Introduction: Older persons are vulnerable to food insecurity. This study
aimed to determine the prevalence of food security and associated factors
among free-living older persons in Petaling District, Selangor. Methods:
A total of 220 free-living older persons aged 60-87 years were selected by
using the cluster sampling method in this cross-sectional study. Faceto-face interviews were conducted to obtain information concerning the
demographic and socioeconomic background, food security, oral health, and
psychosocial status. Chi-square test and binary logistic regression analysis
were used to analyse the studied variables. Results: The median age of the
respondents was 65.5 years, and 19.5% were found as food insecure. There
were significant associations between marital status (χ2=6.818), education
level (χ2=6.242), occupation status (χ2=7.540), monthly income (χ2=9.940,),
and oral health status (χ2=9.627) with food security status. Those with a low
monthly income (AOR=2.449, 95% CI: 1.046-5.732), poor oral health status
(AOR: 3.306, 95% CI: 1.387-7.889) and living in rented accommodation
(AOR=6.218, 95% CI: 1.458-26.518) were more likely to be food insecure.
Conclusion: Respondents with an income lower than the poverty line
income (PLI), living in rented accommodation and poor oral health status
face increased risk of food insecurity. A nutrition assistance programme is
suggested to improve the socioeconomic and food security status of older
persons. Regular oral check-ups are recommended to improve the oral
health status of the elderly.
Introduction: A compromised quality of life (QOL) as a result of haemodialysis
(HD) is a rising global issue. Elderly HD patients face more challenges than
younger counterparts. This study determined the association of socio-demographic
characteristics, nutritional status, risk of malnutrition and depression with QOL,
among elderly HD patients. Methods: A cross-sectional study was conducted
among 112 HD elderly patients in selected dialysis centres in Selangor, Malaysia.
The patients completed interview-based questionnaires on socio-demographic
characteristics, risk of malnutrition (Dialysis Malnutrition Score, DMS), depression
(Patient Health Questionaire-9, PHQ-9) and QOL (KDQOL-36). Anthropometric
measurements, 24-hour dietary recall and food intake information were obtained
from them and biochemical data from their medical records. Results: Just over half
(50.9%) of the patients had a normal body mass index while 85.7% had optimal
albumin levels. The proportion of patients who met the recommended energy and
protein intakes were 19.0% and 3.4%, respectively. Patients were at moderate risk
of malnutrition, had minimal depression level and perceived better QOL in terms of
effects and symptoms of kidney disease. There was a significant positive correlation
between protein intake and the physical domain of QOL (p=0.02) and negative
correlation between risk of malnutrition with physical and mental composites of
QOL (p
Introduction: Studies on metabolic syndrome (MetS) of children are important
in view of rising prevalence of childhood obesity worldwide. This study compares
the risks of insulin resistance, inflammation and metabolic syndrome between
overweight/obese (OW/OB) and normal weight (NW) children in Kuala Lumpur.
Methods: A cross-sectional study was conducted in 12 primary schools selected
using multi-stage stratified random sampling. Height and weight were taken of a
total of 1971 children aged 10-11 years. Based on BMI-for-age, 235 OW/OB children
matched for age, sex and ethnicity with 226 NW children were selected for the study.
Overnight fasting blood samples were collected to determine insulin, high-sensitivity
C-reactive protein (hsCRP), glucose and lipid profiles. Logistic regression analysis
was conducted to estimate associations between weight status and metabolic risk
factors.
Results: Prevalence of MetS among OW/OB children was 3.8% compared to
0% in the NW. Prevalence of insulin resistance among OW/OB was 45.5% compared
to 18.6% among NW children. High risk of inflammation was found in 28.1% of the
OW/OB children compared to 12.4% in the NW. The odds ratio of having insulin
resistance, inflammation and metabolic risk factors among OW/OB were 3.66 (95%
CI: 2.40-5.59), 2.76 (95% CI: 1.69-4.50), 4.93 (95% CI: 3.42-7.10), respectively
compared to the NW.
