Abdominal obesity (AO) is an independent risk factor for cardiovascular disease, hypertension and diabetes mellitus in adults. There is a lack of data on the magnitude and socio-demographic profile of AO among Malaysian adults at the national level. In the Third National Health and Morbidity Survey (NHMS III) conducted in 2006, AO of adults aged 18 years and above was determined based on the waist circumference as part of the nutritional status assessment. This article reports the prevalence of AO in relation to socio-economic factors and demographic characteristics of adult subjects. Out of a total of 33,465 eligible individuals 18 years and above, waist circumference was measured in 32,900 (98.3%) individuals. The prevalence of AO was assessed using the cut-off points recommended by World Health Organization. The mean waist circumference in men and women was 84.0cm [95% confidence interval (95% CI): 83.8, 84.3] and 80.3cm (95% CI: 80.1, 80.6) respectively. The national prevalence of AO was 17.4% (95% CI: 16.9, 17.9). The identified risks of AO were women (OR: 4.2, 95% CI: 3.8, 4.6), aged 50-59 years (OR: 5.6, 95% CI: 4.0, 7.7), Indians (OR: 3.0, 95% CI: 2.4, 3.8), housewives (OR: 1.4, 95% CI: 1.1, 1.7), subjects with primary education (OR: 1.3, 95% CI: 1.1, 1.5) and ever married (OR: 1.4, 95% CI: 1.2, 1.6). Being the largest population-based study on AO among Malaysians, these findings have important public health implications. There is an urgent need to revise public health policies and programmes aimed at prevention of abdominal obesity especially in the groups at risk.
Study name: National Health and Morbidity Survey (NHMS-2006)
A cross sectional study on Type 2 diabetes patients seeking treatment in the Primary Health Care outpatient clinic of the University Malaya Medical Centre, Kuala Lumpur was undertaken. Two hundred and thirty-three subjects participated. They were asked questions on biodata and dietary intake using face-to-face interview techniques. Dietary intake was assessed using the 24-hour dietary recall. Anthropometric measurements including weight and height were taken and Body Mass Index (BMI) was computed to establish the extent of obesity. Of the 196 subjects, 66.8% were overweight (BMI ≥25 kg/m2) with 15.8% obese (BMI ≥30 kg/m2). The mean BMI of males and females were 25.9±4.3 kg/m2 and 27.2±4.7 kg/m2 respectively. The findings from the dietary survey showed that the mean energy intake of the subjects only achieved about 72% of the Recommended Daily Allowance (RDA) for Malaysia while protein intake of all subjects was adequate. The macronutreint contribution to the total calorie was consistent with the recommendation of the Malaysian Diabetic Association for a healthy diet for diabetes patients. The male subjects were found to meet the RDA requirements for all nutrients while the female subjects did not have sufficient intake of calcium, vitamin A and niacin. No consistent pattern in energy and nutrient intake was observed among different age groups. On the other hand, the Malay subjects seemed to have lower energy and all nutrient intake (except vitamin A and vitamin C) compared to the Chinese and Indian subjects. The Indian subjects seemed to have the highest intake of calcium compared to the others. Advice needs to be given to those who did not have adequate nutrient intake as well as those who need to reduce their weight.
Study site: Primary health care clinic, University Malaya Medical Centre (UMMC)
Dietary intakes and lifestyle habits during adolescence may predict the occurrence of obesity and other diet-related chronic diseases later in life. The purpose of this study was to determine dietary intake of adolescents in a fishing community in Tuaran District, Sabah. A total of 199 apparently healthy adolescents comprising 94 male and 105 female subjects were purposively selected for the study. The mean age of the subjects was 15.2 f 2.2 years with female subjects having a higher mean age of 15.7 f 2.4 years compared to the males (14.6 k1.8 years). The mean BMI of the subjects was 18.4 f 2.9 kg/m2 with females having a significantly higher BMI (18.9 f 2.8 kg/m2) than the males (17.8 f 3.0 kg/m2). Based on the WHO classification (WHO, 1995), 19.6% of the subjects could be classified as thin while 4.5% were at risk of overweight. Overall for both sexes, intake of energy and most nutrients were below the Malaysian recommended nutrient intake (RNI) levels for adolescents, with the exception of vitamin C and niacin. The male subjects showed higher mean intake for vitamin A, thiamine, niacin and vitamin C than the females. Calcium and iron intake ranked among the lowest levels, at 33.4% and 47.2% respectively of the RNI values for both sexes. The main sources of energy were rice, flour products and tubers while fish and seafood were the chief sources of protein. Majority of the subjects (84%) reported taking breakfast daily, which often consisted of fried noodles, fried banana, doughnuts and coffee. Consumption of snacks was popular and commonly consumed snacks were bread, biscuits, and fried banana. The present study revealed that 25.5% and 14.3% of the male and female adolescents respectively were thin, with majority of them consuming inadequate levels of energy and several key nutrients. The results underscore the need for adolescents to be targeted for nutrition and health education as they go through a period of marked physical, physiological and psychological changes.
