Introduction: Depression and depressive symptom are common among the
elderly. This study aimed to determine the influence of multiple factors and their
correlations on the prevalence of depressive symptoms among elderly residents in
selected FELDA schemes in Johor state.
Methods: A total of 269 respondents were
recruited through systematic sampling. Face-to-face interviews were conducted to
obtain information on socio-demographic and psychosocial characteristics using
pre-tested validated questionnaires; For functional status, the Lawton-IADL Scale
was used to assess independent living skills; the Short Physical Performance Battery
(SPPB) questionnaire was used to assess physical performance; cognitive function
was assessed by the Hodkinson Abbreviated Mental Test (HAMT); physical activity
level was determined using the Rapid Assessment of Physical Activity (RAPA);
and depressive symptoms were assessed by the Geriatric Depression Scale-15.
Results: Mean age of the respondents was 69.5±5.2 years. Prevalence of depressive
symptoms was determined as 3.7%. Almost half (47.6%) were unable to perform
one or more Lawton-IADL items, 30.9% had low physical performance, 15.6% had
abnormal cognitive function and only 30.6% were physically active. There were
significant correlations between the socio-demographic characteristics (age and
monthly income; r=-0.135 and rs
=-0.133 respectively; p
Introduction: This study aimed to determine the relationship of maternal dietary
intake with human milk nutritional composition, among Malay mothers during the
postpartum period of exclusive breastfeeding. Methods: Human milk samples (20-
30ml) were collected from mothers (n=32) at least once monthly for six months
postpartum. Macronutrients and fatty acids contents were determined using
proximate analysis and gas chromatography methods, respectively. Maternal
dietary intakes were recorded using the multiple-pass diet recall method prior
to each milk sampling and were analysed using the Nutritionist ProTM software.
Associations between the milk composition and maternal diet were tested using
Spearman correlation. Results: The energy content ranged between 49.6-59.2
kcal/100ml, protein 1.3-1.4 g/100ml, carbohydrate 6.5-9.7 g/100ml and total
fat 6.5-9.7 g/100ml. The polyunsaturated, monounsaturated, and saturated fatty
acids concentrations were 10.5-19.1 %, 40.6-43.5 %, and 38.0-49.7 %, respectively.
During confinement (first month postpartum), total energy and total fat content of
human milk were the highest whereas total carbohydrate was the lowest, compared
to the rest of the exclusive breastfeeding period. In contrast, intakes of total calorie
and total fat were the lowest, whereas protein was the highest during this period.
However, no associations were detected between human milk nutritional contents
and maternal dietary intake. Conclusion: In our study population, the composition
of maternal diet and nutritional content of human milk differed between confinement
and post-confinement periods. However, the association between maternal diet and
human milk composition itself warrants further investigation.
Introduction: Older persons are vulnerable to food insecurity. This study
aimed to determine the prevalence of food security and associated factors
among free-living older persons in Petaling District, Selangor. Methods:
A total of 220 free-living older persons aged 60-87 years were selected by
using the cluster sampling method in this cross-sectional study. Faceto-face interviews were conducted to obtain information concerning the
demographic and socioeconomic background, food security, oral health, and
psychosocial status. Chi-square test and binary logistic regression analysis
were used to analyse the studied variables. Results: The median age of the
respondents was 65.5 years, and 19.5% were found as food insecure. There
were significant associations between marital status (χ2=6.818), education
level (χ2=6.242), occupation status (χ2=7.540), monthly income (χ2=9.940,),
and oral health status (χ2=9.627) with food security status. Those with a low
monthly income (AOR=2.449, 95% CI: 1.046-5.732), poor oral health status
(AOR: 3.306, 95% CI: 1.387-7.889) and living in rented accommodation
(AOR=6.218, 95% CI: 1.458-26.518) were more likely to be food insecure.
Conclusion: Respondents with an income lower than the poverty line
income (PLI), living in rented accommodation and poor oral health status
face increased risk of food insecurity. A nutrition assistance programme is
suggested to improve the socioeconomic and food security status of older
persons. Regular oral check-ups are recommended to improve the oral
health status of the elderly.
