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A biomarker for exposure to organophosphate and carbamate pesticides

Lubis SH, El Sersi M, Hussein SH, Sakian NI, Salleh R, Rafai J, et al.

Asia Pac J Public Health, 2008 Oct;20 Suppl:162-5.
PMID: 19533876

A cross sectional study was conducted to investigate the effects of pesticide exposure (organophosphate and carbamate) using nerve conductive velocity, current perception threshold (CPT). Cluster random sampling was employed to recruit 64 paddy farmers and 22 fishermen in June 2006. The duration of pesticide exposure was between (5-20) years. The CPT values were measured using Neurometer CPT/Eagle, on the index finger and the great toe with three neuroselective frequencies range (2000, 250, and 5 Hz). The results showed that at the three different frequencies, the CPT values were significantly elevated among farmers on both the medial and peroneal nerves (P < .002). The measurement of CPT can be used as a biomarker to determine and monitor the effects of organophosphate and carbamate exposure among workers who may have been exposed.
Fulltext A preliminary study of the influence of HIV infection in the transmission of tuberculosis

Mohammad Z, Naing NN, Salleh R, Ahmad N, Hamzah WM, Mahmud R

Southeast Asian J. Trop. Med. Public Health, 2002 Mar;33(1):92-8.
PMID: 12118468

The human immunodeficiency virus (HIV) epidemic has had a profound influence on the epidemiology of tuberculosis (TB). The potential for HIV-associated TB cases to transmit M. tuberculosis and to produce a secondary increase in TB morbidity is unknown. A cross-sectional study was carried out to compare the prevalence of M. tuberculosis infection among the household contacts of HIV-positive and HIV-negative pulmonary tuberculosis (PTB) patients. Records of tuberculin (Mantoux) tests administered during routine contact investigations at the Chest Clinic, Hospital Kota Bharu, from 1999 to 2000 were reviewed. The HIV status of the patients was based on the results of ELISA tests while information on household contacts was gathered during visits to their houses. Ninety-four contacts of 39 HIV-negative patients and 44 contacts of 17 cases of HIV-positive patients were included in this preliminary study. 30% (12/40) of the contacts of HIV-positive PTB had a positive tuberculin compared with 52.8% (47/ 94) of the contacts of HIV-negative patients [OR = 0.41, 95% Confidence interval (CI) 0.17 - 0.97; p = 0.016]. The difference was still significant after performing multivariate logistic regression analysis to adjust for variables associated with infectiousness of TB (adjusted OR = 0.24, 95% CI 0.07 - 0.87; p = 0.03). This study has shown that HIV-infected PTB patients are less infectious to their contacts than HIV-negative patients. The presence of MV in the community may not necessitate a change of the current policy of the management of contacts.
Study site: Chest Clinic, Hospital Kota Bharu, Kelantan, Malaysia
Abdominal obesity and its associated factors among older adults in Malaysia

Baharudin Shaharuddin A, Abdul Aziz NS, Ahmad MH, Manjit Singh JS, Chan YY, Palaniveloo L, et al.

Geriatr Gerontol Int, 2020 Dec;20 Suppl 2:68-72.
PMID: 33370864 DOI: 10.1111/ggi.13962

