Displaying publications 41 - 60 of 98 in total

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  1. Liu A, Byrne NM, Ma G, Nasreddine L, Trinidad TP, Kijboonchoo K, et al.
    Eur J Clin Nutr, 2011 Dec;65(12):1321-7.
    PMID: 21731041 DOI: 10.1038/ejcn.2011.122
    To develop and cross-validate bioelectrical impedance analysis (BIA) prediction equations of total body water (TBW) and fat-free mass (FFM) for Asian pre-pubertal children from China, Lebanon, Malaysia, Philippines and Thailand.
  2. 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.
  3. 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.

  4. Mok WKH, Poh BK, Wee LH, Devanthini DG, Ruzita AT
    Med J Malaysia, 2018 04;73(2):100-105.
    PMID: 29703873
    INTRODUCTION: Obesity and physical inactivity among school children are among the most challenging health problems in Malaysia. The present study aimed to evaluate the sustained impact of Juara Sihat programme on physical activity level and anthropometric status at 18-month post-intervention.

    METHOD: Participants of Juara Sihat (n=55) were followed-up at 18 months after completion of the intervention. Juara Sihat intervention was implemented over 12 weeks and focused on four key components: (i) five one-hour nutrition education classes, (ii) four one-hour physical activity education sessions, (iii) family involvement, and (iv) empowerment of Parents and Teachers Association. Anthropometric variables (body mass index, body fat percentage and waist circumference) were measured and physical activity level was evaluated by using Physical Activity Questionnaire for Children (PAQ-C) at baseline (P0), immediately upon completion of intervention (P1), at three-month post-intervention (P2), and at 18-month postintervention (P3). Analyses of repeated measures analysis of covariance (ANCOVA) with intention-to-treat principle were applied.

    RESULTS: Sustained effects were found in BMI-for-age z-score which showed a reduction (P0 2.41±0.84 vs P3 2.27±0.81) and physical activity level which showed positive improvements (P0 2.46±0.62 vs P3 2.87±0.76) at 18 months after intervention was completed. Body fat and waist circumference had increased over the same time period.

    CONCLUSION: Overall, this study successfully demonstrated sustained intervention effects of Juara Sihat intervention on BMI-for-age z-score and physical activity, but not on body fat percentage and waist circumference.

  5. 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.
  6. Nguyen TH, Mat Daud ZA, Abd Talib R, Mohd R, Poh BK
    Transplant Proc, 2023 Nov;55(9):2176-2182.
    PMID: 37743189 DOI: 10.1016/j.transproceed.2023.08.008
    BACKGROUND: Although metabolic syndrome (MetS) is a significant risk factor, and dietary intake may affect the quality of life (QoL) of kidney transplant recipients (KTRs), the association between them are unclear. This study identified MetS and nutritional factors associated with the QoL of KTRs.

    METHODS: This study reports baseline data from a longitudinal study that was conducted at a hospital in Vietnam. KTRs aged ≥18 years and >3 months post-transplantation were recruited. Assessments included sociodemographic and blood biomarkers. Dietary intake was estimated from 24-hour recalls. A Short Form-36 Health Survey, comprising physical (PCS) and mental component summaries (MCS), was administered to assess QoL. Multivariate linear regression models were performed.

    RESULTS: The study included 106 patients (79 men) with a mean age of 43.2 years (± 11.9). Mean duration after kidney transplantation was 28.5 months (± 14.9). Patients with MetS had 6.43 lower PCS score (P < .05) and 3.20 lower MCS score (P < .05) than their counterparts without MetS. Calcium intake (β = -0.01; 95% CI, -0.03 to 0.00) and inadequate protein (β = -14.8; 95% CI, -23 to -6.65) were negatively associated with PCS score. MCS score was negatively associated with calcium intake (β = -0.02; 95% CI, -0.04 to -0.01) and inadequate protein intake (β = -15.1; 95% CI, -24.3 to -5.86), and positively associated with fat intake (β = 0.43, 95% CI, 0.02-0.85).

