Fasting serum specimens from (a) 217 male and 46 female patients with coronary artery disease (CAD), aged 35-75 years, who had undergone angioplasty (PTCA) / coronary artery bypass graft (CABG), and (b) 160 apparently healthy controls (106 males, 54 females, aged 30-75 years), were assessed for serum lipid profile. Both sex and ethnicity significantly influenced the levels of serum high density lipoprotein cholesterol (HDLC); in the controls, females had higher HDLC levels than males (46.7 mg/dl vs 38.5 mg/dl, p
Elderly people are known to be at a greater risk of malnutrition, particularly those having diseases or illnesses. A prospective study was undertaken on 92 hospitalised geriatric patients (45.6% males), aged 60 to 89 years old, admitted to surgical and medical wards at Hospital Universiti Kebangsaan Malaysia (HUKM). The study aimed to assess malnutrition at admission, day 3 and day 7 of hospitalisation, and its relation with length of stay in the wards. Malnutrition was assessed using anthropometrics and biochemical indicators. Although the majority of subjects had a normal Body Mass Index (BMI), 10.9% had Chronic Energy Deficiency (CED) and 38% were overweight. A total of 10% subjects had muscle wasting as assessed by Mid-upper Arm Circumference (MUAC). Biochemical tests indicated that women subjects were more likely to have hypoalbuminaemia (p <0.05) whilst, men were at risk of anaemia (p < 0.05). Throughout hospitalisation, there was a significant reduction in body weight, biceps skinfold thickness, calf circumference, MUAC, percentage of body fat and body mass index (BMI) in both males and females (p < 0.05 for all parameters). Biochemical tests on a sub sample of subjects indicated that 71.4% had hypoalbuminaemia and 39.6% were anaemic. Subjects diagnosed with cancer, had loss of appetite or had poor nutritional status as assessed by BMI or MUAC on admission were more likely to be hospitalised longer than or equal to 7 days (p < 0.05 for all parameters). Serum albumin levels at admission correlated positively with MUAC values both on admission (r = 0.608, p <0.01) and at clay seven of hospitalisation (r = 0.906, p < 0.05). There is a need to screen elderly patients at high risk of malnutrition at admission in order to reduce the length of stay and increase their health and nutritional status.
Understanding the experiences of household food insecurity is essential for better measurement and assessment of its nutritional, physical and psychological consequences. This qualitative study explored coping strategies and their perceived severity in relation to household food insecurity. Women (n=57; 20-50 years old) from rural and urban areas in Selangor and Negeri Sembilan participated in this study. These women were interviewed using a semi-structured questionnaire. The questionnaire was divided into two parts, that is, demographic and socio-economic information and women's experiences of coping with household food insecurity. Women were chosen since they were primarily responsible for food acquisition and preparation for the all household members. Thematic analysis was utilized in data analysis. Thematic analysis is a method for identifying, analysing and reporting patterns and themes of the qualitative data. Themes capture something important related to the study objectives and describe an integrating as well as relational idea from the data. Results showed that households displayed a variety of non-food related coping strategies and food-related coping strategies. Women's descriptions of non-food related coping strategies to food insecurity were categorised into five themes i.e. cloth purchasing behaviors, reduce school-going children's expenditure, delay the payment of bills, adjust lifestyle and increase cash and income earning. Food related coping strategies were categorised into four themes i.e. food stretching, food rationing, food seeking and food anxiety. Food stretching is a strategy of food insecurity that affects the quality of diet. Food rationing comprises coping strategies of food insecurity related to the quantity of food available for household's consumption. Food seeking is a strategy of acquiring food through socially unacceptable ways and food anxiety is a strategy that indicates households allocating money to buy staple food in order to prevent food insecurity. Each coping strategy showed a different level of perceived severity, that is, less severe, quite severe, severe and very severe. In conclusion, the qualitative data provide valuable information for understanding the experiences of food insecurity that can be used as a basis to develop direct indicators that can capture the core behaviours and their level of severity to measure household food insecurity.
