Self-management using crude herbs and the health-related quality of life among adult patients with hypertension living in a suburban setting of Malaysia.

PURPOSE: To determine the prevalence of crude herbs' use in the self-management of hypertension and the health-related quality of life (HRQOL) in patients with hypertension. METHODS: This cross-sectional study was performed among patients with hypertension attending a government health clinic. Socio-demographic characteristics, lifestyle modifications, medical history and predictors of crude herbs users were obtained. The diversity of crude herbs used was assessed using a modified international complementary and alternative medicine questionnaire (I-CAM-Q) and the HRQOL was assessed using the SF36 instrument. RESULTS: Out of the 294 patients recruited, 52.4% were female, 41.5% were Malay and 38.8% were within the 60 to69 age category. The prevalence of crude herbs users was 30.6% and the most common herbs used were pegaga (Centella asiatica), peria (Momordica charantia) and betik (Carica papaya). Using the regression analysis, significantly higher odds of using crude herbs are noted among Malay or Indian patients who have these characteristics: attained secondary education, experienced falls or muscle pain, and had systolic blood pressure of more than 140 mmHg. There was no significant difference in HRQOL domains between the crude herb users and non-users (p>0.05). CONCLUSION: Besides taking allopathic medications, certain patients with hypertension use crude herbs as a form of self-management. Although patients are adamant about integrating crude herbs as a form of self-management, the effects of doing so have not been properly investigated. This implies that the healthcare staff members need to communicate with the patients regarding the use of crude herbs together with conventional drugs.

Food, culture, and identity in multicultural societies: Insights from Singapore.

The choice of food practices can be influenced by one's identity in many societies, but has mostly been evaluated in light of the maintenance of cultural identity in migrant populations. This study focused on understanding the influence of identity on food practices among individuals in multicultural societies. We conducted 18 focus group discussions (n = 130) among Indian, Chinese and Malay women in Singapore. Focus group transcripts were analysed using Thematic Analysis both inductively and deductively. Deductive analysis was framed within a Social Representations Approach, a social psychological theory that allows a deeper understanding of the contextual aspects of identity. Participants highlighted the central position of food in social events, cultural celebrations, and persistent traditional beliefs about health (such as 'hot-cold balance'). These beliefs extended to the perception of certain traditional foods possessing medicinal properties. Importantly, the consumption of these traditional foods was accepted as necessary for the maintenance of health by the women. We propose that while cultural food practices are integral to identity preservation and identity continuity for Singaporean women from all three racial groups, this is different to other multicultural societies such as Canada where communities preserve their cultural food practices, in part, due to fear of cultural identity loss. In addition, cross-cultural food practices are readily adopted in participants' daily lives for a number of reasons such as the promotion of health, convenience, and variety. At times, this adoption blurred boundaries between different cultural cuisines. Food practices in multicultural societies like Singapore are thus a reflection of everyday multiculturalism, multicultural social policies, and attitudes towards traditional healthful food practices, and these aspects need to be considered in the development of public health policies and interventions.

A Novel Approach for Classifying Native Chinese and Malay Speaking Persons According to Cortical Auditory Evoked Responses.

OBJECTIVES: This study uses a new approach for classifying the human ethnicity according to the auditory brain responses (electroencephalography [EEG] signals) with a high level of accuracy. Moreover, the study presents three different algorithms used to classify the human ethnicity using auditory brain responses. The algorithms were tested on Malays and Chinese as a case study. MATERIALS AND METHODS: The EEG signal was used as a brain response signal, which was evoked by two auditory stimuli (Tones and Consonant Vowels stimulus). The study was carried out on Malaysians (Malay and Chinese) with normal hearing and with hearing loss. A ranking process for the subjects' EEG data and the nonlinear features was used to obtain the maximum classification accuracy. RESULTS: The study formulated the classification of Normal Hearing Ethnicity Index and Sensorineural Hearing Loss Ethnicity Index. These indices classified the human ethnicity according to brain auditory responses by using numerical values of response signal features. Three classification algorithms were used to verify the human ethnicity. Support Vector Machine (SVM) classified the human ethnicity with an accuracy of 90% in the cases of normal hearing and sensorineural hearing loss (SNHL); the SVM classified with an accuracy of 84%. CONCLUSION: The classification indices categorized or separated the human ethnicity in both hearing cases of normal hearing and SNHL with high accuracy. The SVM classifier provided a good accuracy in the classification of the auditory brain responses. The proposed indices might constitute valuable tools for the classification of the brain responses according to the human ethnicity.