Conclusion: The OW/OB children in this study showed higher
risks of developing insulin resistance, inflammation and MetS compared to the NW
counterparts. Further studies are suggested to better understand the relationships
between insulin resistance, inflammation and MetS in children.
Introduction: The purpose of this study was to determine the effects of sports nutrition education intervention on improvements in sports nutrition knowledge, attitude and practice (KAP), and dietary intake among Malaysian team sports athletes. Methods: A total of 105 male participants representing four team sports under the elite sports programme were recruited based on a name list provided by National Sports Council of Malaysia. Teams were assigned by stratified random sampling to either the experimental group (EG) (n=52) or the comparison group (CG) (n=53). The EG received seven weeks of education intervention programme based on a validated booklet covering basic sports nutrition for team sports. A self-administered sports nutrition KAP questionnaire and dietary intake assessment of total energy, carbohydrates, proteins and fats based on three-day food records was conducted before and after the intervention. Results: There were significant increments (p
Seventeen members of the national sepaktakraw squad undergoing centralised training participated in a comprehensive study to determine their daily food intake, activity patterns and energy requirements. Food intake was recorded as a mean of 3-days weighed food intake and the nutrient contents were calculated using a local food composition table. The energy cost of standardised activities was determined by indirect calorimetry while time and motion study was used to estimate the daily energy expenditure of each subject. The mean daily energy intake was 2784±373 kcal (11.6±1.6 MJ) while the mean daily energy expenditure was 3004±298 kcal (12.6±1.2 MJ), with a negative energy balance of 220 kcal ((0.9 MJ). Intake of other nutrients were adequate when compared with the Malaysian RDA, with the exception of niacin. The results of the activity pattern study indicated that the subjects spent about 80% of the day doing light activities while 20% of the day was devoted to their training programme comprising of moderate to heavy activities. This data set represents the first of its kind in Malaysia and should provide impetus for further research in this area which would help establish dietary guidelines for Malaysian sportsmen.
A study to predict energy requirements of national athletes, 84 males and 24 females in 9 and 4 different types of sports respectively, were conducted during centralised training. Parameters assessed were anthropometry, 3-day activity pattern and energy cost (kcal/min) of common activities to derive total daily energy expenditure (TDEE). Based on body mass index (BMI), 68 males or 81% and 19 females or 79% of the athletes were classified as normal. The mean body fat content for males and females were 13.8 ± 4.5% and 24.7 ± 5.3%, respectively. The mean daily activity pattern of males and females athletes were similar for light activities (16½ hr or 68% of day), for moderate activities (3½ hr or 15% of day in male, 4 hr or 17% in females) while moderate to heavy activities related to training were 4 hr (17%) and 3½ hr (15%) in males and females, respectively. Energy cost of some common activities ranges from 1.00-3.00 kcal/min in males and 0.84-2.04 kcal/min in females, while values for jogging were 6.60 kcal/min and 5.62 kcal/min in males and females, respectively. The mean TDEE in male ranges from 2938 kcal (12.3 MJ) in boxers (57 kg) to 4861 kcal (20.3 MJ) in weightlifters (110 kg) while the mean TDEE in female ranges from 2099 kcal (8.8 MJ) in athletics (51 kg) to 3098 kcal (13.0 MJ) in basketball (61.4 kg). The calculated physical activity level (PAL) values using measured BMR for males and females athletes ranges from 1.99-2.58 and 1.77-2.34, respectively. In conclusion, the estimated energy requirement for the various sports event studied ranges from 44-55 kcal/kg/day in males and 38-50 kcal/kg/day in female athletes.
In the field of human energy expenditure, the measurement of basal metabolic rate (BMR) is an essential element to derive energy requirement estimates for any given population. Besides basic anthropometrics data, this paper reports the generation of predictive equation for basal metabolic rates of healthy Malaysian adult from prospective measurements on 307 male and 349 females aged 18-60 years, using the Douglas bag technique. These new equations based on body-weight reveal that the current FAO/WHO/UNU (1985) predictive equations overestimate BMR of adult Malaysian by an average of 13% in males and 9% in female subjects while differences of between 4-5% were observed when compared to Henry and Rees (1991) equations for tropical people. There is a good reason to believe that the capacity to slow down metabolism amidst the hot and humid climate experience throughout the year as a genuine phenomenon for Malaysians. Similarly, these findings suggest that at equal energy intake recommendation for similar body weight, the lower energy needs of Malaysian could put them at greater risk for developing obesity. These observed deviations must be taken into account in formulating energy requirements of the population.