Lifestyle has been shown to exert a major impact on the quality of life and health in mid-life women coping with menopausal changes. This study aimed to assess the efficacy of a lifestyle intervention package in improving nutritional knowledge and composition, dietary habits and related health status in mid-life women. Between Nov 1999 to Oct 2001, 360 disease free women, non users of HRT, aged 45 years and above with intact uterus were recruited into the study. The women were randomised into three groups - I (control), II (lifestyle intervention) and III (lifestyle intervention with HRT) respectively. After 12 months, 85.6% completed the study. The lifestyle intervention programme, well accepted by the participants, brought about an improved dietary composition, better eating habits, more exercise participation and increment in knowledge with concomitant improvement of the health status. The benefits observed were significant reduction in energy, fat and carbohydrate intake with increased intake of legumes; milk and cheese/yogurt; and reduction of tea and coffee. Body weight was reduced and more importantly preventing abdominal obesity in the intervention groups with HRT was more effective. Further adaptations of the dietary component with advice on obtaining micronutrients from local produce would contribute towards a more balanced diet in midlife women as dairy products were not popular and these women had low meat intake.
Introduction: This study aimed to assess the nutritional status of children below 24 months in the district of Pekan, Pahang, and identify the contributing factors. Methods: Using a cross-sectional methodology, a total of 910 children was selected by random sampling from four public health clinics. Anthropometric measurements were taken and weight-for-age, height-for-age, and weight-for- height were calculated in Z scores. Immediate caregivers of children were interviewed by using a pretested validated questionnaire to assess their socio- economic, demographic, educational and occupational status. Results: Of the 910 children who participated in the study, the majority were Malay (70.1%), while the remaining comprised indigenous or Orang-Asli (OA) children. Prevalence of wasting, stunting and underweight were 28.7 %, 15.6 % and 19.0% respectively. There were more underweight males than females. Wasting was most common among children aged below 6 months. Stunting was more prevalent in children between 12 to 24 months. Obesity was seen in 7.3% of the sample. Maternal education, employment and socio-economic status had a significant influence on wasting and underweight. Children were vulnerable to stunting as age advanced, whereas prevalence of wasting tended to decrease. Conclusion: Malnutrition exists in significant proportions among children below 24 months in the Pekan district. This study identified low birth weight along with age, race, gender, large family size and socio-economic status as important risk factors of malnutrition.
Background: Although body fat percentage (BFP) is a widely accepted indicator of total body fat, it has not been extensively used in studies conducted among the Orang Asli in Peninsular Malaysia. Objective: This study was undertaken to determine the BFP distribution in a group of Orang Asli adults living in Cameron Highlands, Malaysia. Methods: Kampung Sungai Ruil, one of the Orang Asli settlements in Cameron Highlands, was conveniently selected for this crosssectional study. A total of 138 respondents aged 18 years and above were assessed. Skinfold thickness was measured using the Slim Guide skinfold caliper to calculate BFP. Waist circumference, BMI, blood pressure and random plasma glucose were also measured. Results: The mean BFP of the females (29.7%) was higher than the males (18.9%) and the respondents with abdominal obesity (36.2%) had higher mean BFP compared to those with normal waist circumference (23.7%) Those in the age group of 18-28 years old (22.1%) had lower BFP than
respondents in the age groups 29-39 years old (27.3%) and 40-50 years old (29.1%) (p=
Introduction: Breakfast skipping is an unhealthy eating behaviour reportedly common among adolescents. A cross-sectional study was carried out to determine the differences in body weight status, socio-demographic, behavioural, and psychological characteristics between daily breakfast takers and breakfast skippers.
