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Title:	Keberkesanan diet penghadan kalori secara berpuasa dalam memperbaiki status pemakanan dan parameter metabolik dalam kalangan lelaki melayu meningkat usia
Authors:	Nur Islami Mohd Fahmi Teng (P53374)
Supervisor:	Suzana Shahar, Prof. Dr.
Keywords:	Diet penghadan kalori Status pemakanan Diet therapy (nutrition) - Malaysia
Issue Date:	3-May-2014
Description:	Diet penghadan kalori (CR), didefinisi sebagai penurunan pengambilan kalori tanpa sebarang malnutrisi. Ianya merupakan sebuah intervensi yang memberi manfaat kesihatan ke atas penuaan dan memanjangkan jangka hayat. Walau bagaimanapun, kelestarian model ini ke atas individu masih dipersoalkan. Berpuasa pula merupakan amalan agama atau budaya yang merupakan model alternatif kepada regim CR. Kajian ini dijalankan bagi menilai keberkesanan gabungan model CR dan amalan berpuasa sunat saranan Islam (Isnin dan Khamis) dalam memperbaiki status pemakanan dan parameter metabolik dalam kalangan lelaki Melayu meningkat usia. Regim intervensi diet penghadan kalori secara berpuasa (FCR) merangkumi pengurangan pengambilan tenaga sebanyak 300 - 500 kkal/hari berserta puasa sunat Muslim selama 2 hari/minggu, untuk jangkamasa 3 bulan. Peserta kajian ini direkrut melalui saringan kesihatan ke atas lelaki Melayu berusia 40 - 75 tahun di sekitar Lembah Klang. Seramai 56 orang lelaki Melayu (purata umur 59.3 ± 5.7 tahun), sihat tubuh badan, dan Indeks Jisim Tubuh 23.0 - 29.9 kg/m² dibahagikan secara rawak kepada dua kumpulan, Intervensi (n=28), dan Kawalan (n=28). Parameter kajian iaitu pengukuran antropometri, tekanan darah, profil lipid dan tekanan oksidatif dinilai pada peringkat dasar, minggu ke-6 dan minggu ke-12. Manakala ujian fungsi kognitif, kualiti hidup dan analisis ekspresi gen dinilai pada peringkat dasar dan minggu ke-12. Sejurus selepas tamat kajian intervensi FCR, kajian susulan dilakukan pada minggu ke-16 dan minggu ke-22 bagi melihat kesan lanjut ke atas subjek. Hasil menunjukkan terdapat penurunan pengambilan tenaga sebanyak 16.2% sepanjang 3 bulan tempoh kajian berbanding peringkat dasar dalam kumpulan intervensi, manakala +7% peningkatan dalam kumpulan kawalan (p<0.01). Kesan intervensi yang signifikan ditemui pada pengukuran antropometri [berat badan (p<0.001), Indeks Jisim Tubuh (p<0.01), peratus lemak (p<0.001) dan jisim lemak (p<0.05)], tekanan darah [sistolik (p<0.05) dan diastolik (p<0.05)] dan profil lipid darah [kolesterol jumlah (p<0.001), kolesterol LDL (p<0.05) dan nisbah kolesterol jumlah kepada HDL (p<0.05)]. Penurunan signifikan pada minggu ke-12 dalam kumpulan intervensi turut ditemui bagi aras kerosakan DNA (p<0.001) dan malondialdehid (p<0.01). Skor sub-ujian kognitif iaitu Rey Auditory Verbal Learning Test (ingatan segera) didapati meningkat secara signifikan dalam kedua-dua kumpulan intervensi (p<0.01) dan kawalan (p<0.05) selepas 12 minggu kajian. Analisis ekspresi gen mendapati sebanyak 280 gen berbeza ekspresi dalam kumpulan intervensi selepas 12 minggu intervensi FCR. Gen IL-8 merupakan perubahan gandaan terbesar (-5.89, p<0.05, kadar pengesanan palsu<0.05). Regulasi tindak balas inflamatori dan imunologi pula merupakan kumpulan biologi utama yang berkait dengan kesan intervensi FCR. Kelestarian model intervensi ini dinilai melalui fasa susulan. Hasil pada fasa susulan menunjukkan peningkatan kembali pengambilan tenaga dalam kumpulan intervensi (p<0.01) selepas 10 minggu pasca-intervensi. Sebagai kesimpulan, regim FCR didapati berkesan untuk memperbaiki status pemakanan dan parameter metabolik dalam kalangan lelaki meningkat usia tanpa memberi kesan negatif kepada fungsi kognitif. Ekspresi gen IL- 8 merupakan penanda-bio novel bagi kajian lanjut