Introduction: This two-phase longitudinal study sought to determine the association between isoflavones intake on cognitive function and comorbidities among older adults from the state of Johor, Malaysia.
Methods: Phase I involved baseline data collection to examine the association between isoflavones intake and cognitive function among 400 respondents aged 60-years and above, recruited through multistage random sampling. Phase 2 determined the association between isoflavones intake at the baseline and comorbidities at an 18-month follow-up. The baseline data collected included information on socio-demographics, health status, andunpometric measurements, and dietary intake using a dietary history questionnaire (DHQ). Each participant's cognitive function was evaluated using a mini mental state examination (MMSE), digit span, digit symbol, and geriatric depression scale (GDS).
Results: The daily intake of total isoflavones, daidzein, and genistein were 19.1±19.7,11.7±12.3 and 7.6+8.1 mg/day, respectively. There was no significant association between isoflavones intake, and specific cognitive function including global, memory, executive functions, and depression. However, there was a significant association (p 0.05).
Conclusion: This study found an association between isoflavones intake and memory function, but not with global cognitive, executive functions, depression, and comorbidities. There is a need to promote adequate isoflavones intake in view of its association with memory function.
Introduction: Malnutrition is a growing problem but quite often under-recognised in elderly people. Calf circumference (CC) is a simple measurement that can be used to identify elderly people who are at high risk of malnutrition; however, a population-specific cut-off point must be developed. Therefore, this study aimed to determine suitable cut-off points and evaluate the predictive value of the CC cut-off point for elderly Malaysians.
Methods: A total of 820 persons comprising 433 men and 387 women were recruited as subjects. The mean age was 69.0 ± 6.8 and ranged between 60 to 97 years. Data were collected from Sabak Bernam, Selangor; Kuala Pilah, Negeri Sembilan; Pasir Mas, Kelantan, and Kodiang, Kedah. A linear regression analysis with the z-score procedure by gender was used to derive the CC prediction equations.
Results: The CC cut-off points for men and women at risk of malnutrition were 30.1 cm and 27.3 cm, respectively. The final predictive CC equations for men was CC (cm) = 3.69 (z score) + 33.81, R2 = 1 and CC (cm) = 0.7103 (BMI) + 18.54, R2 = 1; and for women, CC (cm) = 4.31 (z score) + 31.63, R2 = 1 and CC (cm) = 0.6698(BMI) + 16.847, R2 = 1. Based on these equations, using the z-score equal to negative 1 for men (BMI 16.30 kg/m2 ) and women (BMI 15.64 kg/m2 ), the mean of the predictive value of the CC cut-off point was 32.0 ± 4.2 cm in men and 30.5 ± 4.6 cm in women.
Conclusion: It is suggested that these cut-off points be used to screen elderly individuals who are at risk of malnutrition. Further studies should be undertaken to further verify the application of the findings of this study.
Introduction: Nutrition screening is recommended as a first step of nutrition care to allow early identification and intervention of malnourished patients. The present study determined the validities and reliabilities of two malnutrition screening tools namely, the Malnutrition Universal Screening Tool (MUST) and Malnutrition Screening Tool (MST) among adult patients at the Hospital Kuala Lumpur. Methods: The sensitivity, specificity and predictive value of MUST and MST were conducted against the Subjective Global Assessment (SGA), anthropometric parameters including body mass index (BMI), calf circumference (CC), mid-upper arm circumference (MUAC) and energy intake. Inter-rater reliability was evaluated using kappa value (κ) to determine the level of agreement between raters. Results: A total of 151 subjects with mean age of 45.2 ± 13.7 years participated in this study. Prevalence of malnutrition according to MUST, MST and SGA was 34.4%, 33.8% and 19.9%, respectively. As compared to SGA, MUST and MST had a sensitivity of 96.6% and 93.3% respectively, whereas the specificity was 80.9% for both tools. The sensitivity and specificity of MUST against the anthropometric parameters (BMI, CC and MUAC) were between 53.8% to 88.8% and 67.4% to 69.9%, respectively. The sensitivity values for MST were between 46.1% to 63.6% and specificity values were between 64.4% to 67.6%. The inter-rater reliability of MUST was higher (substantial, mean (κ) = 0.78) than for MST (moderate, mean (κ) = 0.52). Conclusions: In conclusion, MUST was found to have similar validity levels but higher reliability result than MST. Based on our result, MUST is recommended for use in identifying adult patients who are at high risk of malnutrition. It can be used as a malnutrition screening tool but there is a need to evaluate the cost effectiveness of its implementation.