Methods: Data were collected from form four students of four randomly selected secondary schools in Sibu, Sarawak using a self-administered questionnaire. Body weight and height were measured using standard procedures and BMI-for-age z-scores were determined.
Results: A total of 375 students were recruited (male: 32.0%, female: 68.0%; Chinese: 39.5%, Than: 26.4%, Malay: 17.1% and Melanau: 17.1 %; mean age = 16.45 ± 0.53 years). The prevalence rate of breakfast skippers at 40.3% was higher compared to the national prevalence of 32.7%. About 19.7% of the students were found to be at risk of eating disorders. In addition, the prevalence rates of overweight and obesity were 10.9% and 7.7%, respectively. Significant associations were found between breakfast skipping with sex, lunch skipping, dinner skipping, eating attitudes, and body weight status. Binary logistic regression analysis showed that female students and those who skipped lunch or dinner were more likely to skip breakfast.
Conclusion: Breakfast skipping was quite common in this sample of adolescents in Sarawak. As frequent breakfast skipping has negative health and academic performance implications, increased nutrition education and health awareness campaigns on the importance of breakfast taking among school students should be undertaken.
Introduction: High sensitivity C-reactive protein (hs-CRP) is an emerging risk marker for cardiovascular diseases (CVD). In Malaysia, CVD has become a major health problem and the risk factors of CVD have also increased among the middle- aged. Thus, this study aimed to determine factors that influence the level of hs- CRPamongMalaysianadultsaged30-55years-old. Methods:One-hundredand twenty-two (n=122) adults working at an institution were selected systematically in this cross-sectional study. Body weight, height, hip and waist circumference, systolic and diastolic blood pressure, hs-CRP level, total cholesterol, triglycerides, low-density lipoprotein, and high-density lipoprotein were measured. Body mass index (BMI), waist-to-hip ratio, and total cholesterol: high-density lipoprotein ratio were calculated. Results: The sample consisted of 40.2% male and 59.8% female subjects with a mean age± SD of 41.93 ± 8.26 years. Pearson's correlation coefficient showed significant positive correlations between log hs-CRP level (mean± SD= 0.22 ± 0.50 mg/L; 95% CI= 0.13 - 0.31) and age, waist circumference, hip circumference, BMI, systolic blood pressure, total cholesterol, low-density lipoprotein, triglycerides, and total cholesterol: high-density lipoprotein ratio. However, multivariate analysis showed only BMI (R = 0.489, R2 = 0.239, adjusted R2 = 0.232, F = 37.626, p< 0.001) was a predictor of hs-CRP, the risk marker of CVD. Hs-CRP level was greater in overweight (25 - 29.9 kg/m2), and obese(> 30 kg/ m2) subjects (ANOVA p< 0.05) compared to normal weight subjects. Conclusion: BMI is a modifiable risk factor with the change being important for reducing CVD events among adults.
Introduction: Otanges in children's food habits are largely attributed to changes in the family and social environment. 1bis cross-sectional study was carried out to determine the association of socio-demographic factors with food habits among preschool children in Peninsular Malaysia. Methods: A total of 1,933 preschool children aged 4-6 years old participated in the study. Parents or guardians were interviewed on the socio-demographic characteristics and food habits of their children. Height and weight of the preschoolers were measured; BMI-for-age, weight-for-age and height-for-age were determined. Results: The mean monthly household income was RM3,610 with 59.6% of parents having attained secondary education. The prevalence of possible risk of overweight, being overweight and obesity were 3.9%, 7.9% and 8.1%, respectively while the prevalence of underweight and stunting was 8.0% and 8.4%. A majority of the preschoolers consumed breakfast, lunch and dinner every day, with the proportion of children skipping their main meals at about 15.0%. Parents' education level and household income were significantly associated with intakes of fruits, vegetables, milk and dairy products, as well as fast food. However, there was no significant association between children's body weight status and frequency of main meals intake, fruits, vegetables, milk and dairy products, and fast food intake. Conclusion: The preschoolers demonstrated moderately healthy food habits; nevertheless even at this young age, they were inclined towards fried foods, snacking and fast foods intake. Parents and guardians should play a more significant role in educating and promoting good nutrition and food habits among preschoolers.
