Traditionally, Chinese women adhere to special dietary practices during the month following childbirth. This paper discusses the dietary practices and food taboos practised by Chinese women in Kuala Lumpur. A total of 134 Chinese mothers of children below one year were recruited from three Maternal and Child Health Clinics and Maternity Hospital, Kuala Lumpur. Questionnaires and in-depth interviews were used to obtain information on socioeconomic background, dietary practices, food taboos and cooking methods during the confinement period. Food intake was assessed by multiple 24-hour dietary recall among 34 mothers during their confinement month (zuo yuezi). Body weight and height were measured, and body mass index calculated. Majority of the respondents had secondary school education (77.6%), household income between RM1001 and RM3000 (64%), and were homemakers (48.5%). The women were aged 18-39 years, and 68% were of normal weight. Most women (82%) practised 30 days of confinement, during which they adhered to special dietary practices. The diet was directed at attaining yin-yang (cold-hot) balance, whereby “hot†foods were most commonly used and “cold†foods were avoided. Ginger, rice wine and sesame seed oil, considered “hot†foods, were used in large amounts in the cooking. Rice, chicken and pork were also consumed in large amounts. Most vegetables and fruits were considered “cold†and were prohibited during confinement. Most mothers drank specially-prepared teas boiled from Chinese herbs. Mean energy intake was 19% below RNI, while mean protein intake was 93% above RNI (NCCFN, 2005). Mean intakes of thiamin, riboflavin and niacin were above 75% of RNI, while vitamins A and C were at half of RNI or less. Mean iron and calcium intakes were at 222% and 67% of RNI, respectively. It is concluded that most Chinese women in Kuala Lumpur do conform to special dietary practices during zuo yuezi.
Study site: three Maternal and Child Health Clinics and Maternity Hospital, Kuala Lumpur
Women participating in a wide range of competitive sports are at higher risk of developing eating disorders, menstrual irregularities and osteoporosis, which are generally referred to as the 'female athlete triad'. The objective of this study was to determine the prevalence of female athlete triad and factors associated with this condition among athletes participating in different sports. A total of 67 elite female athletes aged between 13-30 years participated in the study and were subdivided into the 'leanness' and 'non-leanness' groups. Eating disorders were assessed using a body image figure rating and the Eating Disorder Inventory (EDI) with body dissatisfaction (BD), drive for thinness (DT), bulimia (B) and perfectionism (P) subscales. Menstrual irregularity was assessed with a self-reported menstrual history questionnaire. Bone quality was measured using a quantitative ultrasound device at one-third distal radius. Prevalence of the female athlete triad was low (1.9%), but the prevalence for individual triad component was high, especially in the leanness group. The prevalence of subjects who were at risk of menstrual irregularity, poor bone quality and eating disorders were 47.6%, 13.3% and 89.2%, respectively, in the leanness group; and 14.3%, 8.3% and 89.2%, respectively, in the non-leanness group. Since the components of the triad are interrelated, identification of athletes at risk of having any one component of the triad, especially those participating in sports that emphasise a lean physique, is an important aid for further diagnosis.
Introduction: Accurate yet inexpensive methods for measuring free-living energy expenditure (EE) are
much needed. The aim of this study was to determine the feasibility of heart-rate monitoring method
(HRM) in measuring EE as compared to the established activity diary (AD) method. Methodology:
Minute-by-minute HRM and an activity diary (AD) were used simultaneously in 34 young adults (18
females, 16 males; mean age 21.5 ± 1.5 years). Estimates of the EE from HRM were based on individual
calibration using the Flex-HR procedure while EE from AD were calculated using both individually
measured and published energy cost of various activities. Total daily energy expenditure (TDEE) and its
components (EE during sleep, during rest and during physical activity) were compared using Student
paired-t tests. Results: TDEE from HRM method averaged 8.17 ± 2.00 MJ/day compared to 8.50 ±
1.28 MJ/day from AD method. Although large intra-individual differences were found (ranging from
-36.9% to 47.4%), there was no significant difference between the two methods (mean difference -3.6 ± 19.4%). The limits of agreement (mean ± 2SD) were -3.77 and 3.11 MJ/day. There were no significant
differences for any of the TDEE components between the two methods, except for EE during sleep
(p
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.
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.
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.
