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.
Introduction: Child malnutrition continues to be a major public health problem in developing countries. This study aims to determine the current nutritional status of Malaysian school children using the anthropometric indicators of weight for age (WAZ), height for age (HAZ), and body mass index for age (BAZ). Methods: A nationwide school-based survey was undertaken in all Malaysian
states and territories, which included 18,078 children aged 8-10 years attending 445 primary schools. The software WHO AnthroPlus was used to calculate zscores for the nutritional status (WAZ, HAZ and BAZ) of the target population relative to the World Health Organization (WHO) 2007 reference. Results: The national prevalence of underweight among school children was 13.6% and in
rural areas, this rate was nearly double that of urban areas. The national prevalence rate for stunting was 10.9%, double among rural school children compared to their urban counterparts. As for thinness, the national prevalence was 6.5%. Using the WAZ indicator, we found that the national prevalence of overweight children was 7.6%. Additionally, we found that urban areas showed a higher
prevalence of overweight children (8.8%) than rural areas (5.9%). Conclusion: The findings of this study indicate that Malaysian school children face the burden of malnutrition, suffering from both undernourishment and overweight. Malaysia must make a concerted effort to overcome the problems of malnutrition among children.
Introduction: This study aimed to determine the prevalence of malnutrition and factors influencing malnutrition among children aged five years and below in Serian District of Sarawak, a district where the majority of people are indigenous. Methods: Using a cross-sectional method, a total of 177 children were randomly selected and assessed, and their mothers or caregivers were interviewed. Data were collected using a pretested questionnaire; anthropometric measurements were also taken. Data were analysed using SPSS version 17.0. Results: The prevalence of underweight, stunting and wasting in children aged five years and below was 20.9%, 11.9% and 10.2% respectively. The results suggest that the significant factors contributing to underweight are birth weight, frequency of child visit to the clinic, and individual insecurity. Only age, when complementary diet was introduced, was found to be significantly associated with stunting. For wasting, individual insecurity, duration of family planning and met recommended protein intake per day were found to be significant factors. Conclusion: The prevalence of malnutrition in children 5 years and below in Serian District of Sarawak is high compared to state figures. The major contributing factors were found to be manifested at the individual and family level. There is a need for appropriate public health promotion and socio- economic improvement interventions towards improving the nutritional status and health of children in Serian District.
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: The Penan people are largely settled in rural and remote areas of
Sarawak with high rates of undernutrition among the children. The study aimed to
determine the nutritional status and infant and young child feeding (IYCF) practices
of Penan children. Methods: Subjects consisted of 121 children, aged between 0-23
months, from 15 Penan longhouses in Belaga district. Malnutrition was assessed
using anthropometric measurements of children and categorised according to the
World Health Organization (WHO) Growth Standards (2006). Feeding practices were
assessed using questionnaires based on WHO IYCF Indicators (2008). Results:
The prevalence of underweight was 29.8%; stunting 43.0% and wasting 5.8%.
Prevalence of exclusive breastfeeding under 6 months was 44.4%. About 86% of
infants aged 6-8 months were already given solid, semi-solid and soft foods. The
proportion of children aged 6-23 months achieving minimum dietary diversity
(MDD) was 76.6%, while minimum meal frequency (MMF) was 83.0% (breastfed and
non-breastfed). Among the children who achieved MDD, 64.9% of their meals were
derived from 4-5 food groups. More than half (55.3%) of all subjects (breastfed and
non-breastfed) received minimum acceptable diet (MAD). Achievement of iron-rich
foods (IRF) indicator was 77.7%. There was no significant association between the
IYCF indicators of MDD, MMF and MAD and underweight, stunting and wasting.
Conclusion: A high prevalence of poor nutritional status was recorded among
the Penan children. While the IYCF indicators apparently showed satisfactory
complementary feeding practices, future studies should assess quantitatively the
intake of complementary food among Penan infants and young children.
