As part of a research programme concerned with the need to lighten the load carried by soldiers engaged in long foot patrols, a field experiment was undertaken in West Malaysia. For 12 d a group of 15 men consumed 7.4 MJ/d (1770 kcal/d) whilst a control group of 14 men ate 12.9 MJ/d (3080 kcal/d); both groups expended on average about 15.8 MJ/d (3770 kcal/d). The low-energy group incurred an energy deficit of 98 MJ (23 410 kcal) with a weight loss of 3.9 kg, whereas corresponding figures for the control group were 37 MJ (8840 kcal) and 2.4 kg. Before, during and after the energy deprivation phase, assessment was made of work capacity (estimated VO2 max), vigilance and military skills but no difference was found between the groups.
1. Anthropometric variables, resting heart rate and respiratory gas exchange were measured in twelve male and nine female Asiatic adult Moslems during the month of Ramadan, the week before and the month after Ramadan. 2. Energy intakes were estimated from dietary recall during fasting and non-fasting conditions. 3. Both male and female subjects experienced a decrease in body mass with the reduction in energy intake during fasting. Males experienced a greater reduction than females in resting heart rate; females lost more body-weight and subcutaneous fat than males. 4. Urine output and fluid intake were measured in twelve male subjects for 1 d during each week of fasting and 1 d during the pre-fasting control period. Among the subjects examined, the Ramadan regimen did not result in changes in the pattern of fluid exchange.
To compare the effects of dietary palmitic acid (16:0) vs oleic acid (18:1) on serum lipids, lipoproteins, and plasma eicosanoids, 33 normocholesterolemic subjects (20 males, 13 females; ages 22-41 years) were challenged with a coconut oil-rich diet for 4 weeks. Subsequently they were assigned to either a palm olein-rich or olive oil-rich diet followed by a dietary crossover during two consecutive 6-week periods. Each test oil served as the sole cooking oil and contributed 23% of dietary energy or two-thirds of the total daily fat intake. Dietary myristic acid (14:0) and lauric acid (12:0) from coconut oil significantly raised all the serum lipid and lipoprotein parameters measured. Subsequent one-to-one exchange of 7% energy between 16:0 (palm olein diet) and 18:1 (olive oil diet) resulted in identical serum total cholesterol (192, 193 mg/dl), low-density lipoprotein cholesterol (LDL-C) (130, 131 mg/dl), high-density lipoprotein cholesterol (HDL-C) (41, 42 mg/dl), and triglyceride (TG) (108, 106 mg/dl) concentrations. Effects attributed to gender included higher HDL in females and higher TG in males associated with the tendency for higher LDL and LDL/HDL ratios in men. However, both sexes were equally responsive to changes in dietary fat saturation. The results indicate that in healthy, normocholesterolemic humans, dietary 16:0 can be exchanged for 18:1 within the range of these fatty acids normally present in typical diets without affecting the serum lipoprotein cholesterol concentration or distribution. In addition, replacement of 12:0 + 14:0 by 16:0 + 18:1, but especially 16:0 or some component of palm olein, appeared to have a beneficial impact on an important index of thrombogenesis, i.e., the thromboxane/prostacyclin ratio in plasma.
Non-communicable diseases with dietary implications, ischaemic heart disease, diabetes mellitus and cancers of the breast and colon are discussed in relation to their prevalence and mortality rates in peninsular Malaysia during the past few decades. The mortality rate due to diseases of the circulatory system has more than doubled since 1970, deaths due to ischaemic heart disease being the major cause. The prevalence of diabetes mellitus has risen from 0.65% in 1960 to about 4% currently. The mortality risk for both ischaemic heart disease and diabetes is highest in the Indian compared to Malay and Chinese populations. The Chinese show the highest mortality rate for cancers of the breast and colon. This could reflect, partly, because more people especially in the urban areas are seeking treatment and improved diagnosis. Empirical dietary data indicate an increase in the prevalence of hypercholesterolaemia among urban adults and overweight among urban and rural adults. Aggregate data from food balance sheets indicate increased availability of energy intake from fats and oils, sugar, and animal products, with concomitant decline in available energy from plant products. Continued public health education on the important linkage between diet and disease is called for.
