Recognising the epidemic of overweight and obesity among Malaysians, formulation of intervention programmes such as
a weight management programme at workplace is essential. This study aimed to determine the effectiveness of a structured
weight management programme at workplace among overweight and obese employees. In this quasi-experimental
study, sixty-four of overweight and obese adults were recruited and divided into two groups (intervention group,
n = 32 and control group, n = 32). Subjects in the intervention group received three months scheduled programme and the
control group received a routine weight management consultation from dietitians. Significant group effect was found on
waist circumference (WC) in men (p < 0.05) and Body Mass Index (BMI) in women (p < 0.05). Men from the intervention
group had reduced their WC by 3.4% (-3.7 cm) as compared to controls of 0.7% (-0.8 cm). Women in the intervention
group improved their BMI by 1.4% (-0.4 kg/m2
) as compared to controls at 0.3% (-0.1 kg/m2
). Total cholesterol and LDL-C
reduced among women in both intervention and control group with significant time effect (p < 0.05). As a conclusion a
structured weight management programme effectively improved WC in men and BMI in women, and appeared to be as
effective as individual diet counselling by dietitians in improving lipid profiles in women.
Introduction: Adequacy of fruit intake contributes to an individual’s health
including reducing the risk of non-communicable disease. This study aimed to
assess consumption of fruits in various forms and to determine associated factors
and barriers. Methods: In this cross-sectional study, a total of 300 adults aged
20-39 years were purposely recruited from several urban locations in the Klang
Valley. Consumption of fruits in the past 12 months was assessed using a selfadministered food frequency questionnaire (FFQ), assisted with pictures of serving
size of fruits. Anthropometric measurements were taken and body mass index
and waist circumference computed. Results: Fruit intake among young adults
was lower (1.6±1.0 servings/day) than the Malaysian Dietary Guideline 2010 of
≥ 2 servings/day. Only 32.3% consumed fruits as recommended, with women
consuming significantly more fruits than men. Preferred fresh fruits were red apple,
banana and papaya. Consumption of fruit juice was associated with increase in
waist circumference (R2=0.261, p=0.027) after adjustment for age, sex, ethnicity,
education level and marital status. Fruit intake showed no significant association
with other anthropometric measurements. Sensory appeal, perceived health benefit,
easy to prepare and influence of family were the main determinants of fruit intake,
whilst affordability and availability were the major barriers. Conclusion: Fruit
consumption among young adults in this study was lower than the recommendation
for daily fruit intake. Studies with larger sample size are suggested to verify the
finding of significant association between fruit juice consumption and risk of
abdominal obesity.
Introduction: Malnutrition among cancer patients is associated with a higher risk of
gastrointestinal toxicity which develops during treatment and may affect quality of life (QOL).
Thus, this cross-sectional study aimed to determine the nutritional status and QOL of 30
oncology patients (mean age 50.0+10.7 years) prior to pelvic radiotherapy at Hospital Sultan
Ismail, Johor Bahru.
Methods: Patients were assessed for anthropometry measurements,
24-h diet recall and nutritional status using Scored Patient-Generated Subjective Global
Assessment (PG-SGA) questionnaire while the European Organization for Research and
Treatment of Cancer Care Quality of Life Questionnaire (EORTC QLQ-C30) was used to
assess QOL two weeks prior to the initiation of pelvic radiotherapy.
Results: Mean Body
Mass Index (BMI) of patients was 23.3+3.3kg/m2
and 33% of patients experienced weight
loss prior to pelvic radiotherapy. The PG-SGA rating indicated that 63% of patients were at
Stage A (well-nourished) and 37% were in Stage B (moderate malnutrition). The PG-SGA
numerical score was a significant predictor of QOL, after adjusting for socio-demographic
factors (R2
=0.861, p
Inclination towards nutrition beliefs by parents and caregivers plays an important role in the dietary intake of children
with leukemia. However, local studies examining on the nutrition practices and dietary beliefs among caregivers of
leukemia patients are very limited. This study aims to assess nutrition beliefs among caregivers of children with leukemia
and healthcare professionals at the Pediatric Institute of Kuala Lumpur Hospital (IPHKL), Malaysia. This qualitative
study was conducted to assess the beliefs and practices towards certain foods among caregivers of pediatric leukemia
patients. Thirty subjects comprising a group of 10 health care professionals and 20 caregivers were interviewed using
semi-structured interview method. The interviews were transcribed and analyzed using ATLAS.ti. version 7.5.6 qualitative
analysis software and subsequently several themes.were obtained. Five themes emerged from this analysis that are
(1) beliefs about foods that can cure cancer, (2) beliefs related to consumption of meat and dairy products, (3) beliefs
towards foods containing pesticides, (4) beliefs that certain food causes itchiness, and (5) source of nutrition information
and nutrition knowledge of caregivers. This study proves that beliefs in various myths related to nutrition and dietary
practices exist among caregivers and health professionals group. Information from these findings can provide perspective
on the beliefs towards dietary practices among caregivers of children with leukemia and healthcare professionals. This
is important for the healthcare professions, especially when planning the strategies for caregivers’ nutrition education
in order to improve the nutritional status of childhood leukemia patients.
