Objective: To assess the prevalence of iron deficiency, anaemia and iron deficiency anemia (IDA) in women aged 20 to 40 years and its association with iron intake. Methods: A total of 388 women were recruited from universities and work sites in Kuala Lumpur and its suburbs. The subjects comprised 135 Malays, 130 Chinese and 123 Indians. Dietary intake was estimated using a single 24-hour food recall and a semi-quantitative food frequency questionnaire. HAemoglobin (Hb), Haematocrit (hct), mean corpuscular volume (MCV) and serum ferritin were determinated. Results: The prevalence of anaemia (Hb <12g/dL) was 20.9%,being highest among the Indians (26.4%) and lowest among the Malays (16.4%). About 10.3% of the women showed iron deficiency anaemia (IDA) (Hb<12g/dL + serum ferritin <15mg/L + MCV < 80fl/). The prevalence of IDA was highest in Indians (18.0%) followed by Chinese (9.9%) and Malays (4.3%). The mean (95% CI) intake of total iron was at 14.4mg/day (95% CI 13.4, 15.5), amounting to 49.7% of the Malaysian recommended nutrient intake (RNI). Intake of Iron was the highest for the Indians (16.0mg/d) and the lowest for the Chinese (11.3mg/d). Conclusions: The overall prevalence of IDA was lower compared to prevalence of anaemia. Nonetheless, the markedly higher prevalence of IDA among the Indians, despite relatively higher intake levels of iron-rich foods warrants further investigations, including the bioavailability of iron in the context of cultural practices that may influence food preferences and meal preparation

Introduction: Data on folate availability of Malaysian cooked foods would be useful for estimation of dietary folate intake; however such information is scarce. Methods: A total of 53 samples of frequently consumed foods in Malaysia were selected from the Nutrient Composition of Malaysian Foods. Folate content was determined using HPLC method hyphenated with a stainless steel C18 column and ultraviolet detector ( = 280 nm). The index of folate availability was defined as the proportion of folate identified as monoglutamyl derivatives from the total folate content. Results: Total folate content of different food samples varied from 30-95 μg/100g fresh weight. Among rice-based dishes, the highest and the lowest total folate was in coconut milk rice (nasi lemak) and ghee rice (nasi minyak), respectively. In noodle dishes, fried rice noodle (kuey teow goreng) and curry noodle (mee kari) had the highest folate contents. The highest index of folate availability was in a flat rice noodle dish (kuey teow bandung) (12.13%), while the lowest was in a festival cake (kuih bakul) (0.13%). Folate content was found to be negatively related to its availability. Conclusion: This study determined folate content and folate availability in commonly consumed cooked foods in Malaysia. The uptake of folate from foods with high folate content may not be necessarily high as folate absorption also depends on the capacity of intestinal deconjugation and the presence of high fibre in the foods.

Introduction: Methylenetetrahydrofolate reductase (MTHFR) C677T is involved in folate and homocysteine metabolism. Disruption in the activity of this enzyme will alter their levels in the body. Methodology: This study assessed MTHFR C677T polymorphism and its relationship with serum homocysteine and Bvitamins levels in a sample of Chinese and Malays subjects in UPM, Serdang. One hundred subjects were randomly selected from among the university population. Folate, vitamin B12, B6, and homocysteine levels were determined using MBA, ECLIA, and HPLC, respectively. PCR coupled with HinfI digestion was used for detection of MTHFR C677T polymorphism. Results: The frequency of T allele was higher in the Chinese subjects (0.40) compared to the Malay (0.14). Folate, vitamin B12 and B6 levels were highest in the wild genotype in both ethnic groups. Subjects with heterozygous and homozygous genotype showed the highest homocysteine levels. The serum folate and homocysteine were mainly affected by homozygous genotype. Conclusion: MTHFR C677T polymorphism plays an important role in influencing the folate and homocysteine metabolism.

