1.Factors associated with poor appetite among residents at selected long-term care facilities in Selangor, Malaysia
Duaa Al-junid ; Chan Yoke Mun ; Siti Nur Asyura Adznam ; Chin Yit Siew ; Zalilah Mohd Shariff ; Lim Poh Ying ; Sazlina Shariff-Ghazali ; Tanti Irawati Rosli
Malaysian Journal of Nutrition 2024;30(No.1):1-14
Introduction: Poor appetite is prevalent among older adults and may negatively
impact on their overall health. This is especially true for institutionalised residents.
Despite this, there is a paucity of research on appetite and its associated factors
among institutionalised residents, which signified the present study. Methods: A
cross-sectional study was conducted among elderly residents at long-term care
facilities in the state of Selangor, Malaysia to ascertain their appetite status and its
associated factors. Results: A total of 97 residents with mean age of 74.2±8.4 years
old were recruited. They comprised 61.9% females and 38.1% males. More than
50% had poor appetite with early satiety. There were 63.0%, 82.4%, and 94.8% who
had poor oral health, poor sleep quality, and depression, respectively. Ethnicity
(OR=2.73; 95% CI=1.00-7.44; p=0.049) was the only factor that predicted poor appetite
among older adults in long-term care facilities, with Malay residents having poorer
appetite than their Chinese and Indian counterparts. Conclusion: The prevalence
of poor appetite was high among residents staying at long-term care facilities in
Selangor, Malaysia, especially among Malays. This issue deserves further studies
to identify the specific underlying factors contributing to poor appetite among older
adults from different ethnicities. Acknowledging the high prevalence of poor appetite
among older adults and its possible unfavourable outcomes, appropriate nutrition
interventions are therefore needed to address this issue among institutionalised
elderly.
2.Association between nutritional status of Filipino preschool children and participation in government programmes at the household and individual levels
Frances Pola S. Arias ; Eldridge B. Ferrer
Malaysian Journal of Nutrition 2024;30(No.1):15-30
Introduction: Health and nutrition interventions in developing countries have been linked to better thriving and survival of children. Identifying programmes with significant effect on the nutritional status of Filipino preschool children may aid in identifying impactful interventions in addressing malnutrition. This study evaluated the association between nutritional status of preschool children and government
programme participation based on the 2018 Expanded National Nutrition Survey (ENNS) results. Methods: Secondary data analysis of 12,949 preschool children was performed from the 2018 ENNS. The selected data included socioeconomic, anthropometric, and self-reported household-level and individual-level government programme participation. Chi-square test for association and multiple logistic regression were conducted using Stata version 16. Results: Participation in immunisation programme, growth monitoring, household food production, and awareness and usage of iodised salt were negatively associated with at least one type of undernutrition. Consequently, participation in deworming programme was positively associated with both underweight and stunting. Regression analysis showed that preschool children who underwent growth monitoring were less likely to be stunted (OR=0.58), while those who underwent newborn screening were less likely to be underweight (OR=0.53) and stunted (OR=0.62). On the contrary, dewormed children were more likely to be stunted (OR=1.63) and those from 4Ps households were more likely to be wasted (OR=2.24). Conclusion: There is a need to re-evaluate programme strategies to maximise the benefits provided. Programmes
showing significant associations with nutritional status including immunisation, growth monitoring, deworming, household food production, and awareness and usage of iodised salt should be continued and sustained with updated policies.
3.Eating behaviour and lifestyle changes among college students in Malaysia during the Movement Control Order (MCO)
Anis Suraya Muhamad Azmi ; Nur Islami Mohd Fahmi Teng ; Norsham Juliana
Malaysian Journal of Nutrition 2024;30(No.1):31-41
Introduction: COVID-19 lockdown has been linked to alterations in eating
behaviour and a sedentary lifestyle. As human-to-human transmission rapidly
increased, the Movement Control Order (MCO) was put in place as an attempt to
minimise the risk of the virus spreading in the community. This study aimed to
determine whether eating behaviour was associated with sleep quality and physical
activity among college students in Malaysia during MCO. Methods: This was a
cross-sectional study among Malaysian students aged between 20 to 34 years old. A
simple random sampling method was applied and the participants had to complete
an online survey consisting of a validated Dutch Eating Behaviour Questionnaire
(DEBQ), Pittsburgh Sleep Quality Index (PSQI), and International Physical Activity
Questionnaire–Short Form (IPAQ-SF), distributed via an online platform. Results:
A total of 370 students participated, with 22.4% emotional eaters, 58.6% external
eaters, and 23.0% restrained eaters. In addition, 64.3% had poor sleep quality,
while 57.6% claimed to be physically active. However, no correlations were found
between all eating behaviour subscales with sleep quality and physical activity.
