Development of nutrition and lifestyle intervention modules and its effectiveness among working adults with metabolic syndrome in mauritius

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.

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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.

Item Type: Thesis (PhD)
Uncontrolled Keywords: Metabolic syndrome
Subjects: R Medicine
Divisions: Kampus Kesihatan (Health Campus) > Pusat Pengajian Sains Kesihatan (School of Health Sciences) > Thesis
Depositing User: Mr Abdul Hadi Mohammad
Date Deposited: 20 Sep 2022 04:09
Last Modified: 21 Dec 2022 00:20

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