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Fulltext Physical activity, eating behaviour and body image perception among young adolescents in Kuantan, Pahang, Malaysia

Farah Wahida Z, Mohd Nasir MT, Hazizi AS

Malays J Nutr, 2011 Dec;17(3):325-36.
PMID: 22655454 MyJurnal

A cross-sectional study was conducted to determine physical activity, eating behaviour, body weight management knowledge, perception of body image and their association with body weight status of adolescents.
Fulltext Body image perception, dietary practices and physical activity of overweight and normal weight Malaysian female adolescents

Pon LW, Kandiah M, Mohd Nasir MT

Malays J Nutr, 2004 Sep;10(2):131-47.
PMID: 22691735 MyJurnal

Body image plays an important role in the management of body weight, especially among female adolescents. This study examined the differences in body image perception, weight management knowledge, eating behaviour and physical activity between overweight and normal weight Malaysian female adolescents. Body mass index screening was done on 588 secondary school students to identify overweight (OW) and normal weight (NW) subjects. A BMI-for-age of => 85th percentile and between => 5th and <85th percentile were used as cut-offs for identifying suitable subjects of overweight and normal weight, respectively. Fifty girls identified as being OW were matched for age and ethnicity with 50 NW students. Subjects completed a self-administered questionnaire on demographics, eating behaviour and physical activity, a weight management knowledge inventory (WMKI) and the Body Silhouette Chart. The study sample comprised Malays (40%), Chinese (30%) and Indians (30%) with a mean age of 14.76 ± 1.15 years. The majority of them were from families with a monthly household income of less than RM1,000. Significantly more NW subjects (χ2=6.112, p=0.013) than OW subjects had incorrect perception of their current body weight status. The WMKI revealed that more OW subjects (64%) than NW subjects (52%) had a low level of weight management knowledge. Eating behaviour patterns were not significantly different between OW and NW subjects, but more OW subjects skipped one or more daily meals as compared to their NW counterparts (χ2=0.174, p=0.010). Physical activity patterns were similar in both groups. Healthy eating and physical activity promotion programmes in schools should include sound weight management practices.
Questionnaire: Figure Rating Scale of Stunkard; Weight Management Knowledge Inventory (WMKI)
Association between behavioural factors and BMI-for-age among early adolescents in Hulu Langat district, Selangor, Malaysia

Woon FC, Chin YS, Mohd Nasir MT

Obes Res Clin Pract, 2015 Jul-Aug;9(4):346-56.
PMID: 25476772 DOI: 10.1016/j.orcp.2014.10.218

This paper investigates the association between behavioural factors and BMI-for-age among early adolescents (10-11 years old) in Hulu Langat district, Selangor.
Disordered eating and its association with overweight and health-related quality of life among adolescents in selected high schools of Tehran

Jalali-Farahani S, Chin YS, Mohd Nasir MT, Amiri P

Child Psychiatry Hum Dev, 2015 Jun;46(3):485-92.
PMID: 25173517 DOI: 10.1007/s10578-014-0489-8

This study aimed to determine the association between disordered eating and overweight and also health-related quality of life (HRQOL) among adolescents in high schools of Tehran. The participants were 465 adolescents, aged 14-17 years. After anthropometric measurements, body mass index-for-age and body weight status were determined using World Health Organization cut offs. The Eating Attitudes Test-26 (EAT-26) and Pediatric Quality of Life Inventory (PedsQL™4.0) were used to assess disordered eating and HRQOL, respectively. Disordered eating was prevalent in 18.9% of adolescents, with higher prevalence in girls (26.4%) compared to boys (11.8%; χ(2):16.29, p < 0.05). Disordered eating was associated with overweight in girls (χ(2) = 11.07, p < 0.05), but not in boys (χ(2) = 2.01, p = 0.16). Disordered eating was associated with poor HRQOL especially in psychosocial domains of HRQOL. Considering the high prevalence of disordered eating and its association with overweight and poor HRQOL, preventive interventions targeting adolescents are recommended.
Psychological distress as a mediator in the relationships between biopsychosocial factors and disordered eating among Malaysian university students

