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Fulltext Lifestyle intervention improved nutritional knowledge, dietary composition and health status of midlife Malaysian women

Noor-Aini, M.Y., Pon, L.W., Ong, F.B., Adeeb, N., Seri, S.S., Shamsuddin, K., et al.

Malays J Nutr, 2006;12(2):125-146.
MyJurnal

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.

Matched MeSH terms: Obesity, Abdominal
Fulltext Knowledge on body weight management amongst working women in Kuala Lumpur. [Pengetahuan pengurusan berat badan di kalangan wanita bekerja di Kuala Lumpur.]

Poh, B.K., Sia, P.H., Norimah A. Karim, Mohd Ismail Noor

Jurnal Sains Kesihatan Malaysia, 2006;4(1):71-84.
MyJurnal

Obesity prevalence and body image consciousness are on the rise, and women often try to lose weight using a variety of methods. This paper reports the knowledge on body weight management amongst working women aged 30 – 45 years in Kuala Lumpur. Respondents comprised 131 school teachers and 122 civil servants. Anthropometric measurements included body weight and height; while knowledge on weight management was assessed using a questionnaire. The respondents were Malay (64%), Chinese (26%) and Indian women (10%) with mean age of 38.3 ± 4.6 years old. The respondents were grouped into two weight categories based on body mass index (BMI): normal weight (BMI 18.5 to 24.9 kg/m2) and overweight (BMI ≥ 25.0 kg/m2). Mean body weight and BMI were significantly different (p < 0.001) between the two weight categories. Overweight and normal weight groups had mean body weight of 69.0 ± 9.5 kg and 53.5 ± 5.3 kg; while mean BMI were 29.2 ± 3.6 kg/ m2 dan 21.9 ± 1.7 kg/m2; respectively. Mean scores for knowledge on weight management were similar for both weight categories, 62.4 ± 13.7 and 61.8 ± 13.4 for overweight and normal weight, respectively. A majority of overweight (71%) and normal weight (73%) women had moderate level (scores 50–74%) of weight management knowledge. However, it was interesting to note that there were more overweight women (20%) who had high knowledge level (scores ≥ 75%) as compared to normal weight women (15%). Only 9% of overweight and 12% of normal weight women demonstrated low knowledge level (scores <50%). School teachers were significantly (p < 0.001) more knowledgeable than civil servants in weight management matters with mean knowledge scores of 65.5 ± 12.3 and 58.4 ± 13.9, respectively. On the whole, the results indicated that women were fairly knowledgeable in healthy body weight management. Knowledge on body weight management is essential for preventing comorbidity risks related to overweight problem. The study also revealed that there was a need for nutrition education related to body image and effective weight management. Key words: Body weight management, working women, overweight, obesity

Matched MeSH terms: Obesity
Fulltext Self-esteem and overvveight among malay adolescents in Kota Bharu, Kelantan

Norhayati, M.N., Zulkifli, A., Naing, L., Rohana, J., Jamil, B.Y.M.

Malaysian Journal of Public Health Medicine, 2006;6(2):13-19.
MyJurnal

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.

Matched MeSH terms: Pediatric Obesity
Nutritional status of primary school children, Sepang district, Selangor 2004

Lekhraj Rampal, G.R., Teh, W.M., Tan, P.H.

