken during clinic attendance. We looked at the
management plan with special interest on assessments or investigations
done to determine cause of weight gain by attending healthy
professionals and follow-up plans. 10% of children studied were
overweight with a male to female ratio of 9:2. Overweight children were
aged between 1.9 to 12.2 years. None of these children were assessed.
However, 50% of the 21% obese children were assessed and had
follow-up plans. Obese children were aged between 1.6 to 16.7 years
with a male to female ratio of 12:10. Childhood obesity is becoming a
huge problem worldwide with a rising prevalence in developed countries.
The number of overweight and obese children in the UK has risen over
the past 20 years with estimated 14 percent of boys and 17 percent of
girls aged two to 15 obese in 2004. It is the duty of health professionals

to identify these children and initiate prompt measures bearing in mind
the health problems associated with obesity in adult life.
S5.4 Promoting Weight Loss among Obese Participants through a
Community-based Behavioural Intervention Program in Kelantan
Wan Suriati WN2 , Wan A Manan1, Rohana AJ2 & Harmy MY2
1School of Health Sciences, USM Health Campus, Kubang Kerian,
Kelantan
2School of Medical Sciences, USM Health Campus, Kubang Kerian,
Kelantan
The purpose of this study was to evaluate the effectiveness of weight
loss and change in body composition among obese adult volunteers
who participated in the healthy lifestyle community-based intervention
program in three districts of Kelantan. Data were derived from 63
participants (at baseline and at the end of the program) from each
district whereby Kota Bharu represented for control groups (n=25)
(Group I), Pasir Mas as an Intervention Group II and participants from
Intervention Group III was carried out in Bachok District. The
intervention was carried out weekly and simultaneously at three different
locations to avoid contamination among participants. The intervention
package consisted of behavioral modification, physical activity, and
nutrition education. No intervention was introduced for the control group,
Group II implemented weight resistance exercise and Group III was
instructed for walking exercise. At the end of the program, the change in
body weight and body composition variables which include percentage
of fat, percentage of body mass and weight of fat showed significant
differences (p<0.05). In term of group comparison, there was a
significant difference (p<0.05) between groups with different intervention
based on ANOVA test. ANOVA Repeated Measures showed there was
a main effect of time (baseline and post intervention) [F (1, 62)=46.75,
p<0.05] and also significant interaction (effect of different intervention
toward weight loss) [F (1, 62)=33.842, p<0.05] in this study. However,
post-hoc study Bonferonni test showed there was a significant
difference of mean weight loss between Control and both intervention
groups, but the difference was not indicated between intervention
groups. In conclusion, this study showed there was a significant
improvement in body weight and body composition in both the aerobic
exercise (walking regiment) and anaerobic exercise (dumb bell
regiment).
44

Symposium 6: Emerging Issues and Technologies
46
Related to Obesity
S6.1 Feeding Regulation and Energy Metabolism in Brain -Novel
GPCR Ligands-
Shioda S, Takenoya F, Shiba K & Kageyama H
Dept of Anatomy, Showa University School of Medicine, Tokyo, Japan
Novel neuropeptides of G-protein coupled receptor (GPCR) ligands are
shown to be localized in brain and play a range of physiological
functions including feeding regulation and energy metabolism. Here, I
will describe the distribution and localization of these GPCR ligands
identified recently and to review their involvement in neuronal networks,
particularly feeding regulation and energy metabolism. This presentation
concerns some novel GPCR ligands of feeding and energy metabolism-regulating
neuropeptides such as orexin, ghrelin, galanin-like peptide
(GALP) and neuropeptide W (NPW), such as those studied by our
research group and others, and neuronal interactions among these and
other well known neuropeptides such as neuropeptide Y (NPY) and
alpha-melanocyte stimulating hormone (alpha-MSH) in the
hypothalamus. Cross-talk among several these neuropeptides-containing
neurons in the hypothalamus plays a key role in determining
feeding states as well as feeding behavior. I will show some structural
and functional characteristics of these very recently discovered
neuropeptides and summarize the known interactions between these
different kind of feeding regulating neurons and leptin-targeting neurons
in the hypothalamus. Moreover, I will present a new strategy for
analyzing the neural circuit of these feeding- and energy metabolism-regulating
GPCR ligands-containing neurons in brain by use of
transgenic model mice. Finally, I will present our very recent results of
GALP which are involved in regulation of feeding as well as energy
homeostasis and body temperature. I will show our hot data of
intranasal infusion of GALP to decrease body weight and locomotor
activity in animal models. Research in this field will serve a very
important role of clarifying neurologically-based causes for appetite
dysfunctions and diseases and it may help to establish and to lead new
therapies for people who are suffering such conditions.

S6.2 BMI, a Better Predictor of Hypertension among a Tribe of
Sikkim, India: Evidence of Gene-lifestyle Interaction
47
Sarkar S
Dept of Anthropology, Vivekananda College for Women & Haldia
Government College, Kolkata 700 008, India
The association of obesity on cardiovascular disease (CVD) risk factors
is well established phenomenon. On the other hand, the angiotensin
converting enzyme (ACE) insertion/deletion (In/Del) polymorphism has
been identified as one of the genetic risk factors for hypertension.
Studies, worldwide, have reported the possible effect of obesity, lifestyle
variables and gene-environment interaction on hypertension. Present
study has examined the possible association of ACE In/Del
polymorphism and a set of lifestyle related variables on hypertension
among the Bhutias, a tribe of Himalayan State of Sikkim, India.
Moreover, it evaluated body mass index as an independent predictor of
hypertension among the population. Such study has never been
attempted among any Himalayan tribe. A total of 739 Bhutias of both
sexes from urban and rural habitat were chosen initially for the study.
After receiving informed consent, data on blood pressures and
anthropometrics were collected from all of them. Further, data on
lifestyle related variables viz. dietary habit, physical activity pattern,
socioeconomic status, perceived psychosocial stress, substance use
and genotype for ACE In/Del polymorphism, were obtained from
systematically selected sub-samples. The data were pooled for sex, as
sex effect was absent in any of the age-adjusted dependent variables.
One way ANOVA shows significant difference for both the blood
pressures when the mean values were compared with BMI sub-categories.
Logistic regression analysis shows ACE In/Del
polymorphism and few lifestyle related variables as significant predictors
of hypertension. Further, after adjustment of significant predictors,
adjusted odds ratio depicted BMI and waist circumference as significant
predictors of hypertension. ROC curve analysis shows BMI as the
independent predictor of hypertension among the study population.
Although association of genetic polymorphism and lifestyle related
variables play an imperative role behind the adverse profile of
hypertension among the study population, BMI is found to be the most
important variable, predicting hypertension significantly.

S6.3 Obesity Screening for Young Japanese Males and Females
Using Skin Fold Measurements: The Classification Revisited
Kagawa M1,2, Uenishi K3, Mori M3, Uchida H4, Kerr D5, Binns CW5 &
Hills AP
1Institute of Health & Biomedical Innovation, School of Human
Movement Studies, Queensland University of Technology, Brisbane,
Australia
2Dept of Health Promotion, National Institute of Public Health, Saitama,
Japan
3Kagawa Nutrition University, Saitama, Japan
4School of Human Science & Environment, University of Hyogo, Japan
5School of Public Health, Curtin University of Technology, Perth,
Australia
Anthropometric assessment is a simple, safe, and cost-efficient method
to examine the health status of individuals. In Japan, the classification of
obesity based on the sum of two skin fold thickness (Σ2SF) is available.
However, the classification was proposed nearly 40 years ago and its
applicability to Japanese living today is unknown. The current study
aimed to determine Σ2SF cut-off values that correspond to percent body
fat (%BF) and BMI values using two datasets of young Japanese adults
(233 males and 139 females). Using regression analysis, Σ2SF and
height-corrected Σ2SF (HtΣ2SF) values that correspond to %BF of 20,
25, and 30% for males and 30, 35, and 40% for females were
determined. In addition, cut-off values of both Σ2SF and HtΣ2SF that
correspond to BMI values of 23 kg/m2, 25 kg/m2 and 30 kg/m2 were
determined. In comparison with the original Σ2SF values, the proposed
values are smaller by about 10 mm at maximum. In comparison with the
original values, the proposed values showed an improvement in
sensitivity from about 25% to above 90% to identify individuals with
≥20% in males and ≥30% in females with high specificity of about 95%
in both genders. The results indicate that the original Σ2SF cut-off
values to screen obese individuals cannot be applied to young
Japanese adults living today and modification is required. Application of
the proposed values may assist screening in the clinical setting. It is
recommended that the present findings be confirmed using more
advanced body composition assessment techniques and with a larger
sample size across a wider age range.
48

S6.4 A Framework of Web-mobile Intelligence Monitoring System in
the Management of Obesity for Malaysian Community
Nasriah Zakaria, Wahidah Husain, Faten Damanhoori & Norlia
Mustaffa
School of Computer Sciences, USM, Minden, Penang
The growing number of our population with obesity and chronic
diseases encourage us to propose the Web-Mobile Intelligence
Monitoring System. Current technologies such as internet and mobile
phone can be used to replace the intensive face to face consultation.
One way to improve current healthcare practice is by introducing new
services that will support the community with obesity problems in self
management and monitoring health disorders. The objectives of the
system are to provide intelligent health-care management that will
contribute to better decision making; to improve the current process of
healthcare delivery by supporting communication and sharing of
information; and to serve the needs of the current life style, improve
health outcomes, and strengthen public health. The system will focus
on three critical issues in management and monitoring health status
which are promoting weight control; encouraging physical activity; and
improving knowledge of healthy life style. In order to handle these
issues, the system will be designed to provide daily/weekly healthcare
data management, intelligent monitoring of diet and physical activities,
intelligent alert and reminding message and intelligent diet planning and
menu construction. The system will combine internet with mobile-phone
technologies in order to develop the intelligent management and
monitoring personalized healthcare application. The system will
integrate personal, food and nutrients databases and general healthcare
knowledge-based, including decision support system to assist in both
technical and clinical decision making. The system can also become an
effective tool to communicate and educate the users in order to improve
their understanding of the related diseases. The system will only focus
on the management of obesity problems in our society. In future the
system can also be applicable to other chronic diseases related to
obesity such as diabetes, high blood pressure and heart disease.
49

S6.5 Body Mass Index, Waist Hip Ratios and Novel Phenotypic
Markers: A Triad for Detecting Diabesity in a Population of
Tamilnadu, South India
Shajithanoop S1, Mohan V2, Arun K3 & Usha Rani MV1
1Genetics Laboratory, Dept of Environmental Sciences, Bharathiar
University Coimbatore 641 046, Tamilnadu, South India
2Madras Diabetes Research Foundation, ICMR Advanced Centre for
Genomics of Diabetes, Gopalapuram, Chennai 600 086, India
3Diabetes Specialities Care, Coimbatore, Tamilnadu, India
Asian Indians have a higher propensity towards diabetes and metabolic
syndrome mainly attributed to the Asian phenotype and lifestyle pattern.
Early detection of obesity and diabetes occupies prime position in health
care systems of today. The clinical diagnosis of obesity and its
management lies in accurate and validated anthropometric standards. A
total of 108 overweight and obese subjects, (mean age: 36 years) from
urban regions of Coimbatore, South India were recruited in the study
with mutual consent. A questionnaire based interview was conducted to
analyze socio-demographic factors and dietary pattern. Routine
anthropometric measurements, (body mass index, waist circumference
and hip circumference) were recorded as per the guidelines for Asian
Indians. Further, novel phenotypic markers namely „double chin‟,
„buffalo hump‟ and „Acanthosis nigricans‟ were used for the detection of
metabolic syndrome and diabesity. Subjects with any two of the novel
phenotypic markers were screened for dyslipidemia and Type 2
Diabetes. Subjects with hypertriglyceridemia (Mean TGL = 165 mg/DL),
elevated BMI ≥ 28.04 kg/m2 (Mean age = 36 years), Acanthosis
nigricans and buffalo hump were at risk for diabesity (Mean FBG = 136
mg/DL). Buffalo hump and double chin had positive correlations with
metabolic syndrome among men in the study cohort. In addition to Body
mass index, and Waist hip ratios, the novel phenotypic markers serve
as quick clinical indicators for detecting diabesity in Asian Indians.
50

