Introduction: It is known that dietary diversity improves diet quality and nutritional status of young children. This study aimed to determine the relationship between dietary diversity and nutritional status of Orang Asli children in Krau Wildlife Reserve. Methods: A total of 216 children from three Orang Asli sub-tribes (Jah Hut, Temuan and Che Wong) aged 1 to 6 years from 162 households in 16 villages participated in this cross-sectional study. Children and mothers were measured for body weight and height. Mothers were interviewed for household socio-demographic information and diet diversity of children in the last 7 days. Diet diversity score (DDS) was calculated based on 15 food groups. Results: There was a high prevalence of underweight (50.9%) and stunting (61.6%) in Orang Asli children. For mothers, 11.1%, 27.8% and 7.4% were underweight, overweight and obese, respectively. Mean DDS of children was 6.38 [95% CI-6.10, 6.65] of the possible 15. Higher DDS of children was significantly related to older age (p<0.05), the non Jahut sub-tribe (p<0.01) and longer maternal years of schooling (p<0.05). DDS was also positively related to weight-for-age z-scores (p<0.001) and height-for-age z-scores (p<0.05). Conclusion: Undernutrition remains a major nutrition problem among Orang Asli children living within the forest reserve. Efforts to promote dietary diversity should emphasise traditional and nutritious foods that could improve health and nutritional status of the Orang Asli children.

Introduction: This is a validation study of the modified version of the Food Choice Questionnaire (FCQ), a multidimensional measure of food choice motives. Methods: Adolescents aged 15 to 17 years attending schools from three randomly selected co-educational and multiracial public secondary schools were invited to participate in this study. Data were collected using a sell-administered modified version of the FCQ consisting of 58 items assessing 13 factors including health, mood, convenience, sensory appeal, natural content, price, weight control, familiarity, ethical concern, religion, parents, peers and media. Factor analysis with the extraction of a maximum likelihood and varimax rotation were performed to validate the FCQ. Results: A total of 306 students comprising 64.7% Malay, 19.3% Chinese and 16.0% Indian with a mean age of 16.1±0.3 years participated in this study. Based on their BMI status, a majority (71.9%) of the participants had normal weight, 8.2% were thin, 1.6% severely thin while 12.1% were overweight and 6.2% obese. Six factors (health and nutrition knowledge, price and convenience, media, mood and sensory appeal, peers, and parents), consisting of 36 items and explaining 45.9% of the variance, remained from the factor analysis. The reliability of the FCQ factors was good, with Cronbach's a coefficient values as follows: health and nutrition knowledge=0.84, price and convenience=0.82, media=0.89, mood and sensory appeal=0.79, peers=0.84, and parents=0.75. Conclusion: This modified version of the FCQ validated among Malaysian adolescents is recommended for future research determining food choice motives of adolescents.

The home environment plays an influential role in affecting dietary and physical activity practices of children. This study aimed to determine the association between the home environment, dietary practice and physical activity among primary school children in Selangor. Methods: This cross-sectional study was conducted in five primary schools selected using multistage stratified sampling. A total of 293 children (32.8% males and 67.2% females) (mean age of 11.0±0.9 years) and their parents (10.7% fathers and 89.3% mothers) completed the study. Dietary practice of the children was assessed using a two-day dietary recall. Energy expenditure and physical activity of the children were assessed using a two-day physical activity recall. Parents of the children completed the Home Environment Survey (HES). Results: The mean energy intake of the children was 1765±416 kcal/day with 75.0% not achieving the Malaysian Recommended Nutrient Intake (RNI) for energy. Almost all children (96.5%) were physically inactive, with a mean energy expenditure of 12693±42 kcal/day. High availability of fruit/vegetable at home was associated with high vegetable intake (r=0.128, p<0.05) and low fat intake (r=-0.115, p<0.05). High availability of fats/sweets at home (r=0.125, p<0.05) and parental role modelling of healthy eating (r=0.117, p<0.05) were associated with high fruit intake. High availability of physical activity equipment at home was associated with high energy expenditure (r=0.123, p<0.05). Parental role modelling of physical activity was associated with high energy expenditure (r=0.123, p<0.05) and high physical activity (r=0.123, p<0.05). Conclusion: The results indicate the important roles of parents in promoting healthy eating and active lifestyles among children.
Diet ; Child ; Motor Activity ; Environment ; Feeding Behavior

INTRODUCTIONNew-onset diabetes after transplantation (NODAT) is an increasingly recognised metabolic complication of kidney transplantation that is associated with increased morbidity and mortality. This study aimed to determine the incidence of NODAT and identify risk factors for development of NODAT among kidney allograft recipients in a single centre.

MATERIALS AND METHODSWe retrospectively reviewed all kidney allograft recipients in our centre between 1998 and 2007. NODAT were determined using criteria as per American Diabetes Association guidelines. Logistic regression analyses were performed to identify predictors of NODAT.

RESULTSAmong 388 patients included in the analysis, NODAT was reported in 94 patients (24.2%) after a median follow-up time of 52.1 months. The cumulative incidence of NODAT was 15.8%, 22.8% and 24.5% at 1, 3, and 5 years following transplantation. Seven clinical factors were independent predictors of NODAT: older age, HLA B13 and B15 phenotypes, use of sirolimus, acute rejections, higher pre-transplant and post-transplant (day 1) plasma glucose levels. Patients with NODAT had poorer outcomes in both graft and patient survival.

CONCLUSIONOur study demonstrates a significant risk and burden of NODAT in an Asian transplant population. Risk stratification and aggressive monitoring of blood glucose early post-transplantation is necessary to identify high-risk patients so that appropriate tailoring of immunosuppression and early institution of lifestyle modifications can be implemented.

Adult ; Blood Glucose ; analysis ; Diabetes Mellitus ; etiology ; genetics ; Female ; Graft Rejection ; complications ; HLA-B Antigens ; analysis ; Humans ; Immunosuppressive Agents ; Kidney Transplantation ; adverse effects ; Male ; Middle Aged ; Risk Factors

INTRODUCTIONWaiting times for kidney transplant are long in Singapore. Healthrelated quality of life (HRQoL) of patients might be affected as a result of the stress of the long wait and the uncertainty of being called to undergo a surgical operation. This study aimed to measure the HRQoL of patients on the kidney transplant waiting list and to identify factors which could impact on the HRQoL scores in this group of patients.

MATERIALS AND METHODSThis was a cross-sectional study of kidney transplant waiting list patients managed at a tertiary renal unit using the SF-36. A SF-36 normative calculator was used to generate HRQoL scores for the Singapore general population matched with the study cohort's age, gender and ethnicity.

RESULTSThere were 265 respondents with a response rate was 81%. Our study shows that HRQoL scores for the kidney transplant waiting list patients were lower than the population norms across all subscales and were clinically significant for General Health, Role Physical, Bodily Pain, Social Functioning and Mental Component Summary scores. Factors such as being Chinese, married, employed and undergoing haemodialysis predicted better HRQoL scores after adjusting for possible confounders. Age, gender, educational level, household income, history of kidney transplant, duration on the transplant waiting list and years on dialysis did not significantly influence SF-36 across all subscales scores.

CONCLUSIONKidney transplant waiting list patients had worse HRQoL compared to the general population. Factors such as ethnicity, marital status, employment status, and type of dialysis treatment significantly influenced patients' perception of their HRQoL.

Cross-Sectional Studies ; Female ; Health Status ; Humans ; Kidney Transplantation ; Male ; Quality of Life ; Surveys and Questionnaires ; Waiting Lists