Displaying publications 21 - 40 of 87 in total

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  1. Kariippanon KE, Chong KH, Janssen X, Tomaz SA, Ribeiro EHC, Munambah N, et al.
    Med Sci Sports Exerc, 2022 Jul 01;54(7):1123-1130.
    PMID: 35142711 DOI: 10.1249/MSS.0000000000002886
    PURPOSE: There is a paucity of global data on sedentary behavior during early childhood. The purpose of this study was to examine how device-measured sedentary behavior in young children differed across geographically, economically, and sociodemographically diverse populations, in an international sample.

    METHODS: This multinational, cross-sectional study included data from 1071 children 3-5 yr old from 19 countries, collected between 2018 and 2020 (pre-COVID). Sedentary behavior was measured for three consecutive days using activPAL accelerometers. Sedentary time, sedentary fragmentation, and seated transport duration were calculated. Linear mixed models were used to examine the differences in sedentary behavior variables between sex, country-level income groups, urban/rural settings, and population density.

    RESULTS: Children spent 56% (7.4 h) of their waking time sedentary. The longest average bout duration was 81.1 ± 45.4 min, and an average of 61.1 ± 50.1 min·d-1 was spent in seated transport. Children from upper-middle-income and high-income countries spent a greater proportion of the day sedentary, accrued more sedentary bouts, had shorter breaks between sedentary bouts, and spent significantly more time in seated transport, compared with children from low-income and lower-middle-income countries. Sex and urban/rural residential setting were not associated with any outcomes. Higher population density was associated with several higher sedentary behavior measures.

    CONCLUSIONS: These data advance our understanding of young children's sedentary behavior patterns globally. Country income levels and population density appear to be stronger drivers of the observed differences, than sex or rural/urban residential setting.

  2. Khoo S, Poh BK, Suhaimi SA, Chong KH, Ramirez Varela A
    Front Public Health, 2020;8:536239.
    PMID: 33194945 DOI: 10.3389/fpubh.2020.536239
    About three quarters of the Malaysian adult population are physically active. There has been growth in physical activity and health research since 2010, with most studies being observational in design and few included objective measures of physical activity. The Malaysian Ministry of Health has published physical activity guidelines, strategies and action plans aimed at promoting physical activity. Physical activity promotion activities have included national campaigns and programmes which target different populations. Further work that incorporates the WHO Global Action Plans on Physical Activity (GAPPA), as well as a more systemic approach is needed, to promote physical activity and a healthy lifestyle. High-level multi-stakeholder collaboration is required for continuing expansion and strengthening of research capacity, and for bridging the physical activity policy gaps in Malaysia.
  3. Kidokoro T, Suzuki K, Naito H, Balasekaran G, Song JK, Park SY, et al.
    BMC Public Health, 2019 Dec 27;19(1):1737.
    PMID: 31881869 DOI: 10.1186/s12889-019-8079-0
    BACKGROUND: Moderate-to-vigorous physical activity (MVPA) and television viewing are independently associated with cardiorespiratory fitness. However, limited evidence is available on their combined effects, specifically of MVPA and watching television, on cardiorespiratory fitness in the young Asian population. Therefore, the present study examined whether MVPA can attenuate the detrimental effects of prolonged television viewing on the cardiorespiratory fitness of Asian adolescents.

    METHODS: This is a cross-sectional study on 9553 adolescents (aged 12-15 years) from 8 Asian metropolitan cities (Tokyo, Hong Kong, Shanghai, Taipei, Bangkok, Kuala Lumpur, Seoul, and Singapore). Cardiorespiratory fitness was assessed by using a 15-m progressive aerobic capacity endurance run (PACER) test. The time spent on MVPA and watching television was assessed using the International Physical Activity Questionnaire-Short Form.

