Diet optimization using linear programming to develop low cost cancer prevention food plan for selected adults in Kuala Lumpur, Malaysia

An optimization protocol for MRI examination resource allocation based on demand forecasting and linear programming

The accessibility of medical services in Mainland China had been on the rise, leading to a surge in the number of Magnetic Resonance Imaging (MRI) scans. This increase had caused substantial delays in MRI examination queues at large hospitals. With MRI equipment and exams being costly, over-purchasing machines could lead to underutilization of resources. It was, therefore, crucial to devise a comprehensive method that could shorten patient wait times and optimize the use of medical resources within hospitals. The research had utilized daily MRI examination application data from a hospital covering the period from July 1, 2017, to November 30, 2022. The Autoregressive Integrated Moving Average (ARIMA) model and the AutoRegressive Integrated Moving Average with exogenous (ARIMAX) model were developed using SAS (version 9.3) software. Moreover, Non-AutoRegressive (NAR) and Non-AutoRegressive with exogenous (NARX) models were built using MATLAB (version R2015b) to forecast future MRI examination demands. Integrating the ARIMAX model with the NARX model, an ARIMAX-NARX model had been constructed.The predictive accuracy of these models was then assessed and compared. Based on the prediction outcomes, an Integer Linear Programming model was employed to calculate the optimal number of MRI examinations per machine per day, targeting cost reduction. An optimization flowchart for MRI examination resource allocation was developed by integrating critical process components, thus streamlining and systematizing the optimization process to improve efficiency. Analysis of the data revealed a weekly cyclical trend in MRI examination applications. Among the ARIMA, ARIMAX, NAR, NARX, ARIMAX-NARX models evaluated for their predictive skills, the NARX model emerged as the most accurate for forecasting. An Integer Linear Programming (ILP) model was utilized to plan the number of examinations for each MRI machine, effectively reducing costs. An optimization flowchart was developed to integrate key factors in MRI examination resource allocation, streamlining and systematizing the optimization process to enhance work efficiency. This study offers a comprehensive protocol for optimizing MRI examination resource allocation, combining the predictive power of the NARX model, the planning capabilities of the Integer Linear Programming model, and the integration of other relevant factors via an optimization flowchart.

Qualitative insights into ecobiosocial factors influencing colorectal cancer risk in Malaysia

Introduction

Colorectal cancer (CRC) is a growing public health concern in Malaysia influenced by a complex interplay of ecological, biological, and social (EBS) factors. Despite its increasing incidence, limited research has explored how these factors interact to shape CRC risk in the Malaysian context, especially from the perspectives of affected individuals. This study explores Malaysians' perceptions and experiences regarding CRC risk within the EBS framework.

Methods

A qualitative case study approach involved in-depth interviews with twelve Malaysians aged 35-75 who had undergone colonoscopy at a university hospital. All interviews were recorded and transcribed. Data were collected until saturation was achieved. The transcripts were coded and analysed using ATLAS.ti software. The data were analysed using thematic analysis.

Results

Findings revealed key themes related to ecological factors in the physical activity environment, which included the sub-themes of type, facilitators, barriers to physical activity, and food sources. The biological factors theme revealed that a family history of CRC influences experience and perception. The subthemes of social factors were sociocultural customs, misconceptions, food preparation methods, CRC-related foods, and food affordability.

Conclusion

The findings highlighted the multifactorial nature of CRC risk. Understanding the aspects of EBS supports the development of targeted public health interventions to address modifiable CRC risk factors and promote prevention and early CRC detection in the Malaysian context.

The use of linear programming approach in diet optimization among children under five: a scoping review

BACKGROUND

Adequate nutrition is crucial for optimal child growth and development, especially for children under five. Over the years, the linear programming (LP) approach has been used to develop food-based recommendations (FBRs) for children under five.

OBJECTIVE

This scoping review aims to (i) summarize the use of LP in diet optimization to improve nutrient adequacy, (ii) evaluate nutrient requirements by using modelling techniques when the use of local foods is optimized, and (iii) identify and compare the problem nutrient(s).

