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Supplementation of red palm olein-enriched biscuits improves levels of provitamin A carotenes, iron, and erythropoiesis in vitamin A-deficient primary schoolchildren: a double-blinded randomised controlled trial

Tan PY, Loganathan R, Teng KT, Mohd Johari SN, Lee SC, Selvaduray KR, et al.

Eur J Nutr, 2024 Apr;63(3):905-918.
PMID: 38240773 DOI: 10.1007/s00394-023-03314-6

PURPOSE: Vitamin A deficiency (VAD) remains a significant contributor to childhood morbidity and mortality in developing countries; therefore, the implementation of sustainable and cost-effective approaches to control VAD is of utmost pertinence. This study aims to investigate the efficacy of red palm olein (RPO)-enriched biscuit supplementation in improving vitamin A, haematological, iron, and inflammatory status among vitamin A-deficient schoolchildren.
METHODS: We conducted a double-blinded, randomised controlled trial involving 651 rural primary schoolchildren (8-12 years) with VAD in Malaysia. The schoolchildren were randomised to receive either RPO-enriched biscuits (experimental group, n = 334) or palm olein-enriched biscuits (control group, n = 317) for 6-month duration.
RESULTS: Significant improvements in retinol and retinol-binding protein 4 levels were observed in both groups after supplementation (P

Matched MeSH terms: Nutritional Status
Fulltext Subtypes of fruit and vegetables, variety in consumption and risk of colon and rectal cancer in the European Prospective Investigation into Cancer and Nutrition

Leenders M, Siersema PD, Overvad K, Tjønneland A, Olsen A, Boutron-Ruault MC, et al.

Int J Cancer, 2015 Dec 01;137(11):2705-14.
PMID: 26077137 DOI: 10.1002/ijc.29640

Previously, a lower risk of colorectal cancer was observed with fruit and vegetable consumption in the European Prospective Investigation into Cancer and Nutrition within a follow-up period of 9 years which was not fully supported by a recent meta-analysis. Therefore, we were interested in the relation with extended follow-up, also focusing on single subtypes and a variety of intake of fruit and vegetables. Fruit and vegetable consumption was assessed at baseline. After an average of 13 years of follow-up, 3,370 participants were diagnosed with colon or rectal cancer. Diet diversity scores were constructed to quantify variety in fruit and vegetable consumption. A lower risk of colon cancer was observed with higher self-reported consumption of fruit and vegetable combined (HR Q4 vs. Q1 0.87, 95% CI 0.75-1.01, p for trend 0.02), but no consistent association was observed for separate consumption of fruits and vegetables. No associations with risk of rectal cancer were observed. The few observed associations for some fruit and vegetable subtypes with colon cancer risk may have been due to chance. Variety in consumption of fruits and vegetables was not associated with a lower risk of colon or rectal cancer. Although a lower risk of colon cancer is suggested with high consumption of fruit and vegetables, this study does not support a clear inverse association between fruit and vegetable consumption and colon or rectal cancer beyond a follow-up of more than 10 years. Attenuation of the risk estimates from dietary changes over time cannot be excluded, but appears unlikely.

Matched MeSH terms: Nutritional Status
Suboptimal Biochemical Riboflavin Status Is Associated with Lower Hemoglobin and Higher Rates of Anemia in a Sample of Canadian and Malaysian Women of Reproductive Age

Aljaadi AM, How RE, Loh SP, Hunt SE, Karakochuk CD, Barr SI, et al.

J Nutr, 2019 Nov 01;149(11):1952-1959.
PMID: 31318024 DOI: 10.1093/jn/nxz151

BACKGROUND: Riboflavin is required for several redox reactions. Clinical riboflavin deficiency occurs mainly in low-income countries, where it is associated with anemia. The functional significance of suboptimal riboflavin status in different populations and its role in anemia is not well understood.
OBJECTIVES: We assessed the biomarker status of riboflavin and its association with hemoglobin concentration and anemia in women living in Vancouver, Canada, and Kuala Lumpur, Malaysia.
METHODS: Healthy nonpregnant, nonbreastfeeding women (19-45 y) were recruited from Canada ( n = 206) and Malaysia (n = 210) via convenience sampling. Fasting blood was collected to assess riboflavin status [erythrocyte glutathione reductase activity coefficient (EGRac)], hematological indicators, soluble transferrin receptor (sTfR), ferritin, vitamin A, folate, and vitamin B-12 concentrations. Linear and logistic regression models were used to assess the association of riboflavin status with hemoglobin concentration and anemia.
RESULTS: EGRac (mean ± SD) values were higher, indicating poorer riboflavin status, in Malaysian compared with Canadian women (1.49 ± 0.17 compared with 1.38 ± 0.11). Likewise, riboflavin biomarker deficiency (EGRac ≥1.40) was significantly more prevalent among Malaysians than Canadians (71% compared with 40%). More Malaysian than Canadian women were anemic (hemoglobin <120 g/L; 18% compared with 7%). With use of linear regression (pooled sample; n = 416), EGRac values were negatively associated with hemoglobin concentration (r = -0.18; P