The study was designed to determine if the activity pattern of pregnancy women on an intake of energy lower than that recommended will affect fetal growth. Subjects who volunteered were either attending public or private hospitals. Pregnant women in the "private" group were significantly older (p < 0.001) weighed somewhat less and significantly taller (p < 0.001) when compared to the "public" group. Differences in energy intake during the second and third trimesters between the "public" and "private" groups were small; 1608 +/- 334, 1726 +/- 271 kcal and 1627 +/- 367, 1778 +/- 260 kcal, respectively. However, daily activity patterns revealed that the "public" group was more active as reflected by the higher energy expenditure of 1412 +/- 74 kcal and 1578 +/- kcal during the second and third trimesters respectively. There was a significant difference (p < 0.01) in birth weight between the "public" and "private" groups; 2951 +/- 377 g and 3173 +/- 357 g respectively. This study indicates that energy intakes lower than recommended and sedentary lifestyles have no direct influence on birth weights of babies.
The objective of this study was to assess the nutritional status of children in FELDA Sungai Koyan, Pahang. Anthropometric measurements were taken from 105 children comprising of 62 boys and 43 girls aged 12 to 72 months. Food intake records from 84 of these children aged 4-6.9 years were obtained. Socio-economic factors which may influence nutritional status were also studied. The anthropometric assessment showed that 14.3% (n=15) of the children were underweight, 10.5% (n=11) stunted and 2.9% (n=3) wasted when compared with the NCHS Reference. It was also found that 28.6% (n=30) of the children had low mid arm circumference for age according to the Frisancho reference, indicating a low protein calorie reserve. The result of the dietary study showed that the intake of calories, calcium, niacin and thiamine were below the recommended daily allowances (RDA) for Malaysia. However, the intake of protein, iron, vitamin A, riboflavin and vitamin C were above the RDA levels. Foods most frequently taken were rice, fish, milk and meat. Vegetables and fruits were also often consumed by the children. Based on the Pearson correlation test, a significant relationship was shown between the nutritional status of the children (weight for age and height for age) with the mother’s educational level, and the number of children in the family. There was also a significant relationship between mother’s nutrition knowledge and the nutritional status of the children (weight for age). Inadequate calorie intake is one of the important factors involved in the causation of protein energy malnutrition. This problem is influenced by socio-economic factor such as low educational level and nutrition knowledge of mothers and large family size. Parents should be encouraged to participate in activities that enhance nutrition knowledge and promote good nutritional practices. FELDA is encouraged to organize more such activities.
Diet is one of the major factors contributing to the development of obesity, apart from heredity and energy balance. The objective of this cross-sectional study is to assess energy, carbohydrate, protein and fat intakes in relation to bodyweight status among government office workers in Kuala Lumpur. A total of 185 Malay men and 196 Malay women aged 18 and above were randomly selected as the study sample. Height and weight were taken to determine body mass index (BMI). The dietary profile was obtained by using 24-hour dietary recalls and food frequency methods. This was analysed to determine average nutrient intake per day. Other information was ascertained from tested and coded questionnaires. The subjects were categorised into three groups of bodyweight status namely underweight (BMI < 20 kg/m2), normal weight (BMI 20-25 kg/m2) and obese (BMI > 25 kg/m2). The prevalence of obesity was 37.8%. The study showed that the mean energy intake of the respondents was 1709 ± 637 kcal/day. The energy composition comprised of 55.7 ± 7.6% carbohydrates, 29.7 ± 21.7 % fat and 15.6 ± 3.8% protein. There was no significant difference in diet composition among the three groups. The findings indicate that normal weight and overweight individuals had a lower intake of calories and carbohydrates than the underweight individuals (p<0.05). However, there were no significant differences in fat intakes.