LIST OF POSTERS
GROUP A CAUSES AND CONSEQUENCES OF OBESITY
GROUP B EPIDEMIOLOGY OF OBESITY
GROUP C CHILDHOOD OBESITY
GROUP D BEHAVIOURAL ASPECTS OF OBESITY
GROUP E MANAGEMENT AND TREATMENT OF OBESITY
GROUP F EMERGING ISSUES AND TECHNOLOGIES
RELATED TO OBESITY
GROUP G EXPERIMENTAL STUDY
GROUP A: CAUSES AND CONSEQUENCES OF OBESITY
A01 Obesity as a Risk Factor for Lower Cognitive Function:
Using Measurement of Visceral Adipose Tissue Areas and
Subcutaneous Tissue Areas by Computed Tomography
Scan
Dae HY
A02 The Relationship of Diet Quality and Body Mass Index (BMI)
of Husbands and Wives in a Selected Urban Area in
Selangor
Asma’ A, Nawalyah AG, Rokiah MY & Mohd Nasir MT
A03 Leg Vascular Conductance Kinetics in Lean versus
Overweight and Obese Young Men
Egaña M & Sherlock M
A04 Metabolic Risk Factors among Adults with Abdominal
Obesity at Universiti Putra Malaysia, Serdang, Selangor
Darul Ehsan
Hazizi AS, Heng KS, Mohd Nasir MT, Hejar AR & Chan YM
A05 Clinical and Biochemical Profiles in Obese Children with
Fatty Liver
Suhaimi H, Anisa, Zaqrul, Yazid & Fatimah H
A06 Obesity and Pregnancy: A Review of the Literature on
51
Obesity and Pregnancy
Buba Amina

A07 Physical Activity and Breast Cancer: A Case-Control Study
Rabeta MS, Suzana S, Poh BK & Ahmad Rohi G
A08 Lower Extremity Biomechanics in Obesity - Rehabilitative
Perspective
Aravind KK, Nagarajan M, Sunitha CN, Praveen JS & Nalini A
A09 Abdominal Adiposity - An Ideal Predictor for Hypertension
in Two Different Occupational Cohorts of a Rural Population
of Tamilnadu, South India
Shajithanoop S & Usharani MV
A10 The Effect of Obesity on Microvascular Endothelial
Function in Humans
Belqes AA, Yvonne-Tee GB, Abdul Aziz AI & Aida Hanum GR
GROUP B: EPIDEMIOLOGY OF OBESITY
B01 Physical Activity & Sedentary Behaviors among the
Adolescents in Petaling District, Selangor
Kee CC, Lim KH, Ismail MN, Poh BK, Amal NM, Sumarni MG,
Christopher VW & Lim KK
B02 BMI & Smoking Habits among Army Personnel in Kelantan
Rehanah MZ, Aziz AI, Azwany YN, Hatim SN, Filza IA, Mohd Zin
B & Mohd Isa B
B03 Eating Attitude, Lifestyle Practices & Body Image
Perception among Middle Eastern & Malaysian Students of
UCSI University
Koh HJ & Satvin K
B04 Gender Differences in Psychosocial Predictors of
Disordered Eating Behaviors
Amina Muazzam & Ruhi K
B05 Gender Differences in Body Weight Perception and Weight-loss
Strategies among Undergraduates
Kuan PX, Henry RG, Ho HL, Shuhaili MS & Siti Alia A
52

B06 The Association between Weight Status and Iron Deficiency
among Male Adolescents
Lau XC, Ismail MN & Poh BK
B07 Knowledge, Attitude & Practice in Relation to Obesity
among Malay Married Women in Hulu Langat, Selangor
Norlaila MT, Aminah A, Suriah AR & Noriah MI
B08 Disordered Eating Behaviors: An Overview of Asian
53
Cultures
Amina Muazzam & Ruhi K
GROUP C: CHILDHOOD OBESITY
C01 Physical Activity, Body Composition and Resting Metabolic
Rate in Relation to Obesity and Metabolic Syndrome among
Schoolchildren Aged 8 to 10 Years Old
Quah YV, Poh BK & Ismail MN
C02 Dietary Intake of Obese and Normal Weight School Children
Aged 9 to 12 Years Old
Kok LP, Poh BK & Ismail MN
GROUP D: BEHAVIOURAL ASPECTS OF OBESITY
D01 Our Children … Our Life … Their Health … Our Concern
Sherif FMO, Abduelkarem AR & Tawati AM
D02 Eating Attitude, Lifestyle Practices and Body Image among
Malaysian and African female Students in UCSI University
Tan ZY & Satvinder K
D03 Readiness to Change among Overweight and Obese
Patients Attending Dietary Counseling: Does It Really
Matter?
Rasyedah AR, Chan SF & Ruzita AT

D04 Relationships between Elevated BMI and Negative Body
Image and Disordered Eating Behaviors in Adolescent Girls
Chin YS, Mohd Nasir MT, Zalilah MS, & Khor GL
D05 Factors Contributing To Body Image Dissatisfaction among
Malaysian Population Tan KL & Woo PJ
GROUP E: MANAGEMENT AND TREATMENT OF OBESITY
E01 The Effect of a 3- Month Modified Lifestyle Program on
Arterial Stiffness and Anthropometric Measurements in
Overweight Patients
Farah Diana A, Vina Tan PS, Aziz Al, Zurkurnai Y, Siti Azima,
Wan Rimei & Aida Hanum GR
E02 ‘Live Healthy, Work Healthy’ Wellness Program Improved
Medical Leave and Health Status for Employees
Bee SW & Wong SF
E03 Effect of 500 kcal Reduction of Estimated Energy
Requirement on Lean Body Mass and Body Fat in
Overweight and Obese Patients
Alireza SS, Mohammadtaghi S& Mohsen N
GROUP F: EMERGING ISSUES AND TECHNOLOGIES
54
RELATED TO OBESITY
F01 Pharmacological & Non-pharmacological Interventions
Beneficial in Improving Vascular Function & Cardiovascular
Risk in Obesity – Study Methodology
Aida Hanum GR, Al-Safi AA, Vina Tan, Belqes AA, Tee GB,
Mazlyn M, Sukari Halim A, Abd Rahim W, Zurkurnai Y, Farah
Diana, Siti Azima, Wan Rimei
F02 Association of Tyr111His Polymorphism of Exon 3 of
Adiponectin Gene with Obesity in Iranian Population
Mesbah-Namin SA, Nejad Ali M, Hosein Panah F, Hedayati M,
Aidi A & Daneshpour MS

F03 Prevalence of the Leptin Gene A19G and Leptin Receptor
Gene K109R, Q223R, K656N Variants and Obesity Risk
Factors among the UTAR Population
Say YH, Liew SF, Chuah HS, Lau CL & Lee CH
F04 Waist Circumference or Waist-hip Ratio: Which Is Better?
55
Eng JY & Moy FM
F05 Waist Circumference versus Waist: Height Ratio in Relation
to Cardiovascular Risk Factors in Children
Wee BS, Poh BK, Bulgiba AM, Ruzita AT & Ismail MN
F06 Ratio of Fasting Glucose to Adiponectin is an Important
Predictor for the Development of Type 2 Diabetes
Islam MN, Hossain MM, Khan I, Shefin SM, Rashid MA, Hafizur
RM, Faruque MO & Ali L
F07 Validation of Bioelectrical Impedance Analysis (BIA) against
Dual Energy X-ray Absorptiometry (DEXA) for the
Estimation of Body Composition among Adolescents
Liew SS, Poh BK, Kanaga KC, Nor Azmi K & Ismail MN
F08 Predicting Total Body Water using Bioelectrical Impedance
Analysis among Malay Children
Ong SC, Poh BK, Ismail MN, Quah YV, Lau YF & Hills AP
F09 Validation of Skinfold Thickness Method against Air
Displacement Plethysmography for Estimation of Body Fat
in Normal Weight and Obese Children
Lee SL, Ismail MN & Poh BK
F10 Development of Waist Circumference Percentiles for
Malaysian Children Aged 6 to 16 Years
Nurul Jannah A, Poh BK, Chong LK, Ruzita AT & Ismail MN
F11 Specificity and Sensitivity of Modified International Physical
Activity Questionnaire (IPAQ) among Middle-aged
Population of the Malaysian Cohort
Norsham Shamsuddin, Poh BK, Ismail MN, Syed Zulkifli Syed
Zakaria & A Rahman A J

GROUP G: EXPERIMENTAL STUDY
G01 Weight Changes After Supplemented of Mixture of
Strobilanthes Crispus and Roselle Tea in Rats
Asmah R & Nurul Syima H
G02 Induction of Cell Cycle Arrest (G1) and Apoptosis in 3T3-L1
Adipocytes by a Standardized Extract of Caralluma
fimbriata and a Pregnane Glycoside in It
Kamalakkannan S, Tirupathi Pichiah PB, Ramaswamy R &
Mohammad AA
G03 Anti-obesity Effect of Emu (Dromaius novachollandiae) Oil
in Diet Induced Obesity (DIO) in Male Wistar Rat
Achiraman S, Kamalakkannan S, Tirupathi Pichiah PB, Gayathri
A, Tamileela Selvi S, Udhaya A & Dora Clotilda JICHIAH P
56

Abstracts for Poster Session
GROUP A: CAUSES AND CONSEQUENCES OF
OBESITY
57

A02 The Relationship of Diet Quality and Body Mass Index (BMI) of
Husbands and Wives in a Selected Urban Area in Selangor
Asma’ A1,2, Nawalyah AG1, Rokiah MY1 & Mohd Nasir MT1
1Dept of Nutrition & Dietetics, Faculty of Medicine & Health Sciences,
2Dept of Food Science, Faculty of Agrotechnology & Food Science,
UMT, Terengganu
The objective of this study was to assess the diet quality of husbands
and wives and to determine the relationship between diet quality and the
Body Mass Index (BMI) of husbands and wives in a selected urban area
in Selangor. This cross-sectional was carried out in Bandar Baru Bangi
among 150 married couples aged 20 and above, who voluntarily agreed
to participate and were not practicing any special diet. Data were
collected using 2 days of 24 hour dietary recall and a food frequency
questionnaire (FFQ) to evaluate the quality of diet among husbands and
wives using the Diet Quality Index Revised (DQI-R). Demographic
characteristics including age, occupation, educational level, household
income and household size were also collected. Data were analyzed
using SPSS version 16 while analysis of nutrient composition was
conducted using the Nutritionist Pro software program (Axxya, USA)
which contains nutrient composition data of Malaysian foods. Results
showed that the mean DQI-R score which ranged from 0 to 100 for
husbands (mean age= 43.33 + 11.16 years) and wives (mean age=
41.28 + 10.93 years) were 67.8 + 9.1 and 64.4 + 9.3 respectively and
there was a significant difference found between scores of husbands
and wives, t (298) = 3.23, p = 0.001. In general, the diet quality of this
study population is not satisfactory and that the diet quality of husbands
is slightly better compared to that of their wives. Those who achieved
DQI-R scores exceeding 80, regardless of gender, had the lowest
percent of energy derived from fat, compared to other scores group;
whereas those who had scores below 50 for husbands and below 40 for
wives had the highest percent of energy derived from fat. As the DQI-R
scores increased, the percent energy derived from fat decreased.
Similarly, those with scores of more than 80 also had low saturated fat
and dietary cholesterol intakes compared to those with scores below 50
for husbands and scores below 40 for wives. Both husbands and wives
that achieved DQI-R scores of more than 80 also had the most
adequate levels of intake of fruits and vegetables as recommended in
the Malaysian Dietary Guidelines. Diet diversity scores were still low
among husbands and wives compared to diet moderation scores.
However, there was a weak correlation between DQI-R and BMI, r =
58

