Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item Relationship between objectively measured physical activity, sedentary behaviour and body mass index among 11-13 year-old adolescents in Colombo(Sri Lanka Medical Association., 2019) Dabare, H.P.M.; Waidyatilaka, P.H.I.U.; de Lanerolle-Dias, M.; Wickremasinghe, R.; Jayawardena, R.; Hills, A.P.; Lanerolle, P.; Wickramasinghe, V.P.INTRODUCTION & OBJECTIVES: Inadequate physical activity (PA) and sedentary behaviour (SB) are attributed to the high prevalence of adolescent obesity in the world. This study aimed to identify the relationship between PA intensity, SB and body mass index (BMI) among I I -13 year-old adolescents in Colombo, Sri Lanka. METHODS: A purposive sample of 95 adolescent school girls and boys were recruited from the Colombo Municipal Council Area. Time spent on moderate-to-vigorous PA (MVPA) and SB were determined by accelerometers (Actigraph-WGT3X-BT) worn on the waist for 10 consecutive days. Height and weight were measured using the standard methodology and BMI was calculated. RESULTS: The sample consisted of 51.6 % of boys (n=49). Mean BMI of the boys was 17.2 ± 3.2 kgm-2 and girls was 17.2 ± 3.2 kgm-2. A significantly (p< 0.05) lower SB (487.4 ± 101.4 min/day vs. 596.4 ± 83.8 min/day) and a significantly higher time spent on MVPA (31.8 ± 15.1 min/day vs. 15 ± 6.7 min/day) were observed among normal weight (NW) girls compared to overweight (OW) girls. Similarly, compared to the OW boys, NW boys had a significantly (p< 0.05) lower SB (578.5 ± 94.1 min/day vs. 696.4 ± 87.4 min/day) and a significantly higher time spent in MVPA (52.9 ± 19.3 min/day vs. 23.4 ± 6.3 min/day). CONCLUSION: Effective strategies should be implemented to reduce SB and increase PA in order to correct the obsogenic behaviour among the adolescents.Item Develepment and validation of a BIA prediction equation for 11-13 year old Sri Lankan girls(Sri Lanka Medical Association, 2018) Samaranayake, D.; Dabare, H. P. M.; de Lanerolle-Dias, M.; Waidyatilaka, I.; Jayawardena, R.; Hills, A. P.; Wickremasinghe, A.R.; Lanerolle, P.; Wickramasinghe, V.P.INTRODUCTION AND OBJECTIVES: Population-specific measures of body composition are important in management of childhood obesity. This study aimed to develop and validate a bioelectrical impedance analysis (BIA) equation to assess total body water (TBW) and fat mass (FM) in Sri Lankan girls aged 11-13 years. METHODS: Forty-six 11-13 year-old healthy school girls were purposively selected and randomly divided into model development (n=30) and model validation (n=l6) sub-samples. Weight, height and impedance using BIA were measured. TBW was determined and FM was derived through the criterion Deuterium-dilution technique. Prediction equations for TBW and FM were developed using impedance index (heightvimpedance; cm2/Q), weight and height as independent variables. Final equations were developed combining the two sub-samples. Validity was assessed using correlation coefficients, paired-samples T-test and Bland-Altman plots. RESULTS: In the validation sample, predicted TBW and FM showed significant correlations and did not significantly differ from reference values, Final prediction equation for TBW had a R2 of 92.3% and RMSE of l.035 while FM prediction equation had a R2 of 94.3% and RMSE of 1.38. TBW predicted from new equation (19.48± 3.45kg) was not significantly different from reference TBW (19.52±3.65kg) and the two measures were significantly correlated (r=0.975, p<0.001). Similarly, predicted FM (10.41±4.39kg) was not significantly different from reference FM (10.38±4.74kg) and predicted and reference values were significantly correlated (r=0.974, p<0.001). In both prediction equations, the majority ofresiduals were within mean± l.96SD. CONCLUSION: Newly developed prediction equations for BIA assessment of TBW and FM show high validity compared to reference technique.Item Validity of BIA prediction equations in determining the fat mass of 11-13 year old Sri Lankan girls(Sri Lanka Medical Association, 2018) Samaranayake, D.; Dabare, H. P. M.; de Lanerolle-Dias, M.; Waidyatilaka, I.; Jayawardena, R.; Hills, A. P.; Wickremasinghe, A.R.; Wickramasinghe, V.P.; Lanerolle, P.INTRODUCTION AND OBJECTIVES: Bioelectrical impedance analysis (BIA) is a simple body composition assessment method, based on use of prediction equations. Validation of equations for the specific populations is important for accurate assessment. This study aimed to determine the validity of available BIA equations in assessing the fat mass (FM) in Sri Lankan girls aged 11-13 years. METHODS: Forty-six 11-13 year-old healthy school girls were purposively selected. Weight, height and