Body weight can be estimated using equations developed from the anthropometric measurements when body weight is difficult to measure for example among bedridden older adults. This study has developed the equation to estimate body weight among older adults resided in Klang Valley from several anthropometric measurements. A cross sectional study was carried out among community dwelling older adults aged 60 years old and above in Klang Valley area. Subjects were recruited through convenience sampling method. Weight, height, knee height (KH), demi span (DS), subscapular skinfold (SSF), calf circumference (CC), waist circumference (WC), hip circumference (HC), mid upper arm circumference (MUAC) and wrist circumference (WrC) were measured according to the standard protocol. Cross validation was performed. 61% from total subjects were selected randomly for the development of equation meanwhile, 39% subjects as control subjects. Equation was generated using stepwise multiple regression analysis. A total of 164 older adults involved in this study which consist of 39.0% men and 61.0% women. Mean age of the subjects was 68.32 ± 5.79 years meanwhile mean of measured body weight was 66.46 ± 11.98 kg. Predictive equation obtained was: estimated body weight = 5.149 (Sex) – 0.082 (Age) + 0.889 (Hip circumference) + 1.112 (Knee Height) – 72.778 (R2 = 0.848, p < 0.001). Correlation coefficient for 61% subjects were higher (r = 0.921) compared to the correlation coefficient for 39% subjects (r = 0.883) (p < 0.001). However, the differences between measured and estimated body weight was not significant (p = 0.798). This showed that the equation developed was able to estimate body weight among older adults, because the value of estimated body weight was closed to the value of measured body weight. The equation developed can be used to estimate body weight among Malaysian older adults. However, further study is warranted to explore this equation into the different settings such as clinical setting.
Introduction: Frailty is related to physical function, nutritional status, and cognition; however, these factors are rarely investigated comprehensively in a single study. Thus, this study aimed to examine the differences in nutritional, physical and cognitive function among frail, pre-frail and robust Malaysian elderly.
Methods: A total of 473 participants were randomly selected from ten different areas in Klang Valley by multistage random sampling. Frailty was characterised using the Fried criteria. Anthropometric measurements, diet intake, body composition, and physical and cognitive function were assessed. Kruskal Wallis test was employed to examine the relationship between the independent variables and frailty.
Results: Frail subjects had significant higher body mass index (26.8±4.4kg/m2 ) compared to pre-frail (25.7±4.4 kg/m2 ) and robust (24.9±3.9kg/ m2 ), (p
The incidence of falls among older adults can be caused by nutritional, health status, physical and environmental factors. The objective of this study was to develop and evaluate the contents in a booklet on nutrition and falls prevention among older adults as a nutritional education material for falls prevention. In Phase I, market survey in bookstore, website search and need assessment among 30 respondents using a questionnaire was conducted. Results from Phase I were used to form a 32-page A5 size booklet that includes information on nutrients related to bone health, recommendations of high protein and calcium menus, ideal exercise and tips to avoid falls in older adults. The content validity of the booklet was conducted among six health professionals to assess the suitability and understanding in Phase II. The content of the booklet (Phase III) was then evaluated among 24 respondents aged 60 years and above. From the need assessment in Phase I, majority of respondents chose 7 to 9 for the score of each questions which indicates the need for all information to be included in the booklet. For Phase II, criteria with highest average score were composition and typography with a score of 60%. For Phase III, most respondents chose “good” for all the criteria stated except for pictures (satisfactory), while 62.5% of respondents stated that they were satisfied with the information contents in the booklet. In conclusion, this booklet can be used as one of the strategies for nutrition education in the prevention of falls among older adults.
Introduction: Omega-3 Polyunsaturated Fatty Acids (PUFAs) play an important role in developing cognitive function in children, especially Docosahexanoic Acid (DHA). However, there is no suitable dietary assessment tool to assess DHA intake among Malaysian children. Thus, this study assessed the validity of an interviewer-administered semi-quantitative Food Frequency Questionnaire (FFQ) for estimating DHA intake among Malay school children in the Sepang District.