Impact of adopting the 2013 World Health Organization criteria for diagnosis of gestational diabetes in a multi-ethnic Asian cohort: a prospective study.

BACKGROUND: We assessed the impact of adopting the 2013 World Health Organization (WHO) diagnostic criteria on the rates of gestational diabetes (GDM), pregnancy outcomes and identification of women at future risk of type 2 diabetes. METHODS: During a period when the 1999 WHO GDM criteria were in effect, pregnant women were universally screened using a one-step 75 g 2-h oral glucose tolerance test at 26-28 weeks' gestation. Women were retrospectively reclassified according to the 2013 criteria, but without the 1-h glycaemia measurement. Pregnancy outcomes and glucose tolerance at 4-5 years post-delivery were compared for women with GDM classified by the 1999 criteria alone, GDM by the 2013 criteria alone, GDM by both criteria and without GDM by both sets of criteria. RESULTS: Of 1092 women, 204 (18.7%) and 142 (13.0%) were diagnosed with GDM by the 1999 and 2013 WHO criteria, respectively, with 27 (2.5%) reclassified to GDM and 89 (8.2%) reclassified to non-GDM when shifting from the 1999 to 2013 criteria. Compared to women without GDM by both criteria, cases reclassified to GDM by the 2013 criteria had an increased risk of neonatal jaundice requiring phototherapy (relative risk (RR) = 2.78, 95% confidence interval (CI) 1.32, 5.86); despite receiving treatment for GDM, cases reclassified to non-GDM by the 2013 criteria had higher risks of prematurity (RR = 2.17, 95% CI 1.12, 4.24), neonatal hypoglycaemia (RR = 3.42, 95% CI 1.04, 11.29), jaundice requiring phototherapy (RR = 1.71, 95% CI 1.04, 2.82), and a higher rate of abnormal glucose tolerance at 4-5 years post-delivery (RR = 3.39, 95% CI 2.30, 5.00). CONCLUSIONS: Adoption of the 2013 WHO criteria, without the 1-h glycaemia measurement, reduced the GDM rate. Lowering the fasting glucose threshold identified women who might benefit from treatment, but raising the 2-h threshold may fail to identify women at increased risk of adverse pregnancy and future metabolic outcomes. TRIAL REGISTRATION: NCT01174875 . Registered 1 July 2010 (retrospectively registered).

Prevalence, risk factors and health outcomes associated with polypharmacy among urban community-dwelling older adults in multi-ethnic Malaysia.

BACKGROUND: Polypharmacy has been associated with increased morbidity and mortality in the older population. OBJECTIVES: The aim of this study was to determine the prevalence, risk factors and health outcomes associated with polypharmacy in a cohort of urban community-dwelling older adults receiving chronic medications in Malaysia. METHODS: This was a baseline study in the Malaysian Elders Longitudinal Research cohort. The inclusion criteria were individuals aged ≥55years and taking at least one medication chronically (≥3 months). Participants were interviewed using a structured questionnaire during home visits where medications taken were reviewed. Health outcomes assessed were frequency of falls, functional disability, potential inappropriate medication use (PIMs), potential drug-drug interactions (PDDIs), healthcare utilisation and quality of life (QoL). Risk factors and health outcomes associated with polypharmacy (≥5 medications including dietary supplements) were determined using multivariate regression models. RESULTS: A total of 1256 participants were included with a median (interquartile range) age of 69(63-74) years. The prevalence of polypharmacy was 45.9% while supplement users made up 56.9% of the cohort. The risk factors associated with increasing medication use were increasing age, Indian ethnicity, male, having a higher number of comorbidities specifically those diagnosed with cardiovascular, endocrine and gastrointestinal disorders, as well as supplement use. Health outcomes significantly associated with polypharmacy were PIMS, PDDIs and increased healthcare utilisation. CONCLUSION: A significant proportion of older adults on chronic medications were exposed to polypharmacy and use of dietary supplements contributed significantly to this. Medication reviews are warranted to reduce significant polypharmacy related issues in the older population.

Role of the Nasogastric Tube and Lingzhi (Ganoderma lucidum) in Palliative Care.

