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  1. Report of a seminar and workshop on Food-based Dietary Guidelines and Nutrition Education: Bridging Science and Communication
    Florentino R, Tee ES, Poh BK
    Asia Pac J Clin Nutr, 1999 Dec;8(4):291-9.
    PMID: 24394232
    The 3-day seminar-workshop on 'Food-based Dietary Guidelines and Nutrition Education' was held from 22-24 July 1998 in Kuala Lumpur, Malaysia to present the latest scientific information on nutrition and health and to discuss its impact on the rationale and process for the development of food-based dietary guidelines (FBDG). The first two sessions were devoted to a review of the current information on the relation between lifestyle factors and chronic diseases, particularly obesity; the present health status and food consumption patterns in Malaysia; the current consensus on carbohydrates and fats and oils and the importance of considering the glycemic index of foods; and the importance of micronutrients in health and disease. The third and fourth sessions dealt with the rationale of FBDG and the process of their development, drawing from the 1990 FAO/WHO Consultation on Development of FBDG and the experience in the Philippines and in Europe. The importance of effective dissemination of nutrition messages to the public was thoroughhly discussed. The workshop sessions arrived at recommendations on important issues in the development of FBDG in the region, including main research and information needs, the steps in the development of FBDG, and strategies for their dissemination.
  2. Fulltext Predictive equations for the estimation of basal metabolic rate in Malaysia adolescents
    Poh BK, Ismail M, Zawiah H, Henry C
    Malays J Nutr, 1999 Dec;5(1):1-14.
    PMID: 22692353
    A longitudinal study was conducted to relate basal metabolic rate (BMR) with growth during adolescence. Subjects comprise 70 boys and 69 girls aged between ten and thirteen years at the time of recruitment. Parameters studied include anthropometric measurements and BMR, which was measured by indirect calorimetry using the Deltatrac metabolic monitor. Measurements were carried out serially once every six months, with a total of 713 BMR data points collected over three years. Mean BMR of boys aged 11, 12, 13 and 14 years were 4.96 ± 0.63 MJ/day, 5.28 ± 0.71 MJ/day, 5.73 ± 0.68 MJ/day and 5.92 ± 0.63 MJ/day, respectively; while mean BMR of girls in the 10, 11, 12 and 13 year age groups were 4.96 ± 0.63 MJ/day, 4.85 ± 0.63 MJ/day, 5.05 ± 0.55 MJ/day and 4.94 ± 0.51 MJ/day, respectively. Comparison of measured BMR with BMR values predicted from the FAO/WHO/UNU (1985) equations shows that the predictive equations overestimated the BMR of Malaysian boys by 3% and that of girls by 5%. The Henry and Rees (1991) equations for populations in the tropics underestimated BMR of boys and girls by 1% and 2%, respectively. Linear regression equations to predict BMR based on body weight were derived according to sex and age groups. It is recommended that these predictive equations be used for the estimation of BMR of Malaysian adolescents.
  3. Determinants of linear growth in Malaysian children with cerebral palsy
    Zainah SH, Ong LC, Sofiah A, Poh BK, Hussain IH
    J Paediatr Child Health, 2001 Aug;37(4):376-81.
    PMID: 11532058
    OBJECTIVE: To compare the linear growth and nutritional parameters of a group of Malaysian children with cerebral palsy (CP) against a group of controls, and to determine the nutritional, medical and sociodemographic factors associated with poor growth in children with CP.

    METHODOLOGY: The linear growth of 101 children with CP and of their healthy controls matched for age, sex and ethnicity was measured using upper-arm length (UAL). Nutritional parameters of weight, triceps skin-fold thickness and mid-arm circumference were also measured. Total caloric intake was assessed using a 24-h recall of a 3-day food intake and calculated as a percentage of the Recommended Daily Allowance. Multiple regression analysis was used to determine nutritional, medical and sociodemographic factors associated with poor growth (using z-scores of UAL) in children with CP.

    RESULTS: Compared with the controls, children with CP had significantly lower mean UAL measurements (difference between means -1.1, 95% confidence interval -1.65 to - 0.59), weight (difference between means -6.0, 95% CI -7.66 to -4.34), mid-arm circumference (difference between means -1.3, 95% CI -2.06 to -0.56) and triceps skin-fold thickness (difference between means -2.5, 95% CI -3.5 to -1.43). Factors associated with low z-scores of UAL were a lower percentage of median weight (P < 0.001), tube feeding (P < 0.001) and increasing age (P < 0.001).