AIM: The rise in the prevalence of abdominal obesity (AO), in particular, has become a major concern as it contributes to diabetes, hypertension, high cholesterol, heart disease and certain types of cancer. The aim of this study is to determine the prevalence and associated factors of AO among older adults aged ≥60 years in Malaysia.
METHODS: This was a nationwide cross-sectional study using two-stage stratified random sampling. In total, 3977 older adults aged ≥60 years were involved in this study. Socio-demography characteristics were obtained using self-administered questionnaire. AO was measured using waist circumference and classified according to the cut-off values of ≥90 cm for men and ≥80 cm for women based on the WHO recommendation. Descriptive and multiple logistic regression analysis using a complex sample design were performed for data analysis.
RESULTS: Our findings showed that 2371 (67.3%) older adults had AO. Older adults who were from urban areas (69.7%), of women (78.4%), married (66.7%), with tertiary education (73.6%) and unemployed (70.9%) had the highest prevalence of AO. Those from urban areas (adjusted odds ratio [aOR] = 1.29), women (aOR = 3.12), unemployed (aOR = 1.14), diagnosed with hypertension (aOR = 1.56) and diabetes mellitus (aOR = 2.08) were also significantly associated with a higher risk of AO.
CONCLUSIONS: This study identified several risk factors that are associated with AO among older adults in Malaysia. Such information is important and needed to improve the healthcare system systematically, enable nutrition screening and appropriate intervention to combat the growing AO in Malaysia. Geriatr Gerontol Int 2020; 20: 68-72.
Fulltext Analysis of Available Nutrition Recommendations to Combat COVID-19: A Scoping Review

Che Abdul Rahim N, Manjit Singh JS, Pardi M, Zainuddin AA, Salleh R

Malays J Med Sci, 2021 Jun;28(3):18-45.
PMID: 34285642 DOI: 10.21315/mjms2021.28.3.3

The current COVID-19 pandemic remains severe. There is no doubt that the COVID-19 pandemic is affecting every aspect of our lives. Currently, the spread of inaccurate information or fake news on the internet to the public is causing the community to panic. Thus, this study aims to obtain available information on food and nutrition related to the prevention and treatment of COVID-19 from various sources. A scoping review framework was used to chart the evidence on nutritional recommendations to prevent COVID-19 based on the preferred method in reporting systematic review and meta-analysis extension for scoping reviews (PRISMA-ScR). The articles were categorised into three main groups: i) general dietary recommendations; ii) supplementation with specific micronutrients and iii) their mixtures and supplementation with traditional herbs and miscellaneous foods. A total of 60 articles met the inclusion criteria and were used in the review. This scoping review demonstrates that there is no miracle cure, food or supplement that can cure or prevent COVID-19. Currently, there is no confirmed treatment or vaccine for the disease. Practicing healthy eating habits is the best nutritional recommendation during the pandemic. Hence, this review hopefully will provide evidence-based nutrition recommendations that are available for current COVID-19 treatment. We hope that the authorities can inform the public and media to stop the spread of nutrition pseudoscience in the wake of the COVID-19 pandemic.
Association between dietary 3-monochloropropane-1,2-diol esters (3-MCPDE) and renal cancer in Peninsular Malaysia: exposure assessment and matched case-control study

Muhamad Rosli SH, Lau MS, Khalid T, Maarof SK, Jeyabalan S, Sirdar Ali S, et al.

Food Addit Contam Part A Chem Anal Control Expo Risk Assess, 2023 Apr;40(4):475-492.
PMID: 36947708 DOI: 10.1080/19440049.2023.2183068

3-Monochloropropane-1,2-diol esters (3-MCPDE) are food contaminants commonly found in refined vegetable oils and fats, which have possible carcinogenic implications in humans. To investigate this clinically, we conducted an occurrence level analysis on eight categories of retail and cooked food commonly consumed in Malaysia. This was used to estimate the daily exposure level, through a questionnaire-based case-control study involving 77 subjects with renal cancer, with 80 matching controls. Adjusted Odds Ratio (AOR) was calculated using the multiple logistic regression model adjusted for confounding factors. A pooled estimate of total 3-MCPDE intake per day was compared between both groups, to assess exposure and disease outcome. Among the food categories analysed, vegetable fats and oils recorded the highest occurrence levels (mean: 1.91 ± 1.90 mg/kg), significantly more than all other food categories (p
Body Weight, Body Weight Perception, and Bullying Among Adolescents in Malaysia

Ganapathy SS, Tan L, Sooryanarayana R, Hashim MH, Saminathan TA, Ahmad FH, et al.