Introduction: Childhood stunting is recognised as one of the most significant
barriers to human development. This cross-sectional study aimed to determine the
factors associated with stunting among Orang Asli (OA) preschool children in Negeri
Sembilan, Malaysia.
Methods: A total of 264 children (50.9% boys and 49.1%
girls) aged 2-6 years (M=4.04, SD=1.21 years) including their mothers from 14 OA
villages in Negeri Sembilan participated in this study. Mothers were interviewed to
obtain information regarding socioeconomic status, sanitation facility and personal
hygiene. The height of the children and their mothers were measured. Venous
blood samples were drawn from the children to estimate haemoglobin level, and
stool samples were collected to screen for intestinal parasitic infections.
Results:
Approximately one third of the children (35.6%) and 7.8% of the mothers were
stunted. One in five of the children were anaemic (21.6%), while one- third had
intestinal parasitic infections (35.0%). Low birth weight (AOR=2.526, 95% CI: 1.310-
4.872; p=0.006), anaemia (AOR=2.742, 95% CI: 1.265-5.945; p=0.011), presence
of intestinal parasitic infections (AOR=2.235, 95% CI: 1.310-3.813, p=0.003), not
wearing shoes (AOR=2.602, 95% CI: 1.453-4.660; p=0.001), absence of piped water
at home (AOR=2.395, 95% CI: 1.047-5.476; p=0.039), dirty nails (AOR=1.956, 95%
CI: 1.163-3.289, p=0.011), and stunted mothers (AOR=3.443, 95% CI: 1.334-8.890;
p=0.011) were identified as significant factors for childhood stunting.
Conclusion:
It is suggested that the factors identified associated with childhood stunting be
included in future intervention programmes that address stunting among OA
children.
Introduction: Findings from the National Health and Morbidity Survey III (MOH, 2008) indicate a 43.7% prevalence of physical inactivity among Malaysian adults. This sedentary lifestyle can also be observed among children and adolescents.
Methods: A cross-sectional study was conducted to determine factors associated with physical activity levels of four hundred, 13 year-old adolescents in Kuantan, Pahang. Data on socio-demographic, health-related, and psychosocial factors were collected using a self-administered questionnaire while physical activity level was assessed using the Physical Activity Questionnaire for Older Children (PAQ-C).
Results: About one-third of the respondents were in the low physical activity level category, 61.5% were in the moderate category and only 3.0% of the adolescents were in the high physical activity level category. Males were more physically active than females (χ2=23.667, p=0.0001) with female adolescents (45.1%) twice as likely as male adolescents (22.1%) to be in the low physical activity level category. The associations between physical activity level with socio-demographic and health-related factors, perception of weight status and body parts satisfaction were not significant. However, physical activity was found to be positively correlated with physical activity self-efficacy (r=0.496,p=0.0001), peer influence (r=0.468, p=0.0001), family influence (r=0.298, p=0.0001) and beliefs in physical activity outcomes (r=0.207, p=0.0001). Negative relationships were found between physical activity with depression (r=-0.116, p=0.021) and body size discrepancy (r=-0.143, p<0.01). Respondents who had a better perception of their current health status were more physically active (χ2=21.062, p=0.0001). Multivariate analyses for the prediction of physical activity showed that physical activity self-efficacy, sex and peer influence were the most significant contributors in explaining physical activity among adolescents.
Conclusion: Physical activity interventions should include psychosocial components as mediator variables in interventions designed to promote regular physical activity in adolescence.
Key words: Adolescents, physical activity, psychosocial factors, health-related factors and socio-demographic factors
This study aimed to evaluate the validity and reliability of the Multidimensional Body Image Scale (MBIS), a seven-factor, 62-item scale developed for Malaysian female adolescents. This scale was evaluated among male and female Malaysian university students.