    RESULTS: MVPA was more closely associated with the PACER score than the duration of watching television. Compared with the reference group (i.e. those with the lowest levels of MVPA [

  4. Koo HC, Poh BK, Lee ST, Chong KH, Bragt MC, Abd Talib R, et al.
    Asia Pac J Public Health, 2016 07;28(5 Suppl):8S-20S.
    PMID: 27073200 DOI: 10.1177/1010539516641504
    A large body of epidemiological data has demonstrated that diet quality follows a sociodemographic gradient. Little is known, however, about food group intake patterns among Malaysian children. This study aimed to assess consumption pattern of 7 food groups, including cereals/grains, legumes, fruits, vegetables, fish, meat/poultry, and milk/dairy products, among children 7 to 12 years of age. A total of 1773 children who participated in SEANUTS Malaysia and who completed the Food Frequency Questionnaire were included in this study. A greater proportion of children aged 10 to 12 years have an inadequate intake of cereals/grains, meat/poultry, legumes, and milk/dairy products compared with children 7 to 9 years old. With the exception of meat/poultry, food consumption of Malaysian children did not meet Malaysian Dietary Guidelines recommendations for the other 6 food groups, irrespective of sociodemographic backgrounds. Efforts are needed to promote healthy and balanced dietary habits, particularly for foods that fall short of recommended intake level.
  5. Koo HC, Poh BK, Talib RA
    Nutrients, 2020 Sep 29;12(10).
    PMID: 33003299 DOI: 10.3390/nu12102972
    Diet composition is a key determinant of childhood obesity. While whole grains and micronutrients are known to decrease the risk of obesity, there are no interventions originating from Southeast Asia that emphasize whole grain as a strategy to improve overall quality of diet in combating childhood obesity. The GReat-Child Trial aimed to improve whole grain intake and quality of diet among overweight and obese children. It is a quasi-experimental intervention based on Social Cognitive Theory. It has a 12-week intervention and 6-month follow-up, consisting of three components that address environmental, personal, and behavioral factors. The intervention consists of: (1) six 30 min lessons on nutrition, using the Malaysian Food Pyramid to emphasize healthy eating, (2) daily deliveries of wholegrain foods to schools so that children can experience and accept wholegrain foods, and (3) diet counseling to parents to increase availability of wholegrain foods at home. Two primary schools with similar demographics in Kuala Lumpur were assigned as control (CG) and intervention (IG) groups. Inclusion criteria were: (1) children aged 9 to 11 years who were overweight/obese; (2) who did not consume whole grain foods; and (3) who had no serious co-morbidity problems. The entire trial was completed by 63 children (31 IG; 32 CG). Study outcomes were measured at baseline and at two time points post intervention (at the 3rd [T1] and 9th [T2] months). IG demonstrated significantly higher intakes of whole grain (mean difference = 9.94, 95%CI: 7.13, 12.75, p < 0.001), fiber (mean difference = 3.07, 95% CI: 1.40, 4.73, p = 0.001), calcium (mean difference = 130.27, 95%CI: 74.15, 186.39, p < 0.001), thiamin (mean difference = 58.71, 95%CI: 26.15, 91.28, p = 0.001), riboflavin (mean difference = 0.84, 95%CI: 0.37, 1.32, p = 0.001), niacin (mean difference = 0.35, 95%CI: 1.91, 5.16, p < 0.001), and vitamin C (mean difference = 58.71, 95%CI: 26.15, 91.28, p = 0.001) compared to CG in T1, after adjusting for covariates. However, T1 results were not sustained in T2 when intervention had been discontinued. The findings indicate that intervention emphasizing whole grains improved overall short-term but not long-term dietary intake among schoolchildren. We hope the present trial will lead to adoption of policies to increase whole grain consumption among Malaysian schoolchildren.
  6. Koo HC, Poh BK, Abd Talib R
    Nutrients, 2018 Jan 30;10(2).
    PMID: 29385769 DOI: 10.3390/nu10020156
    Background: The GReat-Child Trial was a quasi-experimental intervention that has emphasized whole grain as a strategy to manage childhood obesity. Methods: Two schools in Kuala Lumpur with similar demographic characteristics were assigned as intervention (IG) and control (CG). Eligibility criteria were overweight/obese children aged 9 to 11 years who had no serious co-morbidity. Children who reported consuming wholegrain foods in their 3-day diet-recall during screening were excluded. A total of 63 children (31 IG; 32 CG) completed the entire intervention program. The IG children underwent six 30-min nutrition education lessons and had school delivery of wholegrain food on a daily basis over a 12-week period. Parents of IG children attended 1-h individual diet counseling. Anthropometric outcomes including BMI-for-age z-score (BAZ), body fat percentage and waist circumference were measured at baseline [T0], post-intervention [T1] (3rd month) and follow-up [T2] (9th month). Results: IG showed significantly lower BAZ (weighted difference: -0.12; 95% CI: -0.21, -0.03; p = 0.009), body fat percentage (weighted difference: -2.6%; 95% CI: -3.7, -1.5; p < 0.001) and waist circumference (weighted difference: -2.4 cm; 95% CI: -3.8, -1.0; p = 0.001) compared to CG. IG reported significantly lower body fat percentage (weighted difference: -3.4%; 95% CI: 1.8, 5.0; p < 0.001) and waist circumference (weighted difference: -2.1 cm; 95% CI: -3.7, -0.5; p = 0.014) at T1 compared to T0. Conclusions: The GReat-Child Trial made a positive impact in managing childhood obesity. It can be incorporated into childhood obesity intervention programs that are being implemented by the policy makers.
