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Waist circumference percentile curves for Malaysian children and adolescents aged 6.0-16.9 years

Poh BK, Jannah AN, Chong LK, Ruzita AT, Ismail MN, McCarthy D

Int J Pediatr Obes, 2011 Aug;6(3-4):229-35.
PMID: 21668385 DOI: 10.3109/17477166.2011.583658

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.
Fulltext Vitamin D deficiency and its risk factors in Malaysian children with epilepsy

Fong CY, Kong AN, Poh BK, Mohamed AR, Khoo TB, Ng RL, et al.

Epilepsia, 2016 08;57(8):1271-9.
PMID: 27378185 DOI: 10.1111/epi.13443

OBJECTIVE: Long-term use of antiepileptic drugs (AEDs) is a significant risk factor for vitamin D deficiency in children with epilepsy. The aims of our study were to evaluate the prevalence and risk factors for vitamin D deficiency among Malaysian children with epilepsy.
METHODS: Cross-sectional study of ambulant children with epilepsy on long-term AEDs for >1 year seen in three tertiary hospitals in Malaysia from April 2014 to April 2015. Detailed assessment of pubertal status, skin pigmentation, sunshine exposure behavior, physical activity, dietary vitamin D and calcium intake, anthropometric measurements and bone health blood tests (vitamin D, alkaline phosphatase, calcium, phosphate, and parathyroid hormone levels) were obtained on all patients. Vitamin D deficiency was defined as 25-hydroxy vitamin D [25(OH)D] levels ≤35 nmol/L and insufficiency as 25(OH)D levels of 36-50 nmol/L.
RESULTS: A total of 244 children (146 male) participated in the study. Ages ranged between 3.7 and 18.8 years (mean 12.3 years). 25(OH)D levels ranged between 7.5 and 140.9 nmol/L (mean 53.9 nmol/L). Vitamin D deficiency was identified in 55 patients (22.5%), and a further 48 (19.7%) had vitamin D insufficiency. Multivariate logistic regression analysis identified polytherapy >1 AED (odds ratio [OR] 2.16, 95% confidence interval [CI] 1.07-4.36), age >12 years (OR 4.16, 95% CI 1.13-15.30), Indian ethnicity (OR 6.97, 95% CI 2.48-19.55), sun exposure time 30-60 min/day (OR 2.44, 95% CI 1.05-5.67), sun exposure time <30 min/day (OR 3.83, 95% CI 1.61-9.09), and female (OR 2.61, 95% CI 1.31-5.20) as statistically significant (p < 0.05) risk factors for vitamin D deficiency.
SIGNIFICANCE: Despite living in the tropics, a high proportion of Malaysian children with epilepsy are at risk of vitamin D deficiency. Targeted strategies including vitamin D supplementation and lifestyle advice of healthy sunlight exposure behavior should be implemented among children with epilepsy, particularly for those at high risk of having vitamin D deficiency.
Validity of a children's physical activity questionnaire (cPAQ) for the study of bone health

Nor Aini J, Poh BK, Chee WS

Pediatr Int, 2013 Apr;55(2):223-8.
PMID: 23253297 DOI: 10.1111/ped.12035

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.
Fulltext Validity and Reliability of a Food Frequency Questionnaire (FFQ) to Assess Dietary Intake of Preschool Children

Noor Hafizah Y, Ang LC, Yap F, Nurul Najwa W, Cheah WL, Ruzita AT, et al.