Malaysian Journal of Medicine and Health Sciences, 2006;2(1):11-23.
MyJurnal

Objectives: This study was carried out to determine the nutritional status of primary
school children aged 6 to 11 years in Sepang District and to compare the results with a
similar study carried out in 1999. Methods: This cross-sectional study was carried out in
Sepang District using stratified random cluster sampling technique. A pre-tested, structured
questionnaire was used to collect the data. Weight was recorded using a digital bathroom
scale TANITA model HD-309 and height was measured by using a SECA Body meter
Model 208. Body mass index (BMI) was calculated as weight in kilograms divided by the
square of height in meters. Classifications of the nutritional status of respondents was
based on WHO classification 1983 and 1995. Data were analysed using SPSS. Results:
The overall mean BMI for the 1,910 respondents was 16.8 (95% CI= 16.67 - 16.99;
SE=0.08). The median BMI was 15 .7 ranging from 9.51 to 36.75 kg/m2. The majority
(84.4%) had normal weight-for-age status, 7.6% respondents had weight-for-age status
below -2 SD of the NCHS-WHO median and 8.0% had weight-for-age status above +2 SD
of the NCHS-WHO median. The prevalence of underweight and overweight was significantly
higher in the males compared to the females (p< 0.05). There was a significant association
between underweight and ethnicity (p< 0.05). The majority (90.3%) had normal heightfor-
age status, 8.8% had height-for-age below - 2 SD of the NCHS-WHO standard median
and 0.9% had height-for-age above 2 SD from the NCHS median. The prevalence of
stunting was significantly higher in the male (10.3%) as compared to 7.4% in the females
(X2 = 5.11, P = 0.02). The majority (81.4%) of the respondents were within the normal
weight-for-height, 3.4% were wasted (weight-for-height was below - 2 SD of the NCHSWHO
median) and 15.2% of the respondents were obese (weight-for-height that is more
than +2 SD of the NCHS-WHO median). The prevalence of wasting was higher in the
females (4.1 %) compared to males (2.8%). The prevalence of obesity was slightly higher
in the males (15.4%) compared to females (14.9%). Conclusion: The overall nutritional
status of primary schools children is good. However, there still exists pockets of population
in Sepang where chronic and acute forms of undernutrition persist in these children.

Matched MeSH terms: Obesity
Fulltext A population-based study on the prevalence and factors associated with obesity in Selangor

Rampal, G.R. Lekhraj, Sanjay, R., Azhar, M.Z., Sherina, M.S., Ambigga, D., Rahimah, A.

Malaysian Journal of Medicine and Health Sciences, 2006;2(2):89-97.
MyJurnal

Objective: This study was conducted to determine prevalence and factors associated with obesity in Selangor, Malaysia. Methods: A population-based cross-sectional study was conducted in all districts of Selangor State. All individuals, 15 years and above in the selected households, were included. A pre-tested structured questionnaire was used to collect the data. Weight was recorded using TANITA model HD-309 and height was measured using SECA Body meter Model 208. Statistical analysis was performed using Stata 8.2 taking into account the complex survey design. Results: The overall mean age of the 2219 respondents was 36.6(95% CI 35.7 – 37.6) years. There was no significant difference in the mean age of the males and females (p=0.697). The majority of the respondents were Malays (52.9%), followed by Chinese (30.9%), Indians (15.4%) and
other races (0.9%). The overall mean BMI was 24.1 kg/m2 (95% CI=23.8- 24.4). The overall prevalence of obesity was 12.2% (95% CI 10.6%, 14.0%). There was no significant difference in the prevalence of obesity in the males compared to females (p>0.05). The prevalence of obesity increased with age up to the ages of 40-59 years and then decreased after 60 years. The highest prevalence of obesity was in the 40-59 years age groups in both sexes. The overall prevalence of obesity was significantly higher amongst the Malays (15.2%) compared to the Indians (11.6%) and Chinese (7.3%). Multivariate logistic regression analysis showed that only age and ethnicity were associated with obesity. Sex and educational level were not associated with obesity.

Matched MeSH terms: Obesity
Disease of Kings - clinical characteristics at two tertiary referral centers in Malaysia. [Abstract]

Eashwary M, Hussein H

APLAR Journal of Rheumatology, 2006;9 Suppl 1:A89.
DOI: 10.1111/j.1479-8077.2006.00199_15.x

