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
Introduction: Gestational diabetes mellitus (GDM) increases risks for type 2
diabetes and cardiovascular diseases. Low glycaemic index (GI) diets improve
cardio-metabolic outcomes in insulin-resistant individuals. We examined the
feasibility of lowering GI through GI-based-education among Asian post-GDM
women. Methods: A 3-month investigation was carried out on 60 Malaysian
women with a mean age of 31.0±4.5 years and a history of GDM. Subjects were
randomised into two groups: LGIE and CHDR. The CHDR group received
conventional healthy dietary recommendations only. The LGIE group received
GI based-education in addition to conventional healthy dietary recommendations.
At baseline and after 3-months, dietary intake of energy and macronutrient
intakes including GI diet and glycaemic load was assessed using 3-day food
records. Diabetes-Diet and GI-concept scores and physical activity levels were
assessed using a questionnaire. Adherence to dietary instructions was measured
at the end of 3 months. Results: At the end of 3 months, the LGIE group had
significant reductions in energy intake (241.7±522.4Kcal, P=0.037, ES=0.463), total
carbohydrate (48.7±83.5g, P=0.010, ES=0.583), GI (3.9±7.1, P=0.017, ES=0.549) and
GL (39.0±55.3, P=0.003, ES=0.705) and significant increases in protein (3.7±5.4g,
0.003, ES=0.685) and diet fibre (4.6±7.3g, P=0.06). The CHDR group had a significant
reduction in fat only (5.7±9.4g, P=0.006, ES=0.606). There was a 30% increase in
GI-concept scores in the LGIE group (p< 0.001). Changes in GI-concept scores
correlated significantly to the reduction in dietary GI (r = -0.642, P=0.045). Dietary
adherence was comparable in both groups. Conclusion: GI-education improves
GI-concept knowledge and helps lower dietary glycaemic index among women
with a history of GDM.
Keywords: Diet, gestational diabetes mellitus, glycaemic index, glycaemic load,
prevention, type 2 diabetes
This study aimed to determine the effectiveness of a nutrition education intervention package in improving anthropometric, clinical and biochemical indicators of rural older Malays with metabolic syndrome (MS).
Hunger is complex, encompassing experiences ranging from a family's forced acceptance of a monotonous diet to individual physiological pain. I evaluate the Household Food Insecurity Access Scale (HFIAS) as a means of capturing the universal elements of hunger without doing violence to its culturally-specific expressions within two Malay communities. The HFIAS is assessed conceptually by comparing its assumptions and concept-to-measurement gap with competing indicators and practically with respect to village conditions and practices. This case study recommends the HFIAS for this site and for communities that similarly lack maternal buffering, while highlighting the unique features of the local hunger experience.
BACKGROUND: Breast cancer patients often show an interest in making dietary changes after diagnosis of breast cancer to improve their health condition and prevent cancer recurrence.
OBJECTIVE: The objective of the study was to determine changes in dietary intake 2 years after diagnosis among breast cancer patients.
METHODS: One hundred sixteen subjects were asked to complete a semiquantitative food frequency questionnaire, diet recalls, and dietary changes questionnaire to assess dietary intake before and after diagnosis. The information on sociodemographic background, cancer treatment history, and anthropometric indices was also collected.
RESULTS: Seventy-two subjects considered diet as a contributing factor to breast cancer, and 67 subjects changed their dietary habits after breast cancer diagnosis. The reasons for changes in diet were physician and dietitian advice and desire to cure cancer. The sources of information were derived from their physician, mass media, and family members. Total energy, protein, total fat, fatty acids, and vitamin E intake were significantly decreased after diagnosis. Meanwhile, the intake of β-carotene and vitamin C increased significantly after diagnosis. The changes included reduction in red meat, seafood, noodles, and poultry intake. An increased consumption of fruits, vegetables, fish, low-fat milk, and soy products was observed. The subjects tended to lower high-fat foods intake and started to eat more fruits and vegetables.
CONCLUSION: Breast cancer patients had changed to a healthier diet after breast cancer diagnosis, although the changes made were small.
IMPLICATIONS FOR PRACTICE: This will be helpful to dietitians in providing a better understanding of good eating habits that will maintain patients' health after breast cancer diagnosis.
Colorectal cancer is the third and fourth leading cause of cancer incidence and mortality among men and women, respectively in Iran. However, the role of dietary factors that could contribute to this high cancer incidence remains unclear. The aim of this study was to determine major dietary patterns and its relationship with colorectal cancer.