A cross-sectional comparative study was conducted to determine the nutritional status among physically active groups in Kota Bharu. The study population comprised 83 adult male athletes from 8 different types of sports (athlete group), 80 active men who exercised a minimum of 30 min per day for at least 3 times per week (exercise group), and 80 inactive men (sedentary group). All the respondents were aged between 18 to 44 years. Measurements taken from the respondents were anthropometric measurements, systolic (SBP) and diastolic (DBP) blood pressure, and serum total cholesterol (TC). The results showed that the combined prevalence of pre-obese (BMI 25.0-29.9) and obese (BMI ¡Ã30.0) was 21.7% in athletes, 29.9% in exercise group, and 47.5% in sedentary group. The mean (± SD) percentage of body fat in athletes was 15.7 ± 5.4%, which was lower compared to the exercise (18.9 ± 5.5%) and sedentary (20.6 ± 5.8%) groups. The incidence of waist-to-hip ratio above 0.9 in athlete, exercise and sedentary groups was 9.6%, 18.7% and 31.3%, respectively. The incidence of hypertension (SBP ¡Ã140 and/or DBP ¡Ã90 mmHg) was 13.2% in athletes, 17.5% in exercise group and 42.5% in the sedentary group. The TC values showed that the prevalence of “high risk†individuals (TC ¡Ã6.20 mmol/l) was also lower in athletes (20.5%), compared to the exercise (36.2%) and sedentary (47.5%) groups. The study revealed that individuals who are actively involved in physical activity, particularly in sport activities have better nutritional status compared to sedentary people. However, the nutritional status in the athlete and exercise groups was still unsatisfactory. The incidence of poor health status related to over nutrition in the active groups was rather high and needs attention from health professionals. Further studies are needed to determine nutritional practices among physically active groups.
Introduction: The prevalence of child undernutrition and micronutrient deficiencies
are higher in the Orang Asli (OA) than the general Malaysian population. The World
Health Organization recommends the use of multiple micronutrient supplement
(MMS) that is a blend of micronutrients in powder form that can be sprinkled onto
foods for home fortification to prevent undernutrition among children. This pilot
study aimed to assess the feasibility of using MMS among OA children. Methods: A
total of 25 OA children (14 boys and 11 girls) aged 6-31 months (mean±SD = 15.7±7.2
months) in Negeri Sembilan were given three sachets of MMS weekly for 5 weeks.
Caregivers were instructed to add MMS to three types of food from the same food
group per week varying with a different food group weekly. Written instruction for
using MMS in simple language was given prior to the supplementation. Caregivers
were interviewed for information on socio-demographics, compliance, acceptance,
preference and adverse effect of MMS. Results: A high level of compliance was
observed (85%). All caregivers reported that the instructions for use were easy to read.
No noticeable changes to the foods mixed with MMS were observed and no adverse
effects were reported. Conclusion: This study demonstrated feasibility of the use of
MMS for future trials among OA children. The easy to read information that comes
with the MMS, frequent monitoring of MMS use and support to caregivers were
required to ensure compliance. Cultural feeding practices and financial constraints
may limit the types of food that can be mixed with MMS.
The nutritive value of spontaneously fermented brown rice flour medida, a Sudanese cereal thin porridge, is low. This study was carried out to improve the nutritional quality of medida. The flour was soaked and malted at 30◦C to optimise the protein content. Flour malted for two days had the highest protein content. Skim milk was added to the malted brown rice flour medida and fermented using Bifidobacterium longum BB 536. Maximum count of B. longum BB 536 up to 9 log CFU/ ml was attained at 4.6 final fermentation pH. The resultant viscosity was similar to that of the spontaneously fermented brown rice flour medida. There was significant (P< 0.01) increase in both the energy density and the protein content, having increased 12 folds and 24 folds, respectively. The essential amino acids including lysine and methionine were highly augmented. The resultant medida have stable flowing characteristics and meet the whole protein and energy requirements for infants and children aged 1 - 10 years old.
