Our earlier report showed that diet rich in calcium and sodium fed to guinea pigs can be urolithogenic. In this study, we investigated the effect of adding 3% or 15% cellulose as a source of fiber into similar diet to asses the formation of kidney calculus. From the result, animals fed diet with 3% cellulose showed a relatively high concentration of urinary oxalate, urate and large number of crystals in the kidneys. When the cellulose level was raised to 15%, the concentrations of urinary calcium, urate and the number of crystals formed in the kidneys were lowered. We therefore, conclude that high fiber diet may be beneficial in reducing the incidence of kidney stones of calcium origin.
Introduction: Feeding difficulty and functional disability are common problems among patients with dementia but their influence on caregivers' burden has not been addressed comprehensively. Thus, this study aimed to determine the association between feeding problems, functional status and caregiver burden among patients with dementia who receive outpatient treatment at Universiti Kebangsaan Malaysia Medical Centre (UKMMC) in Kuala Lumpur, Malaysia, as compared to their non-demented counterparts. Methods: A cross-sectional comparative study was conducted among 30 patients with dementia (12 men, 18 women, mean age 75 ± 7 years old) and 60 subjects without dementia (25 men, 35 women, mean age 69 ± 7 years), as well as their caregivers. Subjects' functional status, feeding problems and also caregiver burden were assessed using Activities of Daily Livings (ADLs) and Instrumental Activities of Daily Living (IADL) questionnaire, The Edinburgh Feeding Evaluation in Dementia Questionnaire (EdFED-Q) and Zarit Burden Interview (ZBI), respectively. Subjects were also measured for height and weight. Results: Patients with dementia needed supervision (50%) and physical help during mealtime (40%). The mean functional status score of these patients was higher than the patients without dementia (p<0.05). Caregiver burden score was positively correlated with the EdFED-Q score (r=0.405, p<0.05) but negatively correlated with functional status score (r=0.475, p<0.01). Further, multiple regression analysis showed that after adjustment for age, EdFED-Q score and functional status remained correlated with caregiver burden at R2 of 0.210. Conclusion: Caregiver burden is associated with feeding problems and functional disability among patients with dementia. There is a need to educate the caregivers in order to improve the quality of life of both carers and the demented patients.
Key words: Caregiver burden, dementia, feeding problems, functional status, outpatient
Study site: Psychiatric and medical clinics, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
Introduction: Sugar is widely consumed and excessive intake has been associated
with increased risk of weight gain, diabetes mellitus and cardiovascular diseases,
leading to metabolic syndrome (MetSyn). However, the association between sugar
intake and MetSyn has seldom been studied among multi-ethnic Malaysian older
adults.
Methods: A total of 1,057 respondents aged ≥60 years were recruited through
multistage random sampling from selected states. Anthropometric parameters, blood
pressure, blood test for sugar and lipid profile were determined. Dietary intake was
derived using a 7-day dietary history questionnaire (DHQ) and a semi-quantitative
food frequency questionnaire (FFQ) for added sugar intake.
Results: Prevalence of
MetSyn was 39.9%, 30.9% and 42.2% using the harmonised definition, International
Diabetes Federation (IDF) and National Cholesterol Education Program’s Adult
Treatment Panel III (NCEP-ATPIII) definitions respectively. Mean total sugar intake
was 40.5±32.0 g (8 tsp) and added sugar intake was 33.0±31.0 g (6 tsp). Excessive
added sugar consumption at 100th percentile increased risks of high total cholesterol
by two-fold (p
INTRODUCTION: In Malaysia, hypertension prevalence has increased from 13% in 1996 to 43% in 2006 based on the Third National Health and Morbidity Survey.
METHODOLOGY: Recognising the importance of hypertension control to prevent cardiovascular morbidity and mortality, a cross-sectional study was carried out to assess factors influencing blood pressure among 74 hypertensive adults (22 men, 52 women, mean age 61.1 +/- 8.8 years old) attending an outpatient clinic of a government health clinic in Klang Valley. Subjects were interviewed to obtain information on social and health, physical activity level and food intake using Diet History Questionnaire (DHQ) and Food Frequency Questionnaire (FFQ). Anthropometric measurements including weight, height, waist circumference and percentage of body fat were also conducted.
