Anthropometry is the single most portable, easily applied, inexpensive and non-invasive method of assessing body composition. It reflects both health and nutrition and predicts performance, health and survival. The use of body mass index (BMI) as a measure of obesity has been widespread and has recently been promoted for assessment of chronic energy deficiency (CED) in adults. This report provides BMI values of 2636 adult males and 2111 adult females from the three main ethnic groups residing in urban areas and BMI of adult Malay and Dayak (380 males and 496 females) residing in rural areas in Peninsular Malaysia, Sabah and Sarawak. The percent prevalence of obesity and CED in males for the three ethnic groups were apparently quite similar. However, in the females, CED were higher in the Malays and Chinese while overweight problems were more serious in the Indians. Among the Malays, prevalence of CED for males and females were 7% and 11% in urban areas and 11% and 14% in rural areas, respectively. In the males, it is interesting to note that there is a two-fold difference between urban and rural, while a high prevalence of overweight women (20%) even in the rural areas should be viewed as a potential health problem of the future.
Seventeen members of the national sepaktakraw squad undergoing centralised training participated in a comprehensive study to determine their daily food intake, activity patterns and energy requirements. Food intake was recorded as a mean of 3-days weighed food intake and the nutrient contents were calculated using a local food composition table. The energy cost of standardised activities was determined by indirect calorimetry while time and motion study was used to estimate the daily energy expenditure of each subject. The mean daily energy intake was 2784±373 kcal (11.6±1.6 MJ) while the mean daily energy expenditure was 3004±298 kcal (12.6±1.2 MJ), with a negative energy balance of 220 kcal ((0.9 MJ). Intake of other nutrients were adequate when compared with the Malaysian RDA, with the exception of niacin. The results of the activity pattern study indicated that the subjects spent about 80% of the day doing light activities while 20% of the day was devoted to their training programme comprising of moderate to heavy activities. This data set represents the first of its kind in Malaysia and should provide impetus for further research in this area which would help establish dietary guidelines for Malaysian sportsmen.
The energy intake and expenditure of 20 healthy soldiers (mean age, 25 years, weight 61 kg and height 1.67 m) was assessed. Trained personnel stayed in the camp throughout the 5 weeks study period. Each soldier was subjected to a 7-day comprehensive protocol involving anthropometric, food intake, activity pattern and energy expenditure measurements. The mean change in body weight and fat content was minimal, -0.2kg and -0.25%, respectively. Body fat and BMI ranges from 10.0-21.6% and 19.8-24.9, respectively. The mean energy intake of 2190 ± 197 kcal was well below (81%) the recommended allowance of 2700 kcal for the Malaysian Armed Forces. The ration scale analysed chemically provides 2900 kcal thus suggesting a 24% wastage of daily ration. Contribution of protein (15%), fat (25%) and carbohydrate (60%) to energy intake appears to be in line to healthy dietary guidelines. Energy cost of standardised activities were found to be lower in Malaysian soldiers as compared to British soldiers studied under similar environment in the tropics. The mean total daily energy expenditure (TDEE) for soldiers were 2886 ± 222 kcal with a negative energy balance of about 700 kcal. The results suggested that there is a need to review the current provision with regard to food supply and preparation in army camps, to ensure that the menu provided are appealing as well as nutritious for the soldiers.
A study to predict energy requirements of national athletes, 84 males and 24 females in 9 and 4 different types of sports respectively, were conducted during centralised training. Parameters assessed were anthropometry, 3-day activity pattern and energy cost (kcal/min) of common activities to derive total daily energy expenditure (TDEE). Based on body mass index (BMI), 68 males or 81% and 19 females or 79% of the athletes were classified as normal. The mean body fat content for males and females were 13.8 ± 4.5% and 24.7 ± 5.3%, respectively. The mean daily activity pattern of males and females athletes were similar for light activities (16½ hr or 68% of day), for moderate activities (3½ hr or 15% of day in male, 4 hr or 17% in females) while moderate to heavy activities related to training were 4 hr (17%) and 3½ hr (15%) in males and females, respectively. Energy cost of some common activities ranges from 1.00-3.00 kcal/min in males and 0.84-2.04 kcal/min in females, while values for jogging were 6.60 kcal/min and 5.62 kcal/min in males and females, respectively. The mean TDEE in male ranges from 2938 kcal (12.3 MJ) in boxers (57 kg) to 4861 kcal (20.3 MJ) in weightlifters (110 kg) while the mean TDEE in female ranges from 2099 kcal (8.8 MJ) in athletics (51 kg) to 3098 kcal (13.0 MJ) in basketball (61.4 kg). The calculated physical activity level (PAL) values using measured BMR for males and females athletes ranges from 1.99-2.58 and 1.77-2.34, respectively. In conclusion, the estimated energy requirement for the various sports event studied ranges from 44-55 kcal/kg/day in males and 38-50 kcal/kg/day in female athletes.
