Publications by authors named "Mary F Chong"

The associations between circulating PUFA and cardiovascular risk factors and events in healthy Asian populations have been less examined robustly compared with Western populations. This systematic review aimed to summarise current evidence on the associations between -3 and -6 PUFA biomarkers and cardiovascular risk factors and events in healthy Asian populations. Four databases were searched for observational studies from 2010 until 2024.

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Background: The International Code of Marketing of Breast-milk Substitutes, or 'the Code,' sets standards to regulate marketing of commercial milk formula (CMF) to protect breastfeeding. World Health Organization member states are advised to legislate the Code into national law, but understanding of its implementation outcomes is limited. This systematic review aimed to examine implementation outcomes in countries implementing the Code as national law.

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Background: The cognitive benefits of breastfeeding are widely recognized; however, its effects on brain development and later academic skills require further examination. This study aimed to examine the longitudinal relations between breastmilk feeding, neurophysiological changes, and early academic skills.

Methods: In the Growing Up in Singapore Towards healthy Outcomes (GUSTO) birth cohort, breastmilk feeding practices were collected every 3 months from 3 weeks to 18 months postpartum.

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Objective: To characterise lifestyle patterns (comprising dietary and movement behaviour aspects) of children in Singapore and examine the correlates of these patterns.

Design: An observational study approach was used. Children recorded their diet and activities over two weekdays and two weekend days on a validated web-based assessment, My E-Diary for Activities and Lifestyle (MEDAL).

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With emerging Asian-derived diet quality indices and data-driven dietary patterns available, we aimed to synthesize the various dietary patterns and quantify its association with cardiovascular diseases (CVDs) among Asian populations. We systematically searched PubMed, Embase, Scopus, and Web of Science for observational studies in South, Southeast, and East Asia. Dietary patterns were grouped "high-quality," which included high intakes of three or more of the following food groups: 1) fruits and vegetables, 2) whole grains, 3) healthy protein sources (legumes and nuts, fish and seafood, low-fat dairy, and lean meat and poultry), and 4) liquid plant oils.

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Introduction: Early childhood is a critical period for growth and development. Adopting healthy lifestyle behaviours during this period forms the foundation for future well-being and offers the best protection against non-communicable diseases. Singapore studies have shown that many young children are not achieving the recommendations on physical activity, sedentary behaviour and sleep.

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Background: We previously reported that delayed allergenic food introduction in infancy did not increase food allergy risk until age 4 y within our prospective cohort. However, it remains unclear whether other aspects of maternal or infant diet play roles in the development of childhood food allergy.

Objectives: We examined the relationship between maternal pregnancy and infant dietary patterns and the development of food allergies until age 8 y.

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Background: My E-Diary for Activities and Lifestyle (MEDAL) is a web-based time-use diary developed to assess the diet and movement behaviors of Asian school children.

Objective: This study aims to determine the accuracy of MEDAL in assessing the dietary intake of Malaysian school children, using photographs of the children's meals taken by their parents as an objective reference.

Methods: A convenience sample of 46 children aged 10 to 11 years recorded their daily meals in MEDAL for 4 days (2 weekdays and 2 weekend days).

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Background: Setting healthy lifestyle habits during the formative years of childhood is critical as habits can track to adulthood and help prevent obesity and chronic disease risks in later life. While multicomponent interventions have been shown to be effective in changing the lifestyle behaviours of children, there is a limited understanding of the feasibility of such interventions in primary schools in Singapore. A multiphase mixed method study was conducted to develop and examine the feasibility of a theory-based multicomponent school-based intervention-Promoting hEatlthy Eating and Active Lifestyle (PEDAL).

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Background: Tracking combinations of lifestyle behaviours during childhood ("lifestyle pattern trajectories") can identify subgroups of children that might benefit from lifestyle interventions aiming to improve health outcomes later in life. However, studies on the critical transition period from early to middle childhood are limited. We aimed to describe lifestyle patterns trajectories in children from 2 to 8 years of age and evaluated their associations with cardiometabolic risk markers at age 8 years in a multi-ethnic Asian cohort.

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Background: Metabolic syndrome (MetS) is a precursor to cardiovascular diseases and type 2 diabetes. Existing MetS prediction models relied heavily on biochemical measures and those based on non-invasive predictors such as lifestyle behaviours were limited. We aim to (1) develop a weighted lifestyle risk index for MetS and (2) externally validate this index using two Asian-based cohorts in Singapore.

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Article Synopsis
  • Maternal vitamin status before and during pregnancy significantly impacts pregnancy outcomes and offspring development, but there is limited longitudinal data on how it changes from preconception through postpartum.
  • The NiPPeR trial involved 1,729 women who were randomized to receive either a standard or enhanced vitamin supplement from preconception to 6 months postpartum, evaluating the effects on vitamin status and glucose tolerance during pregnancy.
  • Key findings focused on the primary outcome of glucose tolerance at 28 weeks and a secondary outcome related to reducing maternal micronutrient insufficiencies in vitamins B6, B12, riboflavin, and D during pregnancy.
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Background: Increasing maternal glycaemia across the continuum during pregnancy may predispose offspring to subsequent cardiometabolic risk later in life. However, evidence of long-term impacts of maternal glycemic status on offspring amino acid (AA) profiles is scarce. We aimed to investigate the association between maternal antenatal glycaemia and offspring mid-childhood amino acid (AA) profiles, which are emerging cardiometabolic biomarkers.