  7. Lau XC, Chong KH, Poh BK, Ismail MN
    Adv. Food Nutr. Res., 2013;70:49-101.
    PMID: 23722094 DOI: 10.1016/B978-0-12-416555-7.00002-3
    The tropics cover a large section of the world in which both developed and developing countries are situated. Rapid socioeconomic development, modernization, urbanization, and globalization have affected both the food market and physical activity (PA), which in turn have propelled the obesity epidemic in the tropics. There is growing concern that overweight and obesity are emerging as major health problems among children and adolescents in the tropics, despite the fact that undernutrition still exists in many of these countries. Physical inactivity, a low metabolic rate, and lack of physical fitness (PF) have been linked to overweight and obesity. Moreover, PF in several tropical countries is declining, and these changes may be a threat to future health, as low PA and PF levels are important risk factors for noncommunicable chronic diseases. Previous studies have reported that the relationships among PA, PF, overweight, and obesity are inconsistent and inconclusive. There is no indication that variances in the energy cost of physical activities lead to obesity. Despite a lack of definite evidence to prove a causal relationship, there is enough certainty that physical inactivity and low fitness levels are linked to overweight and obesity. Hence, people living in tropical countries need to be encouraged to lead a healthier lifestyle by increasing their PA levels and reducing sedentary behaviors to prevent overweight or obesity.
  8. Lee ST, Wong JE, Shanita SN, Ismail MN, Deurenberg P, Poh BK
    Int J Environ Res Public Health, 2015 Jan;12(1):146-61.
    PMID: 25546277 DOI: 10.3390/ijerph120100146
    Childhood obesity is related to low physical activity level and a sedentary lifestyle. The aim of this study was to assess the physical activity level and sedentary behaviour of Malaysian children aged 7 to 12 years and to examine their association with body mass index (BMI), BMI-for-age Z-score (BAZ), body fatness (%BF) and waist circumference (WC). A total of 1736 children, representing all ethnic groups were recruited from six regions of Malaysia. Anthropometric measurements included body weight, height and waist circumference. Body fat percentage (%BF) was assessed using bioelectrical impedance. Physical activity was assessed by a physical activity questionnaire (PAQ) in all children and by pedometers in a subsample (n = 514). PAQ score and pedometer step counts were negatively associated with BMI, BAZ, %BF and WC after adjusting for covariates. Screen time was positively associated with BAZ and WC. However, other sedentary activities were not significantly related with any anthropometric indicators. Strategies to promote active living among children in Malaysia should focus not only on increasing physical activity but also emphasise reduction in sedentary behaviours.
    MESH: screen time
  9. Lee ST, Wong JE, Ong WW, Ismail MN, Deurenberg P, Poh BK
    Asia Pac J Public Health, 2016 07;28(5 Suppl):21S-34S.
    PMID: 27026634 DOI: 10.1177/1010539516638155
    Children's physical activity has been correlated with child characteristics and social or physical environment. This study aimed to compare preschoolers' physical activity among various sociodemographic characteristics and to determine barriers, motivators, and environmental factors for active play. A total of 835 preschoolers were included in this analysis. Time spent on active play, quiet play, and screen time was reported by parents. Boys spent significantly more time on active play and screen time than girls. Time spent on quiet play was highest in East Coast Peninsular Malaysia and lowest in Sarawak. Some 40% of children achieved active play recommendation while 27% exceeded daily screen time recommendation. Most parents reported that their child played actively in the house area; and that the main barrier and motivator to active play were safety and child's enjoyment, respectively. These findings demonstrate that sociodemographic characteristics and environment should be considered in designing physical activity intervention programs.
    MESH: screen time
  10. Lee ST, Wong JE, Chan GKL, Poh BK
    PMID: 33925298 DOI: 10.3390/ijerph18094611