kesan FCR ke atas parameter metabolik. Kajian lanjutan intervensi FCR dalam skala lebih besar, jangkamasa yang lebih panjang serta melibatkan penanda-bio inflamatori dan imunologi adalah diperlukan bagi membuktikan kelestarian modul ini.,Calorie restriction (CR), defined as a decrease in calorie intake without malnutrition. It is an intervention that provides health benefit for aging and increase longevity. However, the sustainability of such study among individuals is questionable. Fasting due to religious or cultural practice is an alternative model of CR. The present study is to determine the effectiveness of calorie restriction in combination with Muslim Sunnah fasting (Mondays and Thursdays) in improving nutritional status and metabolic parameters among Malay aging men. Fasting calorie restriction (FCR) regime involves a reduction of 300 - 500 kcal/day in combination with 2 days of Muslim Sunnah fasting, for a 3 month period. Subjects were recruited from a health screening among Malay men aged 40 - 75 years old in Klang Valley. A total of 56 healthy Malay men (mean age 59.3 ± 5.7 years), with a Body Mass Index (BMI) of 23.0 - 29.9 kg/m² were randomly assigned to the Intervention (n=28) and Control (n=28) group. Measurements of anthropometry, blood pressure, lipid profile and oxidative stress were performed at baseline, week 6 and week 12. Cognitive function test, quality of life and gene expression profiling study were performed at baseline and week 12. After the FCR intervention, a follow up study was done at week 16 and week 22 to determine the post-intervention effect of the subjects. Results showed that energy intake was reduced by 16.2% throughout the 3 month intervention period as compared to baseline in the intervention group while +7% increased was found in the control group (p<0.01). A significant intervention effect was observed in the measurements of anthropometry [body weight (p<0.001), Body Mass Index (p<0.01), fat percentage (p<0.001) and fat mass (p<0.05)], blood pressure [systolic (p<0.05) and diastolic (p<0.05)] and lipid profile [total cholesterol (p<0.001), LDL cholesterol (p<0.05) and ratio of total cholesterol to HDL (p<0.05)]. A significant reduction at week 12 in the intervention group was also found in DNA damage (p<0.001) and malondialdehyde (p<0.01) levels. A cognitive function sub-test, Rey Auditory Verbal Learning Test (immediate recall) was found to have increased significantly in both the intervention (p<0.01) and control (p<0.05) groups after 12 weeks of the study. Gene expression analysis revealed that a total of 280 genes were differentially expressed in the intervention group after 12 weeks. The IL-8 gene showed the biggest fold change (-5.89, p<0.05, false discovery rate<0.05). The regulation of inflammatory and immune response was the major biological groups enriched following the FCR intervention. The sustainability of this intervention was assessed during follow up phase. Results from the follow up study revealed a rebound effect on energy intake (p<0.01) after 10 weeks post-intervention in the intervention group. In conclusion, FCR resulted in the improvement of the nutritional status and metabolic parameters among aging men without compromising the cognitive function. The IL-8 gene expression warrants novel biomarkers for further study of FCR on metabolic parameters. Future study of FCR on a wider scale and longer duration involving inflammatory and immune biomarkers is needed to prove the sustainability of this module.,PhD
Pages:	371
Call Number:	WB400.N9745k 2014 9 tesis
Publisher:	UKM, Kuala Lumpur
Appears in Collections:	Faculty of Health Sciences / Fakulti Sains Kesihatan

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