Asia Pac J Public Health, 2019 11;31(8_suppl):38S-47S.
PMID: 31617372 DOI: 10.1177/1010539519879339

Body weight is a factor, with body weight perception a mediator, toward being a victim of bullying. This study aimed to explore the association between body weight, body weight perception, and bullying among students 13 to 17 years of age in Malaysia. Data were collected using a self-administered questionnaire. A 2-stage stratified cluster sampling design was used, and 212 schools across Malaysia were selected for this survey. Body weight was measured and body weight perception was the student's reflection of their body weight. The prevalence of being bullied among adolescents in Malaysia was 16.2%. Being too thin or being obese increased the probability of being bullied. Students with a normal body mass index, but with a misperception of their body weight, also had increased odds of being bullied. Obesity prevention, together with instilling positive body weight perception, should be part of all programs directed toward tackling the problem of bullying.
CMF-iteMS: An automatic threshold selection for detection of copy-move forgery

Abd Warif NB, Idris MYI, Abdul Wahab AW, Salleh R, Ismail A

Forensic Sci Int, 2019 Feb;295:83-99.
PMID: 30576953 DOI: 10.1016/j.forsciint.2018.12.004

Taking into consideration that the prior CMF detection methods rely on several fixed threshold values in the filtering process, we propose an efficient CMF detection method with an automatic threshold selection, named as CMF-iteMS. The CMF-iteMS recommends a PatchMatch-based CMF detection method that adapts Fourier-Mellin Transform (FMT) as the feature extraction technique while a new automatic threshold selection based on iterative means of regions size (iteMS) procedure is introduced to have flexibility in changing the threshold value for various characteristics (quality, sizes, and attacks) in each input image. To ensure the reliability of the proposed CMF-iteMS, the method is compared with four state-of-the-art CMF detection methods based on Scale Invariant Feature Transform (SIFT), patch matching, multi-scale analysis and symmetry techniques using three available datasets that cover the variety of characteristics in CMF images. The results show that the F-score of the CMF-iteMS outperformed existing CMF detection methods by exceeding an average of 90% F-score values for image-level evaluation and 82% of F-score value for pixel-level evaluation for all datasets in original size. As special attention is given to the image resizing attack, the method is able to maintain the highest performance even if the images in the datasets are resized to 0.25 parameter.
Fulltext Comparison between self-reported physical activity (IPAQ-SF) and pedometer among overweight and obese women in the MyBFF@home study

Ahmad MH, Salleh R, Mohamad Nor NS, Baharuddin A, Rodzlan Hasani WS, Omar A, et al.

BMC Womens Health, 2018 07 19;18(Suppl 1):100.
PMID: 30066635 DOI: 10.1186/s12905-018-0599-8

BACKGROUND: Several methods have been developed to determine a person's physical activity level. However, there is limited evidence in determining whether someone is physically active or not. This study aims to determine the level of physical activity and to compare the usage of short version International Physical Activity Questionnaire (IPAQ-SF) and pedometer among overweight and obese women who were involved in the My Body is Fit and Fabulous at home (MyBFF@home) study.
METHODS: Baseline and sixth month data from the MyBFF@home study were used for this purpose. A total of 169 of overweight and obese respondents answered the IPAQ-SF and were asked to use a pedometer for 7 days. Data from IPAQ-SF were categorised as inactive and active while data from pedometer were categorised as insufficiently active and sufficiently active by standard classification. Data on sociodemographic and anthropometry were also obtained. Cohen's kappa was applied to measure the agreement of IPAQ-SF and pedometer in determining the physical activity level. Pre-post cross tabulation table was created to evaluate the changes in physical activity over 6 months.
RESULTS: From 169 available respondents, 167 (98.8%) completed the IPAQ-SF and 107 (63.3%) utilised the pedometer. A total of 102 (61.1%) respondents were categorised as active from the IPAQ-SF. Meanwhile, only 9 (8.4%) respondents were categorised as sufficiently active via pedometer. Cohen's κ found there was a poor agreement between the two methods, κ = 0.055, p > 0.05. After sixth months, there was + 9.4% increment in respondents who were active when assessed by IPAQ-SF but - 1.3% reductions for respondents being sufficiently active when assessed by pedometer. McNemar's test determined that there was no significant difference in the proportion of inactive and active respondents by IPAQ-SF or sufficiently active and insufficiently active by pedometer from the baseline and sixth month of intervention.
CONCLUSION: The IPAQ-SF and pedometer were both able to measure physical activity. However, poor agreement between these two methods were observed among overweight and obese women.
Fulltext Dietary Patterns and Associated Factors Among Adolescents in Malaysia: Findings from Adolescent Nutrition Survey 2017