Methods: Thirty 12-year-old Malay children (13 boys and 17 girls) were recruited through purposive sampling. Their DHA intake for one month duration was assessed using a 30-food item FFQ and validated against a 3-day food record.
Results: The majority of the subjects (70%) had normal body mass index, 6.7% were overweight, 16.7% obese, whilst the rest were in the thin category. The reliability of FFQ was found to be good with a Cronbach’s α coefficient value of 0.815. Wilcoxon Signed Rank Test indicated no significant difference in mean intake between the two assessment methods. Significant and strong correlation between FFQ and the 3-day food record was found for total omega-3 PUFAs (r=0.812)and DHA (r=0.839) using both methods. BlandAltman analysis exhibited no apparent systematic bias between the two methods for DHA and total omega-3 PUFAs intake, whilst a quartile analysis assigned 73.3% of the subjects into the same quartile.
Conclusion: The FFQ was found to be valid in estimating DHA intake among Malay school children, and it is recommended that its validity be tested on other ethnic population groups.
A cross-sectional study was conducted to determine bone health status and nutrient intakes among post-menopausal women residing in low cost houses in Cheras, Kuala Lumpur.
Introduction: Feeding difficulty and functional disability are common problems among patients with dementia but their influence on caregivers' burden has not been addressed comprehensively. Thus, this study aimed to determine the association between feeding problems, functional status and caregiver burden among patients with dementia who receive outpatient treatment at Universiti Kebangsaan Malaysia Medical Centre (UKMMC) in Kuala Lumpur, Malaysia, as compared to their non-demented counterparts. Methods: A cross-sectional comparative study was conducted among 30 patients with dementia (12 men, 18 women, mean age 75 ± 7 years old) and 60 subjects without dementia (25 men, 35 women, mean age 69 ± 7 years), as well as their caregivers. Subjects' functional status, feeding problems and also caregiver burden were assessed using Activities of Daily Livings (ADLs) and Instrumental Activities of Daily Living (IADL) questionnaire, The Edinburgh Feeding Evaluation in Dementia Questionnaire (EdFED-Q) and Zarit Burden Interview (ZBI), respectively. Subjects were also measured for height and weight. Results: Patients with dementia needed supervision (50%) and physical help during mealtime (40%). The mean functional status score of these patients was higher than the patients without dementia (p<0.05). Caregiver burden score was positively correlated with the EdFED-Q score (r=0.405, p<0.05) but negatively correlated with functional status score (r=0.475, p<0.01). Further, multiple regression analysis showed that after adjustment for age, EdFED-Q score and functional status remained correlated with caregiver burden at R2 of 0.210. Conclusion: Caregiver burden is associated with feeding problems and functional disability among patients with dementia. There is a need to educate the caregivers in order to improve the quality of life of both carers and the demented patients.
Key words: Caregiver burden, dementia, feeding problems, functional status, outpatient
Study site: Psychiatric and medical clinics, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
Frailty is one of the major health concerns in aging. It is considered a geriatric syndrome characterized by muscle weakness, sarcopenia and fatigue. It is also associated with several adverse health outcomes, including disability. Literature shows that there are a number of studies conducted to define the relationship between frailty and nutrition. The majority is from cross sectional, longitudinal, and cohort studies. Few intervention studies using micronutrients, macronutrients, nutritional supplement, or food regimens have been found. This review examines the nutrition intervention studies targeted towards older adults with frailty, and evaluates the effectiveness of nutrition interventions on frailty indicators. Twenty-four intervention studies from six electronic databases met the inclusion criteria. Sixteen were randomized controlled clinical trials; one was a quasi-experimental design, whilst the rest were controlled trials. Participants included in the studies differed in terms of age and frailty status. The studies were inconsistent in intervention type, duration, and targeted outcomes. Most of the studies indicated that modification of nutrition quality, either by giving supplements or by improving diet intake, could improve strength, walking speed, and nutritional status in majority of frail or pre-frail older adults. However, there was limited evidence on the effectiveness of intervention on inflammatory status and other biomarkers related to frailty due to limited number of studies targeting frailty biomarkers as a major outcome.
