Amutha Ramadas

• PhD; M App Statistics; MSc (Clinical Nutrition); BSc (Nutrition & Community Health); Grad Cert (Higher Education)
• Associate Professor at Monash University Malaysia

Nutritional therapy has been conventionally recommended for people with prediabetes as a method to delay or halt progression to type 2 diabetes. However, recommended nutritional strategies evolve over time. Hence, we performed a scoping review on recently reported nutritional interventions for individuals with prediabetes. Ovid MEDLINE, PubMed, Emb...

Diet therapy is often the first-line approach in prevention and management of type 2 diabetes mellitus (T2DM). Adoption of low glycaemic index (GI) diet one of the recent dietary strategies to modulate glycaemic response in individuals with T2DM. Generally, diet has strong influence on the gut microbiota, which recently have been found to be associ...

Background: While peer support interventions have shown to benefit adults with certain chronic conditions, there is limited evidence on its feasibility and effectiveness among people with metabolic syndrome (MetS). This paper describes the outcomes of a pre-post feasibility trial of "PEeRSUpport program for ADults with mEtabolic syndrome" (PERSUAD...

Metabolic Syndrome (MetS) is a cluster of risk factors that increases the risk for diabetes and cardiovascular diseases. Lifestyle intervention is the gold standard of MetS management and prevention. Despite the growing positive influence of peer support-based interventions on management of various chronic diseases, its potential among adults with...

Objectives Literature shows a high prevalence of MetS among Malaysians, varying across the major ethnicities. Since sociodemographic characteristics, lifestyle factors and diet habits of such communities have been reported to be diverse, the objective of this study was to investigate the association of various sociodemographic characteristics, life...

Background:Cardiovascular disease (CVD) poses a substantial global health burden, necessitating effective and scalable interventions for primary prevention. Despite the increasing recognition of peer-based interventions in managing chronic diseases, their application in CVD prevention still needs to be explored. Aims:We describe the protocol of a q...

Cardiovascular diseases are the leading cause of death in middle-income countries such as Malaysia. There is a significant gap in knowledge between cardiovascular disease-related risk assessments and interventions in the Malaysian population. In this scoping review, we have determined the status of cardiovascular research in Malaysia by prioritisin...

We investigated the association between dietary intake and metabolic risk factors in children and adolescents within a semi-rural Malaysian community. Using an interviewer-led questionnaire, we surveyed 623 participants aged 7–18 from the South East Asia Community Observatory (SEACO). Anthropometric and blood pressure data were collected from all p...

The transition from school to university brings significant adjustments in lifestyle, body weight, and living environment for young adults, potentially impacting their quality of life. Emerging evidence suggests the coronavirus disease of 2019 (COVID-19) pandemic may have exacerbated these changes. This cross-sectional study involved 361 young adul...

The study addressed a significant gap in the profiling and understanding of the gut microbiota’s influence on Malaysian Malay women with gestational diabetes mellitus (GDM). This prospective cohort study aimed to explore the intricate relationship between gut microbiota, dietary choices, and lifestyle factors among Malay women, both with and withou...

Background Peer-led lifestyle interventions have gained recognition as effective approaches for managing and preventing chronic diseases. However, there remains a critical knowledge gap regarding the impact and effectiveness of peer-led interventions specifically in the primary prevention of cardiovascular disease (CVD). Our systematic review aims...

Background Quantifying movement behaviours over 24-hours enables the combined effects of and inter-relations between sleep, sedentary time and physical activity (PA) to be understood. This is the first study describing 24-hour movement behaviours in school-aged children and adolescents in South-East Asia. Further aims were to investigate between-pa...

Engagement in health-promoting behaviors has been argued to be dependent on psychological factors in addition to simply having knowledge or access to resources. We systematically reviewed the evidence for the association between body (dis)satisfaction and health screening behaviors using six electronic databases and supplementary manual searches in...

Obesity is a growing public health concern worldwide, especially among young adults. This scoping review aims to identify and summarize the current evidence on dietary and lifestyle risk factors associated with obesity among young adults. A scoping review was performed using the PRISMA-ScR guidelines. A systematic search of five electronic database...

Purpose of Review There is a lack of synthesized evidence on social media-delivered lifestyle interventions for managing and preventing diabetes. This scoping review aims to evaluate recently reported lifestyle interventions delivered on social media for individuals with diabetes and prediabetes. Recent Findings Twelve studies were included in thi...