Matched MeSH terms: Nutritional Status
Fulltext Study protocol for an open labelled randomised controlled trial of perioperative oral nutrition supplement in breast and colorectal cancer patients undergoing elective surgery

Wong TX, Chen ST, Ong SH, Shyam S, Kandasami P, Chee WSS

Trials, 2021 Nov 03;22(1):767.
PMID: 34732233 DOI: 10.1186/s13063-021-05716-5

BACKGROUND: While it is well established that perioperative use of oral nutrition supplement (ONS) improves nutrition status among severely malnourished surgical cancer patients, the evidence requires further substantiation for non-severely malnourished patients with cancer. This protocol paper presents the rationale and design of a randomised controlled trial to evaluate the effectiveness of preoperative as well as an extended 90-day postoperative use of ONS on nutritional and clinical outcomes among patients undergoing elective surgery for breast and colorectal cancer.
METHODS: Patients with primary breast and colorectal cancer undergoing elective surgery are recruited from two tertiary hospitals. Eligible patients are assigned into one of the three intervention arms: (i) Group SS will receive ONS in addition to their normal diet up to 14 days preoperatively and postoperatively up to discharge; (ii) Group SS-E will receive ONS in addition to their normal diet up to 14 days preoperatively, postoperatively up to discharge and for an extended 90 days after discharge; and (iii) Group DS will receive ONS in addition to their normal diet postoperatively up to discharge from the hospital. The ONS is a standard formula fortified with lactium to aid in sleep for recovery. The primary endpoints include changes in weight, body mass index (BMI), serum albumin and prealbumin levels, while secondary endpoints are body composition (muscle and fat mass), muscle strength (handgrip strength), energy and protein intake, sleep quality, haemoglobin, inflammatory markers (transferrin, high sensitivity C-reactive protein, interleukin-6), stress marker (saliva cortisol), length of hospital stay and postoperative complication rate.
DISCUSSION: This trial is expected to provide evidence on whether perioperative supplementation in breast and colorectal cancer patients presenting with high BMI and not severely malnourished but undergoing the stress of surgery would be beneficial in terms of nutritional and clinical outcomes.
TRIAL REGISTRATION: ClinicalTrial.gov NCT04400552. Registered on 22 May 2020, retrospectively registered.

Matched MeSH terms: Nutritional Status
Stone diet and dietary change: understanding determinants for dietary change behaviour in patients following urinary stones

Muhamad S, Sowtali SN, Arifin SRM, Islah MAR, Mohd Shukri NA

J Hum Nutr Diet, 2023 Oct;36(5):2060-2072.
PMID: 37515409 DOI: 10.1111/jhn.13215

BACKGROUND: Dietary habit is one of the most important methods to prevent and treat urinary stones. However, only limited evidence of the experiences of dietary management among urinary stone patients in Malaysia is available. This study aimed to explore participants' current dietary practices after the diagnosis of urinary stones and to identify the factors that facilitate their dietary changes.
METHODS: A qualitative study with purposive sampling was conducted using face-to-face semistructured interviews. A total of 20 participants from a tertiary general hospital in Kuantan, Malaysia, were recruited in this study. Data were analysed using framework analysis.
RESULTS: Two themes emerged from the analysis. The first theme explained the changes in the dietary practice of the participants postdiagnosis. The second theme revealed that the participants' dietary changes were greatly influenced by personal factors and external support from professionals, family and peers.
CONCLUSIONS: Urinary stone patients highlighted the fear of complications, self-determination and knowledge of nutrition as the main drivers of their dietary change postdiagnosis. Emphasising proper nutritional care by assessing and evaluating dietary self-management among patients can facilitate effective self-care in stone prevention management.