Man CS, Salleh R, Ahmad MH, Baharudin A, Koon PB, Aris T

Int J Environ Res Public Health, 2020 05 14;17(10).
PMID: 32423077 DOI: 10.3390/ijerph17103431

Balanced diet in the early stages of life plays a role in optimum growth and maintains good health status of adolescents. Dietary habits that are established during adolescence will sustain till adulthood. Therefore, this present study aims to identify the dietary patterns and to determine factors associated with dietary patterns in terms of socio-demographic characteristics, locality of schools, ethnicity, eating habits, self-perceived weight status, and food label reading habit among adolescents in Malaysia. Data from the Adolescent Nutrition Survey (ANS) 2017 was used for the present study. ANS is a population representative school-based cross-sectional study among school-going adolescents from primary four to secondary five from schools in 13 states and three federal territories registered under the Ministry of Education Malaysia. A self-administrated questionnaire was used to collect information on socio-demographic characteristics, locality of schools, ethnicity, eating habits, self-perceived weight status, and food label reading habit. A pre-tested face-to-face food frequency questionnaire (FFQ) was used to collect information on food group intake frequency. Dietary patterns were identified by using exploratory factor analysis and associated factors, using complex sample general linear model (GLM) analysis. All statistical analyses were carried out at 95% confidence interval or p-value < 0.05. The dietary patterns identified are healthy, unhealthy, and alternative proteins. The healthy dietary pattern was significantly associated with the types of school and ethnicity. The unhealthy dietary pattern was significantly associated with the locality of schools, ethnicity, frequency of snacks intake per week, frequency of eating out per week, self-perceived weight status, and food label reading habit. Significant associations were found between alternative proteins dietary pattern and locality of schools, ethnicity, and types of school. This study found that there is a disparity of dietary patterns between different ethnicity, locality of schools, and types of school. We recommend strategies of specifying ethnicity and geographical area to improve dietary patterns of adolescents in Malaysia.
Fulltext Electroconvulsive therapy for the acutely psychotic pregnant patient: a review of 3 cases

Loke KH, Salleh R

Med J Malaysia, 1983 Jun;38(2):131-3.
PMID: 6621443

Three cases of acute psychosis during pregnancy had been treated with electroconvulsive therapy (ECT) during their stay in hospital, due to their slow response to anti-psychotic medication. All three responded well to the treatment and two subsequently delivered normal healthy infants and they did not suffer maternal complications. The authors feel that ECT is as safe, if not safer than the use of high dosage of anti-psychotic medication and a review of the world literature appears to confirm this view. In addition, the psychotic process usually settles faster with the use of ECT than with the use of anti-psychotic drugs.
Fulltext Enhanced weight-based clustering algorithm to provide reliable delivery for VANET safety applications