Introduction: This study was conducted on 215 working women from four private corporate companies in a suburb in Malaysia to determine the factors related to their physical activity levels. Methods: Data were collected using a questionnaire which included socio-demographic characteristics, the International Physical Activity Questionnaire (IPAQ), perceived barriers and benefits to physical activity, self-efficacy to physical activity and an 8-item questionnaire on current
behavioral stage of physical activity. Results: The majority of the respondents were Malay (81.9%) with 10.2% being Chinese and 7.9% Indian. Most of the respondents were executives (64.2%), while the rest were non-executives (24.7%) and managers (11.2%). The mean weight, height, BMI and waist circumference were 59.4±13.1 kg, 1.6±0.6 m, 23.7±4.8 kg/m² and 77.0±12.1cm respectively. In this sample, 24.7% and 7.9% were overweight and obese respectively, while 34%
were at risk of abdominal obesity. A total of 28.8% of the respondents had low physical activity level, while 48.8% and 22.3% were in the moderate and high physical activity categories respectively. An association was found between monthly income (χ2=110.17; p
This study was conducted on 215 working women from four private corporate companies in a suburb in Malaysia to determine the factors related to their physical activity levels.
Major sporting events in Malaysia are commonly staged in hot environments where the average daytime temperature is generally in the range of 29 to 31°C with the average relative humidity ranging from 80 to 95%. Exercise capacity and exercise performance are reduced when the ambient temperature is high and it has major implications for competitors as well as for spectators and officials. Prolonged exercise leads to progressive water and electrolyte loss from the body as sweat is secreted to promote heat loss. The rate of sweating depends on many factors and increases in proportion to work rate and environmental temperature and humidity. Sweat rates are highly variable and can exceed 2L.h-1 for prolonged periods in high heat. Since dehydration will impair exercise capacity and can pose a risk to health, the intake of fluid during exercise to offset sweat losses is important. Carbohydrate-electrolyte fluid ingestion during exercise has the dual role of providing a source of carbohydrate fuel to supplement the body's limited stores and of supplying water and electrolytes to replace the losses incurred by sweating. The composition of the drinks to be taken will be influenced by the relative importance of the need to supply fuel and water which, in turn depends on the intensity and duration of exercise activity, the ambient temperature, and humidity. Carbohydrate-electrolyte solutions appear to be more effective in improving performance than plain water. There is no advantage to fluid intake during exercise of less than 30-minute duration. Complete restoration of fluid balance after exercise is an important part of the recovery process and becomes even more important in hot, humid conditions. If a second bout of exercise has to be performed after a relatively short interval, the speed of rehydration becomes of crucial importance. Rehydration after exercise requires not only replacement of volume losses, but also replacement of some electrolytes, primarily sodium. Studies show that rehydration after exercise can be achieved only if sweat electrolyte losses as well as water are replaced. Drinks with low sodium content are ineffective at rehydration and they will only reduce the stimulus to drink. Addition of smalls amounts of carbohydrate to the rehydrating drinks may improve the rate of intestinal uptake of sodium and water and will improve palatability. The volume of the rehydration beverage consumed should be greater than the volume of sweat lost to provide the ongoing obligatory urine losses. Palatability of the beverage is a major issue when a large volume of fluid has to be consumed.
