Carotenoid-rich red palm oil (RPO)-based snacks have been provided to children in impoverished communities to improve their vitamin A status. The non-availabilty of information on the acceptability of RPO-based snacks by Malaysian aborigines (Orang Asli) children forms the basis of this study.
INTRODUCTION: There is a pressing need to better understand the complex biochemical pathways that lead to the pathogenesis of obesity. Increased oxidative stress and decreased antioxidant capacity have been identified to be associated with obesity. Therefore, the objectives of this study were to determine the plasma total antioxidant capacity (TAC) levels of Malaysian subjects and to evaluate its potential association with obesity and related anthropometric measurements.
METHODS: Plasma TAC of 362 multi-ethnic Malaysian subjects from the Kampar Health Clinic (138 males, 224 females; 124 ethnic Malays, 152 Chinese, 86 Indians; 192 non-obese, 170 obese) was measured using Trolox equivalent antioxidant capacity (TEAC) 96-well plate assay.
RESULTS: Plasma TAC was significantly lower in obese subjects (M +/- SE = 292 +/- 10.4 micromol/L) compared to non-obese subjects (397 +/- 8.58 micromol/L), whereas it was significantly higher in males and those in the 21-30 age group. Those with salty food preference and practising a strict vegetarian diet also had significantly higher plasma TAC. However, no association was found for other dietary habits (coffee intake) and lifestyle factors (physical activity, smoking). Plasma TAC was also significantly negatively correlated with diastolic blood pressure, waist and hip circumferences, weight, body mass index, total body fat, % subcutaneous fat, visceral fat level, resting metabolism and % skeletal muscle.
CONCLUSION: Plasma TAC was found to be associated with obesity, strict vegetarian practice, salty food preference and all obesity anthropometric indicators, except systolic blood pressure and pulse rate. Obese people have decreased plasma TAC indicating a compromised systemic antioxidant defence and increased oxidative stress.
INTRODUCTION: Gout and hyperuricaemia attributed to genetic and lifestyle factors have been associated with several chronic diseases. This study aimed to determine the association and interaction effects between vascular endothelial growth factor receptor-2 (VEGFR-2) gene polymorphisms (rs1870377 and rs2071559) and dietary patterns on blood uric acid in Malay and Indian adults.
METHODS: Dietary intakes of 153 Malays and 177 Indians were obtained using a food frequency questionnaire for the construction of dietary patterns using factor analysis. Genotyping of rs1870377 and rs2071559 was performed by real-time PCR using TaqMan probes. Anthropometric measurements, body mass index (BMI) and blood pressure and biomarkers, uric acid, glycated haemoglobin A1c (HbA1c), and blood lipids were determined.
RESULTS: There were significant differences in the mean values for HbA1c (41±-12 vs 45±-8 mmol/mol, p<0.001) and blood lipids levels (p<0.05) between Malays and Indians. Significant correlations were obtained between uric acid with selected blood lipids (p<0.05) and BMI in Malays (r=0.362, p<0.001) and Indians (r=0.212, p<0.01). Four dietary patterns were extracted from dietary intakes of all subjects: ‘Vegetables diet’; ‘Fruits diet’ (FD); ‘Animal protein and rice diet’; and ‘Fast foods and preserved foods diet’. There were no significant associations between dietary patterns (p=0.054-0.609) and VEGFR-2 gene polymorphisms (p=0.348-0.778) with uric acid. In Malay subjects, the interaction of rs2071559 and FD had a borderline effect (p=0.05) on blood uric acid after adjusting for potential confounders.
CONCLUSION: The associations and gene-diet interactions involving VEGFR-2 gene polymorphisms and FD on uric acid provide new information on gout and hyperuricaemia risks in Malays.
Keywords: Gene-diet interaction, VEGFR-2 gene polymorphisms, dietary pattern, uric acid, Malaysians
This study aimed to evaluate the validity and reliability of the Multidimensional Body Image Scale (MBIS), a seven-factor, 62-item scale developed for Malaysian female adolescents. This scale was evaluated among male and female Malaysian university students.
Among the chemicals, pesticides which are mainly used in agriculture pose major health problems to human beings. Indiscriminate use of pesticides belonging to the class organophosphate, organochlorine, carbomate, and pyrethroid leads to various health problems affecting the nervous, endocrine, reproductive and immune systems. The toxicity of pesticide in human beings is influenced by various factors such as age, gender and health status of the individual in addition to the intensity and frequency of pesticide used. Comparatively, children are at greater risk than the adults. The human detoxification system plays a vital role in reducing the harmful effects of the pesticides. However, when the toxic level is increased beyond the capacity of the detoxification system, health condition deteriorates. Human diet plays a crucial role in maintaining the overall health of a person. Vitamins such as Vitamin C and E are effective in preventing DNA damage because of their antioxidant properties. Intake of fruits and vegetables improves the antioxidants level in the blood. Phenolic substances present in certain spices possess potent anticarcinogenic activities. Organic farming may be a viable solution to reduce the toxic effects of chemicals.
