Poor appetite is one of the main contributing factors of poor nutritional status among elderly individuals. Recognizing the importance of assessment of appetite, a cross sectional study was conducted to determine the validity of appetite screening tools namely, the Council on Nutrition Appetite questionnaire (CNAQ) and the simplified nutritional appetite questionnaire (SNAQ) against the appetite, hunger and sensory perception questionnaire (AHSPQ), measures of nutritional status and food intake among geriatric patients at the main general hospital in Malaysia. Nutritional status was assessed using the subjective global assessment (SGA) while food intake was measured using the dietary history questionnaire (DHQ). Anthropometric parameters included weight, height, body mass index (BMI), calf circumference (CC) and mid upper arm circumference (MUAC). A total of 145 subjects aged 60 to 86 years (68.3 ± 5.8 years) with 31.7% men and 68.3% women were recruited from outpatients (35 subjects) and inpatients (110 subjects) of Kuala Lumpur Hospital of Malaysia. As assessed by SGA, most subjects were classified as mild to moderately malnourished (50.4%), followed by normal (38.6%) and severely malnourished (11.0%). A total of 79.3% and 57.2% subjects were classified as having poor appetite according to CNAQ and SNAQ, respectively. CNAQ (80.9%) had a higher sensitivity than SNAQ (69.7%) when validated against nutritional status as assessed using SGA. However, the specificity of SNAQ (62.5%) was higher than CNAQ (23.2%). Positive predictive value for CNAQ and SNAQ were 62.6% and 74.7%, respectively. Cronbach's alpha for CNAQ and SNAQ were 0.546 and 0.578, respectively. History of weight loss over the past one year (Adjusted odds ratio 2.49) (p < 0.01) and thiamine intake less than the recommended nutrient intake (RNI) (Adjusted odds ratio 3.04) (p < 0.05) were risk factors for poor appetite among subjects. In conclusion, malnutrition and poor appetite were prevalent among the geriatric outpatients and inpatients. SNAQ was more reliable and valid as an appetite screening tool among this special group of population. There is a need to regularly include nutritional and appetite assessment for early intervention measures in order to prevent consequences of malnutrition.
Generalised obesity and central obesity are risk factors for Type II diabetes mellitus and cardiovascular diseases. Waist circumference (WC) has been suggested as a single screening tool for identification of overweight or obese subjects in lieu of the body mass index (BMI) for weight management in public health program. Currently, the recommended waist circumference cut-off points of > or = 94cm for men and > or =80cm for women (waist action level 1) and > or = 102cm for men and > or = 88cm for women (waist action level 2) used for identification of overweight and obesity are based on studies in Caucasian populations. The objective of this study was to assess the sensitivity and specificity of the recommended waist action levels, and to determine optimal WC cut-off points for identification of overweight or obesity with central fat distribution based on BMI for Malaysian adults. Data from 32,773 subjects (14,982 men and 17,791 women) aged 18 and above who participated in the Third National Health Morbidity Survey in 2006 were analysed. Sensitivity and specificity of WC at waist action level 1 were 48.3% and 97.5% for men; and 84.2% and 80.6% for women when compared to the cut-off points based on BMI > or = 25kg/m2. At waist action level 2, sensitivity and specificity were 52.4% and 98.0% for men, and 79.2% and 85.4% for women when compared with the cut-off points based on BMI (> or = 30 kg/m2). Receiver operating characteristic analyses showed that the appropriatescreening cut-off points for WC to identify subjects with overweight (> or = 25kg/m2) was 86.0cm (sensitivity=83.6%, specificity=82.5%) for men, and 79.1cm (sensitivity=85.0%, specificity=79.5%) for women. Waist circumference cut-off points to identify obese subjects (BMI > or = 30 kg/m2) was 93.2cm (sensitivity=86.5%, specificity=85.7%) for men and 85.2cm (sensitivity=77.9%, specificity=78.0%) for women. Our findings demonstrated that the current recommended waist circumference cut-off points have low sensitivity for identification of overweight and obesity in men. We suggest that these newly identified cut-off points be considered.
