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).
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.
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.
Food-borne parasitic zoonoses are emerging as major public health problems in most countries because they are widespread and pose a medical challenge. Not only are they important from an economic standpoint, but they also cause severe sequalae in all those affected. The extent of parasitic zoonoses in Malaysia is considered a "tip of the iceberg" problem. Cases of zoonotic diseases, like porocphaliasis, sarcocystosis, toxoplasmosis, cysticercosis, hydatidosis, echinostomiasis, and gnathostomiasis are traced and documented. An epidemiologic reassessment of methods is suggested to determine the extent of these parasitoses in Malaysia.
High intake of trans fatty acids (TFA) may cause adverse changes in blood lipids as shown in many epidemiological studies. The major sources of TFA in human diet come from bakery products such as cookies, cakes, muffins, breads and pastries. In this study, total fat of baked products was determined using Soxhlet method while TFA content was determined on gas chromatograph using a highly polar capillary column and flame ionization detector. Exposure to TFA from the baked product was estimated based on Food Consumption Statistics of Malaysia 2003. High level of TFA was observed in muffins (3.21-7.34 g per 100 g food) followed by pastries (2.90-6.03 g per 100 g food) and cakes (2.26-8.36 g per 100 g food) regardless of products having brand name or not. Among the TFA isomers, trans 18:1 6t was the most abundant followed by trans 18:1 9t, trans 16:1 9t, trans 18:2 and small quantities of trans 18:1 11t. Exposure to TFA based on the Malaysian Food Consumption Statistics 2003 of the baked products was ranging from 0.14-0.18 g/day. Even with the low estimated exposure, actual intake of baked products must be monitored closely as other high fat food as these products is one of main contributor to TFA in the diet following their high frequency of daily intake.
This cross-sectional study was undertaken with 489 secondary school girls, ages 15-17 years, to examine disordered eating behaviours of adolescent girls in Malaysia and to estimate associations with body weight, body-size discrepancy, and self-esteem. Dietary restraint, binge eating, body image, and self-esteem were assessed using the Restrained Eating scale of the Dutch Eating Behaviour Questionnaire, the Binge Scale Questionnaire, the Contour Drawing Rating Scale, and the Rosenberg Self-Esteem Scale, respectively. Pearson correlations estimated associations between variables. There were 3.1% underweight, 9.8% at risk of being overweight, and 8.6% overweight girls. A total of 87.3% were dissatisfied with their own body size. Dietary restraint and binge eating were reported by 36.0% and 35.4%, respectively. Body Mass Index (r = .34, p < .01) and body-size dissatisfaction (r = .24, p < .01) were significantly associated with dietary restraint and binge eating, but self-esteem (r = -.20, p < .001) was significantly associated only with binge eating.
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.
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
Polyphenol is a non-nutrient phytochemical compound existed abundantly in plant-based diet which has the properties to prevent age related oxidative damage induced diseases. However, there are difficulties in quantifying its intake and local food frequency questionnaire (FFQ) for the assessment is not available. Therefore, this study aimed to develop and validate FFQ for estimation of dietary polyphenol intake among 93 individuals aged 60 years and above recruited from several senior citizen clubs in Klang Valley. Phase I of the study involved the development of FFQ consisted of 117 items under 9 categories and formation of the database extracted from PHENOL-EXPLORER. In Phase II, the intake of polyphenol estimated using FFQ was compared with reference method consisted of 2-day diet records and diet history questionnaire (DHQ). The mean dietary polyphenol intake estimated from FFQ and the reference method was 2770.7 ± 1552.4 mg/d and 2171.4 ± 898.8 mg/d, respectively. Spearman’s rho and Kendall’s tau-b analysis indicated that there was a significant positive correlation between polyphenol intake estimated from FFQ and reference method (r = 0.41, p < 0.001; r = 0.28, p < 0.001). For Bland-Altman plot, 95.7% of scattered plot fell within ± 1.96 SD limits of agreement revealed that there was good agreement between the two methods used. Cross-classifi cation analysis showed that 36.6% was categorized in the same quartile, 78.5% in identical and contiguous quartiles, with only 3.2% in the opposite quartiles. Regression analysis showed that all categories in FFQ signifi cantly account for the inter-variance for dietary polyphenol intake after controlling for the other variables (R2 = 1.000, p < 0.001). In conclusion, the newly developed FFQ is considered valid and has the potential to be used as a tool to estimate polyphenol intake among elderly individuals in Malaysia.