    A daily balance of physical activities, sedentary behaviors and sleep are important for maintaining the health of young children. The aim of this study is to explore the association between 24-h movement behavior of Malaysian children aged 4 to 6 years with weight status. A total of 230 preschoolers were recruited from 22 kindergartens in Kuala Lumpur. Physical activity was assessed by Actical accelerometer while screen time and sleep duration were proxy-reported by parents. Children spent on average 5.5 ± 1.3 h on total physical activity (including 1.0 ± 0.4 h of moderate- vigorous physical activity), 3.0 ± 1.6 h on screen activities and 9.5 ± 1.3 h sleeping daily. The proportion of children who complied with physical activity and sleep guidelines were 48.7% and 55.2%, respectively. About 25.2% of children met screen time recommendation. Only 6.5% of children met all three age-specific physical activity, screen time and sleep guidelines. Children who met any two guidelines were less likely to be overweight or obesity compared to those who did not meet any of the guidelines (OR: 0.276; 95% CI: 0.080-0.950). In conclusion, Malaysian preschoolers have low compliance to movement behavior guidelines, especially in meeting screen time recommendations. Compliance to movement behavior guidelines was associated with lower odds of overweight and obesity.
  11. Lee, Szu Ming, Poh, Bee Koon, Mohd Ismail Noor, Ahmad Fuad Shamsuddin
    MyJurnal
    Kafein mempunyai kesan ergogenik terhadap golongan yang terlatih; walaubagaimanapun, kajian kesan fisiologi kafein terhadap golongan sedentari adalah amat terhad. Tujuan kajian ini adalah untuk mengkaji kesan kafein ke atas penggunaan oksigen dan tanggapan tahap lesu semasa senaman intensiti sederhana dalam kalangan dewasa muda perempuan yang sedentari. Subjek terdiri daripada 16 orang mahasiswi yang berumur antara 22 hingga 24 tahun. Kriteria penerimaan adalah tahap aktiviti fizikal yang rendah dan pengambilan kafein adalah kurang daripada 50 mg sehari, disaring dengan menggunakan Soal Selidik Aktiviti Fizikal Antarabangsa (versi pendek) dan soal selidik pengambilan kafein. Reka bentuk kajian eksperimental ini adalah buta tunggal, pindah silang, kawalan plasebo dengan semua subjek menjadi kawalannya tersendiri. Subjek dikehendaki malaporkan diri ke makmal untuk menjalankan dua sesi eksperimen selepas masing-masing mengambil kapsul plasebo atau kafein dengan selang masa 3 hari antara dua sesi eksperimen tersebut. Enam puluh minit selepas mengambil kapsul plasebo (Glucolin, glukosa) atau 100 mg kafein (Pro-plus, United Kingdom), subjek dikehendaki berlari di atas treadmill selama 30 minit pada kuasa kerja yang bersamaan 60% daripada anggaran maksimum kadar denyutan jantung. Penggunaan oksigen, kadar denyutan jantung dan tanggapan tahap lesu direkod pada minit ke-20, ke-25 dan ke-30, manakala tekanan darah direkod serta-merta selepas subjek menghabiskan larian. Perbezaan direkod selepas kesemua subjek menyempurnakan kedua-dua eksperimen plasebo dan kafein. Min peratus lemak tubuh subjek adalah 28.4 ± 5.4. Ujian t bersandar menunjukkan tiada perbezaan signifikan antara trial plasebo dengan trial kafein ke atas penggunaan oksigen (13.99 ± 2.47 vs 14.49 ± 1.73, p = 0.440), tanggapan tahap lesu (12.3 ± 2.5 vs 12.3 ± 2.1, p = 1.000), tekanan darah sistolik (113 ± 10 vs 117 ± 11, p = 0.129), tekanan diastolik (67 ± 8 vs 69 ± 10, p = 0.408) dan kadar denyutan jantung (127.3 ± 11.0 vs 127.1 ± 11.6, p = 0.912). Terdapat korelasi negatif tinggi yang signifikan antara peratusan lemak tubuh dengan pengambilan oksigen (r = –0.568, p < 0.05) serta korelasi positif tinggi yang signifikan antara peratusan lemak tubuh dengan tanggapan tahap lesu (r = 0.515, p < 0.05). Hasil kajian tidak meningkatkan kesan yang signifikan mungkin disebabkan oleh kesan saiz (effect size) kajian ini yang kecil (d = 0.24). Justeru itu, kajian masa depan yang melibatkan lebih ramai subjek harus dijalankan untuk mengkaji kesan kafein semasa senaman dalam kalangan populasi sedentari.
  12. Li B, He Z, Peters R, Allender S, Zou Y, Zhou W, et al.
    Int J Behav Nutr Phys Act, 2023 Sep 18;20(1):111.
    PMID: 37723534 DOI: 10.1186/s12966-023-01510-5
    BACKGROUND: Group Model Building (GMB) is a participatory system dynamics method increasingly used to address complex public health issues like obesity. GMB represents a set of well-defined steps to engage key stakeholders to identify shared drivers and solutions of a given problem. However, GMB has not yet been applied specifically to develop multi-duty interventions that address multiple inter-related issues such as malnutrition in all its forms (MIAIF). Moreover, a recent systematic review of empirical applications of a systems approach to developing obesity interventions found no published work from non-western, low- and middle-income countries (LMICs). In this paper we describe adaptations and innovations to a common GMB process to co-develop systemic MIAIF interventions with Chinese decision-makers.