This study was undertaken to assess the recent data on Malaysian adult body weights and associations of ethnic differences in overweight and obesity with comorbid risk factors, and to examine measures of energy intake, energy expenditure, basal metabolic rate (BMR) and physical activity changes in urban and rural populations of normal weight. Three studies were included (1) a summary of a national health morbidity survey conducted in 1996 on nearly 29 000 adults > or =20 years of age; (2) a study comparing energy intake, BMR and physical activity levels (PALs) in 409 ethnically diverse, healthy adults drawn from a population of 1165 rural and urban subjects 18-60 years of age; and (3) an examination of the prevalence of obesity and comorbid risk factors that predict coronary heart disease and type 2 diabetes in 609 rural Malaysians aged 30-65 years. Overweight and obesity were calculated using body mass index (BMI) measures and World Health Organization (WHO) criteria. Energy intake was assessed using 3-d food records, BMR and PALs were assessed with Douglas bags and activity diaries, while hypertension, hyperlipidaemia and glucose intolerance were specified using standard criteria. The National Health Morbidity Survey data revealed that in adults, 20.7% were overweight and 5.8% obese (0.3% of whom had BMI values of >40.0 kg m(-2)); the prevalence of obesity was clearly greater in women than in men. In women, obesity rates were higher in Indian and Malay women than in Chinese women, while in men the Chinese recorded the highest obesity prevalences followed by the Malay and Indians. Studies on normal healthy subjects indicated that the energy intake of Indians was significantly lower than that of other ethnic groups. In women, Malays recorded a significantly higher energy intake than the other groups. Urban male subjects consumed significantly more energy than their rural counterparts, but this was not the case in women. In both men and women, fat intakes (%) were significantly higher in Chinese and urban subjects. Men were moderately active with the exception of the Dayaks. Chinese women were considerably less active than Chinese men. Chinese and Dayak women were less active than Malay and Indian women. In both men and women, Indians recorded the highest PALs. Hence, current nutrition and health surveys reveal that Malaysians are already affected by western health problems. The escalation of obesity, once thought to be an urban phenomenon, has now spread to the rural population at an alarming rate. As Malaysia proceeds rapidly towards a developed economy status, the health of its population will probably continue to deteriorate. Therefore, a national strategy needs to be developed to tackle both dietary and activity contributors to the excess weight gain of the Malaysian population.
Study name: National Health and Morbidity Survey (NHMS-2006)
This cross-sectional study of age matched (10-11 years), pre-menarcheal girls in England and Malaysia investigated the effect of ethnicity on resting metabolic rate (RMR). The children were recruited from schools in Oxford, England, and Kuala Lumpur, Malaysia, and all measurements were conducted in the schools. The Malaysian girls were shorter (143.7 +/- 6.5 cm and 140.1 +/- 5.3 cm (mean +/- SD) for the English and Malaysian girls respectively) and lighter (32.5 +/- 5.3 kg compared with 38.0 +/- 8.7 kg for the English girls) with a smaller fat mass and fat free mass (FFM) than the English girls. Energy expenditure was lower in the Malaysian girls (4555 +/- 531 kJ/day compared with 5178 +/- 688 kJ/day for the English girls). Although a difference in RMR was observed between the two groups, when corrected for body composition the difference was no longer significant. No effect of ethnicity on the relationship of FFM and RMR was shown when the data were analyzed using analysis of covariance.