    CONCLUSION: A large proportion of Malaysian children with CP have poor nutritional status and linear growth. Nutritional assessment and management at an early age might help this group of children achieve adequate growth.

  4. New predictive equations for estimation of basal metabolic rates of adolescents: tropics versus temperate
    Noor MI, Poh BK, Zawiah H, Henry CJ
    Forum Nutr, 2003;56:250-3.
    PMID: 15806886
    The energy and nutritional requirements of adolescents are influenced primarily by the growth spurt that occurs at puberty, and also by the need to maintain adequate levels of physical activity. Predictions of BMR have gained attention since the publication of the FAO/WHO/UNU (1985) expert consultation report, which adopted the principle of relying on energy expenditure rather than energy intake to derive requirement of individuals. While the report predicts BMR accurately in many individuals from temperate climate, they are said to be less accurate in predicting BMR in populations living in the tropics. The collation of worldwide data on basal metabolism indicated that, relative to adults, there was a paucity of data in other age groups including the adolescents. Although several BMR studies among children had been reported in the 90's, the data in normal weight children are almost exclusively from small control groups in obesity studies. Furthermore, we know little as to whether BMR of children differs in differing climatic conditions. This paper presents predictive equations for estimating BMR from a two-centre study, Bangi (Malaysia) and Oxford (UK) and to compare the results with the currently used predictive equations.
  5. Fulltext Postpartum dietary intakes and food taboos among chinese women attending maternal and child health clinics and Maternity Hospital, Kuala Lumpur
    Poh BK, Wong YP, Abdul Karim N
    Malays J Nutr, 2005;11(1):1-21-.
    MyJurnal
    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
  6. Fulltext Food consumption patterns: Findings from the Malaysian Adult Nutrition Survey (MANS)
    Norimah AK, Safiah M, Jamal K, Haslinda S, Zuhaida H, Rohida S, et al.
    Malays J Nutr, 2008 Mar;14(1):25-39.
    PMID: 22691762 MyJurnal
    This study reports the food consumption patterns of adults aged 18 to 59 years in the Malaysian Adults Nutrition Survey (MANS) carried out between October 2002 and December 2003. A total of 6,742 subjects comprising 3,274 men and 3,468 women representing the northern, central , southern and east coast of Peninsular Malaysia as well as Sabah and Sarawak were interviewed. A semiquantitative food frequency questionnaire (FFQ) which consisted of 126 food items was used to evaluate the food consumption pattern (habitual food intake) of the respondents during the previous one- year period. The results demonstrate that nasi putih (cooked rice) was consumed by 97% of the population twice daily (average 2½ plates per day). Other food items consumed daily were marine fish, (one medium fish per day), green leafy vegetables (one cup per day) and sweetened condensed milk (three teaspoons per day. The mean frequencies for daily intake of rice, leafy vegetables, marine fish, local kuih, anchovy (ikan bilis) and biscuits were significantly higher among the rural compared to the urban adults. In contrast, more urban dwellers consumed chicken and eggs more frequently than their rural counterparts. More men than women consumed chicken and eggs more frequently. Malaysian adults showed a satisfactory habit of drinking plain water, with 99% drinking at least six glasses of plain water daily. Other beverages such as tea (47%), coffee (28%), chocolate-based drinks (23%) and cordial syrup (11%) were also consumed on daily basis, however, in a smaller proportion of the population. There were differences in the prevalence of daily consumption of foods when comparing urban and rural population, and also between men and women. The prevalence of daily consumption of marine fish among rural and urban adults was 51% and 34% respectively. For sweetened condensed milk, men and women consumed 43% and 28% respectively; however, more women drank full cream milk than men. Between the age groups, 21% of adults below 20 years old consumed chicken at least once a day, while this pattern of intake was not shown in the older age groups. Our findings show that adults, aged 50 to 59 years old, had the highest prevalence of daily consumption of full cream milk with 24% while those aged 18 to 19 years old had the lowest prevalence of daily consumption at 15%. The food consumption pattern of Malaysian adults appears to be satisfactory. However, some changes in food habits are recommended especially in substituting the less wholesome sweetened condensed milk with the more nutritious full cream or skimmed milk.