This study determined the association between nutritional status and the use of protease inhibitors (PI) containing regimen among HIV-infected children receiving treatment at the referral centres in Klang Valley. A total of 95 children currently on antiretroviral (ARV) therapy, aged one to eighteen years, were recruited using purposive sampling. Demographic data, anthropometric measurements, medical history, were collected using a structured questionnaire. Serum micronutrients levels and lipid profile were also examined using blood samples. Mean age was 8.8 3.9 years and 44.2% were on PI. Age ( 2 = 10.351, p = .006), weight-for-age ( 2 = 6.567, p = .010), serum selenium ( 2 = 4.225, p = .040) and HDL-C ( 2 = 7.539, p = .006) were significantly associated with the use of PI. Fewer children on PI were deficient in selenium as compared to those not on PI. On the contrary, more children on PI were underweight and had low HDL-C. The use of PI was found to have both positive and negative effects with better selenium level but poorer HDL-C level and weight status.

Objectives: There is a lack of current published information on health and nutritional status of Orang Asli children. A study was conducted to assess breastfeeding practices, dietary intake and growth status of Orang Asli children in Sepang and Carey Island, Selangor.Methods: A total of 173 children(88 Temuan and 85 Mah Meri) from 137 households were measured for body weight and height. Information on breastfeeding practices and dietary intake was obtained from their mothers. Results:Most of the mothers (98.9%) breastfed their infants with a high proportion (86.8%) initiating breastfeeding within one hour after delivery.About 53% of the mothers reported discarding colostrum due to various reasons including the perception that colostrum in undesirable and can produce ill-health. Although many of these mothers (58.3%) discarded colostrum on their own initiative, about 25% of them reported that they were advised by health professionals. Among mothers who had stopped breastfeeding at the time of the study (n=48), the mean duration of breastfeeding was 12.1 ± 8.9 months. About 33% of the mothers stopped breastfeeding before their infants were 6 months old and only 31% breastfed their children for more than 1 year. The percentages of significantly underweight, stunted and wasted were 48.9%, 5.2.2% and 4.3% respectively for children aged 1-3 years, whereas among children aged 4-6 years old, 35.8%, 50.6% and 1.3% were underweight, stunted and wasted, respectively. A higher proportion of Mah Meri than Temuan children in both age groups were significantly underweight, stunted and wasted. Despite the adequate intake of energy and most nutrients,the Orang Asli children had insufficient mean number of servings for all food groups-grain and cereals, fruits, vegetables, meat and fish, and milk and dairy products. Conclusion: In this study, undernutrition is a major health and nutrition problem among the Orang Asli children. The problem could be due to many factors that include poor infant and child feeding practices. Concerted efforts by various government and non government agencies are essential to improve the health and nutrition of Orang Asli.

Introduction: Nutrition and HIV are closely related. Any immune impairment as a result of HIV leads to malnutrition, which in turn, can also lead to reduced immunity, thus contributing to a more rapid progression to AIDS. Methods: This cross-sectional study determined the nutritional status of children living with HIV and are receiving antiretroviral medication in the Klang Valley. A total of 95 children aged one to eighteen years old were recruited between September 2008 and February 2009. Data collected included socio-economic status, anthropometric measurements, dietary intake, medical history and serum levels of selected micronutrients specific for immunity. Results: The mean age of the children was 8.4±3.9 years and the mean duration on antiretroviral medications was 68.3±38.3 months. Anthropometric assessment found that 9.5% of the children were underweight and 31.6% were overweight. In contrast, 20.8% were stunted and 14.6% severely stunted. Biochemical indicators showed that 10.4% had deficiency in vitamin A while 12.5% had deficiency in selenium. Total cholesterol and HDL-C levels were found to be low in 30.5% and 10.5% of the children respectively. Conclusion: Dietary assessment showed almost all the children did not achieve the recommended energy intake for their age groups and almost half of the children did not achieve the RNI for selenium and vitamin A. This study provides an insight on the nutritional status of children living with HIV.