    METHODS: We developed, piloted and implemented multiple cultural adaptations and two methodological innovations to the commonly used GMB process in Fang Cheng Gang city, China. We included formal, ceremonial and policy maker engagement events before and between GMB workshops, and incorporated culturally tailored arrangements during participant recruitment (officials of the same seniority level joined the same workshop) and workshop activities (e.g., use of individual scoring activities and hand boards). We made changes to the commonly used GMB activities which enabled mapping of shared drivers of multiple health issues (in our case MIAIF) in a single causal loop diagram. We developed and used a 'hybrid' GMB format combining online and in person facilitation to reduce travel and associated climate impact.

    RESULTS: Our innovative GMB process led to high engagement and support from decision-makers representing diverse governmental departments across the whole food systems. We co-identified and prioritised systemic drivers and intervention themes of MIAIF. The city government established an official Local Action Group for long-term, inter-departmental implementation, monitoring and evaluation of the co-developed interventions. The 'hybrid' GMB format enabled great interactions while reducing international travel and mitigating limitations of fully online GMB process.

    CONCLUSIONS: Cultural and methodological adaptations to the common GMB process for an Asian LMIC setting were successful. The 'hybrid' GMB format is feasible, cost-effective, and more environmentally friendly. These cultural adaptations could be considered for other Asian settings and beyond to address inter-related, complex issues such as MIAIF.