Nutrient intake was surveyed by the total food duplicate method in 49 adult ethnically Malay women (at the ages of 18 to 47 years and mostly at 30-39 years) working in Kuala Lumpur, Malaysia. Simultaneously, hematological examinations, serum biochemistry, anthropometry and clinical examination were conducted. Nutrient intakes were estimated in reference to the weight of each food item and the standard food composition tables. Lunch was the most substantial meal of the day with rice as a staple food. Compared with the Recommended Dietary Allowance (RDA) values, daily intakes of energy (1,917 kcal as an arithmetic mean), protein (62.2 g), vitamin B1 (0.83 mg) and vitamin B2 (1.18 mg) were sufficient, but intakes of minerals [i.e., calcium (347.8 mg) and iron (12.5 mg)] and some vitamins [i.e., vitamin A (equivalent to 627 micrograms retinol) and niacin (7.84 mg)] were less than RDA. When evaluated on an individual basis, the prevalence of those who took less than 80% RDA was highest for iron (92%), followed by niacin (80%), calcium (57%) and vitamin A (57%). The presence of 7 hypohemoglobinemia cases may be related to the insufficient iron intake. Overweight cases (14 women) were also detected, the prevalence of which increased at advanced ages. Lipid intake was rather high (28% of total food on energy basis), for which the major source was plants with limited contribution from fish/shellfish.
Three primary schools with three different food service managements in Kuala Selangor were selected for this study. Food samples served for five school days were taken and analyzed for calories, protein, fat and carbohydrate. It was observed that most of the food served was rice-based such as nasi lemak, chicken rice, noodles and traditional cakes. The amount of calories and protein per serving ranged from 77-274 kcal and 0.9-3.6 g respectively. Food served under the Supplementary School Feeding Programme contained higher calories than those sold by these school canteens. However, the amounts of protein and calories were still short of the expected amounts recommended by the Ministry of Education, which according to menu should provide at least 10 g protein and 290-390 kcal. The percentage contributions of energy from protein in foods served at school canteens were also lower than the recommended.
An assessment of the daily intake of major nutrients among 409 adults (males and females aged between 18-60 years, normal body mass index) residing in four regions in Malaysia was carried out as part of a major study on energy requirement. Subjects from both urban and rural areas completed a 3-day food record during the study. Mean energy intake among the men and women were 9.05 ± 2.21 MJ/day (2163 kcal/day) and 7.19 ± 1.60 MJ/day (1718 kcal/day) respectively, corresponding to 90% of the Malaysian RDA. A mean of 14% of the total energy was derived from protein, 23% from fat and 63% from carbohydrate. Energy intake amongst male subjects in the rural area (8.47 MJ/day, 2024 kcal) was significantly lower than their urban counterparts (9.52 MJ/day, 2275 kcal). There was no difference in mean energy intake in both the urban (7. 19 MJ/day, 1718 kcal) as well as rural women (7.16 MJ/day, 1711 kcal) corresponding to 86% of the RDA. The distribution of nutrients to the total energy intake amongst rural subjects were 13% for protein in both males and females, 65% for carbohydrate in males and 66% in females and 19% for fat in males and 21% for females. In the urban male and female subjects, the distribution of protein, carbohydrate and fat to the total energy intake were 14%, 55% and 29% and 30% respectively. The rural subjects showed a poorer mean intake of vitamins and minerals compared to the urban subjects. The diets of the male subjects in the rural area were deficient, less than two-third RDA in calcium, riboflavin and niacin. Calcium and iron intakes were less than two-third RDA in both the rural as well as the urban women. The rural women also had a poor intake of vitamin A and niacin. Overall, only protein and vitamin C intake met the RDA in most subjects from rural and urban areas.
AIM: To evaluate the anthropometric measurements and dietary intake of the free-living elderly in a Chinese community.
METHOD: A survey was carried out on 48 male and female subjects aged 60 to 96 years using anthropometric, dietary intake and questionnaire techniques.