RESULTS: The majority of the subjects (71.6%) had poor hypertension control as determined using blood pressure. Women aged 30-59 years old had a higher mean diastolic blood pressure (87.3 +/- 11.6 mmHg) than women aged 60 years old (78.5 +/- 9.5 mmHg) (p < 0.05). Most of the men (36.4%) achieved three out of six Medical Nutrition Therapy (MNT) for Hypertension Recommendations as outlined by the Malaysian Dietitians' Association. About one-third (30.8%) of the women achieved two out of six of the guidelines. High sodium intake (adjusted OR 3.501, 95% CI 1.116-10.985, p < 0.05), daily consumption of coffee (adjusted OR 0.302, 95% CI 0.093-0.983, p < 0.05) and less intake of milk (adjusted OR 3.328, 95% CI 1.055-10.493, p < 0.05) were associated with uncontrolled hypertension.
CONCLUSION: Three quarters of the subjects had unsatisfactory hypertensive control and was related to food intake and eating habits including high salt diet, coffee consumption and inadequate milk intake were unsatisfactory. There is a need to implement a nutrition intervention programme based on MNT to achieve good hypertensive control among subjects.
Study site: klinik kesihatan, Klang Valley, Malaysia
This quasi-experimental study was carried out to evaluate the effectiveness of an eight-week multi-disciplinary pulmonary rehabilitation programme in improving nutritional and functional status and quality of life of COPD out patients at Hospital Universiti Kebangsaan Malaysia. A total of 9 COPD outpatients aged 40 years and above (6 men and 3 women) completed at least 50% of 16 sessions of an eight-week pulmonary rehabilitation programme. Their nutritional and functional status and rating of quality of life were measured at baseline (0 day) and after 8 weeks and these were compared to those of the control group matched for age, comprising 13 subjects (11 men and 2 women). Nutritional status was determined using anthropometry, body composition (Bioelectrical Impedance Analysis) and three-day food record. Assessment of appetite for food was also carried out using the Simplified Nutritional Assessment Questionnaire (SNAQ). Functional status was assessed using the Pulmonary Functional Status and Dyspnea Questionnaire-modified version(PFSDQ-M). The handgrip strength was also measured using handgrip dynamometer. The SF36 questionnaire was used to measure the quality of life of the subjects. There was a reduction in dyspnea (-49.0%, p<0.05) and fatigue (-47.8%, p<0.05) in men after the intervention programme, as compared to their controls (dyspnea -2.9% and fatigue 8.9%). Quality of life in this group was also significantly improved by 31.8% (p<0.05) as compared to their controls (-3.0%,p>0.05). Similar trends were noted for the women, although the difference was not significant. No significant changes were seen in nutritional status assessed by anthropometry, dietary intake and appetite. However, there was a trend of increased nutrient intake and SNAQ score in the intervention group as compared to control. An eight-week pulmonary rehabilitation programme was effective in improving the functional status particularly in men, by reducing dyspnea and fatigue; and also improving their quality of life, but was not effective in changing the nutritional status.
Study site: Physiotherapy Unit, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
INTRODUCTION: Malnutrition is a common phenomenon among the elderly and quite often related to psychosocial problems. The objective of this study was to determine malnutrition risk and its association with appetite, functional and psychosocial status among elderly Malays in an agricultural settlement, i.e. FELDA Sungai Tengi, Selangor.
METHODS: A cross-sectional study was conducted among 160 subjects (men = 36.2%), with a mean age of 65.0 +/- 3.9 years, who were interviewed to obtain information on malnutrition risk and appetite using Mini Nutritional Assessment Short Form and Simplified Nutritional Appetite Questionnaire, respectively. Functional status was determined using Instrumental Activities of Daily Living (IADL), Elderly Mobility Scale (EMS) and handgrip strength. Mini Mental Status Examination (MMSE), Geriatric Depression Scale and De Jong Gierveld Loneliness Scale were used to identify cognitive impairment, depressive symptoms and loneliness status of subjects respectively. A total of 42.5% of subjects were at risk of malnutrition and 61.2% had poor appetite. The mean scores of IADL and EMS were lower in subjects at risk of malnutrition, compared to those who were not at high risk (p < 0.05 for both parameters). Multiple linear regression showed that 19.8% of malnutrition risk was predicted by poor appetite, decreased functional status (IADL) and depression.