This cross sectional study was conducted to determine the validity of three screening tools, Mini Nutritional Assessment Short Form (MNA-SF), Malnutrition Risk Screening Tool for Community (MRST-C) and Malnutrition Risk Screening Tool for Hospital (MRST-H) among elderly people at health clinics. The screening tools were validated against anthropometric and functional assessments. The anthropometric assessments that were carried out included body weight, height, arm span, body mass index (BMI), calf circumference (CC) and mid upper arm circumference (MUAC). A set of questionnaire on manual dexterity, muscular strength, instrumental activities daily living (IADL) and cognitive status was used to assess functional abilities. A total of 156 subjects were recruited from rural (38 subjects) and urban (118 subjects) health clinics at Sabak Bernam and Cheras respectively. Subjects' age ranged from 60 to 83 years old, with 44.2% were men and 55.8% women. The prevalence of muscle wasting among the subjects assessed from MUAC and CC were both 7.0%. MNA-SF had the highest correlation with BMI (r = 0.497, p<0.001), followed by MUAC (r = 0.398, p<0.001), CC (r = 0.473, p<0.001), cognitive assessment (r = 0.229, p<0.001) and handgrip strength (r = 0.209, p<0.001). Whilst MRST-C had the highest correlation with IADL score (r =-0.320, p<0.001) and MRST-H had the highest correlation with the lock and key test (r = -0.325, p<0.01). Sensitivity was the highest for MNA-SF (93.2%), followed by MRST-H (52.5%) and MRST-C (25.8%). Specificity was the highest for MRST-H (97.3%), followed by MRST-C (90.8%) and MNA-SF (79.4%). Positive predictive value (PPV) for MRST-H, MNA-SF and MRST-C was 55.5%, 18.2% and 14.1%, respectively. In conclusion, among the screening tools being validated, MNA-SF is considered the most appropriate tool to be used in health clinics for identification of elderly individuals who are at high risk of malnutrition.
Poor appetite is one of the main contributing factors of poor nutritional status among elderly individuals. Recognizing the importance of assessment of appetite, a cross sectional study was conducted to determine the validity of appetite screening tools namely, the Council on Nutrition Appetite questionnaire (CNAQ) and the simplified nutritional appetite questionnaire (SNAQ) against the appetite, hunger and sensory perception questionnaire (AHSPQ), measures of nutritional status and food intake among geriatric patients at the main general hospital in Malaysia. Nutritional status was assessed using the subjective global assessment (SGA) while food intake was measured using the dietary history questionnaire (DHQ). Anthropometric parameters included weight, height, body mass index (BMI), calf circumference (CC) and mid upper arm circumference (MUAC). A total of 145 subjects aged 60 to 86 years (68.3 ± 5.8 years) with 31.7% men and 68.3% women were recruited from outpatients (35 subjects) and inpatients (110 subjects) of Kuala Lumpur Hospital of Malaysia. As assessed by SGA, most subjects were classified as mild to moderately malnourished (50.4%), followed by normal (38.6%) and severely malnourished (11.0%). A total of 79.3% and 57.2% subjects were classified as having poor appetite according to CNAQ and SNAQ, respectively. CNAQ (80.9%) had a higher sensitivity than SNAQ (69.7%) when validated against nutritional status as assessed using SGA. However, the specificity of SNAQ (62.5%) was higher than CNAQ (23.2%). Positive predictive value for CNAQ and SNAQ were 62.6% and 74.7%, respectively. Cronbach's alpha for CNAQ and SNAQ were 0.546 and 0.578, respectively. History of weight loss over the past one year (Adjusted odds ratio 2.49) (p < 0.01) and thiamine intake less than the recommended nutrient intake (RNI) (Adjusted odds ratio 3.04) (p < 0.05) were risk factors for poor appetite among subjects. In conclusion, malnutrition and poor appetite were prevalent among the geriatric outpatients and inpatients. SNAQ was more reliable and valid as an appetite screening tool among this special group of population. There is a need to regularly include nutritional and appetite assessment for early intervention measures in order to prevent consequences of malnutrition.