Hypertension and obesity are established and independent risk factors for cardiovascular diseases. There are important inter-relationships between these two factors that may explain the aetiology of coronary heart disease. To determine the prevalence of hypertension and obesity in a rural community setting in Malaysia, and to identify their associated factors, a cross-sectional study was conducted among residents aged 15 years and above in Mukim Dengkil, Selangor from June to October 1999. Sample size was 570, giving a response rate of 86.7%. Prevalence of hypertension was 26.8%, with the highest prevalence among those aged 60 years and above (57.3%), and 50 to 59 years old (53.3%). Factors found to be significantly associated with hypertension were male (χ²=4.71, df=1, p<0.05) and age (t=10.7, df=568, p<0.01). Prevalence of obesity was 11.4%, with the highest prevalence among those aged 40 to 49 years (22.7%) and 30 to 39 years (14.4%). The factors associated with obesity were age (p<0.01), female (χ²=12.45, df=1, p<0.05) and ethnicity (Fisher's Exact probability, p<0.05) with Chinese and Malays having a higher prevalence compared to other ethnic groups. However, there was no significant association between hypertension and obesity (OR=1.14, 95% CI=0.65, 2.02). The prevalence of hypertension and obesity in this study is high. There is a need for prevention programs for these risk factors in rural communities in Malaysia.
Childhood obesity has been growing at an alarming rate and is the most common nutritional problem among children in developed as well as in developing countries. It is associated with significant morbidity and mortality, including cardiovascular, respiratory, gastrointestinal, endocrine and psychosocial morbidities. This unhealthy trend will progress to adulthood and is expected to lead to huge economic costs in health and social security systems. Among the many factors which contribute to the increasing prevalence of childhood obesity include environment and genetic factors. This paper discusses the aetiology, consequences and necessary interventions for this problem.
The Ministry of Health has launched healthy lifestyle and diabetes campaigns. However, adopting healthy lifestyle practices is not easy as revealed in this case. Patients and their families need to be supervised personally and counseled regularly. Healthy lifestyle habits such as maintaining a balanced diet, ideal body weight and physical activities need to be cultivated and practised. Dietary counseling sessions need to be implemented, preferably by dietitians as this has been shown to be effective in motivating diabetic patients to achieve a better food choice, as well as better glycaemic, lipid and weight control, as shown in this case.
This study was a cross-sectional survey conducted among 122 women workers employed in the electronics factories in the Ulu Klang Free Trade Zone (FTZ) and the Bangi FTZ, Selangor, Peninsular Malaysia. The purpose of the study was to examine the problem of overweight (>25.0 kg/m2) among this group of women, and factors (socio-demographic, work, exercise, and dietary) associated with overweight, and, to study the food intake pattern of the women in both the overweight and non-overweight groups. Data was collected using a set of questionnaires, while anthropometric measurements were obtained to calculate body mass index (BMI) and waist hip ratio (WHR). The results of the study indicated that 64.0% of the women were overweight (29.5% pre-obese, 34.5% obese). About one-tenth of the women (11.5%) had a WHR of above 0.85. From the bivariate analysis, it was found that women who were older, ever married, had lower educational level, had higher salary, not living in the hostel, involved in shiftwork, and trying to lose weight were more likely to be overweight. After adjusting for age, each of the above factors, except for educational level, remained significantly associated with overweight. Women's diet was found to be monotonous and lacking in variety as accessibility to and availability of a variety of food was a problem for them due to the nature of their work. They also had a sedentary lifestyle. Therefore, further research focusing on changing the poor dietary habits and sedentary lifestyle of the women workers is necessary to address the problem of overweight.