Bello Tambawal A, Md Noor R, Salleh R, Chembe C, Oche M

PLoS One, 2019;14(4):e0214664.
PMID: 30946766 DOI: 10.1371/journal.pone.0214664

A vehicular ad hoc network (VANET) is an emerging and promising wireless technology aimed to improve traffic safety and provide comfort to road users. However, the high mobility of vehicles and frequent topology changes pose a considerable challenge to the reliable delivery of safety applications. Clustering is one of the control techniques used in VANET to make the frequent topology changes less dynamic. Nevertheless, research has shown that most of the existing clustering algorithms focus on cluster head (CH) election with very few addressing other critical issues such as cluster formation and maintenance. This has led to unstable clusters which could affect the timely delivery of safety applications. In this study, enhanced weight-based clustering algorithm (EWCA) was developed to address these challenges. We considered any vehicle moving on the same road segment with the same road ID and within the transmission range of its neighbour to be suitable for the cluster formation process. This was attributed to the fact that all safety messages are expected to be shared among the vehicles within the vicinity irrespective of their relative speedto avoid any hazardous situation. To elect a CH, we identified some metrics on the basis of the vehicle mobility information. Each vehicle was associated with a predefined weight value based on its relevance. A vehicle with the highest weight value was elected as the primary cluster head (PCH). We also introduced a secondary cluster head (SeCH) as a backup to the PCH to improve the cluster stability. SeCH took over the leadership whenever the PCH was not suitable for continuing with the leadership. The simulation results of the proposed approach showed a better performance with an increase of approximately40%- 45% in the cluster stability when compared with the existing approaches. Similarly, cluster formation messages were significantly minimized, hence reducing the communication overhead to the system and improving the reliable delivery of the safety applications.
Fulltext Eyelid hook injury - A preventable domestic injury

Omar N, Salleh R

Saudi J Ophthalmol, 2009 Oct;23(3-4):219-20.
PMID: 23960864 DOI: 10.1016/j.sjopt.2009.10.007

The aim of this report is to describe the presentation and management of eyelid injury resulting from the hook of a rubber string. A seven-year-old boy presented with pain of the right upper eyelid. A rubber string with metal hook ends, snatched his right eye from below. The hook pierced through his upper eyelid from the conjunctival surface and remained in situ. However, there was no globe laceration noted. Removal was performed by reverse-tracking of the hook through the wound. The wound was stitched with 6'0 Vicryl sutures. Healing was excellent with minimal scarring.
Fulltext Factors Associated with High Sodium Intake Assessed from 24-hour Urinary Excretion and the Potential Effect of Energy Intake

Othman F, Ambak R, Siew Man C, Mohd Zaki NA, Ahmad MH, Abdul Aziz NS, et al.

J Nutr Metab, 2019;2019:6781597.
PMID: 31192010 DOI: 10.1155/2019/6781597

Dietary consumption and other environmental factors are known factors associated with sodium intake. However, little is known about the influence of energy intake on this relationship. The aim of this study was to determine the risk factors associated with high sodium intake assessed from urine sodium excretion and the influence of energy intake. A nationwide, cross-sectional study was conducted from 2015 to 2016 among Malaysian health staff (MySalt 2015). A total of 1027 participants from 1568 targeted participants aged 18 years and older that were randomly selected were included in this study. Sodium intake was determined by measuring sodium excretion in the 24 hr urine test. Dietary, sociodemography, and anthropometry variables as associated risk factors were assessed. Multiple logistic regression models were used to determine the association between high sodium intake (≥2000 mg/day urinary sodium) and potential risk factors. The prevalence of high sodium intake in this study was 70.1% (n=733). High sodium intake was associated with male (OR 1.93, 95% confidence interval (CI) 1.41, 2.64), Bumiputera Sarawak ethnicity (OR 0.24, 95% CI 0.09, 0.62), and energy-adjusted sodium intake (mg/d) (OR 1.19, 95% CI 1.03-1.39). Our results suggested that sex, ethnicity, and energy-adjusted sodium consumption were strong risk factors associated with high sodium intake independent from energy and other potential confounding factors.
Factors contributing to food insecurity among older persons in Malaysia: Findings from the National Health and Morbidity Survey (NHMS) 2018

Salleh R, Man CS, Ahmad MH, Palaniveloo L, Zulkafly N, Ab Halim SA, et al.