Decision-making on behalf of an incapacitated patient at the end of life is a complex process, particularly in family-centric societies. The situation is more complex when attempts are made to accommodate Eastern concepts of end-of-life care with more conventional Western approaches. In this case report of an incapacitated 74-year-old Singaporean man of Malay descent with relapsed Stage 4 diffuse large B cell lymphoma who was without an established lasting power of attorney, we highlight the difficult deliberations that ensue when the patient's family, acting as his proxy, elected to administer lingzhi through his nasogastric tube (NGT). Focusing on the questions pertaining to end-of-life decision-making in Asia, we consider the issues surrounding the use of NGT and lingzhi in palliative care (PC) and the implementation of NGT for administering lingzhi in a PC setting, particularly in light of a dearth of data on such treatment measures among PC patients.

Factor Structure of the Spiritual Well-Being Scale: Cross-Cultural Comparisons Between Jordanian Arab and Malaysian Muslim University Students in Jordan.

This study reported the differences in factor structure of the Spiritual Well-Being Scale (SWBS) among Jordanian Arab and Malaysian Muslim participants and further examined its validity and reliability. A convenience sample of 553 Jordanian Arab and 183 Malaysian Malay Muslim university students was recruited from governmental universities in northern Jordan. The findings of this study revealed that this scale consists of two factors for the Jordanian Arab group, representing the "Religious Well-Being" and the "Existential Well-Being" subscales, and consists of three factors for the Malaysian group, representing the "Affiliation/Meaning and Purpose," "Positive Existential Well-Being/God Caring and Love," and "Alienation/Despair" subscales. In conclusion, the factor structure of the SWBS for both groups in this study was psychometrically sound with evidence of acceptable to good validity and reliability. Furthermore, this study supported the multidimensional nature of the SWBS and the earlier notion that ethnicity shapes responses to this scale.

Initial Validation of the Daily Spiritual Experiences Scale in Chinese Immigrants With Cancer Pain.

CONTEXT: Evaluating religious/spiritual influences in the growing Chinese-American population may inform the development of culturally relevant palliative care interventions. OBJECTIVES: We assessed the psychometric properties and acceptability of the Daily Spiritual Experiences Scale-Chinese (DSES-C) in Chinese Americans with cancer-related pain. METHODS: The translated 16-item DSES-C was administered as part of a symptom intervention for Chinese-American cancer patients. Patients were recruited from four New York community oncology practices. RESULTS: Of 321 patients, 78.7% were born in Mainland China, 79.1% spoke Cantonese, and 70.2% endorsed a religious affiliation (Ancestor worship, 31.7%; Chinese God worship, 29.8%; Buddhism, 17.1%; Christianity, 14.0%). In total, 82.6% completed the DSES-C (mean age = 57.7 years; 60.8% women) and 17.4% declined (mean age = 59.3 years; 52.0% women). Reasons for declining included low religiosity or perceived relevance of the scale items and difficulties separating spirituality from religiosity terms. Individuals having a religious affiliation were more likely to complete the DSES-C, whereas those not engaging in individual spiritual/religious practices or frequent group spiritual/religious practices tended to decline (all P < 0.05). The DSES-C (mean total score = 43.6, SD = 19.3) demonstrated high reliability (alpha = 0.94). Exploratory factor analysis suggested a one-factor solution, with significant loadings (>0.40) across items except Item 14 ("Accept others"). Construct validity was suggested by a positive association between DSES-C scores and having a religious affiliation (P < 0.05). CONCLUSION: In Chinese Americans with cancer pain, the DSES-C demonstrated acceptable psychometrics. Some participants experienced linguistic or cultural barriers preventing completion. Future investigations should provide additional validation in different Asian subgroups and those with varied medical conditions.

Experience of menopause in aboriginal women: a systematic review.

Every woman experiences the menopause transition period in a very individual way. Menopause symptoms and management are greatly influenced by socioeconomic status in addition to genetic background and medical history. Because of their very unique cultural heritage and often holistic view of health and well-being, menopause symptoms and management might differ greatly in aboriginals compared to non-aboriginals. Our aim was to investigate the extent and scope of the current literature in describing the menopause experience of aboriginal women. Our systematic literature review included nine health-related databases using the keywords 'menopause' and 'climacteric symptoms' in combination with various keywords describing aboriginal populations. Data were collected from selected articles and descriptive analysis was applied. Twenty-eight relevant articles were included in our analysis. These articles represent data from 12 countries and aboriginal groups from at least eight distinctive geographical regions. Knowledge of menopause and symptom experience vary greatly among study groups. The average age of menopause onset appears earlier in most aboriginal groups, often attributed to malnutrition and a harsher lifestyle. This literature review highlights a need for further research of the menopause transition period among aboriginal women to fully explore understanding and treatment of menopause symptoms and ultimately advance an important dialogue about women's health care.