Gan WY, Mohd Nasir MT, Zalilah MS, Hazizi AS

Appetite, 2012 Dec;59(3):679-87.
PMID: 22885453 DOI: 10.1016/j.appet.2012.08.002

The mechanism linking biopsychosocial factors to disordered eating among university students is not well understood especially among Malaysians. This study aimed to examine the mediating role of psychological distress in the relationships between biopsychosocial factors and disordered eating among Malaysian university students. A self-administered questionnaire measured self-esteem, body image, social pressures to be thin, weight-related teasing, psychological distress, and disordered eating in 584 university students (59.4% females and 40.6% males). Body weight and height were measured. Structural equation modeling analysis revealed that the partial mediation model provided good fit to the data. Specifically, the relationships between self-esteem and weight-related teasing with disordered eating were mediated by psychological distress. In contrast, only direct relationships between body weight status, body image, and social pressures to be thin with disordered eating were found and were not mediated by psychological distress. Furthermore, multigroup analyses indicated that the model was equivalent for both genders but not for ethnic groups. There was a negative relationship between body weight status and psychological distress for Chinese students, whereas this was not the case among Malay students. Intervention and prevention programs on psychological distress may be beneficial in reducing disordered eating among Malaysian university students.
Direct and indirect effects of sociocultural influences on disordered eating among Malaysian male and female university students. A mediation analysis of psychological distress

Gan WY, Mohd Nasir MT, Zalilah MS, Hazizi AS

Appetite, 2011 Jun;56(3):778-83.
PMID: 21435366 DOI: 10.1016/j.appet.2011.03.005

This study aimed to examine the role of psychological distress in the relationships between sociocultural influences (social pressure to be thin and weight teasing) and disordered eating. Data were collected from 584 university students (59.4% females and 40.6% males), aged 18-24 years old (M=20.6, SD=1.4), selected from four universities in the Klang Valley, Malaysia. Participants completed four standardized questionnaires which measured social pressure to be thin, weight-related teasing, psychological distress and disordered eating. A good fit structural equation modeling (SEM) model was developed for both sexes. For males, the SEM model revealed that sociocultural influences showed an indirect effect on disordered eating through psychological distress. For females, the model showed an indirect effect of sociocultural influences on disordered eating through psychological distress, as well as a direct effect of sociocultural influences on disordered eating. In conclusion, psychological distress mediated the relationships between sociocultural influences and disordered eating in both males and females. Our results suggest that disordered eating intervention programs on reducing psychological distress in university students may be beneficial.
Fulltext The prevalence of MTHFR 677C-->T missense mutation, total plasma homocysteine levels and associated risk factors in Malay subjects

Ling KH, Rosli R, Duraisamy G, Mohd Nasir MT

Med J Malaysia, 2003 Jun;58(2):243-54.
PMID: 14569745

The missense mutation of the methylenetetrahydrofolate reductase (MTHFR) gene 677C-->T is associated with modest elevation of homocysteine levels. The bio-ecogenetics factors of total homocysteine levels (tHcy) were investigated in a cross sectional study involving 53 randomly selected healthy Malay subjects. Results indicated that the prevalence of the homozygous 677T/T was 3.8% and heterozygous 677C/T was 17.0%. The levels of tHcy was higher in subjects aged more than 50 years (n = 7, 11.53 +/- 4.45 mumol/l) and in males (10.99 +/- 3.77 mumol/l) especially smoking males (12.19 +/- 3.62 mumol/l). THcy levels were low in the 3 pregnant subjects (4.44 mumol/l, p = 0.036) who were under folate supplementation.
Fulltext Factors associated with breakfast skipping among schoolgoing adolescents in Sarawak, Malaysia