Background: Video and computer games are popular activities, with 72% of adolescents aged 13 to 17 years reporting video game use on either a computer, game console, or portable device. Despite high levels of video and computer game use in adolescence, relatively little scientific literature exists examining the association and effects of video an...

Background: Ramadan fasting (RF) is mandatory for all healthy Muslims in the ninth month of the Islamic calendar. Although pregnant women are exempt from fasting, many make the decision to practise it. Concerns that fasting during pregnancy harms the fetus remain, as there are no firm recommendations regarding its safety. Objectives: To provide...

Plant-based diets have grown increasingly popular across the globe, mainly for their health and environmental benefits. Several studies have identified a link between plant-based diets and the decreased risk of developing cardiovascular diseases, obesity, and other health issues. We systematically reviewed human interventions to identify the relati...

Introduction Digital technology-based interventions have gained popularity over the last two decades, due to the ease with which they are scalable and low in implementation cost. Multicomponent health promotion programmes, with significant digital components, are increasingly being deployed in the workplace to assess and promote employees’ health b...

Purpose of Review Although gut microbiota have been associated with the etiology of some diseases, the influence of foods on gut microbiota, especially among pregnant women, remains unclear. Hence, a systematic review was performed to investigate the association between diet and gut microbiota and their influence on metabolic health in pregnant wom...

BACKGROUND Video and computer games are popular activities, with 72% of adolescents aged 13 to 17 years reporting video game use on either a computer, game console, or portable device. Despite high levels of video and computer game use in adolescence, relatively little scientific literature exists examining the association and effects of video and...

Background Ramadan fasting (RF) is mandatory for all healthy Muslims in the ninth month of Islamic calendar. Pregnant women are exempt from fasting but many willfully practise it. There are concerns that fasting during pregnancy is harmful to the fetus but there are no firm recommendations regarding its safety. Objectives To provide a systematic re...

Ectopic pregnancies (EPs) are potentially fatal if not recognized early. Evidence of an association with chlamydial infection in South East Asia is lacking. This case-control study aims to (i) compare chlamydial infection in women with EP to women who delivered a full-term pregnancy, (ii) investigate classical factors associated with EP, and (iii)...

Personalized nutrition is an approach that tailors nutrition advice to individuals based on an individual’s genetic information. Despite interest among scholars, the impact of this approach on lifestyle habits and health has not been adequately explored. Hence, a systematic review of randomized trials reporting on the effects of personalized nutrit...

Demographically and socio-culturally appropriate care is critical for empowering people with metabolic syndrome (MetS) to self-manage their condition. This focus group study aimed to explore the understanding of nutrition and lifestyle behaviors (NLBs) of Malaysians with MetS. Adults with MetS (N = 21) participated in four focus groups at a univers...

Background: Chronic diseases and the associated risk factors are preventable with lifestyle changes such as eating a healthier diet and being more physically active. In Malaysia, the prevalence of chronic diseases, including diabetes, hypertension, and heart diseases, has risen. In the present study, we explore the potential of co-designing and im...

Sarcopenia refers to common age-related changes characterised by loss of muscle mass, strength, and physical performance that results in physical disability, poorer health status, and higher mortality in older adults. Diet quality is indicated as a potentially modifiable risk factor for sarcopenia. However, the association between diet quality and...

Background and Objectives: Group-based lifestyle interventions reap social support benefits and have been implemented among individuals with various chronic diseases. However, there is a lack of consolidated evidence on its approaches to prevent or manage metabolic syndrome (MetS). This scoping review aims to assess the group-based lifestyle interv...

General gut microbial dysbiosis in diabetes mellitus, including gestational diabetes mellitus (GDM), has been reported in a large body of literature. However, evidence investigating the association between specific taxonomic classes and GDM is lacking. Thus, we performed a systematic review of peer-reviewed observational studies and trials conducte...

Introduction Male medical students globally have difficulty in obtaining consent to perform pelvic examination. We sought to identify independent factors influencing women consenting to male medical students performing general and pelvic examination under supervision. Methods This cross-sectional study conducted at a tertiary hospital and a public...

Metabolic syndrome (MetS) is frequently associated with various health issues and is a major contributor to morbidity and mortality worldwide, particularly with its recent relevance to coronavirus disease 2019 (COVID-19). To combat its increasing prevalence in Southeast Asia, numerous intervention programs have been implemented. We conducted a scop...

Background: Deaf and hard of hearing patients who use sign language face considerable communication barriers while accessing pharmacy services. Low comfort-levels between community pharmacists and Deaf and hard of hearing patients result in poor interactions and increase patient safety risks. Objective: 1) To examine the way community pharmacists i...

