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Fulltext Overweight and obesity among children: a relationship between maternal beliefs and feeding practices with children’s body mass index-for-age in Bandar and Jugra Kuala Langat Selangor

Asrawati Awalina Aslan, Norhasmah Sulaiman

Malaysian Journal of Medicine and Health Sciences, 2020;16(106):11-18.
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Introduction: Childhood obesity is one of the major public concerns as prevalence was showing an increasing trend in Malaysia. This study aimed to determine the associations between maternal beliefs, attitudes and feeding practices with children’s Body Mass Index-for-age (BMI-for-age). Method: A cross-sectional study was carried out in Bandar and Jugra, Kuala Langat, Selangor in two-phase. The first phase was conducted to determine the prevalence of children’s body weight status involving 209 pairs of mothers and children. The second phase of the study aims to determine the socio-demographic characteristics, maternal beliefs, maternal attitudes and feeding practices with childhood obesity involving 148 pairs of mothers and children whose BMI-for-age are normal, overweight and obese only. A set of self-administered questionnaire was answered by the mothers and anthropometric measurements of children were taken. Results: Overall, about 24.9% of the children were overweight and obese. Maternal employ- ment status (X2 = 9.135, p
Fulltext Demographic and socio-economic characteristics, household food security status and academic performance among primary school children in North Kinta, Perak, Malaysia

Nor Syaza Sofiah Ahmad, Norhasmah Sulaiman

Malaysian Journal of Medicine and Health Sciences, 2020;16(106):26-33.
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Introduction: Good academic performance is important for children to ensure their personal well-being. This cross-sectional study investigated the associations between demographic and socio-economic characteristics, house- hold food security status and academic performance among primary school children at North Kinta, Perak, Malaysia. Methods: Two national primary schools were selected randomly and all Standard 5 and 6 students were invited to participate in this study. Self-administered questionnaire on demographic and socio-economic characteristics and food security status was completed by parents. The results from last year examination were acquired from the teach- er to evaluate students’ academic performance. Results: Overall, 140 respondents were involved, in which 51.4% were male. A majority of the household (80.7%) displayed food insecurity. Multiple logistic regression revealed that students from well-off households were more likely to have higher marks in English Language Comprehension (OR=8.28, 95%CI: 1.49, 45.91), Writing (OR=25.02, 95%CI: 2.36, 265.69) and Mathematics (OR=7.79, 95% CI:
1.44, 42.11). Female students showed high odds to pass English Language Comprehension (OR=3.47, 95% CI: 1.49, 8.16) and Writing (OR=4.16, 95%CI: 1.51, 11.45) compared to male students. Conclusion: This study unveiled that gender and low household income results in the low achievement in students’ academic. Therefore, for the upcom- ing intervention programmes should focusing more on helping students from poor households in order to enhance students’ academic performance.
Fulltext Association of socio-demographics and home food environment factors on body weight status among primary school children

Rina Syahira Rathuan, Nurzalinda Zalbahar, Norhasmah Sulaiman

Malaysian Journal of Medicine and Health Sciences, 2020;16(106):19-25.
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Introduction: Obesity in children is a global epidemic issue. Home food environment is an important aspect that may influence children’s body weight status. The aim of this study is to identify the association between socio-de- mographics and home food environment (HFE) factors with body weight status in primary school children in Bangi, Selangor. Methods: There were 398 children (43.5% males and 56.5% females) aged 7-11 years old (mean age of 9.04±1.41 years) and their parents (66.6% mothers and 33.4% fathers) from eight randomly selected primary schools participated in this study. Parents were asked to complete a self-administered questionnaire on socio-demograph- ic background, feeding practices and food availability, while children were interviewed to obtain information on parental styles and physical activity level. Weight and height of children were assessed, and BMI-for-age z-score (BAZ) was calculated by using WHO Anthroplus Software. Results: Overweight and obesity prevalence was 17.8% and 13.1% respectively. A majority of the parents (61.3%) in this study practiced authoritative parenting style. The increased odds of childhood obesity has been found to be associated with an increasing age (OR=1.239, p
Fulltext Socio-demographic factors, food security and mental health status among mothers in Mentakab, Pahang, Malaysia

