Cardiovascular diseases are the major cause of death in Malaysia. Evidence shows that dietary fat intake is one of the important risk factors for cardiovascular disease. However, studies assessing the association of fatty acids and risk of cardiovascular diseases in Malaysia are scarce. Therefore, this study aimed to develop and validate a food frequency questionnaire (FFQ) assessing total fat and different types of fat among Malay adults in Malaysia.
The prevalence of Helicobacter pylori infection is exceptionally low among the Malays in the north-eastern region of Peninsular Malaysia. The reasons are unknown. Our aim was to compare environmental factors that differed in relation to H. pylori prevalence among Malays born and residing in Kelantan.
This study aimed to determine the relationship between child feeding practices, food habits, and anthropometric indicators with cognitive performance of preschoolers aged 4-6 years in Peninsular Malaysia (n=1933). Parents were interviewed on socio-demographic background, nutrition knowledge, child feeding practices and food habits. Height and weight of the preschoolers were measured; BMI-for-age, weight-for-age and height-for-age were determined. Cognitive performance was assessed using Raven's Colored Progressive Matrices. The mean monthly household income was RM3610 and 59.6% of parents attained secondary education. Thirty-three percent of parents had good knowledge on nutrition, 39% satisfactory and 28% poor. For child feeding practices, perceived responsibility had the highest mean score (M=3.99, SD=0.72), while perceived child weight had the lowest (M=2.94, SD=0.38). The prevalence of possible risk of overweight, being overweight, and obesity were 3.9%, 7.9% and 8.1%, respectively, whereas the prevalence of underweight and stunting were 8.0% and 8.4%, respectively. Breakfast was the second most frequently skipped meal (16.8%) after dinner (18.1%). The mean cognitive score was 103.5 (SD=14.4). Height-for-age and consumption of dinner were found to contribute significantly towards cognitive performance after controlling for socio-demographic background and parent's nutrition knowledge.
Early childhood is a period during which many factors influence the development of lifelong eating habits. This study aimed to assess the nutritional status of young children and to determine factors related to eating habits.
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)
Collection of nationwide food consumption data at the individual level is the preferred option for planning fortification programs. However, such data are seldom collected in low-income countries. In contrast, Food Balance Sheets (FBS), published annually for approximately 180 countries, may provide a source of national data for program planning.
INTRODUCTION: There is a pressing need to better understand the complex biochemical pathways that lead to the pathogenesis of obesity. Increased oxidative stress and decreased antioxidant capacity have been identified to be associated with obesity. Therefore, the objectives of this study were to determine the plasma total antioxidant capacity (TAC) levels of Malaysian subjects and to evaluate its potential association with obesity and related anthropometric measurements.
METHODS: Plasma TAC of 362 multi-ethnic Malaysian subjects from the Kampar Health Clinic (138 males, 224 females; 124 ethnic Malays, 152 Chinese, 86 Indians; 192 non-obese, 170 obese) was measured using Trolox equivalent antioxidant capacity (TEAC) 96-well plate assay.
RESULTS: Plasma TAC was significantly lower in obese subjects (M +/- SE = 292 +/- 10.4 micromol/L) compared to non-obese subjects (397 +/- 8.58 micromol/L), whereas it was significantly higher in males and those in the 21-30 age group. Those with salty food preference and practising a strict vegetarian diet also had significantly higher plasma TAC. However, no association was found for other dietary habits (coffee intake) and lifestyle factors (physical activity, smoking). Plasma TAC was also significantly negatively correlated with diastolic blood pressure, waist and hip circumferences, weight, body mass index, total body fat, % subcutaneous fat, visceral fat level, resting metabolism and % skeletal muscle.
CONCLUSION: Plasma TAC was found to be associated with obesity, strict vegetarian practice, salty food preference and all obesity anthropometric indicators, except systolic blood pressure and pulse rate. Obese people have decreased plasma TAC indicating a compromised systemic antioxidant defence and increased oxidative stress.
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.
OBJECTIVE: Obesity prevalence is unequally distributed across gender and ethnic group in Malaysia. In this paper, we examine the role of socioeconomic inequality in explaining these disparities.
DESIGN: The body mass index (BMI) distributions of Malays and Chinese, the two largest ethnic groups in Malaysia, are estimated through the use of quantile regression. The differences in the BMI distributions are then decomposed into two parts: attributable to differences in socioeconomic endowments and attributable to differences in responses to endowments.
RESULTS: For both males and females, the BMI distribution of Malays is shifted toward the right of the distribution of Chinese, i.e., Malays exhibit higher obesity rates. In the lower 75% of the distribution, differences in socioeconomic endowments explain none of this difference. At the 90th percentile, differences in socioeconomic endowments account for no more than 30% of the difference in BMI between ethnic groups.
CONCLUSIONS: Our results demonstrate that the higher levels of income and education that accrue with economic development will likely not eliminate obesity inequality. This leads us to conclude that reduction of obesity inequality, as well the overall level of obesity, requires increased efforts to alter the lifestyle behaviors of Malaysians.
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.
BACKGROUND: Eating habits have been a major concern among university students as a determinant of health status. The aim of this study was to assess the pattern of eating habits and its associated social and psychological factors among medical students.
METHODS: A cross sectional study was conducted among 132 medical students of pre-clinical phase at a Malaysian university. A self-administered questionnaire was used which included questions on socio-demography, anthropometry, eating habits and psychosocial factors.