BACKGROUND: The aim of this cross-sectional study was to examine the ability of a children's physical activity questionnaire (cPAQ) to assess physical activity levels and bone health status of school children.
METHODS: Subjects consisted of 90 pre-pubertal and early pubertal children aged 9-10 years. Components of physical activity were assessed using metabolic intensity (METPA) scores and mechanical bone strain (MECHPA) scores. An Actical accelerometer was used to validate METPA scores among a sub-sample of 57 children. Reliability was assessed by test-retesting all children after a 7 day interval. Whole body bone mineral content (BMC) was measured using dual-energy X-ray absorptiometry.
RESULTS: The reliability of cPAQ for assessment of various categories of physical activity was moderate to high (r ranged from 0.55 to 0.68, P < 0.001). Agreement was fair for repeated use of the cPAQ (Cohen's kappa = 0.32, P < 0.001). Bland-Altman plots show cPAQ had fair agreement only for moderate activity (mean difference 35.4 min/week; 95% limits of agreement -434.0 to +504.9 min/week). Approximately 69.6% of children were correctly classified (into the same or adjacent quartiles) according to the quartiles of BMC for METPA score, and 58.7% were correctly classified according to MECHPA score. Only 10.9% and 12.0% of children were grossly misclassified as compared to METPA and MECHPA scores, respectively.
CONCLUSIONS: The cPAQ has reasonable validity in assessing moderate physical activity, and it demonstrates good ability to accurately classify children according to BMC. It fails, however, to assess other activity levels, suggesting that objective measurement is still a better method of assessment of physical activity among primary school children.
Nutrition is an important factor in mental development and, as a consequence, in cognitive performance. Malnutrition is reflected in children's weight, height and BMI curves. The present cross-sectional study aimed to evaluate the association between anthropometric indices and cognitive performance in 6746 school-aged children (aged 6-12 years) of four Southeast Asian countries: Indonesia; Malaysia; Thailand; Vietnam. Cognitive performance (non-verbal intelligence quotient (IQ)) was measured using Raven's Progressive Matrices test or Test of Non-Verbal Intelligence, third edition (TONI-3). Height-for-age z-scores (HAZ), weight-for-age z-scores (WAZ) and BMI-for-age z-scores (BAZ) were used as anthropometric nutritional status indices. Data were weighted using age, sex and urban/rural weight factors to resemble the total primary school-aged population per country. Overall, 21% of the children in the four countries were underweight and 19% were stunted. Children with low WAZ were 3·5 times more likely to have a non-verbal IQ < 89 (OR 3·53 and 95% CI 3·52, 3·54). The chance of having a non-verbal IQ < 89 was also doubled with low BAZ and HAZ. In contrast, except for severe obesity, the relationship between high BAZ and IQ was less clear and differed per country. The odds of having non-verbal IQ levels < 89 also increased with severe obesity. In conclusion, undernourishment and non-verbal IQ are significantly associated in 6-12-year-old children. Effective strategies to improve nutrition in preschoolers and school-aged children can have a pronounced effect on cognition and, in the longer term, help in positively contributing to individual and national development.
The dual burden of malnutrition reportedly coexists in Malaysia; however, existing data are scarce and do not adequately represent the nutritional status of Malaysian children. The Nutrition Survey of Malaysian Children was carried out with the aim of assessing the nutritional status in a sample of nationally representative population of children aged 6 months to 12 years. A total of 3542 children were recruited using a stratified random sampling method. Anthropometric measurements included weight, height, mid-upper arm circumference, and waist and hip circumferences. Blood biochemical assessment involved analyses of Hb, serum ferritin, and vitamins A and D. Dietary intake was assessed using semi-quantitative FFQ, and nutrient intakes were compared with the Malaysian Recommended Nutrient Intakes (RNI). The prevalence of overweight (9·8%) and obesity (11·8%) was higher than that of thinness (5·4%) and stunting (8·4%). Only a small proportion of children had low levels of Hb (6·6%), serum ferritin (4·4%) and vitamin A (4·4%), but almost half the children (47·5%) had vitamin D insufficiency. Dietary intake of the children was not compatible with the recommendations, where more than one-third did not achieve the Malaysian RNI for energy, Ca and vitamin D. The present study revealed that overnutrition was more prevalent than undernutrition. The presence of high prevalence of vitamin D insufficiency and the inadequate intake of Ca and vitamin D are of concern. Hence, strategies for improving the nutritional status of Malaysian children need to consider both sides of malnutrition and also put emphasis on approaches for the prevention of overweight and obesity as well as vitamin D insufficiency.