    CONCLUSIONS: MetS and poor dietary intake are independently associated with the QoL of KTRs. Nutritional intervention plans developed specifically for the recipients will improve dietary intake, reduce the incidence of MetS, and help enhance QoL.

  7. Nik Shanita S, Siti Hanisa A, Noor Afifah AR, Lee ST, Chong KH, George P, et al.
    PMID: 30360488 DOI: 10.3390/ijerph15112332
    The present study aimed to report the prevalence of anaemia and iron deficiency (ID) and to explore the associations among socio-demographic characteristics, nutritional status and inflammation status in the occurrence of anaemia and ID in a nationally representative sample of Malaysian primary schoolchildren. Using data from the South East Asian Nutrition Surveys (SEANUTS), 544 Malaysian children aged 7 to 12 years were included in this secondary analysis. Blood samples were drawn for haemoglobin and serum ferritin analysis while C-reactive protein (CRP) and α-1-acid glycoprotein (AGP) were measured to detect inflammation. Prevalence of anaemia and ID were 4.0% and 5.2%, respectively. There were significantly more anaemic indigenous bumiputra children (9.9%) than Chinese children (0.6%). Correction for inflammation did not change the prevalence of ID. More overweight/obese children than thin/normal weight children were found to have elevated acute phase protein (APP). Children with elevated inflammatory markers had significantly higher ferritin level than children without inflammation. Periodic health assessments of anaemia and ID at the population level to monitor and clarify the epidemiology of health problems are required to inform public health policies and strategies.
  8. Noor Hafizah Y, Ang LC, Yap F, Nurul Najwa W, Cheah WL, Ruzita AT, et al.
    PMID: 31783477 DOI: 10.3390/ijerph16234722
    As there are few food frequency questionnaires (FFQ) to assess the dietary intake of preschool children, this study examined the validity and reliability of an FFQ for this purpose. A total of 210 preschoolers aged 4 to 6 years participated in the validation study, while a subsample of 66 participants joined the reliability study. The FFQ is modified from the ToyBox-study and South East Asian Nutrition Surveys (SEANUTS), and comprised 108 food items from 13 food groups. A three-day estimated dietary record (3DR) was used as reference and reliability was assessed through a second administration of the FFQ (FFQ2), four weeks after the first administration (FFQ1). For the validation study, Spearman's correlation coefficients showed moderate to high correlations (p < 0.001) between FFQ and 3DR. Cross-classification of quartile analysis showed moderate agreement between the two methods. As for reliability, Spearman's correlation coefficients showed moderate to high correlations (p < 0.001) between FFQ1 and FFQ2. Cronbach's alpha values (0.708 to 0.824) and intraclass correlation coefficients (0.710 to 0.826) showed good agreement between repeated FFQs. The results suggest that the FFQ has acceptable validity and good reliability. Hence, the FFQ can be used to assess preschool children's food intake.
  9. Noor MI, Poh BK, Zawiah H, Henry CJ
    Forum Nutr, 2003;56:250-3.
    PMID: 15806886
    The energy and nutritional requirements of adolescents are influenced primarily by the growth spurt that occurs at puberty, and also by the need to maintain adequate levels of physical activity. Predictions of BMR have gained attention since the publication of the FAO/WHO/UNU (1985) expert consultation report, which adopted the principle of relying on energy expenditure rather than energy intake to derive requirement of individuals. While the report predicts BMR accurately in many individuals from temperate climate, they are said to be less accurate in predicting BMR in populations living in the tropics. The collation of worldwide data on basal metabolism indicated that, relative to adults, there was a paucity of data in other age groups including the adolescents. Although several BMR studies among children had been reported in the 90's, the data in normal weight children are almost exclusively from small control groups in obesity studies. Furthermore, we know little as to whether BMR of children differs in differing climatic conditions. This paper presents predictive equations for estimating BMR from a two-centre study, Bangi (Malaysia) and Oxford (UK) and to compare the results with the currently used predictive equations.
  10. Nor Aini J, Poh BK, Chee WS
    Pediatr Int, 2013 Apr;55(2):223-8.
    PMID: 23253297 DOI: 10.1111/ped.12035
    BACKGROUND: The aim of this cross-sectional study was to examine the ability of a children's physical activity questionnaire (cPAQ) to assess physical activity levels and bone health status of school children.
    METHODS: Subjects consisted of 90 pre-pubertal and early pubertal children aged 9-10 years. Components of physical activity were assessed using metabolic intensity (METPA) scores and mechanical bone strain (MECHPA) scores. An Actical accelerometer was used to validate METPA scores among a sub-sample of 57 children. Reliability was assessed by test-retesting all children after a 7 day interval. Whole body bone mineral content (BMC) was measured using dual-energy X-ray absorptiometry.