Introduction: Gout is a clinical syndrome resulting from the deposition of monosodium urate monohydrate crystals. Recent studies have shown gout to be a significant metabolic disorder. However, there has been insufficient information on the clinical spectrum in the Malaysian population.
Objective: This study is conducted to review the clinical characteristics of patients with gout.
Study methods: In this cross-sectional study 52 patients with gout were recruited. The records of 13 patients from National University of Malaysia Hospital and 39 patients from Putrajaya Hospital, attending the rheumatology clinic between October and December 2005 were reviewed. Results: Gout was found predominantly among ethnic Malays 83%, and Chinese 17% in these centers. The male to female ratio was 12 :1. The peak age of onset of the disease was less than 40 years in 46% of the subjects. Primary gout in females was seen after menopause. 37% cases had a definitive hereditary incidence. At the first presentation 83% had acute monoarthritis and 17% acute polyarticular arthritis. Podagra was seen in 62%. Peripheral joints involvement was seen in 81% patients. Tophaceous gout was seen in 42%. In 85% cases the disease had a chronic polyarticular course, whereas in 15% the disease remained only at a single joint. In 10% cases, there was associated sero-negative arthritis. Associated disorders included hypertension (65%), diabetes mellitus (33%), dyslipidemia (56%), ischemic heart disease (23%), urate nephropathy (39%), uric acid nephrolithiasis (2%). In 88% of cases, there was associated hyperuricaemia. Most of the patients were overweight with body mass index 25-29 (39%) and obese with body mass index 30-70 (36%). Conclusions: Gout is not an unusual disorder in our centre. The age of onset of gout occurred much earlier with forty-six per cent of patients having their first attack of gout before the age of 40. Primary gout in females was seen after menopause. Majority of patients first presented with acute monoarthritis, of which sixty-two per cent presented with podagra. The incidence of tophi was high. Patients with gout should be screened for other associated disorders like diabetes mellitus, hypertension, dyslipidemia and obesity.

Matched MeSH terms: Obesity
Fulltext Body image differences among Malay, Samoan, and Australian women

McDowell AJ, Bond M

Asia Pac J Clin Nutr, 2006;15(2):201-7.
PMID: 16672204

Comparisons of body attitudes and associated behaviours were undertaken using Malay, Samoan, and Australian female students. The general goal of the research was to determine the degree to which the observed pattern of attitudes and behaviours was attributable to culture. The specific analyses comprised an examination of group differences using standard measures that included the Body Attitudes Questionnaire, the Three-Factor Eating Questionnaire and detailed questions concerning the use of diet and exercise as weight control strategies. The main findings concerned a number of cultural differences, particularly in relation to diet and exercise, that were evident even with the effect of body mass index held constant. These results are interpreted in terms of the efficacy of entrenched cultural beliefs in protecting against introduced, more dominant, cultural values. The Australian sample exhibited the most negative body image, although there was some evidence that Malays and Samoans were influenced by Western ideals of weight and shape. It is proposed that to fully understand the differential meaning of negative body image across cultures and the potential impact of westernisation, both within-group and between-group differences in body size need to be acknowledged.

Matched MeSH terms: Obesity/ethnology*; Obesity/psychology
Fulltext Effect of therapeutic lifestyle changes on insulin sensitivity of non-obese hyperlipidemic subjects: preliminary report

Al-Mahmood AK, Ismail AA, Rashid FA, Azwany YN, Singh R, Gill G

J Atheroscler Thromb, 2007 Jun;14(3):122-7.
PMID: 17587763 DOI: 10.5551/jat.14.122

AIM: To determine the effects of lipid lowering by TLC on insulin sensitivity and secretory status of non-obese normoglycemic hyperlipidemic subjects.
METHODS: An intervention study was undertaken on 16 non-obese normoglycemic hyperlipidemic subjects. They underwent 6 months of a TLC regimen. Their insulin sensitivity and lipid status were assessed at baseline and after six months. A control group containing 16 age, sex and body mass index (BMI) matched normolipidemic subjects was also enrolled to compare the change in lipid levels and insulin sensitivity in the hyperlipidemic subjects.
RESULTS: The intervention showed significant reductions in insulin resistance (HOMA-IR reduced from 3.8 to 1.4, p<0.001) and improvement of insulin sensitivity (HOMA%S increased from 50.1% to 121.2%, p=0.004) in hyperlipidemic subjects with associated reductions in lipid levels.
CONCLUSION: Lipid lowering in non-obese hyperlipidemic subjects may be associated with improvement of insulin sensitivity.
Study site: Staff of university and offices, Kelantan, Malaysia

Matched MeSH terms: Obesity
Fulltext Observation of spontaneous cerebrospinal fluid rhinorrhoea to body mass index: a preliminary report