Underlying causes of most nutrition related problems are diverse, including biological, social, cultural, and economic factors. Qualitative approaches complement quantitative methods in identifying the underlying meanings and patterns of relationships involved in managing malnutrition. This study examined perceptions regarding malnutrition among health workers from 7 clinics (community and health clinics) in Tumpat, Kelantan. A total of 18 nurses and 2 doctors, who were involved in monitoring child health and nutrition, were included in the study. These health workers were interviewed using a semi-structured questionnaire adapted from Sastry's framework on malnutrition (Sastry, 1996). The questionnaire included biological, behavioral and environmental factors that influence child health and nutrition. All the health workers perceived that mothers/caregivers play the main role in improving the health of malnourished children. The quality of childcare was rated as moderately satisfactory by the health workers. Most of the affected families who were given the Food Baskets did not fully use all the items for the malnourished child. Child feeding practice was based on the needs of the whole family rather than according to the target child's needs. Most of the mothers preferred processed cereals than rice porridge because the former is easier to prepare for the child. Although they were from a low socioeconomic background, most of the mothers were not earning additional income for the family. The qualitative methodology provided information that can be used as a basis for the designing of quantitative questionnaires to assess malnutrition among children. The induction characteristic of qualitative methods was used to gain an understanding of the underlying reasons or phenomena such as behaviours that are directly observable.
Study site: Klinik kesihatan, Tumpat, Kelantan, Malaysia
Introduction: This study aimed to ascertain the effects of a Facebook-based physical activity intervention on improvements in step counts and metabolic syndrome. Methods: Government employees with metabolic syndrome were randomly assigned by cluster to the Facebook group (n = 44) or the control group (n = 103). All participants were asked to complete self-administered questionnaires at baseline, after the first and second phases. Data from anthropometric (weight, body mass index, fat mass, body fat percentage, waist circumference, hip circumference and waist-to-hip ratio), biochemical (total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides and fasting glucose) and clinical examinations (systolic blood pressure and diastolic blood pressure) were collected. The number of steps per day was determined by a Lifecorder e- STEP accelerometer. Results: A significant difference in the number of steps per day between the baseline and the first phase (p
Introduction: A retrospective study was conducted with the aim of determining
the factors that affect weight loss among post-bariatric surgery patients. Methods:
A successful weight loss outcome in this study was defined as achieving at
least 50% excess weight loss (EWL). Eligible participants were those who had
undergone bariatric surgery at least two years prior to the study. Adherence to
lifestyle recommendations post-bariatric surgery, binge eating, depression, and
social support were assessed. Results: A total of 51 post-bariatric surgery patients
were recruited with a mean post-operative period of 3.2±0.7 years. The mean preoperative weight of 116.6±28.8 kg and body mass index (BMI) 45.2±8.8 kg/m2 were
significantly reduced to 86.6±21.0 kg and 33.6±6.7 kg/m2, respectively, during
follow-up (p
A cross-sectional comparative study was conducted to determine the nutritional status among physically active groups in Kota Bharu. The study population comprised 83 adult male athletes from 8 different types of sports (athlete group), 80 active men who exercised a minimum of 30 min per day for at least 3 times per week (exercise group), and 80 inactive men (sedentary group). All the respondents were aged between 18 to 44 years. Measurements taken from the respondents were anthropometric measurements, systolic (SBP) and diastolic (DBP) blood pressure, and serum total cholesterol (TC). The results showed that the combined prevalence of pre-obese (BMI 25.0-29.9) and obese (BMI ≥30.0) was 21.7% in athletes, 29.9% in exercise group, and 47.5% in sedentary group. The mean (± SD) percentage of body fat in athletes was 15.7 ± 5.4%, which was lower compared to the exercise (18.9 ± 5.5%) and sedentary (20.6 ± 5.8%) groups. The incidence of waist-to-hip ratio above 0.9 in athlete, exercise and sedentary groups was 9.6%, 18.7% and 31.3%, respectively. The incidence of hypertension (SBP ≥140 and/or DBP ≥90 mmHg) was 13.2% in athletes, 17.5% in exercise group and 42.5% in the sedentary group. The TC values showed that the prevalence of "high risk" individuals (TC ≥6.20 mmol/l) was also lower in athletes (20.5%), compared to the exercise (36.2%) and sedentary (47.5%) groups. The study revealed that individuals who are actively involved in physical activity, particularly in sport activities have better nutritional status compared to sedentary people. However, the nutritional status in the athlete and exercise groups was still unsatisfactory. The incidence of poor health status related to over nutrition in the active groups was rather high and needs attention from health professionals. Further studies are needed to determine nutritional practices among physically active groups.