0.116, n = 300, p < 0.05 of husbands and wives in this study. Mean BMI
of the husbands was 25.68 + 3.28 compared to wives, which was 25.0 +
4.14 and no significant differences were found between husbands and
wives. DQI-R may be used as one of the indices to examine the food
intake, gauge macronutrient intake, mineral intake, Food Guide Pyramid
adherence, variety and moderation in the diet but not as the BMI‟s
predictor in this study. It is proposed that for future research, a standard
index for assessing diet quality in Malaysia will be developed. Another
suggestion is to determine whether the DQI-R is a reliable tool in
predicting nutritional status as well as disease outcomes of populations.
A03 Leg Vascular Conductance Kinetics in Lean versus
Overweight and Obese Young Men
59
Egaña M & Sherlock M
Physiology, University of Dublin, Trinity College, Dublin, Ireland.
Obesity is related to exercise impairment. However, the causes for the
exercise impairment are not well understood. Reduced delivery of
oxygen has been suggested to be a potential factor that can affect
exercise performance, but to date, the dynamics of the lower limb blood
flow have not been investigated. The purpose of the study is to
investigate leg vascular conductance (VC) (blood flow/mean arterial
pressure) kinetic responses during a high intensity constant-load calf
plantar-flexion exercise in overweight/obese (BMI: 27-35 kg.m-2) young
University male students. Eight lean (23±3 kg.m-2) and eight
overweight/obese (31±3 kg.m-2) inactive men were tested. Ethical
approval was obtained from the Trinity College Dublin Faculty Research
Ethics Committee. Initially, subjects performed a graded cycling
incremental test where expired gas and cardiac output measurements
were recorded. Subsequently, subjects performed three constant load
exercise bouts (6 min long) of intermittent calf plantar flexion exercise at
an intensity of 70% maximum voluntary contraction (MVC) on a upright
custom-built calf ergometer. Calf BF was measured contraction by
contraction using venous occlusion plethysmography. Kinetic analysis
was performed by fitting a biexponential function to the mean (3 bouts)
of the vascular conductance (BF/MAP) data. Results are shown as
mean±SD. Peak VO2 (ml.kg-1.min-1) was significantly lower for the obese
(29.8±2.4) compared to lean (37.5±4.3). Peak cardiac output (L.min-1)
was not different between groups (19.2±3.4 leans vs 18.6±1.2 obese). In
addition, all the calf VC kinetic parameters, the mean response time of
the complete response and the end-exercise amplitude were not

different between both groups. This study showed that the rate at which
vascular conductance responses increase during high intensity static
calf exercise is similar in lean and overweight/obese young men,
suggesting similar vasodilatory function in the two groups. Cardiac
responses were also similar between gropus. Factors related to oxygen
extraction might be linked to the exercise imparment observed in obese
subjects.
A04 Metabolic Risk Factors among Adults with Abdominal Obesity
at Universiti Putra Malaysia, Serdang, Selangor Darul Ehsan
Hazizi AS¹, Heng KS¹, Mohd Nasir MT¹, Hejar AR² & Chan YM¹
¹Dept of Nutrition & Dietetics, Faculty of Medicine & Health Sciences,
²Dept of Community Health, Faculty of Medicine & Health Sciences,
A cross-sectional study was carried out to assess the prevalence of
metabolic risk factors among staff of Universiti Putra Malaysia, Serdang,
Selangor Darul Ehsan. Recruitment of subjects was conducted between
April to December 2008. Data of metabolic risk factors including waist
circumference (WC), blood pressure (BP), triglycerides (TG), high
density lipoprotein cholesterol (HDL-C) and fasting plasma glucose
(FPG) were collected from physical examinations and biochemical
measurements. Subjects consisted of 201 adults (130 women, 71 men)
of 25 to 55 years of age with no reported chronic diseases but having
abdominal obesity, which was defined by WC ≥ 90cm for men and ≥
80cm for women. The difference of mean WC between men (99.3±8.5
cm) and women (91.7±8.6 cm) was significant (p=0.00, t=5.986). Mean
body mass index (BMI) for all subjects was 28.9±4.3kg/m². A total of
23.4% of the subjects had triglycerides level more than 1.7 mmol/l,
45.3% had HDL-C less than 0.9 mmol/l in males and less than 1.1
mmol/l in females, 21.4% had FPG more than 5.6 mmol/l and 40.3%
had elevated BP (systolic BP≥130mmHg and/or diastolic BP≥85mmHg).
By using the criteria of International Diabetes Association (2005), the
prevalence of metabolic syndrome among this sample was 35.8%, with
a higher prevalence among men (59.2%) as compared to women
(23.1%). Those with metabolic syndrome had higher mean WC
(97.2±8.5cm) than those without metabolic syndrome (92.9±9.3cm). A
positive significant correlation was found between WC and the number
of metabolic risk factors (p=0.000, r=0.268). There were significant
positive correlations between WC and TG (p=0.011, r=0.180), WC and
60

systolic BP (p=0.001, r=0.228) and WC and diastolic BP (p=0.000,
r=0.249) while no significant relationship was found between WC and
HDL-C or FPG. It was observed that among adults with abdominal
obesity, men were more prone to metabolic syndrome. For both gender,
there was an increased risk of metabolic syndrome by WC while those
with higher WC were more likely to have a rise in their TG and BP.
These findings reveal that metabolic syndrome was high in males than
females. Changes in lifestyle should be encouraged to avoid future
cardiovascular morbidity and type 2 diabetes mellitus.
A05 Clinical and Biochemical Profiles in Obese Children with Fatty
Liver
Suhaimi H, Anisa, Zaqrul, Yazid & Fatimah H
Dept of Pediatric, Faculty of medicine, Universiti Malaya, Kuala Lumpur
Objective of this study is to assess correlation between degree of
obesity and biochemical profiles suggestive of steatohepatitis. This is a
retrospective review of records of obese children referred for evaluation
of obesity to endocrine clinic in University Malaya Medical Centre
(UMMC) from 2005 to 2009. The clinical profile and biochemical
characteristic (liver enzymes and fasting lipid profiles) were studied to
find correlation between the degree of obesity as shown by body mass
index (BMI). Obesity related to genetic, syndromes, secondary forms
were excluded from the study. Steatohepatitis is a condition that causes
inflammation and accumulation of fat and fibrous tissue in the liver. It is
commonly seen in patients with obesity, type 2 diabetes and insulin
resistance. It is most often discovered during routine laboratory
investigations and most common findings are raised liver transaminases.
Excessive accumulation of lipids within hepatocytes is thought to be the
cause for steatohepatitis but the exact cause for this condition is
unknown. Non-alcoholic steatohepatitis can progress to liver cirrhosis
from adult studies. A total of 60 patients (40% girls, 60% boys), mean
age 10.3 +/- 3.63, median age 10 years were available for review. The
mean BMI was 29.5 +/- 6.74. Eighty five % had BMI > 24, 11 % with
BMI 20-23 and 3.3% had BMI < 19. At presentation, 80% had raised
ALT above the upper limit, 35% had raised AST, 32 % had raised
cholesterol, and 40% with raised LDL and 80% had low HDL. The
degree of obesity based on BMI was positively correlated with ALT
(r=0.347), cholesterol(r=0.256) and triglyceride level (r=0.307). Majority
of patients with obesity had biochemical evidences for hepatic steatosis.
The more severe the degree of obesity, the more likely the patients to
61

have abnormal biochemical markers for fatty liver. Long term follow up
are needed to determine the significance of metabolic derangements
related to hepatic steatosis in children.
62

A07 Physical Activity and Breast Cancer: A Case-Control Study
Rabeta MS1, Suzana S2, Poh BK2 & Ahmad Rohi G3
1Food Technology Division, School of Industrial Technology, USM,
Minden, Penang
2Dept of Nutrition & Dietetic, Faculty of Allied Health Sciences, UKM,
Kuala Lumpur
3Dept of Biomedical Sciences, Faculty of Allied Health Sciences, UKM,
Kuala Lumpur
A physical activity questionnaire was developed with modification of The
Breast Cancer Comprehensive Questionnaire, prepared for the National
Action Plan on Breast Cancer of the Office on Women‟s Health by
Institute for Survey Research Temple University. The questions about
exercise and physical activity were asked since the subjects were in
high school. The exercise and activities mean at least two hours a week
for four month or more in one year and will be categorized by strenuous
and moderate exercise. Strenuous activity mean the activities increase
the heart rate and breathing, and cause you to break out in a sweat
while the moderate activity mean activities involve prolonged, rhythmic
movements but do not increase your heart rate or breathing as much as
strenuous exercise. A prospective case-control study was done among
70 newly diagnosed breast cancer patients and 138 controls aged 29-65
years old in Klang Valley to examine the lifestyle related risk factors for
breast cancer in women. The study was started from January 2005 until
Jun 2006. The inclusion criteria for cases (i) pathologically newly
diagnosed breast cancer (stage I to III) (ii) that had not undergone any
therapy for cancer (iii) no other chronic diseases such as hypertension
and diabetic (iv) not pregnant and lactating (vi) for those who are not
menopause yet, they are not in period time when participating this study.
The control group comprised women who were healthy, not diagnosed
with cancer and other chronic disease, not pregnant, lactating and not in
menstruation time as well as cases. Demographic data were obtained
through standardized pre-tested questionnaire by trained interviewers.
Results showed that the mean body mass index (BMI) among cases
were 26.1 ± 4.8 kg/m2 and 25.3 ± 4.5 kg/m2 for control group (p>0.05).
Result of this study showed that women who did not have history of
exercises and sports regularly have four times higher risk [adjusted
OR=4.1 (95% CI=2.1-8.1)] compared to those had lifetime physical
activity. Pre menopausal women who did not have history of exercise
and sports had five time higher risk for getting breast cancer [adjusted
OR=5.0 (95% CI=2.1-11.5)] compared to those active women. Physical
activity may an important promising primary prevention strategy to
63

reduce breast cancer risk among women. Changes in patterns of
physical activity in younger women will require some efforts both in
individual and community level. Effort should be taken to increase
awareness and understanding of the important of healthy lifestyle in
reducing risk of cancer. The implementation of regular physical activity
exercise is important in promoting healthy lifestyle especially for
adolescent and adult women.
A08 Lower Extremity Biomechanics in Obesity - Rehabilitative
Perspective
Aravind KK, Nagarajan M, Sunitha CN, Praveen JS & Nalini A
School of Physiotherapy, Faculty of Medical & Health Sciences, INTI
University College, Nilai, N. Sembilan
Obesity is a major public health problem that has become a worldwide
epidemic. Overweight and obesity are now dramatically increasing in
developed countries impairing health-related quality of life and is a
major cause for musculoskeletal disorders. Obesity is associated with
static & dynamic biomechanical changes in trunk & lower extremities.
This study aims to overview lower extremities Biomechanical changes in
obesity & to provide clinical implications towards rehabilitative
perspective. An extensive literature review using Ovid, Science direct,
Pubmed, and Proquest. The results of the overview showed marked
biomechanical alterations in lower extremity like reduced anteversion in
the hip joint, varus and valgus malalignment in the knee-joint, reduced
dorsiflexion in the ankle, pronated foot, metatarsus abductus, out toeing,
and flat foot. Obese persons are characterized with physical inactivity,
general deconditiong of the musculatures, and impaired neuromuscular
function & co-activation. Comparatively the lower extremity strength is
reduced than upper extremity and also impaired dynamic postural
balance. The locomotion changes were evident both in kinematic and
kinetic analysis. The kinematic changes include reduced cadence,
velocity, step length, step frequency, reduced swing phase, increased
step width and prolonged stance phase. Kinetic changes include
increased hip flexor activity, increased knee flexion angle (early stance)
and increased knee extension angle (stance phase). All available
evidence states excessive & prolonged loading as a key factor for
skeletal and neuromuscular abnormalities, which increases the
prevalence of degenerative musculoskeletal disorders in obese persons.
Consideration of this biomechanical adaptability might play a vital role in
clinical decision making towards accurate estimation of contributing
64

factors of musculoskeletal disorder. Since neuromuscular adaptation
primarily results from osseous abnormalities, rehabilitation that promotes
neuromuscular performance (endurance and neuromuscular co-activation)
will be most valuable in management of obese.
65