    RESULTS: The reliability of cPAQ for assessment of various categories of physical activity was moderate to high (r ranged from 0.55 to 0.68, P < 0.001). Agreement was fair for repeated use of the cPAQ (Cohen's kappa = 0.32, P < 0.001). Bland-Altman plots show cPAQ had fair agreement only for moderate activity (mean difference 35.4 min/week; 95% limits of agreement -434.0 to +504.9 min/week). Approximately 69.6% of children were correctly classified (into the same or adjacent quartiles) according to the quartiles of BMC for METPA score, and 58.7% were correctly classified according to MECHPA score. Only 10.9% and 12.0% of children were grossly misclassified as compared to METPA and MECHPA scores, respectively.
    CONCLUSIONS: The cPAQ has reasonable validity in assessing moderate physical activity, and it demonstrates good ability to accurately classify children according to BMC. It fails, however, to assess other activity levels, suggesting that objective measurement is still a better method of assessment of physical activity among primary school children.
  11. Noradilah MJ, Ang YN, Kamaruddin NA, Deurenberg P, Ismail MN, Poh BK
    Asia Pac J Public Health, 2016 Jul;28(5 Suppl):74S-84S.
    PMID: 27073201 DOI: 10.1177/1010539516641505
    This study aims to validate skinfold (SKF) and bioelectrical impedance analysis (BIA) against dual-energy X-ray absorptiometry (DXA) in determining body fat percentage (BF%) of Malay children aged 7 to 11 years. A total of 160 children had their BF% assessed using SKF and BIA, with DXA as the criterion method. Four SKF equations (SKFBray, SKFJohnston, SKFSlaughter, and SKFGoran) and 4 BIA equations (BIAManufacturer, BIAHoutkooper, BIARush, and BIAKushner) were used to estimate BF%. Mean age, weight, and height were 9.4 ± 1.1years, 30.5 ± 9.9 kg, and 131.3 ± 8.4 cm. All equations significantly underestimated BF% (P < .05). BIA equations had reasonable agreement with DXA and were independent of BF% with BIAManufacturer being the best equation. Although BIA underestimates BF% as compared with DXA, BIA was more suitable to measure BF% in a population that is similar to this study sample than SKF, suggesting a need to develop new SKF equations that are population specific.
  12. Norimah AK, Safiah M, Jamal K, Haslinda S, Zuhaida H, Rohida S, et al.
    Malays J Nutr, 2008 Mar;14(1):25-39.
    PMID: 22691762 MyJurnal
    This study reports the food consumption patterns of adults aged 18 to 59 years in the Malaysian Adults Nutrition Survey (MANS) carried out between October 2002 and December 2003. A total of 6,742 subjects comprising 3,274 men and 3,468 women representing the northern, central , southern and east coast of Peninsular Malaysia as well as Sabah and Sarawak were interviewed. A semiquantitative food frequency questionnaire (FFQ) which consisted of 126 food items was used to evaluate the food consumption pattern (habitual food intake) of the respondents during the previous one- year period. The results demonstrate that nasi putih (cooked rice) was consumed by 97% of the population twice daily (average 2½ plates per day). Other food items consumed daily were marine fish, (one medium fish per day), green leafy vegetables (one cup per day) and sweetened condensed milk (three teaspoons per day. The mean frequencies for daily intake of rice, leafy vegetables, marine fish, local kuih, anchovy (ikan bilis) and biscuits were significantly higher among the rural compared to the urban adults. In contrast, more urban dwellers consumed chicken and eggs more frequently than their rural counterparts. More men than women consumed chicken and eggs more frequently. Malaysian adults showed a satisfactory habit of drinking plain water, with 99% drinking at least six glasses of plain water daily. Other beverages such as tea (47%), coffee (28%), chocolate-based drinks (23%) and cordial syrup (11%) were also consumed on daily basis, however, in a smaller proportion of the population. There were differences in the prevalence of daily consumption of foods when comparing urban and rural population, and also between men and women. The prevalence of daily consumption of marine fish among rural and urban adults was 51% and 34% respectively. For sweetened condensed milk, men and women consumed 43% and 28% respectively; however, more women drank full cream milk than men. Between the age groups, 21% of adults below 20 years old consumed chicken at least once a day, while this pattern of intake was not shown in the older age groups. Our findings show that adults, aged 50 to 59 years old, had the highest prevalence of daily consumption of full cream milk with 24% while those aged 18 to 19 years old had the lowest prevalence of daily consumption at 15%. The food consumption pattern of Malaysian adults appears to be satisfactory. However, some changes in food habits are recommended especially in substituting the less wholesome sweetened condensed milk with the more nutritious full cream or skimmed milk.
    Study name: Malaysian Adult Nutrition Survey (MANS-2003)
  13. Okely AD, Kariippanon KE, Guan H, Taylor EK, Suesse T, Cross PL, et al.
    BMC Public Health, 2021 05 17;21(1):940.
    PMID: 34001086 DOI: 10.1186/s12889-021-10852-3
    BACKGROUND: The restrictions associated with the 2020 COVID-19 pandemic has resulted in changes to young children's daily routines and habits. The impact on their participation in movement behaviours (physical activity, sedentary screen time and sleep) is unknown. This international longitudinal study compared young children's movement behaviours before and during the COVID-19 pandemic.