Gendeh BS, Salina H

Med J Malaysia, 2007 Dec;62(5):368-9.
PMID: 18705467

The purpose of this retrospective study is to determine whether there is a correlation among overweight, gender and the risk of development of spontaneous cerebrospinal fluid (CSF) rhinorrhoea. The clinical data of eight patients diagnosed with spontaneous cerebrospinal fluid rhinorrhoea who had been treated at our tertiary referral centre between 1998 and 2007 were assessed. Demographically, seven patients were female and one male with ages ranging from 14 to 53 years with a mean age of 43.6 years. This observation revealed that all patients were overweight with a mean body mass index (BMI) of 32.5 kg/m2. This study suggests that there is a trend of increasing BMI to the risk of developing a spontaneous CSF rhinorrhoea.

Matched MeSH terms: Obesity/complications
Fulltext Anthropometric indices and life style practices of the indigenous Orang Asli adults in Lembah Belum, Grik of Peninsular Malaysia

Yusof HM, Ching TS, Ibrahim R, Lola S

Asia Pac J Clin Nutr, 2007;16(1):49-55.
PMID: 17215180

A nutritional status survey of Orang Asli (Aboriginal) adults in Lembah Belum, Grik, has been conducted involving a total of 138 subjects. Jahai (58.7%) was the main ethnic group as compared to that of Temiar (41.3%). Based on the Body Mass Index (BMI) characteristics, the majority (63.2%) of the respondents were normal, 26.7% underweight and 10.1% were either overweight or obese. However, by using two different indices of waist circumference and waist-to-hip ratio, 1.6% and 10.8% of the total respondents revealed abdominal obesity, respectively. Measurement of mid upper arm muscle circumference (MUAMC) indicated that about 40% showed nutritional insufficiency whereas 0.8% showed over-nutrition. Body fat classification revealed that 53.4% of the respondents were thin, 45.8% at normal level and only 0.8% were obese. Student's t-test revealed a significant difference in anthropometric indices of body weight, height, MUAMC, triceps, sub-scapular, supra-iliac and body fat according to gender. Meanwhile, analysis of variance (ANOVA) showed significant differences in body weight, waist circumference, WHR and body fat according to different age categories. It was also found that those who smoked had lower BMI compared with non-smokers. Alcohol consumption was associated with higher BMI and WHR among the respondents. Pearson's correlation test between anthropometric measurements and socio-economic and demographic factors showed that ethnic group was the strongest variable.

Matched MeSH terms: Obesity/ethnology*; Obesity/epidemiology*
Fulltext A national study on the prevalence of obesity among 16,127 Malaysians

Rampal L, Rampal S, Khor GL, Zain AM, Ooyub SB, Rahmat RB, et al.

Asia Pac J Clin Nutr, 2007;16(3):561-6.
PMID: 17704038

A population-based cross-sectional study was conducted in all states of Malaysia with the aim to determine the prevalence of obesity among Malaysians aged fifteen years and above and factors associated. A stratified two-stage cluster sampling design with proportional allocation was used. Trained interviewers using a standardized protocol obtained the weight and height measurements and other relevant information. Subjects with a body mass index >= 30 kg/m2 were labelled as obese. The results show that the overall national prevalence of obesity among Malaysians aged 15 years old and above was 11.7% (95% CI = 11.1 - 12.4%). The prevalence of obesity was significantly higher in females (13.8%) as compared to 9.6% in males (p< 0.0001). Prevalence of obesity was highest amongst the Malays (13.6%) and Indians (13.5%) followed by the indigenous group of "Sarawak Bumiputra" (10.8%) and the Chinese (8.5%). The indigenous group of "Sabah Bumiputra" had the lowest prevalence of 7.3%. These differences are statistically significant (p< 0.0001). Logistic regression analysis results show that there was a significant association between obesity and age, gender, ethnicity urban/rural status and smoking status. The prevalence of obesity amongst those aged >= 18 years old has markedly increased by 280% since the last National Health and Morbidity Survey in 1996.
Study name: National study on Cardio-Vascular Disease Risk Factors 2004

Matched MeSH terms: Obesity/epidemiology*
Fulltext A multidimensional assessment of nutritional and health status of rural elderly Malays

Shahar S, Ibrahim Z, Fatah AR, Rahman SA, Yusoff NA, Arshad F, et al.