  13. Lim SM, Thien CN, Toure AK, Poh BK
    Foods, 2022 Oct 20;11(20).
    PMID: 37431031 DOI: 10.3390/foods11203284
    Entomophagy has recently sparked widespread attention worldwide. Although entomophagy is not a foreign dietary practice in Malaysia, acceptance of insects as food among Malaysians is still unclear. This study aimed to determine the acceptance of insects as food and its influencing factors among adults living in Klang Valley (Peninsular Malaysia) and Kuching, Sarawak (East Malaysia). A cross-sectional survey was conducted involving 292 adults from Klang Valley (n = 144) and Kuching (n = 148). Data was collected through self-administrated online questionnaires. Although most respondents (96.7%) had prior knowledge of people eating insects, only 30.1% of respondents accepted insects as food, and only 18.2% reported that they would be willing to include insects in their daily diet. There was no statistically significant difference in acceptance rates between Klang Valley and Kuching. The main factors influencing respondents' acceptance of insects as food were insect texture, food safety issues and aversion toward insects. In conclusion, the acceptance of insects as food among adults in Klang Valley and Kuching is still low, with sensory characteristics, food safety and sentiments of distaste being the main barriers. Future studies involving insect tasting and in-depth focus group discussion are needed for deeper insights into the acceptance of insects as food.
  14. Lim SM, Goh YX, Wong JE, Kagawa M, Poh BK
    Percept Mot Skills, 2024 Apr;131(2):381-396.
    PMID: 38150555 DOI: 10.1177/00315125231225022
    The Food Neophobia Scale (FNS) is a research instrument, originally developed in English, to assess an individual's level of food neophobia. However, it has not yet been translated and validated for Malaysians. Therefore, we aimed to translate and validate a Malay-translated version of the FNS. Respondents were 200 young adults (mostly females, 73%; and students, 82.0%; M age = 22.3 years, SD = 2.3). We first translated the FNS into Malay using the forward-backward translation method, and a panel of nutrition and dietetics experts then reviewed it for item relevance, clarity, simplicity, and ambiguity. The translated FNS suggested good content validity with an item-level content validity index (I-CVI) > .8, a scale-level content validity index (S-CVI)/average = .8 and a S-CVI/universal agreement = .96. Principal component analysis revealed a two-factor model: (i) willingness and trust; and (ii) rejection and fear. Cronbach's alpha for the Malay-translated FNS was .808, demonstrating high internal consistency and reliability among young Malaysian adults. Future investigators can now use this Malay-translated FNS instrument to determine levels of food neophobia among Malaysians.
  15. Lim SY, Dora R, Yatiman NH, Wong JE, Haron H, Poh BK
    Appetite, 2021 12 01;167:105629.
    PMID: 34364967 DOI: 10.1016/j.appet.2021.105629
    Studies have shown that monosodium glutamate (MSG) can enhance satiety and reduce appetite among infants and adults. In a multi-ethnic country such as Malaysia, it is also important to consider whether ethnic variations will influence the effects of MSG on appetite regulation. Thus, this crossover study aimed to investigate the effects of MSG on the subjective appetite and subsequent energy intake among Malaysian children from the three major ethnic groups, namely the Malays, Chinese and Indians. A total of 92 participants aged 9-11 years from the three ethnic groups were recruited for this study. A cup of low-energy vegetable preload soup (100g, with MSG or without MSG) was served to each of the participants on the day of the study, followed by an ad libitum meal 45 min later. Appetite ratings of hunger, fullness, desire to eat and desire to snack were recorded using visual analogue scale (VAS) before the preload, after the preload, before the ad libitum meal and after the ad libitum meal. Results