Background Perioperative malnutrition is common in patients undergoing gastrointestinal-oncology surgery and is associated with longer hospital stays, increased postoperative complications, poorer quality of life, and lower survival rates. Current practice emphasizes the role of early perioperative nutrition therapy as an early intervention to combat the postoperative complications of patients and the implementation is now widely adopted. However, there is still a lack of research on determining the effectiveness of intensive nutrition therapy and providing ONS perioperative locally. This becomes the significance of this study and serves as a basis for management and guideline in the local hospital settings. Methods This is a pragmatic randomized control trial study where elective admitted patients will be randomly divided into the intervention (SS) or control (NN) group. All data will be collected during a face-to-face interview, anthropometric measurement, blood sampling (albumin, white blood count, hemoglobin, and c-reactive protein), handgrip strength, and postoperative complications. Group SS will be receiving a tailored lifestyle and intensively supplemented with oral nutrition support as compared to Group NN that will receive standard medical care. The primary outcome for this study is the length of stay in the hospital. Additional outcome measures are changes in biochemical profile and nutritional and functional status. The effects of intervention between groups on the outcome parameters will be analyzed by using the SPSS General Linear Model (GLM) for the repeated measure procedure. Discussion The intervention implemented in this study will serve as baseline data in providing appropriate nutritional management in patients undergoing gastrointestinal and oncological surgery. Trial registration ClinicalTrials.gov Protocol Registration and Results System (PRS) NCT04347772. Registered on 20 November 2019.

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1) Background: Structured nutrition therapy (NT) is essential for the management of type 2 diabetes (T2D), but the optimal delivery during Ramadan fasting remains unclear. The present study aimed to evaluate the effect of structured NT program versus standard care in patients with T2D during Ramadan.(2) Methods: The present study was an 8-week, parallel, non-randomized study with patients' preference design involving 64 patients with T2D. The participants were asked to choose their preferred group, i.e., structured NT (Structured Ramadan NT, sRNT) or standard care (SC). The participants in the sRNT group received a Ramadan-focused nutrition plan, including a diabetes-specific formula throughout the study, whereas the patients in the SC group received standard nutrition care. Study outcomes included clinical outcomes and quality of life (QoL). Data was analyzed using two-way repeated-measures ANOVA and linear mixed-effects model. (3) Results: More than half of the participants (n = 38, 63%) chose sRNT as their preferred group. Both groups had comparable baseline characteristics. After 8-weeks of the respective intervention, participants in the sRNT group had lower levels of fasting plasma glucose (−0.9 ± 0.3 mmol/L vs. 0.2 ± 0.3 mmol/L, p < 0.05), triglycerides (−0.21 ± 0.08 mmol/L vs. 0.20 ± 0.17 mmol/L, p < 0.05), and self-monitoring glucose at pre-dawn (6.9 mmol/L vs. 7.8 mmol/L, p < 0.05) and pre-bedtime (7.6 mmol/L vs. 8.6 mmol/L, p < 0.05) than participants in the SC group. Although not different between groups, HbA1c levels decreased significantly in the sRNT (−0.72 ± 0.16%, p < 0.001) but not in the SC group (−0.35 ± 0.24%, p = 0.155). QoL and satisfaction scores improved significantly in sRNT group, but not in SC group.(4) Conclusions: The structured NT regimen for Ramadan is a feasible and beneficial program for T2D patients observing Ramadan fasting as it showed an improvement in clinical outcomes and QoL.

Adolescence is a crucial stage of development in human life and having adequate dietary intake plays an important role in the physical development and overall well-being. The dietary intake of adolescents is one of the major concerns in public health as there are growing evidences that link poor nutrition to elevated risks of obesity-related health problems. This cross-sectional study aimed to determine the effect of intra and inter-personal factors on energy intake of the adolescents in Hulu Langat District of Selangor, Malaysia.A total of 457 adolescents aged 13-16 years from five selected schools were recruited through multistage cluster sampling. Self-administered questionnaires consisted on socio demographic background, intra and interpersonal factors were distributed. Intrapersonal factors were operationalised as eating behaviour and personality traits. Whereas interpersonal factors include parenting styles and social support. Eating behaviours were assessed using Three-Factor Eating Questionnaire-R18 (1) . TFEQ-R18 has 18-item which measures three types of eating behaviours; restrained eating, uncontrolled eating and emotional eating. Personality traits were obtained using Universiti Sains Malaysia (USM) Personality Inventory (USMaP-i) (2) . USMaP-i has 60-item that measures respondents' personality which divided into extraversion, conscientiousness, agreeableness, neuroticism and openness to experience. Parenting styles were assessed through Parental Authority Questionnaire (3) , while social support was determined using Multidimensional Scale of Perceived Social Support (MSPSS) (4) .The current dietary intake was measured through 24-hour dietary recall. The estimated dietary intakes were computed in Nutritionist Pro software and the energy intakes were compared with Recommended Nutrient Intake (RNI) for adolescents.The sample comprised of 84.2% Malays, 8.1% Chinese, 6.8% Indian, while 0.1% were from other ethnic groups. Distribution of the respondents according to age showed 30.0% aged 13 years old, while 33.9% and 36.1% aged 14 and 16 respectively. Energy intake of the respondents reached an average of 51.9% -62.4% of RNI. Hierarchical multiple linear regression (adjusted for age, sex and ethnicity) (Table 1) revealed that both intra and interpersonal factors contributed to the dietary intakes of adolescents. Adolescents with uncontrolled eating behaviour (B = 0.171,CI: 3.95-11.85) and have significant support from family members (B = 0.101,CI: 7.20-21.40) were found to have strongest influence on their energy intakes. Nevertheless, those with conscientiousness personality trait (B=−0.096,CI: 2.02-25.49) were more cautious in controlling their energy intakes.Energy consumption of adolescents could be influenced by both intra and interpersonal factors, which highlight a need to consider multiple approaches at individual, home and environment in planning and executing any health and nutrition intervention program.

Background: Perioperative malnutrition is common in patients undergoing gastrointestinal-oncology surgical and associated with longer hospital stays, increased post-operative complications, poorer quality of life and lower survival rate. Current practice emphasises the roles of early perioperative nutrition therapy as early intervention in order to combat the post-operative complications of patients and the implementation is now widely adopted. The aim of the study is to determine the effects of intensive perioperative nutrition therapy to overcome the post-operative complications in adult patients undergoing gastrointestinal and oncological surgery. Methods: This is a pragmatic randomised control trial study where elective admitted patients will be randomised into Intervention (SS) or Control (NN) Group. All data will be collected during a face to face interview, anthropometric measurement, blood sampling (albumin, white blood count, haemoglobin and c-reactive protein), handgrip strength and post-operative complications. Group SS will be receiving a tailored lifestyle and intensively supplemented with oral nutrition support as compared with Group NN that receive standard medical care. The primary outcomes are length of stay in hospital, bowel function and solid food toleration. Additional outcome measures are changes in biochemical profile, nutritional and functional status. The effects of intervention between groups towards outcome parameters will be analyse by using the SPSS General Linear Model (GLM) for repeated measure procedure.Discussion: The intervention implemented in this study will serve as a baseline data in providing an appropriate nutritional management in patients undergoing gastrointestinal and oncological surgery. Trial registration: ClinicalTrials.gov Protocol Registration and Results System (PRS), NCT04347772. Registered 20 November 2019, https://www.clinicaltrials.gov