Objective: To assess the prevalence of iron deficiency, anaemia and iron deficiency anaemia (IDA) in women aged 20-40 years and its association with iron intake. Methods: A total of 388 women were recruited from universities and work sites in Kuala Lumpur and its suburbs. The subjects comprised 135 Malays, 130 Chinese and 123 Indians. Dietary intake was estimated using a single 24-hour food recall and a semi-quantitative food frequency questionnaire. Haemoglobin (Hb), haematocrit (hct), mean corpuscular volume (MCV) and serum ferritin were determined. Results: The prevalence of anaemia (Hb
By 2020, non-communicable diseases including cardiovascular diseases (CVD) are expected to account for seven out of every 10 deaths in the developing countries compared with less than half this value today. As a proportion of total deaths from all-causes, CVD in the Asia Pacific region ranges from less than 20% in countries such as Thailand, Philippines and Indonesia to 20-30% in urban China, Hong Kong, Japan, Korea and Malaysia. Countries such as New Zealand, Australia and Singapore have relatively high rates that exceed 30-35%. The latter countries also rank high for coronary heart disease (CHD) mortality rate (more than 150 deaths per 100,000). In contrast, death from cerebrovascular disease is higher among East Asian countries including Japan, China and Taiwan (more than 100 per 100,000). It is worth noting that a number of countries in the region with high proportions of deaths from CVD have undergone marked declining rates in recent decades. For example, in Australia, between 1986 and 1996, mortality from CHD in men and women aged 30-69 years declined by 46 and 51%, respectively. In Japan. stroke mortality dropped from a high level of 150 per 100,000 during the 1920s-1940s to the present level of approximately 100 per 100,000. Nonetheless, CVD mortality rate is reportedly on the rise in several countries in the region, including urban China, Malaysia, Korea and Taiwan. In China, CVD mortality increased as a proportion of total deaths from 12.8% in 1957 to 35.8% in 1990. The region is undergoing a rapid pace of urbanization, industrialization and major technological and lifestyle changes. Thus, monitoring the impact of these changes on cardiovascular risks is essential to enable the implementation of appropriate strategies towards countering the rise of CVD mortality.
Changes in the dietary intake patterns of countries in the Asia Pacific region are considered in relation to trends of cardiovascular disease mortality. Cardiovascular disease now constitutes the major cause of mortality in many of the countries of the region. The mortality rate for coronary heart disease (CHD) has been on the decline since the mid-1960s in countries such as Australia, New Zealand and Japan, while a decline in other countries, including Singapore and Hong Kong, appears to be occurring about two decades later after a delayed increase. In contrast, countries like Malaysia and China have had and continue an upward trend for CHD mortality. Nonetheless, the mortality rates due to CHD in New Zealand, Australia, Singapore followed by Hong Kong rank among the highest in the region. In China, Taiwan and Japan, death due to cerebrovascular disease remains a major cause of death, although the latter two countries have undergone a significant decline in stroke death rates since 1970. The intakes of fat from land animal products, fish and vegetable oils, depending on fatty acid patterns and, possibly other constituents, are candidate contributors to the different atherogenic and thrombotic effects. Countries which have a higher mortality from CHD tend to have a higher intake of energy from fat and proportion of fat from animal products. These fat intakes may operate to increase hypercholesterolemia and overweight in various countries. Again, intakes of other food items and constituents used in the region such as soybeans, dietary antioxidants in fruits, vegetables, seeds, cereals, nuts and tea and alcohol consumption are candidate cardio-protectants. The wide dietary scope of Asia Pacific populations, from diverse socio-cultural backgrounds, and at different levels of economic and technological development poses several analytic challenges and opportunities. Future research should improve the datasets and think laterally about pathogenesis and intervention.
About 10% of 3887 ever-married women included in the 1984-85 Malaysian Population and Family Survey revealed that they were influenced by the new population policy to desire more children than they had originally wanted. These women were more likely to be rural Malays from the lower socioeconomic class. Ideal family size was more than four children. Children are desired for economic benefits and emotional support. The natality of the Malays has risen since 1980: their total fertility rate has increased while their contraceptive prevalence rate has dropped sharply. Coupled with a decline in the crude death rate, the present fertility preferences and behaviour of the Malays will render the target of the population policy more attainable than is reflected by the survey data.
