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  1. Foo LH, Lee YH, Suhaida CY, Hills AP
    BMC Public Health, 2020 Apr 25;20(1):552.
    PMID: 32334561 DOI: 10.1186/s12889-020-08461-7
    BACKGROUND: There is little information about the diet, lifestyle and parental characteristics associated with habitual sugar-sweetened beverage (SSB) consumption in Asian children. The aim of the present study was to assess cross-sectional associations between habitual SSB consumption and preschoolers' diet, physical activity, sedentary behaviour as well as parental and child characteristics in Malaysian preschoolers aged 3 to 6 y.

    METHODS: A total of 590 preschoolers, comprising 317 boys and 273 girls were included. Pre-pilot parental questionnaires were used to assess diet, physical activity (PA) and sedentary behaviour practices and anthropometry was assessed in preschoolers and their parents.

    RESULTS: Multiple logistic regression analyses showed that preschoolers with more frequent weekly intake of snacks [OR 2.7; 95% CI, 1.6-4.4; p 

  2. Teo PS, Nurul-Fadhilah A, Aziz ME, Hills AP, Foo LH
    Int J Environ Res Public Health, 2014 Jun;11(6):5828-38.
    PMID: 24886753 DOI: 10.3390/ijerph110605828
    AIM: To determine the influence of physical activity (PA) and sedentary behavior (SB) on obesity profiles of 454 Malaysian adolescents aged 12 to 19.
    METHODS: Validated PA and SB questionnaires were used and body composition assessed using anthropometry and dual-energy X-ray absorptiometry (DXA).
    RESULTS: Gender-specific multivariate analyses showed boys with high levels of total PA and moderate-to-vigorous physical activity (MVPA) exhibited significantly lower levels of total body fat, percent body fat and android fat mass compared with low PA and MVPA groups, after adjusting for potential confounders. Girls with high SB levels showed significantly higher BMI, waist circumference and DXA-derived body fat indices than those at lower SB level. Multiple logistic analyses indicated that boys with low levels of total PA and MVPA had significantly greater obesity risk, 3.0 (OR 3.0; 95% CI, 1.1-8.1; p < 0.05) and 3.8-fold (OR 3.8; 95% CI, 1.4-10.1; p < 0.01), respectively, than more active boys. Only in girls with high SB level was there a significantly increased risk of obesity, 2.9 times higher than girls at low SP levels (OR 2.8; 95% CI, 1.0-7.5; p < 0.05).
    CONCLUSIONS: The present findings indicate that higher PA duration and intensity reduced body fat and obesity risk while high screen-based sedentary behaviors significantly adversely influenced body fat mass, particularly amongst girls when the PA level was low.
  3. Foo LH, Teo PS, Abdullah NF, Aziz ME, Hills AP
    Asia Pac J Clin Nutr, 2013;22(3):348-56.
    PMID: 23945404 DOI: 10.6133/apjcn.2013.22.3.02
    The main objective of this paper was to determine the utility of various anthropometric measures to assess total and regional body fatness using dual-energy X-ray absorptiometry (DXA) as the criterion in 454 adolescent boys and girls aged 12-19 years. Multivariable regression analyses of gender-specific and gender-combined models were used to determine anthropometric measures on DXA-derived body fatness models, after adjusting for known confounding biological factors. Partial correlation analyses, after adjusting for age, pubertal growth status and ethnicity in boys and girls, showed that body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-height ratio (WhtR) were significantly correlated with total body fat (TBF), percent body fat (%BF), android region fat (ARF) and trunk fat (TF) (all p<0.0001). BMI was the greatest independent determinant, contributing 43.8%-80.9% of the total variance for DXA-derived body fatness models. Results confirmed that a simple anthropometric index such as the BMI is a good surrogate indicator of body fat levels in Malay and Chinese adolescents.
  4. Wee BS, Poh BK, Bulgiba A, Ismail MN, Ruzita AT, Hills AP
    BMC Public Health, 2011;11:333.
    PMID: 21592367 DOI: 10.1186/1471-2458-11-333
    With the increasing prevalence of childhood obesity, the metabolic syndrome has been studied among children in many countries but not in Malaysia. Hence, this study aimed to compare metabolic risk factors between overweight/obese and normal weight children and to determine the influence of gender and ethnicity on the metabolic syndrome among school children aged 9-12 years in Kuala Lumpur and its metropolitan suburbs.
  5. Liu A, Byrne NM, Kagawa M, Ma G, Kijboonchoo K, Nasreddine L, et al.
    BMC Public Health, 2011;11:500.
    PMID: 21703012 DOI: 10.1186/1471-2458-11-500
    Ethnic differences in body fat distribution contribute to ethnic differences in cardiovascular morbidities and diabetes. However few data are available on differences in fat distribution in Asian children from various backgrounds. Therefore, the current study aimed to explore ethnic differences in body fat distribution among Asian children from four countries.
  6. Liu A, Byrne NM, Ma G, Nasreddine L, Trinidad TP, Kijboonchoo K, et al.
    Eur J Clin Nutr, 2011 Dec;65(12):1321-7.
    PMID: 21731041 DOI: 10.1038/ejcn.2011.122
    To develop and cross-validate bioelectrical impedance analysis (BIA) prediction equations of total body water (TBW) and fat-free mass (FFM) for Asian pre-pubertal children from China, Lebanon, Malaysia, Philippines and Thailand.
  7. Liu A, Byrne NM, Kagawa M, Ma G, Poh BK, Ismail MN, et al.
    Br J Nutr, 2011 Nov;106(9):1390-7.
    PMID: 21736824 DOI: 10.1017/S0007114511001681
    Overweight and obesity in Asian children are increasing at an alarming rate; therefore a better understanding of the relationship between BMI and percentage body fat (%BF) in this population is important. A total of 1039 children aged 8-10 years, encompassing a wide BMI range, were recruited from China, Lebanon, Malaysia, The Philippines and Thailand. Body composition was determined using the 2H dilution technique to quantify total body water and subsequently fat mass, fat-free mass and %BF. Ethnic differences in the BMI-%BF relationship were found; for example, %BF in Filipino boys was approximately 2 % lower than in their Thai and Malay counterparts. In contrast, Thai girls had approximately 2.0 % higher %BF values than in their Chinese, Lebanese, Filipino and Malay counterparts at a given BMI. However, the ethnic difference in the BMI-%BF relationship varied by BMI. Compared with Caucasian children of the same age, Asian children had 3-6 units lower BMI at a given %BF. Approximately one-third of the obese Asian children (%BF above 25 % for boys and above 30 % for girls) in the study were not identified using the WHO classification and more than half using the International Obesity Task Force classification. Use of the Chinese classification increased the sensitivity. Results confirmed the necessity to consider ethnic differences in body composition when developing BMI cut-points and other obesity criteria in Asian children.
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