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Fulltext Effects of sports nutrition education intervention on sports nutrition knowledge, attitude and practice, and dietary intake of Malaysian team sports athletes

Siti Soraya Mohd Elias, Hazizi Abu Saad, Mohd Nasir Mohd Taib, Zubaidah Jamil

Malays J Nutr, 2018;24(1):103-116.
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Introduction: The purpose of this study was to determine the effects of sports nutrition education intervention on improvements in sports nutrition knowledge, attitude and practice (KAP), and dietary intake among Malaysian team sports athletes. Methods: A total of 105 male participants representing four team sports under the elite sports programme were recruited based on a name list provided by National Sports Council of Malaysia. Teams were assigned by stratified random sampling to either the experimental group (EG) (n=52) or the comparison group (CG) (n=53). The EG received seven weeks of education intervention programme based on a validated booklet covering basic sports nutrition for team sports. A self-administered sports nutrition KAP questionnaire and dietary intake assessment of total energy, carbohydrates, proteins and fats based on three-day food records was conducted before and after the intervention. Results: There were significant increments (p
Fulltext Insulin resistance, inflammation and metabolic syndrome in normal weight and overweight/obese primary school children in Kuala Lumpur

Mohd Nasir Mohd Taib, Chin, Yit Siew, Zalilah Mohd Shariff, Tung, Serene En Hui, Yim, Hip Seng, Zubaidah Jamil Osman

Malays J Nutr, 2018;24(2):153-161.
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Introduction: Studies on metabolic syndrome (MetS) of children are important
in view of rising prevalence of childhood obesity worldwide. This study compares
the risks of insulin resistance, inflammation and metabolic syndrome between
overweight/obese (OW/OB) and normal weight (NW) children in Kuala Lumpur.

Methods: A cross-sectional study was conducted in 12 primary schools selected
using multi-stage stratified random sampling. Height and weight were taken of a
total of 1971 children aged 10-11 years. Based on BMI-for-age, 235 OW/OB children
matched for age, sex and ethnicity with 226 NW children were selected for the study.
Overnight fasting blood samples were collected to determine insulin, high-sensitivity
C-reactive protein (hsCRP), glucose and lipid profiles. Logistic regression analysis
was conducted to estimate associations between weight status and metabolic risk
factors.

Results: Prevalence of MetS among OW/OB children was 3.8% compared to
0% in the NW. Prevalence of insulin resistance among OW/OB was 45.5% compared
to 18.6% among NW children. High risk of inflammation was found in 28.1% of the
OW/OB children compared to 12.4% in the NW. The odds ratio of having insulin
resistance, inflammation and metabolic risk factors among OW/OB were 3.66 (95%
CI: 2.40-5.59), 2.76 (95% CI: 1.69-4.50), 4.93 (95% CI: 3.42-7.10), respectively
compared to the NW.

Conclusion: The OW/OB children in this study showed higher
risks of developing insulin resistance, inflammation and MetS compared to the NW
counterparts. Further studies are suggested to better understand the relationships
between insulin resistance, inflammation and MetS in children.
Fulltext Reliability and factor structure of the General Health Questionnaire-12 among university students

Normala Ibrahim, Zubaidah Jamil Osman, Khin Ohmar Naing Noor Jan, Siti Irma Fadhilah Ismail, Phang Cheng Kar, Firdaus Mukhtar, et al.

Malaysian Journal of Medicine and Health Sciences, 2014;10(2):53-60.
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The 12- item General Health Questionnaire (GHQ-12) has been translated into many languages and widely used in different settings and countries. Its reliability and psychometric properties were extensively studied in many population groups which suggested that it measures psychological distress in multidimensional construct. Objective: The objective of this study was to assess the reliability and factor structure of the Bahasa Malaysia version of the GHQ-12 among university students attending a health program at a Malaysian public university. Method: The cross sectional survey was conducted on 306 undergraduate students aged between 18 to 27 years old who visited the booth set up for mental health screening at a health program. The screening was conducted using a self-administered, validated Bahasa Malaysia version of GHQ-12 questionnaire. Results: Using exploratory factor analysis, the Bahasa Malaysia version of GHQ-12 was found to have a three factor structures namely depressive symptoms, self-esteem and perceived abilities which accounted for 58% of the item variance. The overall Cronbach’s alpha coefficient of the scale was found to be high (0.84) with each factor having acceptable inter-item consistency ranging from 0.61 to 0.82. Conclusion: The findings of the study show that the Bahasa Malaysia version GHQ-12 is reliable and has good structural characteristics. It can assess a few domains of the psychological status of university students. It also helps in providing more information
on the domain which may become a focus target of intervention in the prevention of mental illness.
Fears related to pregnancy and childbirth among primigravidae who requested caesarean versus vaginal delivery in Iran

