Methods: A multi-centred matched case control study was conducted in five local hospitals. A total of 140 histologically confirmed CRC cases were matched with 280 cancer free controls. Mean value and prevalence of the components of metabolic syndrome between cases and controls were measured based on the three definitions. A multiple variable analysis using Cox regression was conducted to measure the strength of the association between the definitions of MetS, components of MetS and risk of CRC.
Results: Multiple variable analyses showed that metabolic syndrome significantly and independently increased the risk of CRC, with an odds ratio ranging from 1.79 to 2.61. This study identified that the definition of metabolic syndrome by the International Diabetes Federation is the most sensitive in predicting the risk of CRC, compared to metabolic syndrome as defined by the World Health Organization and National Cholesterol Education Program Adults Treatment Panel III. Abdominal obesity, low HDL-cholesterol, and hypertension were identified as the three core risk factors, which promote inflammatory signals that contribute to metabolic syndrome and an increased risk of CRC.
Conclusions: These data hypothesized that simple measurement of abdominal obesity, abnormal BP and HDL-cholesterol especially using International Diabetes Federation (IDF) definition of MetS for South Asians for to detect individuals at CRC risk may have higher clinical utility than applying other universal complex MetS definitions.
SUBJECTS/METHODS: This cross-sectional study was conducted among 348 public university staff in Universiti Putra Malaysia. A pre-tested self-administered questionnaire and two days 24-hour diet recall were used.
RESULTS: Half of the respondents (50%) were in preparation stage, followed by 43% in action/maintenance, 7% in pre-contemplation/contemplation stages. Respondents in action/maintenance stages had significantly higher self-efficacy (F = 9.17, P < 0.001) and perceived benefits (F = 5.07, P < 0.01) while respondents in pre-contemplation/contemplation and preparation stages had significantly higher perceived barriers (F = 4.83, P < 0.05). Perceived benefits tend to outweigh perceived barriers pre-ceding to taking action. Self-efficacy is important in motivating individuals to increase fruit and vegetable intake as self-efficacy and perceived barriers crossed over between preparation and action/maintenance. Respondents in action/maintenance stages had the highest adjusted mean serving of fruit and vegetable intake (F = 4.52, P < 0.05) but the intake did not meet recommendation.
CONCLUSION: Intervention strategies should emphasize on increasing perceived benefits and building self-efficacy by providing knowledge and skills to consume a diet high in fruits and vegetables in order to promote healthy changes in having high fruit and vegetable intake.
METHODS: All measures were taken at three time points: before intervention (Pre), after intervention (Post I) and 3 months after intervention (Post II). The intervention group (IG) participated in the EPaL programme for 16 weeks, whereas the comparison group (CG) received no intervention. Seventy-six adolescents (IG: n = 34; CG: n = 42) aged 13-14 years were included in the final analysis. Repeated measures analysis of covariance (ANCOVA) was used to assess the impact of the EPaL intervention programme on the measures between groups (IG and CG) at Post I and Post II.
RESULTS: The IG reported significantly higher knowledge scores at both Post I (adjusted mean difference = 3.34; 95% confidence interval [CI] = 0.99, 5.69; p = 0.006) and Post II (adjusted mean difference = 2.82; 95% CI = 0.86, 4.78; p = 0.005) compared with the CG. No significant differences between the IG and CG were found at either Post I or Post II in attitudes, practices, zBMI, WC and BF%. The proportion of participants who were overweight or obese was consistent from Pre to Post II in the IG (35.3%) and increased from 26.2% at Pre to 28.5% at Post II in the CG, but the difference was not statistically significant. The proportion of participants who had abdominal obesity in the IG decreased from 17.6% at Pre to 14.7% at Post II and increased from 16.7% at Pre to 21.4% at Post II in the CG, but the differences were not statistically significant.
CONCLUSION: Despite no significant reduction of body composition, this programme shows the positive effect on the adolescents' knowledge regarding healthy lifestyle. This study contributes to the evidence on the effectiveness of school-based health interventions in Malaysian adolescents.
TRIAL REGISTRATION: UMIN Clinical Trial Registration UMIN000024349. Registered 11 October 2016.
AIMS: This cross-sectional study aims to determine the association between sociodemographic factors, parental factors, and lifestyle factors with autism severity in children with ASD.