Matched MeSH terms: Nutritional Status
Southeast Asian perspectives on nutrition needs for the new millennium

Tee ES

Biomed Environ Sci, 2001 Jun;14(1-2):75-81.
PMID: 11594483

Over the last three decades, there has been significant changes in the lifestyles of commmunities, including food habits, and food purchasing and consumption patterns in the Southeast Asian region. As a result, there is a definite change in the food and nutrition issues in the region. Nutritional deficiencies in many of these countries are slowly being decreased in magnitude. On the other hand, the significant proportions of the population are now faced with the other facet of the malnutrition problem, namely diet-related chronic diseases. However, because of the different stages of socio-economic development, the extent of each of these extremes of the malnutrition problems varies considerably between the different countries in Southeast Asia. Nutrition needs in the new millennium would necessarily differ somewhat among these countries while at the same time, there would be a considerable amount of similarities. This presentation highlights several macro issues that countries in the region may focus on in the near future. Various intervention programmes have been undertaken by authorities to tackle the co-existence of twin faces of malnutrition in many developing countries. It would be desirable to have a blue print of such programmes and activities in the National Plans of Action for Nutrition (NPANs) . The NPAN should be more than a framework or a descriptive document. It should be a tool for action, an operational plan that sets out priorities; identifies projects and activities, with details of implementation such as what, how and when; designates responsibilities and accountability for the activities; identifies resource requirements and their source; and sets out the plan for monitoring and evaluation. One of the main obstacles in the formulation and effective implementation of intervention programmes in developing countries is the lack of comprehensive data on the extent of the problems in many cases and the causes of such problems specificy to the communities concerned. It is thus imperative to identify appropriate research priorities and conduct relevant studies. It is also important to have basic baseline data collected at regular intervals such as nutritional status of communities and dietary intake. To conduct all these activities, it is vital to ensure adequate funding, preferably through establishing a dedicated fund for research. There should be closer collaboration between countries in the region in all nutrition activities to enable sharing of resources, experiences and learn from the mistakes of others. One existing mechanism is through the ASEAN structure. The other existing mechanisms are through WHO and FAO. One other mechanism is through the International Life Sciences Institute (ILSI) Southeast Asian Branch. Closely related to this need for networking is the need for continuing harmonization of approaches to nutrition activities in the region. Current efforts in harmonisation include RDA, nutritional status assessment methodologies and dietary guidelines. Other areas of harmonisation in the near future include nutrition labelling and claims.

Matched MeSH terms: Nutritional Status
Soil-transmitted helminthiasis: a critical but neglected factor influencing school participation of Aboriginal children in rural Malaysia

Ahmed A, Al-Mekhlafi HM, Azam MN, Ithoi I, Al-Adhroey AH, Abdulsalam AM, et al.

Parasitology, 2012 May;139(6):802-8.
PMID: 22310239 DOI: 10.1017/S003118201100237X

Soil-transmitted helminthiasis (STH), among the most common neglected tropical diseases, is a major public health problem in Malaysia with a possible impact on the nutritional status and school participation of rural children. This study was carried out among Aboriginal schoolchildren, living in an endemic area for STH in Malaysia, to determine the possible relationship between intestinal helminthiasis and school absenteeism. We also evaluated whether successful treatment of the infection will affect school attendance among the subjects. Stool analysis revealed that more than 90% of the subjects were infected with at least 1 helminth species, with Ascaris lumbricoides and Trichuris trichiura infections being most prevalent. Infection of moderate-to-heavy worm burdens, low level of fathers' education and anaemia were identified as the significant predictors of high absenteeism among the subjects (P<0·05). Following treatment of the infected children, it was found that school absenteeism was reduced significantly (P<0·01). In conclusion, STH continues to have significant impacts on public health, particularly in rural communities with a negatively significant effect on the school participation of Aboriginal children. A school-based de-worming programme should be introduced and incorporated in the current educational assistance targeted towards the Aboriginal communities, under the auspices of the government.

