Nutrition Society of Malaysia , 33 rd Scientific Conference: Investing In Nutrition - Act Now ; 24-26 July 2018 SUNNAH INTERMITTENT FASTING (SIF)ON COGNITIVE AND AMELIORATES THE EFFECT OF OXIDATIVE DAMAGE AMONG MCI OLDER ADULTS Ms Asheila Meramat, UKM PhD candidates Dr Razinah Sharif, Prof Suzana Shahar, Prof Dr Nor Fadilah Rajab
CONTENTS Introduction Methodology of the study Result & Discussion Conclusion
AGEING POPULATION Department Statistic of Malaysia Report, 2014-2016
Aging associated Diseases Metabolic syndromes, Physiological function OLDER Cognitive Diseases, organ function ADULTS Psychological problem mental health (1) physical function PRIMARY (innate maturational processes) caloric intake AGEING Overnutrition/overconsumption of foods SECONDARY (the effects of environment and Physical activity disease) Unhealthy lifestyle • smoking habits
CALORIC REDUCTION & FASTING oxidative stress Less damage to biomolecules and organ Slow aging process Low caloric diet/ Slow down the Fasting metabolism (10%) Reduced production of chronic low grade inflammation Improved mental health Live longer
Research questions Is regularly practicing Sunnah Intermittent Fasting has an effects on cognitive, oxidative pathway, endocrine and metabolites among older adults who had MCI in order to improve cognitive status after 36 months of follow-up? Ha: YES regularly practicing Sunnah Intermittent Fasting has an effects on cognitive, oxidative pathway, endocrine and metabolites among older adults who had MCI in order to improve cognitive status after 36 months of follow-up.
RESULTS & DISCUSSIONS Charact aracteris eristics tics r-SIF IF i-SIF SIF n-SIF IF X P-Val Value (n = 3 33) (n = 3 33) (n = 3 33) Num (%) Num (%) Num (%) Age (mea ean) 68.55 (4.51) 68.04 68.90 0.19 0.82 a (6.02) (5.09 Sex Male 21 (39.6) 14 (26.4) 18 (34.0) 3.0 0.22 Female 12 (26.1) 19 (41.3) 15 (32.6) Years ars of of education ation (year ear) ≥ 6 years 21 (46.7) 15 (33.3) 9 (20.0) 8.8 0.012* < 6 years 12 (22.2) 18 (33.3) 24 (44.4) Livin ving arr rrang angeme ement Alone 1 (8.3) 4 (33.3) 7 (58.3) 5.12 0.07 With others 32 (36.8) 29 (33.3) 26 (29.9) Histo istory ry of of demen menti tia No 32 (36.4) 29 (33.0) 27 (30.7) 3.89 0.14 Yes 1 (9.1) 4 (36.4) 6 (54.5) Smokin king habits bits Active smoker 4 (11.4) 13 (37.1) 18 (51.4) 17.36 0.002* Ex-smoker 9 (52.9) 2 (11.8) 6 (35.3) Passive smoker 20 (42.6) 18 (38.3) 9 (19.1) a One way ANOVA Unless indicated otherwise, data are given as the number (percentage); Chi square test. *p<0.05.
RESULTS & DISCUSSIONS Table 2: Comparison of mean each cognitive test among three different SIF status groups based on time (time*treatment interaction effect) Repeated measures ANCOVA between group analyses with regard to time was applied. Numerical covariate (age, level of education) was controlled using repeated measures ANCOVA. Assumptions of normality, homogeneity of variances, compound symmetry and homogeneity of regression were checked and were fulfilled. *p<0.05
1. Better cognitive performance similar results with previous IF diet exhibit less neuronal dysfunction and degeneration on mice and rats [10] 2. Mechanism contribute to the favorable effects of IF on the nervous systems accumulation of oxidatively damaged molecules improved cellular bioenergetics enhanced neurotrophic factor signaling inflammation 3. IF diets may aids to boost up levels of antioxidant defenses [11] and also promotes restoration of new neurons from neural stem cells (neurogenesis) [12]. BETTER ER CO COGN GNITIVE E FUNC NCTION ON
RESULTS & DISCUSSIONS Table 3: Cognitive changes after 36 months follow-up Characteristics r-SIF i-SIF n-SIF X P value number (%) number (%) number (%) Cognitive changes SA 8 (53.3) 6 (40.0) 1 (6.7) 46.12 0.001* UA 25 (43.9) 23 (40.4) 9 (15.8) MCI 1 (3.7) 3 (11.1) 23 (85.2) Unless indicated otherwise, data are given as the number (percentage); Chi square test. *p<0.05.