The tropics cover a large section of the world in which both developed and developing countries are situated. Rapid socioeconomic development, modernization, urbanization, and globalization have affected both the food market and physical activity (PA), which in turn have propelled the obesity epidemic in the tropics. There is growing concern that overweight and obesity are emerging as major health problems among children and adolescents in the tropics, despite the fact that undernutrition still exists in many of these countries. Physical inactivity, a low metabolic rate, and lack of physical fitness (PF) have been linked to overweight and obesity. Moreover, PF in several tropical countries is declining, and these changes may be a threat to future health, as low PA and PF levels are important risk factors for noncommunicable chronic diseases. Previous studies have reported that the relationships among PA, PF, overweight, and obesity are inconsistent and inconclusive. There is no indication that variances in the energy cost of physical activities lead to obesity. Despite a lack of definite evidence to prove a causal relationship, there is enough certainty that physical inactivity and low fitness levels are linked to overweight and obesity. Hence, people living in tropical countries need to be encouraged to lead a healthier lifestyle by increasing their PA levels and reducing sedentary behaviors to prevent overweight or obesity.
Kafein mempunyai kesan ergogenik terhadap golongan yang terlatih; walaubagaimanapun, kajian kesan fisiologi kafein terhadap golongan sedentari adalah amat terhad. Tujuan kajian ini adalah untuk mengkaji kesan kafein ke atas penggunaan oksigen dan tanggapan tahap lesu semasa senaman intensiti sederhana dalam kalangan dewasa muda perempuan yang sedentari. Subjek terdiri daripada 16 orang mahasiswi yang berumur antara 22 hingga 24 tahun. Kriteria penerimaan adalah tahap aktiviti fizikal yang rendah dan pengambilan kafein adalah kurang daripada 50 mg sehari, disaring dengan menggunakan Soal Selidik Aktiviti Fizikal Antarabangsa (versi pendek) dan soal selidik pengambilan kafein. Reka bentuk kajian eksperimental ini adalah buta tunggal, pindah silang, kawalan plasebo dengan semua subjek menjadi kawalannya tersendiri. Subjek dikehendaki malaporkan diri ke makmal untuk menjalankan dua sesi eksperimen selepas masing-masing mengambil kapsul plasebo atau kafein dengan selang masa 3 hari antara dua sesi eksperimen tersebut. Enam puluh minit selepas mengambil kapsul plasebo (Glucolin, glukosa) atau 100 mg kafein (Pro-plus, United Kingdom), subjek dikehendaki berlari di atas treadmill selama 30 minit pada kuasa kerja yang bersamaan 60% daripada anggaran maksimum kadar denyutan jantung. Penggunaan oksigen, kadar denyutan jantung dan tanggapan tahap lesu direkod pada minit ke-20, ke-25 dan ke-30, manakala tekanan darah direkod serta-merta selepas subjek menghabiskan larian. Perbezaan direkod selepas kesemua subjek menyempurnakan kedua-dua eksperimen plasebo dan kafein. Min peratus lemak tubuh subjek adalah 28.4 ± 5.4. Ujian t bersandar menunjukkan tiada perbezaan signifikan antara trial plasebo dengan trial kafein ke atas penggunaan oksigen (13.99 ± 2.47 vs 14.49 ± 1.73, p = 0.440), tanggapan tahap lesu (12.3 ± 2.5 vs 12.3 ± 2.1, p = 1.000), tekanan darah sistolik (113 ± 10 vs 117 ± 11, p = 0.129), tekanan diastolik (67 ± 8 vs 69 ± 10, p = 0.408) dan kadar denyutan jantung (127.3 ± 11.0 vs 127.1 ± 11.6, p = 0.912). Terdapat korelasi negatif tinggi yang signifikan antara peratusan lemak tubuh dengan pengambilan oksigen (r = –0.568, p < 0.05) serta korelasi positif tinggi yang signifikan antara peratusan lemak tubuh dengan tanggapan tahap lesu (r = 0.515, p < 0.05). Hasil kajian tidak meningkatkan kesan yang signifikan mungkin disebabkan oleh kesan saiz (effect size) kajian ini yang kecil (d = 0.24). Justeru itu, kajian masa depan yang melibatkan lebih ramai subjek harus dijalankan untuk mengkaji kesan kafein semasa senaman dalam kalangan populasi sedentari.