Geriatr Gerontol Int, 2020 Dec;20 Suppl 2:73-78.
PMID: 33370860 DOI: 10.1111/ggi.14006

AIM: Older persons are vulnerable to food insecurity. Therefore, this study aimed to determine the prevalence of food insecurity and associated factors among older persons in Malaysia.
METHODS: This is a cross-sectional study with two-stage stratified random sampling. In total, 3977 older persons participated in this study. Face-to-face interviews were conducted using a mobile device to obtain information about socio-demographic background, food insecurity, non-communicable diseases, social support and living arrangements. Descriptive and multiple complex sample logistic regression analyses were performed for data analysis.
RESULTS: The overall prevalence of food insecurity among older persons was 10.4%. Older persons from rural areas with no or only primary and secondary education, income less than RM 2000 (USD 477.57), at risk of malnutrition and not receiving very high social support were more likely to be food-insecure.
CONCLUSION: Approximately, one-tenth of Malaysian older adults were classified as food-insecure; particularly those living in rural areas from lower socio-economic status, not receiving very high social support and malnourished were more likely to be at risk. A specific nutrition program, such as meals on wheels and food vouchers, should be targeted toward older persons who are at risk to improve their malnutrition status. Geriatr Gerontol Int 2020; 20: 73-78.
Fulltext Factors contributing to poor compliance with anti-TB treatment among tuberculosis patients

Naing NN, D'Este C, Isa AR, Salleh R, Bakar N, Mahmod MR

Southeast Asian J. Trop. Med. Public Health, 2001 Jun;32(2):369-82.
PMID: 11556591

Tuberculosis (TB) has made a comeback. It has become a resurgent public health problem in developing countries in the tropics and is the leading cause of death from any single infectious agent. Non-compliance to anti-tuberculosis treatment is the most serious problem in TB control. A cross-sectional study was conducted to investigate the determinants of poor compliance with anti-tuberculosis treatment among tuberculosis patients in Kota Bharu, Kelantan, Malaysia in 1999. A total of 390 patients were included in the study of which 130 were tuberculosis patients who defaulted treatment and 260 were those compliant to treatment. Data collection was done by interviewing the patients and collecting clinical and laboratory data from their medical records. Using multiple logistic regression analysis, patients who were not on direct observed therapy (DOT) lived distant to the health facility, were non-intravenous drug users (IVDU) and were HIV positive had statistically significant higher odds of being non-compliant. Patients should be given treatment under direct supervision with special attention to IVDU and HIV positive groups. Anti-TB treatment should be accessible to patients at the nearest health center from their residence. Interventions with health education programs emphasizing the benefits of treatment compliance should be implemented by further large-scale multicentered studies.
Study site: Chest clinic, Hospital Kota Bharu, Kelantan, Malaysia
Fulltext High sodium food consumption pattern among Malaysian population

Ahmad MH, Man CS, Othman F, He FJ, Salleh R, Noor NSM, et al.

J Health Popul Nutr, 2021 05 31;40(Suppl 1):4.
PMID: 34059160 DOI: 10.1186/s41043-021-00230-5

BACKGROUND: Sodium is an essential mineral needed by the human body that must be obtained from food. An excess intake, however, can lead to many diseases. As food is the main source of sodium, this study aims to provide information on high sodium food consumption patterns in the Malaysian adult population.
METHODS: The Malaysian Community Salt Study (MyCoSS) was a nationwide cross-sectional study, conducted between October 2017 and March 2018. A multistage complex sample was applied to select a nationally representative sample of respondents aged 18 years and above. Face to face interview by a validated Food Frequency Questionnaire (FFQ) comprising 104 food items was used to gain information on high sodium food consumption patterns.
RESULTS: A total of 1047 respondents were involved in this study, with 1032 (98.6%) answering the FFQ. From the number, 54.1% exceed the recommendation of sodium intake <2000mg/day by FFQ assessment. The results also demonstrated that fried vegetables (86.4%) were the most common high sodium food consumed, followed by bread (85.9%) and omelet (80.3%). In urban areas, bread was the most common while fried vegetables took the lead in rural areas. By sex, bread was most commonly eaten by males and fried vegetables by females. The results also found that kolok mee/kampua mee contributed the highest sodium, 256.5mg/day in 9.0% adult population, followed by soy sauce 248.1mg/day in 33.2% adult population, and curry noodles 164.2mg/day in 18.5% adult population.
CONCLUSION: Fried vegetables, bread, and soy sauce were the main source of sodium consumption among adult. Reducing the amount of sodium added to these foods should be the top priority to reduce population sodium intake and thereby prevent sodium-related diseases in Malaysia.
Incidence of esophageal carcinoma among Malays in North-Eastern Peninsular Malaysia: an area with an exceptionally low prevalence of Helicobacter pylori infection

