Bibi, Zaynab Toorabally
(2022)
Development of nutrition and lifestyle intervention modules and its effectiveness among working adults with metabolic syndrome in mauritius.
PhD thesis, Universiti Sains Malaysia.
Abstract
Mauritius, officially the Republic of Mauritius is an island nation located in
the Indian Ocean and forms part of sub-Saharan Africa. In this region, Mauritius is
well-known for its remarkable economic history, however it is well known as its
high prevalence of chronic diseases due to markedly evolution of of nutrition
transition. While metabolic syndrome (MetS) has established itself as a worldwide
epidemic, there is no local study on nutritional and lifestyle intervention available
carried out among working Mauritian adults with risks of MetS. The study was
divided into 3 major phases notably: (1) Development of new research tool to assess
dietary habit (2) Cross-sectional study and (3) Interventional study. The phase I of
the study aimed to develop and assessing the validity and reproducibility of a new
food frequency questionnaire (FFQ) among Mauritians. The results demonstrated
that the newly developed FFQ has moderately over-estimated the energy and
nutrient intake as compared to the dietary recall approach. Spearman correlation
coefficient for energy, protein, carbohydrate and fat were 0.75, 0.57, 0.39 and 0.53
respectively, showing moderate to good correlations. The Bland Altman plot
demonstrated a good agreement (between ± 2SD) between the developed FFQ and
the 24-hour dietary recalls. The intra-class correlation (ICC) used to assess the
reproducibility of the FFQ was 0.73 for energy and ranged between 0.55 to 0.65 for
macronutrients and 0.31 to 0.69 for micronutrients, therefore, demonstrating a
moderate to good reliability. For the phase II, the prevalence of MetS was found to be 24.4%. Correlation analysis revealed significant moderate to strong correlations
for weight (r=0.603, p<0.001), BMI (r=0.665, p<0.001), visceral fat (r=0.684,
p<0.001) and RMR (r=0.463, p<0.001). Additionally, with increasing energy intake,
there was a significant relationship to an increasing number of metabolic risk factors
(r=0.305, p<0.001). While significant relationship was obtained for protein (r=
0.191, p = 0.011), carbohydrate (r =0.280, p<0.001) and fat (r =0.179, p =0.017) in
terms of dietary intake, however there was no significant relationship between
physical activity and the number of metabolic risk factors. . The phase III of the
study involved a 12-weeks nutrition and lifestyle intervention. Through the 12-
weeks nutrition and lifestyle intervention study, the findings demonstrated
significant differences in terms of fasting blood glucose (p=0.001), fasting HDLCholesterol
(p<0.001), fasting LDL-Cholesterol (p=0.041) and total
cholesterol/HDL ratio (p <0.001). Furthermore, significant results were obtained for
waist circumference (p=0.002) and visceral (p=0.002) in the intervention group.
During the 3-months follow-up, waist circumference (p=0.008), fasting blood
glucose (p<0.001) and HDL-c (p=0.007) revealed significant effects through time.
A time-group interaction was observed for systolic blood pressure with p=0.004 and
multivariate partial eta square of 0.379.
In conclusion, the intervention carried out was effective and further studies
on the effect of intervention can be improvised in other parameters, which related to
metabolic syndrome in a larger population, such as non-working adults or
housewives with the aim of reducing the possible risk factors.
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