This randomised school-based controlled study aimed to evaluate the baseline results of nutrition knowledge, attitude, and practice (NKAP), health-related quality of life (HRQoL), and parents’ report of parenting skills (PRPS) among overweight and obese children. Methods: This study was performed on three intervention groups and one control group. It was conducted among Year Five students from primary schools who had overweight or obese status and were generally healthy without any chronic diseases. The children completed NKAP and child self-report of Pediatric Quality of Life (PedsQoL) questionnaires, while parents completed parent proxy report of PedsQoL and PRPS questionnaires. Descriptive statistics and parametric test in SPSS were utilised. Results: Out of 139 participants involved in the baseline study, 18.7% and 81.3% were overweight and obese respectively. This study revealed a significantly higher knowledge score among boys (p = 0.016) and among those who lived in urban areas (p = 0.019). The children’s selfreport PedsQoL recorded highest score for Social Functioning domain and lowest score for Emotional Functioning domain. A contradictory finding was obtained from the parent proxy report, where the Physical Functioning domain scored the lowest and the Emotional Functioning domain had the highest score. Notably, some of the findings from PRPS questionnaires completed by their parents were unfavourable. Conclusions: This study provided prospective evidence of the current status of NKAP, HRQoL among overweight and obese children as well as findings from PRPS among their parents.

This study aimed to develop and examine the validity and reliability of a pregnancy symptoms questionnaire. A total of 214 pregnant women aged 19 to 40 years old were purposive randomly recruited from December 2009 to January 2010 in Antenatal Clinic, Hospital Universiti Sains Malaysia. Pregnant mothers at second and third trimesters were interviewed to complete the Pregnancy Symptoms Questionnaire (PSQ). The PSQ was developed by experts in nutrition, obstetrics and statistics. The PSQ consists of 38 items on frequency and severity of pregnancy symptoms. Factor analysis was done using Promax rotation method to check for construct validity. A total of 16 items which had poor correlation (<0.3) and less important content were removed during the final revise. The 22 remaining items were found to be loaded on the three components (general, constitutional and somatic pain). The overall Cronbach’s alpha coefficient was 0.93 and for each three components ranges from 0.70–0.87. The results suggest that the final PSQ consisting of 22 items is valid and reliable for measuring the frequency and severity of the symptoms experienced during pregnancy. It can be used in nutritional studies related to pregnancy and its outcome.

Introduction: This study aimed to identify dietary patterns (DPs) and their association with successful aging (SA). Methods: A comparative cross-sectional study was conducted among 579 elderly subjects recruited from four states in Malaysia through a multistage random sampling method. SA was defined as having no chronic illnesses, no functional limitation, normal global function, no depression, a good quality of life and good self-perceived health. Information on dietary intake was obtained using a diet history questionnaire. Cognitive functions were assessed using the Mini Mental State Examination (MMSE), depressive symptoms using Geriatric Depression Score-15 items (GDS-15) and a question regarding their perceived health and quality of life. Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) questionnaires were used to determine functional status. DPs were obtained using the principal component analysis (PCA) approach. An ordinal logistic regression model was used to examine associations between DP scores and SA. Results: Five DPs were identified namely ‘sweet foods-beverages’, ‘meat-vegetablesrice and noodles’, ‘local snacks-fish and seafood-high salt foods’, ‘fruits-legumes’, and ‘tropical fruits-oats’. A higher score for ‘tropical fruits-oats’ DP was associated with SA [Adjusted OR=1.59 (95% CI: 1.08-2.32)]. However, the association diminished when the model was adjusted for education level. Further analysis indicated that this DP increased the chance of SA among those with secondary education and above [Adjusted OR=2.43 (95% CI: 1.09–5.42)]. Conclusion: Tropical fruits-oats’ DP is associated with SA among elderly with secondary education and above. There is a need to investigate DPs among those with lower education.