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)
Introduction: Dietitians play an essential role in the management of childhood obesity and consistency in dietetic practices is required to ensure the effectiveness of treatment. This study assessed dietitians’ current practices in the management of childhood obesity, compared the practices with nutrition practice guidelines used by dietitians in other countries and identified practice components for the development of nutrition practice guidelines for the management of childhood obesity in Malaysia.
Methods: A cross-sectional study was conducted among 40 dietitians in 16 Ministry of Health hospitals and three teaching hospitals. Information on current dietetic practices in the management of childhood obesity was obtained through a mailed survey questionnaire. The practices included nutritional assessment, determination of energy requirement, dietary prescription and physical activity modification. Emails were sent to 31 dietetic associations in other countries to obtain information on practice guidelines used by dietitians.
Results: Frequently used dietary intervention and physical activity modification approaches were high fibre diet (65%), low fat diet (40%), reduction of sedentary pursuits and screen times (67.5%) and an increase in duration of current physical activities (60%). In comparison to other dietetic practice guidelines, the current dietetic practices in Malaysia do not usually include waist circumference, biochemical and blood pressure data. However, similar to other guidelines, the current dietetic practices included low dietary fat, high fibre diet, decreased sedentary activity and increased physical activity level.
Conclusions: The dietetic practices in the management of childhood obesity in Malaysia are diverse. A comprehensive nutrition practice guideline for management of childhood obesity is urgently needed for standardisation of dietetic practices in Malaysia.
Introduction: Studies on metabolic syndrome (MetS) of children are important
in view of rising prevalence of childhood obesity worldwide. This study compares
the risks of insulin resistance, inflammation and metabolic syndrome between
overweight/obese (OW/OB) and normal weight (NW) children in Kuala Lumpur.
Methods: A cross-sectional study was conducted in 12 primary schools selected
using multi-stage stratified random sampling. Height and weight were taken of a
total of 1971 children aged 10-11 years. Based on BMI-for-age, 235 OW/OB children
matched for age, sex and ethnicity with 226 NW children were selected for the study.
Overnight fasting blood samples were collected to determine insulin, high-sensitivity
C-reactive protein (hsCRP), glucose and lipid profiles. Logistic regression analysis
was conducted to estimate associations between weight status and metabolic risk
factors.
Results: Prevalence of MetS among OW/OB children was 3.8% compared to
0% in the NW. Prevalence of insulin resistance among OW/OB was 45.5% compared
to 18.6% among NW children. High risk of inflammation was found in 28.1% of the
OW/OB children compared to 12.4% in the NW. The odds ratio of having insulin
resistance, inflammation and metabolic risk factors among OW/OB were 3.66 (95%
CI: 2.40-5.59), 2.76 (95% CI: 1.69-4.50), 4.93 (95% CI: 3.42-7.10), respectively
compared to the NW.
Conclusion: The OW/OB children in this study showed higher
risks of developing insulin resistance, inflammation and MetS compared to the NW
counterparts. Further studies are suggested to better understand the relationships
between insulin resistance, inflammation and MetS in children.
Synthetic biology makes inroads into clinical therapy with the debut of closed-loop prosthetic gene networks specifically designed to treat human diseases. Prosthetic networks are synthetic sensor/effector devices that could functionally integrate and interface with host metabolism to monitor disease states and coordinate appropriate therapeutic responses in a self-sufficient, timely and automatic manner. Prosthetic networks hold particular promise for the current global epidemic of closely interrelated metabolic disorders encompassing obesity, type 2 diabetes, hypertension and hyperlipidaemia, which arise from the unhealthy lifestyle and dietary factors in the modern urbanised world. This review will critically examine the various attempts at constructing prosthetic gene networks for the treatment of these metabolic disorders, as well as provide insight into future developments in the field.