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
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)
A cross-sectional study was carried out to investigate accelerometer-determined physical activity level of 233 Malay government employees (104 men, 129 women) working in the Federal Government Building Penang, Malaysia.
Introduction: Physical activity has been shown to be beneficial for the prevention of
obesity and non-communicable diseases. Our contemporary way of life that is technology
dependent has significantly reduced physical activity. This study aimed to determine
accelerometer-measured physical activity (moderate-to-vigorous physical activity (MVPA))
among adults in high and low walkability neighbourhoods in Penang and Kota Bharu,
Malaysia.
Methods: Participants (n=490) were sampled using multistage sampling method
from neighbourhoods with varied levels of walkability using Geographical Information
System (GIS). Physical activity was measured objectively using Actigraph GT3X+
accelerometers, worn by the participants on their waists for a period of 5 to 7 days.
Results:
The participants had a mean of 13.5 min/day of MVPA. Total MVPA was significantly
higher among participants in high walkability neighbourhoods (19.7 min/day vs. 9.1 min/
day). Results from t-test showed that the time spent on MVPA per day was significantly
lower among participants residing in low walkability neighbourhoods. The final model
of the MIXED model statistical tests showed that total MVPA was significantly associated
with BMI, but not with WC measurements, after adjusting for covariates.
Conclusion: Most
of the participants had very low MVPA and did not achieve the current physical activity
recommendations, implying that Malaysian adults residing in these two cities were not
physically active to achieve health benefits. Results are suggestive of the importance of the
walkability concept in neighbourhoods in encouraging physical activity and healthy body
weight among Malaysians.
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.
A retrospective study of anaemia in pregnancy in rural Kelantan was conducted. The study sample consist of 9,860 mothers who had antenatal care at one of the 102 rural health clinics selected and had delivered a live baby. Anaemia in pregnancy was determined by reviewing the antenatal records for the haemoglobin level recorded at the first and last antenatal visit. Estimation of haemoglobin was done either by photocalorimetric methods or the Sahli's method in these rural clinics. At the time of booking, 47.5% of the mothers were anaemic by WHO criteria (Hb < 11.0 g/dl), with 1.9% having less than 9.0 g/dl. Age of mother, parity and late gestational age at the first antenatal visit were associated with anaemia during pregnancy at the time of booking. However, practise of contraception by the mother did not show any association with anaemia in pregnancy. There were 594 mothers (6.0%) who delivered a baby weighing less than 2.5 kg. There was no association between the low birth weight of the child and the status of anaemia in the mother at the last antenatal visit.