showed that the subjective appetite of the children did not differ between preload conditions (MSG+ or MSG-) throughout the study. Malay, Chinese and Indian children had similar total energy intake during the subsequent meal after the consumption of preload soups. In conclusion, the addition of MSG to low energy preload neither influenced the perception of appetite nor total energy intake in a subsequent ad libitum meal among children. No difference attributable to the participants' ethnicity was observed. Future studies should be conducted to examine whether repeated ingestion of MSG-containing protein-rich preload has potential longer-term effects on appetite and subsequent meal intakes among children from different ethnicities.
  16. Lim SY, Rosmawati D, Yatiman NH, Wong JE, Haron H, Poh BK
    Curr Res Food Sci, 2022;5:2204-2210.
    PMID: 36387604 DOI: 10.1016/j.crfs.2022.11.006
    Sensitivity to savory taste has been linked to high consumption of savory foods and increased risks of obesity and hypertension. However, there are limited studies that investigate whether obesity indices are correlated with the differences in umami taste perception, particularly in children. This study aimed to investigate the umami detection threshold among children of different ethnicities and the threshold's correlation with obesity indices and blood pressure. A total of 140 subjects were recruited and consisted of a nearly equal distribution of children from three main ethnicities (37.2% Malays, 31.4% Chinese, 31.4% Indians). Umami detection threshold was measured using the two-alternative, forced-choice staircase procedure. Body weight, height, waist circumference and blood pressure of children were measured. Body composition was assessed using bioelectrical impedance analysis (BIA). Mean umami detection threshold was 1.22 ± 1.04 mM and there were no observable differences attributable to the subjects' ethnicities. Body fat percentage was negatively correlated (r = -0.171, p 
  17. Liu A, Byrne NM, Kagawa M, Ma G, Poh BK, Ismail MN, et al.
    Br J Nutr, 2011 Nov;106(9):1390-7.
    PMID: 21736824 DOI: 10.1017/S0007114511001681
    Overweight and obesity in Asian children are increasing at an alarming rate; therefore a better understanding of the relationship between BMI and percentage body fat (%BF) in this population is important. A total of 1039 children aged 8-10 years, encompassing a wide BMI range, were recruited from China, Lebanon, Malaysia, The Philippines and Thailand. Body composition was determined using the 2H dilution technique to quantify total body water and subsequently fat mass, fat-free mass and %BF. Ethnic differences in the BMI-%BF relationship were found; for example, %BF in Filipino boys was approximately 2 % lower than in their Thai and Malay counterparts. In contrast, Thai girls had approximately 2.0 % higher %BF values than in their Chinese, Lebanese, Filipino and Malay counterparts at a given BMI. However, the ethnic difference in the BMI-%BF relationship varied by BMI. Compared with Caucasian children of the same age, Asian children had 3-6 units lower BMI at a given %BF. Approximately one-third of the obese Asian children (%BF above 25 % for boys and above 30 % for girls) in the study were not identified using the WHO classification and more than half using the International Obesity Task Force classification. Use of the Chinese classification increased the sensitivity. Results confirmed the necessity to consider ethnic differences in body composition when developing BMI cut-points and other obesity criteria in Asian children.
  18. Low DW, Jamil A, Md Nor N, Kader Ibrahim SB, Poh BK
    Pediatr Dermatol, 2020 Jan;37(1):69-77.
    PMID: 31667896 DOI: 10.1111/pde.14004
    BACKGROUND: Multiple factors affect growth in children with atopic dermatitis (AD). We investigated food restriction practice, nutrition, and growth in children with AD. Food restriction is defined as restriction ≥3 types of food due to AD or food allergy.