Introduction: A vegetarian diet is generally considered as healthy for preventing metabolic-related diseases. There is lack of studies in Malaysia comparing the nutritional status of vegetarians and non-vegetarians. This cross-sectional study aims to compare body weight status, dietary intake and blood pressure level between these two groups. Methods: A total of 131 vegetarians and 135 non-vegetarians were recruited using convenience sampling from a Buddhist organisation in Kuala Lumpur. Body weight, height, waist circumference, percentage of body fat, and blood pressure measurements were taken, while dietary intake was assessed using a 2-day 24-hour dietary recall. Results: More vegetarians were underweight than non-vegetarians (31.3% vs 15.6%), while prevalence of overweight and obesity was higher among the non-vegetarians (23.7% vs 9.9%). A higher proportion of nonvegetarians (34.1%) had an unhealthy range of body fat percentage and significantly higher risk of abdominal obesity (24.4%) than the vegetarians (19.1% body fat; 13.7% abdominal obesity). Mean intakes for protein and fat were significantly lower among the vegetarians, while no significant differences were observed in the mean intake for energy and carbohydrate. Vegetarians had significantly higher intakes of vitamins C, D and E, calcium, potassium and folate, while vitamin B12 intake was significantly higher in the non-vegetarians. More non-vegetarians presented with unhealthy blood pressure status. Conclusion: Vegetarians in this study generally showed healthier dietary intake and lower body fatness than the non-vegetarians. Studies are suggested to be undertaken on a bigger sample size of vegetarians to confirm these findings.
A cross-sectional study to determine the prevalence of malnutrition and some associated factors among primary one schoolchildren, aged 7 years from rural areas of Tumpat and Bachok in Kelantan was carried out. A total of 922 chiMren from 18 primary schools were examined. The parents completed self-administered questionnaires eliciting demographic and socio-economic information. The weight and height of each child was taken. The nutritional status was assessed by the z-scores of weight-for-age (WAZ) , height- or-age (HAZ) and weight-for-height (WHZ). The prevalence of underweight was 25 .2% , stunting was 21 .1% and wasting was 6 .2%. Less than 1 .0% ofthe children were overweight. Risk factors of underweight were lueinga male (OR=l .4),
having an unemployed father (OR=2 .6) and a monthly family income of RM 251 -500 (OR=2 .0) . Being a male (OR=1 .6) was the only risk factor for stunning and working mother (OR=2 .0) was the only risk factor of wasting. In conclusion, there is still a high prevalence of undemutrition among primary one schoolchildren in rural areas of Tumpat and Bachok. This may be due to the poor socioeconomic status of the rural community and the lack of emphasis ofthe supplementary feeding program on the late preschool children. A comprehensive nutrition support program is essential, especially targeting the preschool children in these rural communities
Introduction: Acute gastroenteritis (AGE) is one of the frequent causes of hospitalization in children under the age of five, particularly in a rural setting. This study was conducted to determine the epidemiology of acute gastroenteritis in indigenous children admitted to a rural district hospital in Sarawak. Methods: A retrospective review of indigenous paediatrics cases of acute gastroenteritis
admitted to the ward of Serian District Hospital, a rural district hospital in Sarawak, between the years
2006-2007. The data was collected from the patients’ case notes, obtained with permission from the
hospital management. Data was entered and analyzed using SPSS version 16. Results: During the study period, 234 indigenous children with acute gastroenteritis were admitted with the highest prevalence in 2006 (53.4%). The findings showed higher prevalence was found in children aged 3 years and below (76.5%) and male (56.4%) The minimum duration of hospital stay is 1 day, and the maximum stay is 5 days. The clinical findings showed that the majority of the cases presented with vomiting, diarrhea, dry mouth and tongue, sunken eye, with the majority (76%) reported having mild dehydration. The most common treatment used is oral rehydration solutions (85.4%), followed by intravenous bolus or drip (82.3%), paracetamol (79%) and antibiotic (36.2%). Peak incidence of admissions was between November to January. About 38.5% of the AGE cases admitted were found to be underweight (weight for- age below -2SD). Conclusion: The findings indicated children aged 3 years and below are the most vulnerable to AGE and malnutrition could be one of the predisposing factors. The peak incidence during the raining season at the end of the year indicated a possible relationship between AGE and seasonal type of virus infection. Prevention in the form of proper hygiene at the household level probably will prove to be useful.