The types and prevalence of coronary heart disease (CHD) risk factors vary somewhat among the three main ethnic groups in peninsular Malaysia. Indians consistently show the highest prevalence for hypercholesterolemia and diabetes mellitus. Among the Malays, a relatively high prevalence of hypertension and hypertriglyceridemia have been reported. Overweight is also a risk factor among the Indians and Malays. In general, Chinese tend to have a lower prevalence for these CHD risk factors than the Indians and Malays. Parallel to the rapid socio-economic development and urbanization in recent decades is a rise in the percentage of deaths due to cardiovascular disease in peninsular Malaysia, that is from 1.8% of total deaths from all causes in 1950 to about 30% in 1991. Coronary heart disease accounts for 40% of all cardiovascular diseases. The mortality rate for CHD has more than doubled between 1965 and 1991, from 24.6 per 100 000 to 57.2. While Indians have been showing the highest CHD mortality rate so far, that of the Malays has been increasing most rapidly since 1970, concomitant with the latter's increase in their proportion of the urban population in peninsular Malaysia.
This paper presents the results of anthropometric assessment of 2,364 boys and 2,415 girls aged 18 years and below drawn from the estates and rural community groups engaged in padi farming, rubber planting, coconut cultivation and fishing. The children were mainly Malay, however in the estates, Indians predominated. The results showed that the percentage of boys who have normal weight-for-age, height-for-age and weight-for-height were respectively 69.4%, 68.3% and 88.8%. Among girls, the percentage with normal values for weight-for-age, height-for-age and weight-for-height were 73.8%, 72.6% and 89.5% respectively. This study also showed the persistence of underweight, stunting and wasting amongst children in the study communities. Overall, the prevalence of underweight among boys was 29.8% and for girls 25.5%. The prevalence of stunting was 31.3% for boys and 26.9% for girls, while wasting was found in 9.3% boys and 8.5% girls. By age groups, the prevalence of underweight was lowest among the infants (16.8% for boys and 13.3% for girls), and highest among children aged above 1 to 6 years old (32.6% and 35.9% for boys and girls respectively). Children from the fishing, rubber and padi villages showed a higher prevalence of acute and chronic undernutrition than those from the coconut and the estate communities. In contrast, the mean prevalence of overweight in the five community groups did not exceed 2%. When compared with another peninsula-wide nutritional assessment of poverty villages undertaken in 1979-1983, it is found, over the past decade, that the prevalence of underweight in rural communities appeared to have decreased somewhat while that of stunting showed a more substantial decline. The persistence of current undernutrition has led to the manifestation of children who were too thin for their "non-stunted" height, thus giving rise to an apparently higher prevalence of wasting as found in this study. The implications of these results are discussed.
A nutritional study was carried out on six (five rural and one urban) low income groups in Peninsular Malaysia from 1992-1995. In this paper, the socio-economic data for the five rural groups - padi farmers, rubber smallholders, coconut smallholders, estate workers, and fishermen - are presented. With the exception of the estate workers, the sample was predominantly Malay, with an overall mean household size of 5.30. Household incomes were generally low, and 47% of all households had incomes that were below the poverty line income (PLI) of RM405. Based on this PLI, the prevalence of poverty was above 50% among the padi, rubber, coconut, and fishing households. Nevertheless, the study population appeared to be better off in terms of the other indicators examined. Poultry rearing, for example, was widespread in the padi, rubber, and coconut villages; 65% of all households owned at least one motorised vehicle, 53% owned a refrigerator, and 83% owned a television set. Furthermore, over 80% of all households had access to piped water, 96% had electricity supply, and over 90% had a flush or pour-flush latrine. In comparison to the 1979-1983 poverty villages study (Chong et al., 1984), the households in the current study enjoyed better living conditions. Strict comparisons between the two studies, however, is difficult owing to the different criteria adopted in the selection of the study villages.