Matinnia N, Faisal I, Hanafiah Juni M, Herjar AR, Moeini B, Osman ZJ

Matern Child Health J, 2015 May;19(5):1121-30.
PMID: 25269852 DOI: 10.1007/s10995-014-1610-0

Pregnancy- and childbirth-related fears are common psychological concerns and the primary reasons for requesting caesarean section (CS). We aimed to examine the content of maternal fear and the associated demographic factors in a sample of Iranian primigravidae. A randomly selected sample of primigravidae (n = 342) was recruited in four health care centres in Iran. Data were collected using a 30-item questionnaire. Principal components factor analysis was applied to identify the main factors of pregnancy- and childbirth-related fears. All primigravidae reported some degree of fear, 48.2 % presented severe fear, and 62.6 % requested a CS because of childbirth-related fear. Most of the employed primigravidae with higher education level, higher family income, and unplanned pregnancy requested CS. The items constructed to measure maternal fear were subjected to exploratory factor analysis. Six categories were identified, including 'process of labour and childbirth', 'life and well-being of the baby', 'competence and behaviour of maternity ward personnel', 'own capabilities and reactions', 'becoming a parent and family life after delivery' and 'general fear in pregnancy' that cumulatively explained 55.3 % of the variance. The most common factor was 'life and well-being of the baby'. Severe fear was found in 70.6 % of those who chose CS, while 10.9 % of those who chose vaginal delivery reported severe fear. The between-group differences for mean scores and levels of fear were statistically significant. Pregnancy- and childbirth-related fears were frequently experienced by all low-risk primigravidae. Better strategies to address women's psychological needs during pregnancy are necessary.
Religious commitment, attitudes toward suicide, and suicidal behaviors among college students of different ethnic and religious groups in Malaysia

Foo XY, Alwi MN, Ismail SI, Ibrahim N, Osman ZJ

J Relig Health, 2014 Jun;53(3):731-46.
PMID: 23196328 DOI: 10.1007/s10943-012-9667-9

The variation in suicide patterns across ethnic groups with different religious background is a puzzling social phenomenon. This study sought to examine the impact of religious commitment and attitudes toward suicide on suicidal behaviors of college students across major ethnic and religious groups in a multicultural society of Malaysia. A total of 139 college students completed Religious Commitment Inventory-10, Attitudes Toward Suicide Scale, and Suicidal Behavior Questionnaire-Revised. Findings showed significant discrepancies in attitudes toward suicide, but not suicidal behaviors across ethnic and religious groups. Suicide acceptance significantly affected suicidal behaviors as well. Although religious commitment is not associated with suicidal behaviors, its deviation is reflected in students' acceptance of suicide. Additionally, college students' suicide risk, lifetime, and recent suicide ideation, as well as their likelihood of future suicide attempt can be associated with their acceptance of suicide. The influence of attitudes toward suicide and religion, therefore, should be taken into consideration while implementing suicide prevention programs as it helps shape the norms about suicide among youths.
Fulltext Knee pain and functional disability of knee osteoarthritis patients seen at Malaysian government hospitals

Foo CN, Manohar A, Rampal L, Lye MS, Mohd Sidik S, Osman ZJ

Malaysian Journal of Medicine and Health Sciences, 2017;13(2):7-15.
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Introduction: Osteoarthritis (OA) is the main cause of knee pain. It also affects individual’s physical functioning. Anti- inflammatory drugs and knee replacement are the mainstay methods in the management of knee OA in Malaysia. However, patients with knee OA often suffer pain. The general objective of the study is to evaluate the effectiveness of a cognitive behavioural intervention module on knee pain, functional disability and psychological outcomes among knee OA patients attending Orthopedics Clinics in Hospital Putrajaya and Hospital Serdang, Malaysia. This study aims to determine the baseline level of knee pain and functional disability among knee OA patients.
Methods: Baseline results on the knee pain and functional disability were obtained from a two arm parallel- group randomized controlled study. Three hundred patients aged 35 to 75 years diagnosed with knee OA were recruited. A set of pre tested and validated Knee injury and Osteoarthritis Outcome Score (KOOS) questionnaire was used in this study.
Results: Mean baseline of KOOS pain was 56.09 (SD=21.75) and 52.26 (SD=22.08) for the intervention and control groups respectively. Participants in the intervention and control groups had a mean KOOS function in daily living of 61.11 (SD=21.20) and 56.72 (SD=22.13) respectively. Overall mean baseline of KOOS function in sport and recreation was 35.30 (SD=27.38).
Conclusions: Majority of participants had moderate level of knee pain and functional disability in daily living. However, participants had more extreme symptoms of functional disability in sport and recreation. Therefore, interventions to reduce knee pain and functional disability symptoms in knee OA are needed.