A case control study to determine the association of dietary fibre and cancer among Malaysians. It was conducted among 100 newly-diagnosed cancer patients admitted to the Radiotherapy and Oncology Ward, Hospital Kuala Lumpur. A total of 100 controls matched with the cases for age, sex and ethnic origin were selected from the Outpatient Health Clinic in Sentul. The subjects were interviewed to obtain information on their habitual dietary intakes and lifestyles. Family history of cancer, smoking habits, and alcohol consumption were found to be significant risk factors for cancer (p<0.05 for all parameters). The mean intake of total energy was higher among men with nasopharyngeal cancer and women with gastrointestinal cancer as compared to their controls (p<0.05 for both parameters). The percentage of energy contribution from fat was higher among cases (35%) than controls (32.1%). The mean dietary fibre intake among cases (10.86 ± 8.90 g/d) was apparently lower than the controls (13.22 ± 5.99 g/d), with significant differences noted for breast cancer and also nasopharyngeal cancer. Women with low fibre intake (<10g/d) had a 2.2 times higher risk of getting breast cancer. There is a need to educate the public to adhere to a wholesome diet, in particular to increase the consumption of high-fibre food for disease prevention.
Study site: Radiotherapy and Oncology Ward, Hospital Kuala Lumpur and Outpatient Health Clinic in Sentu
Loss of appetite, decrease in food intake and changes in body composition appear to be inter-related factors that can influence the well-being of older individuals. Therefore, a study was conducted to determine the level of appetite, food intake and its relation to body composition and functional status among noninstitutionalised elderly Malays in Cheras, Kuala Lumpur. The Council on Nutrition Appetite Questionnaire (CNAQ), Diet History Questionnaire (DHQ), Bio-impedance Analysis (BIA) and Instrumental Activity of Daily Living (IADL) questionnaire and handgrip dynamometer were used to measure appetite, food intake, body composition and functional status respectively. A total of 112 subjects (41.1% men and 58.9% women) participated with mean age being 66.0 ± 5.0 years for men and 66.3 ± 6.2 years for women. Prevalence of poor appetite was higher in elderly women (72.3%) than in men (52.3%) (p<0.05). Pearson's correlation test showed that CNAQ score correlated significantly with age (r=-0.255, p<0.01), energy intake (r=0.272, p<0.01), IADL score (r=0.408, p<0.01) and handgrip strength (r=0.263, p<0.05). Energy intake correlated significantly with fat free mass (r=0.424, p<0.05), muscle mass (r=0.456, p<0.05) and total body water (r=0.403, p<0.05). Multiple regression analysis showed that 27.0% of poor appetite could be explained by advanced age, low energy intake and decreased functional status. In conclusion, the study showed that poor appetite was prevalent among the subjects, especially women and this was influenced by aging, inadequate energy intake and decreased functional status.
INTRODUCTION: Hospitalised elderly patients are at high risk of malnutrition due to the presence of chronic diseases and inadequate food intake. It was on this premise that a Malnutrition Risk Screening Tool-Hospital (MRST-H) was developed for identifying the risk of malnutrition among Malaysian elderly patients.
METHODS: A total of 181 respondents aged 65 years and above who had been admitted to the Geriatric Ward of the University Malaya Medical Centre were recruited. The respondents' nutritional assessment was assessed using the Global Indicator of Malnutrition (GIM), a reference gold standard of malnutrition consisting of anthropometric measurements, biochemical indicators and the Subjective Global Assessment (SGA). Important predictive factors of malnutrition were determined by logistic regression analysis.
RESULTS: Five out of 18 predictive factors were significantly associated with malnutrition (p<0.05) in the final multivariate logistic regression model. These five factors were used to develop the MRST-H. Its validity was tested among 100 elderly inpatients in the Kuala Lumpur Hospital. The MRST-H was found to have 66.7% sensitivity, 96.2% specificity and 82.4% positive predictive value to GIM. The MRST-H was tested for reliability among 40 patients involving three raters (a dietitian and two nurses). The Kappa index of agreement was excellent between the dietitian with nurse A (81.3%, Kappa=0.84) and nurse B (87.5%, Kappa=0.89) respectively.
CONCLUSION: The MRST-H developed showed high validity and reliability as a screening tool for identifying hospitalised elderly patients with high risk of malnutrition.