Breast cancer is the commonest female cancer in Malaysia with a prevalence of 86.2 cases per 100,000 women in 1996. Pronling breast cancer patients is important for better planning of preventive and screening strategies for Malaysian women. The aims of this cross-sectional study were to identify histological presentation, socio-demographic and reproductive characteristics and prevalence of risk or protective factors of breast cancer among women with breast cancer in Kelantan. A total of 175 female breast cancer patients who were diagnosed in 1991 to 2000, were interviewed using standardized questionnaires. The mean (sd) age was 47.0 (9.6) years with 77.7% Malay, 20.6% Chinese and 1.7% others. About half (52.6%) had 9 years or less of formal education, while 59.4% were housewives/unemployed and 60.6% had a monthly family income of less than RM1 ,000. The commonest histological type was innltrative ductal carcinoma (73 .7%) . Presentation of breast cancer with the stage lll or Vl was 59.4%. The prevalence of nulliparity · 13.1%, breastfeeding longer than two years - 58.9%, premenstrual period - 72.0%, menarche at 11 years old or less - 5 .7%, positive family history - 14.4%, overweight/obesity - 48.0%, oral contraceptives use 30.3%, hormone replacement therapy » 1.1%, cigarette smoking - 4.6%, consuming akohol - 3.4%, previous benign breast disease - 6.3%, previous breast biopsy - 2.9% and previous oophorectomy - 4.6%. The patients were younger compared to other studies. The ethnic distribution did not represent the population distribution of Kelantan. The prevalence of overweight/obesity and smoking were higher than the national prevalence among women, thus they should be included in the prevention strategies for breast cancer. Further studies are recommended to investigate why many of breast cancer patients in Kelantan presented at a younger age and at advanced stages of cancer.
We investigated the association between polycystic ovarian syndrome, dyslipidemia and glucose intolerance in a cross sectional analysis comparing 50 patients with polycystic ovary syndrome and 50 patients without the disease (control group) who were attending the Infertility clinic. Variables of interest were their body-mass index (Kg/m2), fasting and blood glucose levels after a 75 gram oral glucose tolerance test and their total cholesterol (mmol/L), total triglycerides (mmol/L), high density cholesterol lipoprotein (HDL) cholesterol (mmol/L) and, low density lipoprotein cholesterol (mmol/L) levels. Except for HDL where significantly lower values were observed, significantly higher levels were detected in patients with PCOS than that of the control group. The difference persisted even when the obesity index were adjusted and matched. We conclude that both glucose intolerance and dyslipidemia were significantly associated with PCOS irrespective of the obesity index.
This is a cross-sectional study in a representative sample of preschool children from 12 preschools (TADIKA KEMAS) Pasir Mas, Kelantan, Malaysia. Data on socioeconomic status and sources of water supply at home were collected through interview with mothers. Children’s anthropometric data (height and weight) and body-mass-index-for-age (BMI-for-age) was calculated. Oral examinations of ECC status was based on the dmft index (WHO, 1997). The results showed mean
carious teeth were very high (dmft 11.1±4.8) and almost every preschool child was affected with ECC (prevalence 98.1%). The majority were in “high caries” category (i.e. dmft >7) and about 51.4% of preschoolers was underweight and only a few was overweight/obese. Preschool children with high caries mostly were underweight and normal of BMI. The BMI-for-age, household income and household expenditure for food were significant correlation with ECC experience (p
Delay in childbearing, family history of type 2 diabetes mellitus and obesity in childbearing years increases a possibility of glucose intolerance or overt diabetes in pregnancy which may remain unrecognised unless an oral glucose tolerance test is done.The International Association of Diabetes and Pregnancy Study Group (IADPSG, 2010) recommended the detection and diagnosis of hyperglycaemic disorders in pregnancy at two stages of pregnancy, the first stage looking for ‘overt diabetes’ in early pregnancy based on risk factors like age, past history of gestational diabetes and obesity and the second stage where ‘gestational diabetes’ at 24-28 weeks with 75 g oral glucose tolerance test. Although the one step approach with 75 g of glucose offers operational convenience in diagnosing gestational diabetes, there are concerns raised by the National Institute of Health in the recent consensus statement, supporting the two step approach (50-g, 1-hour loading test screening 100-g, 3-hour oral glucose tolerance test) as the recommended approach for detecting gestational diabetes. Medical nutrition therapy (MNT) with well-designed meal plan and appropriate exercise achieves normoglycemia without inducing ketonemia and weight loss in most pregnant women with glucose intolerance. Rapidly acting insulin analogues, such as insulin lispro and aspart are safe in pregnancy and improve postprandial glycemic control in women with pre-gestational diabetes. The long acting analogues (Insulin detemir and glargine) though proven to be safe in pregnancy, do not confer added advantage if normoglycemia is achieved with intermediate insulin (NPH). Current evidence indicates the safe use of glyburide and metformin in the management of Type 2 diabetes and gestational diabetes as other options. However, it is prudent to communicate to the women that there is no data available on the long-term health of the offspring and the safety of these oral hypoglycemic drugs are limited to the prenatal period.