METHODS AND PROCEDURES: A total of 224 children with ASD were included in this study. Their mothers completed a self-administered questionnaire on sociodemographic characteristics, autism severity, parenting style, parental feeding practices, parenting stress, child's sleep habits and eating behaviours.
OUTCOMES AND RESULTS: As high as 78.1 % of the children with ASD demonstrated a high level of autism severity. Multiple linear regression showed that father's employment status (B = 6.970, 95 % CI = 3.172, 10.768, p
OBJECTIVE: This study aimed to determine the parental barrier toward the reduction of excessive child screen time and its predictors among parents of children aged younger than 5 years in the Petaling District, Selangor, Malaysia.
METHODS: A cross-sectional study was conducted from April 2019 to June 2020 among 789 parent-child dyads attending child health clinics in the Petaling District. Validated self-administered questionnaires were used to capture information on sociodemographic, parental, child-related, and environmental factors and parental barriers. Stratified sampling with probability proportionate to size was employed. Data were analyzed using SPSS Statistics version 25 (IBM Corp). Descriptive analysis and bivariable analysis were performed before multiple linear regression was used to identify predictors of parental barriers.
RESULTS: The overall mean score of parental barriers was 3.51 (SD 0.83), indicating that the average numbers of barriers experienced by parents were more than 3. The multivariable analysis showed that the predictors of parental barriers included monthly household income (adjusted β=-.03, 95% CI -0.05 to -0.02), parents who worked in public sectors (adjusted β=.18, 95% CI 0.06 to 0.29), positive parental attitude on screens (adjusted β=.68, 95% CI 0.58 to 0.79), low parent self-efficacy to influence child's physical activity (adjusted β=-.32, 95% CI -0.43 to -0.20), and child screen time (adjusted β=.04, 95% CI 0.02 to 0.06).
CONCLUSIONS: The strongest predictor of parental barriers to reduce excessive child screen time was the positive parental attitude on screen time which could contribute to their abilities to limit child screen time. Thus, future intervention strategies should aim to foster correct parental attitudes toward screen time activities among young children.
METHODS: This cross-sectional study was conducted among 555 (164 men, 391 women) Orang Asli adults aged 18-65 years of Jah Hut sub-tribe in Krau Wildlife Reserve (KWR), Peninsular Malaysia. Demographic and socio-economic information were obtained using interviewer-administered questionnaire. Participants were also assessed for serum 25-hydroxyvitamin D (25(OH)D) concentration, adiposity indices (BMI, WC, WHtR, WHR, %BF) and lipid parameters (TC, LDL-C, HDL-C, TG). Data were analyzed using binary logistic regression via SPSS.
RESULTS: The prevalence of suboptimal 25(OH)D concentration was 26.3%, comprising 24.9% insufficiency (50 to <75 nmol/L) and 1.4% deficiency (<50 nmol/L). While men (14-30.5%) were associated with a more proatherogenic lipid profile than women (6.1-14.3%), more women were with central obesity (M: 19.5-46.3%; F: 34.5-49.1%) and suboptimal (<75 nmol/L) vitamin D status (M: 11.6%; F: 32.4%). While suboptimal 25(OH)D concentration was significantly associated with higher odds of at-risk LDL-C (p < 0.01) and obesity (WC, WHtR) (p < 0.05) in men, no significant association was observed for women. Nonetheless, it should be noted that there were only 19 men with suboptimal (<75 nmol/L) vitamin D status.
CONCLUSIONS: While suboptimal vitamin D status was relatively low in Orang Asli adults, the prevalence of obesity and undesirable serum lipids were relatively high. The sex-specific associations between vitamin D status with adiposity indices and serum lipids warrant further investigation.
METHODS: A total of 50 obese children (7-11 years old) were randomized to the intervention group (IG, n = 25) or the control group (CG, n = 25). Data were collected at baseline, at follow-up (every month) and at six months after the end of the intervention. IG received stage-based lifestyle modification intervention based on the Nutrition Practice Guideline for the Management of Childhood Obesity, while CG received standard treatment. Changes in body composition, physical activity and dietary intake were examined in both the intervention and control groups.
RESULTS: Both groups had significant increases in weight (IG: 1.5 ± 0.5 kg; CG: 3.9 ± 0.6 kg) (p z scores decreased significantly in IG (- 0.2 ± 0.0, p
AIMS: To determine the influence of linear growth and home environment towards cognitive development in the first year of life of Malaysian infants.
STUDY DESIGN: Cross-sectional findings at 12-13 months from a prospective cohort study of infants in Malaysia.