This quasi-experimental study was carried out to evaluate the effectiveness of an eight-week multi-disciplinary pulmonary rehabilitation programme in improving nutritional and functional status and quality of life of COPD out patients at Hospital Universiti Kebangsaan Malaysia. A total of 9 COPD outpatients aged 40 years and above (6 men and 3 women) completed at least 50% of 16 sessions of an eight-week pulmonary rehabilitation programme. Their nutritional and functional status and rating of quality of life were measured at baseline (0 day) and after 8 weeks and these were compared to those of the control group matched for age, comprising 13 subjects (11 men and 2 women). Nutritional status was determined using anthropometry, body composition (Bioelectrical Impedance Analysis) and three-day food record. Assessment of appetite for food was also carried out using the Simplified Nutritional Assessment Questionnaire (SNAQ). Functional status was assessed using the Pulmonary Functional Status and Dyspnea Questionnaire-modified version(PFSDQ-M). The handgrip strength was also measured using handgrip dynamometer. The SF36 questionnaire was used to measure the quality of life of the subjects. There was a reduction in dyspnea (-49.0%, p<0.05) and fatigue (-47.8%, p<0.05) in men after the intervention programme, as compared to their controls (dyspnea -2.9% and fatigue 8.9%). Quality of life in this group was also significantly improved by 31.8% (p<0.05) as compared to their controls (-3.0%,p>0.05). Similar trends were noted for the women, although the difference was not significant. No significant changes were seen in nutritional status assessed by anthropometry, dietary intake and appetite. However, there was a trend of increased nutrient intake and SNAQ score in the intervention group as compared to control. An eight-week pulmonary rehabilitation programme was effective in improving the functional status particularly in men, by reducing dyspnea and fatigue; and also improving their quality of life, but was not effective in changing the nutritional status.
Study site: Physiotherapy Unit, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
INTRODUCTION: Malnutrition is a common phenomenon among the elderly and quite often related to psychosocial problems. The objective of this study was to determine malnutrition risk and its association with appetite, functional and psychosocial status among elderly Malays in an agricultural settlement, i.e. FELDA Sungai Tengi, Selangor.
METHODS: A cross-sectional study was conducted among 160 subjects (men = 36.2%), with a mean age of 65.0 +/- 3.9 years, who were interviewed to obtain information on malnutrition risk and appetite using Mini Nutritional Assessment Short Form and Simplified Nutritional Appetite Questionnaire, respectively. Functional status was determined using Instrumental Activities of Daily Living (IADL), Elderly Mobility Scale (EMS) and handgrip strength. Mini Mental Status Examination (MMSE), Geriatric Depression Scale and De Jong Gierveld Loneliness Scale were used to identify cognitive impairment, depressive symptoms and loneliness status of subjects respectively. A total of 42.5% of subjects were at risk of malnutrition and 61.2% had poor appetite. The mean scores of IADL and EMS were lower in subjects at risk of malnutrition, compared to those who were not at high risk (p < 0.05 for both parameters). Multiple linear regression showed that 19.8% of malnutrition risk was predicted by poor appetite, decreased functional status (IADL) and depression.
CONCLUSION: Malnutrition risk was prevalent and associated with poor appetite, functional status and psychosocial problems among the elderly subjects. The psychosocial aspect should also be incorporated in nutrition intervention programmes in order to improve mental well-being and functional independancy.
Study site; FELDA Sungai Tengi, Selangor, Malaysia
Device, Questionnaire & Scale: Mini Nutritional Assessment Short Form; Simplified Nutritional Appetite Questionnaire, Instrumental Activities of Daily Living (IADL); Elderly Mobility Scale (EMS); handgrip strength. Mini Mental Status Examination (MMSE), Geriatric Depression Scale (GDS-15); De Jong Gierveld Loneliness Scale
A cross-sectional study was carried out to evaluate the nutritional status of 51 subjects with leukemia aged 4 to 12 years from the Haematology and Oncology Paediatric Ward, Universiti Kebangsaan Malaysia Medical Centre (PPUKM) and the Paediatric Institute of Kuala Lumpur. Nutritional status was assessed using anthropometric measurements, biochemical and haematological parameters. Subjects comprised 32 (62.7%) males and 19 (27.3%) females. Most of the subjects (41.2%) were in the age group of 4 to 6 years. More than half of the children were Malays (70.6%) followed by Indians (15.7%) and Chinese (13.7%). The subjects were diagnosed as acute lymphoblastic leukemia (ALL) (84.3%) followed by acute myelogenous leukemia (AML) (13.7%) and chronic myelogenous leukemia (CML) (2.0%) respectively. Most of the children were in remission status (54.9%). Underweight (s) of malnutrition (
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