Effect of vitamin D supplementation on cardiometabolic risks and health-related quality of life among urban premenopausal women in a tropical country--a randomized controlled trial.

BACKGROUND: Many observational studies linked vitamin D to cardiometabolic risks besides its pivotal role in musculoskeletal diseases, but evidence from trials is lacking and inconsistent. AIM: To determine whether Vitamin D supplementation in urban premenopausal women with vitamin D deficiency can improve cardiometabolic risks and health-related quality of life (HRQOL). DESIGN: A double-blind randomized controlled trial was conducted in Kuala Lumpur, Malaysia. A total of 192 vitamin D deficient (<50 nmol/l) premenopausal women were randomized to receive either vitamin D 50,000 IU or placebo once a week for 2 months and then monthly for 10 months. Primary outcomes were serum 25(OH)D, serum lipid profiles, blood pressure and HOMA-IR measured at baseline, 6 months and 12 months. HRQOL was assessed with SF-36 at baseline and 12 months. RESULTS: Ninety three and ninety-nine women were randomised into intervention and placebo groups respectively. After 12 months, there were significant differences in the serum 25(OH)D concentration (mean difference: 49.54; 95% CI: 43.94 to 55.14) nmol/l) and PTH levels (mean difference: -1.02; 95% CI: -1.67 to -0.38 pmol/l) in the intervention group compared to placebo group. There was significant difference between treatment group in both serum 25(OH)D and PTH. There was no effect of supplementation on HOMA-IR, serum lipid profiles and blood pressure (all p>0.05) between two groups. There was a small but significant improvement in HRQOL in the components of vitality (mean difference: 5.041; 95% CI: 0.709 to 9.374) and mental component score (mean difference: 2.951; 95% CI: 0.573 to 5.329) in the intervention group compared to placebo group. CONCLUSION: Large and less frequent dosage vitamin D supplementation was safe and effective in the achievement of vitamin D sufficiency. However, there was no improvement in measured cardiometabolic risk factors in premenopausal women. Conversely vitamin D supplementation improves some components of HRQOL. TRIAL REGISTRATION: Australian New Zealand Clinical Trial Registry ACTRN12612000452897.

Dietary changes during pregnancy and the postpartum period in Singaporean Chinese, Malay and Indian women: the GUSTO birth cohort study.

OBJECTIVE: To examine changes in food consumption during pregnancy and the postpartum period in women of major Asian ethnic groups. DESIGN: Using interviewer-administered questionnaires, we assessed changes in food consumption during pregnancy (26-28 weeks' gestation) and the postpartum period (3 weeks after delivery) as compared with the usual pre-pregnancy diet. SETTING: Singapore. SUBJECTS: Pregnant women (n 1027) of Chinese, Malay and Indian ethnicity (mean age 30·4 (SD 5·2) years) who participated in the Growing Up in Singapore Towards healthy Outcomes (GUSTO) study. RESULTS: During pregnancy, participants tended to increase their consumption of milk, fruit and vegetables and decrease their consumption of tea, coffee, soft drinks and seafood (all P < 0·001). Most participants reported adherence to traditional restrictions ('confinement') during the early postpartum period (Chinese: 94·8 %, Malay: 91·6 %, Indian: 79·6 %). During the postpartum period, participants tended to increase their consumption of fish and milk-based drinks and decrease their consumption of noodles, seafood, and chocolates and sweets (all P < 0·001). Ethnic differences in food consumption were pronounced during the postpartum period. For example, most Chinese participants (87·2 %) increased their ginger consumption during the postpartum period as compared with smaller percentages of Malays (31·8 %) and Indians (40·8 %; P for ethnic difference <0·001). Similar ethnic differences were observed for cooking wine/alcohol, herbs and spices, and herbal tea consumption. CONCLUSIONS: Marked changes in food consumption that reflect both modern dietary recommendations and the persistence of traditional beliefs were observed in Singaporean women during pregnancy and the postpartum period. Traditional beliefs should be considered in interventions to improve dietary intakes during these periods.

Complementary alternative medicine use among patients with type 2 diabetes mellitus in the primary care setting: a cross-sectional study in Malaysia.

