Obesity-mediated inflammation represents a key connection between the intake of foods with high inflammatory potential and colorectal cancer (CRC) risk. We aimed to explore the association between energy-adjusted dietary inflammatory index (E-DII) in relation to CRC risk in both obese and non-obese subjects. This study included 99 histopathologically confirmed CRC cases, 73 colonic polyps cases, and 141 healthy controls from tertiary medical centres in both urban and suburban areas in Peninsular Malaysia. The subjects were categorised into body mass index (BMI) < 25 kg/m2 and BMI ≥ 25 kg/m2 groups. E-DII scores were computed based on dietary intake assessed using a validated food frequency questionnaire (FFQ). Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs), adjusted for potential cofounders. The mean dietary energy intake and mean BMI values of the subjects tended to increase as the E-DII scores increased (p for trend < 0.001). E-DII was significantly related to CRC risk only in obese subjects (OR = 1.45; 95% CI = 1.30–1.77; p < 0.001 for trend). Stratified analyses of risk factors showed significant associations between E-DII and CRC risk by age group (p for interaction = 0.030), smoking status (p for interaction = 0.043), and anthropometric indices for both males and females (p for interaction < 0.001) in the most pro-inflammatory E-DII quartile vs. the lowest E-DII quartile. Overall, pro-inflammatory diets were associated with an increased incidence of CRC in the Malaysian population, particularly in obese subjects.

This study aims to report on the validity and reproducibility of a 142-food item Food Frequency Questionnaire (FFQ) for dietary factors related to colorectal cancer among Malaysians. Population aged 30 to 70 years from two cities of Peninsular Malaysia were recruited through voluntary participation.A semi-quantitative FFQ was modified from an established FFQ used in the national survey. It includes specific questions to measure the consumption of food sources related to colorectal cancer development. FFQ was administered two times in two weeks to evaluate reproducibility (FFQ1 and FFQ2). Then the validity was assessed by comparing FFQ against the 3-day Food Record method (FR). A total of 100 respondents (mean age 50.6 years) provided data for both validity and reproducibility. The FFQ had significantly higher estimates of most nutrients and food groups' intake than the FR. The Spearman correlation showed moderate agreement between FFQ and FR while moderate to strong correlation between FFQs. The limit of agreement between both methods using Bland Altman plot was acceptable for both validity and reproducibility. The classification into the same and adjacent quartiles was between 62 to 75% for validity and 77 to 89% for reproducibility assessment. Overall, the validity was satisfactory and reproducibility of the FFQ was good for estimating absolute nutrient and food group intakes. Hence, the FFQ could be used as a valid tool for assessing dietary intake among Malaysians to study dietary factors related to colorectal cancer risk.

Background Studies on the relationship between diet and colorectal cancer (CRC) risk using single food or nutrient approach are widely conducted as opposed to dietary pattern approach. Therefore, this study aimed to determine the major dietary patterns and their association with CRC risk among Malaysians. Methods Patients aged between 18 and 80 years old from two teaching hospitals in Peninsular Malaysia were recruited through purposive sampling. Socio-demographic information and anthropometry data were assessed before the colonoscopy procedure, and dietary intake was also recorded using a validated semi-quantitative food frequency questionnaire (FFQ). Cases were those patients having histopathologically proven CRC, while controls were those without. Results Four major dietary patterns were identified: the allergenic diet, plant-based diet, processed diet, and energy-dense diet pattern. After adjusting for potential covariates, the processed diet pattern was consistently associated with CRC (OR = 3.45; 95% CI = 1.25–9.52; P = 0.017) while the plant-based diet, energy-dense diet, and allergenic diet were not associated with CRC risk. Conclusions The processed diet pattern attributed to a diet high in confectionaries and fast foods was associated with an increased risk of CRC in the Malaysian population. In order to give prevention measures through lifestyle change, more research could be done on the effect of food patterns on faecal microbiota associated with CRC.

Introduction: Eating-out is common in almost all countries, including Malaysia, but this frequent practice may affect human health. In Malaysia, data on eating-out is limited. This study aimed to assess the proportion of eating-out, to assess the association between socio-demographic factors and eating patterns, and to compare energy and nutrient intakes between people eating-out and eating-in. Methods: This cross-sectional study was conducted among 100 adults aged 30 to 70 years old. Three-day food diaries were used to collect data on dietary intake. Eating-out was defined as eating foods prepared outside the home. Respondents who ate outside for at least one meal per day, for two or three days per week were considered as those who frequently practised eating-out. Results: A total of 84% of respondents who ate out had significantly higher sodium intake than those who ate at home (2934 mg/day vs. 2165 mg/day, p=0.025). Foods and drinks that were most commonly consumed outside were nasi lemak, roti canai, rice, ayam masak kicap, vegetable soup, tomyam, rice vermicelli soup (mee-hoon soup), hot teh-o, iced tea, and orange juice. Occupation (p=0.004) and location type (p=0.001) were associated with eatingout. Government and semi-government workers (61%) and urban population (57%) had higher percentage of eating-out compared to eating at home (19% and 12%, respectively). Conclusion: More than two-thirds of our respondents ate out and this habit was related to poor diet quality with excessive intake of sodium. Interventions are needed to improve the diet quality of the overall eating-out behaviour among targeted population.

Breast cancer is the commonest type of cancer among Malaysian women. This study aimed to determine the associated factors for breast cancer occurrence among Malaysian women. A case-control study was conducted at primary cancer referral centre in the East Coast of Peninsular Malaysia from January 2014 to August 2015. Untreated breast cancer (n=55) were assigned as cases compared to healthy controls (n=58). Sociodemographic and reproductive data were collected using a standardized questionnaire while dietary data was obtained using validated diet history questionnaires (DHQ). Anthropometric assessments (weight, height, hip, waist circumference (WC) and body fat composition) were recorded. Overnight fasting venous blood samples were analysed for glucose levels, insulin, high sensitivity C reactive protein (hs-CRP), high molecular weight (HMW) adiponectin and lipid profiles. Simple logistic regression showed factors associated with breast cancer risk include age, lower education level, lower monthly household income and exposure to secondary smoke (sociodemographic factors), pulse rate, the use of more than one year of traditional medicine, systolic, and diastolic blood pressures (physical examination and reproductive factors) as well as WC, HDL cholesterol, TG, blood glucose, and sugar intake (nutritional status) were investigated. Multiple logistic regression showed factors associated with breast cancer risk included exposure to a second-hand smoke (OR=10.00, (95% CI: 2.42, 41.30)), low monthly household income (OR=18.05, (95% CI: 2.56, 127.10)) and high systolic blood pressure (OR=1.08, (95% CI: 1.04, 1.12)). Exposure to second-hand smoke, low monthly household income and high systolic blood pressures are predictors to breast cancer among Malaysian women.