Conclusion: More than half of college students presented with external eating
behaviours. Early screening and further investigations should be done, especially
with the high rate of poor sleepers, to promote and sustain a healthy lifestyle during
and beyond COVID-19.
4.Association between dietary diversity and complications during pregnancy in a South-West District of Bangladesh
Sabrina Zaman ; Tamsel Ahammed ; Md. Abu Bashar
Malaysian Journal of Nutrition 2024;30(No.1):43-57
Introduction: Poor dietary diversity is one of the key factors that increases the rate
of complications during pregnancy. Pregnancy complications significantly increase
the risk of maternal mortality. The aim of this study was to explore the associated
factors between dietary diversity and complications during pregnancy. Method: A
cross-sectional study was conducted among 450 randomly selected pregnant women.
Individual dietary diversity score (IDDS) was used to assess dietary diversity based
on Food Frequency Questionnaire (FFQ). IDDS was derived from 24-hour recalls
from nine food groups. Results: Most of the pregnant women (48.9%) included in
this study were in their second trimester; 19.3% and 31.8% were in first trimester
and third trimester, respectively. About 83.8% of respondents included in this
study experienced pregnancy complications. According to IDDS, most participants
(77.1%) consumed a medium-diversified diet. Only 4.4% and 18.4% of pregnant
women had low and highly diversified dietary intakes, respectively. Mean IDDS was
5.62±0.93, which indicated medium diversity of dietary intake. Dietary diversity had
a statistically significant correlation with age (p=0.003), monthly income (p=0.003),
education level (p=0.001), and respondent’s employment (p=0.004). The study
exposed that pregnancy complications had a negative correlation with food diversity
(r=-0.223), marriage age (r=-0.066), and education level (r=-0.163). Conclusion:
The study concluded that pregnancy complications can be alleviated by improving
dietary diversity practices during pregnancy.
5.Socio-demographic factors and parental feeding practices predicted body mass index of Malaysian children with learning disabilities
Siti Fathiah Mohamed ; Divya Vanoh ; Soo Kah Leng
Malaysian Journal of Nutrition 2024;30(No.1):59-72
Introduction: Overweight and obesity have emerged as significant global health
concerns among children. Previous studies have provided evidence that children with
intellectual and learning disabilities (LD) are at a higher risk of obesity compared to
their peers without disabilities. Methods: This study aimed to predict body weight
status of children with LD who attended Special Education Integration Program
in Kelantan, located on East Coast of Peninsular Malaysia. Parents completed a
self-administered questionnaire in Malay language, which included “Screening
Tool of Feeding Problems” children’s version (STEP-CHILD) and Comprehensive
Feeding Practice Questionnaire (CFPQ). The children’s body weight and height
were measured to determine body mass index (BMI). Research hypothesis was
tested through stepwise multiple linear regression analysis. Results: This study
recruited 245 subjects with mean age of 10.5±1.7 years and mean BMI of 18.5±4.9
kg/m2. Prevalence of underweight, thinness and severe thinness was 12.2%, while
overweight and obesity was 29.0%. Male children with LD (β=0.109, p<0.044), older
age (β=0.226, p<0.001), higher child birth weight (β=0.119, p<0.029), lack of parental
modelling (β=-0.170, p=0.004), lower parental pressure (β=-0.266, p<0.001), and
higher restriction for weight control (β=0.361, p<0.001) were found to predict higher
BMI values. Conclusion: Positive parental feeding practices during mealtime are
crucial for addressing the poor nutritional status of children with LD.