University students may encounter personal, family, social, and financial stresses while trying to cope with their academic challenges. Such constraints could affect their eating behavior and health status which, in turn may have negative effects on their studies. In light of little information in Malaysia on this subject, this study was undertaken on a sample of 180 students pursuing different academic programs in a Malaysian university. The study objectives were to determine the students' eating behavior including body weight control and the extent of fear of being fat, their social self concept that reflects the five selves namely, the psychological self, the social self, the sexual self, the family self and the physical self. Eating behavior and social self concept were determined based on various methods previously validated in studies on young adults in Asia and Australia. This article focuses on gender comparisons for these determinants. The results showed that psychological and emotional factors have a significant bearing on the eating behavior of university students. Uninhibited eating behavior of both the males and females showed significant and negative correlations with feelings pertaining to personal worth, the physical self, and their relationships with peers and families. Gender differences were manifested for some determinants. The females showed more restrained eating behavior than the males; the females have a significantly higher score for family relationship, which appears to be a significant factor on male students' eating behavior. Future studies on a larger sample size may help to unravel the extent to which psychological factors influence eating behavior of students, and the underlying psychosocial basis for some of the gender differences reported in this study.
This study determined the association between nutritional status and the use of protease inhibitors (PI)
containing regimen among HIV-infected children receiving treatment at the referral centres in Klang
Valley. A total of 95 children currently on antiretroviral (ARV) therapy, aged one to eighteen years, were recruited using purposive sampling. Demographic data, anthropometric measurements, medical history, were collected using a structured questionnaire. Serum micronutrients levels and lipid profile were also examined using blood samples. Mean age was 8.8 3.9 years and 44.2% were on PI. Age ( 2 = 10.351, p = .006), weight-for-age ( 2 = 6.567, p = .010), serum selenium ( 2 = 4.225, p = .040) and HDL-C ( 2 = 7.539, p = .006) were significantly associated with the use of PI. Fewer children on PI were deficient in selenium as compared to those not on PI. On the contrary, more children on PI were underweight and had low HDL-C. The use of PI was found to have both positive and negative effects with better selenium level but poorer HDL-C level and weight status.
Non-communicable diseases with dietary implications, ischaemic heart disease, diabetes mellitus and cancers of the breast and colon are discussed in relation to their prevalence and mortality rates in peninsular Malaysia during the past few decades. The mortality rate due to diseases of the circulatory system has more than doubled since 1970, deaths due to ischaemic heart disease being the major cause. The prevalence of diabetes mellitus has risen from 0.65% in 1960 to about 4% currently. The mortality risk for both ischaemic heart disease and diabetes is highest in the Indian compared to Malay and Chinese populations. The Chinese show the highest mortality rate for cancers of the breast and colon. This could reflect, partly, because more people especially in the urban areas are seeking treatment and improved diagnosis. Empirical dietary data indicate an increase in the prevalence of hypercholesterolaemia among urban adults and overweight among urban and rural adults. Aggregate data from food balance sheets indicate increased availability of energy intake from fats and oils, sugar, and animal products, with concomitant decline in available energy from plant products. Continued public health education on the important linkage between diet and disease is called for.
In this randomized controlled trial we evaluated the effectiveness of medical nutritional therapy on Arab patients with Type 2 diabetes in Oman delivered by a dietitian.
The purpose of this study was to report on the estimates and distribution of body mass index in a sample of Malaysian adolescents. The study utilized a cross-sectional design and multi-stage random sampling of secondary schools to select 5 urban and 9 rural schools in Kedah and Penang. A total of 6555 male and female adolescents (11-15 years old) of Malay, Chinese and Indian ethnic groups were measured for weights and heights for body mass index calculation. Information on household demographic and socioeconomic were obtained from parents through self-administered questionnaires. Analyses of body mass index distribution by location, ethnicity, gender and age were conducted using Chi-square test of SPSS 11.5. More of the rural (12.1%) and urban (19.4%) adolescents were underweight and overweight, respectively. While in all ethnic, gender and age groups, rural adolescents were more likely to be underweight, more of the urban adolescents were overweight. The prevalence of underweight was highest among the Indians (19.2%) and lowest in Chinese (7.2%). The prevalence of overweight in the three ethnic groups was in the range of 18-19%. More male than female adolescents were underweight (15% vs 7.8%) and overweight (19.5% vs 16.7%). Consistent patterns were also observed across location, ethnic and age groups. As age increased, the prevalence of overweight decreased across the ethnic and gender groups. The reported findings can serve as current reference on body mass index distribution of Malaysian adolescents and a basis for future efforts in health and nutrition interventions for Malaysian children and adolescents.