Int J Environ Res Public Health, 2019 11 27;16(23).
PMID: 31783477 DOI: 10.3390/ijerph16234722

As there are few food frequency questionnaires (FFQ) to assess the dietary intake of preschool children, this study examined the validity and reliability of an FFQ for this purpose. A total of 210 preschoolers aged 4 to 6 years participated in the validation study, while a subsample of 66 participants joined the reliability study. The FFQ is modified from the ToyBox-study and South East Asian Nutrition Surveys (SEANUTS), and comprised 108 food items from 13 food groups. A three-day estimated dietary record (3DR) was used as reference and reliability was assessed through a second administration of the FFQ (FFQ2), four weeks after the first administration (FFQ1). For the validation study, Spearman's correlation coefficients showed moderate to high correlations (p < 0.001) between FFQ and 3DR. Cross-classification of quartile analysis showed moderate agreement between the two methods. As for reliability, Spearman's correlation coefficients showed moderate to high correlations (p < 0.001) between FFQ1 and FFQ2. Cronbach's alpha values (0.708 to 0.824) and intraclass correlation coefficients (0.710 to 0.826) showed good agreement between repeated FFQs. The results suggest that the FFQ has acceptable validity and good reliability. Hence, the FFQ can be used to assess preschool children's food intake.
Fulltext Umami detection threshold among children of different ethnicities and its correlation with various indices of obesity and blood pressure

Lim SY, Rosmawati D, Yatiman NH, Wong JE, Haron H, Poh BK

Curr Res Food Sci, 2022;5:2204-2210.
PMID: 36387604 DOI: 10.1016/j.crfs.2022.11.006

Sensitivity to savory taste has been linked to high consumption of savory foods and increased risks of obesity and hypertension. However, there are limited studies that investigate whether obesity indices are correlated with the differences in umami taste perception, particularly in children. This study aimed to investigate the umami detection threshold among children of different ethnicities and the threshold's correlation with obesity indices and blood pressure. A total of 140 subjects were recruited and consisted of a nearly equal distribution of children from three main ethnicities (37.2% Malays, 31.4% Chinese, 31.4% Indians). Umami detection threshold was measured using the two-alternative, forced-choice staircase procedure. Body weight, height, waist circumference and blood pressure of children were measured. Body composition was assessed using bioelectrical impedance analysis (BIA). Mean umami detection threshold was 1.22 ± 1.04 mM and there were no observable differences attributable to the subjects' ethnicities. Body fat percentage was negatively correlated (r = -0.171, p
Triple burden of malnutrition among Malaysian children aged 6 months to 12 years: Current findings from SEANUTS II Malaysia

Poh BK, Wong JE, Lee ST, Chia JSM, Yeo GS, Sharif R, et al.

Public Health Nutr, 2023 Nov 07.
PMID: 37932916 DOI: 10.1017/S1368980023002239

OBJECTIVE: This paper aims to report South East Asian Nutrition Surveys (SEANUTS) II Malaysia data on nutritional status, dietary intake, and nutritional biomarkers of children aged 6 months to 12 years.
DESIGN: Cross-sectional survey conducted in 2019-2020.
SETTING: Multistage cluster sampling conducted in Central, Northern, Southern, and East Coast regions of Peninsular Malaysia.
PARTICIPANTS: 2989 children aged 0.5-12.9 years.
RESULTS: Prevalences of stunting, thinness, overweight, and obesity among children aged 0.5-12.9 years were 8.9%, 6.7%, 9.2%, and 8.8%, respectively. Among children below 5 years old, 11.4% were underweight, 13.8% had stunting, and 6.2% wasting. Data on nutritional biomarkers showed a small proportion of children aged 4-12 years had iron (2.9%) and vitamin A deficiencies (3.1%). Prevalence of anaemia was distinctly different between children below 4 years old (40.3%) and those aged 4 years and above (3.0%). One-fourth of children (25.1%) had vitamin D insufficiency, which was twice as prevalent in girls (35.2% vs. boys: 15.6%). The majority of children did not meet the recommended dietary intake for calcium (79.4%) and vitamin D (94.8%).
CONCLUSIONS: Data from SEANUTS II Malaysia confirmed that triple burden of malnutrition co-exists among children in Peninsular Malaysia, with higher prevalence of overnutrition than undernutrition. Anaemia is highly prevalent among children below 4 years old, while vitamin D insufficiency is more prevalent among girls. Low intakes of dietary calcium and vitamin D are also of concern. These findings provide policymakers with useful and evidence-based data to formulate strategies that address the nutritional issues of Malaysian children.
Fulltext The female athlete triad among elite Malaysian athletes: prevalence and associated factors