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Objective: This study aimed to fill the current gap in the understanding of the knowledge, attitudes and behaviours (KAB) related to dietary Na among adult residents in Singapore.

Design: A cross-sectional online survey was conducted between October and December 2020 on 955 participants selected through random sampling.

Setting: The survey was conducted in Singapore.

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We examined the associations of perinatal plasma carotenoids and E vitamers concentrations with glycemia, insulin resistance, and gestational and type 2 diabetes mellitus during pregnancy and post-pregnancy in GUSTO women. Plasma carotenoid and E vitamer concentrations were measured at delivery, and principal component analysis was used to derive the patterns of their concentrations. Fasting and 2 h glucose levels and fasting insulin were measured at 26-28 weeks gestation and 4-6 years post-pregnancy, with the derivation of homeostatic model assessment for insulin resistance (HOMA-IR).

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Background & Aims: To examine whether predominant night-eating, defined as more than 50% of total daily energy intake consumed between 1900 and 0659 h, is associated with glycemic outcomes in pregnancy.

Methods: This was a prospective cohort study of 277 healthy pregnant women with complete 4-day dietary intake records at 18-24 weeks gestation, recruited from KK Women's and Children's Hospital, Singapore. Primary outcomes were fasting, 1-h, and 2-h plasma glucose after a 75-g oral glucose tolerance test at 24-28 weeks gestation.

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Background: Promoting active, balanced lifestyles among children may be an important approach to optimising their health-related quality of life (HRQoL). However, the relationships between children's movement behaviours and HRQoL remain unclear.

Methods: We examined the associations between movement behaviours (sleep, inactivity, light and moderate-to-vigorous intensity physical activity) assessed using accelerometers at ages 8 and 10 years and self-reported HRQoL scores (overall, and physical and emotional well-being, self-esteem, relationship with family and friends, and school functioning domains) at age 10 years among 370 children in a local birth cohort using compositional isotemporal substitution techniques.

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Adversity exposures in the prenatal and postnatal period are associated with an increased risk for psychopathology, which can be perpetuated across generations. Nonhuman animal research highlights the gut microbiome as a putative biological mechanism underlying such generational risks. In a sample of 450 mother-child dyads living in Singapore, we examined associations between three distinct adversity exposures experienced across two generations-maternal childhood maltreatment, maternal prenatal anxiety, and second-generation children's exposure to stressful life events-and the gut microbiome composition of second-generation children at 2 y of age.

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Background And Objectives: Studies on longitudinal trajectories of diet and the influence on aging in older adults are limited. We characterized diet quality trajectories over the past 2 decades among adults aged ≥85 years and examined their associations with cognitive and psychosocial outcomes.

Research Design And Methods: We used data from 861 participants in the population-based Singapore Chinese Health Study.

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Objectives: A bidirectional relationship between periodontitis and diabetes has been reported. Its mechanisms are yet to be elucidated. This study examines the interplays amongst dental conditions (periodontitis and functional dentition), diet, and glycaemic control of adults.

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Background: The timing of introduction of complementary foods and the duration of breastfeeding (BF) have been independently associated with child overweight and obesity; however, their combined influence on body fat partitioning and cardiometabolic risk is unclear.

Objective: We investigated the associations of the timing of introduction of complementary foods, the duration of BF, and their interaction with child adiposity and cardiometabolic risk markers.

Methods: We analyzed data from 839 children in the prospective Growing Up in Singapore Towards healthy Outcomes (GUSTO) cohort.

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Importance: Although multiple modifiable risk factors have been identified for reduced fecundability (defined as lower probability of conception within a menstrual cycle), no scoring system has been established to systematically evaluate fecundability among females who are attempting to conceive.

Objective: To examine the association of a risk score based on 6 modifiable factors with fecundability, and to estimate the percentage reduction in incidence of nonconception if all study participants achieved a minimal risk score level.

Design, Setting, And Participants: This population-based cohort study obtained data from the S-PRESTO (Singapore Preconception Study of Long-Term Maternal and Child Outcomes) prospective cohort study.

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Background: Diet indices are widely used in nutritional research across communities but do not "capture" the full extent of diet variability across multiple countries. Empirically derived dietary patterns can provide additional information because they reflect combinations of foods potentially associated with health outcomes. Limited studies have evaluated preconception dietary patterns in heterogeneous populations.

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Article Synopsis
  • Subfertility is a widespread issue, and this study researched how preconception micronutrient supplements might influence the time it takes to get pregnant among women.
  • Conducted in Singapore, the study involved 908 women aged 18-45, measuring their supplement intake and sociodemographic characteristics to determine their fecundability.
  • Results showed that folic acid and iodine supplementation linked to shorter time to pregnancy, while evening primrose oil seemed to have the opposite effect, suggesting further research is needed to confirm these findings.
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