Several risk factors for cardiovascular disease amongst a sample of urban Chinese women were investigated. These factors included body mass index (BMI), waist hip ratio, total blood cholesterol (TC), HDL-cholesterol and Lp(a) levels, blood pressure, cigarette smoking, family history of chronic disease, dietary habits and frequency of selected food intake. The subjects were found to have coronary risks with respect to BMI and TC level, both of which increased with age of the women. Hypertension, HDL-cholesterol and Lp(a) levels appeared not to pose as risk factors amongst these subjects. Dietary habits and intake showed significant correlations with subjects' BMI status. Health promotion is called for towards reducing the modifiable coronary risk factors.
Methylenetetrahydrofolate reductase (MTHFR) C677T is involved in folate and homocysteine metabolism. Disruption in the activity of this enzyme will alter their levels in the body.
During the past four decades, Oman has undergone a rapid socioe-conomic and epidemiological transition leading to a substantial reduction in the prevalence of various communicable diseases, including vaccine-preventable diseases. Health care planning together with the commitment of policy makers has been a critical factor in this reduction. However, with rapid social and economic growth, lifestyle-related non communicable diseases have emerged as new health challenges to the country. Diabetes and obesity are leading risks posed by the chronic diseases. The burden of diabetes has increased sharply in Oman over the last decade, rising from 8.3% in 1991 to 11.6% in 2000 among adults aged 20 years and older. The World Health Organization (WHO) predicted an increase of 190% in the number of subjects living with diabetes in Oman over the next 20 years, rising from 75,000 in 2000 to 217,000 in 2025. There is a lack of awareness of the major risk factors for diabetes mellitus in the Omani population generally. As education is often the most significant predictor of knowledge regarding risk factors, complications and the prevention of diabetes, health promotion in Oman is deemed critical, along with other prevention and control measures. Suitable prevention strategies for reducing the prevalence of diabetes in Oman are discussed. Recommendations are made for reforms in the current health care system; otherwise, diabetes will constitute a major drain on Oman's human and financial resources, threatening the advances in health and longevity achieved over the past decades.
As a part of the recent UPM-IMR collaborative study on the nutritional status of communities in rural villages and estates in Peninsular Malaysia from 1992-1995, this report presents findings on the haemoglobin levels and the prevalence of anaemia amongst these rural dwellers. A total of 69 villages and 7 estates located in 9 states in Peninsular Malaysia were studied. Results of the study on the 5 communities (total n=8024), namely fishing, padi, rubber, coconut and estate communities, are presented according to five age groups, namely less than 7 years (n=1418), 7-12.9 years (n=1778), 13-17.9 years (n=701), 18-59.9 years (n=3241) and 60 years (n=886). The extent of the anaemia problem varied considerably amongst the various age groups and community types. The prevalence of anaemia and mean Hb level (g/dl) for subjects of both sexes were respectively 24% and 12.1 for those < 7 years; 21.9% and 13.0 for the 7-12.9 years old; 17.8% and 13.7 for the 13-17.9 years; 21.0% and 13.8 for 18-59.9 years; and 22.7% and 13.6 for those 60 years of age and above. While the female adults (18-59.9 years) had a significantly higher prevalence rate for anaemia of 25% compared to 14% found in the male adults, no significant difference in the prevalence rates were found between the sexes for the other age groups. The problem was most serious among adult women, young children and the elderly. Amongst the various community types, the fishing community had the highest prevalence of anaemia at an overall rate of 50%, taking into consideration both sexes and all age groups. The rubber smallholders, in contrast, had the lowest prevalence of anaemia, at an overall rate of about 10%. Intervention and preventive health programmes should therefore be continued to be focussed on the above groups of rural subjects, particularly those in the fishing community.