Quah YV, Poh BK, Ng LO, Noor MI

Asia Pac J Clin Nutr, 2009;18(2):200-8.
PMID: 19713179

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.
Fulltext The determinants of participation in physical activity in Malaysia

Cheah YK, Poh BK

Osong Public Health Res Perspect, 2014 Feb;5(1):20-7.
PMID: 24955308 DOI: 10.1016/j.phrp.2013.12.002

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)
The authors reply

Tah PC, Lee ZY, Poh BK, Abdul Majid H, Hakumat-Rai VR, Mat Nor MB, et al.

Crit Care Med, 2021 08 01;49(8):e804-e805.
PMID: 34261937 DOI: 10.1097/CCM.0000000000005082
The associations between meeting 24-hour movement guidelines and adiposity in Asian Adolescents: The Asia-Fit Study

Hui SS, Zhang R, Suzuki K, Naito H, Balasekaran G, Song JK, et al.

Scand J Med Sci Sports, 2021 Mar;31(3):763-771.
PMID: 33249648 DOI: 10.1111/sms.13893

Less is known about how compliance with 24-hour movement guidelines for physical activity (PA), sedentary behavior, and sleep affects adiposity in young people. The purposes of this study were to compare compliance with 24-hour movement guidelines in Asian adolescents and to examine the associations between compliance with 24-hour movement guidelines and body fat percentage. A sample of 12 590 adolescents aged 13.63 (± 1.01) years from eight Asian metropolitan cities including Bangkok (Thailand), Hong Kong SAR, Kuala Lumpur (Malaysia), Seoul (South Korea), Shanghai (China), Singapore, Taipei (Taiwan), and Tokyo (Japan) completed interviewer-administered questionnaires to assess moderate-to-vigorous PA, recreational screen time, sleep duration, and covariates. Body fat percentage was measured using bioelectrical impedance analysis. We found that compliance with 24-hour movement guidelines differed in Asian adolescents across the eight cities. Adjusting for covariates, there was a negative association between number of the guidelines being met and body fat percentage in Asian adolescents. In addition, meeting only the sleep guideline and both the PA and sleep guidelines had negative associations with body fat percentage compared with no guidelines being met. Our findings improve the understanding about how compliance with 24-hour movement guidelines benefit a healthy body weight in adolescents, as well as contribute to development of evidence-based 24-hour movement guidelines for Asian young people. Future research is needed to gain better insights into the directionality of the associations between compliance with 24-hour movement guidelines and adiposity, as well as the mechanisms underlying the associations in Asian adolescents.
Fulltext The GReat-Child™ Trial: A Quasi-Experimental Intervention on Whole Grains with Healthy Balanced Diet to Manage Childhood Obesity in Kuala Lumpur, Malaysia