6.Development and validation of the Salt Intake-Related Knowledge, Attitude, and Practice Questionnaire for Malaysian adults
Zainorain Natasha Zainal Arifen ; Ngoh Wan Hwah ; Hng Jie Wei ; Siti Aishah Ismail ; Maryam Hanis Fairuzam ; Hasnah Haron
Malaysian Journal of Nutrition 2024;30(No.1):73-86
Introduction: Malaysian adults consume excessive amounts of salt daily, which
could lead to hypertension. Understanding knowledge, attitudes, and practices
(KAP) surrounding salt intake is crucial for designing effective interventions to
reduce excessive consumption and its associated health risks. Therefore, this study
aimed to adapt an existing salt intake-related KAP questionnaire that was previously
employed in a local population-based survey and to validate and test its reliability.
Methods: This cross-sectional study comprised two phases: (1) adaptation, content
validation (CV), and face validation (FV); (2) pilot testing and reliability testing. CV
and FV involved a total of seven experts and ten Malaysian adults from the Klang
Valley, respectively. Pilot testing involved 139 Malaysian adults to determine the
questionnaire’s reliability. Content validity index (CVI) and Face validity index
(FVI) values were calculated to analyse CV and FV. Reliability of each domain was
analysed by obtaining Cronbach’s alpha (α) values. Results: A self-administered
questionnaire comprising six items each for knowledge, attitude, and practice was
developed. The questionnaire demonstrated acceptable item-level CVI (I-CVI) and
item-level FVI (I-FVI) values of at least 0.83, indicating that the items were relevant,
clear, non-ambiguous, and simple. Reliability test showed acceptable α values
of at least 0.70 for each domain, suggesting that the questionnaire was reliable.
Conclusion: This tool could be considered valid and reliable for assessing the level
of KAP towards salt intake among adults in Malaysia.
7.Associations between quantity and quality of dietary intake with haemoglobin concentration among female adolescents in Tasikmalaya, West Java, Indonesia
Lilik Hidayanti ; Dian Saraswati ; Iseu Siti Aisyah
Malaysian Journal of Nutrition 2024;30(No.1):87-94
Introduction: An imbalance in diet can lead to anaemia in young women, which
can impact not only themselves, but also the next generation. This study aimed
to determine associations between quantity and quality of dietary intake with
haemoglobin (Hb) concentration among female adolescents in Tasikmalaya, West
Java, Indonesia. Methods: A cross-sectional study was conducted on 347 young
women aged 12-18 years from ten districts in Tasikmalaya City, selected by simple
random sampling. Quantity and quality of dietary intake were measured by 2-repeated
24-hour dietary recalls, while portable haemoglobinometer (HemoCue® Hb 201+) was
used to measure Hb concentration. Linear regression model predicted associations
between quantity and quality of dietary intake with Hb concentration in female
adolescents. Results: The proportion of subjects suffering from anaemia were
47.3%. Average intake of dietary iron was 6.7±3.0 mg and average dietary quality
score was 32.6%. Dietary quality score and days of menstrual bleeding contributed
as much as 12.7% to the variation in Hb concentration among female adolescents.
Conclusion: Anaemia in female adolescents in Tasikmalaya, West Java, Indonesia
is a serious public health problem. Diet quality score was associated with female
adolescents’ Hb concentration; therefore, improving the quality of diet is important
to reduce anaemia.
8.Effects of nut and legume powder substitution in crackers prepared with wheat flour on postprandial plasma glucose response among healthy Thai adults
Wongdokmai Rossukon ; Sridonpai Pimnapanut ; Prachansuwan Aree
Malaysian Journal of Nutrition 2024;30(No.1):95-106
Introduction: Crackers, one of the most consumed baked products, primarily
contain refined wheat flour and have a moderate glycaemic index (GI). Nut and
legume powders are used in baked goods to help regulate postprandial glycaemia;
however, their glycaemic responses remain controversial. Our study aimed to
compare the postprandial glycaemic responses between crackers with 30% wheat
flour substitution by white kidney beans, cashew nuts, and almonds versus standard
wheat crackers. Methods: Twelve adults were recruited for a five-session randomised
controlled crossover study. In each session, they were randomly assigned to receive
50g carbohydrates from either a glucose solution or one of the four crackers.