Matched MeSH terms: Nutritional Status
Socioeconomic profile and nutritional status of children in rubber smallholdings

Marjan ZM, Kandiah M, Lin KG, Siong TE

Asia Pac J Clin Nutr, 2002;11(2):133-41.
PMID: 12074180

This paper will present the socioeconomic profile and nutritional status of children aged 1-6 years in the rubber smallholdings of Peninsula Malaysia. A total of 323 households were involved in this study. The sociodemographic data were obtained through interviews with heads of households using a set of questionnaires. Anthropometric measurements were taken from 506 children aged 1-6 years from these households. The weight and height of the children were compared with the reference values of the National Center for Health Statistics (NCHS) and the nutritional status was classified based on the recommendations of WHO. The average age of the fathers was 39.9+/-8.6 years and 34.4+/-7.0 years for the mothers. The mean household size was 6.67+/-2.27. The majority (49.7%) of the heads of households received 4-6 years of formal education and 7.9% received no formal education. Based on the monthly per capita income, 24.0% were found to be in the hardcore poor category, 38.3% fall into the poor category and 37.7% in the above poverty income group. The prevalence of stunting and underweight among children between the ages of 1-6 years were highest among children from the hardcore poor, followed by the poor category and above the poverty line income group. Wasting was present in all income groups, with a prevalence of 4.2% found among the hardcore poor, 9.4% among the poor group and 8.4% in the above poverty income group. The Pearson Product Moment Correlation showed significant relationships between household total income and height-for-age (r = 0.131, P = 0.05) and weight-for-age (r = 0.127, P = 0.05). There were also significant correlations between monthly per capita income with height-for-age (r = 0.16, P < 0.01) and weight-for-age (r = 0.13, P < 0.05). The acreage of land utilised was correlated with height-for-age (r = 0.11, P < 0.05), weight-for-age (r = 0.17, P < 0.05) and weight-for-height (r = 0.16, P < 0.05). However, stepwise multiple regression analysis indicated that the predictor of height-for-age was monthly per capita income (R2 = 0.03, P < 0.01) and acreage of land utilised was a predictor for weight-for-age (R2 = 0.03, P < 0.01) and weight-for-height (R2 = 0.01, P < 0.01). Because income and acreage of land utilised have been shown to be associated with nutritional status, it is recommended that intervention programs that focus on generation of income and diversification of land utilisation should be undertaken. A multidiscipline approach involving the family, community and government agencies should be applied to any type of intervention program.

Matched MeSH terms: Nutritional Status/physiology*
Fulltext Sociodemographic, nutritional, and environmental factors are associated with cognitive performance among Orang Asli children in Malaysia

Murtaza SF, Gan WY, Sulaiman N, Mohd Shariff Z, Ismail SIF

PLoS One, 2019;14(7):e0219841.
PMID: 31306442 DOI: 10.1371/journal.pone.0219841

Children aged 2 to 6 years are in a crucial period of growth development, during which it is important for them to attain specific cognition related to concentration and attention so that they can perform well in school later in life. Various factors influence children's cognition during this crucial period. However, to date, only a limited number of studies have examined the cognitive performance of underprivileged children living in poverty, particularly indigenous children (also known as Orang Asli children in Malaysia). Therefore, this cross-sectional study aimed to determine the associations between sociodemographic factors, nutritional factors (body composition and hemoglobin), and environmental factors (home environment and parasitic infections) with cognitive performance among Orang Asli children in Negeri Sembilan, Malaysia. The participants were 269 children (51% boys, 49% girls) aged 2 to 6 years (M = 4.0, SD = 1.2 years) and their mothers, from 14 Orang Asli villages. Face-to-face interviews were conducted with the mothers, and the children's cognitive performance, operationalized as working memory index (WMI), processing speed index (PSI), and cognitive proficiency index (CPI), was assessed using the Wechsler Preschool and Primary Scale of Intelligence, Fourth Edition (WPPSI-IV). The children's weight and height were measured, and their blood and stool samples were collected to assess hemoglobin level and parasitic infections, respectively. Multiple linear regression analysis showed that the father's years of education (β = 0.262-0.342, p < 0.05), availability of learning materials at home (β = 0.263-0.425, p < 0.05), and responsiveness of the parent to the child (β = 0.192-0.331, p < 0.05) were consistently associated with all three cognitive indices (WMI, PSI, and CPI). A holistic approach involving parents, communities, and government agencies should be established to improve the cognitive performance of these underprivileged children.