Obesity is a risk factor for chronic diseases which can affect work productivity and physical function of employees
particularly among those in security sector. The study aimed to determine the association between obesity with total
days of sick leave and health related quality of life (HRQoL) among Malay male security officers. A cross-sectional
study was conducted among Malay male security officers working in a Malaysian higher learning institution. Subjects
were evaluated using anthropometric measurements, quality of life and number of sick leave taken within two months
prior to the study. A total of 194 subjects (mean age 40.12 ± 11.41 years) were recruited. A total of 30.4% were obese,
39.7% were pre-obese and only 29.9% had normal body weight or underweight. Central obesity was observed in 57.7%
of them and 87.1% shown excessive body fat percentage. Number of sick leave days was positively correlated with Body
Mass Index (BMI) (r = 0.162, p = 0.024) and waist circumference (r = 0.181, p = 0.012). Score of the general health
component was negatively correlated with BMI (r = -0.161, p = 0.025), waist circumference (r = -0.194, p = 0.007) and
body fat percentage (r = -0.191, p = 0.008). Physical functioning score was lowest in obese subjects than normal and
pre-obese subjects (p = 0.046). Score of the bodily pain component was positively correlated with waist circumference (r
= 0.156, p = 0.030). Obesity is associated with number of sick leave days and quality of life in the studied group. Hence,
body weight of the security staff should be monitored and appropriate intervention should be conducted to improve their
work attendance and quality of life.
Fruit and vegetable are the natural foods that contained various nutrients vital for good health and help in weight loss
by suppressing an individual’s appetite. Therefore, this review aimed to investigate the acute effect of fruit and vegetable
intake on satiety and energy intake. We included randomized controlled trial or experimental designs measuring fruit
and/or vegetable intake on satiety using subjective appetite rating and appetite related hormone and energy intake among
healthy adults, published in English-language. The use of extract, powder form or concentrated fruit and/or vegetable
and animal study were excluded. Twelve studies were identified from Pubmed, Science Direct and Cochrane from the
year 1995 to August 2017, consists of six studies on fruit and six studies on vegetable. This review discussed the preload
of fruit and vegetable in promoting satiety and reducing the energy intake. Manipulating energy density rather than
portion size was effective in reducing total energy intake and promotes satiety. Fruit and vegetable in solid form had a
greater satiety effect and significantly reduce energy intake compared to liquid or pureed form. The variation in time
interval between fruit and/or vegetable intake and the test meal may also account a significant effect on satiety up to 2
h and diminished 3 h onward. The satiety effect of fruit and vegetable would be beneficial in body weight management.
Adequate nutrition is important for mothers and their offspring during and after birth. This cross sectional study was conducted to determine nutritional status and nutritional knowledge of pregnant women from two selected private hospitals in Klang Valley, Malaysia. A total of 236 Malay pregnant women aged between 20 to 45 years old (mean age 31+5 years) were recruited through convenient sampling method. Socio-demographic data, nutritional knowledge and a 24-hours diet recall were obtained through a self-administered questionnaire. Anthropometric and haemoglobin data were obtained from the antenatal records in the respective hospitals. The percentages of participants who were underweight, normal, overweight and obese before pregnancy were 12.7%, 55.1%, 25.0% and 7.2% respectively. Among those who were obese before pregnancy, a total of 59.7% had inadequate weight gain, 24.6% gained adequate weight and 15.7% gained excessive gestational weight. About 33.5% of subjects were anaemic (Hb < 11.0g/dL). The mean daily energy intake of the participants was 1748 ± 526 kcal which was 76% of RNI. Calcium (73% of RNI), folic acid (36% of RNI), niacin (89% of RNI) and vitamin D (40% of RNI). The nutritional knowledge level of subjects was moderate (51.9 ± 13.8%). Lower monthly household income (p < 0.001), educational level (p < 0.001) and gestational stage (p < 0.05) of participants were associated with a lower nutritional knowledge level. Nutritional knowledge score was positively correlated with gestational weight gain (r = 0.166, p < 0.05) and haemoglobin level (r = 0.200, p < 0.05). Subjects who claimed practising food taboos had higher nutritional knowledge score (54.9 ± 12.5%) than those who did not (49.9 ± 14.4%)(p < 0.05). A comprehensive nutrition education should be integrated in the antenatal classes to improve nutritional status of pregnant women.