impedance using BIA were measured. Total body water was determined and FM was derived through the criterion Deuterium dilution technique. Twelve BIA prediction equations applicable to the age and sex were identified from literature. Predicted FM calculated according to each equation was compared with reference FM (assessed through isotope dilution), and validity was assessed using correlation coefficients, paired samples T-test and Bland-Altman plots. RESULTS: FM predicted by all twelve equations was significantly correlated (r>0.93, p<0.05) with reference FM. Mean (±SD) bias of predicted FM ranged from -5.32 (±1.79) kg to 5.8 (±2.1 l) kg. Only four equations predicted mean FM values that were not significantly different from the mean reference FM values, the mean bias (±SD) ranging from -0.21 (±2.23) kg to 0.06 (±l.72) kg. Of these four prediction equations, only one had a symmetric, uniform distribution of error within the ±l .96 SD limits in the Bland-Altman analysis. CONCLUSION: Most available BIA prediction equations are unsatisfactory for use in the local context. Cross validation of existing prediction equations before use or development of BIA prediction equations to suit the local populations is recommended.Item Relationship between physical activity, sedentary behaviour and body composition among 11-13 year-old adolescent girls in Colombo(Sri Lanka Medical Association, 2018) Dabare, H. P. M.; Waidyatilaka, P.H.I.U.; de Lanerolle-Dias, M.; Wickremasinghe, R.; Jayawardena, R.; Hills, A.P.; Lanerolle, P.; Wickremasinghe, V.P.INTRODUCTION AND OBJECTIVES: Physical activity (PA) is essential in reducing the risk of obesity. This study aimed to identify the relationship between the intensity of PA and body composition among 11-13 year-old adolescent girls from Colombo, Sri Lanka. METHODS: This is part of a larger study. A purposive sample of 46 adolescent school girls were recruited from the Colombo Municipal Council area. Time spent on light (LPA), moderate (MPA), vigorous (VPA), moderate-to• vigorous (MVPA) PA and sedentary behaviour were determined by waist-worn accelerometers (Actigraph• WGT3X-BT). Deuterium dilution (gold standard) was used with Fourier Transform Infrared (Agilent 4500®) spectroscopy to assess fat mass (FM) and fat-free mass. The% FM cut-off of 33.7% for Sri Lankan children was used to categorize the sample into high fat (HF) and normal fat (NF) groups. RESULTS: The mean age was 12.3 ± 1 year. %FM was significantly correlated with sedentary behaviour (r = 0.65, p < 0.001) and negatively correlated with'Mvf'A duration (r = -0.4, p < 0.01). Time spent on VPA (15.8 ± 6.7 min/day vs. 7.6 ± 3.2 min/day) and MVPA (33.9 ± 13.3 min/da vs. 15.5 ± 7.5 min/day) were significantly (p <0.01) higher among the NF group compared to the HF group. The NF group had significantly (p < 0.01) lower sedentary behaviour (379.7 ± 135 min/day vs. 622.7 ± 105.3 min/day) compared to the HF group. CONCLUSION: %FM was higher among the adolescent girls who spent more time in sedentary behaviours and among those who spent less time engaged in MVPAItem Translational research for diabetes self-management in Sri Lanka: A randomized controlled trial(Elsevier, 2015) Jayasuriya, R.; Pinidiyapathirage, M.J.; Jayawardena, R.; Kasturiratne, A.; de Zoysa, P.; Godamunne, P.; Gamage, S.; Wickremasinghe, A.R.AIMS: The study tested the hypothesis that a theory driven Diabetes Self-Management (DSM) intervention delivered by trained nurses would result in a clinically significant improvement in glycaemic control. METHODS: Patients with an HbA1c >7.5% (58mmol/mol) and free of diabetes complications were enrolled into a randomized controlled trial (n=85). Intervention consisted of four sessions and monthly follow up for 6 months. Biochemical tests, and diet and physical activity assessments were done in both groups. Analysis of covariance was used to test the effectiveness of the intervention. RESULTS: At 6 months, there was a significant difference (P=0.001) in HbA1c between the groups controlling for baseline values and other variables. Based on the primary outcome, 28% in the intervention group achieved the target value of 6.5% HbA1c, compared to 8% in the "usual care" group (P<0.001; η2=0.65). The reduction in total energy intake and increase in physical activity was significant in the intervention group between baseline and follow up. CONCLUSIONS: The DSM intervention has resulted in a clinically significant impact on glycaemia, change in diet and physical activity, and has demonstrated the feasibility of using it within existing care arrangements in a developing country setting. Copyright © 2015 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.