A10 The Effect of Obesity on Microvascular Endothelial Function in
Humans
Belqes AA1, Yvonne-Tee GB2, Abdul Aziz AI3 & Aida Hanum GR1
1Pharmacology Vascular Laboratory, School of Medical Sciences, USM
Health Campus, Kubang Kerian, Kelantan
Kelantan
3Community Health Dept, School of Medical Sciences, USM Health
Campus, Kubang Kerian, Kelantan
Obesity is a major public health problem; the 2007 Malaysian NCD
Surveillance showed that 13.9% and 18.8% of adult males and females
are obese. Obesity is associated with cardiovascular risk including
microvascular complications such as retinopathy, nephropathy, and
heart failure. This study aims to determine microvascular endothelial
function in obese subjects compared to non-obese controls. A cross-sectional
prospective study was conducted involving 36 healthy non-obese
subjects (mean body mass index {BMI} 21.01±0.35 kg/m²; mean
age 26.47±0.8 years) and 36 healthy obese subjects (BMI 35.10±0.91
kg/m²; mean age 26.58±0.9 years). Microvascular endothelial function
was measured using Laser Doppler fluximetry and the process of
iontophoresis. Iontophoresis is a non-invasive technique of introducing
drugs across the skin by means of a small electrical current.
Acetylcholine was used to assess endothelial dependent vasodilatation,
while sodium nitroprusside assessed endothelial independent
vasodilatation. Obese subjects had higher systolic (118.83±1.51 vs
105.72±2.01 mmHg, p<0.001) and DBP (71.61±1.35 vs 64.53±1.40
mmHg, p<0.001), higher serum triglyceride (1.35±0.13 vs 0.79 ± 0.05
mmol/L, p<0.001) and lower high density lipoprotein cholesterol
(1.43±0.04 vs 1.62±0.05 mmol/L, p=0.003) compared to non-obese
individuals. Difference in LDL-C levels did not reach statistical
significance (3.29±0.14 vs 3.10±0.10 mmol/l, p=0.356). C-reactive
protein levels were significantly higher in obese compared to controls
(0.02 ± 0.001 vs. 0.16 ± 0.04 mg/L, p<0.001). Acetylcholine mediated
vasodilatation was significantly lower in obese individuals compared to
non-obese individuals (40.534±6.59 vs 71.03±7.13 AU, p=0.001), while
sodium nitroprusside mediated vasodilatation was not significantly
different between the 2 groups (p=0.053). Microvascular endothelial
function was impaired with obesity; this is associated with higher blood
pressure, inflammatory and triglyceride levels in the obese group.
66

GROUP B: EPIDEMIOLOGY OF OBESITY
B01 Physical Activity & Sedentary Behaviors among the
Adolescents in Petaling District, Selangor
Kee CC1, Lim KH1, Ismail MN2, Poh BK2, Amal NM1, Sumarni MG1,
Christopher VW3 & Lim KK4
1Epidemiology & Biostatistics Unit, Institute for Medical Research, Kuala
Lumpur
Kuala Lumpur
3College for Allied Health Science, Sg. Buluh, Selangor
4Environmental Health Research Center, Institute for Medical Research,
Kuala Lumpur
Physical inactivity is strongly associated with obesity in childhood and
adolescence, and an increased risk of cardiovascular disease at a later
age. Sedentary behaviors have been associated with low levels of
physical activity. A cross sectional study was carried out to determine
the association between demographic characteristics, sedentary
behaviors and physical activity levels among adolescents. Data were
collected from 792 adolescents (417 boys; 375 girls) aged 16 years
attending 15 schools in Petaling District, Selangor using a self-administrated
questionnaire adapted from the Physical Activity Modules
of the School Health Action, Planning and Evaluation System (SHAPE).
Results showed that more females (49.6%) were physically inactive
compared to males (39.6%) [OR: 1.47, 95% confident interval (CI: 1.05,
2.04)]. Physically inactive adolescents were less likely to participate in
intramural/house league sports (OR: 1.72, 95% CI: 1.20, 2.47), school
team sports (OR: 1.48, 95% CI: 1.05, 2.08) and individual physical
activities outside of school (OR: 1.59, 95% CI: 1.15, 2.21) compared to
their physically active counterparts. However, physically inactive
adolescents were also less likely to engage in sedentary activities
[television watching (OR: 0.68, 95% CI: 0.50, 0.93), playing
computer/video game (OR: 0.46, 95% CI: 0.29, 0.73), talking on the
telephone/text messaging (OR: 0.47, 95% CI: 0.32, 0.70) and reading
(OR: 0.43, 95% CI: 0.23, 0.83)] compared to those who were physically
active. These findings suggest that adolescents may be physically
active and yet still engaged in sedentary behaviours.
67

B02 BMI & Smoking Habits among Army Personnel in Kelantan
Rehanah MZ, Aziz AI, Azwany YN, Hatim SN, Filza IA, Mohd Zin B &
Mohd Isa B
School of Health Sciences, USM Health Campus, Kubang Kerian,
Kelantan
BMI provides a reliable indicator of body fatness for most people,
including army and is used to screen for weight categories that may lead
to health problems. However, the BMI calculator does have limitations. It
may overestimate body fat in those people with a muscular build such
as army profession. Overweight and obesity contribute to the
hypertension, cardiovascular disease (CVD) are known to influence the
impact of this disease on the population. The army profession is known
as high demanding job associated with lots of physical activities (ideal
weight), stress and high risk behavior such as smoking habits. A cross-sectional
study was carried out in Kelantan to determine body mass
index (BMI), prevalence of smoking, prevalence of hypertension and
physical activities among army aged 19 to 57 years. A total of 319 were
selected using random sampling from four army camps in Kelantan.
Current weight and height were measured and body mass index (BMI)
were calculated. Blood pressure was measured in triplicate at one
minute interval using Digital Sphygmomanometer. The mean age of the
subjects was 31.52 ± 7.40 years while the mean BMI of the subjects
was 24.73 ± 3.85 kg/m2. Based on the classification of weight status
according to BMI in Asian Adults, the prevalence of armies: 8(2.5%)
were underweight (< 18.5 kg/m2), 112 (35.1%) were normal or ideal
weight (18.5 – 22.9 kg/m2), 58(18.2%) were overweight (>23.0 kg/m2),
116(36.4%) were over weight at risk (23.0 -24.9 kg/m2) and 25(7.8%)
were obese class 1 (25.0 – 29.9 kg/m2). From the measurement of
waist; 289(90.6%) ≤ 94 cm and only 30(9.4%) ≥ 94 cm which denotes
increased risk of metabolic complication and from the waist hip ratio
category; more than 98.4% subjects measured ≤ 94cm. About 67.7%
(n=216) of the subjects were smokers. Mean Systolic Blood Pressure
(SBP) and Diastolic Blood Pressure (DBP) were 114.88 ± 12.83 mmHg
and 70.93 ± 10.22 mmHg respectively. SBP was significantly higher in
non-smokers (117.15 ± 11.30 mmHg) than smokers (113.81 ± 13.39
mmHg). However, DBP was higher in non-smokers (71.02 ± 10.06
mmHg) than smokers (70.89 ± 10.32 mmHg), although not significant.
Prevalence of HPT among army personnel was 4.1% (n=13). The mean
physical activities in minutes/day, (vigorous exercise = 98.31 ± 10.70),
(walking and cycling = 98.57 ± 18.43), (exercise during leisure time =
96.66 ± 10.00). Findings showed more than 50%, armies were
68

overweight and obese although armies have enough physical activities
in line with Healthy Lifestyle Campaign which recommended at least 30
minutes/day. However, many in the military have high rates of muscle
mass, which weighs more than fat, putting their BMI in the overweight
category. From the study also showed high prevalence of smokers
among army personnel in Kelantan. These results indicated significant
rise in cardiovascular risk factors among army personnel and urgent
intervention is needed to overcome this problem.
B03 Eating Attitude, Lifestyle Practices & Body Image Perception
among Middle Eastern & Malaysian Students of UCSI University
69
Koh HJ & Satvin K
School of Applied Science, UCSI University, Kuala Lumpur
The purpose of this study was to compare the eating attitude, lifestyle
habits, nutritional status and body image perception between Malaysian
and Middle Eastern female students in UCSI University. A sample of
130 female university students aged 18-25 completed anthropometric
measurements and a self administered questionnaire, which
incorporated questions on demographic data, lifestyle practices which
included smoking habit, alcohol consumption, fast food intake, and
physical activity level using IPAQ, 24-hour food record, eating attitude
using Eating Attitude Test-26 and body image perception using Figure
Rating Scale. Eating disorder risk was more prevalent among Middle
Eastern students (29.2%) compare to Malaysian (6.2%) with significant
difference found (p< 0.001). Significantly (p<0.05) Middle Eastern
students (1616kcal) consumed higher calories than Malaysian
(1275kcal). Based on result, 7.7% of Middle Eastern students and no
Malaysian student were smoking. Middle Eastern students were found
to be more physically active as 50.8% of them involved in moderate
physical activity level while 58.5% of Malaysian involved in low physical
activity level. Generally, Middle Eastern students had higher BMI (20.9)
and larger waist circumference (68cm) compare with Malaysian
students (19.0, 63cm) and were at risk for eating disorder. Majority of
Middle Eastern students (81.54%) perceived their body image correctly
(55.28% for Malaysian). Malaysian students who were at risk of eating
disorder tend to have lower energy intake (1087kcal). Smaller waist
circumference was associated with lower BMI in both origins. As
conclusion, Middle Eastern students have higher prevalence in eating
disorder, have bigger body size and tend to perceive their body image
correctly than Malaysian students. Educating young people about

healthy nutrition will be helpful to prevent eating disorders, which are
significant in terms of public health.
B05 Gender Differences in Body Weight Perception and Weight-loss
Strategies among Undergraduates
Kuan PX2, Henry RG1, Ho HL2, Shuhaili MS2 & Siti Alia A2
1Dept of Pathology, Faculty of Medicine & Health Sciences, UNIMAS,
Sarawak
2Faculty of Medicine & Health Sciences, UNIMAS, Sarawak
The knowledge of the association between Body Mass Index (BMI),
body weight perception, eating attitudes and weight loss strategies can
help direct future intervention efforts. We carried out a study among
undergraduate students with the objective of comparing BMI with body
weight perception and to determine the relationship between gender with
BMI, body weight perception, eating attitudes and weight-loss strategies.
Subjects consisted of 600 undergraduates (300 males and 300 females)
from the various faculties in Universiti Malaysia Sarawak recruited from
early September 2008 until mid November 2008. The Original Figure
Rating Scale: Body Weight Perception, Body Shape Questionnaire
(BSQ) and Eating Attitudes Test-26 (EAT-26) were used as assessment
tools. Overall, 52.8% of students have normal BMI, with approximately
equal number of both genders. More males than females are overweight
(33.7%), while more females than males are underweight (25.3%).
Males are more likely to perceive themselves as overweight than
females and fail to see themselves as underweight. More than half of the
females want their ideal figure to be underweight whereas about 30%
males choose overweight as their ideal figure. Females are generally
more concerned about body weight, body shape and eating than males.
They more frequently diet, have self-induced vomiting, use laxatives,
and exercise as their weight-loss strategies. In conclusion, issues
pertaining to body weight perception, eating attitudes and weight-loss
strategies exists with differences among males and females. Thus, more
in-depth studies into the various factors involved are required as these
have far-reaching implications on health policies.
70

