2024_ Association between dietary patterns and coronary heart disease among high-risk adults in Malaysia

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date 2024-11-06 09:37
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originalfilename ASSOCIATION BETWEEN DIETARY PATTERNS AND CORONARY HEART DISEASE AMONG HIGH-RISK ADULTS IN MALAYSIA (MASTER_2024).pdf
person Nur Ain Fatinah Binti Abu Bakar
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spelling 16806 https://intelek.unisza.edu.my/intelek/pages/view.php?ref=16806 https://intelek.unisza.edu.my/intelek/pages/search.php?search=!collection3 General Document Malaysia Library Staff (Top Management) Library Staff (Management) Library Staff (Support) Terengganu Faculty of Health Sciences English application/pdf 1.7 Server storage Scanned document Universiti Sultan Zainal Abidin UniSZA Private Access Universiti Sultan Zainal Abidin 277 Copyright©PWB2025 Nur Ain Fatinah Binti Abu Bakar Coronary heart disease (CHD) is a significant global health burden and has been the leading cause of death in Malaysia since 1980. The yearly mortality rate due to CHD has risen to 16.1% in 2022. Associations between nutrients and CHD have been extensively studied worldwide, however, the link with dietary patterns (DPs) among Malaysians, remains inconclusive. This study aimed to recruit high-risk adult patients with and without CHD, to identify DPs and to determine the association between DP and CHD. This comparative cross-sectional study involved 365 participants (178 CHD (48.8%); 187 non-CHD (51.2%)) recruited from selected hospitals and health clinics using consecutive sampling. Dietary intake, physical activity and stress level were measured using 189-item foods frequency questionnaire, short version International Physical Activity Questionnaire (IPAQ), and Perceived Stress Scale (PSS-10) respectively, whilst anthropometry (body mass index (BMI), waist circumference (WC)), clinical data (blood pressure) were measured by trained researcher, and biochemical data (lipid profile, blood sugar profile) were obtained from medical records. The reduced rank regression (RRR) method was used to derive DPs scores whilst binary logistic regression was used to assess the associations between DPs and CHD. The mean age of all study participants was 51.6±9.1 years old, with over 50% were men and with low household income. Majority of participants were Malay (81.6%), with low education level (61.9%) and mean BMI of 28.4±5.9 kg/m2. The CHD group had significantly higher WC (95.47±11.19 vs 90.10±12.27 cm; P-value<0.001),total cholesterol (5.43±1.22 vs 5.13±1.12 mmol/L; P-value=0.016), triglyceride (1.77±0.56 vs 1.47±0.49 mmol/L; P-value<0.001), and systolic blood pressure(139.24±15.72 vs 134.77±12.28 mmHg; P-value=0.003), with lower high-density lipoprotein cholesterol (1.03±0.21 vs 1.15±0.23 mmol/L; P-value<0.001), HbA1C (6.74±1.54 vs 7.18±1.35 %; P-value=0.005) and fasting blood sugar (6.63±1.77 vs 7.14±1.58 mmol/L; P-value=0.004) than non-CHD group. Both groups showed no significant difference in BMI, lower-density lipoprotein cholesterol, diastolic blood pressure, physical activity, and perceived stress score. The main DP found in this study is characterised by “high saturated fatty acid (SFA), high dietary energy density (DED), high sodium” (explained variation = 21.52%). This DP, which is attributed to high consumption of coconut-based dishes, fast foods and snacks, rice dishes, fat spread,seasoning sauces, salted and processed foods, and low intake of fruits, green leafy vegetables, white rice, and other vegetables were associated with CHD (OR:1.32, 95% CI:1.03, 1.69; P-value=0.026) when, adjusted for age, sex, race, education level, income, family history of CHD, marital status, smoking status, physical activity, stress level and BMI. This is the first study to identify a DP associated with CHD among highrisk adults in Malaysia, however, the cross-sectional design of this study was unable to confirm the causality of the disease. Longitudinal prospective studies with larger sample sizes are highly warranted to establish the cause-effect relationship.Nonetheless, the findings of this study are practically translatable and useful to assist health professionals in providing food-based information to the public in addition to the current nutrient recommendations for effective dietary changes. 2024-11-06 09:37 uuid:0A2716D1-7D2E-41AF-907A-DDE3F3FC1E21 Microsoft® Word 2021 ASSOCIATION BETWEEN DIETARY PATTERNS AND CORONARY HEART DISEASE AMONG HIGH-RISK ADULTS IN MALAYSIA (MASTER_2024).pdf 2024_ Association between dietary patterns and coronary heart disease among high-risk adults in Malaysia Coronary Heart Disease (CHD) Dietary Patterns Nutrition and Cardiovascular Health Nutrient Intake Diet and Heart Disease Malaysian Adults Reduced Rank Regression (RRR) Cardiometabolic Risk Dietary Fat Intake Coronary heart disease — Malaysia Diet — Health aspects — Malaysia Nutrition — Physiological aspects Thesis
