METHODS: A systematic review was performed on articles published from 2014-2021 related to maternal anemia and stunting. The electronic databases used were ScienceDirect, PubMed, Scopus, ProQuest, Google Search, and AJOG (American Journal of Obstetrics and Gynecology). The literature search was performed up to December 7, 2021.
RESULTS: Twelve studies were included. Nine studies examined the correlation between maternal anemia and length or weight in children. Seven of the nine studies showed an association between maternal anemia and stunting in children; the others showed an association between maternal anemia and birth length. Three studies found no association between maternal anemia and stunting in children under age 5 y.
CONCLUSIONS: The current review emphasizes that stunting in children may be associated with maternal anemia, specifically in developing countries. This implies that it is crucial to prevent anemia in adolescent girls and women before and during pregnancy as a part of programs to eliminate stunting in children.
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.
METHODS: This is a prospective cohort study following urban poor adolescents aged 10-17 years living in low-cost high-rise flats in Kuala Lumpur, Malaysia, across two monsoon seasons. The baseline assessment will be conducted during the onset of the Northeast Monsoon and followed up during Southwest Monsoon. Climate data will be collected by obtaining the climatological data (rainfall, temperature, and relative humidity) from Malaysia Meteorological Department. Geospatial data for food accessibility and availability, and also built (recreational facilities) environments, will be analyzed using the QGIS 3.4 Madeira software. Information on socio-demographic data, food security, lifestyle (diet and physical activity), and neighbourhood environment (food and built environment) will be collected using a self-administrative questionnaire. Anthropometric measurements, including weight, height, and waist circumference, will be conducted following WHO standardized protocol. WHO Anthro Plus was used to determine the height-for-age (HAZ) and BMI-for-age (BAZ). Anaemic status through biochemical analyses will be taken using HemoCue 201+® haemoglobinometer.
DISCUSSION: The study will provide insights into the seasonal effects in nutritional status and its associated factors of urban poor adolescents. These findings can be useful for relevant stakeholders, including policymakers and the government sector, in seizing context-specific strategies and policy opportunities that are seasonally sensitive, effective, and sustainable in addressing multiple challenges to combat all forms of malnutrition, especially among urban poor communities.
TRIAL REGISTRATION: The protocol for this review has not been registered.
SUBJECTS/METHODS: Urine color was used to measure hydration status, while fluid intake was assessed using the 15-item beverage intake questionnaire. Cognitive function was assessed using the Wechsler Intelligence Scale for Children, Fourth Edition.
RESULTS: More than half of the adolescents were mildly or moderately dehydrated (59.6%) and only one-third (33.0%) were well hydrated. Among the daily fluid types, intakes of soft drinks (r = -0.180; P = 0.006), sweetened tea (r = -0.184; P = 0.005) and total sugar-sweetened beverages (SSBs) (r = -0.199; P = 0.002) were negatively correlated with cognitive function. In terms of hydration status, cognitive function score was significantly higher (F-ratio = 4.102; P = 0.018) among hydrated adolescents (100.38 ± 12.01) than in dehydrated (92.00 ± 13.63) counterparts. Hierarchical multiple linear regression analysis, after adjusting for socio-demographic factors, showed that soft drinks (β = -0.009; P < 0.05) and sweetened tea (β = -0.019; P < 0.05) negatively predicted cognitive function (ΔR2 = 0.044). When further control for sources of fluid, hydration status (β = -2.839; P < 0.05) was shown to negatively predict cognitive function (ΔR2 = 0.021). The above variables contributed 20.1% of the variance in cognitive function.
CONCLUSIONS: The results highlight the links between fluid intake (soft drinks, sweetened tea, total SSBs) and hydration status with cognitive function in adolescents. Interventions aimed at decreasing the consumption of SSBs and increasing hydration status through healthy fluid choices, such as water, could improve cognitive performance in adolescents.
OBJECTIVE: The purpose of this study was to assess the association between dietary pattern and H. pylori infection among patients aged 18 years and above that went for first esophagogastroduodenoscopy (OGDS) in 2021 at Queen Elizabeth Hospital (QEH), Kota Kinabalu.
METHODS: Dietary intake of positive H. pylori was compared with healthy subjects by using questionnaire adapted from Malaysian Adult Nutrition Survey (MANS) 2014. Using logistic regression models, we evaluated the association between dietary pattern and H. pylori infection risk.