B06 The Association between Weight Status and Iron Deficiency
among Male Adolescents
Lau XC, Ismail MN & Poh BK
Kuala Lumpur
The prevalence of obesity had increased at an epidemic rate, and
obesity has become one of the most common health concerns in
Malaysia. Some studies have found a possible association between iron
deficiency and obesity. This is a cross-sectional study that aims to
investigate the association between weight status and iron deficiency of
male adolescents. Subjects comprised 25 obese and 25 normal weight
boys, aged 12 to 17 years, from secondary schools in Kuala Lumpur.
Data on socio-demography, anthropometry, iron status and dietary
intake were collected. Multiple iron status indicators namely, serum
ferritin, transferrin saturation, mean corpuscular volume (MCV), total iron
binding capacity (TIBC) and hemoglobin were determined. Logistic
regression was used to estimate the association between weight status
and iron deficiency. Mean age of subjects was 13.2 ± 1.1 years, while
mean BMI for obese and normal groups were 31.1 ± 5.1 kg/m2 and 18.6
± 3.9 kg/m2, respectively. The percentages of iron deficiency in the
obese and normal group male adolescent were 12% and 8%
respectively. Obese subjects demonstrated the highest percentage of
iron deficiency. Obese subjects were found to have significantly higher
TIBC than normal weight subjects (p<0.05). Results from logistic
regression analysis showed that, adolescent who were obese were
approximately 1.3 times more prone to be iron-deficient. In conclusion,
obese adolescents demonstrated higher percentage of iron deficiency
compared to their normal weight counterparts. Given the increasing
numbers of overweight and obese adolescent and the known morbidities
of iron deficiency, these findings suggest that guidelines for screening for
iron deficiency may need to be modified to include adolescents with
elevated BMI.
71

B07 Knowledge, Attitude & Practice in Relation to Obesity among
Malay Married Women in Hulu Langat, Selangor
Norlaila MT1, Aminah A2, Suriah AR2 & Noriah MI3
1Faculty of Hotel and Tourism, Universiti Teknologi MARA, Dungun,
Terengganu
2Dept of Food Science & Nutrition, Faculty of Science & Technology,
UKM, Bangi, Selangor
3Faculty of Education, UKM, Bangi, Selangor
A study involving 160 subjects, age between 19 and 50 years was
conducted among the Malay married women in Selangor. The objective
of the study is to identify the relationships between knowledge, attitude
and practice in relation to obesity among Malay married women. A
survey among Malay married women in Hulu Langat was conducted
using semi-conducted questionnaires. Knowledge was assessed through
multiple answer questions on definition of obesity, BMI calculation and
factors contributing to obesity. 20 items of each attitudes and practice
towards obesity were asked using Likert Scale items. Questions on
attitudes assessed the women’s perception towards obesity, their
concern on the treatment of obesity and preventive measures towards
the problem. Questions on practice assessed their actions in maintaining
their ideal weight, and how they treat their obesity. 42.5% of the subjects
were obese (using BMI 30 as cut off points), 98.8% with waist
circumference above 80 cm and 10% with WHR above 1. 40.6% of the
subjects were having a hypertension problem and 53.1%
hypercholesterolemia. There was a significant correlation between BMI
and practice (p<0.05), and a small correlation between attitude and
practice. There was no significant relationship between knowledge,
attitude and practice in relation to obesity among the subjects involved.
Obesity epidemic is at an alarming rate. Knowledge on obesity should be
imparted to the community and effective interventions program are
needed to improve the dietary habits in this community.
72

GROUP C: CHILDHOOD OBESITY
C01 Physical Activity, Body Composition and Resting Metabolic
Rate in Relation to Obesity and Metabolic Syndrome among
Schoolchildren Aged 8 to 10 Years Old
74
Quah YV, Poh BK & Ismail MN
Kuala Lumpur
Metabolic syndrome is a complication of obesity that is related to
physical inactivity and low metabolic rate. This study aimed to determine
the physical activity, body composition, resting metabolic rate and
incidence of metabolic syndrome among overweight/obese and normal
weight children. Subjects comprised 97 schoolchildren aged between 8
and 10 years; divided into overweight/obese (O/O) (BMI-for-age ≥ 1SD)
and normal weight group (-1SD <BMI-for-age ≤ median) based on WHO
(2007) growth reference. Physical activity was measured objectively
using Actical accelerometer. Body composition was assessed using
Bioelectrical Impedance Analysis method and body mass index was
calculated from weight and height measurements. Blood biochemical
profiles included triglyceride, HDL cholesterol, fasting blood glucose,
and blood pressure. Metabolic syndrome (MS) was defined according to
International Diabetes Federation (2007) criteria. Deltatrac Metabolic
Monitor MBM-2, an indirect calorimetry method, was used to measure
the resting metabolic rate (RMR) of a sub-sample of 23 subjects. O/O
subjects (9.2 ± 0.9 years) were of similar age with their normal weight
counterparts (9.2 ± 0.8 years) but their BMI were significantly higher
(24.6 ± 4.0 kg/m2 versus 15.1 ± 0.8 kg/m2). Only one obese subject
(1.3%) had metabolic syndrome; 92.9% overweight/obese was at risk
for at least one component. In comparison, only 9.1% normal weight
was at risk for at least one component. Among the components of
metabolic syndrome, HDL cholesterol showed a negative correlation
with % body fat (r=-0.523) whereas systolic blood pressure (r=0.636),
diastolic blood pressure (r=0.486) and waist circumference (r=0.901)
showed moderate relationship with % body fat (p<0.001). Normal weight
subjects spent twice as much time (0.6 ± 0.6 minutes) on vigorous
activity (4923±4890 counts) per day as compared to the O/O group
(p<0.01). Similarly, normal weight subjects and subjects free of any risk
of metabolic syndrome had a significantly higher RMR (38 ± 4 kcal/kg
body weight/day, 38 ± 5 kcal/kg body weight/day) as compared to 29 ± 3
kcal/kg body weight/day reported for O/O subjects and 29 ± 4 kcal/kg
body weight/day reported for subjects at-risk of metabolic syndrome.

Low vigorous-intensity activity and resting metabolic rate were found to
be lower among O/O subjects and subjects at-risk of metabolic
syndrome. Hence, it is important intervention be undertaken to increase
participation of O/O children in vigorous intensity activity.
C02 Dietary Intake of Obese and Normal Weight School Children
Aged 9 to 12 Years Old
75
Kok LP, Poh BK & Ismail MN
Dept of Nutrition & Dietetics, Faculty of Allied Health Science, UKM,
Kuala Lumpur
Rising awareness of the vital role of diet for health promotion and
obesity prevention has resulted in a greater concern about the diet and
eating patterns of school children and adolescents. The aim of this study
is to compare the dietary intake of obese and normal weight children. A
cross sectional study was conducted using quota sampling according to
ethnic ratio. A total of 168 children aged 9 to 12 years comprise of 84
normal weight and 84 obese subjects follow ethnic of Malay (59.5%),
Chinese (31.0%) and Indian (9.5%) ethnicity participated in the study.
Anthropometric screening was carried out to determine weight status
based on BMI-for-age reference (WHO 2007). Food intake was
assessed through face-to-face interviews using diet history technique.
Results show that energy, macronutrient and micronutrient intakes were
significantly (p<0.05) higher among obese children compared to normal
weight children. Significant differences (p<0.05) were found in
percentage of fat and carbohydrate contribution to energy intake of
normal weight (25% fat, 61% carbohydrate) and obese (28% fat, 58%
carbohydrate) girls. Daily breakfast consumption was higher among
normal weight children (66.7%) compared with obese (46.4%).
Frequency of daily fast foods processed foods and vegetable
consumption were higher among obese children; whereas daily snacks,
fruits and milk consumption were lower among obese children. We
found that 32.1% obese children tended to underreport their intake while
10.7% normal weight children over-reported their intake. Energy intake
(r=0.427), protein (r=0.320), carbohydrate (r= 0.402), fat (r=0.379),
calcium (r=0.196), iron (r=0.258), vitamin B2 (r=0.190), vitamin B3
(r=0.198) and vitamin A (r=0.276) were found to have significant positive
correlation (p<0.05) with BMI. Based on percentage of macronutrient
energy contribution, a significant negative relationship (r= -0.179,
p<0.05) was found between carbohydrate and BMI whereas fat was
positively significant correlated (r=0.159, p<0.05) with BMI. In

conclusion, there were an apparent differences in the energy,
macronutrient and micronutrient intakes among obese and normal
weight school children.
76

GROUP D: BEHAVIOURAL ASPECTS OF OBESITY
D02 Eating Attitude, Lifestyle Practices and Body Image among
Malaysian and African female Students in UCSI University
Tan ZY & Satvinder K
Dept of Food Science & Nutrition, Faculty of Applied Sciences, UCSI
University, Kuala Lumpur
This study aimed to compare eating attitude, lifestyle practices and body
image between Malaysian and African female students in UCSI
University. Subjects consisted of 120 students who completed
anthropometric measurements and a self-administered questionnaire
assessing on socio-demographics, lifestyle practices which included
physical activity using IPAQ, cigarette smoking and alcohol, eating
pattern, eating attitude using EAT and body image using FRS. Results
showed that 31.7% Malaysian and 41.7% African subjects were at risk of
developing eating disorder with no significant difference found between
the groups. African subjects had significantly higher median BMI (22.1,
4.2) and mean waist circumference (71.2±6.2) than Malaysian subjects
(18.7, 3.4; 68.3±7.1). Significantly more Malaysian subjects consumed
alcohol, practised consistent meal time and consumed vegetables daily
whereas more African subjects skipped lunch, snacking daily and had
higher fast food consumption. Physical activity level did not differ
significantly between subject groups with 8.3% Malaysian and 11.7%
African subjects achieved high physical activity level. No correlation
found between IPAQ and EAT-26 score with BMI of all subjects. Body
dissatisfaction and body image perception did not differ significantly
between subject groups. However, significantly more African subjects
desired bigger body size (15.0% African; 6.7% Malaysian) and they were
more likely to underestimate their body size (6.7% African; 1.7%
Malaysian) as compared to Malaysian subjects. Higher BMI was
associated with increased body dissatisfaction in both subject groups
and those who were more dissatisfied with their body image exercised
more. Majority of subjects with distorted body image overestimated their
body weight (96.0% Malaysian; 84.6% African). African subjects without
body image distortion exercised more than those who had distorted body
image. In conclusion, no significant differences found in eating attitude,
lifestyle practices and body image between subject groups. However,
African subjects had more negative eating patterns and tend to idealize
bigger body size and underestimate their body weight as compared to
Malaysian subjects.
77