Lee YY, Raj SM, Sharif SE, Salleh R, Ayub MC, Graham DY

Dig Dis Sci, 2011 May;56(5):1438-43.
PMID: 21082350 DOI: 10.1007/s10620-010-1473-1

Obesity, gastroesophageal reflux, and Barrett's esophagus have all been linked to esophageal adenocarcinoma. In addition, the decline in Helicobacter pylori (H. pylori) infection in affluent societies has also been suggested to be a major factor in the recent rise in the incidence of esophageal adenocarcinoma. If H. pylori infection has a protective role, populations with a naturally low prevalence of H. pylori infection such as the ethnic Malays of Northeastern Peninsular Malaysia should have high rates of esophageal adenocarcinoma.
Fulltext Is socio-demographic status, body mass index, and consumption of food away from home associated with high sodium intake among adults in Malaysia?: findings from the Malaysian Community Salt Survey (MyCoSS)

Salleh R, Ganapathy SS, Ibrahim Wong N, Cheong SM, Ahmad MH, Palaniveloo L, et al.

J Health Popul Nutr, 2021 05 31;40(Suppl 1):12.
PMID: 34059166 DOI: 10.1186/s41043-021-00236-z

BACKGROUND: Studies have shown that having away from home meals contributes to high sodium intake among young people and those who lived in urban areas. This study aimed to determine the association between dietary sodium intake, body mass index, and away from home meal consumption behaviour among Malaysian adults.
METHODS: MyCoSS was a cross-sectional household survey involving 1440 adults age 18 years and above. This study utilized stratified cluster sampling to obtain a nationally representative sample. Data was collected between October 2017 and March 2018. Socio-demographic information, dietary assessment using food frequency questionnaire (FFQ), and away from home meal consumption were assessed through a face-to-face interview by trained health personnel. Descriptive analysis and logistic regression were applied to identify the association of socioeconomic status and away from home meal consumption with dietary sodium intake.
RESULTS: A total of 1032 participants completed the FFQ, with a mean age of 48.8 + 15.6 years. Based on the FFQ, slightly over half of the participants (52.1%) had high sodium intake. Results showed that 43.6% of participants consumed at least one to two away from home meals per day, while 20.8% of them had their three main meals away from home. Participants aged less than 30 years old were the strongest predictor to consume more sodium (adjusted OR: 3.83; 95%CI: 2.23, 6.58) while those of Indian ethnicity had significantly lower sodium intake. Surprisingly, having three away from home meals per day was not associated with high dietary sodium intake, although a significant association (crude OR; 1.67, 95% CI: 1.19, 2.35) was found in the simple logistic regression. Obese participants were less likely to have high dietary sodium intake compared with the normal BMI participants in the final model.
CONCLUSION: Over half of the participants consumed sodium more than the recommended daily intake, especially those who consumed three away from home meals. However, there was no significant association between high sodium intake and having three away from home meals per day. The promotion of healthy cooking methods among the public must continue to be emphasized to reduce the dietary sodium intake among Malaysian adults.
Fulltext Knowledge, perception, and practice related to sodium intake among Malaysian adults: findings from the Malaysian Community Salt Study (MyCoSS)

Cheong SM, Ambak R, Othman F, He FJ, Salleh R, Mohd Sallehudin S, et al.

