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Fulltext Obesity-related behaviors of Malaysian adolescents: a sample from Kajang district of Selangor state

Rezali FW, Chin YS, Mohd Yusof BN

Nutr Res Pract, 2012 Oct;6(5):458-65.
PMID: 23198026 DOI: 10.4162/nrp.2012.6.5.458

This study aims to determine the association between obesity-related behaviors (dietary practices, physical activity and body image) and body weight status among adolescents. A total of 382 adolescents (187 males and 195 females) aged 13 to 15 years in Kajang, Selangor participated in this study. Majority of the respondents were Malays (56.0%), followed by Chinese (30.1%) and Indians (13.9%). Dietary practices, physical activity and body image of the adolescents were assessed through the eating behaviors questionnaire, two-day dietary record, two-day physical activity record and multi-dimensional body image scale (MBIS), respectively. Body weight and height were measured by trained researchers. The prevalence of overweight and obesity (19.5%) was about twice the prevalence of underweight (10.5%). About two-thirds of the respondents (72.3%) skipped at least one meal and half of them (56.2%) snacked between meals with a mean energy intake of 1,641 ± 452 kcal/day. More than half of the respondents (56.8%) were practicing sedentary lifestyle with a mean energy expenditure of 1,631 ± 573 kcal per day. Energy intake (r = 0.153, P < 0.05), physical activity (r = 0.463, P < 0.01) and body image (r = 0.424, P < 0.01) were correlated with BMI. However, meal skipping, snacking and energy expenditure per kg body weight were not associated with body weight status. Multiple linear regression analysis showed that body image, physical activity and energy intake contributed significantly in explaining body weight status of the adolescents. In short, overweight and obesity were likely to be associated not only with energy intake and physical activity, but also body image. Hence, promoting healthy eating, active lifestyle and positive body image should be incorporated in future obesity prevention programmes in adolescents.

Matched MeSH terms: Thinness
Fulltext Development of multi-dimensional body image scale for malaysian female adolescents

Chin YS, Taib MN, Shariff ZM, Khor GL

Nutr Res Pract, 2008;2(2):85-92.
PMID: 20126371 DOI: 10.4162/nrp.2008.2.2.85

The present study was conducted to develop a Multi-dimensional Body Image Scale for Malaysian female adolescents. Data were collected among 328 female adolescents from a secondary school in Kuantan district, state of Pahang, Malaysia by using a self-administered questionnaire and anthropometric measurements. The self-administered questionnaire comprised multiple measures of body image, Eating Attitude Test (EAT-26; Garner & Garfinkel, 1979) and Rosenberg Self-esteem Inventory (Rosenberg, 1965). The 152 items from selected multiple measures of body image were examined through factor analysis and for internal consistency. Correlations between Multi-dimensional Body Image Scale and body mass index (BMI), risk of eating disorders and self-esteem were assessed for construct validity. A seven factor model of a 62-item Multi-dimensional Body Image Scale for Malaysian female adolescents with construct validity and good internal consistency was developed. The scale encompasses 1) preoccupation with thinness and dieting behavior, 2) appearance and body satisfaction, 3) body importance, 4) muscle increasing behavior, 5) extreme dieting behavior, 6) appearance importance, and 7) perception of size and shape dimensions. Besides, a multidimensional body image composite score was proposed to screen negative body image risk in female adolescents. The result found body image was correlated with BMI, risk of eating disorders and self-esteem in female adolescents. In short, the present study supports a multi-dimensional concept for body image and provides a new insight into its multi-dimensionality in Malaysian female adolescents with preliminary validity and reliability of the scale. The Multi-dimensional Body Image Scale can be used to identify female adolescents who are potentially at risk of developing body image disturbance through future intervention programs.

Matched MeSH terms: Thinness
Fulltext The All-Cause Mortality and a Screening Tool to Determine High-Risk Patients among Prevalent Type 2 Diabetes Mellitus Patients

Bujang MA, Kuan PX, Tiong XT, Saperi FE, Ismail M, Mustafa FI, et al.

J Diabetes Res, 2018;2018:4638327.
PMID: 30116741 DOI: 10.1155/2018/4638327

AIMS: This study aims to determine the all-cause mortality and the associated risk factors for all-cause mortality among the prevalent type 2 diabetes mellitus (T2DM) patients within five years' period and to develop a screening tool to determine high-risk patients.
METHODS: This is a cohort study of T2DM patients in the national diabetes registry, Malaysia. Patients' particulars were derived from the database between 1st January 2009 and 31st December 2009. Their records were matched with the national death record at the end of year 2013 to determine the status after five years. The factors associated with mortality were investigated, and a prognostic model was developed based on logistic regression model.
RESULTS: There were 69,555 records analyzed. The mortality rate was 1.4 persons per 100 person-years. The major cause of death were diseases of the circulatory system (28.4%), infectious and parasitic diseases (19.7%), and respiratory system (16.0%). The risk factors of mortality within five years were age group (p < 0.001), body mass index category (p < 0.001), duration of diabetes (p < 0.001), retinopathy (p = 0.001), ischaemic heart disease (p < 0.001), cerebrovascular (p = 0.007), nephropathy (p = 0.001), and foot problem (p = 0.001). The sensitivity and specificity of the proposed model was fairly strong with 70.2% and 61.3%, respectively.
CONCLUSIONS: The elderly and underweight T2DM patients with complications have higher risk for mortality within five years. The model has moderate accuracy; the prognostic model can be used as a screening tool to classify T2DM patients who are at higher risk for mortality within five years.