This comparative study was conducted to determine the anthropometric measurements and body composition of football teams in the UK and Malaysia. A total of 32 footballers from two teams were studied. The teams were the St Mary’s University team (UK) and the Selangor Reserved League team. The height and body weight of the subjects were measured using SECA digital balance with height attachment. Skinfold thickness measurements were taken using Harpenden skinfold callipers at four sites (biceps, triceps, subscapular and suprailiac) and the VO2 max of the subjects was estimated by participation in a multi-stage 20m shuttle-run test. The UK team were significantly heavier (p
A cross sectional study on Type 2 diabetes patients seeking treatment in the Primary Health Care outpatient clinic of the University Malaya Medical Centre, Kuala Lumpur was undertaken. Two hundred and thirty-three subjects participated. They were asked questions on biodata and dietary intake using face-to-face interview techniques. Dietary intake was assessed using the 24-hour dietary recall. Anthropometric measurements including weight and height were taken and Body Mass Index (BMI) was computed to establish the extent of obesity. Of the 196 subjects, 66.8% were overweight (BMI ≥25 kg/m2) with 15.8% obese (BMI ≥30 kg/m2). The mean BMI of males and females were 25.9±4.3 kg/m2 and 27.2±4.7 kg/m2 respectively. The findings from the dietary survey showed that the mean energy intake of the subjects only achieved about 72% of the Recommended Daily Allowance (RDA) for Malaysia while protein intake of all subjects was adequate. The macronutreint contribution to the total calorie was consistent with the recommendation of the Malaysian Diabetic Association for a healthy diet for diabetes patients. The male subjects were found to meet the RDA requirements for all nutrients while the female subjects did not have sufficient intake of calcium, vitamin A and niacin. No consistent pattern in energy and nutrient intake was observed among different age groups. On the other hand, the Malay subjects seemed to have lower energy and all nutrient intake (except vitamin A and vitamin C) compared to the Chinese and Indian subjects. The Indian subjects seemed to have the highest intake of calcium compared to the others. Advice needs to be given to those who did not have adequate nutrient intake as well as those who need to reduce their weight.
Study site: Primary health care clinic, University Malaya Medical Centre (UMMC)
Studies were carried out in two estates in Kedah and Johor to characterize the anthropometry and dietary patterns of 334 (169 females, 165 males) Malaysian estate workers. Subjects were Malay and Indian adults (aged 18 to 60 years) engaged in various work activities including rubber tappers, palm fruit harvesters, field supervisors and workers in the estate factories. Anthropometric results showed that the prevalence of overweight (26% in men, 25% in women) and obesity (5% in men, 11% in women) were higher compared to prevalence of underweight (11% in men, 9% in women) in these workers despite being engaged in moderate to heavy activities. The dietary intake pattern revealed that the main sources of calories in the diet were rice, cooking oil and sugar. Major sources of protein in the Malay diet were anchovies and fish whilst in the Indian diet protein was provided by salted fish, anchovies, eggs, fish, and pulses. The consumption of poultry, meat and dairy products were low for both ethnic groups. The dietary intakes of a subsampel of 108 normal weight subjects (56 females, 52 males) were recorded for 3 days. The results showed that the mean energy intake was 8.44 ± 2.12 MJ in males and 6.48 ± 1.29 MJ in females. The contribution of calories from protein, fat and carbohydrate were 13%, 22% and 60% in males and 12%, 23% and 65% in females, respectively. Alcohol intake was found to contribute five percent of energy in the diet of the Indian male subjects. Calcium, iron, vitamin A, thiamin, riboflavin and niacin intake were below 66% of the Malaysian RDA, particularly amongst the women. Income appeared to have a significant correlation with energy and iron intakes of the female workers as well as thiamin, niacin and riboflavin intakes of the male workers. There is a need for improving the quality of the dietary intakes of these workers as well as nutrition education on the prevention of obesity and its consequences.
Chemical preservatives have been used in the food industry for many years. However, with increased health concerns, consumers prefer additive-free products or food preservatives based on natural products. This study evaluated antimicrobial activities of extracts from Emilia sonchifolia L. (Common name: lilac tassel flower), Tridax procumbens L. (Common name: tridax daisy) and Vernonia cinerea L. (Common name: Sahadevi), belonging to the Asteracea family, to explore their potential for use against general food spoilage and human pathogens so that new food preservatives may be developed. Three methanol extracts of these plants were tested in vitro against 20 bacterial species, 3 yeast species, and 12 filamentous fungi by the agar diffusion and broth dilution methods. The V. cinerea extract was found to be most effective against all of the tested organisms and the methanol fraction showed the most significant (p < 0.05) antimicrobial activity among all the soluble fractions tested. The minimum inhibitory concentrations (MICs) of extracts determined by the broth dilution method ranged from 1.56 to 100.00mg/mL. The MIC of methanol fraction was the lowest in comparison to the other four extracts. The study findings indicate that bioactive natural products from these plants may be isolated for further testing as leads in the development of new pharmaceuticals in food preservation as well as natural plant-based medicine.