J Health Popul Nutr, 2021 05 31;40(Suppl 1):5.
PMID: 34059162 DOI: 10.1186/s41043-021-00231-4

BACKGROUND: Excessive intake of sodium is a major public health concern. Information on knowledge, perception, and practice (KPP) related to sodium intake in Malaysia is important for the development of an effective salt reduction strategy. This study aimed to investigate the KPP related to sodium intake among Malaysian adults and to determine associations between KPP and dietary sodium intake.
METHODS: Data were obtained from Malaysian Community Salt Survey (MyCoSS) which is a nationally representative survey with proportionate stratified cluster sampling design. A pre-tested face-to-face questionnaire was used to collect information on socio-demographic background, and questions from the World Health Organization/Pan American Health Organization were adapted to assess the KPP related to sodium intake. Dietary sodium intake was determined using single 24-h urinary sodium excretion. Respondents were categorized into two categories: normal dietary sodium intake (< 2000 mg) and excessive dietary sodium intake (≥ 2000 mg). Out of 1440 respondents that were selected to participate, 1047 respondents completed the questionnaire and 798 of them provided valid urine samples. Factors associated with excessive dietary sodium intake were analyzed using complex sample logistic regression analysis.
RESULTS: Majority of the respondents knew that excessive sodium intake could cause health problems (86.2%) and more than half of them (61.8%) perceived that they consume just the right amount of sodium. Overall, complex sample logistic regression analysis revealed that excessive dietary sodium intake was not significantly associated with KPP related to sodium intake among respondents (P > 0.05).
CONCLUSION: The absence of significant associations between KPP and excessive dietary sodium intake suggests that salt reduction strategies should focus on sodium reduction education includes measuring actual dietary sodium intake and educating the public about the source of sodium. In addition, the relationship between the authority and food industry in food reformulation needs to be strengthened for effective dietary sodium reduction in Malaysia.
Fulltext Low potassium intake and its association with blood pressure among adults in Malaysia: findings from the MyCoSS (Malaysian Community Salt Survey)

Palaniveloo L, Ambak R, Othman F, Mohd Zaki NA, Baharudin A, Abdul Aziz NS, et al.

J Health Popul Nutr, 2021 05 31;40(Suppl 1):7.
PMID: 34059161 DOI: 10.1186/s41043-021-00238-x

BACKGROUND: High blood pressure or hypertension is well recognized as an important modifiable risk factor for cardiovascular diseases. Several studies had indicated potassium intake has a blood pressure lowering effect. This study aimed to estimate potassium intake via 24-h urinary potassium excretion and to determine the association between potassium intake and blood pressure among adults in Malaysia.
METHODS: Data for 424 respondents in this study were drawn from MyCoSS, a nationwide cross- sectional study conducted among Malaysians who were 18 years and above. Respondents were recruited using stratified cluster sampling, covering urban and rural areas in each state in Malaysia. Data collection was undertaken from October 2017 until March 2018. A single urine sample was collected over 24 h for quantification of potassium excreted. Information on socio-demography and medical history of the respondents were collected by interviewer-administered questionnaires. Anthropometric measurements were measured using validated equipment. BMI was estimated using measured body weight and height. Digital blood pressure monitor (Omron HBP-1300) was used to measure blood pressure. Descriptive statistics, analysis of variance (ANOVA), and multivariable linear regression were used to analyze the data in SPSS Version 21.
RESULTS: Mean 24-h urinary potassium excretion for the 424 respondents was 37 mmol (95% CI 36, 38). Gender and ethnicity showed statistically significant associations with 24-h urinary potassium excretion. However, potassium excretion was not significantly associated with blood pressure in this study.
CONCLUSION: Potassium intake is very low among the adults in Malaysia. Therefore, further education and promotional campaigns regarding daily consumption of potassium-rich diet and its benefits to health need to be tailored for the Malaysian adult population.

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