METHODS

This scoping review was performed by searching PubMed and Wiley databases from 2012 to 2025, and also screened the reference lists of included publications to identify potentially eligible articles. Forward and backward citation searches were also performed to supplement the structured searches in the databases.

RESULTS

Fourteen studies were included after a systematic literature search. The objective functions and the final set of FBRs of the included studies were summarized. Moreover, the nutrient intakes in the optimized diets and the problem nutrients of the included studies were compared and discussed. When optimizing diets using the LP approach, most of the nutrient requirements can be achieved, except for iron and zinc and, in some studies, thiamine, niacin, folate, and calcium. Iron was identified as the problem nutrient in all studies involving infants aged 6 to 11 months old, followed by calcium and zinc. In children aged 12 to 23 months, iron and calcium were identified as the problem nutrients in almost all studies, followed by zinc and folate. In children aged 1 to 3 years, fat, calcium, iron, and zinc were recognized as the absolute problem nutrients, while fat, calcium, and zinc were the absolute problem nutrients for children aged 4 to 5 years. Findings on dietary inadequacy of nutrient intakes were remarkably consistent across studies conducted in different geographic and socioeconomic settings.

CONCLUSIONS

Modeled diets involving local foods are inadequate to meet the requirements for certain micronutrients, particularly iron and zinc. Cost-effective strategies are required to improve the dietary adequacy of young children.

Optimized menu formulation to enhance nutritional goals: design of a mixed integer programming model for the workers' food program in Brazil

BACKGROUND

In Brazil, institutional foodservices are required to meet the recommendations of the Workers? Food Program (WFP), a national public policy used to plan collective menus. The current study aimed to propose a mathematical model to generate a one-month menu that meets the nutritional recommendations of the WFP, with low cost and good quality.

METHODS

We considered aspects related to the eating habits of the Brazilian population, spacing of repetitions between the dishes, texture combination, and monotonicity of colors of the dishes served. A mixed integer programming model was built to formulate daily menus for an institutional foodservice for one month. The menu consisted of a base dish, a base dish option, salads (2 options), a protein dish, a protein dish option, a side dish, and a dessert.

RESULTS

The model ensured compliance with the recommendations proposed by the WFP and the provision of healthy and nutritionally balanced meals. The menu generated met the recommendations of the WFP, with an average of 716.97 kcal/meal, including on average 58.28% carbohydrates, 17.89% proteins, and 24.88% total fats/meal.

CONCLUSION

The model used can help in the menu elaboration dynamics of institutional foodservices, optimizing the work of the nutritionist in charge.

A Scoping Review of Epidemiological Studies on Intake of Sugars in Geographically Dispersed Asian Countries: Comparison of Dietary Assessment Methodology

Previous systematic reviews, which focused on sugar intake and its relation with health issues, were mainly conducted in Western countries, not Asian countries characterized by differences in dietary habits and disease prevalence. The scarcity of Asian studies may be attributed to the lack of assessment tools for estimating sugar intake. To provide an overview of the epidemiological studies on sugar intake in Asian countries, with a primary focus on dietary assessment methodology for estimating sugar intake, we conducted a scoping review of the epidemiological studies estimating sugar intake in Asian countries (the United Nations' definition) and Taiwan using PubMed and Web of Science. Study quality was evaluated based on its assessment of sugar intake in the whole diet, dietary assessment methods, and data sources used for estimating sugar content. We identified 143 studies from 136 publications from Eastern (n = 63), Southern (n = 30), South-Eastern (n = 26), and Western (n = 24) Asia. Total sugars were investigated in 95 studies, while 23-30 studies investigated sucrose, fructose, added sugars, and free sugars. The main aim of the selected studies was assessment of diet-disease relations (n = 85) and estimation of dietary intake (n = 40), and 62 studies assessed sugars as the primary exposure/outcome. A total of 120 studies assessed sugar intake in the whole diet, and 62 studies used validated FFQs or multiple-day dietary assessment methods. Only 41 studies used country-specific comprehensive food-composition databases or directly measured sugar content. Only 17 studies reported high-quality data. This review elucidated a sufficient number of epidemiological studies estimating sugar intake across Asian countries; however, most studies reported low-quality data. The results from our review showed that both feasible and validated dietary assessment methods, as well as comprehensive country-specific sugar-composition databases, are essential for producing high-quality studies with accurate sugar intake to examine its association with health outcomes.