CONCLUSION: Malnutrition risk was prevalent and associated with poor appetite, functional status and psychosocial problems among the elderly subjects. The psychosocial aspect should also be incorporated in nutrition intervention programmes in order to improve mental well-being and functional independancy.
Study site; FELDA Sungai Tengi, Selangor, Malaysia
Device, Questionnaire & Scale: Mini Nutritional Assessment Short Form; Simplified Nutritional Appetite Questionnaire, Instrumental Activities of Daily Living (IADL); Elderly Mobility Scale (EMS); handgrip strength. Mini Mental Status Examination (MMSE), Geriatric Depression Scale (GDS-15); De Jong Gierveld Loneliness Scale
A case control study to determine the association of dietary fibre and cancer among Malaysians. It was conducted among 100 newly-diagnosed cancer patients admitted to the Radiotherapy and Oncology Ward, Hospital Kuala Lumpur. A total of 100 controls matched with the cases for age, sex and ethnic origin were selected from the Outpatient Health Clinic in Sentul. The subjects were interviewed to obtain information on their habitual dietary intakes and lifestyles. Family history of cancer, smoking habits, and alcohol consumption were found to be significant risk factors for cancer (p<0.05 for all parameters). The mean intake of total energy was higher among men with nasopharyngeal cancer and women with gastrointestinal cancer as compared to their controls (p<0.05 for both parameters). The percentage of energy contribution from fat was higher among cases (35%) than controls (32.1%). The mean dietary fibre intake among cases (10.86 ± 8.90 g/d) was apparently lower than the controls (13.22 ± 5.99 g/d), with significant differences noted for breast cancer and also nasopharyngeal cancer. Women with low fibre intake (<10g/d) had a 2.2 times higher risk of getting breast cancer. There is a need to educate the public to adhere to a wholesome diet, in particular to increase the consumption of high-fibre food for disease prevention.
Study site: Radiotherapy and Oncology Ward, Hospital Kuala Lumpur and Outpatient Health Clinic in Sentu
This cross sectional study was conducted to determine the validity of three screening tools, Mini Nutritional Assessment Short Form (MNA-SF), Malnutrition Risk Screening Tool for Community (MRST-C) and Malnutrition Risk Screening Tool for Hospital (MRST-H) among elderly people at health clinics. The screening tools were validated against anthropometric and functional assessments. The anthropometric assessments that were carried out included body weight, height, arm span, body mass index (BMI), calf circumference (CC) and mid upper arm circumference (MUAC). A set of questionnaire on manual dexterity, muscular strength, instrumental activities daily living (IADL) and cognitive status was used to assess functional abilities. A total of 156 subjects were recruited from rural (38 subjects) and urban (118 subjects) health clinics at Sabak Bernam and Cheras respectively. Subjects' age ranged from 60 to 83 years old, with 44.2% were men and 55.8% women. The prevalence of muscle wasting among the subjects assessed from MUAC and CC were both 7.0%. MNA-SF had the highest correlation with BMI (r = 0.497, p<0.001), followed by MUAC (r = 0.398, p<0.001), CC (r = 0.473, p<0.001), cognitive assessment (r = 0.229, p<0.001) and handgrip strength (r = 0.209, p<0.001). Whilst MRST-C had the highest correlation with IADL score (r =-0.320, p<0.001) and MRST-H had the highest correlation with the lock and key test (r = -0.325, p<0.01). Sensitivity was the highest for MNA-SF (93.2%), followed by MRST-H (52.5%) and MRST-C (25.8%). Specificity was the highest for MRST-H (97.3%), followed by MRST-C (90.8%) and MNA-SF (79.4%). Positive predictive value (PPV) for MRST-H, MNA-SF and MRST-C was 55.5%, 18.2% and 14.1%, respectively. In conclusion, among the screening tools being validated, MNA-SF is considered the most appropriate tool to be used in health clinics for identification of elderly individuals who are at high risk of malnutrition.
Introduction: Adequate, nutritive and safe foods are crucial for growth and healthy
living. Adolescents are vulnerable to food insecurity. This study was aimed at
determining the demographic factors, food security status, health-related quality of
life (HRQOL) and body weight status of adolescents in Mentakab, Pahang, Malaysia.