Introduction: The use of email and website as channels for workplace health
information delivery is not fully explored. This study aims to describe the
rationale, design, and baseline findings of an email-linked website intervention
to improve modifiable cancer risk factors. Methods: Employees of a Malaysian
public university were recruited by systematic random sampling and randomised
into an intervention (n=174) or control group (n=165). A website was developed
for the intervention and educational modules were uploaded onto the website.
The intervention group received ten consecutive weekly emails with hypertext
links to the website for downloading the modules and two individual phone
calls as motivational support whilst the control group received none. Diet,
lifestyle, anthropometric measurements, psychosocial factors and stages of change
related to dietary fat, fruit and vegetable intake, and physical activity were
assessed. Results: Participants were predominantly female and in non-academic
positions. Obesity was prevalent in 15% and 37% were at risk of co-morbidities.
Mean intake of fats was 31%, fruit was ~1 serving/day and vegetable was <1
serving/day. Less than 20% smoked and drank alcohol and about 40% were
physically inactive. The majority of the participants fell into the Preparation
stage for decreasing fat intake, eating more fruit and vegetables, and increasing
physical activity. Self-efficacy and perceived benefits were lowest among participants in the Precontemplation/Contemplation stage compared to the Preparation
and Action/Maintenance stages. Conclusion: Baseline data show that dietary and
lifestyle practices among the employees did not meet the international guidelines
for cancer prevention. Hence the findings warrant the intervention planned.
Keywords: Cancer, risk factors, email, website, worksite
A cross-sectional study was conducted to determine the physical activity levels of 400 adolescents (13 years old) in Kuantan, Pahang using the Physical Activity Questionnaire for Older Children (PAQ-C). The associations of physical activity levels with sex, ethnicity and body mass index were also determined. About one third (35.3%) of the adolescents were in the low physical activity level category, 61.5% in the moderate physical activity level and only 3.0% of the adolescents were in the high physical activity level category. More males (77.9%) were physically active than females (54.9%). Twice as many female adolescents (45.1%) were in the low physical activity level category compared to the male adolescents (22.1%). The associations between physical activity with ethnicity and body mass index were not significant. However, there was a significant interaction effect of sex and ethnicity in mean physical activity score (F = 2.36, p<0.01). Malay males had a significantly higher mean physical activity score as compared to Chinese males (t=2.13; p<0.05). Although Chinese females had a higher mean physical activity score than Malay females, the difference was not statistically significant. Conversely, there was no interaction effect of sex and BMI status in mean physical activity score. This study suggests that physical activity intervention to promote regular physical activity is needed since a high proportion of the adolescents fall within the low physical activity level category.
Studies were conducted in selected areas in three states namely Johor (n=117, male=55, female=62), Negeri Sembilan (n=130, male=52, female=78) and Malacca (n=97, male=33, female=64) involving free living elderly (age range from 60 to 93 years old). Respondents were divided into three age cohort groups that is 60 to 69 years, 70 to 79 years and above 80 years old. Assessment of macro and micronutrients were obtained from 24-hour diet recall for three consecutive days. Household measurements were used to estimate the amount of food consumed. Mean energy intake for both sexes were lower than the Malaysian RDA. Mean energy intake were also found to decline with age increment. The percentage of carbohydrate from total calories is higher compared to fat and protein. No respondents were found to consume less than 1/3 RDA for protein. Although no significant difference in nutrient intake was noted among age cohort groups, there was a decline in the intake of protein, fat and carbohydrate. Significantly (p <0.05) lower carbohydrate intake was noted in cohort group above 80 years. As for vitamins and minerals consumption, more than 50% of the elderly population studied consumed less than 2/3 RDA for vitamin A, thiamine, riboflavin, niacin and calcium. Very low intake of nutrient may lead to many health problems. Overall mean energy intake indicate the respondents consume less than the Malaysian RDA for all three age cohort groups. Total mean energy intake were also found to decline with age increment for both sexes. Due to the low energy intake, higher percentage of elderly were found consuming less than 2/3 RDA for thiamine (65%), riboflavin (63%) and niacin (90%). Other nutrients which were also being consumed less than 2/3 RDA by the respondents are vitamin A (67%) and calcium (65%). The intake of calcium which was found to be extremely low (ranged from 277 to 303 mg) could lead to problems like osteoporosis.