D03 Readiness to Change among Overweight and Obese Patients
Attending Dietary Counseling: Does It Really Matter?
Rasyedah AR1,2, Chan SF1 & Ruzita AT1
Kuala Lumpur
2School of Exercise & Nutrition Sciences, Faculty of Health, Medicine,
Nursing & Behavioural Sciences, Deakin University, Australia
The objective of this study was to assess readiness to change among
overweight and obese patients. This study was carried out by
interviewing new patients and follow-up patients aged 19 to 59 years old
who were overweight and obese and enrolled in dietary counseling
sessions at Poliklinik Warga, Universiti Kebangsaan Malaysia Medical
Centre (UKMMC) of which 76 respondents participated (38 new cases,
38 follow ups). Readiness to change is assessed by three dietary
behavior algorithms for reducing fat intake, increasing fruits and
vegetables consumption and portion size control. These algorithms
categorized patients according to their readiness to change status which
may influence their food intake. Food intake is determined through food
frequency questionnaires which consisted of 126 food items. Back to
back translation is done on three readiness to change algorithms.
Readiness to change is classified into these stages: pre-contemplation,
contemplation, preparation, action and maintenance. The hypothesis is
that respondents in the action and maintenance stages tend to consume
less fat, higher in fruits and vegetables intake and able to control portion
size. Results shown there is no respondent in pre-contemplation stage
while contemplation, preparation, action and maintenance stage are
7.9%, 71.1%, 5.2% and 15.8% respectively in the reducing fat intake
stages of change algorithm. In the increasing of fruits and vegetables
intake algorithms, percentage of respondents in pre-contemplation,
contemplation, preparation, action and maintenance stages are 14.5%,
7.9%, 61.8%, 6.6% and 9.2% respectively. The highest percentage of
respondents reported to control their portion are in action stage,
followed by those in the maintenance stage (30.3%), contemplation
stage (10.5%), preparation stage (9.2%) and pre-contemplation stage
(2.6%). Fruits and vegetables intakes were significantly higher among
those in action and maintenance stages (465.40 + 248.23 g/day; 329.23
+ 209.95 g/day, p<0.05) compared to other stages. The association
between portion control behavior and portion control stages of change is
significantly higher in new cases patients compared to follow-up patients
(p<0.001). In conclusion, readiness to change can assist health
providers (nutritionists and dietitians especially) in tailoring dietary
78

counseling according to their patients‟ readiness. This will increase their
patients‟ compliance in meeting the dietary recommendations, ultimately
the weight reduction goal.
D04 Relationships between Elevated BMI and Negative Body Image
and Disordered Eating Behaviors in Adolescent Girls
Chin YS, Mohd Nasir MT, Zalilah MS, & Khor GL
Dept of Nutrition & Dietetics, Faculty of Medicine & Health Sciences,
As preoccupation with the thin beauty ideal is very common among
adolescent girls, it is not surprising that elevated BMI is one of the risk
factors contributing to negative body image and disordered eating
behaviors. This study aimed to determine the relationships between
elevated BMI and negative body image and disordered eating behaviors
among adolescent girls. A total of 407 adolescent girls aged between 13
to 19 years from secondary schools in Kuantan district, state of Pahang,
were randomly selected to complete the Multidimensional Body Image
Scale (MBIS), Eating Attitudes Test-26 (EAT-26), and their weight and
height were measured. The study found that overweight and obese
respondents (23.9%) were five times more than underweight
respondents (4.7%), and about one in ten of the respondents (12.8%)
were at-risk of eating disorders. BMI was moderately correlated with
MBIS score (r=0.591) but weakly correlated with EAT score (r=0.271),
and MBIS score was strongly correlated with EAT score (r=0.603).
Additionally, BMI was found to predict MBIS score after controlling for
EAT score (R2=0.561; F=258.218; P<0.05) and EAT score after
controlling for MBIS score (R2=0.375; F=121.138; P<0.05). Further, the
relationship between BMI and EAT score was found to partially
mediated by MBIS score (Sobel test=10.053, P<0.05), and hence,
elevated BMI predicted disordered eating behaviors of the adolescent
girls both directly and indirectly through negative body image. In short,
adolescent girls who have an elevated BMI were at-risk for both
negative body image and disordered eating behaviors. Promoting health
body weight should be integrated in both negative body image and
disordered eating behaviors prevention programs.
79

GROUP E: MANAGEMENT AND TREATMENT OF
81
OBESITY
E01 The Effect of a 3- Month Modified Lifestyle Program on Arterial
Stiffness and Anthropometric Measurements in Overweight
Patients
Farah Diana A1, Vina Tan PS2, Aziz Al3, Zurkurnai Y4, Siti Azima5,
Wan Rimei5 & Aida Hanum GR1
1Pharmacology Vascular Laboratory, USM Health Campus, Kubang
Kerian, Kelantan
Kelantan
3Dept of Community Medicine, USM Health Campus, Kubang Kerian,
Kelantan
4Dept of Medicine, USM Health Campus, Kubang Kerian, Kelantan
5Dietetic Unit of Hospital USM, USM Health Campus, Kubang Kerian,
Kelantan
Obesity is associated with increased stiffness of the large arteries which
can lead to increased cardiovascular risk. Lifestyle modification through
exercise and dietary intervention had been proven to reduce the body
weight and cardiovascular risk. The aim of this study is to assess the
effect of lifestyle modification on arterial stiffness and anthropometric
measurement in overweight patients. 22 overweight subjects (body
mass index [BMI>25.0 kg/m2, age: 32.6 ± 2.2 years) participated in
lifestyle modification intervention program encompassing three principal
components: diet, exercise and behavior therapy. This intervention
program aims to produce energy deficit of 500 kcal/day by modifying
diet, increasing physical activity and exercise. Assessment of arterial
stiffness was assessed using parameters carotid-femoral pulse wave
velocity (PWV) and augmentation index (AIx) using the SphygmoCor
device. Anthropometric indices, blood pressure and body fat percentage
were accessed 3 monthly and the Queen Step test was used as
indicator for fitness level. Body weight and BMI before and after
intervention were 79. 1± 3.5 vs 77.7 ± 3.5 kg (p=0.104), 31.6 ± 1.0 vs
31.0 ± 1.0 kg/m2 (p= 0.101) respectively. There was no significance
difference in augmentation index, pulse wave velocity, blood pressure
and pulse before and after 3 months intervention. Significant decrease
in waist and hip circumference was observed, from 89.8 ± 1.9 to 87.9 ±
1.8 cm (p=0.036) and 109.7 ± 2.4 to 107.5 ± 2.5 cm (p= 0.003)
respectively. Fitness level increased significantly from 46.1 ± 2.5 to 49.9

± 2.3 ml/min/kg (p=0.04). Body fat percentage at baseline and after 3
months were 35.6 ± 1.2 and 35.1 ± 1.3 % (p=0.322). This study showed
improvement in waist and hip circumference and fitness level of
overweight subjects after 3 months intervention. However, 3 months
may be too short a period to show significant improvement in arterial
stiffness.
E02 ‘Live Healthy, Work Healthy’ Wellness Program Improved
Medical Leave and Health Status for Employees
82
Bee SW & Wong SF
Dietetic Services, Sime Darby Medical Centre, Subang Jaya, Selangor
Worksite wellness program was implemented for employees in Support
Services Division from the month of May to December 2009. The
objective of the program is to create health awareness and improve
medical leave among the employees. Forty-six employees (20 men and
26 women) were selected from Support Services Division based on their
previous year medical certificate (MC) records. Data was collected via
questionnaire to assess employee‟s lifestyle habits, stress levels and
health conditions. Anthropometry data on BMI, body weight, body fat
percentage and visceral fat were measured using the Omron Fat
Analyzer. Data indicated that that 81% (37) employees were overweight
and obese and ≥75% (35) have poor lifestyle habits i.e. poor diet,
inadequate sleep hours, smoking and no exercise. The program was
planned according to the results from questionnaire and employee‟s
health status, which comprise of nutrition activities, motivation, stress
management and fitness. Attendance rate, anthropometry
measurements, MC record were charted on the 3rd and 6th month from
the program initiated. Two follow-up sessions were conducted after six
month program. The results indicated that 57% (26) employees lost
weight, 41% (19) employees reduced body fat and 20% (9) employees
reduced visceral fat over the 12 months period. Sixty three percents (29)
of employees reduced MC rate by 46%, from average of 447 days to
240 days. In conclusion, wellness program has created an awareness of
health and reduced medical leave for employee effectively.

GROUP F: EMERGING ISSUES AND TECHNOLOGIES
84
RELATED TO OBESITY
F01 Pharmacological & Non-pharmacological Interventions
Beneficial in Improving Vascular Function & Cardiovascular Risk in
Obesity – Study Methodology
Aida Hanum GR1, Al-Safi AA2, Vina Tan3, Belqes AA1, Tee GB3,
Mazlyn M4, Sukari Halim A5, Abd Rahim W6, Zurkurnai Y6, Farah
Diana1, Siti Azima7, Wan Rimei7
1Pharmacology Vascular Laboratory, 2Community Health,
5Reconstructive, 6Cardiology Unit & 4Physiology Departments, School of
Medical Sciences, USM Health Campus, Kubang Kerian, Kelantan
3School of Health Sciences & 7Dietetic Unit of Hospital USM, USM
Health Campus, Kubang Kerian, Kelantan
Obesity is associated with significant cardiovascular related morbidity
and mortality. We have shown that microvascular endothelial function is
impaired in obese subjects compared to controls, this was associated
with increased blood pressure, the inflammatory marker C reactive
protein and serum triglycerides. This project aims to assess the effects
of 2 pharmacological interventions or monitored lifestyle modifications in
improving vascular function and reducing cardiovascular risk in
overweight and obese subjects. This presentation will describe the
details of the methodology in this project. This clinical study involved
approximately 108 patients divided into three intervention groups for 9
months. Patients will be randomised to receive pharmacological
intervention with Orlistat 120 mg three times daily, or sibutramine 10 mg
daily. The third group does not receive any drugs but will undergo
monitored lifestyle modification consisting of dietary intervention and
increasing physical activity under the supervision of qualified sports
science instructors and dieticians. Arterial stiffness, an index of vascular
health will be assessed using the principles of pulse wave analysis and
pulse wave velocity. Microvascular endothelial function will be
determined using the laser Doppler fluximetry and the process of
iontophoresis (transdermal drug delivery). Other parameters that will be
monitored include changes in anthropometric measurements with body
fat percentages, central (aortic) blood pressure, metabolic risk markers
and cardiovascular inflammatory markers at baseline before intervention
and 3 monthly thereafter up till 9 months. Adverse effects throughout
study duration will be monitored and recorded. Physical activity level will
be assessed using a validated questionnaire while subject‟s calorie

intake is estimated by study dieticians. Fitness testing is performed in
the monitored lifestyle modification group. Approximately 100 patients
have been recruited; 90 have been randomised. Results from this project
will possibly be available early 2010.
85