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
The Orang Asli of Malaysia continue to experience poor health. There appears to be stagnation of certain aspect of their health status. Underweight (low weight-for-age) and stunting (low height-for-age) are significant amongst Orang Asli children. Worm infestation such as Ascaris, Trichuris and hookworm continue to afflict Orang Asli communities in Malaysia. Orang Asli communities can also be afflicted by other kinds of parasites, e.g. malaria parasites, microsporida parasites and Cryptosporidium parasites. Thus, primary care doctors who treat Orang Asli patients should be on the lookout for malnutrition and its effects (including anaemia, iodine deficiency, Vitamin A deficiency) as well as worm and parasite infestations. Such patients may need to undergo de-worming at regular intervals because of the tendency to get re-infected. Primary care doctors also need to be aware of possible interactions between infestations and nutritional deficiencies.
Poor appetite and inadequate food intake together with depression are associated with malnutrition, that will increase risk of morbidity and mortality among elderly people. Identifying factors associated with these conditions are essential for formulation of preventive strategies. Therefore, a study was conducted to identify factors associated with poor appetite and depression among institutionalised Chinese elderly people in Butterworth, Penang. A total of 100 Chinese elderly (49 men and 51 women) aged 60 years and above, (mean age ± SD of 74.7 ± 9.2 years), with no known terminal and mental illnesses from two nursing homes participated in this study. Subjects were interviewed to gather information on appetite using Council of Nutrition Appetite Questionnaire (CNAQ), depression using Geriatric Depression Scale (GDS) and also socio demographic and health status. Food intake was assessed using a combination of one-day food weighing and 24 hour diet recall. Body weight and height were measured. Results showed that the mean energy and nutrients intake did not achieve the Recommended Nutrient Intake of Malaysia (RNI), with the exception for vitamin C. Only 4% of the subjects were underweight and obese, 65% normal and 31% overweight. A total of 70% and 73% of subjects had poor appetite and depression, respectively. Subjects who had depression (adjusted OR = 2.78, 95% CI = 0.95-8.03), energy intake below RNI (adjusted OR = 2.34, 95% CI = 0.68-6.95) and difficulty to fall asleep at night (insomnia) (adjusted OR = 2.22, 95% CI = 0.72-6.82) were more likely to have poor appetite. Subjects who had poor appetite (adjusted OR = 3.36, 95% CI = 1.19-9.47) and insomnia (adjusted OR = 2.58, 95% CI = 0.83-7.98) were more likely to have depression. In conclusion, although the majority of subjects had normal body weight but the nutrient intake was inadequate. Poor appetite and depression were prevalent and interrelated and also strongly associated with insomnia.
Device, Scales & Questionnaire: Council of Nutrition Appetite Questionnaire (CNAQ-8); Geriatric Depression Scale (GDS-15)
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.
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.
Objective: The objectives of this study were to asses body mass index, fasting blood sugar , serum cholesterol levels and prevalence of Diabetes Mellitus among outpatients attending the Clozapine clinic at University Malaya Medical Center. Method: 36 patients had their height and weight taken at the start of the study. Their BMI (body mass index) was calculated. Fasting blood sugar, (FBS) and Fasting Serum Lipid (FSL) were performed. Result: The mean body mass index was 24.63. The prevalence of obesity was 13.89%. The prevalence of overweight was 27.8 % and the prevalence of underweight was 5.55%. The prevalence of Diabetes Mellitus was 2.78 %. Serum triglyceride levels appear to be elevated in those receiving Clozapine.Conclusion: It appears that Clozapine may predispose one to obesity. From our study we cannot conclude if Clozapine causes Diabetes Mellitus. However treatment with Clozapine may be associated with elevated levels of serum triglycerides.