BACKGROUND: Limited study on the use of complementary alternative medicine (CAM) among patients with diabetes mellitus (DM), particularly in primary -care settings. This study seeks to understand the prevalence, types, expenditures, attitudes, beliefs, and perceptions of CAM use among patients with DM visiting outpatient primary care clinics. METHODS: This is a descriptive, cross-sectional study of 240 diabetic patients. CAM is defined as a group of diverse medical and healthcare systems, practices, and products that are not generally considered part of conventional Western medicine. Data analysis was done using SPSS v. 19 and multiple logistic regressions were used to identify predictors of CAM use. RESULTS: The prevalence of CAM use was 62.5 percent. Female were 1.8 times more likely than male in using CAM. Malays (75%) were the most frequent users, followed Indians (18%) and Chinese (6%). Biological therapy (50.0%) were the most widely used, followed by manipulative-body based systems (9.2%), energy system (8.8%), alternative medicine systems (4.6%) and mind-body system (1.7%). In biological therapy, a total of 30.4 percent, 24.2 percent, 13.3 percent, and 7.9 percent of diabetic patients consumed bitter gourd (Momordica Charantia), followed by Misai Kucing (Orthosiphon Stamineus Benth), garlic (Allium Sativum), and Sabah snake grass (Clinacanthus Nutans Lindau) respectively. The mean of the expenditure on CAM usage was RM 52.8 ± 101.9 (US $16.9 ± 32.5) per month. According to multiple logistic regression analyses, being Muslim (OR 5.258, 95 percent CI 2.952-9.368) had significant positive association with CAM use. CONCLUSIONS: The prevalence of CAM use was high among diabetics. Islam faith is predictor for CAM use among Type 2 DM patients. The most-common herbs used were bitter gourd (Momordica Charantia) and Misai Kucing (Orthosiphon Stamineus, Benth). Further studies on the anti-glycemic activity of the isolated compound may be needed in the future.

Qualitative inquiry into premarital sexual behaviours and contraceptive use among multiethnic young women: implications for education and future research.

BACKGROUND: This study was a qualitative investigation into sexual attitudes and behaviours, and contraceptive use among Malaysian youth, based on constructs from the health belief model, theory of reasoned action, and problem behaviour theory. METHODS: A total of 34 focus group discussions with 185 participants were conducted among the Malay (35%), Chinese (34%), and Indian (31%) young females between November, 2010 and April, 2011. The participants were secondary school students and university undergraduates from Selangor and the Federal Territory of Kuala Lumpur. RESULTS: The study found a lack of knowledge about sexual issues and contraception among the participants. Many engaged in unprotected sexual intercourse and relied on periodic abstinence, natural methods, and traditional folk pregnancy preventive practices. The findings also revealed numerous categories of factors influencing sexual attitudes and behaviours: ethnic group and religion, level of religiosity, peer pressure and norms, and parental monitoring. With regard to condom use, factors such as embarrassment about condom acquisition, low perceived susceptibility to sexually transmitted infections (STIs), and perceived efficacy of traditional and folk methods of contraception, were uncovered from the discussions. CONCLUSION: This study underscores the importance of development of culturally specific interventions that address the identified promoting factors of premarital sex. Behavioral interventions to promote condom use should increase awareness about condom effectiveness against not only unwanted pregnancies but also STIs.

Patrescence in Southern Thailand: cosmological and social dimensions of fatherhood among the Malay-Muslims.

This paper examines fatherhood among the Malay Muslims of Southern Thailand (representing a minority at the national level, but constituting the majority population in the region). Traditional practices related to birth and the postpartum period are upheld as a marker of ethnic and religious identity by such groups. Building on the concept of patrescence as 'becoming a father', proposed by Dana Raphael, the data presented show how the process of assuming fatherhood develops during pregnancy and continues after birth through a series of ritual practices in which a man contributes to female postpartum practices. The medicalisation of birth in synergy with recent literalist interpretations of Islam has impacted on these practices, making it difficult to comply with the ritual burial of the afterbirth, which constitutes the cosmological and physical anchoring of individual and ethnic identity to the soil.

Tobacco use, knowledge and attitude among Malaysians age 18 and above.

This study aims to determine the level of knowledge and to understand their attitude towards smoking and secondly to determine how sociodemographic background, smoking status and knowledge on the health risks of smoking contribute toward the development of such attitude. A total of 10,545 respondents age 18 years and above across Malaysia were interviewed. Results indicated that level of knowledge and attitude varied by gender, education level, smoking status, age, ethnicity and smoker category. Smokers' low education, poor knowledge on the dangers of smoking and being males had more positive or greater impact on their attitudes towards smoking. Formulation and implementation of a holistic programme aimed at increasing knowledge and attitude change that accounts for sociodemographic background of the population is recommended in order to bring down smoking rates and thus reduce smoking related health problems in this country.