Methods: This study involved 160 households that comprised pairs of mothers and
children aged 13-17 years. Face-to-face interviews were conducted with the mothers
to assess their demographic and food security status (Radimer/Cornell Hunger and
Food Insecurity Instrument). Meanwhile, the children answered a self-administered
HRQOL questionnaire (Pediatric Quality of Life Inventory, PedsQL). Body weight
and height were measured to obtain the body mass index (BMI). Results: About
48.8% of the adolescents were from households with food insecurity. The number
of school-going siblings, occupation status of mother, occupation status of father,
household income and house ownership status were predictors of food security
status (p
Studies were conducted in selected areas in three states namely Johor (n=117, male=55, female=62), Negeri Sembilan (n=130, male=52, female=78) and Malacca (n=97, male=33, female=64) involving free living elderly (age range from 60 to 93 years old). Respondents were divided into three age cohort groups that is 60 to 69 years, 70 to 79 years and above 80 years old. Assessment of macro and micronutrients were obtained from 24-hour diet recall for three consecutive days. Household measurements were used to estimate the amount of food consumed. Mean energy intake for both sexes were lower than the Malaysian RDA. Mean energy intake were also found to decline with age increment. The percentage of carbohydrate from total calories is higher compared to fat and protein. No respondents were found to consume less than 1/3 RDA for protein. Although no significant difference in nutrient intake was noted among age cohort groups, there was a decline in the intake of protein, fat and carbohydrate. Significantly (p <0.05) lower carbohydrate intake was noted in cohort group above 80 years. As for vitamins and minerals consumption, more than 50% of the elderly population studied consumed less than 2/3 RDA for vitamin A, thiamine, riboflavin, niacin and calcium. Very low intake of nutrient may lead to many health problems. Overall mean energy intake indicate the respondents consume less than the Malaysian RDA for all three age cohort groups. Total mean energy intake were also found to decline with age increment for both sexes. Due to the low energy intake, higher percentage of elderly were found consuming less than 2/3 RDA for thiamine (65%), riboflavin (63%) and niacin (90%). Other nutrients which were also being consumed less than 2/3 RDA by the respondents are vitamin A (67%) and calcium (65%). The intake of calcium which was found to be extremely low (ranged from 277 to 303 mg) could lead to problems like osteoporosis.
Body composition was assessed in a group of 344 free-living elderly between 60 and 89 years by means of anthropometry. The height, weight and body mass indexes of the elderly were reduced with advancing age in both the males and females. Skinfold thickness measurements also declined with age. Overall, the female elderly had a greater tricep skinfold thickness but smaller mid-arm circumferences, mid-arm muscle circumference and mid-arm muscle area compared to the male.
Introduction: This study aimed to determine the nutrient content of cornflakes and muesli, ready-to-eat cereal products available in the Malaysian market. Cornflakes and muesli were chosen due to their popularity as a breakfast meal especially in urban areas. Methods: A total of six brands each for cornflakes and muesli were purchased from supermarkets in the Klang Valley using stratified random sampling. All samples were analysed using AOAC official methods of analysis. The validity of the test data was monitored with the application of internal quality controls in line with the requirements of ISO 17025. Results: Proximate analysis revealed significantly higher mean levels of carbohydrate (86.94 ± 0.59 mg/lOOg), minerals such as iron (8.48±1.72 mg/lOOg) and sodium (674.83±102.99 g/lOOg), B3 as niacinamide (25.87 ± 6.14 g/lOOg) and sucrose (5.10 ± 0.90 mg/lOOg) in cornflakes than in muesli. However, muesli contained significantly more mean moisture (10.23 ± 0.72 mg/lOOg), protein (10.07 ± 0.79 mg/lOOg), total dietary fibre (12.49 ± 1.44 mg/lOOg), magnesium (113.22 ± 7.93 mg/lOOg), zinc (1.65 ± 0.16 mg/lOOg), copper (0.25 ± 0.02 mg/lOOg), total sugar (18.75 ± 2.05 mg/lOOg), glucose (7.70±1.77 mg/lOOg) and fructose (8.68±1.76 mg/lOOg) than cornflakes. Most of the fatty acids analysed were not detected or of low value in both the cereal products. Conclusion: The nutrient analysis of cornflakes and muesli suggests that both ready-to-eat cereals are nutritionally good choice as breakfast for consumers as it provides carbohydrate, minerals, fibre and vitamins. The data provides additional information to the Malaysian Food Composition Database.