    METHODS: Parents of children aged 3-5 years, from 14 countries (8 low- and middle-income countries, LMICs) completed surveys to assess changes in movement behaviours and how these changes were associated with the COVID-19 pandemic. Surveys were completed in the 12 months up to March 2020 and again between May and June 2020 (at the height of restrictions). Physical activity (PA), sedentary screen time (SST) and sleep were assessed via parent survey. At Time 2, COVID-19 factors including level of restriction, environmental conditions, and parental stress were measured. Compliance with the World Health Organizations (WHO) Global guidelines for PA (180 min/day [≥60 min moderate- vigorous PA]), SST (≤1 h/day) and sleep (10-13 h/day) for children under 5 years of age, was determined.

    RESULTS: Nine hundred- forty-eight parents completed the survey at both time points. Children from LMICs were more likely to meet the PA (Adjusted Odds Ratio [AdjOR] = 2.0, 95%Confidence Interval [CI] 1.0,3.8) and SST (AdjOR = 2.2, 95%CI 1.2,3.9) guidelines than their high-income country (HIC) counterparts. Children who could go outside during COVID-19 were more likely to meet all WHO Global guidelines (AdjOR = 3.3, 95%CI 1.1,9.8) than those who were not. Children of parents with higher compared to lower stress were less likely to meet all three guidelines (AdjOR = 0.5, 95%CI 0.3,0.9).

    CONCLUSION: PA and SST levels of children from LMICs have been less impacted by COVID-19 than in HICs. Ensuring children can access an outdoor space, and supporting parents' mental health are important prerequisites for enabling pre-schoolers to practice healthy movement behaviours and meet the Global guidelines.