Noratikah Mamat, Norhasmah Sulaiman, Siti Farhana Mesbah

Malaysian Journal of Medicine and Health Sciences, 2019;15(201):47-52.
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Introduction: Women are vulnerable to food insecurity. This study aimed to determine the demographic factors, food security and mental health status among mothers in Mentakab, Pahang. Methods: This cross-sectional study was participated by 129 mothers aged 20 years to 59 years old. Mothers were interviewed to obtain information on demographic factors, food security status (Radimer/Cornell Hunger Scale) and mental health status (DASS-21). Chi-square and binary logistic regression were used to determine an association between factors and food security status. General linear model (GLM) was used to determine the difference in mental health score according to food security status group after controlling for covariates. Significance level was set at 0.05. Results: The mother’s mean age was 38.30 ± 9.70 years. Prevalence of food insecurity was 55.8%. About 39.5% of mothers were depressed, 24.0% were experienced anxiety and 16.3% of mothers were stressed. The mean depression and anxiety score were 4.11 ± 3.54 and 2.96 ± 3.19 respectively. The mean stress score was 3.91 ± 3.44. Low household income (p
Fulltext Prevalence of food insecurity and associated factors among freeliving older persons in Selangor, Malaysia

Siti Farhana Mesbah, Norhasmah Sulaiman, Zalilah Mohd Shariff, Zuriati Ibrahim

Malays J Nutr, 2018;24(3):349-357.
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Introduction: Older persons are vulnerable to food insecurity. This study
aimed to determine the prevalence of food security and associated factors
among free-living older persons in Petaling District, Selangor. Methods:
A total of 220 free-living older persons aged 60-87 years were selected by
using the cluster sampling method in this cross-sectional study. Faceto-face interviews were conducted to obtain information concerning the
demographic and socioeconomic background, food security, oral health, and
psychosocial status. Chi-square test and binary logistic regression analysis
were used to analyse the studied variables. Results: The median age of the
respondents was 65.5 years, and 19.5% were found as food insecure. There
were significant associations between marital status (χ2=6.818), education
level (χ2=6.242), occupation status (χ2=7.540), monthly income (χ2=9.940,),
and oral health status (χ2=9.627) with food security status. Those with a low
monthly income (AOR=2.449, 95% CI: 1.046-5.732), poor oral health status
(AOR: 3.306, 95% CI: 1.387-7.889) and living in rented accommodation
(AOR=6.218, 95% CI: 1.458-26.518) were more likely to be food insecure.
Conclusion: Respondents with an income lower than the poverty line
income (PLI), living in rented accommodation and poor oral health status
face increased risk of food insecurity. A nutrition assistance programme is
suggested to improve the socioeconomic and food security status of older
persons. Regular oral check-ups are recommended to improve the oral
health status of the elderly.
Fulltext Overweight and obesity among Orang Asli adults in Krau Wildlife Reserve, Pahang: a four-year follow-up study

Chua, Ee Yin, Zalilah Mohd Shariff, Norhasmah Sulaiman, Appannah, Geeta

Malays J Nutr, 2019;25(3):199-207.
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Introduction: Obesity and excess weight gain in adults are linked to an increased
risk of cardiometabolic abnormalities. The changing lifestyle experienced by the
Orang Asli predisposes the population to the risk of obesity and non-communicable
diseases. This study aimed to describe the prevalence of overweight and obesity as
well as body-weight change over a period of four years among Orang Asli adults.
Methods: Data were collected from Orang Asli adults aged ≥18 years, who were
enrolled in the 2011-2012 and 2015-2016 surveys, and who were residing within
the Krau Wildlife Reserve. Weight and height of the adults (N2011-2012=828; N2015-
2016=662) were measured at both time points. Follow-up data were available for 378
adults (male:113; female:265). Results: The prevalence of overweight and obesity
were 18.8% and 7.4% in 2011-2012 and 26.1% and 9.5% in 2015-2016. In the
follow-up group, significant differences in body weight and body mass index (BMI)
were observed in men and women, respectively. More than one-third (35.5%) of the
adults had weight gain of more than 5.0%. The increasing percentage of body weight
change was associated with being female, younger age, more years of schooling and
reduced household income. Conclusion: Obesity is a growing health problem in
the Orang Asli adult population. Weight gain was associated with socioeconomic
indicators and it was more prominent in women. Effective strategies are needed to
address the increasing prevalence of overweight and obesity in this population to
further reduce adverse health outcomes.
Fulltext Demographic factors, food security, health-related quality of life and body weight status of adolescents in rural area in Mentakab, Pahang, Malaysia