Relatively less comprehensive web based programme has been developed for detecting risk of mild cognitive impairment (MCI) and further impart preventive strategies and lifestyle education. Thus, this study has developed a comprehensive web based programme for early screening of risk of MCI together with education package for preventing MCI known as WESIHAT 2.0. WESIHAT 2.0 is a senior friendly website which has appropriate design interface facilitating access of older people especially with the use of touch-screen technology. WESIHAT 2.0 has incorporated four major components namely TUA WELLNESS screening tool, which is a comprehensive, online based, 10-item screening tool for detecting risk of MCI, 10-guides for preventing MCI, health diary and healthy food. Evaluation of acceptance of WESIHAT 2.0 was done among 71 people which comprised of 30 older people and 30 caregivers, chosen equally based on ethnic composition and 11 health care professionals who has experience working in the field of geriatric and 2 freelance website developer. All older people and caregivers stated that the content of website was very useful for preventing MCI, however, about 36.4% of health professionals stated several improvements needed to be done before releasing the end-product to the users. Comments given were smaller font size (27.3), addition of more pictures (27.3%), using simpler terms (36.4%) and changing certain design for better view of older people (18.2%). Amendments were made based on each comment given and the finalized website were used for a 6-month intervention programme for neuroprotection among older people who failed to achieve successful aging. It is timely for an online based approach for prevention of MCI. WESIHAT 2.0 is the first website in Malaysia which has been accepted by all older people and caregiver and more than half of healthcare professionals to prevent memory decline.
The prevalence of chronic kidney disease (CKD) have increased and become one of the major public health concerns
worldwide including Malaysia. Previous studies on CKD generally focused on patients who were already undergoing
dialysis treatment; however, studies investigating the stresses experienced by pre-dialysis CKD patients were limited. This
study aimed to examine the prevalence of psychological distress and their association with the Health Related Quality
of Life (HRQoL) during the different stages of CKD. This cross-sectional study involved 200 pre-dialysis patients from
stages 3 to 5, who were recruited from the Nephrology Clinic at the National University of Malaysia Medical Centre
(UKMMC). The instruments used in this study were the Short Form 36 (measuring HRQoL) and Hospital Anxiety and
Depression Scale (HADS) to measure the psychological distress. The results showed that the prevalence of depression
and anxiety increased proportionally with the CKD stages. The HRQoL sub-component scores declined as the CKD stages
increased except for social functioning. An impaired HRQoL was associated with depression and anxiety in the CKD
patients. The results suggested that it is very important to manage kidney disease at an early stage and that a healthier
lifestyle is adopted.
A structured weight management programme at a workplace may help in reducing the prevalence of overweight and obesity.
Therefore, this intervention study was to determine the effectiveness of weight loss programmes including face-to-face,
online and control group at workplace among employees who are overweight and obese. A total of 108 overweight and
obese adults were recruited and randomly divided into three groups (face-to-face group (FT), n=38; online group (OG),
n=31; control group (CG), n=39). In the FT group, the participants took part in health talks, interactive activities and
counselling; the OG group was given access to an online weight management program and the CG group was provided
with educational booklets on weight loss. All information given was related to nutrition, physical activity and motivation
to reduce weight. Body weight, body mass index (BMI), waist circumference (WC), body fat percentage, dietary intake,
fasting lipid profile and glucose levels were assessed at baseline and 4 months. The FT group showed greater reduction
in body weight (-5.80 kg) compared to OG (-1.12 kg) and CG (-1.82 kg). Significant interaction effects were found for BMI,
WC, fasting serum triglycerides, HDL-cholesterol and total cholesterol/HDL-cholesterol ratio (all p<0.05), with the FT
group showing the biggest improvements, compared to the other groups. The face-to-face weight management program
offered in the workplace showed to be the most effective at improving anthropometric profile, fasting serum triglycerides,
HDL-C, total cholesterol/HDL-C ratio, and dietary intake among overweight and obese employees.