Malaysia is a rapidly developing economy experiencing a nutrition transition. It suffers from a double burden of over- and undernutrition, making it essential to understand diet quality in the population. In this scoping review, we have collated the existing literature on Malaysian diet quality, including factors that influence it, and the associat...

Dietary interventions have been a first-line strategy in the long-term management and prevention of type 2 diabetes mellitus (T2DM). Recently, low carbohydrate diets and ketogenic diets emerged as common dietary approaches in managing T2DM. Literature suggests macronutrients impose significant impacts on the gut microbiome related to glucose tolera...

A rapid increase in the prevalence of gestational diabetes mellitus (GDM) has been associated with various factors such as urbanization, lifestyle changes, adverse hyperglycemic intrauterine environment, and the resulting epigenetic changes. Despite this, the burden of GDM has not been well-assessed in Southeast Asia. We comprehensively reviewed pu...

Introduction: Evidence has shown an increase in paediatric hypertension globally and this could give rise to increase prevalence of adult hypertension. The purpose of this paper was to determine the prevalence of hypertension among adolescents in Malaysia as well as the association between hypertension and lifestyle factors selected based on publis...

The mortality rate of very preterm infants with birth weight <1500 g is as high as 15%. The survivors till discharge have a high incidence of significant morbidity, which includes necrotising enterocolitis (NEC), early-onset neonatal sepsis (EONS) and late-onset neonatal sepsis (LONS). More than 25% of preterm births are associated with microbial i...

Background: Thalassaemia is a recessively-inherited blood disorder that leads to anaemia of varying severity. In those affected by the more severe forms, regular blood transfusions are required which may lead to iron overload. Accumulated iron from blood transfusions may be deposited in vital organs including the heart, liver and endocrine organs...

Background Nutrition and lifestyle behaviour of individuals have been associated with the risk of metabolic syndrome (MetS). In order to better control the prevalence of MetS nationwide, an effective health promotion program must provide age-appropriate care information that addresses critical factors such as physiological function, social psycholo...

Objectives: This study was undertaken to investigate the occurrence of metabolic syndrome (MetS) and cardiovascular disease (CVD) risk in Orang Asli (OA), the indigenous people of Peninsular Malaysia. OA consist of Negrito, Proto-Malay, and Senoi groups who collectively comprise only 0.76% of the population of Peninsular Malaysia. Owing to the chal...

Objectives Literature shows a high prevalence of MetS among Malaysians, varying across major ethnicities. As sociodemographic characteristics, lifestyle factors and diet habits of such communities have been reported to be diverse, the study objective was to investigate the association of various sociodemographic characteristics, lifestyle factors a...

Diabetes complications, medication adherence, and psychosocial well-being have been associated with quality of life (QOL) among several Western and Asian populations with diabetes, however, there is little evidence substantiating these relationships among Malaysia’s unique and diverse population. Therefore, a cross-sectional study was conducted in...

We explored the severity and risk factors for cardiac and liver iron overload (IOL) in 69 thalassemia patients who underwent T2* magnetic resonance imaging (T2* MRI) in a Malaysian tertiary hospital from 2011 to 2015. Fifty-three patients (76.8%) had transfusion-dependent thalassemia (TDT) and 16 (23.2%) had non transfusion-dependent thalassemia (N...

Background: Thalassaemia is a public health burden in Malaysia and its prevention faces many challenges. In this study, we aimed to assess the effectiveness of a web-based educational module in improving knowledge and attitudes about thalassaemia prevention amongst Malaysian young adults. Methods: We designed an interactive web-based educational...

Introduction: Evidence has shown an increase in paediatric hypertension globally and this could give rise to increase prevalence of adult hypertension. The purpose of this paper was to determine the prevalence of hypertension among adolescents in Malaysia as well as the association between hypertension and lifestyle factors selected based on publis...

Introduction: Good control of glycaemia negates potential maternal and fetal complications. A diet suitable for women with gestational diabetes mellitus (GDM) is a first line approach. However, little is said about suitable exercise in pregnancy that will potentially help control glycaemia. This pilot study seeks to understand the perceived barrier...

Background The prevalence of chronic kidney disease-associated pruritus (CKD-aP) varies from 22% to 84% among patients receiving hemodialysis. It occurs more frequently at night, and often affects patient’s sleep quality. CKD-aP is often unreported by patients, and many do not receive effective treatment. There is, however, a paucity of available d...