FINDINGS: Our finding identified four dietary patterns, namely "high carbohydrate pattern", "high fiber pattern", "high fat/cholesterol pattern" and "high salt pattern". After adjustment for potential confounders, the highest quartile of "high salt pattern" showed greater odds of H. pylori infection (OR = 1.26; 95% Cl: 1.032-1.459; P = 0.045) than lowest quartile, while highest quartile of "high fiber pattern" demonstrated lower odd of the infection (OR = 0.69; 95% Cl: 0.537-0.829; P = 0.008) than those in lowest quartile. If compared with Recommended Nutrient Intake (RNI) 2017, positive H. pylori consumed high carbohydrates and sodium with insufficient fiber intake.
CONCLUSION: To conclude, "high fiber pattern" lowers the risk of H. pylori infection while "high salt pattern" increases the infection risk. Our study also highlighted the importance of nutrient intake within daily allowances.
METHODS: This was a cross-sectional study conducted among 284 Malaysian university students in Kuala Lumpur, Malaysia. An online self-administered questionnaire was employed to assess subjects' nutrition knowledge, dietary habits, attitude towards functional foods, recognition and consumption of functional food products.
RESULTS: Out of 284 respondents, 41.9% had poor level of nutrition knowledge and 57% had moderate level of functional food-related attitude, with seven types of functional foods consumed on average (57.0%). Binary logistic regression showed that university students who consumed fruits at least three times per day (aOR = 11.18; 95% CI: 1.46, 80.17), salty snacks (aOR = 2.90; 95% CI: 1.43, 5.86), soft drinks/sugar-sweetened beverages (SSB) (aOR = 3.12; 95% CI: 1.53, 5.26) and pure juice (aOR = 2.80; 95% CI: 1.48, 5.30) were more likely to consume functional foods during COVID-19 (P < 0.05).
CONCLUSION: The findings could provide information to public and private sectors in terms of creating a supportive environment to encourage and promote the awareness and consumption of functional foods and their associated health benefits.
SUBJECTS/METHODS: A cross-sectional survey was conducted among 188 adolescents aged 13-18 yrs living in Kuala Lumpur, Malaysia. Household food insecurity and dietary intake data were collected using the Radimer/Cornell hunger and food insecurity instrument and 2-day 24-h dietary recalls, respectively. Diet quality was determined using the Malaysian Healthy Eating Index (HEI). Weight and height were measured and body mass index-for-age, as well as height-for-age z scores were calculated.
RESULTS: The present study revealed that 47.9% of the adolescents experienced household food insecurity, 24.5% experienced individual food insecurity, 18.6% household food security, and 9.0% child hunger. The mean score of diet quality was 56.83 ± 10.09, with a significantly lower HEI score among food insecure adolescents (household food insecure, individual food insecure, and child hunger) than household food secure adolescents (P = 0.001). The differences between food secure and food insecure households were found to be significant for energy (P = 0.001) and nutrients including proteins (P = 0.006), carbohydrates (P = 0.005), dietary fiber (P = 0.001), folate (P < 0.001), and vitamin C (P = 0.006). The multiple linear regression showed that adolescents who experienced food insecurity (β = -0.328; P = 0.003) were found to be significantly associated with poor diet quality (F = 2.726; P < 0.01), wherein 13.3% of the variation in the diet quality was explained by the food security status.
CONCLUSIONS: Experiencing food insecurity contributed to poor diet quality among urban poor adolescents. Further longitudinal studies are needed to comprehensively understand this association to improve food insecurity and diet quality among urban poor communities.
METHODS: In this cross-sectional study, the scales were sent to 974 students studying in higher education (60% females) in Taiwan through online media including email and social networks. Rasch modeling was used to assess dimensionality, difficulty level, and item misfit and hierarchy. Differential item functioning (DIF) was performed to examine consistency of the items across gender and weight status.
RESULTS: Rasch analysis indicated 3 items of the 35 items belonging to the YFAS 2.0 (8.6%) and none belonging to the mYFAS 2.0 were misfit. Unidimensionality and construct validity of both scales were supported by appropriate goodness-of-fit for diagnostic criteria. The person separation was 3.14 (reliability = 0.91) for the YFAS 2.0 and 2.17 (reliability = 0.82) for mYFAS 2.0, indicating the scales could distinguish participants into more than 3 strata. Only one substantial DIF was found for diagnostic criteria of "Failure to fulfill major role obligation" in the YFAS 2.0 across gender.