  14. Ong LC, Chandran V, Lim YY, Chen AH, Poh BK
    Singapore Med J, 2010 Mar;51(3):247-52.
    PMID: 20428748
    The aim of this study was to identify factors associated with poor academic achievement during the early school years.
  15. Parikh P, Semba R, Manary M, Swaminathan S, Udomkesmalee E, Bos R, et al.
    Matern Child Nutr, 2022 Jan;18(1):e13264.
    PMID: 34467645 DOI: 10.1111/mcn.13264
    Growth faltering under 5 years of age is unacceptably high worldwide, and even more children, while not stunted, fail to reach their growth potential. The time between conception and 2 years of age is critical for development. The period from 6 to 23 months, when complementary foods are introduced, coincides with a time when growth faltering and delayed neurocognitive developments are most common. Fortunately, this is also the period when diet exercises its greatest influence. Growing up in an adverse environment, with a deficient diet, as typically seen in low- and middle-income countries (LMICs), hampers growth and development of children and prevents them from realising their full developmental and economic future potential. Sufficient nutrient availability and utilisation are paramount to a child's growth and development trajectory, especially in the period after breastfeeding. This review highlights the importance of essential amino acids (EAAs) in early life for linear growth and, likely, neurocognitive development. The paper further discusses signalling through mammalian target of rapamycin complex 1 (mTORC1) as one of the main amino acid (AA)-sensing hubs and the master regulator of both growth and neurocognitive development. Children in LMICs, despite consuming sufficient total protein, do not meet their EAA requirements due to poor diet diversity and low-quality dietary protein. AA deficiencies in early life can cause reductions in linear growth and cognition. Ensuring AA adequacy in diets, particularly through inclusion of nutrient-dense animal source foods from 6 to 23 months, is strongly encouraged in LMICs in order to compensate for less than optimal growth during complementary feeding.
  16. Parvaneh K, Poh BK, Hajifaraji M, Ismail MN
    Asia Pac J Clin Nutr, 2014;23(1):84-90.
    PMID: 24561976 DOI: 10.6133/apjcn.2014.23.1.02
    Sleep deficiency is becoming widespread in both adults and adolescents and is accompanied by certain behaviors that can lead to obesity. This study aims to investigate differences in sleep duration of overweight/obese and normal weight groups, and the association between sleep deprivation and obesity, dietary intake and physical activity. A cross-sectional study was conducted among 226 Iranian working adults (109 men and 117 women) aged 20 to 55 years old who live in Tehran. Body weight, height, waist and hip circumferences were measured, and BMI was calculated. Questionnaires, including the Sleep Habit Heart Questionnaire (SHHQ), International Physical Activity Questionnaire (IPAQ) and 24-hour dietary recall, were interview-administered. Subjects were categorized as normal weight (36.3%) or overweight/obese (63.7%) based on WHO standards (2000). Overweight/ obese subjects slept significantly (p<0.001) later (00:32±00:62 AM) and had shorter sleep duration (5.37±1.1 hours) than normal weight subjects (23:30±00:47 PM and 6.54±1.06 hours, respectively). Sleep duration showed significant (p<0.05) direct correlations to energy (r = 0.174), carbohydrate (r = 0.154) and fat intake (r = 0.141). This study revealed that each hour later in bedtime (going to bed later) increased the odds of being overweight or obese by 2.59-fold (95% CI: 1.61-4.16). The findings in this study confirm that people with shorter sleep duration are more likely to be overweight or obese; hence, strategies for the management of obesity should incorporate a consideration of sleep patterns.
  17. Peters R, Li B, Swinburn B, Allender S, He Z, Lim SY, et al.
    Bull World Health Organ, 2023 Nov 01;101(11):690-706F.
    PMID: 37961057 DOI: 10.2471/BLT.23.289973
    OBJECTIVE: To identify and analyse ongoing nutrition-related surveillance programmes led and/or funded by national authorities in countries in South-East Asian and Western Pacific Regions.

    METHODS: We systematically searched for publications in PubMed® and Scopus, manually searched the grey literature and consulted with national health and nutrition officials, with no restrictions on publication type or language. We included low- and middle-income countries in the World Health Organization South-East Asia Region, and the Association of Southeast Asian Nations and China. We analysed the included programmes by adapting the United States Centers for Disease Control and Prevention's public health surveillance evaluation framework.