Matched MeSH terms: Nutritional Status*
Socio-economic determinants of nutritional status of children in rural peninsular Malaysia

Marjan ZM, Taib MN, Lin KG, Siong TE

Asia Pac J Clin Nutr, 1998 Dec;7(3/4):307-10.
PMID: 24393689

The data presented is part of the findings from a four-year collaborative research project between Universiti Putra Malaysia, the Institute for Medical Research and the Ministry of Health Malaysia. The project assessed the nutritional status of the major functional groups in Peninsular Malaysia. Mukim Sayong and Pulau Kemiri in the District of Kuala Kangsar, Perak were two of the subdistricts selected to represent small rubber holdings in Peninsular Malaysia. This paper attempts to analyse the socio-economic profile of the households and the nutritional status of children below 9 years of age. A total of 307 households were studied. Approximately 63% of the households were involved in rubber activities and the majority of them were hired tappers. The average monthly income of the households was RM467 and the income ranged between RM30 to RM2120. Based on the per capita poverty line income of RM84.38, it was found that 14.1% of the households earned less than RM42.19, which can be considered as hard-core poor, while 32.7% were poor (monthly per capita income between RM42.19 and RM84.38). Slightly more than half (52.7%) earned income above the poverty line. The average family size was 4.5, ranging from 1 through to 16. The majority of the heads of households (56.6%) had between 3 and 6 years of education, and 14.5% did not receive any formal education. The prevalence of stunting among children 0-5 years of age was 26%, while 31.5% were underweight and 3.8% wasted. Among children aged between 5 and 9 years, almost the same pattern of nutritional status was noted. The overall percentages of stunting, underweight and wasting among these children were 29.2%, 26.1% and 0.62%, respectively. Analysis on nutritional status according to income level showed a noticeable difference in the prevalence of malnutrition in children above and below the poverty line income. The Student's t-test indicated significant differences in weight-for-age and weight-for-height between the two poverty line income for children below 5 years of age. Pearson's correlation coefficient showed a significant correlation between height-for-age with household size (r = -0.26, p<0.05), and monthly per capita income with weight-for-height (r = 0.25, p<0.05). There was a highly significant correlation between acreage of land cultivated and weight-for-height (r = 0.42, p<0.01), and weight-for-age (r = 0.25, p<0.05). The findings indicated the influence of socio-economic factors on the nutritional status of children.

Matched MeSH terms: Nutritional Status
Fulltext Socio-Cultural and Economic Drivers of Plant and Animal Protein Consumption in Malaysia: The SCRiPT Study

Drewnowski A, Mognard E, Gupta S, Ismail MN, Karim NA, Tibère L, et al.

Nutrients, 2020 May 25;12(5).
PMID: 32466102 DOI: 10.3390/nu12051530

Countries in South East Asia are undergoing a nutrition transition, which typically involves a dietary shift from plant to animal proteins. To explore the main drivers of protein consumption, the SCRiPT (Socio Cultural Research in Protein Transition) study recruited a population sample in Malaysia (N = 1604). Participants completed in-person 24 h dietary recalls and socio-demographic surveys. Energy and nutrient intakes were estimated using Nutritionist Pro. A novel recipe-based frequency count coded protein sources as meat (chicken, beef, pork, and mutton), fish, eggs, dairy, and plants (cereals, pulses, tubers). Dietary intakes and frequencies were examined by gender, age, income, education, ethnicity, religion, and family status, using ANOVAs and general linear models. Energy intakes were 1869 kcal/d for men and 1699 kcal/d for women. Protein intakes were 78.5 g/d for men and 72.5 g/d for women. Higher energy and protein intakes were associated with Chinese ethnicity, higher education and incomes. Frequency counts identified plant proteins in 50% of foods, followed by meat (19%), fish (12%), eggs (12%), and dairy (7%). Most frequent source of meat was chicken (16%) rather than pork or beef (1.5% each). In bivariate analyses, animal protein counts were associated with younger age, higher education and incomes. In mutually adjusted multivariate regression models, animal proteins were associated with education and ethnicity; plant proteins were associated with ethnicity and religion. Protein choices in Malaysia involve socio-cultural as well as economic variables.

Matched MeSH terms: Nutritional Status
Social and health factors influencing poor nutritional status among rural elderly Malays

Suzana S, Earland J, Suriah AR, Warnes AM

J Nutr Health Aging, 2002;6(6):363-9.
PMID: 12459886

Older people especially those residing in rural areas are at a greater risk of malnutrition.