CONCLUSION: According to Rasch modeling, both the YFAS 2.0 and mYFAS 2.0 have acceptable construct validity in Chinese-speaking youth. Scoring methods using either diagnostic criteria or symptom counts for both the YFAS 2.0 and mYFAS 2.0 are supported by the present Rasch findings.
METHODS: University students who were studying in a Malaysia university with a mean age of 24.0 years (n = 380; females 71.6%) were recruited through convenience sampling between 19 August and 30 September 2021. They completed a Google Form consisting of information on sociodemographic background, weight stigma, psychological distress and self-reported body weight and height. Psychometric testing was conducted using the classical test theory (including confirmatory factor analysis) and Rasch models to confirm the two-factor structure of WSSQ and the unidimensional structure of the PWS using the various fit indices. Concurrent validity of the total scores of WSSQ and PWS with psychological distress and body mass index (BMI) was also investigated. Internal consistency using Cronbach's alpha was conducted.
RESULTS: The confirmatory factor analyses and Rasch analyses verified the two-factor structure for the WSSQ and the single-factor structure for the PWS. Both the WSSQ and PWS showed good internal consistency and good concurrent validity as demonstrated by their significant correlations with psychological distress and BMI.
CONCLUSION: The WSSQ and PWS have strong validity and reliability, and they can both be used to assess weight stigma among Malaysian university students.
LEVEL OF EVIDENCE: V: Descriptive study.
METHODS: An online survey comprising the YFAS 2.0, mYFAS 2.0, Weight Self-Stigma Questionnaire (WSSQ) and International Physical Activity Questionnaire-Short Form (IPAQ-SF) were used to assess food addiction, self-stigma, and physical activity.
RESULTS: All participants (n = 687; mean age = 24.00 years [SD ± 4.48 years]; 407 females [59.2%]) completed the entire survey at baseline and then completed the YFAS 2.0 and mYFAS 2.0 again three months later. The results of confirmatory factor analysis (CFA) indicated that the YFAS 2.0 and mYFAS 2.0 both shared a similar single-factor solution. In addition, both the YFAS 2.0 and mYFAS 2.0 reported good internal consistency (Cronbach's α = 0.90 and 0.89), good test-retest reliability (ICC = 0.71 and 0.69), and good concurrent validity with the total scores being strongly associated with the WSSQ (r = 0.54 and 0.57; p < 0.01), and less strongly associated with BMI (r = 0.17 and 0.13; p < 0.01) and IPAQ-SF (r = 0.23 and 0.25; p < 0.01).
DISCUSSION: Based on the findings, the Taiwan versions of the YFAS 2.0 and mYFAS 2.0 appear to be valid and reliable instruments assessing food addiction.
METHODS: A multi-center, web-based cross-sectional study was conducted among 458 university students (74% female; mean age 22.5 years) in Indonesia from June to December 2021. The BSMAS and IGDS9-SF were translated into Indonesian. Internal consistency (using Cronbach's α and McDonald's ω) and factor structure (using confirmatory factor analysis) of the two instruments were examined. Concurrent validity of BSMAS and IGDS9-SF was examined using their correlations with two external concepts: nomophobia and psychological distress.
RESULTS: Internal consistency of the Indonesian BSMAS and IGDS9-SF were both acceptable (Cronbach's α=0.80 and 0.90; McDonald's ω=0.86 and 0.92). Both instruments were unidimensional with good factor loadings (0.54-0.78 for BSMAS; 0.63-0.79 for IGDS9-SF). Moreover, BSMAS and IGDS9-SF had stronger associations with nomophobia (r=0.58 and 0.12; p<0.001) than with psychological distress (r=0.43 and 0.15; p<0.001).
CONCLUSION: The Indonesian versions of the BSMAS and IGDS9-SF had good psychometric properties in terms of linguistic validity, unidimensionality, and reliability. The findings indicate the tools are appropriate for assessing the risk of social media addiction and internet gaming disorder among university students in Indonesia.