Law LS, Mohd Nasir MT, Hazizi AS

Malays J Nutr, 2013;19(3):401-407.
MyJurnal

Introduction: Breakfast skipping is an unhealthy eating behaviour reportedly common among adolescents. A cross-sectional study was carried out to determine the differences in body weight status, socio-demographic, behavioural, and psychological characteristics between daily breakfast takers and breakfast skippers.
Methods: Data were collected from form four students of four randomly selected secondary schools in Sibu, Sarawak using a self-administered questionnaire. Body weight and height were measured using standard procedures and BMI-for-age z-scores were determined.
Results: A total of 375 students were recruited (male: 32.0%, female: 68.0%; Chinese: 39.5%, Than: 26.4%, Malay: 17.1% and Melanau: 17.1 %; mean age = 16.45 ± 0.53 years). The prevalence rate of breakfast skippers at 40.3% was higher compared to the national prevalence of 32.7%. About 19.7% of the students were found to be at risk of eating disorders. In addition, the prevalence rates of overweight and obesity were 10.9% and 7.7%, respectively. Significant associations were found between breakfast skipping with sex, lunch skipping, dinner skipping, eating attitudes, and body weight status. Binary logistic regression analysis showed that female students and those who skipped lunch or dinner were more likely to skip breakfast.
Conclusion: Breakfast skipping was quite common in this sample of adolescents in Sarawak. As frequent breakfast skipping has negative health and academic performance implications, increased nutrition education and health awareness campaigns on the importance of breakfast taking among school students should be undertaken.
Fulltext Sex and ethnic differentials in physical activity levels of adolescents in kuantan

Dan SP, Mohd Nasir MT, Zalilah MS

Malays J Nutr, 2007 Sep;13(2):109-20.
PMID: 22691749 MyJurnal

A cross-sectional study was conducted to determine the physical activity levels of 400 adolescents (13 years old) in Kuantan, Pahang using the Physical Activity Questionnaire for Older Children (PAQ-C). The associations of physical activity levels with sex, ethnicity and body mass index were also determined. About one third (35.3%) of the adolescents were in the low physical activity level category, 61.5% in the moderate physical activity level and only 3.0% of the adolescents were in the high physical activity level category. More males (77.9%) were physically active than females (54.9%). Twice as many female adolescents (45.1%) were in the low physical activity level category compared to the male adolescents (22.1%). The associations between physical activity with ethnicity and body mass index were not significant. However, there was a significant interaction effect of sex and ethnicity in mean physical activity score (F = 2.36, p<0.01). Malay males had a significantly higher mean physical activity score as compared to Chinese males (t=2.13; p<0.05). Although Chinese females had a higher mean physical activity score than Malay females, the difference was not statistically significant. Conversely, there was no interaction effect of sex and BMI status in mean physical activity score. This study suggests that physical activity intervention to promote regular physical activity is needed since a high proportion of the adolescents fall within the low physical activity level category.
Fulltext A Qualitative Study on Coping Strategies among Women from Food Insecurity Households in Selangor and Negeri Sembilan

Norhasmah S, Zalilah MS, Mohd Nasir MT, Kandiah M, Asnarulkhadi AS

Malays J Nutr, 2010 Apr;16(1):39-54.
PMID: 22691852 MyJurnal

Understanding the experiences of household food insecurity is essential for better measurement and assessment of its nutritional, physical and psychological consequences. This qualitative study explored coping strategies and their perceived severity in relation to household food insecurity. Women (n=57; 20-50 years old) from rural and urban areas in Selangor and Negeri Sembilan participated in this study. These women were interviewed using a semi-structured questionnaire. The questionnaire was divided into two parts, that is, demographic and socio-economic information and women's experiences of coping with household food insecurity. Women were chosen since they were primarily responsible for food acquisition and preparation for the all household members. Thematic analysis was utilized in data analysis. Thematic analysis is a method for identifying, analysing and reporting patterns and themes of the qualitative data. Themes capture something important related to the study objectives and describe an integrating as well as relational idea from the data. Results showed that households displayed a variety of non-food related coping strategies and food-related coping strategies. Women's descriptions of non-food related coping strategies to food insecurity were categorised into five themes i.e. cloth purchasing behaviors, reduce school-going children's expenditure, delay the payment of bills, adjust lifestyle and increase cash and income earning. Food related coping strategies were categorised into four themes i.e. food stretching, food rationing, food seeking and food anxiety. Food stretching is a strategy of food insecurity that affects the quality of diet. Food rationing comprises coping strategies of food insecurity related to the quantity of food available for household's consumption. Food seeking is a strategy of acquiring food through socially unacceptable ways and food anxiety is a strategy that indicates households allocating money to buy staple food in order to prevent food insecurity. Each coping strategy showed a different level of perceived severity, that is, less severe, quite severe, severe and very severe. In conclusion, the qualitative data provide valuable information for understanding the experiences of food insecurity that can be used as a basis to develop direct indicators that can capture the core behaviours and their level of severity to measure household food insecurity.
Fulltext Comparison of Food Choice Motives between Malay Husbands and Wives in an Urban Community