Asia Pac J Clin Nutr, 2007;16(2):346-53.
PMID: 17468093

A multidimensional assessment of nutritional and health status comprised of subjective global assessment (SGA), anthropometry function, biochemistry, dietary intake, social and health aspects was carried out on 820 older people (52.8% men and 47.2% women) from four rural areas of Peninsular Malaysia. A proportion of the subjects had been classified as either overweight (25.7%) or chronic energy deficient (20.3%). Although 49% of subjects had normal body weight, 68.4% have been classified as having mild to moderate malnutrition according to the SGA. Only 1.1% and 2.3% had low serum albumin and ferritin, respectively. Almost 80% of subjects, especially men, were at high risk of cardiovascular diseases on the basis of the assessment of total cholesterol and LDL-cholesterol. The majority of the subjects (87.2%) were fully independent in performing daily tasks, with men having a significantly higher score compared to women (p<0.001). However, men were less likely to be able to perform a flexibility test (50.7%) than were women (27.0%) (p<0.05). The mean energy intake for men (1412 +/- 461 kcal/d) and women (1201 +/- 392 kcal/d) were below the Recommended Nutrient Intake (RNI) for Malaysia, although this is a difficult assertion to make in an age-group which generally experiences declining energy expenditure. Moreover, 52.5% of men and 47.5% of women might have underreported their food intake. Dietary micronutrients most likely to be deficient were thiamin, riboflavin and calcium. It is concluded that a substantial proportion of rural elderly Malays had problems related to both undernutrition and overnutrition. An appropriate nutrition intervention program is needed to improve the nutritional status of rural elderly Malays.

Matched MeSH terms: Obesity/epidemiology
Fulltext Obesity among urban primary schoolchildren

Shariff, A.H., Sazlina, S.G., Shamsul, A.S.

JUMMEC, 2007;10(1):17-20.
MyJurnal

Three urban public primary schools in the district of Petaling, Selangor were surveyed for obesity amongst the schoolchildren and factors related to it. The prevalence of obesity amongst primary schoolchildren, with the mean age of 8.91 years was 9.5%. In addition, it was more prevalent among the boys (p

Matched MeSH terms: Obesity
Fulltext Review paper soft drinks and hard facts: a health perspective

Xavier, R., Sreeramanan, S., Diwakar, A., Sivagnanam, G., Sethuraman, K.R.

International Food Research Journal, 2007;14(2):69-81.
MyJurnal

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.

Matched MeSH terms: Obesity
Fulltext Obesity among patients with schizophrenia, attending outpatient psychiatric clinic, Hospital Universiti Kebangsaan Malaysia

Salmi Razali, Ainsah Omar, Osman Che Bakar, Shamsul Azman Shah

ASEAN Journal of Psychiatry, 2007;8(2):90-96.
MyJurnal

Objective: This study aimed to determine the prevalence of obesity among patients with schizophrenia and its association with the demographic profile. Methods: This is a cross sectional study. Subjects were selected using systematic sampling. Patients attending the out patient psychiatric clinic, Hospital Universiti Kebangsaan Malaysia, who fulfilled the criteria and able to give consent were included in this study. Diagnosis of schizophrenia was made using Structured Clinical Interview (SCID) for DSM-IV. Demographic profiles of the patients were obtained and anthropometric measurements were measured and classified according to Body Mass Index (BMI) and Waist Circumference (WC) of Asian population. Results: A total of 97 patients were included. The prevalence of overweight (BMI: 23.0- 27.4 kg/m2) was 39.2% (n=38), and the prevalence of obesity (BMI: >27.0 kg/m2) was 35.1% (n=34). BMI was higher among non-Chinese (Malay and Indian, p=.03) and those who had low total household income (p=.03). Sixty-two patients (63.9%) had high WC, which was associated with male (p=.003) and non-Chinese (p=.03). Conclusions: Obesity is highly prevalent among patients with schizophrenia. The risk factors for obesity include male, non-Chinese and those with low total income. The high WC among non-Chinese and male patients suggests that they are at a higher risk of developing obesity-related physical illnesses. These findings support that obesity is a common critical issue among schizophrenic patients, and it warrants serious clinical interventions.