Matched MeSH terms: Nutritional Status*
Fulltext Serum potassium and handgrip strength as predictors of sleep quality among hemodialysis patients in Malaysia

Ling LL, Chan YM, Mat Daud Z'

Asia Pac J Clin Nutr, 2019;28(2):401-410.
PMID: 31192570 DOI: 10.6133/apjcn.201906_28(2).0023

BACKGROUND AND OBJECTIVES: Poor sleep quality is prevalent among hemodialysis (HD) patients and leads to adverse health outcomes. This study investigated the association of nutritional parameters with sleep quality among Malaysian HD patients.
METHODS AND STUDY DESIGN: A cross-sectional study was conducted among 184 Malaysian HD patients. Anthropometric measurements and handgrip strength (HGS) were obtained using standardized protocols. Relevant biochemical indicators were retrieved from patients' medical records. Nutritional status was assessed using the dialysis malnutrition score. The sleep quality of patients was determined using the Pittsburgh Sleep Quality Index questionnaire on both dialysis and non-dialysis days.
RESULTS: Slightly more than half of the HD patients were poor sleepers, with approximately two-third of them having a sleep duration of <7 hours per day. Sleep latency (1.5±1.2) had the highest sleep component score, whereas sleep medicine use (0.1±0.6) had the lowest score. Significantly longer sleep latency and shorter sleep duration were observed in the poor sleepers, regardless of whether it was a dialysis day or not (p<0.001). Poor sleep quality was associated with male sex, old age, small triceps skinfold, hypoproteinemia, hyperkalemia, hyperphosphatemia, and poorer nutritional status. In a multivariate analysis model, serum potassium (β=1.41, p=0.010), male sex (β=2.15, p=0.003), and HGS (β=-0.088, p=0.021) were found as independent predictors of sleep quality.
CONCLUSIONS: Poor sleep quality was evident among the HD patients in Malaysia. The sleep quality of the HD patients was associated with nutritional parameters. Routine assessment of sleep quality and nutritional parameters indicated that poor sleepers have a risk of malnutrition and may benefit from appropriate interventions.

Matched MeSH terms: Nutritional Status*
Fulltext Sensitivity, specificity, predictive value and inter-rater reliability of malnutrition screening tools in hospitalised adult patients

Nor Azian, M.Z., Suzana, S., Romzi, M.A.

Malays J Nutr, 2014;20(2):209-219.
MyJurnal

Introduction: Nutrition screening is recommended as a first step of nutrition care to allow early identification and intervention of malnourished patients. The present study determined the validities and reliabilities of two malnutrition screening tools namely, the Malnutrition Universal Screening Tool (MUST) and Malnutrition Screening Tool (MST) among adult patients at the Hospital Kuala Lumpur. Methods: The sensitivity, specificity and predictive value of MUST and MST were conducted against the Subjective Global Assessment (SGA), anthropometric parameters including body mass index (BMI), calf circumference (CC), mid-upper arm circumference (MUAC) and energy intake. Inter-rater reliability was evaluated using kappa value (κ) to determine the level of agreement between raters. Results: A total of 151 subjects with mean age of 45.2 ± 13.7 years participated in this study. Prevalence of malnutrition according to MUST, MST and SGA was 34.4%, 33.8% and 19.9%, respectively. As compared to SGA, MUST and MST had a sensitivity of 96.6% and 93.3% respectively, whereas the specificity was 80.9% for both tools. The sensitivity and specificity of MUST against the anthropometric parameters (BMI, CC and MUAC) were between 53.8% to 88.8% and 67.4% to 69.9%, respectively. The sensitivity values for MST were between 46.1% to 63.6% and specificity values were between 64.4% to 67.6%. The inter-rater reliability of MUST was higher (substantial, mean (κ) = 0.78) than for MST (moderate, mean (κ) = 0.52). Conclusions: In conclusion, MUST was found to have similar validity levels but higher reliability result than MST. Based on our result, MUST is recommended for use in identifying adult patients who are at high risk of malnutrition. It can be used as a malnutrition screening tool but there is a need to evaluate the cost effectiveness of its implementation.