Asma A, Nawalyah AG, Rokiah MY, Mohd Nasir MT

Malays J Nutr, 2010 Apr;16(1):69-81.
PMID: 22691854 MyJurnal

The main objective of this study was to determine the motives underlying the selection of foods between husbands and wives in an urban community. Thiscross-sectional study was carried out in Bandar Baru Bangi, Selangor, Malaysia among 150 married couples aged 20 and above, who voluntarily agreed to participate and were not on any special diet. Data were collected using the Food Choice Questionnaire (FCQ) which measured the health-related and non health related factor that influence people's food choices. It consisted of 36 items designed to assess the reported importance of nine factors: health, mood, convenience, sensory appeal, natural content, price, weight control, familiarity, and ethical concern. In this study, the FCQ was adapted and a new factor, religion (religious guidelines), was included. Demographic characteristics including age, occupation, education, household income and household size were also collected. Data were analysed using SPSS version 16. Results showed that 40.7% of husbands (mean age= 43.33 + 11.16 years) and 55.3% of wives (mean age= 41.28 + 10.93 years) perceived themselves as the main food shopper while 12.0% of the husbands and 85.3% of the wives perceived themselves as the main meal planner. Husbands rated religion as the most prominent factor in food choice motives with a mean average rating of 4.56 + 0.59 on a 5-point rating scale, followed by health and convenience factor. Meanwhile, the wives rated health as the most essential factor with mean average rating of 4.49 + 0.58, followed by religion and convenience factor. Sensory appeal, ethical concerns and familiarity were rated as the bottom three factors of food choice motives among these two groups. Price of foods was not considered as an important factor in making food choices for the subjects in this study. In conclusion, the husbands and wives of this urban community rated religion, health and convenience as the three most important food choice motives in food selection.
Fulltext Socio-demographic and psychosocial factors associated with physical activity of working woman in Petaling Jaya, Malaysia

Siti Affira K, Mohd Nasir MT, Hazizi AS, Kandiah M

Malays J Nutr, 2011 Dec;17(3):315-24.
PMID: 22655453

This study was conducted on 215 working women from four private corporate companies in a suburb in Malaysia to determine the factors related to their physical activity levels.
Qualitative study on identification of common coping strategies practised by Indigenous Peoples (Orang Asli) in Peninsular Malaysia during periods of food insecurity

Law LS, Norhasmah S, Gan WY, Mohd Nasir MT

Public Health Nutr, 2018 Oct;21(15):2819-2830.
PMID: 29976262 DOI: 10.1017/S136898001800160X

OBJECTIVE: To examine the types of coping strategies practised by Indigenous women or Orang Asli (OA) in Peninsular Malaysia during times of food shortage and to determine the level of severity for food insecurity that will trigger each specific coping strategy.
DESIGN: A qualitative case study was conducted. Pertinent information about each type of coping strategy was gathered by in-depth interviews. To gauge the level of severity for each of the coping strategies, focus group discussions (FGD) were held. Thematic analysis was used for data analysis.
SETTING: OA villages in the states of Kelantan, Pahang, Perak and Selangor, Malaysia.
SUBJECTS: Sixty-one OA women from three ethnic groups (Senoi, Proto-Malay and Negrito) for in-depth interviews and nineteen OA women from the Proto-Malay ethnic group for three FGD.
RESULTS: The findings identified twenty-nine different coping strategies and these were divided into two main themes: food consumption (sub-themes of food consumption included dietary changes, diversification of food sources, decreasing the number of people and rationing) and financial management (sub-themes of financial management included increasing household income, reducing expenses for schooling children and reducing expenses on daily necessities). Three levels of severity were derived: less severe, severe and very severe.
CONCLUSIONS: This information would enable local authorities or non-governmental organisations to more precisely target and plan interventions to better aid the OA communities needing assistance in the areas of food sources and financial management.
Dietary patterns and cognitive ability among 12- to 13 year-old adolescents in Selangor, Malaysia

