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  1. Vaidehi U, Shashikala S, Mirnalini K
    J Nutr Sci Vitaminol (Tokyo), 2020;66(Supplement):S256-S261.
    PMID: 33612607 DOI: 10.3177/jnsv.66.S256
    Dietary habits and choice of food influences nutritional status of adolescence. Malnutrition have been associated with adolescents' dietary habits that may predispose to chronic disease during their adulthood. The aim of this study is to determine the association between food habit and nutritional status of adolescents. In the baseline study, a total of 924 students from 10 secondary schools were randomly selected from a total of 62 secondary schools in Kuala Lumpur. The students were assessed on various dietary components including food habits using a structured questionnaire as well as for anthropometry measurements. All data were analyzed using SPSS 23. The prevalence of obesity was significantly higher among males compared to females (16.4% vs. 8.4%, X2=25.42, p<0.001). Food habit exhibits an inversed association with z-score of body mass index for age (β=-0.107, 95% CI=-0.053, -0.013), especially via food habits such as often eat dinner (r=-0.102, p=0.002), often have breakfast before school (r=-0.100, p=0.002), often eat cake or dessert at meal (r=-0.110, p=0.001), often drink eight glasses of water (r=0.132, p<0.001), often eat food from school canteen (r=-0.071, p=0.031) and often bring own snack from home (r=-0.112, p=0.001). This study suggested that the type of food and timing of meal should be considered to prevent obesity among adolescents.
  2. Ang YK, Mirnalini K, Zalilah MS
    Malays J Nutr, 2013 Apr;19(1):37-51.
    PMID: 24800383 MyJurnal
    Introduction: The use of email and website as channels for workplace health
    information delivery is not fully explored. This study aims to describe the
    rationale, design, and baseline findings of an email-linked website intervention
    to improve modifiable cancer risk factors. Methods: Employees of a Malaysian
    public university were recruited by systematic random sampling and randomised
    into an intervention (n=174) or control group (n=165). A website was developed
    for the intervention and educational modules were uploaded onto the website.
    The intervention group received ten consecutive weekly emails with hypertext
    links to the website for downloading the modules and two individual phone
    calls as motivational support whilst the control group received none. Diet,
    lifestyle, anthropometric measurements, psychosocial factors and stages of change
    related to dietary fat, fruit and vegetable intake, and physical activity were
    assessed. Results: Participants were predominantly female and in non-academic
    positions. Obesity was prevalent in 15% and 37% were at risk of co-morbidities.
    Mean intake of fats was 31%, fruit was ~1 serving/day and vegetable was <1
    serving/day. Less than 20% smoked and drank alcohol and about 40% were
    physically inactive. The majority of the participants fell into the Preparation
    stage for decreasing fat intake, eating more fruit and vegetables, and increasing
    physical activity. Self-efficacy and perceived benefits were lowest among participants in the Precontemplation/Contemplation stage compared to the Preparation
    and Action/Maintenance stages. Conclusion: Baseline data show that dietary and
    lifestyle practices among the employees did not meet the international guidelines
    for cancer prevention. Hence the findings warrant the intervention planned.
    Keywords: Cancer, risk factors, email, website, worksite
  3. Zalilah MS, Mirnalini K, Khor GL, Merlin A, Bahaman AS, Norimah K
    Med J Malaysia, 2006 Mar;61(1):48-58.
    PMID: 16708734 MyJurnal
    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.
  4. Zalilah MS, Khor GL, Mirnalini K, Norimah AK, Ang M
    Singapore Med J, 2006 Jun;47(6):491-8.
    PMID: 16752017
    INTRODUCTION: Paediatric obesity is a public health concern worldwide as it can track into adulthood and increase the risk of adult morbidity and mortality. While the aetiology of obesity is multi-factorial, the roles of diet and physical activity are controversial. Thus, the purpose of this study was to report on the differences in energy intake, diet composition, time spent doing physical activity and energy expenditure among underweight (UW), normal weight (NW) and at-risk of overweight (OW) Malaysian adolescents (317 females and 301 males) aged 11-15 years.
    METHODS: This was a cross-sectional study with 6,555 adolescents measured for weights and heights for body mass index (BMI) categorisation. A total of 618 subjects were randomly selected from each BMI category according to gender. The subjects' dietary intake and physical activity were assessed using self-reported three-day food and activity records, respectively. Dietary intake components included total energy and macronutrient intakes. Energy expenditure was calculated as a sum of energy expended for basal metabolic rate and physical activity. Time spent (in minutes) in low, medium and high intensity activities was also calculated.
    RESULTS: The OW adolescents had the highest crude energy intake and energy expenditure. However, after adjusting for body weight, the OW subjects had the lowest energy intake and energy expenditure (p-value is less than 0.001). The study groups did not differ significantly in time spent for low, medium and high intensity activities. Macronutrient intakes differed significantly only among the girls where the OW group had the highest intakes compared to UW and NW groups (p-value is less than 0.05). All study groups had greater than 30 percent and less than 55 percent of energy intake from fat and carbohydrate, respectively.
    CONCLUSION: The data suggested that a combination of low energy expenditure adjusted for body weight and high dietary fat intake may be associated with overweight and obesity among adolescents. To prevent overweight and obesity among children and adolescents, strategies that address eating behaviours and physical activity are required. Various segments of the society must be involved in efforts to promote healthful dietary intakes and active lifestyle in children and adolescents.
