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  1. Ahmad Ali Zainuddin, Rusidah Selamat, Azli Baharudin, Suhaila Abdul Ghaffar, Norsyamline Che Abdul Rahim, Tahir Aris
    Malays J Nutr, 2013;19(2):149-161.
    MyJurnal
    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.
  2. Ahmad Ali Zainuddin, Norazmir Md. Nor, Safiah Md Yusof, Adriana Irawati Nur Ibrahim, Tahir Aris, Foo, Leng Huat
    Malays J Nutr, 2019;25(3):273-285.
    MyJurnal
    Introduction: Monitoring changes in energy and nutrient intakes of the population
    over the course of time is essential to help healthcare providers develop effective
    dietary policies. The aim of this study was to assess the changes in the nutrient
    intake and Recommended Nutrient Intake (RNI) achievements by using the data
    obtained from the Malaysian Adult Nutrition Surveys (MANS) that were carried out
    in 2003 and 2014. Mis-reporting of energy intake was taken into account. Methods:
    Dietary data were obtained from MANS 2003 and MANS 2014, which involved a
    combined total of 4,044 randomly selected respondents, aged 18-59 years, using
    a single 24-hour diet recall. Energy and nutrients calculations were based on the
    Malaysian Food Composition database using the Nutritionist Pro software. The
    results were compared against the RNI for Malaysia to assess dietary adequacy.
    Results: The proportions of calories derived from macronutrients were within the
    recommendations for a healthy diet. The consumption of protein, fat, calcium, iron
    and vitamin A was significantly higher in 2014 than in 2003. The consumption
    of protein, iron, vitamin C, and vitamin A was found to exceed the RNIs in 2014.
    However, carbohydrate and sodium intakes had significantly decreased. Despite the
    decrease, sodium intake still exceeded RNI recommendations. Conclusion: Signs
    of changing energy and nutrient intakes were found, including increases in protein
    and fat intakes since 2003, and decreased carbohydrates. This could be an alarming
    indicator of the tendency to eat energy dense food among the population.
  3. Ahmad Ali Zainuddin, Norazmir Md. Nor, Safiah Md Yusof, Adriana Irawati Nur Ibrahim, Tahir Aris, Foo, Leng Huat
    Malays J Nutr, 2019;25(3):261-271.
    MyJurnal
    Introduction: Under-reporting of energy intake is a common cause of bias
    in nutritional studies. This study was aimed at examining the extent of underreporting of energy intake and its related characteristics among respondents in
    the Malaysian Adult Nutrition Survey (MANS) 2003 and MANS 2014. Methods:
    The present study analysed energy intakes of 9,624 adults aged 18-59 years from
    the MANS in year 2014 (2,890 respondents) and 2003 (6,734 respondents) using
    a single 24-hour diet recall. Basal metabolic rates (BMR) were calculated from the
    age- and gender-specific equations of Schofield. Under-reporting was defined as an
    energy intake:BMR ratio of
  4. Lim, Kuang Kuay, Chan, Ying Ying, Ahmad Ali Zainuddin, Teh, Chien Huey, Hasimah Ismail, Lim, Kuang Hock, et al.
    Int J Public Health Res, 2014;4(1):419-424.
    MyJurnal
    Introduction Iodine deficiency disorders (IDD), is one of the most important micronutrient
    deficiencies which has multiple adverse effects on growth and development.
    The aim of this study was to determine the prevalence of IDD among school
    children and to elucidate the distribution of iodized salt at household level in
    Sarawak, East Malaysia.

    Methods This cross-sectional study was conducted among school children aged 8 to 10
    years in 2008. A multi-stage probability proportionate to population size
    (PPS) cluster sampling method was used to obtain a representative state
    sample of 1200 school children. Spot urine samples were collected for the
    determination of urinary iodine concentration while the iodine content in salt
    was determined using field rapid test kits. The thyroid status was determined
    by palpation.

    Results Response rate was 92.0% (n=1104/1200). The prevalence of goitre among
    school children in Sarawak was 2.9% (5.2% in urban, 0.7% in rural). The
    median urinary iodine concentration (UIC) among the school children was
    102.1 μg/L (IQR, 62.3-146.5 μg/L). Urban children had significantly higher
    median UIC of 109.3 μg/L (IQR, 72.4-159.0 μg/L) than their rural
    counterparts [91.9 μg/L (IQR, 55.7-140.2 μg/L)]. The salt samples tested by
    rapid test kit (RTK) showed only 46.0% of household salt contained iodine.