RESULTS & DISCUSSIONS Diagram 1 and 2: Comparison of mean DNA Damage parameter among three different SIF status groups based on time (time*treatment interaction effect) Diagram 2: Tail moment (%) among MCI older Diagram 1: DNA in tail (%) among MCI older adults based on consistency of SIF adults based on consistency of SIF 1.8 25 1.6 DNA in tail (%) Tail moment (%) 1.4 20 1.2 15 1 * 0.8 10 0.6 0.4 5 0.2 0 0 r-SIF i-SIF n-SIF r-SIF i-SIF n-SIF Consistency of SIF Consistency of SIF Baseline 36 months Baseline 36 months Repeated measures ANCOVA between group analyses with regard to time was applied. Numerical covariate (age, level of education) was controlled using repeated measures ANCOVA. Assumptions of normality, homogeneity of variances, compound symmetry and homogeneity of regression were checked and were fulfilled. *p<0.05
RESULTS & DISCUSSIONS Diagram 3 and 4: Comparison of mean MDA & SOD levels among three different SIF status groups based on time (time*treatment interaction effect) SOD level among MCI older adults based on Diagram 3: MDA level among MCI older consistency of SIF SOD level (u.e/min/mg protein) adults based on consistency of SIF MDA level (nmol/mg protein) 90 180 * 80 * 160 70 140 * 60 120 * 50 100 40 80 * 30 60 40 20 20 10 0 0 r-SIF i-SIF n-SIF r-SIF i-SIF n-SIF Consistency of SIF Consistency of SIF Baseline 36 months Baseline 36 months Repeated measures ANCOVA between group analyses with regard to time was applied. Numerical covariate (age, level of education) was controlled using repeated measures ANCOVA. Assumptions of normality, homogeneity of variances, compound symmetry and homogeneity of regression were checked and were fulfilled. *p<0.05
RESULTS & DISCUSSIONS Diagram 5 and 6: Comparison of mean CRP & INS levels among three different SIF status groups based on time (time*treatment interaction effect) Diagram 6: INS level among MCI older adults Diagram 5: CRP level among MCI older based on consistency of SIF adults based on consistency of SIF 2.5 350 * * 300 2 INS level (pmol/L) CRP level (mg/L) 250 1.5 200 * * 150 1 * 100 * 0.5 50 0 0 r-SIF i-SIF n-SIF r-SIF i-SIF n-SIF Consistency of SIF Consistency of SIF Baseline 36 months Baseline 36 months Repeated measures ANCOVA between group analyses with regard to time was applied. Numerical covariate (age, level of education) was controlled using repeated measures ANCOVA. Assumptions of normality, homogeneity of variances, compound symmetry and homogeneity of regression were checked and were fulfilled. *p<0.05
1. SIF protection against lipid peroxidation in plasma. 2. Possible mechanism SIF reduces the ROS production by macrophage or reduce oxidative stress on macrophage 3. Growing evidence proposed that hypo- and hyper-nutrition are associated with a higher likelihood of cellular oxidation, mediated by nutrient pathways 4. Older adults who are not practicing SIF are more prone to gain weight after 36 months might be due to accumulation of saturated fatty acids (SFAs) and polyunsaturated fatty acids (PUFAs). SFAs are more toxic than unsaturated fats. High SFA intake pro-inflammatory status resulting from an imbalance in lipid signaling pathways and production of inflammatory cytokines. 5. SIF the oxidative stress level, antioxidant defense ( SOD). SIF oxidative stress level reduce the incidence of DNA damage cognitive • impairment. • SIF insulin and glucose level ketone body levels generate a protective environment DNA damage and enhancing the programmed cell death for damaged DNA [13, 10]. BETTER ER CO COGN GNITIVE E FUNC NCTION ON
CONCLUSION 1. SIF has an effect on ROS, inflammation markers , insulin levels incidence of DNA damage revert back MCI to SA or UA (better cognitive function) 2. R-SIF NAS, acetoacetic acid metabolites (ketogenic pathway) neuroprotective effects and oxidative damage better cognitive status and health status
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FUTURE DIRECTIONS Large scale of the study population that involved different races and religion Different target population (middle age)
ACKNOWLEDGEMENT We are grateful for the Longitudinal Research Grant Scheme awarded by Ministry of Education (LRGS/BU/2012/UKM- UKM/K/01) and all the participants Bioscience Institute (IBS, UPM) Makmal Bioserasi UKM, Bangi Special thanks to : Supervisor: Dr Razinah Sharif Co-Supervisor: Prof Suzana Shahar & Prof Nor Fadilah Rajab
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