Journal/Magazine Articles
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This collection contains original research articles, review articles and case reports published in local and international peer reviewed journals by the staff members of the Faculty of Medicine
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Item Lifestyle patterns and dysglycaemic risk in urban Sri Lankan women(Cambridge University Press, 2014) Waidyatilaka, I.; de Silva, A.; de Lanerolle-Dias, M.; Wickremasinghe, R.; Atukorala, S.; Somasundaram, N.; Lanerolle, P.Specific dietary patterns are associated with the risk of chronic disease. An in-depth understanding more reflective of lifestyle would be possible when assessing the synergistic effects of both diet and physical activity in pattern analysis. In the present study, we examined the biochemical markers of dysglycaemia and cardiometabolic risk in relation to lifestyle patterns using principal component analysis (PCA). Urban women (n 2800) aged 30-45 years were screened for dysglycaemia using cluster sampling from the Colombo Municipal Council area. All the 272 dysglycaemic women detected through screening and 345 randomly selected normoglycaemic women were enrolled. The International Physical Activity Questionnaire and a quantitative FFQ were used to assess physical activity and diet, respectively. Anthropometric measurements, bioelectrical impedance analysis and biochemical estimations were carried out. Lifestyle patterns were identified based on dietary and physical activity data using exploratory factor analysis. PCA was used for the extraction of factors. A total of three lifestyle patterns were identified. Women who were predominantly physically inactive and consumed snacks and dairy products had the greatest cardiometabolic risk, with a higher likelihood of having unfavourable obesity indices (increased waist circumference, fat mass percentage and BMI and decreased fat-free mass percentage), glycaemic indices (increased glycosylated Hb (HbA1c) and fasting blood sugar concentrations) and lipid profile (increased total cholesterol/TAG and decreased HDL-cholesterol concentrations) and increased high-sensitivity C-reactive protein concentrations. For the first time, we report lifestyle patterns and demonstrate the synergistic effects of physical activity/inactivity and diet and their relative association with cardiometabolic risk in urban women. Lifestyle pattern analysis greatly increases our understanding of high-risk behaviours occurring within real-life complexities. © The Authors 2014Item Sedentary behaviour and physical activity in South Asian women: time to review current recommendations?(Public Library of Science, 2013) Waidyatilaka, I.; Lanerolle, P.; Wickremasinghe, R.; Atukorala, S.; Somasundaram, N.; de Silva, A.OBJECTIVE: Our aims were to describe activity and sedentary behaviours in urban Asian women, with dysglycaemia (diagnosed at recruitment), and without dysglycaemia and examine the relative contribution of these parameters to their glycaemic status. METHODS: 2800 urban women (30-45 years) were selected by random cluster sampling and screened for dysglycaemia for a final sample of 272 newly diagnosed, drug naive dysglycaemic and 345 normoglycaemic women. Physical activity and sedentary behaviours were assessed by the International Physical Activity Questionnaire (IPAQ). Demographic data, diet and anthropometry were recorded. Logistic regression analysis assessed contribution of all parameters to dysglycaemia and exposure attributable fractions were calculated. RESULTS: The mean energy expenditure on walking (2648.5±1023.7 MET-min/week) and on moderate and vigorous physical activity(4342.3±1768.1 MET-min/week) for normoglycemic women and dysglycaemic women (walking;1046.4±728.4 MET-min/week, moderate and vigorous physical activity; 1086.7±1184.4 MET-min/week) was above the recommended amount of physical activity per week. 94.3% ofwomen spent >1000 MET-minutes/week on activity. Mean sitting and TV time for normoglycaemic and dysglycaemic women were 154.3±62.8, 38.4±31.9, 312.6±116.7 and 140.2±56.5 minutes per day respectively. Physical activity and sedentary behaviour contributed to dysglycaemia after adjustment for family history, diet, systolic blood pressure and Body Mass Index. Exposure attributable fractions for dysglycaemia were; lower physical activity: 78%, higher waist circumference: 94%, and TV viewing time: 85%.CONCLUSIONS: Urban South Asian women are at risk of dysglycaemia at lower levels of sedentary behaviour and greater physical activitythan western populations, indicating the need for re-visiting current physical activity guidelines for South AsiansItem Low folic acid status and its association with anaemia in urban adolescent girls and women of childbearing age in Sri Lanka(Cambridge University Press, 2006) Thoradeniya, T.; Wickremasinghe, R.; Ramanayake, R.; Atukorala, S.Folic acid deficiency is implicated in the aetiology of nutritional anaemia and adverse pregnancy outcomes for the fetus. Data on folic acid status among adolescent girls and non-pregnant, non-lactating young women are limited. We assessed folic acid status in a random sample of 552 subjects (277 adolescent girls aged 15-18.9 years and 275 women aged 19-30 years) living in Colombo, Sri Lanka. The association of low folic acid status with anaemia was evaluated. Socio-economic, food intake and anthropometric data were obtained. Hb, serum folic acid, vitamin B12 and ferritin and plasma homocysteine concentrations were measured. Forty-three per cent of subjects studied had low serum folic acid concentrations (<3 ng/ml) and 47 % had low Fe stores (serum ferritin <20 microg/l). Overall prevalence of anaemia was 12.9 %, and 43.9 % of anaemic subjects had both low folicacid status and depleted Fe stores (serum ferritin <12 microg/l). Both low folate status and depleted Fe stores were significantly associated with anaemia (odds ratio = 2.32; 95 % CI 1.34, 4.01 and odds ratio = 5.98; 95 % CI 3.36, 10.63, respectively). Serum folic acid concentration was associated (r = 0.108, P = 0.015) with folate intake as indicated by a computed folate index. Folate index was associated inversely with household size and positively with economic status and education level. In this study population low folic acid status, besides depleted Fe stores, was associated with anaemia. The high prevalence of low folic acid status observed highlights the need for nutrition education to improve intakes of folate, Fe and other micronutrients among adolescent girls and young women.Item The use of iron-fortified wheat flour to reduce anemia among the estate population in Sri Lanka(Hans Huber, 2004) Nestel, P.; Nalubola, R.; Sivakaneshan, R.; Wickremasinghe, A.R.; Atukorala, S.; Wickramanayake, T.The use of flour fortified with 66 mg/kg of electrolytic or reduced iron to reduce the prevalence of anemia was determined in a two-year, double-blind, controlled trial. The trial was conducted in Sri Lanka among preschoolers between 9 and 71 months old, primary schoolers 6 to 11 years old, and nonpregnant women. At baseline, 18.4% of the preschoolers had low hemoglobin (Hb) concentrations. Neither electrolytic nor reduced iron had an effect on Hb concentration among preschoolers. Only 7% of the primary schoolers were anemic at the start of the trial and, again, fortification had no effect on Hb concentration. Twenty-nine percent of women had a low Hb at outset and there was no evidence that fortification had an effect on Hb in this group. The findings from this study suggest that fortification of flour with electrolytic iron or reduced iron was not beneficial in reducing anemia in this population. This was probably due to the low prevalence of anemia and low bioavailability of the fortificant iron. Fortification with either iron fortificant was acceptableItem Treatment of bancroftian filariasis with ivermectin in Sri Lanka, evaluation of efficacy and adverse reaction(Malaysian Society of Parasitology and Tropical Medicine, 1991) Ismail, M.M.; Premaratne, U.N.; Abeyewickreme, W.; Jayasinghe, K.S.A.; de Silva, W.A.S.; Atukorala, S.; de Abrew, K.; Dissanaike, A.S.