Growth status was examined in relation to gender and age factors in urban primary school children (6-10 years old) from low income households in Kuala Lumpur, Wilayah Persekutuan. The sample consisted of 4212 boys (53%) and 3793 girls (47%). Data on weight and height data were obtained from two sources - investigator's and teachers' measurements of the school children. This study defined mildly and significantly underweight, stunted or wasted as z-score below minus one and below minus two of the NCHS/CDC reference median, respectively. Approximately 52% (n = 4149), 50% (n = 3893) and 30% (n = 2568) of the school children were underweight, stunted and wasted, respectively. However, the majority of these undernourished children were in the mild category. Prevalence of overweight (> 2 SD of NCHS/WHO reference median) was found in 5.8% of the sample. For both, prevalence of undernutrition and overnutrition, more boys than girls were found to be underweight stunted wasted and overweight. Compared to girls, boys had lower mean z-scores for the variables height-for-age (p<0.05) and weight-for-height (p<0.01). Older children had significantly lower mean z-scores for height-for-age (p<0.001) but higher mean z-scores for weight-for-height (P<0.001) than younger children. This finding indicates that with increasing age, stunting is associated with improved weight-for-height or that the children's weights have been adapted to their short statures. In conclusion, results demonstrate a high prevalence of underweight, stunting and wasting and an increasing prevalence of overweight among these low-income school children. Efforts recommended to address health and nutrition problems among school children should include health and nutrition monitoring (e.g. growth monitoring using the existing growth data collected by schools) and interventions.
Introduction: The benefits of breastfeeding for both mothers and infants are
widely recognised. Breastfeeding confirms a woman’s unique ability to care for her
infant in the best way possible and promotes optimum infant and maternal health.
Methods: A qualitative research method involving five focus group discussions
(n=33) was chosen in this study to compare and contrast the breastfeeding practice
in two different locations: the communities of Pos Pulat and the regroupment
scheme settlement at Rancangan Pengumpulan Semula (RPS) Kuala Betis in
Kelantan, Malaysia which represents different lifestyle experiences of indigenous
Temiar population. Results: The benefits of breastfeeding to the infants reported
by some Temiar women (42.4%) were for the infant’s health and growth. Responses
from urban RPS Kuala Betis women include breast milk contains antibodies (3.0%),
delays in the return of regular ovulation (6.1%), thus lengthening birth intervals
and bonding between maternal-baby (6.1%). In general, respondents from Pos
Pulat seemed to have little knowledge regarding this issue, except for a woman who
mentioned that maternal milk contains vitamins. Based on the narrative analysis,
knowledge gap was observed between these two communities. Conclusion: Although
all the women interviewed had the experience of breastfeeding their infants, most
of them lacked the knowledge regarding the benefits of the breastfeeding either
to the infants or to the mothers. The findings from this study are crucial for the
preservation of breastfeeding culture among the Temiar women and can be used to
improve promotion of breastfeeding to other Orang Asli groups in Malaysia.
Introduction: The Temiar who ethnically belong to Senoi, one of the major groups of Orang Asli (indigenous people) in Peninsular Malaysia, have their own distinctive food taboos and avoidances during the postpartum period. These traditions are deeply rooted in their culture, customs, values and beliefs system.
Methods: A qualitative research method involving five focus group discussions were conducted to compare and contrast four different locations: the communities of Pos Tohoi, Pos Simpor, Rancangan Pengumpulan Semula Orang Asli (RPSOA) in Kelantan and the community at Batu 12 in Gombak, Selangor, representing different lifestyle experiences and food practices of Orang Asli Temiar in Peninsular Malaysia. All the transcripts were coded and categorised and then ‘thematised’ using the software package for handling qualitative data, NVivo 8.
Results: Despite variations in locations, there were five agreed prohibited food items during the postpartum period: cooking oil, salt, monosodium glutamate, sugar, and meat from game or domesticated animals. Dietary restrictions begin immediately after childbirth and varied from seven, eight, and fourteen days to one month. Besides food restrictions, there were other prescribed avoidances for mothers after delivering a baby.
Conclusion: Prohibitions placed upon women during the postpartum period are intended to protect the new mother, the newborn baby and also the community. It appears that regardless of whether they live in the most traditional or the least traditional locations, the Temiar lineage and societal norms in the form of taboos during the female reproductive cycle are handed down to the new generation by their elders.
INTRODUCTION: A qualitative comparative case study was conducted to compare and contrast food taboos and avoidance practices during pregnancy among Orang Asli or indigenous Temiar women in four distinct locations that represent different lifestyle experiences and cultural practices.