A food habits and health status study was carried out among 100 Malay adults aged 40 years and above. The study protocol incorporated anthropometric measurements, evaluation of food habits and determination of blood glucose, cholesterol and blood pressure. Mean body mass index (BMI) for men and women were 27.2 ± 4.2 kg/m2 and 27.0 ± 5.2 kg/m2 respectively, which on average showed that the subjects were overweight. Food habits evaluation indicated that rice, fish and vegetables were the foods consumed almost everyday by the majority of the subjects. Meat, dairy products and fruits were eaten once to three times per week. Food intake score for sugar and salt demonstrated that a majority of men and women consumed moderate amounts of these foods. Most subjects exercised twice to three times a week for 15 min per session. Blood glucose tests revealed a mean of 5.04 ± 1.60 mmol/l in men and 4.86 ± 2.10 mmol/l for women. Mean cholesterol for men was 5.06 ± 1.22 mmol/l while it was 4.90 ± 1.34 mmol/l in women. Mean systolic and diastolic blood pressure in men was normal of 127.69 ± 13.60 mm Hg dan 85.87 ± 7.97 mm Hg, while in women it was 127.42 ± 17.54 mm Hg, 83.53 ± 9.50 mm Hg. The mean value for glucose, cholesterol and blood pressure increased with age. The food habits of these adults were satisfactory; however blood test for the nutrients of interest exhibited an increasing trend towards blood pressure, blood cholesterol and glucose with age. Middle-aged adults should adapt to a more active lifestyle and be more cautious of their food habits. This is to ensure a healthy well being throughout their life span.
A cross-sectional comparative study was conducted to determine the nutritional status among physically active groups in Kota Bharu. The study population comprised 83 adult male athletes from 8 different types of sports (athlete group), 80 active men who exercised a minimum of 30 min per day for at least 3 times per week (exercise group), and 80 inactive men (sedentary group). All the respondents were aged between 18 to 44 years. Measurements taken from the respondents were anthropometric measurements, systolic (SBP) and diastolic (DBP) blood pressure, and serum total cholesterol (TC). The results showed that the combined prevalence of pre-obese (BMI 25.0-29.9) and obese (BMI ≥30.0) was 21.7% in athletes, 29.9% in exercise group, and 47.5% in sedentary group. The mean (± SD) percentage of body fat in athletes was 15.7 ± 5.4%, which was lower compared to the exercise (18.9 ± 5.5%) and sedentary (20.6 ± 5.8%) groups. The incidence of waist-to-hip ratio above 0.9 in athlete, exercise and sedentary groups was 9.6%, 18.7% and 31.3%, respectively. The incidence of hypertension (SBP ≥140 and/or DBP ≥90 mmHg) was 13.2% in athletes, 17.5% in exercise group and 42.5% in the sedentary group. The TC values showed that the prevalence of "high risk" individuals (TC ≥6.20 mmol/l) was also lower in athletes (20.5%), compared to the exercise (36.2%) and sedentary (47.5%) groups. The study revealed that individuals who are actively involved in physical activity, particularly in sport activities have better nutritional status compared to sedentary people. However, the nutritional status in the athlete and exercise groups was still unsatisfactory. The incidence of poor health status related to over nutrition in the active groups was rather high and needs attention from health professionals. Further studies are needed to determine nutritional practices among physically active groups.
The relationship between dietary habits and bone health status was evaluated in 61 pairs of premenopausal mothers and their biological daughters aged 10-19 years. Subjects were volunteers living in Kuala Lumpur. Bone status of the calcaneus was assessed using Quantitative Ultrasound (QUS) which measured the Broadband Ultrasound Attenuation (BUA; in units of dB/MHz) of the bone. Daily nutrient intake of all subjects was evaluated using a 3-day dietary record. Reproductive history, food intake habits, and physical activity level were assessed using questionnaires. Bone health status of mothers (mean BUA of 98.0 ± 15.8 dB/MHz) was significantly higher (p<0.001) compared to their daughters (mean BUA of 86.4 ± 17.0 dB/MHz). BUA (r=0.30, p<0.05), weight (r=0.30, p<0.05) and BMI (r=0.32, p<0.05) were significantly correlated within mother-daughter pairs. Lifestyle characteristics such as calcium intake and physical activity were not correlated. However, other dietary habits (energy intake, milk intake and frequency of skipping meals) in daughters were significantly correlated with their mothers. This study suggests that mothers play an important role in influencing the dietary habits of their daughters, which in turn may affect their bone health status.
INTRODUCTION: The present study describes a randomised controlled trial (RCT) based on a novel, generalisable intervention for childhood obesity, comparing the intervention with a no-treatment control group.
METHOD: The Malaysian Childhood Obesity Treatment Trial (MASCOT) was a single-blind RCT of a dietetic treatment for childhood obesity in children of primary school age (7 to 11 years old) in Kuala Lumpur, Malaysia. The MASCOT comprising eight sessions, of an 8-hour family-centred group treatment programme is described, based on behavioural change techniques. The study sample was characterised by BMI z-score, health related quality of life reported by participants and their parents (PedsQL questionnaire), objectively measured habitual physical activity and sedentary behaviour (Actigraph accelerometry)
RESULTS: The MASCOT sample of 107 children was characterised by a low quality of life, mean total score on PedsQL 67.7 (4.5) as reported by the children, and 66.0 (16.4) as reported by their parents. The children spent, on average, 89% of their waking day on sedentary activity, and 1% of the day in moderate-vigorous intensity physical activity, equivalent to only around 8 minutes/day.