Obesity is a growing epidemic due to an accelerated phase of industrialization and urbanization with the overfed people
now outnumbered the underfed. It is the major public health problem with a lot of research interest as it is associated
with many complicated chronic disorders such as type-2 diabetes, cardiovascular diseases (CVD) and cancers. A global
estimation of 2.8 million deaths per year is due to obesity and there are tremendous on-going efforts to identify hosts
and environmental factors that infl uence the cause and pathogenesis of obesity. Concerted efforts from different research
groups had successfully shown that obese subjects have altered composition of gut microbiota and transplantation of this
microbiota infl uences body weight in the germ-free recipient mice. The advancement of technology had made possible
the study of gut microbiota which was unculturable for better understanding of their impact to human health. Rapid
deep sequencing of DNA at reasonable cost through various options of platforms followed by data analysis using robust
bioinformatic tools are an important way of analysing the gut microbiome. Here we review the role of gut microbiota
which modulates host’s metabolic functions and gene expression, facilitating the extraction and storage of energy from the
ingested dietary substances and leading to body-weight gain. We will discuss on the different techniques used, focusing
on the high-defi nition technologies for the determination of the composition, function and ecology of gut microbiota. This
allows the appropriate selection of platform which becomes the key for success of subsequent research.
Childhood obesity is a global epidemic, which leads to the increasing number of studies on genetic locations associated with obesity-related traits. Polymorphisms of insulin (INS) gene have been shown to be associated with obesity-related phenotypes in Europeans; while insulin receptor (INSR) gene has been associated with energy regulation. Therefore, this study was conducted to investigate the association between the INS (rs689) and INSR (rs3745551) gene polymorphisms with childhood obesity risk in a Malay childhood population. Normal weight (538) and overweight or obese (557) children aged 6-12 years old were genotyped using semi-automated Sequenom iPLEX® Gold. Body mass index (BMI) was calculated from measured body weight and height. The rs689 (T/T: 0.006, A/T: 0.159 and A/A: 0.835) and rs3745551 (G/G: 0.054, A/G: 0.378 and A/A: 0.568) genotype distributions were consistent with Hardy Weinberg equilibrium. The T-minor allele frequency for rs689 was 8.6% and G-minor allele frequency for rs3745551 was 24.3%. Minor allele of INS gene polymorphisms significantly increased risk of obesity among Malay children (sex- and age-adjusted
OR=1.580; 95%CI: 1.134-2.201). However, INSR gene polymorphisms were not significantly associated with childhood obesity. In conclusion, the polymorphisms of INS gene, rather than INSR gene, were associated with childhood obesity in the Malay population.
Overweight during adolescence has many psychological consequences and low self·esteem is the immediate detrimental effect observed. Adolescents with low self»esteem are at risk for many emotional and behavioural disorders while high self-esteem adolescents experience an incremental improvement in their quality of life. The objective of this study was to compare seh'-esteem between overweight and non-overweight Malay adolescents in Kota Bharu, Kelantan. A cross-sectional study was conducted between January to ]une 2005 among 1364 students selected from ten co-educational government secondary schools in Kota Bharu using stratified multistage cluster sampling. A set of guided self-administered questionnaire which included a Malaysian version of Rosenberg Self-Esteem Scale and Body Mass Index measurement was used. Data was entered using SPSS 12.0 and analysed using STATA 8. O. The prevalence of overweight among secondary school students in Kota Bharu was 12.5% and there was no significant difference in self-esteem between overweight and non-overweight students. However, the findings may not be generalized to out-of-school youth and other ethnic groups in this country. Infomation on other modifers, such as parental acceptance or lack of concern regarding the child’ obesity was not elicited in this study. It is an important protective factor for self-esteem and need to be included in future studies.