Matched MeSH terms: Thinness
Fulltext Nutrition and educational achievement of urban primary schoolchildren in Malaysia

Shariff ZM, Bond JT, Johnson NE

Asia Pac J Clin Nutr, 2000 Dec;9(4):264-73.
PMID: 24394502

The relationship between nutrition, health and educational achievement of school-age population in less developed countries has been of interest to many researchers due to the frequent observation that many children did not complete primary school and those who completed, did not do as well as children in the developed countries. Nevertheless, nutritional and health status by itself is not the only variable affecting educational achievement, since biological, psychological, socioeconomic and cultural factors could directly or indirectly affect both nutrition, health status and educational achievement. The mechanism by which health and nutrition influence educational achievement is not well established, but poor health and malnutrition in early childhood may affect cognitive abilities, necessary for learning process and consequently educational achievement. A study was conducted in Kuala Lumpur, Malaysia, to investigate the relationship between nutritional status and educational achievement among primary schoolchildren from low income households (n = 399). A high percentage of them were mild-significantly underweight (52%), stunted (47%) and wasted (36%) and increasingly overweight (6%). In general, more boys than girls were found to experience some form of malnutrition. While weight-for-height did not differ significantly according to family, child and school factors, weight-for-age and height-for-age differed significantly by gender. Also, height-for-age was significantly related to household income. This indicates that stunting may be a consequence of prolonged socioeconomic deprivation. Educational achievement was measured based on test scores for Malay language (ML), English language (EL) and mathematics (MT). While a majority of the schoolchildren obtained optimum scores (>75) for ML and MT, the majority of them had insufficient scores (<50) for EL. Children's total score (TS) for the three subjects was significantly associated with household socioeconomic status, gender, birth order and heightfor- age. Even after controlling for household socioeconomic status, significant association between TS and height-for-age persisted. In this sample of schoolchildren, household income, gender, birth order and height-forage were significant predictors of TS. The finding that height-for-age is related to educational achievement agrees with other studies, which have reported that height-for-age, compared to weight-for-height or weight-forage is linked to educational achievement. Height-for-age reflects the accumulation of nutritional deprivation throughout the years, which may consequently affect the cognitive development of the children.

Matched MeSH terms: Thinness
Fulltext Evaluation of nutritional status among a group of young Chinese adults in Kuala Lumpur, Malaysia

Karim N, Leong SW

Asia Pac J Clin Nutr, 2000 Jun;9(2):82-6.
PMID: 24394392

A nutritional status study was carried out among a group of young Chinese adults, aged between 19 and 25, in Kuala Lumpur, Malaysia. Subjects comprised 108 young adults (55 women, 53 men) who were students at two institutes of higher learning. Physical characteristics were evaluated by anthropometric measurements while food intake was determined with a 3-day food record. Blood cholesterol and triglyceride were assessed using the Reflotron analyser. Birthweight was obtained from birth certificates or by proxy. The results showed that the mean body mass index (BMI) for men and women was 21.4 ± 3.3 and 20.0 ± 2.0, respectively, indicating normal weight. Further analysis of BMI classification demonstrated that 28% of men and 39% of women were underweight, 11% of men and 2% of women were overweight while 2% of men were obese. Mean waist-to-hip ratio showed that the subjects had a low risk of developing cardiovascular disease (0.72 ± 0.03 women; 0.81 ± 0.05 men). Mean energy intake was 8841 ± 1756 kJ per day for men and 6426 ± 1567 kJ per day for women. Closer analysis of energy intake of the subjects showed that 86% of men and 91% of women were consuming below the Malaysian recommendation for energy. Nutrients found to be deficient in at least one third of women were calcium, vitamin A, niacin and iron. Mean cholesterol intake in the diet was 278.7 ± 108.7 mg in men and 207.0 ± 82.5 mg in women and there was a significant difference between genders. Blood cholesterol and triglyceride levels were 3.88 ± 0.76 mmol/L and 1.08 ± 0.33 mmol/L, respectively in men, while these levels were lower in women, 3.87 ± 0.80 mmol/L for cholesterol and 0.99 ± 0.29 mmol/L for triglyceride. A general trend of higher mean blood cholesterol and triglyceride levels was shown in adults who were born with lower birthweights.