This study was conducted to determine changes in nutrition knowledge, attitude and practice of 8-year-old school children after receiving a nutrition education package. A total of 418 school children from urban and rural areas participated in this study. The intervention group consisted of 237 children while 181 children who did not receive the nutrition education package acted as controls. The nutrition education programme that was conducted for 3 weeks comprised of a video viewing session and a comic reading session followed by exercise questions as reinforcement for each session, and also classroom activities. Knowledge, attitude and practice questionnaires were distributed to the children before (pre-intervention) and after (postintervention) receiving the nutrition education programme. A follow-up visit was conducted six months after the programme had elapsed. The results obtained indicated that the nutrition knowledge score increased significantly in the intervention group from 48.3±13.2 at pre-test to 54.6±16.2 in post-test and 55.0±14.3 in follow-up test (p<0.05). The nutrition attitude score also increased significantly from 68.7±15.5 at pre-intervention to 72.6±15.0 and 74.7±15.8 during post-test and follow-up test respectively (p<0.05). However, the nutrition practice score had no significant improvement in both groups throughout the study period. There were no significant changes in the control group in knowledge, attitude and practice scores at pre, post and follow-up tests. In conclusion, this study showed that a good nutrition education programme had a positive impact whereby better nutrition knowledge, attitude and healthy eating habits in children were seen. It is hoped that the improvements would be sustained throughout their lives.
The Malaysian Dietary Guidelines (MDG) with eight key messages were first published in 1999. An updated version consisting of 14 key messages is being developed. The objective of this study was to evaluate the understanding of five key messages of the updated MDG among adults aged 18-59 years in Kuala Lumpur. A total of 773 adults comprising 330 Malays, 364 Chinese and 79 Indians were included in the study. A self-administrated questionnaire was used to obtain demographic data and to determine the level of understanding of key words and messages to be included in the new MDG. The results showed that 63% of the subjects were not aware of the existence of the MDG published in 1999. Overall, the understanding of the five messages in the updated MDG was moderate with a mean score of 60.0 ± 16.5. Between 52% to 93% of the subjects did not understand such key words as serving size, sedentary habits, blended vegetable oil and shortenings. The mean scores of understanding were significantly higher (p< 0.05) among the Chinese subjects (61.3 ± 17.8) than Malays (58.6 ± 14.2) and Indians (60.0 ± 18.9). The younger subjects (61.2 + 16.0) scored significantly (p< 0.05) higher than the older (58.7 ± 17.0) counterparts. There was also a significant association between the level of understanding of MDG with education level (p< 0.001) and occupational status (p< 0.001), respectively. This study suggests that some key words and messages in the updated MDG should be simplified to ensure that they are understood by Malaysians.
This cross-sectional study investigates the association between energy intake and macronutrient composition of the diet with overweight and obesity among Malaysian women. One hundred and fifteen adult Malay women aged 20 to 59 years (mean age 37.2±7.6 years) were interviewed. Dietary intake was assessed using the food history method. Body weight status was assessed using weight, height, waist circumference and fat percentage measurements. When energy intake was assessed for accuracy, only 41% of the subjects (n=47) were normal energy reporters. Among the normal energy reporters, 55% were of normal weight whereas 32% and 13% were overweight and obese. Mean energy intake for normal weight, overweight and obese subjects was 1685±199 kcal/day, 1810±166 kcal/day and 2119±222 kcal/day, respectively. Energy intake increased with body mass index (BMI) category. Among the overweight and obese, energy intake was respectively higher by 125 kcal/day and 434 kcal/day as compared to their normal weight counterparts (p< 0.001). There was also a significant, moderate and positive correlation between energy intake and BMI (r=0.635), waist circumference (r=0.545), and body fat percentage (r=0.534). When macronutrient composition of diet was analysed (% energy and g/1000 kcal), there was no significant difference in carbohydrate, protein or fat intake between the obese, overweight and normal weight subjects. There was also no significant correlation between macronutrient composition of the diet and body weight status. Based on these findings, we conclude that the subjects' body weight status is likely to be influenced by energy intake rather than the macronutrient composition of the diet.