F03 Prevalence of the Leptin Gene A19G and Leptin Receptor Gene
K109R, Q223R, K656N Variants and Obesity Risk Factors among
the UTAR Population
Say YH, Liew SF, Chuah HS, Lau CL & Lee CH
Dept of Science, Faculty of Engineering & Science, UTAR, Kuala
Lumpur
Obesity is due to the combined effects of genes, environment, lifestyle,
and the interactions of these factors. Leptin is secreted by white adipose
tissues and binds to leptin receptor to signal and regulate food intake
and energy expenditure. The leptin gene (LEP) A19G and leptin receptor
gene (LEPR) K109R, Q223R and K656N variants have been associated
with obesity in different populations, mostly in the West. The study was
to investigate the association of these gene polymorphisms with obesity
in Malaysia, preliminarily among the population of UTAR campuses
around Klang Valley. Random convenience sampling was performed
with informed consents, obesity risk factors were assessed by
questionnaire and anthropometric measurements were taken.
Mouthwash samples were obtained, genomic DNA was extracted and
genotyping was performed using Polymerase Chain Reaction -
Restriction Fragment Length Polymorphism (PCR-RFLP). A lower BMI
cut-off point of 27kg/m2 for obesity was adapted; categorizing the 200
subjects (85 males, 115 females) into 143 non-obese and 57 obese.
There was no significant difference in the genotype and allele
frequencies of LEP A19G and LEPR K109R, Q223R variants between
obese and non-obese subjects. Only the K656N genotype, but not the
656N allele was associated with obesity. There was no significant
difference in the genotype frequencies between Malays, Chinese and
Indians - either in obese and non-obese groups. Physical activity
frequency, blood pressure, Waist Hip Ratio (WHR) and Total Body Fat
(TBF) were significantly different between the non-obese and obese
groups. Age, WHR and TBF were significantly correlated with BMI, but
not alcohol consumption and family history of obesity. In conclusion, only
the K656N genotype was significantly associated with obesity among
this preliminary small-sampled UTAR subjects. In the future, we hope to
conduct a larger scale study involving more subjects and covering other
gene polymorphisms of the leptin-melanocortin pathway associated with
obesity.
86

F04 Waist Circumference or Waist-hip Ratio: Which Is Better?
87
Eng JY & Moy FM
Dept of Social & Preventive Medicine, Faculty of Medicine, Universiti
Body weight status is an important indicator for health risk and
previously Body Mass Index (BMI) has been extensively used as an
indicator for the risk cardiovascular diseases. However, recent
investigations emphasized the importance of body fat distribution as a
predictor of health risk. Waist circumference (WC) and waist-to-hip ratio
(WHR) are common measurements used to assess central distribution
of fat. A survey was conducted among 151 Malays at a workplace in
Kuala Lumpur. The objective was to investigate whether WC or WHR
was a better measuring tool to estimate body weight status. Pearson‟s
correlation was used to determine the correlation of WC and WHR.
Receiver operating characteristic (ROC) curves were plotted to compare
the above by using BMI as the gold standard. The correlation between
BMI and WC were good among males (r = 0.759, p < 0.001) and
females (r = 0.771, p < 0.001). WHR showed a lower correlation with
BMI among males (r = 0.577, p <0.001) and females (r = 0.499, p <
0.001) compared to WC. The area under the curve (AUC) generated by
waist circumference was 0.877 (95% CI: 0.767 – 0.987) among males
and 0.873 (95% CI: 0.809 – 0.937) among females. While AUC
generated by WHR was 0.836 (95% CI: 0.687 – 0.984) among males
and 0.692 (95% CI: 0.588 – 0.796) among females. The AUC of waist
circumference for both males and females was good while WHR did not
perform well among females. In conclusion, waist circumference is a
better and more efficient measurement compared to WHR.

F05 Waist Circumference versus Waist: Height Ratio in Relation to
Cardiovascular Risk Factors in Children
Wee BS1,2, Poh BK1, Bulgiba AM2, Ruzita AT1 & Ismail MN1
Kuala Lumpur
2Dept of Social & Preventive Medicine, Faculty of Medicine, Universiti
This study was undertaken to determine the relationship between waist
circumference and cardiovascular disease risk factors with waist height
ratio in children. A total of 403 subjects (195 boys and 208 girls) aged 9
– 12 years in Selangor and Kuala Lumpur participated in this study, with
mean age of 11.06  0.84 years and 10.94  0.86 years, respectively.
Subjects were 61% Malay, 30.5% Chinese and 8.2% Indian.
Anthropometric measurements comprised weight, height, waist
circumference and hip circumference. Blood pressure was measured,
and 5ml of overnight fasting blood was drawn by venous puncture.
Fasting blood glucose (FBG), full lipid profile including triglycerides (TG),
high lipoprotein cholesterol (HDL-C), low lipoprotein cholesterol (LDL-C)
and total cholesterol (TC) were determined. The cut-offs of 0.5 for waist
height ratio (WHtR) and 90th percentile for sex and age specific for waist
circumference (WC) were used, relatively. More girls (46.2%) had larger
WC than boys (43.6%); while more boys (41.5%) had WHtR >0.5
compared to girls (37.0%). WC was better correlated with weight and
systolic blood pressure (r=0.932, p<0.001; r=0.436, p<0.001) as
compared to WHtR (r=0.738, p<0.001; r=0.400, p<0.001), respectively.
However, WHtR was better correlated with TG and TC/HDL (r=0.334,
p=0.001; r=0.410, p<0.001) compared with WC (r=0.330, p<0.05;
r=0.401, p<0.000), relatively. In conclusion, waist circumference and
waist height ratio showed significant relationship with the cardiovascular
risk clustering in children. Waist height ratio may be used as an
alternative option in estimating cardiovascular risk because of its
simplicity, easy and non age dependent index compared to waist
circumference.
88

F07 Validation of Bioelectrical Impedance Analysis (BIA) against
Dual Energy X-ray Absorptiometry (DEXA) for the Estimation of
Body Composition among Adolescents
Liew SS, Poh BK, Kanaga KC, Nor Azmi K & Ismail MN
Kuala Lumpur
Bioelectrical impedance analysis (BIA) is an alternative method for the
estimation of body composition that requires population specific
predictive equations. This study aimed to evaluate the predictive validity
of four previously published bioelectrical impedance equations against
dual energy X-ray absorptiometry (DEXA) in determining the body
composition of the adolescents. A total of 150 Malay adolescents (76
boys; 74 girls, mean age = 14.9 ± 1.2 y/o) participated and underwent
measurement of FM% by DEXA (Hologic QDR-4500) and BIA
(ImpediMed DF50). Impedance, reactance, and resistance values from
the BIA were entered into four predictive equations and body fat
percentage was calculated. Paired t-tests and Pearson correlation were
used to assess differences and correlation between methods. Methods
agreement was assessed by Bland and Altman technique. Lukaski et al.
(1986) and Schaefer et al. (1994) equations tend to overestimate the
body fat percentage, whereas Segal et al. (1988) and Houtkooper et al.
(1992) equations tend to underestimate body fat percentage of
adolescents compared to DEXA. For all categories of boys, overweight
and obese girls, the Bland-Altman method showed poor agreement
between the four BIA equations and DEXA. For normal weight girls, the
Lukaski et al. (1986) equation provided the best estimation of body fat
percentage with no significant difference (+0.8 ± 2.3 %, p>0.05) and
good agreement (percentage points with 95% confidence interval -3.78
and 5.33) with DEXA. In conclusion, The Lukaski et al. (1986) equation
is a valid BIA equation to estimate body fat percentage among normal
weight girls. However, all the equations selected appear to be
inappropriate for use among boys, overweight girls and obese girls in
the targeted population. This proves that specific predictive equation is
needed for each population to ensure accuracy of prediction.
90

F08 Predicting Total Body Water using Bioelectrical Impedance
Analysis among Malay Children
Ong SC, Poh BK, Ismail MN, Quah YV, Lau YF & Hills AP
Kuala Lumpur
Bioimpedance analysis (BIA) is a widely used, quick and simple
technique for determination of body composition. However, BIA
equations tend to be population specific, therefore most equations which
had been generated in Caucasian populations, may not be suitable for
the Malaysian population. The aim of this study was to develop a single
BIA equation to predict the total body water (TBW) of Malay children. A
total of 90 Malay children (45 boys; 45 girls) aged 8 – 10 years
participated in this study. Subjects were randomly divided into
developmental (30 boys, 30 girls) and cross-validation (15 boys, 15 girls)
groups. Body weight and height were measured, and BMI was
calculated. Deuterium dilution method was used as the gold standard
technique to determine TBW for developing predictive equations based
on single-frequency bioelectrical impedance analyzer (Omron pre-commercial
unit). Predictive equations were developed using stepwise
regression analysis in the developmental group. Independent variables
such as impedance index, decimal age, body weight, height and gender
were tested. Impedance index was identified as the strongest predictor;
and by adding weight, the accuracy of the equation improved (R2 =
0.665, SEE = 1.24 kg). The predictive equation was then applied to the
cross validation group. Predicted TBW (15.88 ± 1.87 kg) in the cross
validation group was not significantly different from measured TBW
(15.79 ± 2.36 kg), with a pure error of 0.97 kg which was similar to the
SEE in developmental group. This cross validation results was
satisfactory, hence, a single predictive equation was developed with the
total sample (n=90): TBW (kg) = (0.183 x impedance index) + (0.246 x
weight (kg)) + 2.399, with impedance index as the strongest predictor.
(R2 = 0.731, SEE = 1.15 kg) In conclusion, the new BIA equation was
valid for predicting the TBW of Malay children aged 8-10 years.
91

F09 Validation of Skinfold Thickness Method against Air
Displacement Plethysmography for Estimation of Body Fat in
Normal Weight and Obese Children
92
Lee SL, Ismail MN & Poh BK
Kuala Lumpur
Skinfold thickness (SKF) is widely used to estimate body composition in
children, but with little information on its validity. The aim of this study is
to validate six existing SKF equations against air displacement
plethysmography (ADP) for estimation of body fat in normal weight and
obese children aged 9-12 years. The SKF equations tested were Brook
(1971), Johnston et al. (1988), Slaughter et al. (1988) (triceps and
subscapular), Slaughter et al. (1988) (triceps and calf), Deurenberg et al.
(1990) and Lohman et al. (2000) equations. Subjects comprised 63
normal weight and 63 obese children who were categorized according
to WHO (2007) BMI-for-age reference. Mean percentage of body fat
(%BF) measured by ADP for normal weight and obese children were
19.9 ± 5.4% and 40.4 ± 4.9%, respectively. Among normal weight
children, all the SKF equations were significantly correlated with ADP
(p<0.05) with r values ranging from 0.420 to 0.707. However, Bland-
Altman analyses revealed that all six SKF equations significantly
underestimated %BF (p<0.01) for normal weight children with the
exception of Lohman et al. (2000) equation (+1.0%, p=0.11). Among
obese children, all SKF equations were significantly correlated with ADP
with r values ranging from 0.390 to 0.468 (p<0.01). %BF was
significantly underestimated (p<0.01) by all the equations in obese
children with the smallest bias shown by Lohman et al. (2000) equation
(-7.7%, p<0.0001). Bland-Altman 95% limits of agreement between all
six equations and ADP were wide in either normal weight or obese
children, indicating poor agreement for individual predictions. In
conclusion, it was found that validity of SKF method was poorer in
obese children with weaker correlation, larger mean bias and wider
limits of agreement compared with normal weight children. The present
study shows that SKF technique is a valid method for estimating %BF
for groups but may not be suitable for individual assessment.