Introduction: A culturally valid tool is lacking in order to assess vitamin D intake among Malaysians. This study aimed to develop and determine the validity and reliability of a semi-quantitative food frequency questionnaire (FFQ) for assessment of vitamin D intake among pregnant women living in urban areas of Malaysia. Method: A total of 79 volunteer mothers (aged 18 to 40 years) in their first trimester of pregnancy participated in this study voluntarily. They completed both the 3-day 24-hour dietary recalls (3DR) and semi-quantitative food frequency questionnaires (FFQ1). The FFQ1 was validated against vitamin D intake calculated from the 3DR. After one week, 41 (51.89%) subjects completed the same FFQ1 (now called FFQ2) for reliability assessment. Results: The median vitamin D intake from 3DR was 117.6 IU/ day with an interquartile range (IQR) of 54.8 to 193.7 IU/ day. The median and IQR values from FFQ1 were 147.7 and 103.7 to 233.9 IU/ day, respectively. The Spearman correlation coefficient was strong and positive, r=0.810 (p=0.01); cross-classification analyses revealed no misclassification and the Bland-Altman plot showed good agreement between the two dietary methods. The intra-class correlation (ICC) for reliability of vitamin D intake was 0.98; the cross-classification analysis showed 95.12% and was classified into the same quartile which supported a consistent habitual eating pattern. Conclusion: The new FFQ developed to assess vitamin D intake showed high correlation and high agreement with the majority of the sample population classified into the same quartile. It is concluded that the new FFQ is a valid and reliable screening tool for vitamin D intake for pregnant women in the urban areas of Malaysia.

The Third National Health and Morbidity Survey (NHMS III) was conducted in 2006 on a nationally representative sample of population in Malaysia. Over 21,000 children aged 0-17.9 years were measured for body weight and stature according to the protocol of the World Health Organization. This article describes the nutritional status of children aged 0-59.9 months. Mean z score for weightfor-age (WAZ), height-for-age (HAZ) and BMI-for-age were compared with the z-scores tables of the WHO standards. The overall prevalence of underweight and stunting of the children were 12.9% and 17.2% respectively. These levels included 2.4% severe underweight and 6.0% severe stunting. In terms of z scores, the age group of 0–5.9 months showed the best nutritional status with mean WAZ of -0.33 (95%CI: -0.52, 0.15) and -0.40 (-0.57, 0.24) for boys and girls respectively, while mean HAZ was 0.64 (0.38, 0.89) for boys and 0.76 (0.54, 0.98) for girls. Mean HAZ and WAZ status was least satisfactory after about 6 months, suggesting a faltering in growth rate at an age that coincides with dependence on complementary feeding. Prevalence of overweight based on BMI-for-age for the sexes combined was 6.4%, while that based on WAZ was 3.4%. The NHMS III results indicate that Malaysian children have better nutritional status compared to children under 5 years in neighbouring countries. In order to meet the targets set in the National Plan of Nutrition (2006-2015), more effective intervention programmes are needed to accelerate the reduction of underweight and stunting, and to arrest the rise of overweight in young children.

Abdominal obesity (AO) is an independent risk factor for cardiovascular disease, hypertension and diabetes mellitus in adults. There is a lack of data on the magnitude and socio-demographic profile of AO among Malaysian adults at the national level. In the Third National Health and Morbidity Survey (NHMS III) conducted in 2006, AO of adults aged 18 years and above was determined based on the waist circumference as part of the nutritional status assessment. This article reports the prevalence of AO in relation to socio-economic factors and demographic characteristics of adult subjects. Out of a total of 33,465 eligible individuals 18 years and above, waist circumference was measured in 32,900 (98.3%) individuals. The prevalence of AO was assessed using the cut-off points recommended by World Health Organization. The mean waist circumference in men and women was 84.0cm [95% confidence interval (95% CI): 83.8, 84.3] and 80.3cm (95% CI: 80.1, 80.6) respectively. The national prevalence of AO was 17.4% (95% CI: 16.9, 17.9). The identified risks of AO were women (OR: 4.2, 95% CI: 3.8, 4.6), aged 50-59 years (OR: 5.6, 95% CI: 4.0, 7.7), Indians (OR: 3.0, 95% CI:2.4, 3.8), housewives (OR: 1.4, 95% CI: 1.1, 1.7), subjects with primary education (OR: 1.3, 95% CI: 1.1, 1.5) and ever married (OR: 1.4, 95% CI: 1.2, 1.6). Being the largest population-based study on AO among Malaysians, these findings have important public health implications. There is an urgent need to revise public health policies and programmes aimed at prevention of abdominal obesity especially in the groups at risk.