Metabolic syndrome was once reported only in adults but is now occurring more frequently in children. This study compared the incidence of metabolic syndrome and its components among normal and obese children using the 2007 International Diabetes Federation (IDF) pediatric definition for metabolic syndrome. Subjects comprised 78 school children aged 8-10 years, with 34 obese and 44 normal weight children. Body weight, height, and waist circumference (WC) were measured and body mass index was calculated. Clinical profiles measured included fasting blood glucose, triglyceride, HDL cholesterol, LDL cholesterol, total cholesterol, and blood pressure. Metabolic syndrome (MS) was defined using the 2007 IDF pediatric criteria. Obese subjects had a significantly (p< 0.001) higher mean BMI (26.0 ± 3.6 kg/m2) compared to normal weight subjects (15.1 ± 0.8 kg/m2). Only one obese subject (1.3% of subjects) had metabolic syndrome based on the IDF definition, but all obese subjects had at least one component of metabolic syndrome. In comparison, no normal weight subjects had metabolic syndrome and only 9.1% of normal weight subjects had at least one component of metabolic syndrome. The most common component was central obesity, observed in 43.6% of subjects having WC equal to or greater than the 90th percentile. In concurrence with central obesity as the core feature of the IDF criteria, WC showed the strongest correlation with indicators of obesity such as BMI (r=0.938, p< 0.001), fat mass (r=0.912, p< 0.001) and fat-free mass (r=0.863, p< 0.001). We conclude that the problem of metabolic syndrome is more prominent among obese children, although the incidence of MS as defined by the 2007 pediatric IDF criteria, is low in this population (1.3%).
INTRODUCTION: The basal metabolic rate (BMR) is essential in deriving estimates of energy requirements for a population. The aim of this study was to measure the BMR in order to derive a predictive equation for the Malaysian Armed Forces (MAF) naval trainees.
METHODS: A total of 79 naval trainees aged 18 to 25 years from a training centre (Group A) and on board a ship (Group B) participated in the study. Anthropometric measurements included height and weight. Body fat and free fat mass were measured using the bioelectrical impedance analysis method. BMR was measured by indirect calorimetry with a canopy system.
RESULTS: The mean height, weight and body fat for Group A was 1.67 +/- 0.04 m, 61.0 +/- 3.9 kg and 12.7 percent +/- 2.5 percent, respectively, and 1.67 +/- 0.05 m, 62.3 +/- 6.2 kg and 14.0 percent +/- 3.5 percent, respectively, for Group B. The mean BMR for Group A (6.28 +/- 0.40 MJ/ day) did not differ significantly (p is more than 0.05) from that of Group B (6.16 +/- 0.67 MJ / day). The Food and Agriculture Organization/World Health Organization/United Nations University and the Henry and Rees equations overestimated the measured BMR by 9 percent (p is less than 0.001) and 0.5 percent (p is more than 0.05), respectively, while the Ismail et al equation underestimated the measured BMR by 5.6 percent (p is less than 0.001). A predictive equation, BMR = 3.316 + 0.047 (weight in kg) expressed in MJ /day with weight as the only independent variable, was derived using regression analysis.
CONCLUSION: We recommend that this predictive equation be used to estimate the energy requirements of MAF naval trainees.
BACKGROUND: The prevalence of obesity is increasing rapidly and abdominal obesity especially is known to be a risk factor for metabolic syndrome and other non-communicable diseases. Waist circumference percentile curves are useful tools which can help to identify abdominal obesity among the childhood and adolescent populations.
OBJECTIVE: To develop age- and sex-specific waist circumference (WC) percentile curves for multi-ethnic Malaysian children and adolescents aged 6.0-16.9 years. Subjects and methods. A total of 16,203 participants comprising 8,093 boys and 8,110 girls recruited from all regions of Malaysia were involved in this study. Height, weight, WC were measured and BMI calculated. Smoothed WC percentile curves and values for the 3rd, 5th, 10th, 25th, 50th, 75th, 90th, 95th and 97th percentiles were constructed using the LMS Method.
RESULTS: WC was found to increase with age in both sexes, but boys had higher WC values at every age and percentile. Z-scores generated using the UK reference data shows that Chinese children had the highest WC compared to Malays, Indians and other ethnicities. Comparisons with other studies indicate that at the 50th percentile, Malaysian curves did not differ from the UK, Hong Kong and Turkish curves, but at the 90th percentile, Malaysian curves were higher compared with other countries, starting at 10 years of age. The 90th percentile was adopted as the cut-off point to indicate abdominal obesity in Malaysian children and adolescents.