SUBJECTS: One hundred fifty-one infants recruited at 2-5 months were visited at home at 12-13 months (M = 12.95, SD = 0.98).
OUTCOME MEASURES: Maternal and infant measures during pregnancy and at birth were obtained from patient health clinic cards. Weight and length of infants were measured at 12-13 months. Home environment and cognitive development were assessed using HOME inventory and Bayley-III, respectively.
RESULTS: About 22.5% of infants experienced stunting and 14.6% had low home environment quality. The mean cognitive score was 94.54 (SD = 12.00). Stunted infants had 7.59 lower cognitive scores than non-stunted infants, while infants with low home environment quality had 12.09 lower cognitive scores than those with high home environment quality. Cognitive scores increased with better home environment quality in both stunted and non-stunted infants, but stunted infants scored lower than non-stunted infants in all conditions.
CONCLUSION: Stunting, a form of chronic undernutrition, and poor home environment may significantly influence cognitive development of infants. Interventions to prevent undernutrition should start as early as during pregnancy and caregivers should be informed on their roles in providing cognitive stimulation within the home environment for their children.
METHODS: The respondents had their body weight, height, waist circumference and body fat percentage measured, as well as interviewed for their socio-demographic characteristics, sun exposure and dietary intake. Fasting blood samples were obtained from the respondents to measure their serum 25-hydroxyvitamin D [25(OH)D] concentration.
RESULTS: There were 82.7% (95% CI: 77.6%, 87.8%) of the respondents that had serum vitamin D insufficiency (< 50 nmol/L) with an average of 37.4 ± 14.3nmol/L. In stepwise multiple linear regression, high percentage of body fat (ß = -0.211, p <0.01) and low consumption of milk and dairy products (ß = 0.135, p <0.05) were the main contributors towards insufficient serum vitamin D levels, but not socio-demographic characteristics, other anthropometric indices, sun exposure and diet quality.
CONCLUSION: Older women with high body fat percentage and low dairy product consumption were more likely to have serum vitamin D insufficiency. Older women should ensure their body fat percentage is within a healthy range and consume more milk and dairy products in preventing serum vitamin D insufficiency.
MATERIALS AND METHODS: This randomized, double-blind, placebo controlled, and parallel design trial will be carried out in a public university teaching hospitals in Malaysia. Eligible type 2 diabetes mellitus subjects will be randomly assigned to receive either acupuncture (n = 30) or a placebo (n = 30). The intervention is carried out using press needle or press placebo on abdomen area (10 sessions of treatment). Both groups will continue with their routine diabetes care. Primary outcome of HOMA-IR will be measured at the time of recruitment (-week 0), and after completion of 10 sessions (week 7) of the treatment. Additionally, secondary outcome of HRQoL will be measured at the time of recruitment (-week 0), after completion of 5 sessions (week 3/4), and 10 sessions (week 7) of the treatment. Any adverse event will be recorded at every visit.
DISCUSSION: The findings of this study will provide important clinical evidence for the effect of acupuncture as adjunctive therapy on HOMA-IR, adiposity and HRQoL of type 2 diabetes mellitus.
TRIAL REGISTRATION NUMBER: NCT04829045.
DESIGN: A qualitative study involving twelve focus groups.
SETTING: Two secondary schools in the district of Hulu Langat in Selangor, Malaysia.
PARTICIPANTS: Seventy-two adolescents aged 13-14 years.
RESULTS: Adolescents had some understanding regarding healthy eating and were able to relate healthy eating with the concepts of balance and moderation. The adolescents' perceptions of healthy and unhealthy eating were based on food types and characteristics, cooking methods and eating behaviours. Facilitators for healthy eating were parents' control on adolescents' food choices, feeling concern about own health and body, being influenced by other's health condition, and knowledge of healthy or unhealthy eating. On the other hand, barriers for healthy eating were the availability of food at home and school, taste and characteristics of foods, and lack of knowledge on healthy or unhealthy foods.
CONCLUSIONS: The findings contribute to a better understanding of the adolescents' concept of healthy eating, as well as the facilitators and barriers to practising healthy eating. Future interventions should include a method of promoting the immediate benefits of healthy eating, the way to cope with environmental barriers for healthy eating, and increasing the availability of healthy food choices at home and in the school environment. The health and nutrition education programmes should also focus on educating parents, as they can be role models for adolescents to practise more healthful behaviours.