Beliefs about schizophrenia and its treatment in Kota Kinabalu, Malaysia.

BACKGROUND: Lay beliefs about schizophrenia have been extensively studied in cross-cultural settings, but research on ethnic differences are currently lacking. AIMS: This study examined beliefs about the manifestations, causes and cures of schizophrenia in a multi-ethnic sample from Malaysia. METHODS: In this study, 561 Malay, Chinese and Kadazan-Dusun participants rated 72 statements about schizophrenia on a 7-point scale. RESULTS: Results showed that Malaysians tended to favour social-environmental explanations for schizophrenia. There were also ethnic and sex differences in these results. Specifically, Malay participants more strongly agreed that schizophrenia has a social cause, that treatment should affect changes at a societal level, that schizophrenic behaviour is sinful and that mental hospitals do not provide effective treatments. CONCLUSIONS: Lay beliefs about schizophrenia may serve different functions for different ethno-cultural groups, which have an influence on help-seeking behaviour.

Interethnic variability of warfarin maintenance requirement is explained by VKORC1 genotype in an Asian population.

BACKGROUND: Chinese and Malay subjects have been reported to require less maintenance warfarin than Indians that could not be accounted for by cytochrome P450 (CYP) 2C9 variants. Vitamin K epoxide reductase complex 1 (VKORC1) is the target enzyme of warfarin, and VKORC1 intronic variants and haplotypes have recently been shown to influence VKORC1 activity and warfarin requirements. METHODS: We sequenced the coding regions of CYP2C9 and VKORC1 and inferred VKORC1 haplotype from 10 intronic variants in 147 Chinese, 85 Malay, and 43 Indian patients receiving maintenance warfarin. RESULTS: The mean weight-normalized warfarin dose was lower for Chinese and Malays than for Indians (0.058 +/- 0.025 mg/kg, 0.059 +/- 0.023 mg/kg, and 0.089 +/- 0.036 mg/kg, respectively; P < .001 for comparisons between Chinese and Malays with Indians). CYP2C9*2 and VKORC1 coding region variants were rare (<2%), whereas CYP2C9*3 associated with lower warfarin requirements was less common in Chinese and Malays (7% and 9%, respectively) than in Indians (18%) and could not account for their lower warfarin requirements. VKORC1 H1 and H7/H8/H9 haplotypes were associated with lower and higher warfarin requirements, respectively (0.050 +/- 0.019 mg/kg and 0.092 +/- 0.057 mg/kg, respectively; P < .001). VKORC1 H1 haplotype (requiring low warfarin doses) was common in Chinese (87%) and Malays (65%) but uncommon in Indians (12%), whereas H7, H8, and H9 haplotypes (requiring high warfarin doses) were rare in Chinese (9%), intermediate in Malays (30%), and common in Indians (82%). The interethnic difference in warfarin requirements became nonsignificant when adjusted for VKORC1 haplotype. CONCLUSIONS: Interethnic difference in VKORC1 haplotypes accounts for the difference in warfarin requirements between Chinese, Malays, and Indians, providing interesting insights into genetic variation between ethnogeographically distinct Asian groups.

The effect of Malaysian cocoa extract on glucose levels and lipid profiles in diabetic rats.

The present study aims to investigate the effect of cocoa extract on serum glucose levels and lipid profiles in streptozotocin-diabetic rats. Cocoa extract (contained 285.6 mg total polyphenol per gram extract) was prepared from fermented and roasted (140 degrees C, 20 min) beans by extracting using 80% ethanol in the ratio of 1-10. The extract of three dosages (1, 2, and 3%) was fed to normal and diabetic rats for a period of 4 weeks. In hyperglycaemic group, cocoa extract (1 and 3%) diets were found to significantly lower (p<0.05) the serum glucose levels compared to the control. Furthermore, supplementation of 1 and 3% cocoa extract had significantly reduced (p<0.05) the level of total cholesterol in diabetic rats. In addition, 1, 2, and 3% cocoa extract diets had significantly lowered (p<0.05) the total triglycerides. Interestingly, this study found that serum HDL-cholesterol had increased significantly (p<0.05) in diabetic rats fed with 2% cocoa extract, while the LDL-cholesterol had decreased significantly (p<0.05) in the 1% treated group. These results indicate that cocoa extract may possess potential hypoglycaemic and hypocholestrolemic effects on serum glucose levels and lipid profiles, respectively. The results also found that the effect of cocoa extract was dose-dependent.