METHODS: Through snowballing sampling, a total of 38 participants took part in five focus groups: one group each in Pos Simpor and Pos Tohoi in Kelantan state, one group in Batu 12, Gombak in Selangor state, and two groups in a regroupment scheme (RPSOA) in Kuala Betis, Kelantan. All the transcripts were coded, categorised and 'thematised' using the software package for handling qualitative data, NVivo 8.
RESULTS: Variant food prohibitions were recorded among the Temiar women residing in different locations, which differ in food sources and ways of obtaining food. Consumption of seventeen types of food items was prohibited for a pregnant Temiar woman and her husband during the prenatal period. Fear of difficulties during labour and delivery, convulsions or sawan, harming the baby (such as foetal malformation), and twin pregnancy seemed to trigger many food proscriptions for the pregnant Temiar women, most of which have been passed on from generation to generation.
CONCLUSION: The findings of this study confirm that beliefs about food restrictions are strong among those Temiar living a traditional lifestyle. However, those who have adopted a more modern lifestyle also preserve them to some extent.pregnancy among Orang Asli or indigenous Temiar women in four distinct locations that represent different lifestyle experiences and cultural practices.
INTRODUCTION: The present study describes a randomised controlled trial (RCT) based on a novel, generalisable intervention for childhood obesity, comparing the intervention with a no-treatment control group.
METHOD: The Malaysian Childhood Obesity Treatment Trial (MASCOT) was a single-blind RCT of a dietetic treatment for childhood obesity in children of primary school age (7 to 11 years old) in Kuala Lumpur, Malaysia. The MASCOT comprising eight sessions, of an 8-hour family-centred group treatment programme is described, based on behavioural change techniques. The study sample was characterised by BMI z-score, health related quality of life reported by participants and their parents (PedsQL questionnaire), objectively measured habitual physical activity and sedentary behaviour (Actigraph accelerometry)
RESULTS: The MASCOT sample of 107 children was characterised by a low quality of life, mean total score on PedsQL 67.7 (4.5) as reported by the children, and 66.0 (16.4) as reported by their parents. The children spent, on average, 89% of their waking day on sedentary activity, and 1% of the day in moderate-vigorous intensity physical activity, equivalent to only around 8 minutes/day.
CONCLUSION: Obese children in the MASCOT study had an impaired quality of life, high levels of sedentary behaviour and very low levels of physical activity.
Food insecurity exists whenever people are not able to access sufficient food at all times for an active and healthy life. This study used the Radimer/Cornell hunger and food insecurity instrument to assess food insecurity and to determine the risk factors and consequences of food insecurity among low-income households in Kuala Lumpur. One hundred and thirty-seven Malay pre-school children (4-6 years old) from Taman Sang Kancil were measured for their weights and heights. Questionnaires were used to collect food security and socioeconomic information on the households. The findings indicated that 34.3% of the households were food secure, while 65.7% experienced some kind of food insecurity, (27.7% households were food insecure, 10.9% individuals were food insecure and 27.0% fell into the child hunger category). The prevalence of underweight, stunting and wasting were 44.5%, 36.5% and 30.7% respectively. The prevalence of high weight-for-height (overweight) was 13.1%. Based on multinomial logistic regression, larger household size (OR=1.418; p<0.01) and lower educational level of mothers (OR=0.749; p<0.01) and fathers (OR=0.802; p<0.05) were found to be significant risk factors for food insecurity. The study, however, did not find any significant difference in children's nutritional status according to household food security levels. It is recommended that for the Malaysian population, the Radimer/Cornell hunger and food insecurity instrument should be modified and further validated with various ethnic groups in a variety of settings. The validation should include the appropriateness of the statements to the target grounds and their different risk factors and outcomes of food insecurity.
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.