Media pendidikan bercetak merupakan saluran komunikasi yang utama dalam pendidikan kesihatan awam. Namun, kajian tempatan yang menilai penerimaan media pendidikan bercetak masih terhad di Malaysia. Maka, kajian ini dilakukan untuk menilai media pendidikan bercetak sedia ada yang mensasarkan obesiti di kalangan kanak-kanak untuk kegunaan dalam program pendidikan atau promosi pemakanan. Kajian ini melibatkan dua peringkat. Peringkat pertama merupakan tinjauan keperluan iaitu tinjauan terhadap media pendidikan bercetak sedia ada yang mensasarkan kanak kanak yang mengalami masalah berlebihan berat badan dan obes dan kajian rintis terhadap borang soal selidik yang dibentuk. Manakala peringkat kedua adalah penilaian penerimaan subjek kajian terhadap media pendidikan bercetak dan perubahan tahap pengetahuan mereka selepas membaca media pendidikan bercetak yang diberikan. Skala Likertn digunakan dalam penilaian ini iaitu daripada 1 (sangat tidak memuaskan) hingga 5 (sangat memuaskan). Jumlah subjek dalam kajian ini adalah seramai 67 orang yang terdiri daripada golongan profesional dalam bidang pendidikan dan kesihatan (n = 7), subjek dewasa (n = 30) dan subjek kanak-kanak (n = 30). Di dalam kajian ini, subjek dewasa diberi satu buku kecil yang mengandungi maklumat berkenaan pencegahan dan pengurusan masalah obesiti di kalangan kanak-kanak seperti komplikasi masalah obesiti dan penyediaan makanan. Subjek kanak-kanak pula menerima satu buku kecil yang mengandungi maklumat berkenaan piramid makanan, kepentingan sarapan, aktiviti fi zikal dan sebagainya di samping satu poster yang mengandungi maklumat berkenaan pemilihan makanan sihat. Manakala golongan profesional menerima semua media pendidikan bercetak ini. Kajian ini mendapati penerimaan subjek terhadap isi kandungan, gambar, jadual dan rajah, warna, susun atur gambar, susun atur kandungan, bahasa dan saiz huruf bagi ketiga-tiga media pendidikan bercetak adalah pelbagai, iaitu daripada sangat tidak memuaskan hingga sangat memuaskan. Min skor penilaian keseluruhan terhadap buku kecil yang mensasarkan populasi dewasa adalah 3.9 ± 0.5 manakala min skor penilaian keseluruhan terhadap buku kecil yang mensasarkan populasi kanak-kanak adalah 4.3 ± 0.4 dan poster adalah 3.9 ± 0.9. Skor pengetahuan pemakanan golongan profesional meningkat dari 88.6 ± 11.2% kepada 95.5 ± 3.2% selepas membaca media tersebut. Skor pengetahuan pemakanan subjek dewasa juga meningkat secara signifi kan (p < 0.001)daripada 67.7 ± 13.6% kepada 84.8 ± 15.9%; bagi subjek kanak-kanak, skor pengetahuan pemakanan juga meningkat secara signifi kan (p < 0.001) daripada 65.3 ± 14.4% kepada 84.0 ± 11.4%. Kesimpulannya, media pendidikan bercetak sedia ada mendapat penerimaan yang baik dan dapat meningkatkan tahap pengetahuan kumpulan sasaran. Oleh itu, media pendidikan bercetak tersebut sesuai digunakan dalam mana-mana program pendidikan pemakanan yang berkaitan dengan obesiti kanak-kanak.