Study site: Psychiatric clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)

Matched MeSH terms: Obesity
Fulltext Body composition and nutritional habits among first year medical students in a Malaysian public university

Narimah AHH, Adlina S, Hakimi ZA

Malaysian Journal of Public Health Medicine, 2007;7(1):52-55.
MyJurnal

Various studies have reported that excess body weight may increase the risk to various diseases and death. A study reported that adolescents who were overweight were almost 18 times more likely than their leaner peers to be obese in early adulthood and were 8.5 times more likely to have hypertension as young adults. Therefore, this study was conducted to determine the body composition and four dietary factors i.e., prudent diet habits, calorie control habits, dietary fat/ cholesterol and sodium/salt control which may affect blood pressure and the risk of heart disease among year 1 medical students in a public university in Selangor. Body composition was determined by measuring the body mass index (BMI) and body fat percentage. None of the female students showed excellent/good eating habits while majority were fair (37.7%) and poor/very poor (62.3%). Nearly half of the male students showed excellent/good eating habits (42.5%), but more than half (57.5%) were poor/very poor. Majority of the female (85.7%, 85.7% and 94.8% respectively) and male students (80.9%, 57.5% and 93.6% respectively) showed excellent/good eating habits in calorie, dietary fat and salt control. Majority of the students (64.9% female and 61.7% male) have normal BMI values while 24.7% of female and 10.6% of male students were underweight (BMI values less than 18.5). Only a small number of female students were overweight (5.2%) and obese (5.2%). However 14.9% of male students were overweight and another 12.8% were obese.

Matched MeSH terms: Obesity
Fulltext Blood pressure patterns and the prevalence of hypertension and its associated factors in a rural community in Northern Malaysia

Narayan, K.A., A Rashid, K.

Malaysian Journal of Public Health Medicine, 2007;7(1):14-19.
MyJurnal

This study was conducted to study the blood pressure pattern and the prevalence of hypertension and its associated factors in a rural community in two coastal villages in rural Kedah, Mahysia. Out of the total population 504 were above 20 years of age and were eligible to participate. There were 227 males and 252 females. The mean systolic blood pressure was found to rise with age, peaking in the 6l·70 years age group, For women the mean blood pressure rose earlier from the age group of 4-l· 50 years. Mean blood pressures rose with increasing body mass index. lt also varied with occupation and education. The retired and unemployed had a higher blood pressure than those employed and there was an inverse relationship with increasing education. The prevalence of hypertension was 33.6%. More females were hypertensive (36.5%) as compared to males (3 0.4%) and this finding was the same for both systolic and diastolic hypertension. Majority (71.4%) of the hypertensives were undiagnosed. 72.5% of hypertensives who were on treatment were not under control. Hypertension was more prevalent among retirees and illiterates. Prevalence of hypertension increased correspondingly with age. Obesity was associated with hypertension. There was no association with family history of hypertension. Multiple logistic regression showed a positive association only for obesity. ln conclusion, given the high prevalence of hypertension at
present, it appears that the prevalence will increase as each age cohort grows older. Obesity, especially among housewives is a significant assorted factor.

Matched MeSH terms: Obesity
Fulltext Night Eating Syndrome with Morbid Obesity and Dysthymia A Case Report - A Psychobiological Approach

Anisah, O., Osman, C.B.

Medicine & Health, 2007;2(2):154-157.
MyJurnal

The traditional physical and cosmetic-centered model without paying serious attention on the underlying psychosocial issues of care are ill suited to successful treatment outcome of obesity. The objective of this article is to report a case of a retired Malay army sergeant who presented with night eating syndrome (NES) with morbid obesity and dysthymia, and to discuss the psychobiological aspect of the case including to evaluate the effectiveness of the combination treatment of pharmacotherapy and cognitive behavior therapy along with diet counseling. The diagnosis was made by using the Structured Clinical Interview Diagnosis (SCID) for DSM-III-R diagnosis and the severity of depression was assessed by Hamilton Depressive Rating Scale. The patient’s body mass index was 45, He was found to have dysthymia and the Hamilton Depressive Rating Scale score was 13. We found that the combination of pharmacotherapy, cognitive behavior therapy and nutritional education with the help of the physician proved to be effective in treating morbid obesity with NES and Dysthymia.

