The objective of this paper is to report on the reliability and validity of a knowledge, attitude and practice instrument used among young primary school children. The instrument was developed as an evaluation tool in the HELIC study and consisted of 23 knowledge, 11 attitude and 10 practice items. A total of 335 Year 2 students from 4 randomly selected primary schools in Selangor and Wilayah Persekutuan participated in the HELIC study. Students were divided into small groups and an enumerator verbally administered the instrument to each group. Reliability for each construct (knowledge, attitude and practice) was estimated as item to total score correlation and internal consistency (Cronbach's alpha). Construct validity was determined through factor analysis and Pearson correlation. Results indicated that 3 attitude and 3 practice items did not correlate significantly to the total score (p>0.05). However, the deletion of these items did not significantly alter the Cronbach's alpha coefficients. Internal consistency was good for knowledge (a=0.68) but low for attitude (a=0.37) and practice (a=0.36) constructs. Based on factor analysis, 5 factor-solutions emerged for knowledge and 4 factor solutions for attitude and practice. Sufficient variance was obtained for the factors in knowledge (51.7%), attitude (51.2% and practice (51.0%). There were also significant positive correlations among the constructs ( ~ 4 . 0 1 ) . In conclusion, the instrument was valid and reliable, especially for the knowledge construct. Further improvements, particularly on the attitude and practice constructs, are needed in order for the instrument to be an effective assessment or evaluation tool in various settings.
Amino acid profiles, protein digestibility, corrected amino acid scores (PDCAAS), chemical scores, essential amino acid indexes, and calculated biological values of controlcowpea flour (CCF), germinated cowpea flour (GCF) prepared from cowpeas germinated at 25 degrees C for either 24 h or 48 h and weaning foods prepared from cowpea flours were determined. Locally available rice, cowpea flour, banana-pumpkin slurry, and skim milk powder and sucrose in the ratio 35:35:15:15:5 were used to formulate weaning food containing not less than 15% protein. The ingredients were cooked into a slurry and oven-dried to produce flakes. The nutritional and sensory qualities of the weaning products were evaluated. Germination had little effect on the amino acid profile of cowpeas. In vitro protein quality and starch digestibility were improved in germinated cowpea flour. The PDCAAS of 24 h germinated cowpea flour (GCF) weaning food was higher (55.49%) than CCF-weaning food (46.74%). Vitamin A activity in 24 h GCF weaning food was higher than in CCF-weaning food. In vitro starch digestibilities of 24 h GCF and 48 h GCF-weaning foods were higher than that of CCF weaning food. The 24 h GCF-weaning food which had a higher overall acceptability score by sensory panelist than 48 h GCF and CCF-weaning food is recommended for household consumption.
A case control study was carried out to investigate associations between breast cancer risk, antioxidant status and oxidative stress among women in Klang Valley and Selangor. A total of 57 newly diagnosed cases aged 30 to 66 years old participated and were matched for age and ethnicity with 139 controls with no diagnosis of cancer or other chronic diseases. An interview based questionnaire designed to collect information on demographic and socioeconomic status, as well as reproductive, medical and dietary history was used. Anthropometric measurements including weight, height, waist and hip circumference were made and a 10 ml fasting venous blood sample was taken for glucose testing and analysis of plasma vitamin antioxidants and malondialdehyde. Hair and toenail samples were taken for selenium analysis. Results showed that the mean intake of vitamin A, vitamin E and selenium among cases (606.8 +/- 334.8 microg/d, 6.1 +/- 2.4 g/d, 56.9 +/- 16.2 microg/d) was lower than controls (724.7 +/- 414 microg/day, 6.9 +/- 3.0 g/d, 60.8 +/- 17.5 microg/d, respectively) (p<0.05 for all parameters). A similar trend was noted for plasma vitamin A and E and also selenium in hair and toenails. Poor antioxidant status as indicated by low plasma vitamin A (<284.3 microg/l or <366.3 microg/l) increased risk of breast cancer by approximately two fold, whilst low plasma vitamin E (<2.5 mg/dl, <2.8 mg/dl and <3.1 mg/dl) increased the risk by two to three fold [Adjusted OR 2.97 (95% CI 1.38-3.48), 2.32 (95% CI 1.07-2.41) and 2.12 (95% CI 1.00-4.21)]. Cases had a greater level of malondialdehyde 4.4 +/- 1.1 mmol/g protein), an indicator of oxidative stress, as compared to controls (3.2 +/- 1.7 mmol/g protein) (p<0.05). A high level of MDA (> or = 4.8 mmol/g protein) was associated with breast cancer [Adjusted OR 6.82 (95% CI 1.95-23.9)]. It is concluded that a poor antioxidant status and high oxidative stress are associated with breast cancer risk. Thus, it is essential for Malaysian women to obtain a good antioxidant status by consuming a diet rich in vitamins A and E as well as selenium and adopt healthy behaviour to reduce oxidative stress in order to prevent breast cancer.
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)
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)