RESULTS: Mean (± SD) age of the respondents was 22.7 (± 2.4) years and (the age) ranged from 18 to 30 years. More than half had regular meals and breakfast (57.6% &, 56.1% respectively). Majority (73.5%) consumed fruits less than three times per week, 51.5% had fried food twice or more a week and 59.8% drank water less than 2 liters daily. Eating habits score was significantly low among younger students (18-22 years), smokers, alcohol drinkers and those who did not exercise. (p<0.05). Four psychological factors out of six, were significantly associated with eating habits (p<0.05). In multivariate analysis, age and 'eating because of feeling happy' were significantly associated with eating habits score (p<0.05).
CONCLUSION: Most of the students in this study had healthy eating habits. Social and psychological factors were important determinants of eating habits among medical students.
Study site: Management and Science University, Selangor, Malaysia
Scales & Questionnaires: Compulsive Eating Scale
Among most important aspects in conducting a clinical trial are random sampling and allocation of subjects. The processes could be easier if done with familiar software used for data entry and analysis instead of relying on other programs or methods. The objective of this article is to demonstrate random sampling and allocation using SPSS in step-by-step manners using examples most relevant to clinicians as well as researchers in health sciences.
Vitamin B12 deficiency is a well-known cause of megaloblastic anaemia and pancytopenia. However, the incidence in pregnancy is rarely reported. We present a case of a 32-year old multigravid woman who was diagnosed with megaloblastic anaemia since 22 weeks gestation and progressed to develop severe pancytopenia at 30 weeks gestation. She was also diagnosed with vitamin B12 deficiency related to dietary and sociocultural habits. Folate and iron levels were normal throughout pregnancy. Treatment with parenteral cyano-cobalamin resulted in sustained improvement of haematological parameters. The pregnancy was carried to term and the baby was born weighing 2,050gm but otherwise well at birth and had normal developmental milestones thereafter. This case illustrates the clinical presentation of maternal vitamin B12 deficiency and demonstrates the importance of detecting and treating maternal vitamin B12 deficiency during pregnancy in at-risk patients. Failure to diagnose and institute treatment carries significant risks to both mother and child. Oral vitamin B12 supplementation should be considered for patients who are strict vegetarians or consume very little animal products.
Food frequency questionnaire (FFQ) must be tailored to the target populations because dietary habits vary within the populations due to differences in cultural and lifestyles practices. Limited information is available to assess the validity of FFQ used among Malaysian adolescents.
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).
Diet and lifestyle modification is commonly used in constipation management. As there is a dearth of studies on this topic in Malaysia, we aim to elucidate the relations between stool patterns, dietary intake and physical activity levels among adults with functional constipation.
Introduction: The use of email and website as channels for workplace health
information delivery is not fully explored. This study aims to describe the
rationale, design, and baseline findings of an email-linked website intervention
to improve modifiable cancer risk factors. Methods: Employees of a Malaysian
public university were recruited by systematic random sampling and randomised
into an intervention (n=174) or control group (n=165). A website was developed
for the intervention and educational modules were uploaded onto the website.
The intervention group received ten consecutive weekly emails with hypertext
links to the website for downloading the modules and two individual phone
calls as motivational support whilst the control group received none. Diet,
lifestyle, anthropometric measurements, psychosocial factors and stages of change
related to dietary fat, fruit and vegetable intake, and physical activity were
assessed. Results: Participants were predominantly female and in non-academic
positions. Obesity was prevalent in 15% and 37% were at risk of co-morbidities.
Mean intake of fats was 31%, fruit was ~1 serving/day and vegetable was <1
serving/day. Less than 20% smoked and drank alcohol and about 40% were
physically inactive. The majority of the participants fell into the Preparation
stage for decreasing fat intake, eating more fruit and vegetables, and increasing
physical activity. Self-efficacy and perceived benefits were lowest among participants in the Precontemplation/Contemplation stage compared to the Preparation
and Action/Maintenance stages. Conclusion: Baseline data show that dietary and
lifestyle practices among the employees did not meet the international guidelines
for cancer prevention. Hence the findings warrant the intervention planned.
Keywords: Cancer, risk factors, email, website, worksite
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
Nutrition is a well-known factor in the growth, health and development of children. It is also acknowledged that worldwide many people have dietary imbalances resulting in over- or undernutrition. In 2009, the multinational food company FrieslandCampina initiated the South East Asian Nutrition Survey (SEANUTS), a combination of surveys carried out in Indonesia, Malaysia, Thailand and Vietnam, to get a better insight into these imbalances. The present study describes the general study design and methodology, as well as some problems and pitfalls encountered. In each of these countries, participants in the age range of 0·5-12 years were recruited according to a multistage cluster randomised or stratified random sampling methodology. Field teams took care of recruitment and data collection. For the health status of children, growth and body composition, physical activity, bone density, and development and cognition were measured. For nutrition, food intake and food habits were assessed by questionnaires, whereas in subpopulations blood and urine samples were collected to measure the biochemical status parameters of Fe, vitamins A and D, and DHA. In Thailand, the researchers additionally studied the lipid profile in blood, whereas in Indonesia iodine excretion in urine was analysed. Biochemical data were analysed in certified laboratories. Study protocols and methodology were aligned where practically possible. In December 2011, data collection was finalised. In total, 16,744 children participated in the present study. Information that will be very relevant for formulating nutritional health policies, as well as for designing innovative food and nutrition research and development programmes, has become available.