Matched MeSH terms: Nutritional Status
Sensitivity and specificity of visual clinical assessment as compared to WHO 2006 standard and NCHS 1977 reference in measuring the growth status of Malaysian infants

Selamat R, Zain F, Raib J, Zakaria R, Marzuki MS, Ibrahim TF

J Am Coll Nutr, 2011 Dec;30(6):522-8.
PMID: 22331687

OBJECTIVE: To study the validity of the visual clinical assessment of weight relative to length and length relative to age as compared to the World Health Organization (WHO) 2006 standard and National Center for Health Statistics (NCHS) 1977 reference in asssessing the physical growth of children younger than 1 year.
MATERIALS AND METHODS: A prospective cohort study was carried out among 684 infants attending goverment health clinics in 2 states in Malaysia. Body weight, length, and clinical assessment were measured on the same day for 9 visits, scheduled every month until 6 months of age and every 2 months until 12 months of age. All of the 3 z-scores for weight for age (WAZ), length for age (HAZ), and weight for length (WHZ) were calculated using WHO Anthro for Personal Computers software.
RESULTS: The average sensitivity and specificity for the visual clinical assessment for the detection of thinness were higher using the WHO 2006 standard as compared with using NCHS 1977. However, the overall sensitivity of the visual clinical assessment for the detection of thin and lean children was lower from 1 month of age until a year as compared with the WHO 2006 standard and NCHS 1977 reference. The positive predictive value (PPV) for the visual clinical assessment versus the WHO 2006 standard was almost doubled as compared with the PPV of visual clinical assessment versus the NCHS 1977 reference. The overall average sensitivity, specificity, PPV, and negative predictive value for the detection of stunting was higher for visual clinical assessment versus the WHO 2006 standard as compared with visual clinical assessment versus the NCHS 1977 reference.
CONCLUSION: The sensitivity and specificity of visual clinical assessment for the detection of wasting and stunting among infants are better for the WHO 2006 standard than the NCHS 1977 reference.

Matched MeSH terms: Nutritional Status
Seminar on young child nutrition: improving nutrition and health status of young children in indonesia

Isabelle M, Chan P

Asia Pac J Clin Nutr, 2011;20(1):141-7.
PMID: 21393122

The Seminar on Young Child Nutrition: Improving Nutrition and Health Status of Young Children in Indonesia held in Jakarta on November 2009 reviewed the current nutritional and health status of young children in Indonesia and identified key nutrient deficiencies affecting their optimal growth. The continuation of child growth from fetal stage is of paramount importance; and maternal and child health should be a central consideration in policy and strategy development. Clinical management of nutrient deficiency and malnutrition, as well as strategies and education to improve feeding practices of young Indonesian children were discussed in the seminar. Relevant experiences, approaches and strategies from France, New Zealand and Malaysia were also shared and followed with discussion on how regulatory systems can support the development of health policy for young children. This report highlights important information presented at the seminar.

Matched MeSH terms: Nutritional Status*
Fulltext Seasonality, food security, diet quality and nutritional status in urban poor adolescents in Malaysia

Tay JEF, Tung SEH, Kaur S, Gan WY, Che'Ya NN, Tan CH

Sci Rep, 2023 Sep 12;13(1):15067.
PMID: 37700109 DOI: 10.1038/s41598-023-42394-6

Seasonality was shown to have an effect on food availability and accessibility, increasing the risk of food insecurity and causing poor diet quality and malnutrition. Therefore, this study aimed to determine seasonal effects on household food security status, diet quality, and nutritional status of urban poor adolescents in Malaysia. A cohort study was conducted among 164 adolescents aged 10-17 from 12 People Housing Programme in Kuala Lumpur, Malaysia during the Northeast (November 2021 till March 2022) and Southwest (June 2022 till September 2022) monsoon. Household food security status was measured using the 18-item USDA Household Food Security Survey Module. Dietary intake was determined using a two-days 24-h dietary recall and translated into Standardized Malaysian Healthy Eating Index (S-MHEI). Anthropometric and haemoglobin level measurements were performed to determine nutritional status. Seasonality was found to have a significant effect on overall diet quality (p = 0.021), food groups such as fish (p

Matched MeSH terms: Nutritional Status*
Fulltext School-based intervention that integrates nutrition education and supportive healthy school food environment among Malaysian primary school children: a study protocol

Teo CH, Chin YS, Lim PY, Masrom SAH, Shariff ZM

BMC Public Health, 2019 Oct 30;19(1):1427.
PMID: 31666034 DOI: 10.1186/s12889-019-7708-y