F10 Development of Waist Circumference Percentiles for Malaysian
Children Aged 6 to 16 Years
Nurul Jannah A, Poh BK, Chong LK, Ruzita AT & Ismail MN
Kuala Lumpur
Obesity is a global concern irrespective of socioeconomic status,
ethnicity or age groups, and is a known health risk for various diseases.
Waist circumference (WC) is a surrogate measurement to determine
abdominal obesity. This paper reports the development of age- and
gender-specific WC percentile curves for Malaysian children and
adolescents aged 6 –to 16 years. A total of 16,239 (8123 boys; 8116
girls) were participated in this study. Weight and height were measured
and body mass index (BMI) was determined. WC measurements were
taken at the middle line between the tenth rib and the iliac crest.
Smoothed percentile charts for the 3rd, 5th, 10th, 25th, 50th, 75th, 90th, 95th
and 97th were constructed using LMS Method. Mean weight, height, WC
and BMI were 38.3 ± 16.7 kg, 141.0 ± 16.7 cm, 63.9 ± 12.9 cm, 18.4 ±
4.8 kg/m2 respectively for boys and lower among girls at 36.3 ± 14.4 kg,
139.2 ± 14.1 cm, 60.7 ± 10.6 cm, 18.1 ± 4.5 kg/m2, respectively. WC
was found to increase with age for both sexes but boys tend to have
higher values than the girls at every age and percentile points.
Comparisons with other studies indicate that at 50th percentile, Malaysia
was not different with British, Hong Kong and Turkey but at 90th
percentile, Malaysia had higher values compared to other countries
starting at 10 years old. The 90th percentile was adopted as cut off point
to assess abdominal obesity in Malaysian children and adolescents.
These curves represent the first WC percentiles reported for Malaysian
children and adolescents and they can be employed as a reference for
future studies.
93

F11 Specificity and Sensitivity of Modified International Physical
Activity Questionnaire (IPAQ) among Middle-aged Population of
the Malaysian Cohort
Norsham Shamsuddin1, Poh BK2, Ismail MN2, Syed Zulkifli Syed
Zakaria1 & A Rahman AJ1
1UKM Medical Molecular Biology Institute (UMBI), Kuala Lumpur
2Dept of Nutrition & Dietetics Faculty of Allied Health Sciences, UKM,
Kuala Lumpur
Physical inactivity is a global health concern. Tools to measure physical
activity are very challenging to use and validate. The aim of this project
was to determine the specificity and sensitivity of modified IPAQ against
Actical accelerometer. Subjects comprised of 129 Malaysian adults (74
women, 55 men) aged 40-65 years participating in The Malaysian
Cohort project. The IPAQ was interview-administered on two different
occasions (Day 1 and Day 8). Subjects wore the Actical accelerometer
for seven consecutive days between the two interview sessions.
Specificity and sensitivity were calculated based on classification of
subjects into two groups, whether meeting physical activity guidelines or
not. The modified IPAQ identified 89% (specificity) of those who met the
current PA guidelines of accumulating more than 30min day-1 spent in
vigorous and moderate activities as determined by accelerometer,
whereas only 13% (sensitivity) of those not meeting the guidelines were
classified correctly. Median of total time spent in vigorous and moderate
activity (MVPA) for modified IPAQ was 87 (137) (min day-1) whereas
MVPA for accelerometer was 60 (47) (min day-1). These results indicate
that the specificity was acceptable, however the sensitivity was low. In
addition, Malaysian adults tend to over-report their physical activities.
94

GROUP G: EXPERIMENTAL STUDY
G01 Weight Changes After Supplemented of Mixture of
Strobilanthes Crispus and Roselle Tea in Rats
95
Asmah R & Nurul Syima H
Dept of Nutrition & Dietetics, Faculty of Medicine & Health Sciences,
The objective of this study was to determine the body weight after
administration of Strobilanthes crispus tea (SCT), roselle tea ® and the
mixture of S.crispus and roselle tea (M). The treatments were given
through forced fed for 7 days to a total number of 120 rats which were
divided into 12 groups whereby 4 groups received low dose at 2.5% (L)
for each treatment (LNC, LSCT, LR and LM), 4 groups received medium
dose at 25% (M) for each treatment (MNC, MSCT, MR and MM) and the
other 4 groups received high dose at 50% (H) for each treatment
denotes HNC, HSCT, HR and HM. Each group contains 10 rats with 5
males and 5 females. They were housed in standard cages at the
animal house of Faculty Medicine and Health Sciences and fed with
standard rat chow with water ad libitum. The result showed that there
were significant differences in the mean body weight for all groups in
each dose given at different treatment. There was an increased in body
weights in all groups of rats with low dose except for the LSCT and LM
that had slightly decreased in mean body weight after 7 days. There
were significant different in mean body weight before and after the
treatment with medium dose or 25%. Normal control group and MR was
found to have the highest percentage of difference and less increased in
MM was noted. HSCT showed small differences in mean body weight
compared to normal control. All the groups receiving high concentration
of treatments were significantly different in their body or weight from day
1 to day 7 (p<0.05). In conclusion, the Strobilanthes crispus or a mixture
with roselle tea showed less increased of mean body weight in rats.

G02 Induction of Cell Cycle Arrest (G1) and Apoptosis in 3T3-L1
Adipocytes by a Standardized Extract of Caralluma fimbriata and a
Pregnane Glycoside in It
Kamalakkannan S1, Tirupathi Pichiah PB2, Ramaswamy R1 &
Mohammad AA1
AH PATHI PICHIAH
1Dept of Animal Science, School of Life Sciences, Bharathidasan
University, Tiruchirappalli 620 024, Tamilnadu, India
2Dept of Food Science & Human Nutrition, College of Human Ecology
Chonbuk National University, South Korea
Obesity is a disease of multi-factorial origin and forms the root cause for
several major diseases creating a serious problem that has social as
well as economic implications. The pharmacological approaches, for
obesity management include interventions to decrease appetite,
increase energy expenditure, inhibit differentiation and proliferation of
pre-adipocytes, decrease lipogenesis and increase lipolysis. Here,
induction of adipocyte apoptosis is a recent concept. Apoptosis is critical
tissue homeostasis, and its disruption has been linked to a wide variety
of disorders including obesity. Caralluma fimbriata (Asclepiadaceae), an
edible succulent, listed in Indian Materia Medica, is believed to possess
several phytotherapeutic properties including anti-obesigenic, anti-diabetic,
anti-atherosclerotic and appetite reducing activities. Our earlier
investigations on standardized extract of C. fimbriata (CFE)
[SlimalumaTM] in rodent and cell line models have provided evidence in
support of these activities. The objective of the study is to determine the
pathways involved in induction of cell cycle arrest (G1) and apoptosis by
CFE and the major principle in it, a pregnane glycoside. The study was
conducted in two phases using 3T3-L1 pre-adipocyte cells. The pre-adipocyte
cells were differentiated into mature adipocytes adopting the
established protocol. In the first phase, the cells were treated with CFE
at 100 ug/ml concentration, and subjected to flow assisted cell sorter
(FACS) analysis, confocal microscopy and immuno-fluorescent
localization of cyclin D1, followed by immuno-blotting of CDK4/6. In the
second phase of the study, the cells were treated with CFE and the
purified major pregnane glycoside in this extract and screened for
induction of apoptosis. Analysis of apoptosis was carried out adopting
AO&EB, Hoechst 33258, JC-1 and Annexin V -Cy3 staining and
immuno-blotting of caspases 3/9, followed by comet assay to find DNA
damage. Flow cytometry, immuno-fluroscent analysis and confocal
microscopy revealed that CFE inhibits adipocyte proliferation, induces
G1 cell cycle arrest and reduces the expression of CDK 4/6. Further,
apoptosis specific staining of treated cells indicated that the cell death
96

could be mediated via mitochondria-mediated pathway. Immuno-blotting
analysis indicated activation of caspases 3 and 9. The purified pregnane
glycoside also produced similar results but was less efficient. The
results reveal that CFE can significantly inhibit adipocyte proliferation,
induce cell cycle arrest and bring about apoptotic cell death. The less
significant results produced by the pregnane glycosides may be due to
solubility, stability, etc consequent upon isolation and purification, thus,
signifying the importance of synergism in therapeutic applications of
herbal extracts.
G03 Anti-obesity Effect of Emu (Dromaius novachollandiae) Oil in
Diet Induced Obesity (DIO) in Male Wistar Rat
Achiraman S1, Kamalakkannan S2, Tirupathi Pichiah PB3, Gayathri
A1, Tamileela Selvi S1, Udhaya A1 & Dora Clotilda J1ICHIAH P
ATHI PICHIAH
1Dept of Eco-Biotechnology, School of Environmental Sciences,
Bharathidasan University, Tiruchirappalli 620 024, Tamilnadu, India
2Dept of Animal Science, School of Life Sciences, Bharathidasan
University, Tiruchirappalli 620 024, Tamilnadu, India, India
3Dept of Food Science & Human Nutrition, College of Human Ecology
Chonbuk National University, South Korea
Obesity is a “nutritional disorder”, has become huge burden both in
developed and developing countries. It forms the root cause for most of
the diseases which are fatal leading to death. Several strategies were
adopted to treat or curb the rising level of obesity, which include social,
cultural, behavioral, nutritional modification, surgery and
pharmacological approaches. Researchers in the past as well as in the
present depend mostly on plant resources to find the lead molecule and
ignored animal sources to treat any diseases. Resources obtained from
animals like oil do have medicinal properties. The objective of the study
is to investigate the anti-obesity efficacy of Emu oil in diet induced
obesity condition and to screen the principles present in Emu oil. Emu
oil was subjected for GC-MS analysis for chemo-profiling. Briefly, male
Wistar rats (150-180 g) were classified into five groups (N=5), group one
served as untreated control and fed with pellet chow, whereas rats in
groups two-five were fed with cafeteria diet for 12 weeks to induce
obesity. After induction, rats in group 3-5 were administered with three
doses of Emu oil orally through gavages for five weeks. After the
treatment period, body weight, fat pad and liver weight were recorded.
Serum lipid profiles, blood sugar and hormonal (insulin, LH and
testosterone) levels were estimated. Liver and kidney function test along
97

with histopathological analysis (liver, testis, spleen, kidney) were carried
out for toxicological evaluation. The GC-MS analysis revealed the
presence of various fatty acids like octadecanoic acid, hexadecanoic
acid and linoleic acids. Administration of Emu oil to obese rats produced
significant reduction in feed and water intake leading to reduced body
weight, fat pads and liver mass. The impact of reduced fat mass was
reflected in serum lipid and hormonal profiles compared untreated
obese rats (group 2). Liver and kidney function test reveals that
treatment with Emu oil has ameliorated the changes induced by feeding
cafeteria diet. Histo-pathological analysis of vital organs does show a
similar pattern with less signs of toxicity. Hormone analysis of obese
rats indicated an alteration in insulin and testosterone level whereas no
significant changes were observed in LH levels. These alterations were
restored back to normalcy upon Emu oil administration. We believe that
the fatty acids present in the Emu oil could have played a major role in
conferring the anti-obesity effect. The present study provides the first
scientific evidence for anti-obesity property of Emu oil, which can be
taken to the next level of research and applications to control obesity.
98

Acknowledgements
MASO gratefully acknowledges contributions
99
from the following:
Platinum Sponsor
Abbott Laboratories (M) Sdn Bhd
Silver Sponsors
Totalife (M) Sdn Shd
Nestle Malaysia Berhad
Other Sponsors
DSM Nutritional Products (M) Sdn Bhd
GlaxoSmithKline Consumer Healthcare Sdn Bhd
Graf Medical Systems
Kuala Lumpur Convention Centre
Lazcorp Holdings Sdn Bhd
MASWings Sdn Bhd
Neucor Alliance (M) Sdn Bhd
Nova Nutritional Supplies Sdn Bhd
Roche Diagnostic Malaysia
Department of Nutrition and Dietetics,
Universiti Kebangsaan Malaysia
for supporting facilities

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