Elderly people are known to be at a greater risk of malnutrition, particularly those having diseases or illnesses. A prospective study was undertaken on 92 hospitalised geriatric patients (45.6% males), aged 60 to 89 years old, admitted to surgical and medical wards at Hospital Universiti Kebangsaan Malaysia (HUKM). The study aimed to assess malnutrition at admission, day 3 and day 7 of hospitalisation, and its relation with length of stay in the wards. Malnutrition was assessed using anthropometrics and biochemical indicators. Although the majority of subjects had a normal Body Mass Index (BMI), 10.9% had Chronic Energy Deficiency (CED) and 38% were overweight. A total of 10% subjects had muscle wasting as assessed by Mid-upper Arm Circumference (MUAC). Biochemical tests indicated that women subjects were more likely to have hypoalbuminaemia (p <0.05) whilst, men were at risk of anaemia (p < 0.05). Throughout hospitalisation, there was a significant reduction in body weight, biceps skinfold thickness, calf circumference, MUAC, percentage of body fat and body mass index (BMI) in both males and females (p < 0.05 for all parameters). Biochemical tests on a sub sample of subjects indicated that 71.4% had hypoalbuminaemia and 39.6% were anaemic. Subjects diagnosed with cancer, had loss of appetite or had poor nutritional status as assessed by BMI or MUAC on admission were more likely to be hospitalised longer than or equal to 7 days (p < 0.05 for all parameters). Serum albumin levels at admission correlated positively with MUAC values both on admission (r = 0.608, p <0.01) and at clay seven of hospitalisation (r = 0.906, p < 0.05). There is a need to screen elderly patients at high risk of malnutrition at admission in order to reduce the length of stay and increase their health and nutritional status.
Energy and nutrient intake estimated using a pre-coded dietary history questionnaire (DHQ) was compared with results obtained from a 7-d weighed intake record (WI) in a group of 37 elderly Malays residing in rural areas of Mersing District, Johor, Malaysia to determine the validity of the DHQ. The DHQ consists of a pre-coded dietary history with a qualitative food frequency questionnaire which was developed to obtain information on food intake and usual dietary habits. The 7-d WI requires subjects to weigh each food immediately before eating and to weigh any leftovers. The medians of intake from the two methods were rather similar and varied by less than 30% for every nutrient, except for vitamin C (114%). For most of the nutrients, analysis of group means using the Wilcoxon matched pairs signed rank sum test showed no significant difference between the estimation of intake from the DHQ and from the WI, with the exceptions of vitamin C and niacin. The DHQ significantly overestimated the intake of vitamin C compared to the WI (p<0.05), whilst, the intake of niacin was significantly underestimated (p<0.05). The consistency of ranking as assessed using the Spearman's rank correlation coefficient (r) was satisfactory since there were positive correlations between all of the investigated nutrients estimated using the DHQ with those assessed using the WI, except for niacin. Furthermore, both the DHQ and the WI classified approximately 38 to 62% of the subjects into the same tertile for all nutrients, except vitamin C. Therefore, the DHQ was modified by adding a checklist of foods rich in vitamin C and niacin. In conclusion, the DHQ was fairly valid for obtaining the usual intake of most nutrients, particularly on a group basis. These findings indicate that in an elderly population with a high prevalence of illiteracy, a specially designed DHQ can provide very similar estimations to that obtained from 7-d WI.
A cross-sectional study was conducted to determine the familial and socio-environmental predictors of overweight and obesity among 1430, 9-12 year-old primary school children and their parents in Selangor and Kuala Lumpur.
Introduction: Validation of a culturally specific FFQ is important in assessing habitual dietary intake of ethnic population groups. This study aimed to assess the validity and reproducibility of a FFQ developed specifically for determining the dietary intake of Malaysian Punjabis.
Methods: Subjects were approached through voluntary participation for the development and validation phase in the Klang Valley. A list of foods consumed by participants (n=100) was documented through a 3-day dietary recall. The validation process was conducted by verifying the developed FFQ against another group of Punjabi adult volunteers (n=101) who kept a 2-day dietary record. Macronutrients, dietary fibre, fatty acids, cholesterol, three types of minerals (calcium, sodium, iron) and four vitamins (B12, folate, C, A) were included in the analysis. Reproducibility was shown with intraclass correlation (ICC) values between FFQ1 vs FFQ2 that were administered 6 months apart among 32 participants.