BACKGROUND: Malnutrition among school children may contribute to adverse health consequences such as non-communicable diseases, poor cognitive performance, psychological distress and poor quality of life that may persist into adulthood. In order to prevent childhood malnutrition, an intervention programme that integrates nutrition education and healthy school food environment is needed to provide nutrition information and reinforce the skills on healthy eating behaviours in schools. This paper describes a study protocol of a school-based intervention programme that integrates nutrition education and healthy school food environment, namely School Nutrition Programme (SNP). The SNP is a primary prevention programme that promotes healthy lifestyle among primary school children in light of the high prevalence of malnutrition in Malaysian children.
METHODS/DESIGN: This quasi-experimental study aimed to evaluate the effectiveness of the SNP between intervention and comparison groups before and after the SNP, and after a 3-month follow-up. The SNP consisted of two main components, whereby three nutrition education sessions were implemented by trained teachers using three standardised modules, and healthy school food environment was implemented by the canteen food handlers with the provision of healthy menu to children during school recess times. Children from intervention group participated in the SNP, in addition to the standard Physical and Health Curriculum. The comparison group attended only the standardised Physical and Health Curriculum and the school canteen food handlers were reminded to follow the standard canteen guidelines from the Ministry of Education Malaysia. The assessment parameters in evaluating the effectiveness of the programme were knowledge, attitude and practice on nutrition, eating behaviours, physical activity, body composition, psychological distress, cognitive performance and health-related quality of life. Assessments were conducted at three time points: pre-intervention, post-intervention and 3-month follow-up.
DISCUSSION: It was hypothesised that the SNP would be effective in promoting healthy lifestyle among school children, and further contributes in preventing malnutrition problem, enhancing cognitive performance and improving health-related quality of life among school children. Findings of the present study can be expanded to other schools in future on ways to improve nutrition education and healthy school food environment.
TRIAL REGISTRATION: UMIN Clinical Trial Registration UMIN000032914 (Date of registration: 7th June 2018, retrospectively registered).
PROTOCOL VERSION: 16th September 2019 & Version 4.

Matched MeSH terms: Nutritional Status
River flow, zooplankton and dominant zooplanktivorous fish dynamics in a warm-temperate South African estuary

Mbandzi N, Wasserman RJ, Deyzel SHP, Vine NG, Whitfield AK

J Fish Biol, 2018 Jun;92(6):1747-1767.
PMID: 29696653 DOI: 10.1111/jfb.13617

The possible links between river flow, zooplankton abundance and the responses of zooplanktivorous fishes to physico-chemical and food resource changes are assessed. To this end, the seasonal abundance, distribution and diet of the estuarine round-herring Gilchristella aestuaria and Cape silverside Atherina breviceps were studied in the Kariega Estuary. Spatio-temporal differences were determined for selected physico-chemical variables, zooplankton abundance and zooplanktivorous fish abundance and distribution. Results indicated that, following a river flood event in winter (>30 m3 s-1 ), altered physico-chemical conditions occurred throughout the estuary and depressed zooplankton stocks. Abundance of G. aestuaria was highest in spring, with this species dominant in the upper and middle zones of the estuary, while A. breviceps was dominant in summer and preferred the middle and lower zones. The catch per unit of effort of both zooplanktivores also declined significantly following the flooding, thus suggesting that these fishes are reliant on zooplankton as a primary food source for healthy populations. Copepods dominated the stomach contents of both fish species, indicating a potential for strong interspecific competition for food, particularly in the middle reaches. Temporal differences were evident in dietary overlap between the two zooplanktivorous fish species and were correlated with river flow, zooplankton availability and fish distribution. The findings of this study emphasize the close trophic linkages between zooplankton and zooplanktivorous fishes under changing estuarine environmental conditions, particularly river flow and provide important baseline information for similar studies elsewhere in South Africa and the rest of the world.

Matched MeSH terms: Nutritional Status
Fulltext Risk factors of malnutrition among preschool children in Terengganu, Malaysia: a case control study

Wong HJ, Moy FM, Nair S

BMC Public Health, 2014;14:785.
PMID: 25086853 DOI: 10.1186/1471-2458-14-785

Childhood malnutrition is a multi-dimensional problem. An increase in household income is not sufficient to reduce childhood malnutrition if children are deprived of food security, education, access to water, sanitation and health services. The aim of this study is to identify the characteristics of malnourished children below five years of age and to ascertain the risk factors of childhood malnutrition in a state in Malaysia.

Matched MeSH terms: Nutritional Status*

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