    METHODS: A cross-sectional study was performed in 150 children aged 12-36 months.

    EXCLUSION CRITERIA: recurrent infections, moderate to severe asthma, recent systemic steroid, other diseases affecting growth/nutrition. Growth parameters, SCORing Atopic Dermatitis (SCORAD), hemoglobin, hematocrit, sodium, potassium, albumin, protein, calcium, phosphate, B12, iron, and folate values were determined. Parents completed a 3-day food diary.

    RESULTS: The prevalence of food restriction was 60.7%. Commonly restricted foods were shellfish 62.7%, nuts 53.3%, egg 50%, dairy 29.3%, and cow's milk 28.7%. Food-restricted children have significantly lower calorie, protein, fat, riboflavin, vitamin B12, calcium, phosphorus and iron intakes and lower serum iron, protein and albumin values. Z scores of weight-for-age (-1.38 ± 1.02 vs -0.59 ± 0.96, P = .00), height-for-age (-1.34 ± 1.36 vs -0.51 ± 1.22, P = .00), head circumference-for-age (-1.37 ± 0.90 vs -0.90 ± 0.81, P = .00), mid-upper arm circumference (MUAC)-for-age (-0.71 ± 0.90 vs -0.22 ± 0.88, P = .00), and BMI-for-age (-0.79 ± 1.15 vs -0.42 ± 0.99, P = .04) were significantly lower in food-restricted compared to non-food-restricted children. More food-restricted children were stunted, underweight with lower head circumference and MUAC. Severe disease was an independent risk factor for food restriction with OR 5.352; 95% CI, 2.26-12.68.

    CONCLUSION: Food restriction is common in children with AD. It is associated with lower Z scores for weight, height, head circumference, MUAC, and BMI. Severe disease is an independent risk factor for food restriction.

  19. Mok, Wilfred Kok Hoe, Devanthini Dewi Gunasekaran, Wee, Lei Hum, Poh, Bee Koon, Ruzita Abd. Talib
    Jurnal Sains Kesihatan Malaysia, 2019;17(3):157-167.
    MyJurnal
    Global prevalence of childhood overweight and obesity have increased drastically in the past years, including in Malaysia. School-based obesity intervention is important to promote healthy eating and behavioural change. Many obesity interventions have been conducted to combat childhood obesity; however, the sustainability of childhood obesity interventions are often overlooked. This study aimed to explore the factors that influenced sustainability of Juara Sihat intervention programme in Kuala Lumpur primary school. Face-to-face in-depth interviews were conducted with 26 children aged 12- 14 years old whom participated in the Juara Sihat intervention programme were purposively selected. Data was transcribed verbatim and analysed using thematic analysis. The main themes identified as motivators are (1) support from family, facilitators, school teachers, and friends; (2) physical activity and healthy eating practices after intervention; (3) self-awareness; (4) knowledge on food pyramid and healthy eating; and (5) home environment. While the barriers are (1) knowledge inconsistency; (2) own safety; (3) peers influence; (4) self-attitude; (5) boredom towards programme. The results showed that the main promoting factor for sustainability of Juara Sihat intervention programme is continued practice of physical activity and healthy eating, while the main barrier is knowledge inconsistency. Therefore, school-based obesity intervention programmes should consider these promoting and hindering factors that could influence the sustainability of intervention programmes. Future studies should consider those factors during program intervention planning especially when factors that influence implementation and sustainability are carefully considered and taken care of to ensure long-term success.
  20. Nguyen Bao KL, Sandjaja S, Poh BK, Rojroongwasinkul N, Huu CN, Sumedi E, et al.
    Nutrients, 2018 Jun 13;10(6).
    PMID: 29899251 DOI: 10.3390/nu10060759
    Despite a major decrease in undernutrition worldwide over the last 25 years, underweight and stunting in children still persist as public health issues especially in Africa and Asia. Adequate nutrition is one of the key factors for healthy growth and development of children. In this study, the associations between dairy consumption and nutritional status in the South East Asian Nutrition Survey (SEANUTS) were investigated. National representative data of 12,376 children in Indonesia, Malaysia, Thailand, and Vietnam aged between 1 and 12 years were pooled, representing nearly 88 million children in this age category. It was found that the prevalence of stunting and underweight was lower in children who consumed dairy on a daily basis (10.0% and 12.0%, respectively) compared to children who did not use dairy (21.4% and 18.0%, respectively) (p < 0.05). The prevalence of vitamin A deficiency and vitamin D insufficiency was lower in the group of dairy users (3.9% and 39.4%, respectively) compared to non-dairy consumers (7.5% and 53.8%, respectively) (p < 0.05). This study suggests that dairy as part of a daily diet plays an important role in growth and supports a healthy vitamin A and vitamin D status.
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