CONCLUSION: Obese children in the MASCOT study had an impaired quality of life, high levels of sedentary behaviour and very low levels of physical activity.
INTRODUCTION: University students are potentially important targets for the promotion of healthy lifestyles as this may reduce the risks of lifestyle-related disorders later in life. This cross-sectional study examined differences in eating behaviours, dietary intake, weight status, and body composition between male and female university students.
METHODOLOGY: A total of 584 students (59.4% females and 40.6% males) aged 20.6 +/- 1.4 years from four Malaysian universities in the Klang Valley participated in this study. Participants completed the Eating Behaviours Questionnaire and two-day 24-hour dietary recall. Body weight, height, waist circumference and percentage of body fat were measured.
RESULTS: About 14.3% of males and 22.4% of females were underweight, while 14.0% of males and 12.3% of females were overweight and obese. A majority of the participants (73.8% males and 74.6% females) skipped at least one meal daily in the past seven days. Breakfast was the most frequently skipped meal. Both males and females frequently snacked during morning tea time. Fruits and biscuits were the most frequently consumed snack items. More than half of the participants did not meet the Malaysian Recommended Nutrient Intake (RNI) for energy, vitamin C, thiamine, riboflavin, niacin, iron (females only), and calcium. Significantly more males than females achieved the RNI levels for energy, protein and iron intakes.
CONCLUSION: This study highlights the presence of unhealthy eating behaviours, inadequate nutrient intake, and a high prevalence of underweight among university students. Energy and nutrient intakes differed between the sexes. Therefore, promoting healthy eating among young adults is crucial to achieve a healthy nutritional status.
A cross-sectional study was conducted to determine the familial and socio-environmental predictors of overweight and obesity among 1430, 9-12 year-old primary school children and their parents in Selangor and Kuala Lumpur.
INTRODUCTION: In Malaysia, hypertension prevalence has increased from 13% in 1996 to 43% in 2006 based on the Third National Health and Morbidity Survey.
METHODOLOGY: Recognising the importance of hypertension control to prevent cardiovascular morbidity and mortality, a cross-sectional study was carried out to assess factors influencing blood pressure among 74 hypertensive adults (22 men, 52 women, mean age 61.1 +/- 8.8 years old) attending an outpatient clinic of a government health clinic in Klang Valley. Subjects were interviewed to obtain information on social and health, physical activity level and food intake using Diet History Questionnaire (DHQ) and Food Frequency Questionnaire (FFQ). Anthropometric measurements including weight, height, waist circumference and percentage of body fat were also conducted.
RESULTS: The majority of the subjects (71.6%) had poor hypertension control as determined using blood pressure. Women aged 30-59 years old had a higher mean diastolic blood pressure (87.3 +/- 11.6 mmHg) than women aged 60 years old (78.5 +/- 9.5 mmHg) (p < 0.05). Most of the men (36.4%) achieved three out of six Medical Nutrition Therapy (MNT) for Hypertension Recommendations as outlined by the Malaysian Dietitians' Association. About one-third (30.8%) of the women achieved two out of six of the guidelines. High sodium intake (adjusted OR 3.501, 95% CI 1.116-10.985, p < 0.05), daily consumption of coffee (adjusted OR 0.302, 95% CI 0.093-0.983, p < 0.05) and less intake of milk (adjusted OR 3.328, 95% CI 1.055-10.493, p < 0.05) were associated with uncontrolled hypertension.
CONCLUSION: Three quarters of the subjects had unsatisfactory hypertensive control and was related to food intake and eating habits including high salt diet, coffee consumption and inadequate milk intake were unsatisfactory. There is a need to implement a nutrition intervention programme based on MNT to achieve good hypertensive control among subjects.
Study site: klinik kesihatan, Klang Valley, Malaysia
Peptide Tyrosine-Tyrosine (PYY) is a 36-amino acid peptide hormone released post-prandially from the endocrine cells in the intestinal tract to suppress pancreatic secretions and eventually reduce appetite. The R72T variant in the PYY gene (rs1058046) has been associated with increased susceptibility to obesity. Therefore, the objective of this study was to investigate the association of this variant with obesity and its related anthropometric measurements among the Kampar Health Clinic cohort, Malaysia.