Both obesity and DENV infections are growing public health concerns that have far-ranging socioeconomic effects, especially in developing countries. Despite the increasing prevalence of these conditions, there is a scarcity of data investigating the potential relationships between these two entities. Our study aims to examine the influence of obesi...

Isomaltulose (IM) is a naturally occurring disaccharide composed of alpha-1,6-linked glucose and fructose monomers. IM is gaining interest as an alternative sweetener to sucrose primarily because of its low glycaemic index (GI) properties. Low GI has been implicated in the prevention and management of chronic diseases such as cardio-metabolic disea...

This was a group-based intervention program with pre- and post-test design, carried out among breast cancer (BCa) survivors (n=37). A validated self-administered questionnaire was used to assess the impact of the program on psychosocial well-being and HRQOL of the participants. The mean age of BCa survivors was 58.1 years (SD=9.7), with mean age at...

Abstract Background Increasing prevalence and disease burden has led to an increasing demand of programs and studies focused on dietary and lifestyle habits, and chronic diseases such as type 2 diabetes mellitus (T2DM). We evaluated the effects of a 6-month web-based dietary intervention on Dietary Knowledge, Attitude and Behaviour (DKAB), Dietary...

Diet therapy, the cornerstone of gestational diabetes mellitus (GDM) management aims to promote adequate weight gain and ensure glycaemic control in the pregnant mother. Achievement of these maternal goals improves pregnancy and neonatal outcomes. The advocacy of low-GI foods is based on slower rate of carbohydrate absorption of these foods, which...

Introduction: Often considered a legitimate strategy to enhance health and performance, the consumption of nutritional supplements (NS) has become a common practice which frequently results in unintentional doping among athletes. Despite a probable association between NS and doping, there are limited studies on this topic in developing countries su...

Background Thalassaemia is a recessively-inherited blood disorder that leads to anaemia of varying severity. In those affected by the more severe forms, regular blood transfusions are required which may lead to iron overload. Accumulated iron from blood transfusions may be deposited in vital organs including the heart, liver and endocrine organs su...

Introduction: This study aimed to (i) determine rapid weight loss (RWL) practices among Malaysian elite combat sports athletes and (ii) examine the relationship between the characteristics of athletes, self-reported history of weight loss, perceived influence on weight loss and RWL practices. Methods: This was a cross-sectional study conducted at t...

Severe thrombocytopenia is common in dengue virus (DENV) infections. However, studies focusing on the role of profound thrombocytopenia (PT) (nadir platelet counts ≤ 20 000/mm3) in DENV infections are scarce. This study aims to identify the associated features and outcome of DENV patients with PT. It involves 237 adult hospitalized patients who wer...

Background: The pervasive use of mobile computing and communication technologies in healthcare and public health is expanding even in low and middle income countries. Among all types of mobile phones, smartphones are a more recent development, with features such as computing capability, capacious memories, large screens and open operating systems....

Introduction. Type 2 Diabetes Mellitus (T2DM) in recent years, has emerged as a very important health issue in developing countries such as Malaysia. Diet, the frontline in self-management practice of diabetic patients often gets side-lined during the standard care routine due to time constraint. A dietary e-intervention programme was developed to...

Introduction: Cardiometabolic diseases such as diabetes, hypertension, obesity and cardiovascular disease have been associated with changes in dietary patterns and lifestyle behaviours. Being an important source of micronutrients, dietary fibre and phytochemicals, vegetables contribute significantly towards human nutrition. However, there is a conf...

This is the protocol for a review and there is no abstract. The objectives are as follows: To assess the risks and benefits of GH therapy in people with thalassaemia.

The younger generation are now becoming more aware of their body image, and with the availability of cosmetic surgery to enhance appearance, many are beginning to seek this service as means to alter their body images to more “ideal” figures. The aim of this study was to identify behavioural factors that are associated with inclination towards cosme...

More than 6000 Malaysians have thalassaemia disease, an autosomal recessive condition. An estimated 4.5% of Malaysians are B-thalassemia carriers. About RM3 million is needed to support one patient till the age of 30 and 200 new births of thalassaemic patients is estimated annually in Malaysia.Barriers to thalassaemia prevention in Malaysia include...

Even after completion of conventional treatment, breast cancer survivors continue to exhibit a variety of psychological and physical symptoms, affecting their quality of life. The study aimed to investigate the relationship between socio-demography, medical characteristics and health-related quality of life (HR-QOL) of a sample of breast cancer sur...