Study site: Orthopedics Clinics in Hospital Putrajaya and Hospital Serdang, Malaysia
Self-management of chronic pain in Malaysian patients: effectiveness trial with 1-year follow-up

Cardosa M, Osman ZJ, Nicholas M, Tonkin L, Williams A, Abd Aziz K, et al.

Transl Behav Med, 2012 Mar;2(1):30-37.
PMID: 22448204

Self-management of chronic illnesses has been widely recognised as an important goal on quality of life, health service utilisation and cost grounds. This study describes the first published account on the application of this approach to people suffering from chronic pain conditions in a Southeast Asian country, Malaysia. A heterogeneous sample of chronic pain patients in Malaysia attended a 2-week cognitive-behavioural pain management programme (PMP) aimed at improving daily functional activities and general psychological well-being. Complete datasets from 70 patients out of 102 patients who attended 11 programmes conducted from 2002 to 2007, as well as the 1-month and 1-year follow-up sessions at the hospital clinic, are reported. The pre- to post-treatment results on self-report measures indicate that significant gains were achieved on the dimensions of pain, disability and psychological well-being. These gains were maintained at both 1-month and 1-year follow-ups. The results mirror those reported from similar interventions in Europe and North America and indicate the concept of self-management of a chronic illness is acceptable and meaningful to Asian patients. Importantly, the achieved outcomes were independent of gender and ethnic group status.
Testing comparison models of DASS-12 and its reliability among adolescents in Malaysia

Osman ZJ, Mukhtar F, Hashim HA, Abdul Latiff L, Mohd Sidik S, Awang H, et al.

Compr Psychiatry, 2014 Oct;55(7):1720-5.
PMID: 24952938 DOI: 10.1016/j.comppsych.2014.04.011

OBJECTIVE: The 21-item Depression, Anxiety and Stress Scale (DASS-21) is frequently used in non-clinical research to measure mental health factors among adults. However, previous studies have concluded that the 21 items are not stable for utilization among the adolescent population. Thus, the aims of this study are to examine the structure of the factors and to report on the reliability of the refined version of the DASS that consists of 12 items.
METHOD: A total of 2850 students (aged 13 to 17 years old) from three major ethnic in Malaysia completed the DASS-21. The study was conducted at 10 randomly selected secondary schools in the northern state of Peninsular Malaysia. The study population comprised secondary school students (Forms 1, 2 and 4) from the selected schools.
RESULTS: Based on the results of the EFA stage, 12 items were included in a final CFA to test the fit of the model. Using maximum likelihood procedures to estimate the model, the selected fit indices indicated a close model fit (χ(2)=132.94, df=57, p=.000; CFI=.96; RMR=.02; RMSEA=.04). Moreover, significant loadings of all the unstandardized regression weights implied an acceptable convergent validity. Besides the convergent validity of the item, a discriminant validity of the subscales was also evident from the moderate latent factor inter-correlations, which ranged from .62 to .75. The subscale reliability was further estimated using Cronbach's alpha and the adequate reliability of the subscales was obtained (Total=76; Depression=.68; Anxiety=.53; Stress=.52).
CONCLUSION: The new version of the 12-item DASS for adolescents in Malaysia (DASS-12) is reliable and has a stable factor structure, and thus it is a useful instrument for distinguishing between depression, anxiety and stress.
Fulltext A pilot placebo-controlled, double-blind, and randomized study on the cognition-enhancing benefits of a proprietary chicken meat ingredient in healthy subjects

Azhar ZM, Zubaidah JO, Norjan KO, Zhuang CY, Tsang F

Nutr J, 2013;12:121.
PMID: 23945213 DOI: 10.1186/1475-2891-12-121

It has long been postulated that the relative abundance of specific nutrients can affect cognitive processes and emotions. Newly described influences of dietary factors on neuronal function and synaptic plasticity have revealed some of the vital mechanisms that could be responsible for the action of diet on brain health and cognitive function. Here, through a double-blind, randomized, placebo-controlled trial, we asked if the newly discovered chicken meat ingredient-168 (CMI-168) could be beneficial to the cognitive function in healthy adults.
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.
Fulltext Fluid intake, hydration status and its association with cognitive function among adolescents in Petaling Perdana, Selangor, Malaysia

Tung SEH, Ch'ng YZ, Karnan TV, Chong PN, Zubaidah JO, Chin YS

Nutr Res Pract, 2020 Oct;14(5):490-500.
PMID: 33029289 DOI: 10.4162/nrp.2020.14.5.490

BACKGROUND/OBJECTIVES: A cross-sectional study was undertaken to evaluate fluid intake and hydration status in association with cognitive function among 230 adolescents (10-14 years of age) in Petaling Perdana, Selangor, Malaysia.
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.

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