Matched MeSH terms: Obesity, Morbid
Fulltext Applicability of the stages of change and Weight Efficacy Lifestyle Questionnaire with natives of Sarawak, Malaysia

Chang CT

Rural Remote Health, 2007 Oct-Dec;7(4):864.
PMID: 18076311

INTRODUCTION: There is an increase in the prevalence of overweight and obesity in Malaysia. Besides prevalence studies, not much is known about either overweight or obese individuals. The objective of this study was to determine the stages of change in losing weight and the self-efficacy in eating control of three indigenous groups of overweight and obese adults in Sarawak, Malaysia.
METHODS: A cross-sectional study was conducted in one rural region in Sarawak using a purposive sample. A structured questionnaire, which included two scales: (1) Weight: Stages of change (SOC) to assess readiness to change; and (2) Weight Efficacy Lifestyle Questionnaire (WEL) (both adopted from the transtheoretical model of change); and a set of pre-tested questionnaires on socio-demographic data, the presence of health problems and self-assessment of weight appropriateness, was used to interview respondents.
RESULTS: The stage distribution for weight loss of these adults respondents (n = 271) showed that 60.5% (n = 164) were in the pre-contemplation stage, 20.7% (n = 56) were in the contemplation stage, 8.5% (n = 23) were in the preparation stage, and 8.9% (n = 24) were in the action stage, while only 1.5% (n = 4) were in the maintenance stage. Except for education, the stage differences were generally stable across age, sex, race, household income, presence or absence of health problem, self-perceived weight and presence of overweight or obesity. Respondents were least able to control their eating under social pressure and food availability, according to their WEL score.
CONCLUSION: A large proportion of the overweight or obese adults was not intending to lose weight. The factor structure of the two WEL original subscales enabled partial differentiation between respondents who were able or unable to resist eating in situations where there were availability of food and experienced physical discomfort. The study results indicate the importance of assessing individuals' SOC score in order to implement stage-matched intervention strategies. More studies should be performed in order to validate the WEL questionnaire for use with a Malaysian sample.

Matched MeSH terms: Obesity/epidemiology*; Obesity/prevention & control; Obesity/psychology
An audit on diabetes management in Asian patients treated by specialists: the Diabcare-Asia 1998 and 2003 studies

Mohamed M, Diabcare-Asia 2003 Study Group

Curr Med Res Opin, 2008 Feb;24(2):507-14.
PMID: 18184454 DOI: 10.1185/030079908X261131

OBJECTIVE: To collect information on diabetes management, including psychosocial aspects, in patients managed by specialists 5 years after they were first surveyed in 1998.
METHODS: Data on demography, diabetes status, management and complications were collected via medical records, interview and laboratory assessments. HbA(1c) was analysed by a central laboratory prospectively.
RESULTS: Patient profile was similar in the 1998 (N = 21,838) and 2003 cohorts (N = 15,549): 95% were diagnosed as type 2 diabetes mellitus and were obese (BMI approximately 25 kg/m(2)). Glycaemic control was unsatisfactory in many patients (mean HbA(1c) approximately 8%; fasting glucose approximately 9 mmol/L). Lipids were well-controlled but hypertension was not. The incidence of neuropathy ( approximately 33%) and cataract ( approximately 27%) were high. The majority ( approximately 71%) of patients in both cohorts were treated with oral antidiabetic drug (OAD) monotherapy; approximately 24% were on insulin therapy. Approximately half of the 2003 cohort reported a healthy state of well-being. Quality of life did not appear to have suffered as a result of having diabetes. However, many patients were worried about hypoglycaemic risk (53.9%) or worsening of diabetes (45.8%) and insulin initiation (64.5%).
CONCLUSIONS: Although both cohorts were separate cross-sectional studies of diabetes management status in Asia, the results showed that the demography profile, glycaemic control and cardiovascular risk factors were remarkably similar in both cohorts 5 years after the first survey. More concerted efforts are needed to increase diabetes awareness and education.

Matched MeSH terms: Obesity/epidemiology; Obesity/physiopathology*

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