Susanti Alie, Norhasmah Sulaiman, Fadilah Mohd Nor, Siti Farhana Mesbah

Malays J Nutr, 2019;25(3):297-307.
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Introduction: Adequate, nutritive and safe foods are crucial for growth and healthy
living. Adolescents are vulnerable to food insecurity. This study was aimed at
determining the demographic factors, food security status, health-related quality of
life (HRQOL) and body weight status of adolescents in Mentakab, Pahang, Malaysia.
Methods: This study involved 160 households that comprised pairs of mothers and
children aged 13-17 years. Face-to-face interviews were conducted with the mothers
to assess their demographic and food security status (Radimer/Cornell Hunger and
Food Insecurity Instrument). Meanwhile, the children answered a self-administered
HRQOL questionnaire (Pediatric Quality of Life Inventory, PedsQL). Body weight
and height were measured to obtain the body mass index (BMI). Results: About
48.8% of the adolescents were from households with food insecurity. The number
of school-going siblings, occupation status of mother, occupation status of father,
household income and house ownership status were predictors of food security
status (p
Fulltext Factors associated with stunting among Orang Asli preschool children in Negeri Sembilan, Malaysia

Wan, Ying Gan, Siti Fatihah Murtaza, Norhasmah Sulaiman, Zalilah Mohd Shariff

Malays J Nutr, 2018;24(2):215-226.
MyJurnal

Introduction: Childhood stunting is recognised as one of the most significant
barriers to human development. This cross-sectional study aimed to determine the
factors associated with stunting among Orang Asli (OA) preschool children in Negeri
Sembilan, Malaysia.

Methods: A total of 264 children (50.9% boys and 49.1%
girls) aged 2-6 years (M=4.04, SD=1.21 years) including their mothers from 14 OA
villages in Negeri Sembilan participated in this study. Mothers were interviewed to
obtain information regarding socioeconomic status, sanitation facility and personal
hygiene. The height of the children and their mothers were measured. Venous
blood samples were drawn from the children to estimate haemoglobin level, and
stool samples were collected to screen for intestinal parasitic infections.

Results:
Approximately one third of the children (35.6%) and 7.8% of the mothers were
stunted. One in five of the children were anaemic (21.6%), while one- third had
intestinal parasitic infections (35.0%). Low birth weight (AOR=2.526, 95% CI: 1.310-
4.872; p=0.006), anaemia (AOR=2.742, 95% CI: 1.265-5.945; p=0.011), presence
of intestinal parasitic infections (AOR=2.235, 95% CI: 1.310-3.813, p=0.003), not
wearing shoes (AOR=2.602, 95% CI: 1.453-4.660; p=0.001), absence of piped water
at home (AOR=2.395, 95% CI: 1.047-5.476; p=0.039), dirty nails (AOR=1.956, 95%
CI: 1.163-3.289, p=0.011), and stunted mothers (AOR=3.443, 95% CI: 1.334-8.890;
p=0.011) were identified as significant factors for childhood stunting.

Conclusion:
It is suggested that the factors identified associated with childhood stunting be
included in future intervention programmes that address stunting among OA
children.
Fulltext Anthropometry measurements to determine nutritional status among cerebral palsy children: a scoping review

Mahnon Suria Mokhy, Rosita Jamaluddin, Abd Rasyid Ismail, Woan Yie Siah, Norhasmah Sulaiman, Siti Nur ‘Asyura Adznam, et al.

Malaysian Journal of Medicine and Health Sciences, 2020;16(106):213-218.
MyJurnal

This article aimed to review the available anthropometry measurements used in the assessment of nutritional sta- tus among Cerebral Palsy (CP) children. Searched journals were from Medline, PubMed and Ovid published from 2015 to 2018. The search identified 443 articles, and eight studies met the criteria. Anthropometric measurements included weight, height, recumbent length, knee height, tibia length, Dual-energy X-ray absorptiometry (DXA), Bio- electrical impedance (BIA), Mid arm circumference (MUAC) subscapular skinfold (SFT), Triceps skinfold (TSF) and prediction equations. Body fat composition can be obtained by DXA, BIA, skinfold measurement, and also prediction equation. The predictive equation is the most reported method to determine nutritional status among CP. This review found that TSF and SFT are more accurate to determine body fat percentage when using together with the predictive equation. Besides, predictive equations using segmental length are reliable in estimating the height and can be used to evaluate the nutritional status using the specific CP growth chart.
Qualitative study on identification of common coping strategies practised by Indigenous Peoples (Orang Asli) in Peninsular Malaysia during periods of food insecurity