Introduction: The implementation of front-of-pack (FOP) energy icon labelling helps
consumers in making good food choices. This is the first study in Malaysia focusing
on such labelling since it was launched in 2012. It was aimed at determining the
awareness and understanding of the FOP energy icon on food labels in Malaysia.
Methods: A total of 366 consumers aged 18-60 years old in the state of Negeri
Sembilan participated in the study. A guided, self-administered survey was
conducted using a convenient sampling method. Results: The results showed
that 85% of consumers surveyed were aware of FOP energy icon. Among those
who were aware of the icon, 50% (n=155) were categorised as ‘excellent’ and 41%
(n=128) categorised as ‘good’, for understanding the FOP. Conclusion: This study
indicated that the icon could be viewed as a potential tool to be used in conjunction
with the nutrition information panel (NIP). Most of the respondents could extract
nutrition information from the FOP (energy) icon. The study showed that those who
had understood the icon were in the group categories of high education, youth
and female. There was also no significant association between those who received
nutrition labelling education and level of understanding nutrition information from
the icon. Therefore, it is important to further explore the possibility the beneficial
impact of FOP labelling system, including consumer education aspects.
Introduction: Cancer chemopreventive agents from natural sources have been actively investigated over the years to seek prevention against cancer. In this study, cocoa polyphenols extract (CPE) was examined to explore its antioxidant and cytotoxicity activities. Methods: CPE was analysed for total phenolic content (TPC) and antioxidant activity (DPPH radical scavenging activity and FRAP ferric-reducing antioxidant power assays). In vitro cytotoxicity effect of CPE
against HepG2, HT-29, HeLa, MCF-7, MDA-MB-231 and WRL-68 cell lines after 48 h exposure was measured by MTT assay. Results: The study showed that CPE had higher total phenolic content (13560.0±420.1 mg GAE/100g dry weight of sample) than vitamin E (p
Introduction: Adequacy of fruit intake contributes to an individual’s health
including reducing the risk of non-communicable disease. This study aimed to
assess consumption of fruits in various forms and to determine associated factors
and barriers. Methods: In this cross-sectional study, a total of 300 adults aged
20-39 years were purposely recruited from several urban locations in the Klang
Valley. Consumption of fruits in the past 12 months was assessed using a selfadministered food frequency questionnaire (FFQ), assisted with pictures of serving
size of fruits. Anthropometric measurements were taken and body mass index
and waist circumference computed. Results: Fruit intake among young adults
was lower (1.6±1.0 servings/day) than the Malaysian Dietary Guideline 2010 of
≥ 2 servings/day. Only 32.3% consumed fruits as recommended, with women
consuming significantly more fruits than men. Preferred fresh fruits were red apple,
banana and papaya. Consumption of fruit juice was associated with increase in
waist circumference (R2=0.261, p=0.027) after adjustment for age, sex, ethnicity,
education level and marital status. Fruit intake showed no significant association
with other anthropometric measurements. Sensory appeal, perceived health benefit,
easy to prepare and influence of family were the main determinants of fruit intake,
whilst affordability and availability were the major barriers. Conclusion: Fruit
consumption among young adults in this study was lower than the recommendation
for daily fruit intake. Studies with larger sample size are suggested to verify the
finding of significant association between fruit juice consumption and risk of
abdominal obesity.
Low vegetable consumption in children is always a matter of concern. The aim of this study was to determine the effect of multiple exposures on acceptance of a test vegetable among preschoolers aged 6 years.
