ORCID Profile
0000-0002-0756-6344
Current Organisations
Flinders University Caring Futures Institute
,
Flinders University
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Publisher: Elsevier BV
Date: 2018
DOI: 10.1093/AJCN/NQX003
Publisher: JMIR Publications Inc.
Date: 23-12-2019
Abstract: he prevalence of nonalcoholic fatty liver disease (NAFLD) reaches up to 30% in the Asian adult population, with a higher prevalence in obese patients. Weight reduction is typically recommended for patients at high risk or diagnosed with NAFLD, but is a challenge to achieve. e aimed to evaluate the effect of a lifestyle intervention with a mobile app on weight loss in NAFLD patients. his prospective randomized controlled trial included 108 adults with NAFLD confirmed by steatosis on ultrasound and a body mass index ≥23 kg/m sup /sup who were recruited from a fatty liver outpatient clinic. The patients were randomly allocated to either a control group (n=53) receiving standard care, consisting of dietary and lifestyle advice by a trained nurse, or an intervention group (n=55) utilizing the Nutritionist Buddy (nBuddy) mobile app in addition to receiving dietary and lifestyle advice by a dietitian. Body weight, alanine aminotransferase (ALT), aspartate aminotransferase (AST), waist circumference, and blood pressure were measured at baseline, and then at 3 and 6 months. Intention-to-treat and per-protocol analyses were used for statistical comparisons. he intervention group had a 5-fold higher likelihood (relative risk 5.2, i P /i =.003, 95% CI 1.8-15.4) of achieving ≥5% weight loss compared to the control group at 6 months. The intervention group also showed greater reductions in weight (mean 3.2, SD 4.1 kg vs mean 0.5, SD 2.9 kg i P /i & .001), waist circumference (mean 2.9, SD 5.0 cm vs mean –0.7, SD 4.4 cm i P /i & .001), systolic blood pressure (mean 12.4, SD 14.8 mmHg vs mean 2.4, SD 12.4 mmHg i P /i =.003), diastolic blood pressure (mean 6.8, SD 8.9 mmHg vs mean –0.9, SD 10.0 mmHg i P /i =.001), ALT (mean 33.5, SD 40.4 IU/L vs mean 11.5, SD 35.2 IU/L i P /i =.004), and AST (mean 17.4, SD 27.5 U/L vs mean 7.4, SD 17.6 IU/L, i P /i =.03) at 6 months. ifestyle intervention enabled by a mobile app can be effective in improving anthropometric indices and liver enzymes in patients with NAFLD. This treatment modality has the potential to be extended to a larger population scale. ustralian New Zealand Clinical Trials Registry ACTRN12617001001381 9xnfmp
Publisher: MDPI AG
Date: 26-06-2022
DOI: 10.3390/NU14132642
Abstract: Cancer-associated malnutrition, or cachexia, stemming from cancer or its treatments, is particularly prevalent in metastatic cancers, and is often interrelated with sarcopenia and frailty. Evidence suggests that dietary supplements play a role in managing these conditions. As metastatic cancer cells are associated with notable genomic and phenotypic alterations, response to dietary supplements may differ between metastatic and non-metastatic cancers. However, research in this area is lacking. This scoping review aims to identify the dietary supplements that have been studied in patients with metastatic cancers and malnutrition-related conditions, along with their proposed effects, mechanisms, outcome measures, and tools used. A systematic search was conducted across databases, including MEDLINE, EMBASE, CINAHL, and clinical trial registries. Of the initial 6535 records screened, a total of 48 studies were included, covering a range of dietary supplements—vitamins, minerals, antioxidants, proteins, amino acids, fatty acids, fiber, and others. While the types of dietary supplements included varied across cancer types, omega-3 and carnitine were investigated most often. Proposed relevant attributes of dietary supplements included their antioxidant, anti-inflammatory, anti-cancer, and immunomodulatory properties. Overall, there was a paucity of interventional studies, and more randomized controlled trials are warranted.