RESULTS: The study indicated female subjects to have more health problems, like pain at the joints (33%), hypertension (17%) and diabetes (27%) as compared to the male subjects. Dietary intake analysis showed the Chinese male subjects to have a higher energy intake (1,623 kcal) compared to the females (1,197 kcal) even though they did not fulfill the recommended dietary intake. The intake for energy, fats and carbohydrates, was found to be significantly different (p < 0.05) between both sexes. Anthropometric measurements indicated male elderly subjects to be significantly heavier (p < 0.05, 55.4 kg) and taller (161.8 cm) than female elderly subjects (49.5 kg; 146.2 cm respectively). About half of the elderly were normal in their BMI (male 55.6%; female 50%) and only 6.6% of the female subjects were obese. More male subjects were found to be underweight (33%) compared to female subjects (17%). Waist hip ratio was 0.92 for male and 0.87 for female.
CONCLUSION: Our study showed that female elderly subjects had more health problems compared to male elderly subjects. On the whole, the elderly did not fulfill the recommended amount for energy intake while the percentage for carbohydrates, fats and protein from the total calorie intake were not in accordance with the healthy diet guidelines. Anthropometrically, male subjects were heavier and taller than female subjects. Looking at body mass index, most of the male elderly subjects were in the normal to underweight range. With these results, more research is warranted to give a clearer picture of the Chinese elderly in the country.
Study site: Kampung Baru Tabuh Naning, Alor Gajah, Malacca
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 & 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.
This study was carried out to determine the nutritional status of 16 elite netball players of the Commonwealth Games 1998, during centralised training at Bukit Jalil. The mean age of the subjects was 21.1 ± 3.1 year. The physical characteristics were assessed through antropometric measurements. The dietary intake was estimated as a mean of 3-days weighed food record while the physical activity pattern was determined by time and motion study which was carried out simultaneously. A biochemical analysis test was carried out to evaluate the haemoglobin status of the athletes. The results indicated that the mean body weight and height were 62.5 ± 7.9 kg and 1.69 ± 0.06 meter, respectively. The percentage average body fat of the subjects was 23.7 ± 2.8. Mean energy intake was recorded as 2726 ± 507 kcal/day while energy expenditure was 3225 ± 409 kcal/d with a negative energy balance of 499 kcal. The contribution of calories from carbohydrate, protein and fat were 59%, 16% and 26%, respectively. Intake of most micronutrients was sufficient and met the Malaysian RDA. The percentage average of the daily physical activity pattern revealed that 74% was spent for light activities, 12% for moderate while 14% for heavy activities. 94% of the athletes took supplements which vitamin C was the most popular (64%).
A nutritional status study was carried out among a group of young Chinese adults, aged between 19 and 25, in Kuala Lumpur, Malaysia. Subjects comprised 108 young adults (55 women, 53 men) who were students at two institutes of higher learning. Physical characteristics were evaluated by anthropometric measurements while food intake was determined with a 3-day food record. Blood cholesterol and triglyceride were assessed using the Reflotron analyser. Birthweight was obtained from birth certificates or by proxy. The results showed that the mean body mass index (BMI) for men and women was 21.4 ± 3.3 and 20.0 ± 2.0, respectively, indicating normal weight. Further analysis of BMI classification demonstrated that 28% of men and 39% of women were underweight, 11% of men and 2% of women were overweight while 2% of men were obese. Mean waist-to-hip ratio showed that the subjects had a low risk of developing cardiovascular disease (0.72 ± 0.03 women; 0.81 ± 0.05 men). Mean energy intake was 8841 ± 1756 kJ per day for men and 6426 ± 1567 kJ per day for women. Closer analysis of energy intake of the subjects showed that 86% of men and 91% of women were consuming below the Malaysian recommendation for energy. Nutrients found to be deficient in at least one third of women were calcium, vitamin A, niacin and iron. Mean cholesterol intake in the diet was 278.7 ± 108.7 mg in men and 207.0 ± 82.5 mg in women and there was a significant difference between genders. Blood cholesterol and triglyceride levels were 3.88 ± 0.76 mmol/L and 1.08 ± 0.33 mmol/L, respectively in men, while these levels were lower in women, 3.87 ± 0.80 mmol/L for cholesterol and 0.99 ± 0.29 mmol/L for triglyceride. A general trend of higher mean blood cholesterol and triglyceride levels was shown in adults who were born with lower birthweights.