Introduction: This cluster randomised controlled study design aimed to evaluate the effectiveness of implementing nutrition education intervention (NEI) that targeted at incremental reduction of body weight and increased physical activity level among university students. Methods: Body weight and physical activity level were assessed before and after intervention. A total of 417 university students from four public universities in Terengganu participated in the study. They were randomly selected and assigned into two arms, that is, intervention group (IG) or control group (CG) according to their cluster. The IG received 10 weeks intervention focused on NEI promotion using three modes which were conventional lecture, three brochures as take-home messages and text messages for intervention reinforcement while CG did not receive any intervention. Analysis of covariance (ANCOV A) and adjusted effect size were used to determine differences in body weight and physical activity levels between groups and time. Results: No significant changes in body weight were observed among both groups. The average weight and body mass index (BMI) were slightly reduced in IG compared to CG after the 10-week intervention (p>0.05). Nevertheless, physical activity level improved significantly among IG participants compared to CG with increased metabolic equivalent (MET) min/week spent for walking, moderate and vigorous activities and significantly decreased sitting time. The largest adjusted effect size was shown in total physical activity (0.75). Conclusion: The multimodal NEI had a positive influence on physical activity outcomes among university students. NEI should be continuously implemented in this particular population group.
The role of diet in the aetiology of dental caries occurrence has been questioned recently. Aim: This cross-sectional study was conducted to determine the relationship between dietary habits and dental caries among 105 children aged 2 to 5 years old in Kuala Lumpur. Methodology: Subjects were selected using convenient sampling method. Their body weight and height were measured and their dental check-up was performed by qualified dental nurses. A Structured questionnaire and 3-day food diaries were distributed to their parents/caretakers to obtain socio-demographic data, oral health practice and dietary habits of the subjects. The dft (decayed, filled teeth) score was used to describe dental caries incidence. Results: Caries was found in 36.6% subjects with mean dft score of 1.95±3.59 (range: 0-16). Energy (r=-0.334, p=0.008), carbohydrate (r=-0.353, p=0.005), fat (r=-0.325, p=0.01), protein (r=-0.264, p=0.038), and calcium (r=-0.470, p
INTRODUCTION: There is a pressing need to better understand the complex biochemical pathways that lead to the pathogenesis of obesity. Increased oxidative stress and decreased antioxidant capacity have been identified to be associated with obesity. Therefore, the objectives of this study were to determine the plasma total antioxidant capacity (TAC) levels of Malaysian subjects and to evaluate its potential association with obesity and related anthropometric measurements.
METHODS: Plasma TAC of 362 multi-ethnic Malaysian subjects from the Kampar Health Clinic (138 males, 224 females; 124 ethnic Malays, 152 Chinese, 86 Indians; 192 non-obese, 170 obese) was measured using Trolox equivalent antioxidant capacity (TEAC) 96-well plate assay.
RESULTS: Plasma TAC was significantly lower in obese subjects (M +/- SE = 292 +/- 10.4 micromol/L) compared to non-obese subjects (397 +/- 8.58 micromol/L), whereas it was significantly higher in males and those in the 21-30 age group. Those with salty food preference and practising a strict vegetarian diet also had significantly higher plasma TAC. However, no association was found for other dietary habits (coffee intake) and lifestyle factors (physical activity, smoking). Plasma TAC was also significantly negatively correlated with diastolic blood pressure, waist and hip circumferences, weight, body mass index, total body fat, % subcutaneous fat, visceral fat level, resting metabolism and % skeletal muscle.
CONCLUSION: Plasma TAC was found to be associated with obesity, strict vegetarian practice, salty food preference and all obesity anthropometric indicators, except systolic blood pressure and pulse rate. Obese people have decreased plasma TAC indicating a compromised systemic antioxidant defence and increased oxidative stress.
The aim of this study was to develop and validate a semiquantitative food frequency questionnaire (FFQ) for assessing habitual added sugar consumption of adults in the Klang Valley.
Collection of nationwide food consumption data at the individual level is the preferred option for planning fortification programs. However, such data are seldom collected in low-income countries. In contrast, Food Balance Sheets (FBS), published annually for approximately 180 countries, may provide a source of national data for program planning.
Early childhood is a period during which many factors influence the development of lifelong eating habits. This study aimed to assess the nutritional status of young children and to determine factors related to eating habits.
INTRODUCTION: Meal patterns have received little attention in nutrition studies. The aim of this study is to present the findings on general meal patterns of Malaysian adults.
METHODS: The Malaysian Adults Nutrition Survey (MANS), carried out in 2002 and 2003, involved 6,928 adults selected by stratified random sampling from all households by zone in Peninsular Malaysia, Sabah and Sarawak.
RESULTS: In general, the results showed that most respondents (74.16%) ate three meals per day; 89.20% of the respondents consumed breakfast, while 88.57% consumed lunch and 91.97% consumed dinner with no significant difference in terms of sex. In Peninsular Malaysia, the Northern Zone had the highest number of people consuming breakfast compared to other zones. Meanwhile, the population in Sarawak had the largest proportion of people consuming lunch and dinner, but the smallest proportion of people consuming breakfast. A significantly higher number of the rural population consumed breakfast and lunch than urbanites; however there was no significant difference in dinner consumption. Generally, breakfast consumption increased with age whereby significant difference existed between the 18 to 19 years age group and the age group of 30 years and older. Lunch intake among the age groups showed no significant difference. In contrast, dinner consumption was significantly lower among the 18 to 19 years age group compared to all other age groups. Comparison among the ethnic groups showed that the Indian population had the lowest percentage of having breakfast and lunch while the Orang Asli had the lowest percentage of consuming dinner. However, the Orang Asli recorded the highest percentage for taking breakfast and lunch while the Chinese had the highest percentage of taking dinner.