Results: In the validation study, the FFQ1 was found to have over-estimated almost all nutrients compared to those in the dietary records. The Spearman correlation coefficients for energy, carbohydrate, protein and fat intake based on the FFQ1 and 2-day dietary records were 0.54, 0.38, 0.47, and 0.31, respectively. The classification into the same and adjacent quartiles was between 61- 84% for the nutrients consumed. Bland Altman plots showed relatively good agreement (between ±2 standard deviation) for both the dietary methods used. Reproducibility analysis of ICC (FFQ1 vs FFQ2) was between 0.46-0.76 for macronutrients and 0.20-0.92 for micronutrients.
Conclusion: The developed FFQ could be used as a valid tool for assessing dietary intake of Malaysian Punjabis, as it showed a moderate agreement with dietary record for intake of energy and macronutrients.
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
Introduction: Malnutrition is a growing problem but quite often under-recognised in elderly people. Calf circumference (CC) is a simple measurement that can be used to identify elderly people who are at high risk of malnutrition; however, a population-specific cut-off point must be developed. Therefore, this study aimed to determine suitable cut-off points and evaluate the predictive value of the CC cut-off point for elderly Malaysians.
Methods: A total of 820 persons comprising 433 men and 387 women were recruited as subjects. The mean age was 69.0 ± 6.8 and ranged between 60 to 97 years. Data were collected from Sabak Bernam, Selangor; Kuala Pilah, Negeri Sembilan; Pasir Mas, Kelantan, and Kodiang, Kedah. A linear regression analysis with the z-score procedure by gender was used to derive the CC prediction equations.
Results: The CC cut-off points for men and women at risk of malnutrition were 30.1 cm and 27.3 cm, respectively. The final predictive CC equations for men was CC (cm) = 3.69 (z score) + 33.81, R2 = 1 and CC (cm) = 0.7103 (BMI) + 18.54, R2 = 1; and for women, CC (cm) = 4.31 (z score) + 31.63, R2 = 1 and CC (cm) = 0.6698(BMI) + 16.847, R2 = 1. Based on these equations, using the z-score equal to negative 1 for men (BMI 16.30 kg/m2 ) and women (BMI 15.64 kg/m2 ), the mean of the predictive value of the CC cut-off point was 32.0 ± 4.2 cm in men and 30.5 ± 4.6 cm in women.
Conclusion: It is suggested that these cut-off points be used to screen elderly individuals who are at risk of malnutrition. Further studies should be undertaken to further verify the application of the findings of this study.
INTRODUCTION: Hospitalised elderly patients are at high risk of malnutrition due to the presence of chronic diseases and inadequate food intake. It was on this premise that a Malnutrition Risk Screening Tool-Hospital (MRST-H) was developed for identifying the risk of malnutrition among Malaysian elderly patients.
METHODS: A total of 181 respondents aged 65 years and above who had been admitted to the Geriatric Ward of the University Malaya Medical Centre were recruited. The respondents' nutritional assessment was assessed using the Global Indicator of Malnutrition (GIM), a reference gold standard of malnutrition consisting of anthropometric measurements, biochemical indicators and the Subjective Global Assessment (SGA). Important predictive factors of malnutrition were determined by logistic regression analysis.
RESULTS: Five out of 18 predictive factors were significantly associated with malnutrition (p<0.05) in the final multivariate logistic regression model. These five factors were used to develop the MRST-H. Its validity was tested among 100 elderly inpatients in the Kuala Lumpur Hospital. The MRST-H was found to have 66.7% sensitivity, 96.2% specificity and 82.4% positive predictive value to GIM. The MRST-H was tested for reliability among 40 patients involving three raters (a dietitian and two nurses). The Kappa index of agreement was excellent between the dietitian with nurse A (81.3%, Kappa=0.84) and nurse B (87.5%, Kappa=0.89) respectively.
CONCLUSION: The MRST-H developed showed high validity and reliability as a screening tool for identifying hospitalised elderly patients with high risk of malnutrition.