Study name: National Health and Morbidity Survey (NHMS-2006)
The National Health and Morbidity Survey III 2006 wanted to perform anthropometric measurements (length and weight) for children in their survey. However there is limited literature on the reliability, technical error of measurement (TEM) and validity of these two measurements. This study assessed the above properties of length (LT) and weight (WT) measurements in 130 children age below two years, from the Hospital Universiti Kebangsaan Malaysia (HUKM) paediatric outpatient clinics, during the period of December 2005 to January 2006. Two trained nurses measured WT using Tanita digital infant scale model 1583, Japan (0.01kg) and Seca beam scale, Germany (0.01 kg) and LT using Seca measuring mat, Germany (0.1cm) and Sensormedics stadiometer model 2130 (0.1cm). Findings showed high inter and intra-examiner reliability using 'change in the mean' and 'intraclass correlation' (ICC) for WT and LT. However, LT was found to be less reliable using the 'Bland and Altman plot'. This was also true using Relative TEMs, where the TEM value of LT was slightly more than the acceptable limit. The test instruments were highly valid for WT using 'change in the mean' and 'ICC' but was less valid for LT measurement. In spite of this we concluded that, WT and LT measurements in children below two years old using the test instruments were reliable and valid for a community survey such as NHMS III within the limits of their error. We recommend that LT measurements be given special attention to improve its reliability and validity.
Study site: Paediatric clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
Frailty is one of the major health concerns in aging. It is considered a geriatric syndrome characterized by muscle weakness, sarcopenia and fatigue. It is also associated with several adverse health outcomes, including disability. Literature shows that there are a number of studies conducted to define the relationship between frailty and nutrition. The majority is from cross sectional, longitudinal, and cohort studies. Few intervention studies using micronutrients, macronutrients, nutritional supplement, or food regimens have been found. This review examines the nutrition intervention studies targeted towards older adults with frailty, and evaluates the effectiveness of nutrition interventions on frailty indicators. Twenty-four intervention studies from six electronic databases met the inclusion criteria. Sixteen were randomized controlled clinical trials; one was a quasi-experimental design, whilst the rest were controlled trials. Participants included in the studies differed in terms of age and frailty status. The studies were inconsistent in intervention type, duration, and targeted outcomes. Most of the studies indicated that modification of nutrition quality, either by giving supplements or by improving diet intake, could improve strength, walking speed, and nutritional status in majority of frail or pre-frail older adults. However, there was limited evidence on the effectiveness of intervention on inflammatory status and other biomarkers related to frailty due to limited number of studies targeting frailty biomarkers as a major outcome.
INTRODUCTION: The Third National Health and Morbidity Survey Malaysia 2006 includes a nutritional status assessment of children. This study aimed to assess the inter- and intra-examiner reliability, the technical error of measurement and the validity of instruments for measuring weight, height and waist circumference.
METHODS: A convenience sample of 130 adults working in a selected office setting was chosen to participate in the study, subject to the inclusion and exclusion study criteria. Two public health nurses, trained to follow a standard protocol, obtained the weight, height and waist circumference measurements. The weight was measured using the Tanita HD-318 digital weighing scale to the nearest 0.1 kg, and Seca Beam Scale to the nearest 0.01 kg. The height was measured using the Seca Bodymeter 206 and Stadiometer, both to the nearest 0.1 cm. The waist circumference was measured using the Seca circumference measuring tape S 201, to the nearest 0.1 cm.
RESULTS: The intra-examiner reliability in descending order was weight and height followed by waist circumference. The height measurement, on average, using the test instrument, reported a recording of 0.4 cm higher than the reference instrument, with the upper and lower limits at 2.5 cm and 1.6 cm, respectively. The technical error of measurement and coefficient of variation of weight and height for both inter-examiner and intra-examiner measurements were all within acceptable limits (below five percent).
CONCLUSION: The findings of this study suggest that weight, height and waist circumference measured in adults aged 18 years and above, using the respective above mentioned instruments, are reliable and valid for use in a community survey. Limiting the number of examiners, especially for waist circumference measurements, would yield a higher degree of reliability and validity.
Introduction: This two-phase longitudinal study sought to determine the association between isoflavones intake on cognitive function and comorbidities among older adults from the state of Johor, Malaysia.
Methods: Phase I involved baseline data collection to examine the association between isoflavones intake and cognitive function among 400 respondents aged 60-years and above, recruited through multistage random sampling. Phase 2 determined the association between isoflavones intake at the baseline and comorbidities at an 18-month follow-up. The baseline data collected included information on socio-demographics, health status, andunpometric measurements, and dietary intake using a dietary history questionnaire (DHQ). Each participant's cognitive function was evaluated using a mini mental state examination (MMSE), digit span, digit symbol, and geriatric depression scale (GDS).