Law LS, Norhasmah S, Gan WY, Mohd Nasir MT

Public Health Nutr, 2018 Oct;21(15):2819-2830.
PMID: 29976262 DOI: 10.1017/S136898001800160X

OBJECTIVE: To examine the types of coping strategies practised by Indigenous women or Orang Asli (OA) in Peninsular Malaysia during times of food shortage and to determine the level of severity for food insecurity that will trigger each specific coping strategy.
DESIGN: A qualitative case study was conducted. Pertinent information about each type of coping strategy was gathered by in-depth interviews. To gauge the level of severity for each of the coping strategies, focus group discussions (FGD) were held. Thematic analysis was used for data analysis.
SETTING: OA villages in the states of Kelantan, Pahang, Perak and Selangor, Malaysia.
SUBJECTS: Sixty-one OA women from three ethnic groups (Senoi, Proto-Malay and Negrito) for in-depth interviews and nineteen OA women from the Proto-Malay ethnic group for three FGD.
RESULTS: The findings identified twenty-nine different coping strategies and these were divided into two main themes: food consumption (sub-themes of food consumption included dietary changes, diversification of food sources, decreasing the number of people and rationing) and financial management (sub-themes of financial management included increasing household income, reducing expenses for schooling children and reducing expenses on daily necessities). Three levels of severity were derived: less severe, severe and very severe.
CONCLUSIONS: This information would enable local authorities or non-governmental organisations to more precisely target and plan interventions to better aid the OA communities needing assistance in the areas of food sources and financial management.
Fulltext Obesity indices predict hypertension among indigenous adults in Krau Wildlife Reserve, Peninsular Malaysia

Chua EY, Zalilah MS, Haemamalar K, Norhasmah S, Geeta A

J Health Popul Nutr, 2017 05 25;36(1):24.
PMID: 28545536 DOI: 10.1186/s41043-017-0102-4

BACKGROUND: The disease burden of indigenous peoples has been augmented by the rising prevalence of obesity and hypertension in this population. This study assessed the ability of obesity indices to predict hypertension among indigenous adults of Peninsular Malaysia.
METHODS: In this cross-sectional study, 482 adults (223 men, 259 women) aged ≥18 years old were measured for body mass index (BMI), waist circumference (WC), waist-height ratio (WHtR), waist-hip ratio (WHR), and blood pressure. Receiver operating characteristic (ROC) analysis was used to determine the predictive ability of obesity indices for hypertension in men and women. Gender-specific logistic regression analyses were done to examine the association between obesity, defined by BMI, WC, WHtR and WHR, and hypertension.
RESULTS: Prevalence of hypertension was 25.5%. Overall, WHtR was the best predictor of the presence of hypertension, in both men and women. The optimal WHtR cut-off values for hypertension were 0.45 and 0.52 in men and women, respectively. Obese adults with WHtR ≥0.5 had about two times increased odds of having hypertension compared to non-obese adults.
CONCLUSIONS: WHtR may serve as a simple and inexpensive screening tool to identify individuals with hypertension in this relatively difficult to reach population.
Fulltext The Identification of the Factors Related to Household Food Insecurity among Indigenous People (Orang Asli) in Peninsular Malaysia under Traditional Food Systems

Law LS, Norhasmah S, Gan WY, Siti Nur'Asyura A, Mohd Nasir MT

Nutrients, 2018 Oct 08;10(10).
PMID: 30297599 DOI: 10.3390/nu10101455

Over the course of 16 years, a high percentage of Orang Asli (OA) households in Malaysia has been found to be burdened with food insecurity. Therefore, a study was conducted to improve the understanding of the challenges faced by the OA in Peninsular Malaysia to achieve food security under traditional food systems. In this study, in-depth interview sessions, which were assisted by an interview protocol, were conducted with 61 OA women from nine villages that were selected purposefully across three states (Kelantan, Pahang, and Perak) in Peninsular Malaysia. Furthermore, thematic analysis was performed during data analysis. As a result, four themes were identified, namely (i) the failure in agriculture (sub-themes: threats from wild animals and insufficient land supply), (ii) ineffectiveness of traditional food-seeking activities (sub-themes: exhausting, tiring, dangerous, and time-consuming journey for food-seeking activities, depletion of natural commodities, reduced demands of natural commodities, and lack of equipment), (iii) weather (sub-themes: rainy and dry seasons), and (iv) water issues (subthemes: continuity of water supply and cleanliness of water). The identified modifiable factors of this issue should be incorporated into future schemes of food security intervention in order to efficiently manage the food shortage among the OA.

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