Publisher: Elsevier BV
Date: 10-2023
Publisher: SAGE Publications
Date: 23-01-2020
Abstract: The aim of the study is to gain insights into the relationship between diabetes-related nutrition knowledge (DRNK) and diet quality in Singapore. Forty-two participants were recruited from a tertiary hospital. DRNK and diet quality were ascertained with the DRNK questionnaire and Alternate Healthy Eating Index 2010, respectively. Twenty-one semi-structured interviews of perceived barriers and enablers to adherence to dietary guidelines were audio recorded, transcribed and analysed. Participants had a poor mean percentage DRNK score of 39.7% (±17.7) and diet quality of 54.2% (±9.4). Pearson’s correlation tests revealed no correlation between DRNK and diet quality ( r –0.29 p=0.065) but suggest a moderate positive correlation between DRNK and psychosocial self-efficacy ( r 0.41 p=0.008). Thematic analysis revealed six barriers (obesogenic environment lack of time conflict between advice and personal values stress from external sources lack of personal motivation gaps in DRNK) and four enablers (personal motivation to improve condition fear of T2DM complications sufficient DRNK presence of social support) to adherence to dietary guidelines. DRNK may not correlate with adherence to dietary guidelines multiple mediating factors are identified when translating DRNK to practice.
Publisher: Wiley
Date: 31-01-2019
Abstract: Diabetes-related nutrition knowledge (DRNK) is essential for the self-care of patients with type 2 diabetes mellitus (T2DM). A specific tool measuring DRNK can help us to understand awareness levels and tailor structured nutrition education programs. Our study aimed to develop a questionnaire to assess DRNK for in iduals with T2DM in Singapore. An expert panel was formed to consolidate in-depth, culturally suitable, and current information on DRNK. A literature review of diabetes self-care knowledge questionnaires was performed to outline the scope of the questionnaire and generate a question pool. User friendliness was tested in the first draft of the questionnaire (n = 21). Then, a second draft was tested for item difficulty, discrimination index, and internal consistency (n = 62). The final draft was examined for construct validity and test-retest reliability (n = 100). The final questionnaire (four sections: 27 questions) was found to be consistent and reliable. The item difficulty scores of the selected questions ranged from difficult to desirable (2-85). There was fair to good internal consistency (Cronbach's alpha: 0.66, 0.79, 0.56, and 0.78 for Sections 1, 2, 3 and 4, respectively) and construct validity (independent t-test: P < 0.001). Questions in the final questionnaire had an average discrimination index of 0.3 (reasonably good). The questionnaire was revealed to have good test-retest reliability (intraclass correlation: 0.82-0.84). The DRNK questionnaire is a valid and reliable measure to complement assessment tools measuring self-efficacy/behaviour in in iduals with T2DM living in Singapore.
Publisher: BMJ
Date: 12-2020
DOI: 10.1136/BMJOPEN-2020-040146
Abstract: To determine the effectiveness of combined exercise-nutrition interventions in prefrail/frail hospitalised older adults on frailty, frailty-related indicators, quality of life (QoL), falls and its cost-effectiveness. Randomised controlled trials (RCTs) of combined exercise-nutrition interventions on hospitalised prefrail/frail older adults ≥65 years were collated from MEDLINE, Emcare, CINAHL, Ageline, Scopus, Cochrane and PEDro on 10 October 2019. The methodological quality was appraised, and data were summarised descriptively or by meta-analysis using a fixed effects model. The standardised mean difference (SMD) or difference of means (MD) with 95% CIs was calculated. Twenty articles from 11 RCTs experimenting exercise-nutrition interventions on hospitalised older adults were included. Seven articles were suitable for the meta-analyses. One study had low risk of bias and found improvements in physical performance and frailty-related biomarkers. Exercise interventions were mostly supervised by a physiotherapist, focusing on strength, ranging 2–5 times/week, of 20–90 min duration. Most nutrition interventions involved counselling and supplementation but had dietitian supervision in only three studies. The meta-analyses suggest that participants who received exercise-nutrition intervention had greater reduction in frailty scores (n=3, SMD 0.25 95% CI 0.03 to 0.46 p=0.02) and improvement in short physical performance battery (SPPB) scores (n=3, MD 0.48 95% CI 0.12 to 0.84 p=0.008) compared with standard care. Only the chair-stand test (n=3) out of the three SPPB components was significantly improved (MD 0.26 95% CI 0.09 to 0.43 p=0.003). Patients were more independent in activities of daily living in intervention groups, but high heterogeneity was observed (I 2 =96%, p .001). The pooled effect for handgrip (n=3)±knee extension muscle strength (n=4) was not statistically significant. Nutritional status, cognition, biomarkers, QoL, falls and cost-effectiveness were summarised descriptively due to insufficient data. There is evidence, albeit weak, showing that exercise-nutrition interventions are effective to improve frailty and frailty-related indicators in hospitalised older adults.
Publisher: JMIR Publications Inc.