In thalassaemic patients, the impact of the disease especially on quality of life (QOL) of the caregivers in Malaysia has not been established. This study was conducted to assess the health-related quality of life (HRQOL) of thalassaemia patients and their caregivers in order to explore factors affecting their QOL. A cross-sectional study was conducted on 75 thalassaemic children and adolescents aged between 7 and 18 years old and their caregivers. The PedsQLTM 4.0
generic core scales questionnaire was administered to both thalassaemic children and their caregivers while the health questionnaire EQ 5D was given to caregivers only. The subjects were recruited from Hospital Kuala Lumpur (HKL) and Universiti Kebangsaan Malaysia Medical Centre (UKMMC). The results revealed that the mean of psychosocial HRQOL score in patients (63.91±14.65) was significantly lower than parent proxy reports (67.14±10.48) (p=0.008). The
school functioning score (50.59±15.31) was the lowest of the psychosocial measure, followed by emotional functioning (59.92±16.83) and social functioning (78.01±13.92) score. The patients’ pre-transfusion haemoglobin concentration was significantly associated with their QOL (p=0.02). Having more children, higher numbers of thalassaemic children and lower educational level of caregivers were associated with poorer QOL. In conclusion, caregivers underestimated
the QOL of their thalassaemic children. The school functioning domain was affected the most domain. There is a need to improve the QOL of thalassaemic children and their caregivers.
Islam merupakan satu agama yang menitikberatkan kesihatan manusia termasuklah sistem pencernaan manusia. Najis
(tinja) manusia yang dibincangkan dalam kajian ini merupakan hasil buangan manusia yang menjadi salah satu kaedah
untuk melihat sudut kesihatan manusia. Objektif penyelidikan ini ialah untuk mengkaji fizikokimia dan ciri-ciri najis
serta kegunaannya daripada perspektif sains dan sudut pandangan Islam terutamanya mengenai diet yang diamalkan
oleh Rasulullah SAW. Kajian ini dijalankan dengan menggunakan ulasan literatur secara deskriptif. Kajian mendapati
bahawa sistem pencernaan merupakan satu sistem yang rumit. Tinja terdiri daripada 75% air dan 25% bahan pepejal
serta ciri-ciri tinja seperti bentuk, warna dan bau memberi kesan kepada kesihatan manusia. Daripada sudut Islam
warna, bau dan rasa tinja merupakan perkara asas yang dititikberatkan semasa proses pembersihan najis terutamanya
bagi memulakan sesuatu ibadah. Selain itu, diet, senaman, umur dan jantina merupakan faktor-faktor yang membezakan
jenis tinja bagi setiap individu. Malah, kajian ini juga merungkai beberapa alternatif yang kini diguna pakai bagi
mengurus najis-najis manusia dalam menjamin kesihatan dan pemeliharaan alam sekitar. Kajian ini kemudiannya
mengupas diet makanan-makanan sunnah yang terdapat di dalam Al-Quran dan hadis yang terbukti kaya dengan serat
dan sihat untuk manusia terutamanya bagi sistem pencernaan manusia. Oleh itu, najis (tinja) manusia daripada sudut
sains mampu menggambarkan kesihatan seseorang dan amalan diet makanan-makanan sunnah sangat baik dalam
memelihara sistem pencernaan manusia.
Involvement of informal carer in post-stroke care is important to prevent development of secondary complications particularly among stroke survivors with severe disability. However, to date, evidence on the benefit of stroke care training and involving carer to assist in the care for this group of stroke survivors is still limited. In this study, we evaluated the outcome of a carer-assisted care program for stroke survivors with severe disability who live at home. Sixteen stroke survivors with severe disability and 16 primary carers participated in this pre-test post-test intervention study. Carers were trained using a stroke care module which was developed by a group of multidisciplinary researchers from Universiti Kebangsaan Malaysia, prior to implementing the daily care for 8 weeks. Outcome of care on stroke survivors was assessed in term of change in disability level and quality of life using Modified Barthel Index (MBI) and EuroQol health-state measure (EQ-5D and EQ-VAS), respectively. While outcome of stroke care training on carer was determined using Modified
Caregiver Strain Index (MCSI). Significant improvement is shown in the stroke survivors’ EQ-VAS component of EuroQol health state measure (average increase by 12%, t = 2.86, p = 0.01) following the care. Although not statistically significant (t = 0.97; p = 0.35), the mean score of MCSI reduced by 14%. No significant change was found in the MBI of the stroke survivors at completion of the program. Carer-assisted care is useful in improving quality of life of stroke survivors and can potentially reduce stress level among carers. Larger study may assist in establishing these preliminary findings.