Background: Diabetes is becoming a very important health issue in rapidly developing nations and there is an urgent need to improve overall diabetes self-management education in these countries. Although e-health is an emerging theme, only a few successful web-based studies on diabetes self-management have been reported. Purpose: We describe the...

Objectives: To measure plasma pro-apoptotic and pro-necrotic activity in severe acute kidney injury (AKI) patients within a randomized controlled trial of continuous veno-venous hemofiltration with high cut-off filters (CVVH-HCO) versus standard filters (CVVH-Std). Methods: We measured pro-apoptotic and pro-necrotic plasma activity by trypan blu...

Diabetes education and self-care remains the cornerstone of diabetes management. There are many structured diabetes modules available in the United Kingdom, Europe and United States of America. Contrastingly, few structured and validated diabetes modules are available in Malaysia. This pilot study aims to develop and validate diabetes education mat...

Aim To study the spectrum of diseases in lymphadenopathy and identify features that help predict malignant lymphadenopathy. Methods: A 3-year retrospective study was conducted to analyse the spectrum of diagnoses with respect to age, gender, site and size of the lymph nodes. Results and Discussion There were 565 patients with isolated excised lymp...

Although the Internet is a convenient and effective intervention delivery medium, no web-based dietary management intervention in type 2 diabetes mellitus (T2DM) patients has been reported. We developed a web-based dietary intervention programme and studied its impact on dietary habits of T2DM patients (n=128) with uncontrolled HbA1c (>7.0%) throug...

Patients that has never received any diabetes self management education has a four-fold risk of developing diabetes complication. Culturally-tailored diabetes education programme has shown an improvement in some clinical outcomes eg. glycaemic, quality of life etc. The aim of this study was to develop and evaluate a Malaysian Diabetes Education Mod...

The Internet has emerged as a potentially effective medium for information exchange. The Internet's potential has been recognised and web-based education programmes have been steadily adopted in recent years in preventing and managing chronic diseases such as diabetes mellitus. This review provides a descriptive discussion of web-based behavioural...

The potential of web-based interventions in dietary behaviour modification of the diabetics has not been fully explored. We describe the protocol of a 12-month match-design randomised controlled trial of a web-based dietary intervention for type 2 diabetic patients with primary aim to evaluate the effect of the intervention on their dietary knowled...

Increasing global prevalence of type 2 diabetes is tied to rising rates of obesity. We evaluated the prevalence of obesity in diabetic patients who have been recruited into myDIDeA, a 12-month web-based dietary education programme. A total of 128 participants attending outpatient follow-ups at Hospital Serdang and Putrajaya were recruited in the st...

The study's aim was to construct and validate a diabetes mellitus knowledge questionnaire in Bahasa Malaysia for Orang Asli (OA-DKQ). The questionnaire was administered to; case (Orang Asli) and control (administrative staff) groups at baseline and retested two weeks later. The Cronbach's Alpha was used to determine internal consistency and intracl...

Background: Internet has emerged as a strong communication tool besides being an important source of health information. A number of successful web-based studies have been published previously but only one pilot dietary intervention has been conducted for prevention of type 2 diabetes mellitus and none for management of the disease. This is despite...

At least 6 million deaths occurred worldwide are due to cancer and this figure is expected to rise to 15 millions by the year 2020. Colorectal cancer is among the most commonly occurring cancers both globally and in Malaysia. Numerous studies have shown significant relationships between various dietary components and the risks for colorectal cancer...

The most important and possible risk factor of colorectal adenomas is the individual’s nutritional status. The role of nutritional status in the aetiology of colorectal adenomas remains an area of active investigation, as the exact relationship between nutritional status and colorectal adenomas remains unclear. The objective of this case-control wa...

Colorectal adenomas are precursor lesions of colorectal cancer. Several studies have proposed that obesity is a risk factor for colorectal adenoma. This case-control study examined the relationship between body mass index (BMI), waist circumference, waistto-hip ratio (WHR), body fat percentage and colorectal adenomatous polyps (CRA) in patients who...

It is well established that almost all colorectal cancers arise from benign, neoplastic adenomatous polyps. In previous studies, intake of fruits, vegetables and legumes were found to decrease the risk for colorectal adenomas (CRA) and colorectal cancer. This case-control study aimed to evaluate the roles of a variety of foods in contributing to th...

Comprehensive evaluation of the large body of consistent evidence from laboratory, epidemiologic and clinical studies has led to the conclusion that modification of the dietary and lifestyle patterns of populations has considerable potential for reducing cancer risk. This paper describes a randomized-controlled trial involving a diet and lifestyle...