Koo HC, Poh BK, Abd Talib R

Nutrients, 2018 Jan 30;10(2).
PMID: 29385769 DOI: 10.3390/nu10020156

Background: The GReat-Child Trial was a quasi-experimental intervention that has emphasized whole grain as a strategy to manage childhood obesity. Methods: Two schools in Kuala Lumpur with similar demographic characteristics were assigned as intervention (IG) and control (CG). Eligibility criteria were overweight/obese children aged 9 to 11 years who had no serious co-morbidity. Children who reported consuming wholegrain foods in their 3-day diet-recall during screening were excluded. A total of 63 children (31 IG; 32 CG) completed the entire intervention program. The IG children underwent six 30-min nutrition education lessons and had school delivery of wholegrain food on a daily basis over a 12-week period. Parents of IG children attended 1-h individual diet counseling. Anthropometric outcomes including BMI-for-age z-score (BAZ), body fat percentage and waist circumference were measured at baseline [T0], post-intervention [T1] (3rd month) and follow-up [T2] (9th month). Results: IG showed significantly lower BAZ (weighted difference: -0.12; 95% CI: -0.21, -0.03; p = 0.009), body fat percentage (weighted difference: -2.6%; 95% CI: -3.7, -1.5; p < 0.001) and waist circumference (weighted difference: -2.4 cm; 95% CI: -3.8, -1.0; p = 0.001) compared to CG. IG reported significantly lower body fat percentage (weighted difference: -3.4%; 95% CI: 1.8, 5.0; p < 0.001) and waist circumference (weighted difference: -2.1 cm; 95% CI: -3.7, -0.5; p = 0.014) at T1 compared to T0. Conclusions: The GReat-Child Trial made a positive impact in managing childhood obesity. It can be incorporated into childhood obesity intervention programs that are being implemented by the policy makers.
Fulltext The GReat-Child TrialTM: A Quasi-Experimental Dietary Intervention among Overweight and Obese Children

Koo HC, Poh BK, Talib RA

Nutrients, 2020 Sep 29;12(10).
PMID: 33003299 DOI: 10.3390/nu12102972

Diet composition is a key determinant of childhood obesity. While whole grains and micronutrients are known to decrease the risk of obesity, there are no interventions originating from Southeast Asia that emphasize whole grain as a strategy to improve overall quality of diet in combating childhood obesity. The GReat-Child Trial aimed to improve whole grain intake and quality of diet among overweight and obese children. It is a quasi-experimental intervention based on Social Cognitive Theory. It has a 12-week intervention and 6-month follow-up, consisting of three components that address environmental, personal, and behavioral factors. The intervention consists of: (1) six 30 min lessons on nutrition, using the Malaysian Food Pyramid to emphasize healthy eating, (2) daily deliveries of wholegrain foods to schools so that children can experience and accept wholegrain foods, and (3) diet counseling to parents to increase availability of wholegrain foods at home. Two primary schools with similar demographics in Kuala Lumpur were assigned as control (CG) and intervention (IG) groups. Inclusion criteria were: (1) children aged 9 to 11 years who were overweight/obese; (2) who did not consume whole grain foods; and (3) who had no serious co-morbidity problems. The entire trial was completed by 63 children (31 IG; 32 CG). Study outcomes were measured at baseline and at two time points post intervention (at the 3rd [T1] and 9th [T2] months). IG demonstrated significantly higher intakes of whole grain (mean difference = 9.94, 95%CI: 7.13, 12.75, p < 0.001), fiber (mean difference = 3.07, 95% CI: 1.40, 4.73, p = 0.001), calcium (mean difference = 130.27, 95%CI: 74.15, 186.39, p < 0.001), thiamin (mean difference = 58.71, 95%CI: 26.15, 91.28, p = 0.001), riboflavin (mean difference = 0.84, 95%CI: 0.37, 1.32, p = 0.001), niacin (mean difference = 0.35, 95%CI: 1.91, 5.16, p < 0.001), and vitamin C (mean difference = 58.71, 95%CI: 26.15, 91.28, p = 0.001) compared to CG in T1, after adjusting for covariates. However, T1 results were not sustained in T2 when intervention had been discontinued. The findings indicate that intervention emphasizing whole grains improved overall short-term but not long-term dietary intake among schoolchildren. We hope the present trial will lead to adoption of policies to increase whole grain consumption among Malaysian schoolchildren.
Fulltext The Consumption of Dairy and Its Association with Nutritional Status in the South East Asian Nutrition Surveys (SEANUTS)

Nguyen Bao KL, Sandjaja S, Poh BK, Rojroongwasinkul N, Huu CN, Sumedi E, et al.