Nurliyana AR, Mohd Nasir MT, Zalilah MS, Rohani A

Public Health Nutr, 2015 Feb;18(2):303-12.
PMID: 24507623 DOI: 10.1017/S1368980014000068

OBJECTIVE: The present study aimed to identify dietary patterns and determine the relationship between dietary patterns and cognitive ability among 12- to 13 year-old Malay adolescents in the urban areas of Gombak district in Selangor, Malaysia.
DESIGN: Data on sociodemographic background were obtained from parents. Height and weight were measured and BMI-for-age was determined. Adolescents were interviewed on their habitual dietary intakes using a semi-quantitative FFQ. Cognitive ability was assessed using the Wechsler Nonverbal Scale of Ability in a one-to-one manner. Dietary patterns were constructed using principal component analysis based on thirty-eight food groups of the semi-quantitative FFQ.
SETTING: Urban secondary public schools in the district of Gombak in Selangor, Malaysia.
SUBJECTS: Malay adolescents aged 12 to 13 years (n 416).
RESULTS: The mean general cognitive ability score was 101·8 (sd 12·4). Four major dietary patterns were identified and labelled as 'refined-grain pattern', 'snack-food pattern', 'plant-based food pattern' and 'high-energy food pattern'. These dietary patterns explained 39·1 % of the variance in the habitual dietary intakes of the adolescents. The refined-grain pattern was negatively associated with processing speed, which is a construct of general cognitive ability. The high-energy food pattern was negatively associated with general cognitive ability, perceptual reasoning and processing speed. Monthly household income and parents' educational attainment were positively associated with all of the cognitive measures. In multivariate analysis, only the high-energy food pattern was found to contribute significantly towards general cognitive ability after controlling for socio-economic status.
CONCLUSIONS: Consumption of foods in the high-energy food pattern contributed towards general cognitive ability after controlling for socio-economic status. However, the contribution was small.
Fulltext Gender differences in the attitude and strategy towards weight control among government employees in Penang, Malaysia

Aina Mardiah B, Hazizi A, Nasir MM, Zaitun Y, Jan JH

Iran J Public Health, 2012;41(1):28-36.
PMID: 23113119

Background: This was a cross-sectional study on the gender differences in weight-control behavior. The strategies used, weight status, weight satisfaction, and proportion of individuals attempting to lose weight among 233 government employees (104 men and 129 women) working in the Federal Government Building in Penang, Malaysia, were assessed.
Methods: Anthropometric indicators such as body mass index, waist-to-hip ratio, and body fat percentage were measured to determine the subjects’ body weight status. A questionnaire covering the following items was used to assess weight-control behavior: social support, self-monitoring, self-efficacy, outcome expectations, planning, preparation/buying, portion control, social interactions, and cognitive behavioral strategies.
Results: About 50% of the subjects were classified as overweight. Based on percent body fat percentage, 70% of them were classified as having unhealthy levels of body fat. Women were found to be more dissatisfied with their current weight, and were more likely to attempt weight reduction compared to men. Women reported higher levels of social support for dieting and had better expectations for diet and exercise (P < 0.05). They also reported higher use of weight control strategies. For self-monitoring, although no gender-dependent differences (P > 0.05) were observed, women reported more frequent self-monitoring of diet, whereas men reported more frequent self-monitoring of exercise.
Conclusion: Health care professionals and researchers should be aware of the different strategies used by men and women in order to plan and/or implement community-wide weight management programmes.
Keywords: Weight Control, Body Weight Status, Diet, Exercise, Gender Differences
Fulltext Associations between socio-demographic characteristics and pubertal status with disordered eating among primary school children in Selangor, Malaysia