  5. Mirnalini K, Zalilah MS, Safiah MY, Tahir A, Siti Haslinda MD, Siti Rohana D, et al.
    Malays J Nutr, 2008 Mar;14(1):1-24.
    PMID: 22691761 MyJurnal
    Nutrition surveys based on a representative sample of the Malaysian adult population have hitherto not been reported. In 2003, the Ministry of Health, Malaysia, conducted the Malaysian Adult Nutrition Survey (MANS), the first and largest nutrition survey in the country which aimed to provide detailed quantitative information on nutritional status, food and nutrient intakes, and physical activity pattern on a nationwide representative sample of adult subjects between the ages of 18 and 59 years. The survey covered four zones in Peninsular Malaysia (Central, Southern, Northern and East Coast), Sabah and Sarawak. This paper presents the mean and selected percentiles of energy and nutrient intake of 6886 subjects by selected demographic and socioeconomic characteristics. Energy contributions by macronutrients and dietary adequacy in relation to the Recommended Nutrient Intake for Malaysians are also described. Information on dietary intake was collected by trained nutritionists using a one day 24-hour diet recall. Dietary data were analysed using Nutritionist Pro, a diet analysis software and statistical analysis was carried out using the SPSS ver. 13.0. In most of the demographic and socioeconomic groups, males had higher mean energy (1776 kcal) and nutrient intake and percent achievement of RNI than females (1447 kcal). The proportions of calories derived from macronutrients were within the recommendations for a healthy diet. Intake of micronutrients such as iron, calcium and vitamin A was about 50% of RNI particularly in women. Sodium intake of Malaysians, not reported in earlier studies, is also made available. Under-reporting using the EI/BMR ratio was found in half of the population studied. The present study provides the first national estimates of energy and nutrient intake of the Malaysian adult population. Regular nutrition surveys are needed at the national level to provide valuable information on trends in food and nutrient intake, particularly among age and ethnically diverse subgroups of the population.
    Study name: Malaysian Adult Nutrition Survey (MANS-2003)
  6. Zalilah MS, Mirnalini K, Safiah MY, Tahir A, Siti Haslinda MD, Siti Rohana D, et al.
    Malays J Nutr, 2008 Mar;14(1):41-55.
    PMID: 22691763 MyJurnal
    Meal and snack patterns are associated with energy and nutrient intakes and consequently health and nutritional status. The aim of this paper is to describe the percentage of daily energy intake from meals and afternoon snack among Malaysian adults. The study included a representative sample of adults aged 18-59 years (n=7349) from a nationwide Food Consumption Survey conducted by the Ministry of Health. Information on dietary intake was obtained using a one day 24-hour diet recall (24-HDR). Dietary data on 6886 adults were analysed using Nutritionist ProTM and statistical analysis was carried out using the SPSS 13.0. The median percentage of daily energy intake is reported only for adults consuming meals and afternoon tea and by socio-demographic characteristics as well as body mass index (BMI) status. More than 80% of Malaysian adults consumed morning meals, lunch and dinner and 54% reported having afternoon tea. The median percentage of energy intake from morning meals, lunch, dinner and afternoon tea was 29.9%, 30.5%, 32.4% and 17%, respectively. There were variations in the median percentage of energy from meals and snacks according to the socio-demographic variables and BMI status. It is important to understand the eating patterns of Malaysians as the information can assist in efforts to address obesity and diet-related chronic diseases among adults.
    Study name: Malaysian Adults Nutrition Survey (MANS-2003)
  7. Wan Abdul Manan WM, Nur Firdaus I, Safiah MY, Siti Haslinda MD, Poh BK, Norimah AK, et al.
    Malays J Nutr, 2012 Aug;18(2):221-30.
    PMID: 24575668 MyJurnal
    INTRODUCTION: Meal patterns have received little attention in nutrition studies. The aim of this study is to present the findings on general meal patterns of Malaysian adults.
    METHODS: The Malaysian Adults Nutrition Survey (MANS), carried out in 2002 and 2003, involved 6,928 adults selected by stratified random sampling from all households by zone in Peninsular Malaysia, Sabah and Sarawak.
    RESULTS: In general, the results showed that most respondents (74.16%) ate three meals per day; 89.20% of the respondents consumed breakfast, while 88.57% consumed lunch and 91.97% consumed dinner with no significant difference in terms of sex. In Peninsular Malaysia, the Northern Zone had the highest number of people consuming breakfast compared to other zones. Meanwhile, the population in Sarawak had the largest proportion of people consuming lunch and dinner, but the smallest proportion of people consuming breakfast. A significantly higher number of the rural population consumed breakfast and lunch than urbanites; however there was no significant difference in dinner consumption. Generally, breakfast consumption increased with age whereby significant difference existed between the 18 to 19 years age group and the age group of 30 years and older. Lunch intake among the age groups showed no significant difference. In contrast, dinner consumption was significantly lower among the 18 to 19 years age group compared to all other age groups. Comparison among the ethnic groups showed that the Indian population had the lowest percentage of having breakfast and lunch while the Orang Asli had the lowest percentage of consuming dinner. However, the Orang Asli recorded the highest percentage for taking breakfast and lunch while the Chinese had the highest percentage of taking dinner.
    CONCLUSION: Considering that Malaysian adults consumed their conventional breakfast, lunch and dinner, these findings indicatethat Malaysians are maintaining their traditional meal patterns.
    Study name: Malaysian Adult Nutrition Survey (MANS-2003)
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