Heat production (HP) of male and female mouse deer during eating, standing and sitting was determined using the open circuit respiration chamber (RC). The time taken for similar activities was also determined in an outdoor enclosure (OD). The animals were fed kangkong (Ipomoea aquatica), sweet potato (Ipomoea batatas) and rabbit pellet ad libitum. Male mouse deer consumed more dry matter (DM), organic matter (OM) and gross energy (GE) than female. The time for each activity of male and female mouse deer kept in RC and OD was similar. The average time spent in RC and OD for both male and female, respectively, for sitting (956 and 896 min/day) was significantly (P<0.01) longer than standing (463 and 520 min/day) and eating (21 and 24 min/day). Heat production for male and female mouse deer, respectively, during eating was the highest (0.44 and 0.43 kJ/kg W(0.75)/min) followed by standing (0.37 and 0.33 kJ/kgW(0.75)/min) and sitting (0.26 and 0.26 kJ/kg W(0.75)/min). The difference in HP per min during standing between male and female was significant (P<0.05). The HP for 08.00-14.00 h and 14.00-20.00 h periods were higher than 20.00-02.00 h and 02.00-08.00 h periods. The overall HP for males during 08.00-14.00 h and 14.00-20.00 h periods were significantly (P<0.05) higher (114.8 and 119.2 kJ/kg W(0.75)) than female (107.5 and 110.4 kJ/kg W(0.75)), respectively.
This study was undertaken to assess the recent data on Malaysian adult body weights and associations of ethnic differences in overweight and obesity with comorbid risk factors, and to examine measures of energy intake, energy expenditure, basal metabolic rate (BMR) and physical activity changes in urban and rural populations of normal weight. Three studies were included (1) a summary of a national health morbidity survey conducted in 1996 on nearly 29 000 adults > or =20 years of age; (2) a study comparing energy intake, BMR and physical activity levels (PALs) in 409 ethnically diverse, healthy adults drawn from a population of 1165 rural and urban subjects 18-60 years of age; and (3) an examination of the prevalence of obesity and comorbid risk factors that predict coronary heart disease and type 2 diabetes in 609 rural Malaysians aged 30-65 years. Overweight and obesity were calculated using body mass index (BMI) measures and World Health Organization (WHO) criteria. Energy intake was assessed using 3-d food records, BMR and PALs were assessed with Douglas bags and activity diaries, while hypertension, hyperlipidaemia and glucose intolerance were specified using standard criteria. The National Health Morbidity Survey data revealed that in adults, 20.7% were overweight and 5.8% obese (0.3% of whom had BMI values of >40.0 kg m(-2)); the prevalence of obesity was clearly greater in women than in men. In women, obesity rates were higher in Indian and Malay women than in Chinese women, while in men the Chinese recorded the highest obesity prevalences followed by the Malay and Indians. Studies on normal healthy subjects indicated that the energy intake of Indians was significantly lower than that of other ethnic groups. In women, Malays recorded a significantly higher energy intake than the other groups. Urban male subjects consumed significantly more energy than their rural counterparts, but this was not the case in women. In both men and women, fat intakes (%) were significantly higher in Chinese and urban subjects. Men were moderately active with the exception of the Dayaks. Chinese women were considerably less active than Chinese men. Chinese and Dayak women were less active than Malay and Indian women. In both men and women, Indians recorded the highest PALs. Hence, current nutrition and health surveys reveal that Malaysians are already affected by western health problems. The escalation of obesity, once thought to be an urban phenomenon, has now spread to the rural population at an alarming rate. As Malaysia proceeds rapidly towards a developed economy status, the health of its population will probably continue to deteriorate. Therefore, a national strategy needs to be developed to tackle both dietary and activity contributors to the excess weight gain of the Malaysian population.