BACKGROUND: A qualitative study providing an in-depth exploration of people's view and the increasing burden of overweight and obesity is required. This study aimed to explore the understanding of dieting and previous experiences on weight loss attempts among overweight and obese government employees in Kelantan, Malaysia, prior to recruitment into the intervention program. METHODS: Thirteen focus group discussions involving 129 participants from a weight-loss intervention program were conducted within the first 1 month of recruitment. These discussions were moderated by two trained researchers in the Malay language and assisted by an interview guide. They were audio-recorded and transcribed verbatim. A thematic analysis was performed, and codes and themes from each discussion were constructed. RESULTS: The participants understood dieting with various meanings, including skipping meals and removing rice from daily diets. They applied numerous methods to lose weight and achieved various outcomes. Health and appearance, social support, and compliance with current trends were the factors motivating these participants to lose weight. Their determination to lose weight was limited by lack of self-control and motivation, experiences of unpleasant effects, influence on weight, and environmental and health factors. CONCLUSION: Real-life weight loss experiences and perceptions provided relevant insights into current weight loss management strategies. Some of these issues and misunderstandings should be emphasized in weight loss strategies during health promotion.
Compliance ; Diet ; Focus Groups ; Health Promotion ; Malaysia ; Meals ; Motivation ; Obesity ; Overweight ; Qualitative Research ; Self-Control ; Weight Loss

Introduction: Despite abundant sunshine for cutaneous vitamin D synthesis, low levels of vitamin D have been documented among the Malaysian population. The aim of this study was to characterise the effects of occupational sunlight exposure and monsoon season on serum 25-hydroxyvitamin D [25(OH)D] concentration. Methods: A comparative cross-sectional study was performed among Malay outdoor (n=119) and indoor workers (n=119) in Kelantan. Two-point data were collected on the same participants, first during non-monsoon season and second during the northeast monsoon season. Data collection comprised of anthropometry measurements (body mass index and body fat), fasting blood test [serum 25(OH)D concentration], and questionnaire (physical activity level, sun exposure, sun protection use, and vitamin D intake). Vitamin D classification was based on the 2011 Endocrine Society Clinical Practice Guidelines. Results: This study found that serum 25(OH)D concentrations were significantly higher in outdoor compared to indoor workers irrespective of season (p<0.001) and sex (p<0.001). Monsoonal differences in serum 25(OH)D concentration was only observed in male outdoor workers (mean difference=10.39 nmol/l, p<0.001). Significant association between vitamin D status and occupation was also observed (p<0.001). However, no significant association was found between vitamin D status and monsoon season [χ2(1)=0.076, p=0.783]. Conclusion: Seasonal and occupational factors should be considered while evaluating individual serum 25(OH)D concentration and in comparing community studies, especially among workers.

Introduction: Eating-out is common in almost all countries, including Malaysia, but this frequent practice may affect human health. In Malaysia, data on eating-out is limited. This study aimed to assess the proportion of eating-out, to assess the association between socio-demographic factors and eating patterns, and to compare energy and nutrient intakes between people eating-out and eating-in. Methods: This cross-sectional study was conducted among 100 adults aged 30 to 70 years old. Three-day food diaries were used to collect data on dietary intake. Eating-out was defined as eating foods prepared outside the home. Respondents who ate outside for at least one meal per day, for two or three days per week were considered as those who frequently practised eating-out. Results: A total of 84% of respondents who ate out had significantly higher sodium intake than those who ate at home (2934 mg/day vs. 2165 mg/day, p=0.025). Foods and drinks that were most commonly consumed outside were nasi lemak, roti canai, rice, ayam masak kicap, vegetable soup, tomyam, rice vermicelli soup (mee-hoon soup), hot teh-o, iced tea, and orange juice. Occupation (p=0.004) and location type (p=0.001) were associated with eatingout. Government and semi-government workers (61%) and urban population (57%) had higher percentage of eating-out compared to eating at home (19% and 12%, respectively). Conclusion: More than two-thirds of our respondents ate out and this habit was related to poor diet quality with excessive intake of sodium. Interventions are needed to improve the diet quality of the overall eating-out behaviour among targeted population.