Chong LS, Chin YS, Gan WY, Nasir MT

Asia Pac J Clin Nutr, 2017 Mar;26(2):326-333.
PMID: 28244713 DOI: 10.6133/apjcn.012016.10

BACKGROUND AND OBJECTIVES: To determine the associations between socio-demographic characteristics and pubertal status with disordered eating among primary school children.
METHODS AND STUDY DESIGN: Using a stratified multi-stage sampling, a total of 816 children (282 boys and 534 girls) aged 10 to 11 years from 12 selected primary schools in the state of Selangor, participated in this study. Data were collected on socio-demographic characteristics, pubertal status and disordered eating behaviors. The Pubertal Development Scale and the Children's Eating Attitudes Test (ChEAT) were used to assess pubertal status and disordered eating, respectively. Logistic regression analysis was conducted to determine the risk factors of disordered eating.
RESULTS: The prevalence of disordered eating was 30.8% (32.8% in boys and 29.7% in girls). However, the sex difference in the prevalence was not statistically significant. Age, ethnicity and pubertal status were significantly associated with disordered eating in univariate logistic regression analysis. Multivariate logistic regression analysis showed that among boys, being either in an advanced or post-pubertal stage (adjusted OR=8.64) and older age group (adjusted OR=2.03) were risk factors of disordered eating. However, among girls, being a Malay (adjusted OR=3.79) or Indian (adjusted OR=5.04) in an advanced or post-pubertal stage (adjusted OR=2.34) and older age group (adjusted OR=1.53) were risk factors of disordered eating.
CONCLUSION: This study found one in three children had disordered eating. Since ethnicity and pubertal status were identified as risk factors, ethnicity-specific intervention programs on the prevention of disordered eating among children should take into consideration their pubertal status.
Nutritional supplement use among fitness club participants in Tehran, Iran

Saeedi P, Mohd Nasir MT, Hazizi AS, Vafa MR, Rahimi Foroushani A

Appetite, 2013 Jan;60(1):20-26.
PMID: 23017466 DOI: 10.1016/j.appet.2012.09.011

The aim of this study was to assess nutritional supplement use among fitness club participants in Tehran, Iran. A cross sectional study was conducted in 24 fitness clubs throughout the city of Tehran, Iran. A total of 1625 fitness club participants were recruited to participate in this study. They were asked to complete a self-administered pre-tested questionnaire. Descriptive statistics and chi-square test were performed to determine the characteristics of participants, reasons for supplement use, sources of information and also the influential advisors regarding nutritional supplement use. A high prevalence rate of nutritional supplement use (66.7%) was reported. Overall, multivitamin-mineral (43.8%) and iron tablets (30.5%) were the common nutritional supplements used and only a small number of participants used illegal substances (0.5%). Younger participants were more likely to use ergogenic aids, whereas, older participants were more likely to use vitamin D. Males were more likely than females to use creatine and amino acids, whereas, iron tablets and mint water were more common among females. Also, males were more likely to use nutritional supplements for increasing energy, whereas, females were more likely to use nutritional supplements for nutritional deficiencies. In conclusion, a high prevalence rate of nutritional supplement use was seen among participants.
Child feeding practices, food habits, anthropometric indicators and cognitive performance among preschoolers in Peninsular Malaysia