Results: The daily intake of total isoflavones, daidzein, and genistein were 19.1±19.7,11.7±12.3 and 7.6+8.1 mg/day, respectively. There was no significant association between isoflavones intake, and specific cognitive function including global, memory, executive functions, and depression. However, there was a significant association (p 0.05).
Conclusion: This study found an association between isoflavones intake and memory function, but not with global cognitive, executive functions, depression, and comorbidities. There is a need to promote adequate isoflavones intake in view of its association with memory function.
Introduction: Omega-3 Polyunsaturated Fatty Acids (PUFAs) play an important role in developing cognitive function in children, especially Docosahexanoic Acid (DHA). However, there is no suitable dietary assessment tool to assess DHA intake among Malaysian children. Thus, this study assessed the validity of an interviewer-administered semi-quantitative Food Frequency Questionnaire (FFQ) for estimating DHA intake among Malay school children in the Sepang District.
Methods: Thirty 12-year-old Malay children (13 boys and 17 girls) were recruited through purposive sampling. Their DHA intake for one month duration was assessed using a 30-food item FFQ and validated against a 3-day food record.
Results: The majority of the subjects (70%) had normal body mass index, 6.7% were overweight, 16.7% obese, whilst the rest were in the thin category. The reliability of FFQ was found to be good with a Cronbach’s α coefficient value of 0.815. Wilcoxon Signed Rank Test indicated no significant difference in mean intake between the two assessment methods. Significant and strong correlation between FFQ and the 3-day food record was found for total omega-3 PUFAs (r=0.812)and DHA (r=0.839) using both methods. BlandAltman analysis exhibited no apparent systematic bias between the two methods for DHA and total omega-3 PUFAs intake, whilst a quartile analysis assigned 73.3% of the subjects into the same quartile.
Conclusion: The FFQ was found to be valid in estimating DHA intake among Malay school children, and it is recommended that its validity be tested on other ethnic population groups.
Introduction: Frailty is related to physical function, nutritional status, and cognition; however, these factors are rarely investigated comprehensively in a single study. Thus, this study aimed to examine the differences in nutritional, physical and cognitive function among frail, pre-frail and robust Malaysian elderly.
Methods: A total of 473 participants were randomly selected from ten different areas in Klang Valley by multistage random sampling. Frailty was characterised using the Fried criteria. Anthropometric measurements, diet intake, body composition, and physical and cognitive function were assessed. Kruskal Wallis test was employed to examine the relationship between the independent variables and frailty.
Results: Frail subjects had significant higher body mass index (26.8±4.4kg/m2 ) compared to pre-frail (25.7±4.4 kg/m2 ) and robust (24.9±3.9kg/ m2 ), (p
Introduction: Malnutrition is a growing problem but quite often under-recognised in elderly people. Calf circumference (CC) is a simple measurement that can be used to identify elderly people who are at high risk of malnutrition; however, a population-specific cut-off point must be developed. Therefore, this study aimed to determine suitable cut-off points and evaluate the predictive value of the CC cut-off point for elderly Malaysians.
Methods: A total of 820 persons comprising 433 men and 387 women were recruited as subjects. The mean age was 69.0 ± 6.8 and ranged between 60 to 97 years. Data were collected from Sabak Bernam, Selangor; Kuala Pilah, Negeri Sembilan; Pasir Mas, Kelantan, and Kodiang, Kedah. A linear regression analysis with the z-score procedure by gender was used to derive the CC prediction equations.
Results: The CC cut-off points for men and women at risk of malnutrition were 30.1 cm and 27.3 cm, respectively. The final predictive CC equations for men was CC (cm) = 3.69 (z score) + 33.81, R2 = 1 and CC (cm) = 0.7103 (BMI) + 18.54, R2 = 1; and for women, CC (cm) = 4.31 (z score) + 31.63, R2 = 1 and CC (cm) = 0.6698(BMI) + 16.847, R2 = 1. Based on these equations, using the z-score equal to negative 1 for men (BMI 16.30 kg/m2 ) and women (BMI 15.64 kg/m2 ), the mean of the predictive value of the CC cut-off point was 32.0 ± 4.2 cm in men and 30.5 ± 4.6 cm in women.
Conclusion: It is suggested that these cut-off points be used to screen elderly individuals who are at risk of malnutrition. Further studies should be undertaken to further verify the application of the findings of this study.
INTRODUCTION: In Malaysia, hypertension prevalence has increased from 13% in 1996 to 43% in 2006 based on the Third National Health and Morbidity Survey.