Nutrients, 2018 Jun 13;10(6).
PMID: 29899251 DOI: 10.3390/nu10060759

Despite a major decrease in undernutrition worldwide over the last 25 years, underweight and stunting in children still persist as public health issues especially in Africa and Asia. Adequate nutrition is one of the key factors for healthy growth and development of children. In this study, the associations between dairy consumption and nutritional status in the South East Asian Nutrition Survey (SEANUTS) were investigated. National representative data of 12,376 children in Indonesia, Malaysia, Thailand, and Vietnam aged between 1 and 12 years were pooled, representing nearly 88 million children in this age category. It was found that the prevalence of stunting and underweight was lower in children who consumed dairy on a daily basis (10.0% and 12.0%, respectively) compared to children who did not use dairy (21.4% and 18.0%, respectively) (p < 0.05). The prevalence of vitamin A deficiency and vitamin D insufficiency was lower in the group of dairy users (3.9% and 39.4%, respectively) compared to non-dairy consumers (7.5% and 53.8%, respectively) (p < 0.05). This study suggests that dairy as part of a daily diet plays an important role in growth and supports a healthy vitamin A and vitamin D status.
South East Asian Nutrition Surveys (SEANUTS) II - a multi-country evaluation of nutrition and lifestyle indicators in children aged 12 years and below: Rationale and Design

Tan SY, Poh BK, Sekartini R, Rojroongwasinkul N, Tran TN, Wong JE, et al.

Public Health Nutr, 2024 Apr 19.
PMID: 38639132 DOI: 10.1017/S1368980024000910

OBJECTIVE: To assess the nutritional status, growth parameters and lifestyle behaviours of children between 0.5-12 years in nationally representative samples in Malaysia, Indonesia, Thailand, and Vietnam.
DESIGN: A cross-sectional study was conducted in the four countries, between May 2019 and April 2021. Data collected can be categorized into four categories: (1) Growth - anthropometry, body composition, development disorder, (2) Nutrient intake and dietary habits - 24-hour dietary recall, child food habits, breast feeding and complementary feeding, (3) Socio-economic status - food insecurity and child health status/environmental, and (4) Lifestyle behaviours - physical activity patterns, fitness, sunlight exposure, sleep patterns, body image and behavioural problems. Blood samples were also collected for biochemical and metabolomic analyses. With the pandemic emerging during the study, a COVID-19 questionnaire was developed and implemented.
SETTING: Both rural and urban areas in Malaysia, Indonesia, Thailand, and Vietnam.
PARTICIPANTS: Children who were well, with no physical disability or serious infections/injuries and between the age of 0.5-12 years old were recruited.
RESULTS: The South East Asian Nutrition Surveys II recruited 13,933 children. Depending on the country, data collection from children were conducted in schools and commune health centres, or temples, or sub-district administrative organizations.
CONCLUSIONS: The results will provide up-to-date insights into nutritional status and lifestyle behaviours of children in the four countries. Subsequently, these data will facilitate exploration of potential gaps in dietary intake among Southeast Asian children and enable local authorities to plan future nutrition and lifestyle intervention strategies.
Sleep habits, food intake, and physical activity levels in normal and overweight and obese Malaysian children

Firouzi S, Poh BK, Ismail MN, Sadeghilar A

Obes Res Clin Pract, 2014 Jan-Feb;8(1):e70-8.
PMID: 24548579 DOI: 10.1016/j.orcp.2012.12.001

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.
Fulltext Sleep deprivation is related to obesity and low intake of energy and carbohydrates among working Iranian adults: a cross sectional study

Parvaneh K, Poh BK, Hajifaraji M, Ismail MN

Asia Pac J Clin Nutr, 2014;23(1):84-90.
PMID: 24561976 DOI: 10.6133/apjcn.2014.23.1.02

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.
Sensitivity And Specificity Of WHO-BMI Criteria For Obesity Of Asian Youth: The Asia-fit Study: 615 Board #5 June 1, 1: 00 PM - 3: 00 PM

Sai-Chuen Hui S, Suzuki K, Naito H, Balasekaran G, Song JK, Park SY, et al.