CONCLUSION: These curves represent the first WC percentiles reported for Malaysian children, and they can serve as a reference for future studies.
Overweight and obesity in Asian children are increasing at an alarming rate; therefore a better understanding of the relationship between BMI and percentage body fat (%BF) in this population is important. A total of 1039 children aged 8-10 years, encompassing a wide BMI range, were recruited from China, Lebanon, Malaysia, The Philippines and Thailand. Body composition was determined using the 2H dilution technique to quantify total body water and subsequently fat mass, fat-free mass and %BF. Ethnic differences in the BMI-%BF relationship were found; for example, %BF in Filipino boys was approximately 2 % lower than in their Thai and Malay counterparts. In contrast, Thai girls had approximately 2.0 % higher %BF values than in their Chinese, Lebanese, Filipino and Malay counterparts at a given BMI. However, the ethnic difference in the BMI-%BF relationship varied by BMI. Compared with Caucasian children of the same age, Asian children had 3-6 units lower BMI at a given %BF. Approximately one-third of the obese Asian children (%BF above 25 % for boys and above 30 % for girls) in the study were not identified using the WHO classification and more than half using the International Obesity Task Force classification. Use of the Chinese classification increased the sensitivity. Results confirmed the necessity to consider ethnic differences in body composition when developing BMI cut-points and other obesity criteria in Asian children.
To develop and cross-validate bioelectrical impedance analysis (BIA) prediction equations of total body water (TBW) and fat-free mass (FFM) for Asian pre-pubertal children from China, Lebanon, Malaysia, Philippines and Thailand.
Ethnic differences in body fat distribution contribute to ethnic differences in cardiovascular morbidities and diabetes. However few data are available on differences in fat distribution in Asian children from various backgrounds. Therefore, the current study aimed to explore ethnic differences in body fat distribution among Asian children from four countries.
With the increasing prevalence of childhood obesity, the metabolic syndrome has been studied among children in many countries but not in Malaysia. Hence, this study aimed to compare metabolic risk factors between overweight/obese and normal weight children and to determine the influence of gender and ethnicity on the metabolic syndrome among school children aged 9-12 years in Kuala Lumpur and its metropolitan suburbs.
This study aimed to measure the basal metabolic rate (BMR) of elite athletes and develop a gender specific predictive equation to estimate their energy requirements.
Population surveys and species recognition for roosting bats are either based on capture, sight or optical-mechanical count methods. However, these methods are intrusive, are tedious and, at best, provide only statistical estimations. Here, we demonstrated the successful use of a terrestrial Light Detection and Ranging (LIDAR) laser scanner for remotely identifying and determining the exact population of roosting bats in caves. LIDAR accurately captured the 3D features of the roosting bats and their spatial distribution patterns in minimal light. The high-resolution model of the cave enabled an exact count of the visibly differentiated Hipposideros larvatus and their roosting pattern within the 3D topology of the cave. We anticipate that the development of LIDAR will open up new research possibilities by allowing researchers to study roosting behaviour within the topographical context of a cave's internal surface, thus facilitating rigorous quantitative characterisations of cave roosting behaviour.
This study aimed to assess the physical activity levels of pediatric patients with acute leukemia undergoing chemotherapy. Thirty-eight pediatric patients and matched controls, aged 3-12 years old, were measured for weight, height, and other anthropometric parameters. Physical activity was assessed using actical accelerometer and activity log book. Patients recorded significantly lower mean total activity counts (26.2±30.2 cpm vs. 192.2±68.8 cpm; p<0.01) and spent more time in sedentary activities (1301±121 min vs. 1020±101 min; p<0.001) compared to controls. They also achieved fewer 1-5-min bouts of moderate-vigorous physical activity (MVPA) compared to controls (1.50±5.95 vs. 37.38±40.36; p<0.001). In conclusion, patients had lower physical activity level and intensity; and simple exercise intervention programs may be needed to minimize the detrimental effects of prolonged sedentary behaviors.
The assessment of nutritional status among paediatric patients is important for the planning and execution of nutritional strategies that strive to optimise the quality of life and growth among sick children. The present study aimed to evaluate the nutritional status and dietary intake among children with acute leukaemia.