Mohd Nasir MT, Norimah AK, Hazizi AS, Nurliyana AR, Loh SH, Suraya I

Appetite, 2012 Apr;58(2):525-30.
PMID: 22265752 DOI: 10.1016/j.appet.2012.01.007

This study aimed to determine the relationship between child feeding practices, food habits, and anthropometric indicators with cognitive performance of preschoolers aged 4-6 years in Peninsular Malaysia (n=1933). Parents were interviewed on socio-demographic background, nutrition knowledge, child feeding practices and food habits. Height and weight of the preschoolers were measured; BMI-for-age, weight-for-age and height-for-age were determined. Cognitive performance was assessed using Raven's Colored Progressive Matrices. The mean monthly household income was RM3610 and 59.6% of parents attained secondary education. Thirty-three percent of parents had good knowledge on nutrition, 39% satisfactory and 28% poor. For child feeding practices, perceived responsibility had the highest mean score (M=3.99, SD=0.72), while perceived child weight had the lowest (M=2.94, SD=0.38). The prevalence of possible risk of overweight, being overweight, and obesity were 3.9%, 7.9% and 8.1%, respectively, whereas the prevalence of underweight and stunting were 8.0% and 8.4%, respectively. Breakfast was the second most frequently skipped meal (16.8%) after dinner (18.1%). The mean cognitive score was 103.5 (SD=14.4). Height-for-age and consumption of dinner were found to contribute significantly towards cognitive performance after controlling for socio-demographic background and parent's nutrition knowledge.
Fulltext The Identification of the Factors Related to Household Food Insecurity among Indigenous People (Orang Asli) in Peninsular Malaysia under Traditional Food Systems

Law LS, Norhasmah S, Gan WY, Siti Nur'Asyura A, Mohd Nasir MT

Nutrients, 2018 Oct 08;10(10).
PMID: 30297599 DOI: 10.3390/nu10101455

Over the course of 16 years, a high percentage of Orang Asli (OA) households in Malaysia has been found to be burdened with food insecurity. Therefore, a study was conducted to improve the understanding of the challenges faced by the OA in Peninsular Malaysia to achieve food security under traditional food systems. In this study, in-depth interview sessions, which were assisted by an interview protocol, were conducted with 61 OA women from nine villages that were selected purposefully across three states (Kelantan, Pahang, and Perak) in Peninsular Malaysia. Furthermore, thematic analysis was performed during data analysis. As a result, four themes were identified, namely (i) the failure in agriculture (sub-themes: threats from wild animals and insufficient land supply), (ii) ineffectiveness of traditional food-seeking activities (sub-themes: exhausting, tiring, dangerous, and time-consuming journey for food-seeking activities, depletion of natural commodities, reduced demands of natural commodities, and lack of equipment), (iii) weather (sub-themes: rainy and dry seasons), and (iv) water issues (subthemes: continuity of water supply and cleanliness of water). The identified modifiable factors of this issue should be incorporated into future schemes of food security intervention in order to efficiently manage the food shortage among the OA.
Psychological Factors and Cardiovascular Disease Risk Factors as Mediators of the Relationship between Overweight/Obesity and Cognitive Function among School Children in Kuala Lumpur, Malaysia

Tung SEH, Mohd Nasir MT, Chin YS, Zalilah MS, Zubaidah JO, Yim HS

Child Obes, 2019 01;15(1):56-62.
PMID: 30339034 DOI: 10.1089/chi.2018.0066

BACKGROUND: Recent research suggests that a negative relationship exists between adiposity and cognitive function in children. However, limited information is known on how they are related. This study aimed to examine the mediators of the relationship between overweight/obesity and cognitive function among school children in Kuala Lumpur, Malaysia.
METHODS: This is a cross-sectional comparison study whereby 225 overweight/obese children matched for age, sex, and ethnicity with 225 normal weight children participated in this study. Body image dissatisfaction, disordered eating, and depressive symptoms were assessed through a self-administered questionnaire. Blood pressure was measured, whereas blood was drawn to determine insulin, high-sensitivity C-reactive protein (hs-CRP), glucose, and lipid profiles. Homeostasis model assessment-estimated insulin resistance (HOMA-IR) was calculated using glucose and insulin levels. Wechsler's Intelligence Scale for Children-Fourth Edition (WISC-IV) was used to assess cognitive function in children. Ordinary least square regression analysis was conducted to determine the direct and indirect relationships between weight status and cognitive function.
RESULTS: A negative relationship was found between overweight/obesity with cognitive function. Overweight/obese children were on average 4.075 units lower in cognitive function scores compared to normal weight children. Such difference was found through mediators, such as body image dissatisfaction, disordered eating, depression, systolic blood pressure, triglycerides, HOMA-IR, and hs-CRP, contributing 22.2% of the variances in cognitive function in children.
CONCLUSION: Results highlight the important mediators of the relationship between overweight/obesity and cognitive function. Consequently, future interventions should target to improve psychological well-being and reduce cardiovascular disease risk for the prevention of poorer cognitive performance in overweight/obese children.

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