Effectiveness of optimized food-based recommendation promotion to improve nutritional status and lipid profiles among Minangkabau women with dyslipidemia: A cluster-randomized trial

BACKGROUND

In women of Minangkabau ethnicity, a high prevalence of dyslipidemia, overweight, and obesity is thought to be closely related to poor dietary practices. Promotion of local specific food-based recommendations (FBRs) was previously found to be effective in improving dietary practice and nutrient intakes related to dyslipidemia. This study aimed to describe the effects of the FBR promotion on the nutritional status and lipid profiles of Minangkabau women with dyslipidemia.

METHODS

We used a cluster-randomized design with a total subject of 123 Minangkabau women of reproductive age with dyslipidemia. They were recruited from 16 sub-villages and assigned to either the FBR group (n = 61) or the non-FBR group (n = 62). Data on body weight, height, waist circumference, and lipid profiles were collected at the baseline and the end of the trial. Linear mixed model analysis was used to analyze the effect of the intervention on nutritional status and lipid profiles.

RESULTS

The mean effect (95% confidence interval) of the intervention on body weight, body mass index, and waist circumference for the FBR group versus the non-FBR group were -1.1 (-1.8; -0.39) kg, -0.43(-0.76; -0.11) kg/m2 and -2.1(-3.7;-0.46) mm respectively (p <0.05). The Castelli's index in the FBR group improved, but there was no significant between-group difference in the change of total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides at the end of the intervention.

CONCLUSION

The promotion of the FBRs positively impact the nutritional status but did not significantly affect the blood lipid profile of Minangkabau women with dyslipidemia.

TRIAL REGISTRATION

The trial was retrospectively registered at ClinicalTrials.gov Protocol Registration and Result System (PRS) as NCT04085874, in September 2019.

Health, access and nutritional issues among low-income population in Malaysia: introductory note

The current issue of BMC Public Health presents work by the Consortium of Low Income Population Research (CB40R), highlighting a comprehensive aspect of health, i.e., physical health, mental health, health behaviour and health financing; and also nutrition involving all stages of lifespan of the socioeconomic deprived group in Malaysia.Consortium of B40 Research (CB40R) reposited and harmonised shared, non-identifiable data from epidemiological studies involving low income population (B40) in Malaysia. CB40R also performed joint or mega-analyses using combined, harmonised data sets that yield collated results with enhanced statistical power, more variabilities (study population, geographical regions, ethnicities and sociocultural groups) to better understand the needs, characteristics and issues of B40 groups in Malaysia. It also aimed to develope a system/framework of minimum/standard variables to be collected in research involving B40 in future. For this special issues, members of the consortium have been invited to contribute an original article involving analysis of the health aspects, access to health and nutritional issues of the B40 samples.All the papers in this special issue have successfully highlighted the health and nutritional issues (i.e., non-communicable disease (NCD), inflammatory bowel disease (IBD), knowledge towards sexually transmitted disease (STD), low birth weight, Motoric Cognitive Risk (MCR) syndrome, urinary incontinence), mental health, oral health and inequalities among the low-income group in Malaysia, including the rural population and also the urban poor. The low-income population in Malaysia is also at risk of both under- and over nutrition, of which specific cost effective strategies are indeed needed to improve their quality of life.The low income population in Malaysia is facing various health challenges, particularly related to NCD and poor mental health, nutritional and physical function. There is a need for a sustainable intervention model to tackle the issues. It is also important to highlight that reducing SES disparities in health will require policy initiatives addressing the components of socioeconomic status (income, education, and occupation) as well as the pathways by which these affect health.