Med Sci Sports Exerc, 2016 May;48(5 Suppl 1):159.
PMID: 27584229 DOI: 10.1249/01.mss.0000485478.41107.7a
School health in Malaysia: where are we now?

Pavlin BI, Ali O, Poh BK

Asia Pac J Public Health, 2014 Sep;26(5 Suppl):4S-6S.
PMID: 25143526 DOI: 10.1177/1010539514545286
Fulltext Results from the Malaysia 2022 report card on physical activity for children and adolescents

Shahril MR, Unal TI, Wong JE, Sharif R, Koh D, Lee ST, et al.

J Exerc Sci Fit, 2023 Jan;21(1):88-94.
PMID: 36447627 DOI: 10.1016/j.jesf.2022.11.001

BACKGROUND: The Malaysia 2022 Report Card on Physical Activity for Children and Adolescents provides evidence-based assessment across 12 indicators of physical activity-related behaviors, individual characteristics, settings and sources of influence, and strategies and investments for children and adolescents.
METHODS: The development process follows the systematic steps recommended by the Active Healthy Kids Global Alliance was used. Nationally representative data from 2016 to 2021, government reports and unpublished data were reviewed and consolidated by a panel of experts. Letter grades were assigned based on predefined benchmarks to 12 indicators including 10 core physical activity indicators that are common to Global Matrix 4.0 and two additional indicators (Diet and Weight Status). The current grading was then compared against those obtained in 2016.
RESULTS: Four of six indicators in the Daily Behaviors category received D- or C grades [Overall Physical Activity, Active Transportation and Diet (D-); Sedentary Behaviors (C)], which remains poor, similar to the 2016 report card. School indicator was graded for the Settings and Sources of Influence category, which showed an improvement from grade B (2016) to A- (2022). As for the Strategies and Investments category, B was again assigned to the Government indicator. Two new indicators were added after the 2016 Report Card, and they were graded B (Physical Fitness) and B- (Weight Status). Four indicators (Organized Sports and Physical Activity, Active Play, Family and Peers, and Community and Environment) were again graded Incomplete due to a lack of nationally representative data.
CONCLUSION: The 2022 Report Card revealed that Malaysian children and adolescents are still caught in the "inactivity epidemic". This warrants more engagement from all stakeholders, public health actions, and timely research, to comprehensively evaluate all indicators and drive a cultural shift to see Malaysian children and adolescents moving more every day.
Results from Malaysia's 2016 report card on physical activity for children and adolescents

Sharif R, Chong KH, Zakaria NH, Ong ML, Reilly JJ, Wong JE, et al.

J Phys Act Health, 2016 11;13(11 Suppl 2):S201-S205.
PMID: 27848721 DOI: 10.1123/jpah.2016-0404

BACKGROUND: The 2016 Malaysia Active Healthy Kids Report Card aims to collect, assess, and grade current and comprehensive data on physical activity (PA) and associated factors in Malaysian children and adolescents aged 5 to 17 years.
METHODS: This report card was developed following the Active Healthy Kids Canada Report Card protocol. The Research Working Group identified the core matrices, assessed the key data sources, and evaluated the evidence gathered for grade assignments. A grade was assigned to each indicator by comparing the best available evidence against relevant benchmark using a standardized grading scheme.
RESULTS: Overall Physical Activity, Active Transportation, and Sedentary Behavior were assigned the D grade. The lowest grade of F was assigned to Diet, while School and Government Strategies and Investments were graded higher with a B. Five indicators were assigned INC (incomplete) due to a lack of representative data.
CONCLUSIONS: The report card demonstrates that Malaysian children and adolescents are engaging in low levels of PA and active commuting, high levels of screen time, and have extremely low compliance with dietary recommendations. More efforts are needed to address the root causes of physical inactivity while increasing the opportunities for children and adolescents to be more physically active.
MESH: screen time

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