Matched MeSH terms: Thinness
Fulltext The female athlete triad among elite Malaysian athletes: prevalence and associated factors

Quah YV, Poh BK, Ng LO, Noor MI

Asia Pac J Clin Nutr, 2009;18(2):200-8.
PMID: 19713179

Women participating in a wide range of competitive sports are at higher risk of developing eating disorders, menstrual irregularities and osteoporosis, which are generally referred to as the 'female athlete triad'. The objective of this study was to determine the prevalence of female athlete triad and factors associated with this condition among athletes participating in different sports. A total of 67 elite female athletes aged between 13-30 years participated in the study and were subdivided into the 'leanness' and 'non-leanness' groups. Eating disorders were assessed using a body image figure rating and the Eating Disorder Inventory (EDI) with body dissatisfaction (BD), drive for thinness (DT), bulimia (B) and perfectionism (P) subscales. Menstrual irregularity was assessed with a self-reported menstrual history questionnaire. Bone quality was measured using a quantitative ultrasound device at one-third distal radius. Prevalence of the female athlete triad was low (1.9%), but the prevalence for individual triad component was high, especially in the leanness group. The prevalence of subjects who were at risk of menstrual irregularity, poor bone quality and eating disorders were 47.6%, 13.3% and 89.2%, respectively, in the leanness group; and 14.3%, 8.3% and 89.2%, respectively, in the non-leanness group. Since the components of the triad are interrelated, identification of athletes at risk of having any one component of the triad, especially those participating in sports that emphasise a lean physique, is an important aid for further diagnosis.

Matched MeSH terms: Thinness
Child feeding practices, food habits, anthropometric indicators and cognitive performance among preschoolers in Peninsular Malaysia

Mohd Nasir MT, Norimah AK, Hazizi AS, Nurliyana AR, Loh SH, Suraya I

Appetite, 2012 Apr;58(2):525-30.
PMID: 22265752 DOI: 10.1016/j.appet.2012.01.007

This study aimed to determine the relationship between child feeding practices, food habits, and anthropometric indicators with cognitive performance of preschoolers aged 4-6 years in Peninsular Malaysia (n=1933). Parents were interviewed on socio-demographic background, nutrition knowledge, child feeding practices and food habits. Height and weight of the preschoolers were measured; BMI-for-age, weight-for-age and height-for-age were determined. Cognitive performance was assessed using Raven's Colored Progressive Matrices. The mean monthly household income was RM3610 and 59.6% of parents attained secondary education. Thirty-three percent of parents had good knowledge on nutrition, 39% satisfactory and 28% poor. For child feeding practices, perceived responsibility had the highest mean score (M=3.99, SD=0.72), while perceived child weight had the lowest (M=2.94, SD=0.38). The prevalence of possible risk of overweight, being overweight, and obesity were 3.9%, 7.9% and 8.1%, respectively, whereas the prevalence of underweight and stunting were 8.0% and 8.4%, respectively. Breakfast was the second most frequently skipped meal (16.8%) after dinner (18.1%). The mean cognitive score was 103.5 (SD=14.4). Height-for-age and consumption of dinner were found to contribute significantly towards cognitive performance after controlling for socio-demographic background and parent's nutrition knowledge.

Matched MeSH terms: Thinness
Fulltext Living environment and health of under-five children in urban slums of a coastal region in South India

Roja VR, Narayanan P, Sekaran VC, Ajith Kumar MG

Ghana Med J, 2020 Dec;54(4):238-244.
PMID: 33883772 DOI: 10.4314/gmj.v54i4.6

Objective: The primary objective of the study was to determine the association between the living environment and morbidity, nutritional status, immunization status, and personal hygiene of under-five children living in urban slums in southern India.
Methods: This study included 224 mothers of under-five children living in urban slums of Udupi Taluk, Karnataka. A total of 17 urban slums were selected randomly using random cluster sampling.
Results: Undernutrition was high among children of illiterate mothers (63.8%), and the children of working mothers were affected by more morbidity (96.6%) as compared with housewives. Morbidity was also found to be high among children belonging to families with low incomes (66.1%) and low socio-economic backgrounds (93.1%). Safe drinking water, water supply, sanitation, hygiene, age of the child, mother's and father's education, mother's occupation and age, number of children in the family, use of mosquito nets, type of household, and family income were significantly associated with child morbidity, nutritional status, immunization status, and personal hygiene of under-five children living in urban slums.
Conclusion: Overall, in our study, family characteristics including parental education, occupation and income were significantly associated with outcomes among under-five children. The availability of safe drinking water and sanitation, and the use of mosquito nets to prevent vector-borne diseases are basic needs that need to be urgently met to improve child health.
Funding: Self-funded.

Matched MeSH terms: Thinness