Some synthetic preservatives have become controversial because they have been proven to cause health problems. These increased health concerns have led consumers to prefer food preservatives based on natural products. Hence, Stenochlaena palustris leaf extract was used in this study to evaluate the antifungal activity against food borne pathogen, Aspergillus niger. The value of minimum inhibitory concentration and minimum fungicidal concentration of leaf extract for this fungus grown on Potato Dextrose Agar medium was 50 mg/ml. IC50 value for the hyphal growth of A. niger was at a concentration of 17.41 mg/ml. Morphology changes of A. niger treated with the fern leaf extract was observed through scanning electron microscope. The thread-like and elongated hyphae cell wall was disrupted, with some appearing flattened and others being broken. Currently, there is growing interest in using natural food preservatives such as medicinal plant extracts for preserving foods to reduce outbreaks of foodborne pathogenic microorganisms. Hence, S. palustris appears to have promise as a safe alternative natural product-based food preservative for future generations.
L-arginine is an amino acid, which serves as the sole substrate for nitric oxide (NO) synthesis with the concomitant formation of L-citrulline in biologic system. NO has been demonstrated to be involved in smooth muscle relaxation and vasodilation, immune regulation and neurotransmission. It also has an important function as both intercellular and intracellular signals in many physiological systems, including the reproductive system where NO mediates penis erection. This study was undertaken to determine the effects of L-arginine on sperm motility, sperm count, and the nitric oxide level in the seminal plasma. Twelve sexually matured male rabbits (Oryctolagus cuniculus) were randomly divided into four groups with three rabbits each, which were control, low, medium, and high concentration groups. The treatment groups were force-fed with 100mg/kg, 200mg/kg, and 300mg/kg body weight of L-arginine for four weeks, whereas the control group was force-fed with water. Semen samples were collected every three days alternatively for a week before starting treatment and then after four weeks of treatment. Pre-treatment and post-treatment results were compared. Semen samples were collected using artificial vaginas from each group for sperm analysis such as sperm motility, sperm count and NO level in seminal plasma. Sperm motility and sperm count were analysed manually under microscope (twenty power objective), using a Makler counting chamber. NO levels in the seminal plasma were determined using Griess reaction. The results obtained from this study showed that oral consumption of L-arginine exerted a significant (p
The antioxidant activity of two edible medicinal plants commonly used in Malaysian traditional medicine i.e. Piper sarmentosum (kadok) and Morinda elliptica (mengkudu) were tested for antioxidant activity. The methanolic leave extracts of kadok and mengkudu, at 250ug/ml, were tested using the Xanthine/Xanthine Oxidase (X/XOD) Superoxide Scavenging assay. Both extracts showed high superoxide scavenging assay, 88% and 80% respectively compared to superoxide dismutase (SOD) standard. The crude extracts were further fractionated using column chromatography and tested for superoxide scavenging activity, to obtain antioxidant active fractions. Two active fractions were obtained from kadok, PsFr6-71.3%, PsFr7-71.3%, and one active fraction from mengkudu, MeFr3-86.6%. These active fractions were compared against 14 phenolic compound standards. After a series of HPLC analysis of samples and standards, a natural antioxidant compound was identified in kadok and mengkudu i.e. Naringenin (4',5,7-Trihydroxyflavanone) with 75.7% superoxide scavenging activity. Naringenin is a highly potent natural antioxidant that has been reported in the raw materials of larch and grapefruit extracts. Thus, kadok and mengkudu which contain Naringenin, could be used as antioxidant dietary supplements.
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.
INTRDUCTION: Obesity and chronic diseases have been increasing since the last few decades alongside rapid economic development in developed and developing countries. The alarming increase in the prevalence of childhood obesity had been shown by many epidemiological studies worldwide. The aims of this study were to determine the prevalence of overweight and obesity among Chinese school children in Kota Bharu, Kelantan, and to map the association between dietary practices and their nutritional status.
METHODS: A cross-sectional study was conducted on 278 school children aged 10 to 12 years old (144 boys and 134 girls) studying in a Chinese primary school in Kota Bharu.