    Study name: Malaysian Adult Nutrition Survey (MANS-2003)
  7. Fulltext Body mass index (BMI) of adults: Findings of the Malaysian Adult Nutrition Survey (MANS)
    Azmi MY, Junidah R, Siti Mariam A, Safiah MY, Fatimah S, Norimah AK, et al.
    Malays J Nutr, 2009 Sep;15(2):97-119.
    PMID: 22691810 MyJurnal
    The Malaysian Adults Nutrition Survey (MANS) was carried out between October 2002 and July 2003, involving 6,775 men and 3,441 women aged 18 - 59 years. Anthropometric assessment showed that the overall mean body weight and BMI were 62.65 kg (CI: 62.20, 63.09) and 24.37 kg/m2 (CI: 24.21, 24.53) respectively. Based on the WHO (1998) classification of BMI, 12.15% (CI: 11.26, 13.10) were obese (BMI > 30 kg/m2), and 26.71% (CI: 25.50, 27.96) overweight (BMI > 25 - 29.9 kg/m2). Significantly, more women were obese [14.66% (CI: 13.37, 16.04)] while significantly more men were overweight [28.55% (CI: 26.77, 30.40)]. Ethnicitywise, prevalence of obesity was highest among the Malays [15.28% (CI: 13.91, 16.77)] while overweight was highest for the Indians [31.01% (CI: 26.64, 35.76)]. Both obesity and overweight were highest among those aged 40 - 49 years. Obesity was highest for those whose household income was between RM1,500 - 3,500 while overweight was more prevalent for those whose household income exceeded RM3,500. The prevalence of overweight was highest for those with primary education [31.90% (CI: 29.21, 34.72)]. There was no significant urban rural differential in both obesity and overweight. The study found 9.02% (CI:8.82, 10.61) with chronic energy deficiency (CED) (BMI < 18.5 kg/m2). The prevalence of CED was relatively higher in the indigenous population (Orang Asli) [14.53% (CI: 5.14, 34.77)], subjects aged 18-19 years [26.24% (CI: 21.12, 32.09)], and with monthly household income of < RM1,500 [10.85% (CI: 9.63, 12.20)]. The prevalence of CED was not significantly different among the geographical zones and educational levels, and between urban/rural areas and sexes. The results call for priority action to address the serious problem of overweight and obesity among Malaysian adults as it poses a grave burden to the country's resources and development.
    Study name: Malaysian Adult Nutrition Survey (MANS-2003)
  8. 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.
  9. Fulltext Factors associated with poor academic achievement among urban primary school children in Malaysia
    Ong LC, Chandran V, Lim YY, Chen AH, Poh BK
    Singapore Med J, 2010 Mar;51(3):247-52.
    PMID: 20428748
    The aim of this study was to identify factors associated with poor academic achievement during the early school years.
  10. Fulltext Metabolic Syndrome Based on IDF Criteria in a Sample of Normal Weight and Obese School Children
    Quah YV, Poh BK, Ismail MN
    Malays J Nutr, 2010 Aug;16(2):207-17.
    PMID: 22691926 MyJurnal
    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%).
  11. Fulltext Predictive equation for estimating the basal metabolic rate of Malaysian Armed Forces naval trainees
    Razalee S, Poh BK, Ismail MN
    Singapore Med J, 2010 Aug;51(8):635-40.
    PMID: 20848060
    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.
  12. Plasma vitamin C and tocotrienols changes in response to dietary supplementation among young male adults
    Zahara AM, Lee CC, Fatimah IS, Poh BK, Khairul O, Das S, et al.
    Clin Ter, 2010;161(2):121-4.
    PMID: 20499024
    Intake of the antioxidant vitamins C and E lowers the oxidative stress. The study aimed to determine plasma concentrations of vitamin C and tocotrienols after supplementation of both vitamins in young male adults.
  13. 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.
  14. Ethnic differences in the relationship between body mass index and percentage body fat among Asian children from different backgrounds
    Liu A, Byrne NM, Kagawa M, Ma G, Poh BK, Ismail MN, et al.
    Br J Nutr, 2011 Nov;106(9):1390-7.
    PMID: 21736824 DOI: 10.1017/S0007114511001681
    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.
  15. Validation of bioelectrical impedance analysis for total body water assessment against the deuterium dilution technique in Asian children
    Liu A, Byrne NM, Ma G, Nasreddine L, Trinidad TP, Kijboonchoo K, et al.