Study name: National Health and Morbidity Survey (NHMS-2006)
This report is a part of a multi-centre study in Asia on the problem of dual forms of malnutrition in the same households. In Malaysia, the prevalence of underweight and stunting persist among young children from poor rural areas. Overweight in adults, especially women from poor rural areas has been reported in recent years. Thus, this study was undertaken in order to assess the presence of the dual burden of underweight child-overweight mother pairs in a poor rural community. Out of 140 Malay households identified to have at least one child aged 1-6 years and mother aged above 20 years, 52.1% of the mothers were overweight, 15.7% of the children were underweight, 27.1% stunted and 5% wasted. Socio-economic background and food intake frequency data were collected from 54 underweight child/overweight mother pairs (UW/OW) and 41 normal weight child/normal weight mother pairs (NW/NW). Compared with the overweight mothers, a higher percentage of the normal weight mothers had received secondary education, were employed and with a higher household monthly income, although these differences were not significant. Patterns of food intake of the mothers and children appeared to have more similarities than differences between the UW/OW and NW/NW groups. Quantitative dietary intakes for 2 days using 24-hr recall and physical activity energy expenditure over the same period were assessed in a sub-group of UW/OW and NW/NW mothers and children. The NW/NW children showed significantly higher intake of total calories, fat and riboflavin than the UW/OW counterparts. Mean energy and nutrient intake of mothers from both groups were not significantly different, although the NW/NW mothers showed higher intake adequacy for total calories and most nutrients. While most of the mothers from both groups reported having no chronic illnesses, about half of the children in both groups had infections, especially gastrointestinal infections, over a 2-week period. Energy expenditure from physical activity for both UW/OW and NW/NW mothers and children did not differ significantly. This study confirmed inadequate intake of total energy and nutrients as the major factor for underweight in Malay children from rural areas. However, assessing intake and physical activity by interview methods were not sensitive enough to overcome perceived problems of under-reporting of energy intake and over-estimation of energy expenditure, especially by overweight subjects. Further investigations on a larger sample are necessary to understand the family dynamics leading to the double burden of malnutrition within the same household.
Current understanding of the use of exclusion diets in the management of asthma in children is limited and controversial. The aim of this study was to examine the effects of excluding eggs and milk on the occurrence of symptoms in children with asthma and involved 22 children aged between three and 14 years clinically diagnosed as having mild to moderate disease. The investigation was single blind and prospective, and parents were given the option of volunteering to join the 'experiment' group, avoiding eggs, milk and their products for eight weeks, or the 'control' group, who consumed their customary food. Thirteen children were recruited to the experimental group and nine to the control group. A trained paediatrician at the beginning and end of the study period assessed the children. A seven-day assessment of food intake was made before, during and immediately after the period of dietary intervention in both groups. A blood sample was taken from each child for determination of food specific antibodies and in those children who could do so, the peak expiratory flow rate (PEFR) was measured. Based on the recommended nutrient intake (RNI), the mean percentage energy intake of the children in the experimental group was significantly lower (p < 0.05) in the experimental group. After the eight-week study period and compared with baseline values, the mean serum anti-ovalbumin IgG and anti-beta lactoglobulin IgG concentrations were statistically significantly reduced (p < 0.05) for both in the experimental group. In contrast, the values for anti-ovalbumin IgG in the control group were significantly increased and those for anti-beta lactoglobulin IgG were practically unchanged. The total IgE values were unchanged in both groups. Over the study period, the PEFR in those children in the experimental group able to perform the test was significantly increased, but no such change was noted in the children in the control group who could do the test. These results suggest that even over the short time period of eight weeks, an egg- and milk-free diet can reduce atopic symptoms and improve lung function in asthmatic children.
Study site: Outpatient Department, Royal County Hospital and the Frimley Children’s Centre, United Kingdom