The objective of this paper is to report on the reliability and validity of a knowledge, attitude and practice instrument used among young primary school children. The instrument was developed as an evaluation tool in the HELIC study and consisted of 23 knowledge, 11 attitude and 10 practice items. A total of 335 Year 2 students from 4 randomly selected primary schools in Selangor and Wilayah Persekutuan participated in the HELIC study. Students were divided into small groups and an enumerator verbally administered the instrument to each group. Reliability for each construct (knowledge, attitude and practice) was estimated as item to total score correlation and internal consistency (Cronbach's alpha). Construct validity was determined through factor analysis and Pearson correlation. Results indicated that 3 attitude and 3 practice items did not correlate significantly to the total score (p>0.05). However, the deletion of these items did not significantly alter the Cronbach's alpha coefficients. Internal consistency was good for knowledge (a=0.68) but low for attitude (a=0.37) and practice (a=0.36) constructs. Based on factor analysis, 5 factor-solutions emerged for knowledge and 4 factor solutions for attitude and practice. Sufficient variance was obtained for the factors in knowledge (51.7%), attitude (51.2% and practice (51.0%). There were also significant positive correlations among the constructs ( ~ 4 . 0 1 ) . In conclusion, the instrument was valid and reliable, especially for the knowledge construct. Further improvements, particularly on the attitude and practice constructs, are needed in order for the instrument to be an effective assessment or evaluation tool in various settings.
Introduction: Hygrocybe conica (HC), a wild mushroom commonly consumed by the indigenous people (Orang Asli) in Peninsular Malaysia, was assessed for its antioxidant content. Methods: The HC mushroom was extracted using distilled water and the crude extract partitioned using different solvents and open column chromatography to evaluate its potential antioxidant properties. The mushroom extract was partitioned using liquid-liquid extraction into the hexane (Fl), chloroform (F2), butanol (F3) and formic acid (F4) fractions. Based on solvent polarity, the water extract of the mushroom was fractionated into non-polar (FI), semi-polar (Fii), and polar fractions (Fiii) using open column chromato graphy. Antioxidant capacities were determined using DPPH, ABTS, and ferric reducing antioxidant power (FRAP) assays while Folin-Ciocalteu reagent assay was used to determine total phenolic content (TPC). Results: The HC extract had the highest TPC and DPPH scavenging capacity compared to its extract fractions. TE values (ABTS assay) of F2 and F4 were not significantly higher than the HC extract. Among the extract fractions of different polarities, Fiii had the highest antioxidant capacities (DPPH and FRAP) compared to FI and Fii while FRAP values of these fractions were not significantly lower than the FRAP value of HC extract. The HC extract had significantly lower antioxidant capacity than antioxidant standards (ascorbic acid and BHA). Tannie acid as the main bioactive component in HC mushroom was detected using HPLC method. The presence of phenolics in HC extract was also confirmed using TLC. Conclusion: Due to the presence of potent phenolic components, the mycelia of HC could be consumed for potential antioxidative benefits.
Excess dietary fat intake is associated with many chronic diseases. This cross-sectional study determines the differences in nutritional status and diet-related psychosocial factors by accuracy levels of dietary fat intake perceptions among adults. A total of 202 Universiti Putra Malaysia staff (20-55 years old) volunteered to participate in the study. Dietary fat accuracy levels (under-estimate, accurate and over-estimate) were determined by assessing actual fat intake through 24-hour diet recall and self-rated fat intake. Diet-related psychosocial factors assessed were perceived risks, intention to change, outcome expectancies and perceived barriers. About half (49.5%) of the respondents were classified as accurate estimators, while 35.6% and 14.9% were under-estimators and over-estimators, respectively. Dietary fat intake differed significantly between the dietary fat accuracy groups with under-estimators having the highest amount of dietary fat intake (F=17.10; p<0.001) and percentage of fat calories (F=103.99 + 0.533%, p<0.001). Over-estimators had the highest mean BMI (F=3.11, p<0.05) compared to other groups. Among the fat accuracy groups, under-estimators reported the least barriers to eating low fat foods (F= 3.671, p<0.05). There were no significant differences in waist circumference, energy intake, perceived disease risks, intention to change and outcome expectancies among the dietary fat accuracy groups. These findings suggest that inaccurate perceptions of dietary fat intake should not be overlooked as one of the cognitive barriers to dietary change and factors that influence nutritional status among adults.