Date: 13-04-2020
DOI: 10.2196/14802
Abstract: The prevalence of nonalcoholic fatty liver disease (NAFLD) reaches up to 30% in the Asian adult population, with a higher prevalence in obese patients. Weight reduction is typically recommended for patients at high risk or diagnosed with NAFLD, but is a challenge to achieve. We aimed to evaluate the effect of a lifestyle intervention with a mobile app on weight loss in NAFLD patients. This prospective randomized controlled trial included 108 adults with NAFLD confirmed by steatosis on ultrasound and a body mass index ≥23 kg/m2 who were recruited from a fatty liver outpatient clinic. The patients were randomly allocated to either a control group (n=53) receiving standard care, consisting of dietary and lifestyle advice by a trained nurse, or an intervention group (n=55) utilizing the Nutritionist Buddy (nBuddy) mobile app in addition to receiving dietary and lifestyle advice by a dietitian. Body weight, alanine aminotransferase (ALT), aspartate aminotransferase (AST), waist circumference, and blood pressure were measured at baseline, and then at 3 and 6 months. Intention-to-treat and per-protocol analyses were used for statistical comparisons. The intervention group had a 5-fold higher likelihood (relative risk 5.2, P=.003, 95% CI 1.8-15.4) of achieving ≥5% weight loss compared to the control group at 6 months. The intervention group also showed greater reductions in weight (mean 3.2, SD 4.1 kg vs mean 0.5, SD 2.9 kg P .001), waist circumference (mean 2.9, SD 5.0 cm vs mean –0.7, SD 4.4 cm P .001), systolic blood pressure (mean 12.4, SD 14.8 mmHg vs mean 2.4, SD 12.4 mmHg P=.003), diastolic blood pressure (mean 6.8, SD 8.9 mmHg vs mean –0.9, SD 10.0 mmHg P=.001), ALT (mean 33.5, SD 40.4 IU/L vs mean 11.5, SD 35.2 IU/L P=.004), and AST (mean 17.4, SD 27.5 U/L vs mean 7.4, SD 17.6 IU/L, P=.03) at 6 months. Lifestyle intervention enabled by a mobile app can be effective in improving anthropometric indices and liver enzymes in patients with NAFLD. This treatment modality has the potential to be extended to a larger population scale. Australian New Zealand Clinical Trials Registry ACTRN12617001001381 9xnfmp
Publisher: Oxford University Press (OUP)
Date: 13-07-2023
Abstract: Chronic inflammation, characterized by prolonged elevated inflammation markers, is linked to several chronic conditions. Diet can influence the levels of inflammation markers in the body. The aim of this systematic review was to assess the effects of anti-inflammatory diets on 14 different inflammation markers in adults. This systematic review conducted searches using Medline, PubMed, EMCare, Cochrane, and CINAHL, to locate randomized controlled trials (RCTs). Two researchers independently screened 1537 RCTs that measured changes in inflammation markers after prescription of an intervention diet. In total, 20 RCTs were included and assessed qualitatively. The results demonstrated that a Mediterranean diet can bring about statistically significant and clinically meaningful between-group differences in interleukins -1α, -1β, -4, -5, -6, -7, -8, -10, and -18, interferon γ, tumor necrosis factor α, C-reactive protein, and high-sensitivity C-reactive protein, as compared with a control diet. There may be a link between diet, inflammation markers, and disease outcomes in various adult populations. However, further research using consistent RCT protocols is required to determine correlations between diet, specific inflammation markers, and clinically relevant outcomes.
Publisher: Frontiers Media SA
Date: 24-01-2022
Abstract: Landmark studies have established that lifestyle interventions focused on weight loss, diet modification and physical activity can prevent diabetes progression. However, the effectiveness of mobile health application among Asians with prediabetes remains largely unexamined. We aimed to assess whether a smartphone app-based lifestyle intervention program would lead to weight loss, normoglycemia and improved metabolic indices in a multiethnic Asian population with prediabetes. This multicentre prediabetes RCT is part of the Diabetes Lifestyle Intervention using Technology Empowerment (D'LITE) trial. Adults ( n = 148) with prediabetes and BMI ≥ 23 kg/m 2 were randomly allocated either to the intervention group ( n = 72) empowered by self-monitoring features of the Nutritionist Buddy Diabetes app with in-app dietitian coaching for 6 months, or the control group ( n = 76) receiving standard diet counseling at baseline. Primary outcome was defined as change in body weight at 6 months, while secondary outcomes included glycemic control and other metabolic indices analyzed using Generalized Linear Mixed Model analysis with intention-to-treat approach. Intervention group achieved a significantly greater weight loss of 4.2 vs. 1.3 kg [mean difference of −3.1 kg (95% CI −4.5 to −1.7), p & 0.001], and a 4.3-fold increased likelihood of achieving ≥ 5% weight loss, as compared to the control group at 6 months. The likelihood of achieving normoglycemia (defined as HbA 1c & 5.7%) was 2.1 times higher in intervention group than in the control group ( p & 0.018). Changes to blood pressure, total and LDL cholesterol were not statistically significant. An app-based lifestyle program led to clinically significant weight loss and improved glycemia, and can potentially augment current standard care in the prevention of diabetes among an Asian multiethnic population. anzctr.org.au , identifier: ACTRN12617001112358.