    FINDINGS: We identified 82 surveillance programmes in 18 countries that repeatedly collect, analyse and disseminate data on nutrition and/or related indicators. Seventeen countries implemented a national periodic survey that exclusively collects nutrition-outcome indicators, often alongside internationally linked survey programmes. Coverage of different subpopulations and monitoring frequency vary substantially across countries. We found limited integration of food environment and wider food system indicators in these programmes, and no programmes specifically monitor nutrition-sensitive data across the food system. There is also limited nutrition-related surveillance of people living in urban deprived areas. Most surveillance programmes are digitized, use measures to ensure high data quality and report evidence of flexibility; however, many are inconsistently implemented and rely on external agencies' financial support.

    CONCLUSION: Efforts to improve the time efficiency, scope and stability of national nutrition surveillance, and integration with other sectoral data, should be encouraged and supported to allow systemic monitoring and evaluation of malnutrition interventions in these countries.

  18. Poh BK, Ng BK, Siti Haslinda MD, Nik Shanita S, Wong JE, Budin SB, et al.
    Br J Nutr, 2013 Sep;110 Suppl 3:S21-35.
    PMID: 24016764 DOI: 10.1017/S0007114513002092
    The dual burden of malnutrition reportedly coexists in Malaysia; however, existing data are scarce and do not adequately represent the nutritional status of Malaysian children. The Nutrition Survey of Malaysian Children was carried out with the aim of assessing the nutritional status in a sample of nationally representative population of children aged 6 months to 12 years. A total of 3542 children were recruited using a stratified random sampling method. Anthropometric measurements included weight, height, mid-upper arm circumference, and waist and hip circumferences. Blood biochemical assessment involved analyses of Hb, serum ferritin, and vitamins A and D. Dietary intake was assessed using semi-quantitative FFQ, and nutrient intakes were compared with the Malaysian Recommended Nutrient Intakes (RNI). The prevalence of overweight (9·8%) and obesity (11·8%) was higher than that of thinness (5·4%) and stunting (8·4%). Only a small proportion of children had low levels of Hb (6·6%), serum ferritin (4·4%) and vitamin A (4·4%), but almost half the children (47·5%) had vitamin D insufficiency. Dietary intake of the children was not compatible with the recommendations, where more than one-third did not achieve the Malaysian RNI for energy, Ca and vitamin D. The present study revealed that overnutrition was more prevalent than undernutrition. The presence of high prevalence of vitamin D insufficiency and the inadequate intake of Ca and vitamin D are of concern. Hence, strategies for improving the nutritional status of Malaysian children need to consider both sides of malnutrition and also put emphasis on approaches for the prevention of overweight and obesity as well as vitamin D insufficiency.
  19. Poh BK, Jannah AN, Chong LK, Ruzita AT, Ismail MN, McCarthy D
    Int J Pediatr Obes, 2011 Aug;6(3-4):229-35.
    PMID: 21668385 DOI: 10.3109/17477166.2011.583658
    BACKGROUND: The prevalence of obesity is increasing rapidly and abdominal obesity especially is known to be a risk factor for metabolic syndrome and other non-communicable diseases. Waist circumference percentile curves are useful tools which can help to identify abdominal obesity among the childhood and adolescent populations.
    OBJECTIVE: To develop age- and sex-specific waist circumference (WC) percentile curves for multi-ethnic Malaysian children and adolescents aged 6.0-16.9 years. Subjects and methods. A total of 16,203 participants comprising 8,093 boys and 8,110 girls recruited from all regions of Malaysia were involved in this study. Height, weight, WC were measured and BMI calculated. Smoothed WC percentile curves and values for the 3rd, 5th, 10th, 25th, 50th, 75th, 90th, 95th and 97th percentiles were constructed using the LMS Method.
    RESULTS: WC was found to increase with age in both sexes, but boys had higher WC values at every age and percentile. Z-scores generated using the UK reference data shows that Chinese children had the highest WC compared to Malays, Indians and other ethnicities. Comparisons with other studies indicate that at the 50th percentile, Malaysian curves did not differ from the UK, Hong Kong and Turkish curves, but at the 90th percentile, Malaysian curves were higher compared with other countries, starting at 10 years of age. The 90th percentile was adopted as the cut-off point to indicate abdominal obesity in Malaysian children and adolescents.
    CONCLUSION: These curves represent the first WC percentiles reported for Malaysian children, and they can serve as a reference for future studies.
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