spellingShingle 2024_ Association between dietary patterns and coronary heart disease among high-risk adults in Malaysia
state Terengganu
subject Coronary heart disease — Malaysia
Diet — Health aspects — Malaysia
Nutrition — Physiological aspects
summary Coronary heart disease (CHD) is a significant global health burden and has been the leading cause of death in Malaysia since 1980. The yearly mortality rate due to CHD has risen to 16.1% in 2022. Associations between nutrients and CHD have been extensively studied worldwide, however, the link with dietary patterns (DPs) among Malaysians, remains inconclusive. This study aimed to recruit high-risk adult patients with and without CHD, to identify DPs and to determine the association between DP and CHD. This comparative cross-sectional study involved 365 participants (178 CHD (48.8%); 187 non-CHD (51.2%)) recruited from selected hospitals and health clinics using consecutive sampling. Dietary intake, physical activity and stress level were measured using 189-item foods frequency questionnaire, short version International Physical Activity Questionnaire (IPAQ), and Perceived Stress Scale (PSS-10) respectively, whilst anthropometry (body mass index (BMI), waist circumference (WC)), clinical data (blood pressure) were measured by trained researcher, and biochemical data (lipid profile, blood sugar profile) were obtained from medical records. The reduced rank regression (RRR) method was used to derive DPs scores whilst binary logistic regression was used to assess the associations between DPs and CHD. The mean age of all study participants was 51.6±9.1 years old, with over 50% were men and with low household income. Majority of participants were Malay (81.6%), with low education level (61.9%) and mean BMI of 28.4±5.9 kg/m2. The CHD group had significantly higher WC (95.47±11.19 vs 90.10±12.27 cm; P-value<0.001),total cholesterol (5.43±1.22 vs 5.13±1.12 mmol/L; P-value=0.016), triglyceride (1.77±0.56 vs 1.47±0.49 mmol/L; P-value<0.001), and systolic blood pressure(139.24±15.72 vs 134.77±12.28 mmHg; P-value=0.003), with lower high-density lipoprotein cholesterol (1.03±0.21 vs 1.15±0.23 mmol/L; P-value<0.001), HbA1C (6.74±1.54 vs 7.18±1.35 %; P-value=0.005) and fasting blood sugar (6.63±1.77 vs 7.14±1.58 mmol/L; P-value=0.004) than non-CHD group. Both groups showed no significant difference in BMI, lower-density lipoprotein cholesterol, diastolic blood pressure, physical activity, and perceived stress score. The main DP found in this study is characterised by “high saturated fatty acid (SFA), high dietary energy density (DED), high sodium” (explained variation = 21.52%). This DP, which is attributed to high consumption of coconut-based dishes, fast foods and snacks, rice dishes, fat spread,seasoning sauces, salted and processed foods, and low intake of fruits, green leafy vegetables, white rice, and other vegetables were associated with CHD (OR:1.32, 95% CI:1.03, 1.69; P-value=0.026) when, adjusted for age, sex, race, education level, income, family history of CHD, marital status, smoking status, physical activity, stress level and BMI. This is the first study to identify a DP associated with CHD among highrisk adults in Malaysia, however, the cross-sectional design of this study was unable to confirm the causality of the disease. Longitudinal prospective studies with larger sample sizes are highly warranted to establish the cause-effect relationship.Nonetheless, the findings of this study are practically translatable and useful to assist health professionals in providing food-based information to the public in addition to the current nutrient recommendations for effective dietary changes.
title 2024_ Association between dietary patterns and coronary heart disease among high-risk adults in Malaysia
title_full 2024_ Association between dietary patterns and coronary heart disease among high-risk adults in Malaysia
title_fullStr 2024_ Association between dietary patterns and coronary heart disease among high-risk adults in Malaysia
title_full_unstemmed 2024_ Association between dietary patterns and coronary heart disease among high-risk adults in Malaysia
title_short 2024_ Association between dietary patterns and coronary heart disease among high-risk adults in Malaysia
title_sort 2024_ association between dietary patterns and coronary heart disease among high-risk adults in malaysia