    Conclusions The present study revealed that the population in Sarawak were of borderline
    iodine sufficient with mild IDD seen in rural areas. Hence, the state IDD
    control programmes need to encourage and advocate the consumption of
    iodized salt in order to eliminate IDD-related health problems in Sarawak.
  5. Lim, Kuang Kuay, Chan, Ying Ying, Ahmad Ali Zainuddin, Teh, Chien Huey, Rusidah Selamat, Kee, Chee Cheong, et al.
    Int J Public Health Res, 2013;3(1):198-203.
    MyJurnal
    Iodine deficiency is still prevalent worldwide and it is the main cause of goiter, thyroid dysfunction and mental retardation. The aim of the study was to determine the iodine status and goiter prevalence among the school children in Terengganu. The representative sample consists of 1163 primary school children aged 8-10 years old randomly selected from urban and rural schools in Terengganu using stratified systematic random sampling technique. Urinary iodine levels in spot urine were determined by in house modified micro-method while goiter assessment was carried out by palpation of thyroid gland. The status of iodine deficiency was determined by the median urinary iodine concentrations (UIC) and total goiter prevalence (TGP) in accordance with the WHO criteria. The result showed the median [inter-quartile range (IQR)] urinary iodine concentrations was 78.7µg/L (50.1µg/L -120.0µg/L) indicating the iodine intake was slightly lower than recommended range of 100 µg/L. The rural school children had a significantly lower Iodine levels (median UIC=72.4µg/L, IQR=46.7µg/L -113.0µg/L) than the urban school children (median UIC=87.7µg/L, IQR=54.5 µg/L - 127.5µg/L). The total goiter prevalence (TGP) was 5.7%. The prevalence of goiter was significantly higher in rural (TGP=6.9%) compared to urban areas (TGP=3.6%). The study revealed that school children in Terengganu showed mild iodine deficiency and the condition is more pronounced in children from rural areas. The findings emphasize the importance of intervention implementation, universal salt iodization to ensure sufficient intake of iodine among the Terengganu school children.
  6. Azli Baharudin, Mohamad Hasnan Ahmad, Balkish Mahadir Naidu, Nurul Rufaidah Hamzah, Nor Azian Mohd Zaki, Ahmad Ali Zainuddin, et al.
    MyJurnal
    This study sought to examine the reliability and validity of height measurements using a portable
    stadiometer as compared to a mechanical scale. Samples from 142 adults aged 22 to 57 were taken during data collection in November 2014. There was a high degree of reliability for the inter-examiner, intraexaminer and inter-instrument aspects with regards to mean difference, the inter correlation coefficient (ICC) and Bland-Altman Plot. For the inter-examiner aspect, the height measurement taken by the first examiner was 0.01 cm higher than that by the second examiner with an ICC of 0.999. For the intraexaminer aspect, the difference was 0.1 cm; this was higher in the first measurement compared to the second. The ICC was also 0.999. For the inter-instrument aspect, measurement taken by stadiometer was 0.61 cm higher than the measurement taken by mechanical scale and the ICC was 0.997. The Bland-Altman plot showed a distribution of differences between measurements in the inter-examiner, intraexaminer and inter-instrument aspects that were close to zero within the narrow range of ±1.96SD. The technical error of measurement (TEM), coefficient of reliability (R) and coefficient of variation (CV) for the inter-examiner, intra-examiner and inter-instrument aspects were within the acceptable limits. This study suggests that the portable stadiometer is reliable and valid for use in community surveys.
  7. Ahmad Ali Zainuddin, Mala A. Manickam, Azli Baharudin, Rusidah Selamat, Kee, Chee Cheong, Noor Ani Ahmad, et al.
    Int J Public Health Res, 2016;6(1):661-669.
    MyJurnal
    Introduction Overweight and obesity is a major public health problem in Malaysia. This study aims to determine the prevalence of overweight and obesity among the Malaysian adult population and their association with socio-demographic characteristics (gender, ethnic, and age groups).
    Methods A total of 17,257 adults aged 18 years and older (8,252 men, 9,005 women)
    were assessed for BMI status, with a response rate of 97.8%, through a household survey from the National Health and Morbidity Survey (NHMS), conducted in all states of Malaysia in 2011.
    Results All socio-demographic factors were consistently associated with higher chance of being overweight (except gender and location) and obesity (except location and household income). The identified risk of overweight were
    Indian (aOR: 1.8, 95% CI: 1.2-2.8), aged 50-59 years (aOR: 2.8, 95% CI: 2.0-3.9), widower (aOR: 1.6, 95% CI: 1.3-2.0), subject with secondary education (aOR: 1.2, 95% CI: 1.0-1.4), Homemaker/unpaid worker (aOR:
    1.3, 95% CI: 1.1-1.4), and with high household income group (aOR: 1.3, 95% CI: 1.2-1.6). The identified risk of obesity were women (aOR: 1.4, 95% CI: 1.2-1.6), Indian (aOR: 1.7, 95% CI: 0.9-3.2), aged 30-39 years (aOR: 3.6,
    95% CI: 2.4-5.5), widower (aOR: 1.2, 95% CI: 0.9-1.6), subjects with primary education (aOR: 1.2, 95% CI: 0.9-1.6), Homemaker/unpaid worker (aOR: 1.3, 95% CI: 1.1-1.6), and with middle household income group (aOR: 1.3, 95% CI: 1.2-1.6).
    Conclusions Our data indicate a high prevalence of overweight and obesity in the
    population. Several sociodemographic characteristics are associated with both overweight and obesity. This study highlights the serious problem ofoverweight and obesity among Malaysia adults. Documentation of these problems may lead to research and policy agendas that will contribute both to our understanding and to the reduction of these problems.
    Study name: National Health and Morbidity Survey (NHMS-2011)
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