METHODOLOGY: Recognising the importance of hypertension control to prevent cardiovascular morbidity and mortality, a cross-sectional study was carried out to assess factors influencing blood pressure among 74 hypertensive adults (22 men, 52 women, mean age 61.1 +/- 8.8 years old) attending an outpatient clinic of a government health clinic in Klang Valley. Subjects were interviewed to obtain information on social and health, physical activity level and food intake using Diet History Questionnaire (DHQ) and Food Frequency Questionnaire (FFQ). Anthropometric measurements including weight, height, waist circumference and percentage of body fat were also conducted.
RESULTS: The majority of the subjects (71.6%) had poor hypertension control as determined using blood pressure. Women aged 30-59 years old had a higher mean diastolic blood pressure (87.3 +/- 11.6 mmHg) than women aged 60 years old (78.5 +/- 9.5 mmHg) (p < 0.05). Most of the men (36.4%) achieved three out of six Medical Nutrition Therapy (MNT) for Hypertension Recommendations as outlined by the Malaysian Dietitians' Association. About one-third (30.8%) of the women achieved two out of six of the guidelines. High sodium intake (adjusted OR 3.501, 95% CI 1.116-10.985, p < 0.05), daily consumption of coffee (adjusted OR 0.302, 95% CI 0.093-0.983, p < 0.05) and less intake of milk (adjusted OR 3.328, 95% CI 1.055-10.493, p < 0.05) were associated with uncontrolled hypertension.
CONCLUSION: Three quarters of the subjects had unsatisfactory hypertensive control and was related to food intake and eating habits including high salt diet, coffee consumption and inadequate milk intake were unsatisfactory. There is a need to implement a nutrition intervention programme based on MNT to achieve good hypertensive control among subjects.
Study site: klinik kesihatan, Klang Valley, Malaysia
INTRODUCTION: Hospitalised elderly patients are at high risk of malnutrition due to the presence of chronic diseases and inadequate food intake. It was on this premise that a Malnutrition Risk Screening Tool-Hospital (MRST-H) was developed for identifying the risk of malnutrition among Malaysian elderly patients.
METHODS: A total of 181 respondents aged 65 years and above who had been admitted to the Geriatric Ward of the University Malaya Medical Centre were recruited. The respondents' nutritional assessment was assessed using the Global Indicator of Malnutrition (GIM), a reference gold standard of malnutrition consisting of anthropometric measurements, biochemical indicators and the Subjective Global Assessment (SGA). Important predictive factors of malnutrition were determined by logistic regression analysis.
RESULTS: Five out of 18 predictive factors were significantly associated with malnutrition (p<0.05) in the final multivariate logistic regression model. These five factors were used to develop the MRST-H. Its validity was tested among 100 elderly inpatients in the Kuala Lumpur Hospital. The MRST-H was found to have 66.7% sensitivity, 96.2% specificity and 82.4% positive predictive value to GIM. The MRST-H was tested for reliability among 40 patients involving three raters (a dietitian and two nurses). The Kappa index of agreement was excellent between the dietitian with nurse A (81.3%, Kappa=0.84) and nurse B (87.5%, Kappa=0.89) respectively.
CONCLUSION: The MRST-H developed showed high validity and reliability as a screening tool for identifying hospitalised elderly patients with high risk of malnutrition.
A cross-sectional study was conducted to determine bone health status and nutrient intakes among post-menopausal women residing in low cost houses in Cheras, Kuala Lumpur.
The Third National Health and Morbidity Survey (NHMS III) was conducted in 2006 on a nationally representative sample of population in Malaysia. Over 21,000 children aged 0-17.9 years were measured for body weight and stature according to the protocol of the World Health Organization. This article describes the nutritional status of children aged 0-59.9 months. Mean z score for weightfor-age (WAZ), height-for-age (HAZ) and BMI-for-age were compared with the z-scores tables of the WHO standards. The overall prevalence of underweight and stunting of the children were 12.9% and 17.2% respectively. These levels included 2.4% severe underweight and 6.0% severe stunting. In terms of z scores, the age group of 0-5.9 months showed the best nutritional status with mean WAZ of -0.33 (95%CI: -0.52, 0.15) and -0.40 (-0.57, 0.24) for boys and girls respectively, while mean HAZ was 0.64 (0.38, 0.89) for boys and 0.76 (0.54, 0.98) for girls. Mean HAZ and WAZ status was least satisfactory after about 6 months, suggesting a faltering in growth rate at an age that coincides with dependence on complementary feeding. Prevalence of overweight based on BMI-for-age for the sexes combined was 6.4%, while that based on WAZ was 3.4%. The NHMS III results indicate that Malaysian children have better nutritional status compared to children under 5 years in neighbouring countries. In order to meet the targets set in the National Plan of Nutrition (2006-2015), more effective intervention programmes are needed to accelerate the reduction of underweight and stunting, and to arrest the rise of overweight in young children.