CONCLUSION: Considering that Malaysian adults consumed their conventional breakfast, lunch and dinner, these findings indicatethat Malaysians are maintaining their traditional meal patterns.
Study name: Malaysian Adult Nutrition Survey (MANS-2003)
This study aimed to determine the relationship between child feeding practices, food habits, and anthropometric indicators with cognitive performance of preschoolers aged 4-6 years in Peninsular Malaysia (n=1933). Parents were interviewed on socio-demographic background, nutrition knowledge, child feeding practices and food habits. Height and weight of the preschoolers were measured; BMI-for-age, weight-for-age and height-for-age were determined. Cognitive performance was assessed using Raven's Colored Progressive Matrices. The mean monthly household income was RM3610 and 59.6% of parents attained secondary education. Thirty-three percent of parents had good knowledge on nutrition, 39% satisfactory and 28% poor. For child feeding practices, perceived responsibility had the highest mean score (M=3.99, SD=0.72), while perceived child weight had the lowest (M=2.94, SD=0.38). The prevalence of possible risk of overweight, being overweight, and obesity were 3.9%, 7.9% and 8.1%, respectively, whereas the prevalence of underweight and stunting were 8.0% and 8.4%, respectively. Breakfast was the second most frequently skipped meal (16.8%) after dinner (18.1%). The mean cognitive score was 103.5 (SD=14.4). Height-for-age and consumption of dinner were found to contribute significantly towards cognitive performance after controlling for socio-demographic background and parent's nutrition knowledge.
The prevalence of Helicobacter pylori infection is exceptionally low among the Malays in the north-eastern region of Peninsular Malaysia. The reasons are unknown. Our aim was to compare environmental factors that differed in relation to H. pylori prevalence among Malays born and residing in Kelantan.
OBJECTIVE: Obesity prevalence is unequally distributed across gender and ethnic group in Malaysia. In this paper, we examine the role of socioeconomic inequality in explaining these disparities.
DESIGN: The body mass index (BMI) distributions of Malays and Chinese, the two largest ethnic groups in Malaysia, are estimated through the use of quantile regression. The differences in the BMI distributions are then decomposed into two parts: attributable to differences in socioeconomic endowments and attributable to differences in responses to endowments.
RESULTS: For both males and females, the BMI distribution of Malays is shifted toward the right of the distribution of Chinese, i.e., Malays exhibit higher obesity rates. In the lower 75% of the distribution, differences in socioeconomic endowments explain none of this difference. At the 90th percentile, differences in socioeconomic endowments account for no more than 30% of the difference in BMI between ethnic groups.
CONCLUSIONS: Our results demonstrate that the higher levels of income and education that accrue with economic development will likely not eliminate obesity inequality. This leads us to conclude that reduction of obesity inequality, as well the overall level of obesity, requires increased efforts to alter the lifestyle behaviors of Malaysians.
Food variety scores (FVS) and dietary diversity scores (DDS) were estimated based on foods consumed weekly by 285 Malaysian households using a food frequency questionnaire. The scoring system of FVS and DDS was based on a scale of 0-7 and 0-6 respectively. The mean household FVS and DDS was 164.1 ± 93 and 6 ± 0.4. The age of respondents (husbands or wives; p < .01), sex (p < .05), and household food expenditure (p < .01) had a significant influence on both FVS and DDS. The food-intake pattern of Malaysian households showed that their typical diets had high protein and energy-based foods.
BACKGROUND: Eating habits have been a major concern among university students as a determinant of health status. The aim of this study was to assess the pattern of eating habits and its associated social and psychological factors among medical students.
METHODS: A cross sectional study was conducted among 132 medical students of pre-clinical phase at a Malaysian university. A self-administered questionnaire was used which included questions on socio-demography, anthropometry, eating habits and psychosocial factors.
RESULTS: Mean (± SD) age of the respondents was 22.7 (± 2.4) years and (the age) ranged from 18 to 30 years. More than half had regular meals and breakfast (57.6% &, 56.1% respectively). Majority (73.5%) consumed fruits less than three times per week, 51.5% had fried food twice or more a week and 59.8% drank water less than 2 liters daily. Eating habits score was significantly low among younger students (18-22 years), smokers, alcohol drinkers and those who did not exercise. (p<0.05). Four psychological factors out of six, were significantly associated with eating habits (p<0.05). In multivariate analysis, age and 'eating because of feeling happy' were significantly associated with eating habits score (p<0.05).
CONCLUSION: Most of the students in this study had healthy eating habits. Social and psychological factors were important determinants of eating habits among medical students.
Study site: Management and Science University, Selangor, Malaysia
Scales & Questionnaires: Compulsive Eating Scale
Food frequency questionnaire (FFQ) must be tailored to the target populations because dietary habits vary within the populations due to differences in cultural and lifestyles practices. Limited information is available to assess the validity of FFQ used among Malaysian adolescents.