Study site: Clozapine clinic at University Malaya Medical Center
Adequate nutrition is important for mothers and their offspring during and after birth. This cross sectional study was conducted to determine nutritional status and nutritional knowledge of pregnant women from two selected private hospitals in Klang Valley, Malaysia. A total of 236 Malay pregnant women aged between 20 to 45 years old (mean age 31+5 years) were recruited through convenient sampling method. Socio-demographic data, nutritional knowledge and a 24-hours diet recall were obtained through a self-administered questionnaire. Anthropometric and haemoglobin data were obtained from the antenatal records in the respective hospitals. The percentages of participants who were underweight, normal, overweight and obese before pregnancy were 12.7%, 55.1%, 25.0% and 7.2% respectively. Among those who were obese before pregnancy, a total of 59.7% had inadequate weight gain, 24.6% gained adequate weight and 15.7% gained excessive gestational weight. About 33.5% of subjects were anaemic (Hb < 11.0g/dL). The mean daily energy intake of the participants was 1748 ± 526 kcal which was 76% of RNI. Calcium (73% of RNI), folic acid (36% of RNI), niacin (89% of RNI) and vitamin D (40% of RNI). The nutritional knowledge level of subjects was moderate (51.9 ± 13.8%). Lower monthly household income (p < 0.001), educational level (p < 0.001) and gestational stage (p < 0.05) of participants were associated with a lower nutritional knowledge level. Nutritional knowledge score was positively correlated with gestational weight gain (r = 0.166, p < 0.05) and haemoglobin level (r = 0.200, p < 0.05). Subjects who claimed practising food taboos had higher nutritional knowledge score (54.9 ± 12.5%) than those who did not (49.9 ± 14.4%)(p < 0.05). A comprehensive nutrition education should be integrated in the antenatal classes to improve nutritional status of pregnant women.
This is a cross»sectional study to determine the nutritional status of Malay children aged 6 to 10 years in Kampongknderam Hilir. A cross sectional study design was used.All households were included in the study. All the 218 Malaysian children aged 6 to 10 years in Kamponglenderam Hilir were included in the study. A pre-tested structured questionnaire was used to collect the data.
Data were analyzed by using Statistical Package of Social Sciences (SPSS) version 10. The minority of the chihlren were within normal range for weight·for-age, normal height for age status and weight for height status. However in small proportion of children, there was a persistence of protein·energy malnutrition problems. Overall 11% were underweight. There was no significant difference in the prevalence ofunderweight between males and females. The prevalence of overweight and stunting was 5 .3% and 11 .5%. There was no significant difference in the prevalence of sturtting in male compared to females. Although stunting was prevalent in all age groups (4.4% to 19.6%) a significant higher prevalence was observed in the age group 9 - 9.9 years compared to other age groups (p< 0.05). Wasting was present in 7.6% of the respondents. The 6 - 6.9 years age group had the highest wasting prevalence compared to other age groups. The prevalence of wasting was significantly higher in males. ln conclusion the overall nutritional status of children aged 6 to 10 years old in Kampong]enderam Hilir was satnfactory. However, there was still malnutrition in a small proportion of chihlren. Underweight, stunting and overweight were seen in all age groups. As such there is a need to identify these chiMren and improve their nutritional status.