RESULTS: The survey revealed that while only 1.4% (n=4) were overweight, 23.4% (n=65) of the children were obese. A total of 67.7% (n=44) of the obese children were boys. The overweight and obese children (n=70) were compared with a randomly selected group of normal weight children (n=70). Dietary assessment showed that protein, fat and total calorie intake were significantly higher among the overweight group (p<0.05). A significantly higher proportion of the normal weight children (85.7%) took breakfast daily or at least 4 days per week compared to the overweight groups (59.4%) (p<0.05).
CONCLUSION: The prevalence of obesity among school children in the study is a matter of concern. These findings may be useful in targeting programmes and strategies for prevention and intervention of childhood obesity.
The antimicrobial activity of the Centipeda minima L. (Asteraceae) extract was evaluated against seven microorganisms using the disc diffusion method. The extract showed a broad spectrum of antimicrobial activity against all the tested bacterial strains, especially Enterobacter aerogenes, Klebsiella pneumonia, Staphylococcus aureus and Yersinia enterocolitica. The chemical composition of the extract obtained from Centipeda minima was analysed by GC-MS. Twentythree compounds, constituting about 84.75 % of the total extract, were identified. The main constituents were palmitic acid (7.47%), (Z,Z)-9-,12-octadecatrienoic acid (6.52%), (Z,Z,Z)-9-,12-octadecatrienoic acid (7.01%), phytol (7.01%), naptho[2.3-b]furan-2-(3H)-on (6.21%), 1-(1,2,3,4,7,7a-hexahydro-1,4,4,5-tetramethyl-1,3a-ethano-3aH-inden-6-yl)etanon (7.95%), 1,3,5-tri-tertbutyl- benzene (4.52%), (3Z)-2-methyl-3-octen-2-ol (5.95%) and artemisia ketone (4.98%). The extract was also tested against brine shrimp for toxicity. There was no significant toxicity as it only recorded a LC50 value of 4.92 mg/ml. The study shows that the extract is a good antimicrobial agent with potential applications in public health against diseases.
Introduction: The purpose of this study was to determine the effects of sports nutrition education intervention on improvements in sports nutrition knowledge, attitude and practice (KAP), and dietary intake among Malaysian team sports athletes. Methods: A total of 105 male participants representing four team sports under the elite sports programme were recruited based on a name list provided by National Sports Council of Malaysia. Teams were assigned by stratified random sampling to either the experimental group (EG) (n=52) or the comparison group (CG) (n=53). The EG received seven weeks of education intervention programme based on a validated booklet covering basic sports nutrition for team sports. A self-administered sports nutrition KAP questionnaire and dietary intake assessment of total energy, carbohydrates, proteins and fats based on three-day food records was conducted before and after the intervention. Results: There were significant increments (p
The objective of this paper is to report on the reliability and validity of a knowledge, attitude and practice instrument used among young primary school children. The instrument was developed as an evaluation tool in the HELIC study and consisted of 23 knowledge, 11 attitude and 10 practice items. A total of 335 Year 2 students from 4 randomly selected primary schools in Selangor and Wilayah Persekutuan participated in the HELIC study. Students were divided into small groups and an enumerator verbally administered the instrument to each group. Reliability for each construct (knowledge, attitude and practice) was estimated as item to total score correlation and internal consistency (Cronbach's alpha). Construct validity was determined through factor analysis and Pearson correlation. Results indicated that 3 attitude and 3 practice items did not correlate significantly to the total score (p>0.05). However, the deletion of these items did not significantly alter the Cronbach's alpha coefficients. Internal consistency was good for knowledge (a=0.68) but low for attitude (a=0.37) and practice (a=0.36) constructs. Based on factor analysis, 5 factor-solutions emerged for knowledge and 4 factor solutions for attitude and practice. Sufficient variance was obtained for the factors in knowledge (51.7%), attitude (51.2% and practice (51.0%). There were also significant positive correlations among the constructs ( ~ 4 . 0 1 ) . In conclusion, the instrument was valid and reliable, especially for the knowledge construct. Further improvements, particularly on the attitude and practice constructs, are needed in order for the instrument to be an effective assessment or evaluation tool in various settings.