Plasma glucose levels were measured at baseline and 15, 30, 45, 60, 90, and 120
minutes after consumption. Satiety and hunger were evaluated using 100mm visual
analogue scales at baseline and every 30 minutes until 120 minutes. Results: Mean
incremental area under the curve (IAUC) for plasma glucose did not differ between
the alternatives and wheat crackers, but was lowest for almond crackers. Compared
with GI value of glucose solution, that of wheat, cashew nut, white kidney bean, and
almond crackers were 39.97±23.13, 37.66±24.66, 35.85±10.86, and 28.09±17.92,
respectively. Almond cracker consumption resulted in the highest mean IAUC
for satiety and lowest for hunger, though non-significant. Conclusion: Crackers
with 30% wheat flour substitution by nut and legume powders tended to improve
postprandial glycaemia more than the standard crackers; however, acute responses
on insulin and glucagon-like peptide-1 require further examination.
9.Correlation between body mass index and haemoglobin level of adolescent girls in a stunting locus area at Tangerang, Indonesia
Nadiyah ; Idrus Jus&rsquo ; at
Malaysian Journal of Nutrition 2024;30(No.1):107-116
Introduction: In Indonesia, anaemia is known to be extremely common in
female adolescents. In addition, the problem of overweight/obesity in teenagers
is becoming more prevalent, even in stunting locus areas. This study aimed to
examine the correlation between body mass index (BMI) and haemoglobin levels
among adolescent girls in Tangerang’s stunting locus area. Methods: This crosssectional study included 171 adolescent girls attending four junior and senior
high schools in Tangerang’s stunting locus area. Adolescents who matched the
inclusion criteria— healthy, having lived in Sukamantri for more than six months,
and willing to participate were chosen by a multistage cluster sampling procedure.
Body weight and fat were measured, and Z-score for BMI-for-age was determined.
Haemoglobin levels were measured by the Mission Hb Testing System. Multiple
linear regression test was applied for the analysis. Results: The prevalences of
thinness/severe thinness, normal, and overweight/obesity were 5.3%, 70.8%,
and 23.9%, respectively. There were 20% of anaemic girls. Among anaemic girls,
there were 26% overweight/obese and no thin/very thin girls. A weak, negative
correlation between BMI with haemoglobin levels was observed (R2=0.054, p<0.001).
Conclusion: The correlation between BMI and haemoglobin level was weak in our
sample of adolescent girls in the stunting locus area. The current study emphasised
the importance of additional research that includes several haematological and
inflammatory biomarkers to better understand the complex relationship between
nutritional status and haemoglobin level.
10.Online training needs assessment (TNA) among Municipal Nutrition Action Officers (MNAOs) in the Philippines
Idelia G. Glorioso ; Milflor S. Gonzales ; Trina Mae B. Santos
Malaysian Journal of Nutrition 2024;30(No.1):117-128
Introduction: A training needs assessment (TNA) was conducted by the Department
of Science and Technology, Food and Nutrition Research Institute (DOST-FNRI) to
design appropriate and relevant trainings for Municipal Nutrition Action Officers
(MNAOs). In the Philippines, MNAO is a nutrition officer who serves at the municipal
level and is tasked to ensure the localisation of the Philippine Plan of Action for
Nutrition (PPAN) in Local Government Units (LGU) to ensure proper implementation
of activities on Public Health Nutrition (PHN). Methods: A total of 162 MNAOs in
the country answered the online TNA survey conducted from April to May 2023.
Results: Based on the results of the TNA survey, there was a need for DOST-FNRI
to design and conduct trainings related to the top three core competencies identified
by MNAOs: Creating policies and standards related to food and nutrition; advocating
legislation, regulation, and nutrition policies; and designing appropriate nutrition
information education and communication (IEC) materials. Conclusion: Based on
the study results, it is recommended that LGUs allocate funds for capacity building
of the public health workforce to create a skilled workforce in the community
that will coordinate the formulation, implementation, monitoring, and evaluation
of nutrition plans at the municipal level. For future consideration, curriculum
design for professional development in public health nutrition should include
core competencies on food and nutrition policy programme, nutrition programme
management, and IEC development.


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