Study name: National Health and Morbidity Survey (NHMS-2006)
This study sought to examine the reliability of two measurements; Calf Circumference (CC) and Mid-half Arm Span (MHAS). A sample of 130 elderly persons aged 60 years and above seen consecutively in the Kuala Lumpur Hospital outpatient clinic during the period of December 2005 to January 2006, upon consent, were recruited to the study. There was a high degree of reliability for both inter- and intra-examiner (r close to 1). For inter-examiner, on average the CC measurements taken by the first examiner were 0.3 cm lower than that of the second examiner. The upper and lower limit of the differences were +0.4 to -0.9 cm respectively. Inter-examiner MHAS measurements on average by the first examiner were 0.2 cm lower than that of the second examiner. The limits were +1.7 to -2.1 cm. By comparison, the inter-examiner CC measurements were more reliable than the MHAS measurements. For intra-examiner, on average the CC measurements at Time 1 were consistent with Time 2 (mean difference=0) with limits of the difference at + 0.5 cm. MHAS measurements at Time 1 were on average 0.1 cm less than at Time 2 with limits at +1.7 and -1.8 cm. The technical error of measurement (TEM) and coefficient of variation of CC and MHAS for both interexaminer and intra-examiner measurements were within acceptable limits with the exception of MHAS TEM. This study suggests that CC and MHAS measured in elderly persons 60 years and above, using Seca Circumference Tape ® 206, Germany (0.05 cm) are reliable and can be used in a community survey.
Study site: Outpatient clinic, Hospital Kuala Lumpur
Abdominal obesity (AO) is an independent risk factor for cardiovascular disease, hypertension and diabetes mellitus in adults. There is a lack of data on the magnitude and socio-demographic profile of AO among Malaysian adults at the national level. In the Third National Health and Morbidity Survey (NHMS III) conducted in 2006, AO of adults aged 18 years and above was determined based on the waist circumference as part of the nutritional status assessment. This article reports the prevalence of AO in relation to socio-economic factors and demographic characteristics of adult subjects. Out of a total of 33,465 eligible individuals 18 years and above, waist circumference was measured in 32,900 (98.3%) individuals. The prevalence of AO was assessed using the cut-off points recommended by World Health Organization. The mean waist circumference in men and women was 84.0cm [95% confidence interval (95% CI): 83.8, 84.3] and 80.3cm (95% CI: 80.1, 80.6) respectively. The national prevalence of AO was 17.4% (95% CI: 16.9, 17.9). The identified risks of AO were women (OR: 4.2, 95% CI: 3.8, 4.6), aged 50-59 years (OR: 5.6, 95% CI: 4.0, 7.7), Indians (OR: 3.0, 95% CI: 2.4, 3.8), housewives (OR: 1.4, 95% CI: 1.1, 1.7), subjects with primary education (OR: 1.3, 95% CI: 1.1, 1.5) and ever married (OR: 1.4, 95% CI: 1.2, 1.6). Being the largest population-based study on AO among Malaysians, these findings have important public health implications. There is an urgent need to revise public health policies and programmes aimed at prevention of abdominal obesity especially in the groups at risk.