Aims: 1) To assess salivary leptin levels in normal-underweight versus overweight and obese healthy adult males aged 18-25 years old. 2) The relative contribution of anthropometric measurements, fat percentage, fat distribution (visceral versus subcutaneous) and total as well as regional muscle mass in arms, trunk and legs respectively in predicting salivary leptin levels. Methods: A total of 92 adult males were classified into two groups based on their body mass index (BMI): normal-underweight, BMI <24.9 kg/m2 (n=51); overweight-obese, BMI >25 kg/m2 (n=41). Anthropometric measurements such as BMI, waist circumference (WC), hip circumference (HC) and waist-hip ratio (WHR) were measured through standardised methods. Fat percentage, visceral fat level, subcutaneous fat and muscle mass (total and regional) were measured using Karada scan bioelectrical impedance method. Fasting saliva samples were collected and used for assessing salivary leptin concentrations using enzyme-linked immunosorbent assay. Results: Statistical analysis of the data showed a significant difference between the two groups in all of the parameters measured except height and salivary leptin levels. Multiple regression analysis showed that HC, WC and WHR were good predictors for salivary leptin levels in normal-underweight group. However, in the overweight-obese group, height was the most important independent variable that could predict salivary leptin levels as a dependent variable. Conclusions: Predictors for salivary leptin levels in adult healthy males are different in normal-underweight subjects from overweight-obese subjects. The most important predictor for salivary leptin levels is HC in normal weight subjects, while it is height in overweight and obese healthy adult males.
Women participating in a wide range of competitive sports are at higher risk of developing eating disorders, menstrual irregularities and osteoporosis, which are generally referred to as the 'female athlete triad'. The objective of this study was to determine the prevalence of female athlete triad and factors associated with this condition among athletes participating in different sports. A total of 67 elite female athletes aged between 13-30 years participated in the study and were subdivided into the 'leanness' and 'non-leanness' groups. Eating disorders were assessed using a body image figure rating and the Eating Disorder Inventory (EDI) with body dissatisfaction (BD), drive for thinness (DT), bulimia (B) and perfectionism (P) subscales. Menstrual irregularity was assessed with a self-reported menstrual history questionnaire. Bone quality was measured using a quantitative ultrasound device at one-third distal radius. Prevalence of the female athlete triad was low (1.9%), but the prevalence for individual triad component was high, especially in the leanness group. The prevalence of subjects who were at risk of menstrual irregularity, poor bone quality and eating disorders were 47.6%, 13.3% and 89.2%, respectively, in the leanness group; and 14.3%, 8.3% and 89.2%, respectively, in the non-leanness group. Since the components of the triad are interrelated, identification of athletes at risk of having any one component of the triad, especially those participating in sports that emphasise a lean physique, is an important aid for further diagnosis.
The relationship between nutrition, health and educational achievement of school-age population in less developed countries has been of interest to many researchers due to the frequent observation that many children did not complete primary school and those who completed, did not do as well as children in the developed countries. Nevertheless, nutritional and health status by itself is not the only variable affecting educational achievement, since biological, psychological, socioeconomic and cultural factors could directly or indirectly affect both nutrition, health status and educational achievement. The mechanism by which health and nutrition influence educational achievement is not well established, but poor health and malnutrition in early childhood may affect cognitive abilities, necessary for learning process and consequently educational achievement. A study was conducted in Kuala Lumpur, Malaysia, to investigate the relationship between nutritional status and educational achievement among primary schoolchildren from low income households (n = 399). A high percentage of them were mild-significantly underweight (52%), stunted (47%) and wasted (36%) and increasingly overweight (6%). In general, more boys than girls were found to experience some form of malnutrition. While weight-for-height did not differ significantly according to family, child and school factors, weight-for-age and height-for-age differed significantly by gender. Also, height-for-age was significantly related to household income. This indicates that stunting may be a consequence of prolonged socioeconomic deprivation. Educational achievement was measured based on test scores for Malay language (ML), English language (EL) and mathematics (MT). While a majority of the schoolchildren obtained optimum scores (>75) for ML and MT, the majority of them had insufficient scores (<50) for EL. Children's total score (TS) for the three subjects was significantly associated with household socioeconomic status, gender, birth order and heightfor- age. Even after controlling for household socioeconomic status, significant association between TS and height-for-age persisted. In this sample of schoolchildren, household income, gender, birth order and height-forage were significant predictors of TS. The finding that height-for-age is related to educational achievement agrees with other studies, which have reported that height-for-age, compared to weight-for-height or weight-forage is linked to educational achievement. Height-for-age reflects the accumulation of nutritional deprivation throughout the years, which may consequently affect the cognitive development of the children.