Kajian pengetahuan pemakanan dalam kalangan pelbagai kumpulan populasi kerap dilaporkan tetapi kajian berkaitan dalam kalangan tentera jarang dilaporkan. Tujuan kajian ini adalah untuk menentukan tahap pengetahuan pemakanan dan amalan penggunaan suplemen dalam kalangan anggota Tentera Laut Diraja Malaysia (TLDM). Sejumlah 909 anggota TLDM berpangkalan di Lumut, Kuantan dan Johor terlibat dalam kajian ini. Soal selidik digunakan bagi menentukan latar belakang, ciri-ciri sosio demografi, pengetahuan pemakanan dan penggunaan suplemen. Pengukuran antropometri yang dijalankan termasuk berat dan tinggi. Keputusan menunjukkan bahawa min skor pengetahuan pemakanan subjek ialah 62.5% iaitu pada tahap pengetahuan sederhana. Min skor pengetahuan pemakanan adalah lebih tinggi dalam kalangan anggota di Pangkalan Lumut, lebih berusia, lebih berpendidikan, berpangkat pegawai dan berat badan berlebihan. Sumber maklumat pemakanan yang paling popular ialah televisyen/radio (27.3%), kursus/seminar (24.9%) dan doktor/jururawat (21.6%). Sejumlah 36% subjek melaporkan menggunakan sekurang-kurangnya satu atau lebih suplemen dalam seminggu dan ini termasuk 5.8% yang menggunakannya setiap hari. Kajian asas ini dijangka memberikan maklumat berguna kepada Angkatan Tentera Malaysia dan adalah dicadangkan pendidikan pemakanan perlu diperkenalkan dalam program latihan anggota TLDM bagi memastikan status kesihatan anggota sentiasa terpelihara.
Objectives: In light of the importance of physical activity, the aim of the present study is to examine the factors affecting participation in physical activity among adults in Malaysia.
Methods: A logistic regression model and the Third National Health and Morbidity Survey consisting of 30,992 respondents were used.
Results: Age, income, gender, education, marital status, region, house locality, job characteristics, and medical conditions are significantly associated with participation in physical activity. In particular, old individuals, high income earners, females, the well-educated, widowed or divorced individuals, East Malaysians, urban dwellers, the unemployed, and individuals who are not diagnosed with hypercholesterolemia are less likely to be physically active than others.
Conclusion: Because sociodemographic and health factors play an important role in determining physical activity, the government should take them into account when formulating policy.
Keywords: Malaysia; demography; health; participation; physical activity.
Study name: National Health and Morbidity Survey (NHMS-2006)
Obesity is a worldwide pandemic, and the prevalence rate has doubled since the 1980s. Asian countries are also experiencing the global epidemic of obesity with its related health consequences. The prevalence of overweight and obesity are increasing at an alarming rate across all age groups in Asia. These increases are mainly attributed to rapid economic growth, which leads to socio-economic, nutrition and lifestyle transitions, resulting in a positive energy balance. In addition, fat mass and obesity-associated gene variants, copy number variants in chromosomes and epigenetic modifications have shown positive associations with the risk of obesity among Asians. In this review highlights of prevalence and related ecological and genetic factors that could influence the rapid rise in obesity among Asian populations are discussed.
Sleep deficiency is becoming widespread in both adults and adolescents and is accompanied by certain behaviors that can lead to obesity. This study aims to investigate differences in sleep duration of overweight/obese and normal weight groups, and the association between sleep deprivation and obesity, dietary intake and physical activity. A cross-sectional study was conducted among 226 Iranian working adults (109 men and 117 women) aged 20 to 55 years old who live in Tehran. Body weight, height, waist and hip circumferences were measured, and BMI was calculated. Questionnaires, including the Sleep Habit Heart Questionnaire (SHHQ), International Physical Activity Questionnaire (IPAQ) and 24-hour dietary recall, were interview-administered. Subjects were categorized as normal weight (36.3%) or overweight/obese (63.7%) based on WHO standards (2000). Overweight/ obese subjects slept significantly (p<0.001) later (00:32±00:62 AM) and had shorter sleep duration (5.37±1.1 hours) than normal weight subjects (23:30±00:47 PM and 6.54±1.06 hours, respectively). Sleep duration showed significant (p<0.05) direct correlations to energy (r = 0.174), carbohydrate (r = 0.154) and fat intake (r = 0.141). This study revealed that each hour later in bedtime (going to bed later) increased the odds of being overweight or obese by 2.59-fold (95% CI: 1.61-4.16). The findings in this study confirm that people with shorter sleep duration are more likely to be overweight or obese; hence, strategies for the management of obesity should incorporate a consideration of sleep patterns.
This study aimed to determine the association between sleep habits (including bedtime, wake up time, sleep duration, and sleep disorder score) and physical characteristics, physical activity level, and food pattern in overweight and obese versus normal weight children.