Study name: National Health and Morbidity Survey (NHMS-2006)
This quasi-experimental study was carried out to evaluate the effectiveness of an eight-week multi-disciplinary pulmonary rehabilitation programme in improving nutritional and functional status and quality of life of COPD out patients at Hospital Universiti Kebangsaan Malaysia. A total of 9 COPD outpatients aged 40 years and above (6 men and 3 women) completed at least 50% of 16 sessions of an eight-week pulmonary rehabilitation programme. Their nutritional and functional status and rating of quality of life were measured at baseline (0 day) and after 8 weeks and these were compared to those of the control group matched for age, comprising 13 subjects (11 men and 2 women). Nutritional status was determined using anthropometry, body composition (Bioelectrical Impedance Analysis) and three-day food record. Assessment of appetite for food was also carried out using the Simplified Nutritional Assessment Questionnaire (SNAQ). Functional status was assessed using the Pulmonary Functional Status and Dyspnea Questionnaire-modified version(PFSDQ-M). The handgrip strength was also measured using handgrip dynamometer. The SF36 questionnaire was used to measure the quality of life of the subjects. There was a reduction in dyspnea (-49.0%, p<0.05) and fatigue (-47.8%, p<0.05) in men after the intervention programme, as compared to their controls (dyspnea -2.9% and fatigue 8.9%). Quality of life in this group was also significantly improved by 31.8% (p<0.05) as compared to their controls (-3.0%,p>0.05). Similar trends were noted for the women, although the difference was not significant. No significant changes were seen in nutritional status assessed by anthropometry, dietary intake and appetite. However, there was a trend of increased nutrient intake and SNAQ score in the intervention group as compared to control. An eight-week pulmonary rehabilitation programme was effective in improving the functional status particularly in men, by reducing dyspnea and fatigue; and also improving their quality of life, but was not effective in changing the nutritional status.
Study site: Physiotherapy Unit, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
INTRODUCTION: Malnutrition is a common phenomenon among the elderly and quite often related to psychosocial problems. The objective of this study was to determine malnutrition risk and its association with appetite, functional and psychosocial status among elderly Malays in an agricultural settlement, i.e. FELDA Sungai Tengi, Selangor.
METHODS: A cross-sectional study was conducted among 160 subjects (men = 36.2%), with a mean age of 65.0 +/- 3.9 years, who were interviewed to obtain information on malnutrition risk and appetite using Mini Nutritional Assessment Short Form and Simplified Nutritional Appetite Questionnaire, respectively. Functional status was determined using Instrumental Activities of Daily Living (IADL), Elderly Mobility Scale (EMS) and handgrip strength. Mini Mental Status Examination (MMSE), Geriatric Depression Scale and De Jong Gierveld Loneliness Scale were used to identify cognitive impairment, depressive symptoms and loneliness status of subjects respectively. A total of 42.5% of subjects were at risk of malnutrition and 61.2% had poor appetite. The mean scores of IADL and EMS were lower in subjects at risk of malnutrition, compared to those who were not at high risk (p < 0.05 for both parameters). Multiple linear regression showed that 19.8% of malnutrition risk was predicted by poor appetite, decreased functional status (IADL) and depression.
CONCLUSION: Malnutrition risk was prevalent and associated with poor appetite, functional status and psychosocial problems among the elderly subjects. The psychosocial aspect should also be incorporated in nutrition intervention programmes in order to improve mental well-being and functional independancy.
Study site; FELDA Sungai Tengi, Selangor, Malaysia
Device, Questionnaire & Scale: Mini Nutritional Assessment Short Form; Simplified Nutritional Appetite Questionnaire, Instrumental Activities of Daily Living (IADL); Elderly Mobility Scale (EMS); handgrip strength. Mini Mental Status Examination (MMSE), Geriatric Depression Scale (GDS-15); De Jong Gierveld Loneliness Scale
A case control study to determine the association of dietary fibre and cancer among Malaysians. It was conducted among 100 newly-diagnosed cancer patients admitted to the Radiotherapy and Oncology Ward, Hospital Kuala Lumpur. A total of 100 controls matched with the cases for age, sex and ethnic origin were selected from the Outpatient Health Clinic in Sentul. The subjects were interviewed to obtain information on their habitual dietary intakes and lifestyles. Family history of cancer, smoking habits, and alcohol consumption were found to be significant risk factors for cancer (p<0.05 for all parameters). The mean intake of total energy was higher among men with nasopharyngeal cancer and women with gastrointestinal cancer as compared to their controls (p<0.05 for both parameters). The percentage of energy contribution from fat was higher among cases (35%) than controls (32.1%). The mean dietary fibre intake among cases (10.86 ± 8.90 g/d) was apparently lower than the controls (13.22 ± 5.99 g/d), with significant differences noted for breast cancer and also nasopharyngeal cancer. Women with low fibre intake (<10g/d) had a 2.2 times higher risk of getting breast cancer. There is a need to educate the public to adhere to a wholesome diet, in particular to increase the consumption of high-fibre food for disease prevention.
Study site: Radiotherapy and Oncology Ward, Hospital Kuala Lumpur and Outpatient Health Clinic in Sentu