    Eur J Clin Nutr, 2011 Dec;65(12):1321-7.
    PMID: 21731041 DOI: 10.1038/ejcn.2011.122
    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.
  16. Fulltext Risk of metabolic syndrome among children living in metropolitan Kuala Lumpur: a case control study
    Wee BS, Poh BK, Bulgiba A, Ismail MN, Ruzita AT, Hills AP
    BMC Public Health, 2011;11:333.
    PMID: 21592367 DOI: 10.1186/1471-2458-11-333
    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.
  17. Fulltext High prevalence of vitamin D insufficiency and its association with BMI-for-age among primary school children in Kuala Lumpur, Malaysia
    Khor GL, Chee WS, Shariff ZM, Poh BK, Arumugam M, Rahman JA, et al.
    BMC Public Health, 2011;11:95.
    PMID: 21310082 DOI: 10.1186/1471-2458-11-95
    Deficiencies of micronutrients can affect the growth and development of children. There is increasing evidence of vitamin D deficiency world-wide resulting in nutritional rickets in children and osteoporosis in adulthood. Data on the micronutrient status of children in Malaysia is limited. The aim of this study was to determine the anthropometric and micronutrient status of primary school children in the capital city of Kuala Lumpur.
  18. Fulltext Nutritional status, dietary intake patterns and nutrition knowledge of children aged 5-6 years attending kindergartens in the Klang Valley, Malaysia
    Poh BK, Kathryn Tham BL, Wong SN, Winnie Chee SS, Tee ES
    Malays J Nutr, 2012 Aug;18(2):231-42.
    PMID: 24575669 MyJurnal
    Early childhood is a period during which many factors influence the development of lifelong eating habits. This study aimed to assess the nutritional status of young children and to determine factors related to eating habits.
  19. Fulltext Meal patterns of Malaysian adults: findings from the Malaysian adults nutrition survey (MANS)
    Wan Abdul Manan WM, Nur Firdaus I, Safiah MY, Siti Haslinda MD, Poh BK, Norimah AK, et al.
    Malays J Nutr, 2012 Aug;18(2):221-30.
    PMID: 24575668 MyJurnal
    INTRODUCTION: Meal patterns have received little attention in nutrition studies. The aim of this study is to present the findings on general meal patterns of Malaysian adults.
    METHODS: The Malaysian Adults Nutrition Survey (MANS), carried out in 2002 and 2003, involved 6,928 adults selected by stratified random sampling from all households by zone in Peninsular Malaysia, Sabah and Sarawak.
    RESULTS: In general, the results showed that most respondents (74.16%) ate three meals per day; 89.20% of the respondents consumed breakfast, while 88.57% consumed lunch and 91.97% consumed dinner with no significant difference in terms of sex. In Peninsular Malaysia, the Northern Zone had the highest number of people consuming breakfast compared to other zones. Meanwhile, the population in Sarawak had the largest proportion of people consuming lunch and dinner, but the smallest proportion of people consuming breakfast. A significantly higher number of the rural population consumed breakfast and lunch than urbanites; however there was no significant difference in dinner consumption. Generally, breakfast consumption increased with age whereby significant difference existed between the 18 to 19 years age group and the age group of 30 years and older. Lunch intake among the age groups showed no significant difference. In contrast, dinner consumption was significantly lower among the 18 to 19 years age group compared to all other age groups. Comparison among the ethnic groups showed that the Indian population had the lowest percentage of having breakfast and lunch while the Orang Asli had the lowest percentage of consuming dinner. However, the Orang Asli recorded the highest percentage for taking breakfast and lunch while the Chinese had the highest percentage of taking dinner.
    CONCLUSION: Considering that Malaysian adults consumed their conventional breakfast, lunch and dinner, these findings indicatethat Malaysians are maintaining their traditional meal patterns.
    Study name: Malaysian Adult Nutrition Survey (MANS-2003)
  20. Nutritional status among pediatric cancer patients: a comparison between hematological malignancies and solid tumors
    Tah PC, Nik Shanita S, Poh BK
    J Spec Pediatr Nurs, 2012 Oct;17(4):301-11.
    PMID: 23009042 DOI: 10.1111/j.1744-6155.2012.00341.x
    This study aimed to compare the nutritional status of pediatric patients with hematological malignancies and solid tumors.
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