Introduction: Hypercholesterolemia is an important modifiable risk factor for coronary heart disease. Lifestyle changes in diet and physical activity can improve cholesterol levels. This study aimed to compare the fruits and vegetables (FV) intake and physical activity (PA) between hypercholesterolemic adults and non- hypercholesterolemic adults in Malaysia, and to investigate factors associated with meeting the recommended levels of FV intake and PA in a hyper- cholesterolemic population. Methods: This study was based on 17,988 participants (response rate 98.7%) aged 18 years and above who responded to the hypercholesterolemia questionnaire in the 2011 Malaysian National Health and Morbidity Survey (NHMS), a cross-sectional study with two-stage stratified sampling design. Data were obtained by trained enumerators via face-to-face interviews and were analysed by descriptive analysis, chi-square test, and univariable and multivariable logistic regression. Results: Out of the total population assessed, 39.0% had hypercholesterolemia. The prevalence of consuming five or more servings of FV per day is low (7.8%) while 36.0% were physically inactive among the hypercholesterolemic adults. No significant differences were observed in FV intake and PA between hypercholesterolemic and non-hypercholesterolemic populations. Gender, age and educational levels were associated with FV intake and PA among hypercholesterolemic adults. Hypercholesterolemic adults who were underweight or obese were less likely to consume FV, while those who were former smokers and those who had diabetes and heart disease were less likely to be physically active. Conclusion: These findings are relevant for future health promotion strategies, suggesting that more intensive interventions are needed to increase FV intake and PA level in hypercholesterolemic population and in the general population.
Study name: National Health and Morbidity Survey (NHMS-2011)
BACKGROUND/OBJECTIVES: In the era of modern multidisciplinary clinical management, very little is known about the prevalence and presentation of malnutrition in children with gastrointestinal disorders (GastroD) particularly employing composite, global measures of nutritional status.
SUBJECTS/METHODS: Anthropometry, body composition, dietary intake, eating habits and grip strength were assessed with bedside methods in 168 patients from outpatient gastroenterology clinics (n, median (IQR) years; Crohn's disease (CD): n=53, 14.2 (11.6:15.4); ulcerative colitis (UC): n=27, 12.2 (10.7:14.2); coeliac disease: n=31, 9.3 (7.5:13.6); other GastroD: n=57, 9.8 (7.2:13.8)) and compared with 62 contemporary healthy controls (n, median (IQR): 9.8 (6.9:13.8)) and the results of the recent UK, National Diet and Nutritional Survey (NDNS).
RESULTS: Children with CD had lower BMI z-scores than controls (median (IQR): -0.3 (-0.9:0.4) vs 0.3 (-0.6:1.4); P=0.02) but only 2% were classified as thin (BMI z-score
The evolution in lifestyle and dietary habits of the Malaysian people that have taken place over the last few decades can be largely attributed to both family and social environment. These factors are known to affect the nutritional status of the community, in both children and adults. Reduced physical activity and changes in their diet have been one of the contributing factors to the rising prevalence of overweight and obesity. However, in Malaysia, in which nutrition transition has been a norm, it is worrying when the trends of overweight and obesity have been rising steadily over the years especially among children. Although numerous strategies to control obesity in Malaysia have been taking place, many had shown little effect. Analysing strategies implemented at national level is thus crucial in order to ascertain reasons for the shortfalls of these strategies especially among children. Obesity most commonly begins as early as the ages of 5 and 6 years, or during adolescence. Obesity is indeed a major public health concern due to its huge negative impact on the society at large which is well supported by evidence-based literatures. Managing this issue is complex and holistic approach is thus crucial in reducing its incidence and prevalence.
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)
All living organisms including human beings in this biosphere are constantly exposed to a variety of xenobiotics. The enormous chemical load in the environment has been primarily through the modernization, industrialization and changes in lifestyle. The changing food habits to suit modern living pose a serious threat to a healthy life. Among others, consumption of soft drinks invariably forms a part of modern life. Mostly children and adolescents are the target groups vulnerable to frequent consumption, compromising the nutritious foods such as fruits, vegetables, milk and milk products. Logically, the quality of the soft drinks is determined by the type and quantity of chemicals present, including those present inherently in the water used for such preparations. The impact of soft drinks on human health has been a subject of in depth research. Consumption of soft drinks plays a major role in a variety of diseases like obesity, diabetes, dental and bone disorders and others, more so among children and adolescents. The toxic effects of soft drinks have gained much attention, due to the frequent scientific reports and media attention. The objective of this review is to provide a comprehensive scrutiny of the impact of soft drinks on health, as well as to suggest alternatives for a healthy life style.
The prevalence of lifestyle-related chronic diseases is increasing and gene-diet interaction studies are limited among the Malaysian population. This study was conducted to evaluate the association and interaction effects of vascular endothelial growth factor receptor-2(VEGFR2) gene polymorphisms and dietary patterns on anthropometric and biochemical risk factors of chronic diseases in 179 Chinese Malaysian adults.
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
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.
An examination of the fat composition of the diet of a Malaysian urban hostel population obtained by chemical analysis of representative meals prepared by a 7-day rotation menu, revealed both nutritional attributes and limitations when compared against the dietary messages contained in the American Heart Association (AHA) and World Health Organisation (WHO) models. The Malaysian diet supplies 26% kcal i.e. 66 g total fat (51 g vegetable fats, 15 g animal fats) and contains