Publisher: Informa UK Limited
Date: 05-2023
DOI: 10.2147/CIA.S405144
Publisher: Springer Science and Business Media LLC
Date: 22-11-2021
DOI: 10.1007/S12603-021-1704-5
Abstract: The Scored Patient-Generated Subjective Global Assessment (PG-SGA) and Edmonton Frail Scale (EFS) are widely used in acute care settings to assess nutritional and frailty status, respectively. We aimed to determine whether the scored PG-SGA can identify pre-frailty and frailty status, to simultaneously evaluate malnutrition and frailty in clinical practice. Cross-sectional study. A convenience s le of 329 consecutive patients admitted to an acute medical unit in South Australia. Nutritional and frailty status were ascertained with scored PG-SGA and EFS, respectively. Optimal cut-off scores to identify pre-frailty and frailty were determined by calculating the Scored PG-SGA's sensitivity, specificity, positive and negative predictive values, Youden Index (YI), Liu index, Receiver Operator Curves (ROC) and Area Under Curve (AUC). Nutritional status and patient characteristics were analysed according to frailty categories. The optimal cut-off PG-SGA score as determined by the highest YI, to identify both pre-frailty and frailty was >3, with a sensitivity of 0.711 and specificity of 0.746. The AUC was 0.782 (95% CI 0.731-0.833). In this cohort, 64% of the patients were well-nourished, 26% were moderately malnourished and 10% were severely malnourished. Forty-three percent, 24% and 33% of the patients were classified as robust, pre-frail and frail, respectively. Bivariate analysis showed that those robust were significantly younger than those who were pre-frail (-2.8, 95% CI -5.5 to -0.1, p=0.036) or frail (-3.4, 95% CI -5.9 to -1.0, p=0.002). Robust patients had significantly lower Scored PG-SGA than those who were pre-frail (-2.5, 95%CI -3.8 to -1.1, p<0.001) or frail (-4.9, 95% CI -6.1 to -3.7, p<0.001). The Scored PG-SGA is moderately sensitive in identifying pre-frailty/frailty in older hospitalized adults and can be useful in identifying both conditions concurrently.
Publisher: American Medical Association (AMA)
Date: 03-06-2021
Publisher: MDPI AG
Date: 06-11-2019
DOI: 10.3390/NU11112686
Publisher: Springer Science and Business Media LLC
Date: 16-12-2023
Publisher: Springer Science and Business Media LLC
Date: 25-11-2015
Publisher: MDPI AG
Date: 13-09-2021
DOI: 10.3390/NU13093182
Abstract: It is imperative that the surgical treatment of hip fractures is followed up with rehabilitation to enhance recovery and quality of life. This randomized controlled trial aimed to determine if an in idualised, combined exercise–nutrition intervention significantly improved health outcomes in older adults, after proximal femoral fracture. We commenced the community extended therapy while in hospital, within two weeks post-surgery. The primary outcome was gait speed and secondary outcomes included physical function, strength and balance, body composition, energy and protein intake. Eighty-six and 89 participants were randomized into six months in idualised exercise and nutrition intervention and attention-control groups, respectively. There were no statistically significant differences in gait speed between the groups at six and 12 months. There were no major differences between groups with respect to the secondary outcomes, except estimated energy and protein intake. This may be explained by the s le size achieved. Participants in the intervention group had greater increment in energy (235 kcal 95% CI, 95 to 375 p = 0.01) and protein intake (9.1 g 95% CI, 1.5 to 16.8 p = 0.02), compared with those in the control group at six months but not significant at 12 months. This study has demonstrated that providing early, combined exercise and nutrition therapy can improve dietary energy and protein intake in older adults with hip fractures.
Publisher: Public Library of Science (PLoS)
Date: 10-08-2016
No related grants have been discovered for chad Yixian Han.