1.Development and Validation of Food Frequency Questionnaire (FFQ) Among Elderly Individuals in Klang Valley
Suzana Shahar ; Chiah Hui Lin ; Hasnah Haron
Malaysian Journal of Health Sciences 2014;12(2):33-40
Polyphenol is a non-nutrient phytochemical compound existed abundantly in plant-based diet which has the properties
to prevent age related oxidative damage induced diseases. However, there are diffi culties in quantifying its intake and
local food frequency questionnaire (FFQ) for the assessment is not available. Therefore, this study aimed to develop and
validate FFQ for estimation of dietary polyphenol intake among 93 individuals aged 60 years and above recruited from
several senior citizen clubs in Klang Valley. Phase I of the study involved the development of FFQ consisted of 117 items
under 9 categories and formation of the database extracted from PHENOL-EXPLORER. In Phase II, the intake of polyphenol
estimated using FFQ was compared with reference method consisted of 2-day diet records and diet history questionnaire
(DHQ). The mean dietary polyphenol intake estimated from FFQ and the reference method was 2770.7 ± 1552.4 mg/d and
2171.4 ± 898.8 mg/d, respectively. Spearman’s rho and Kendall’s tau-b analysis indicated that there was a signifi cant
positive correlation between polyphenol intake estimated from FFQ and reference method (r = 0.41, p < 0.001; r = 0.28,
p < 0.001). For Bland-Altman plot, 95.7% of scattered plot fell within ± 1.96 SD limits of agreement revealed that there
was good agreement between the two methods used. Cross-classifi cation analysis showed that 36.6% was categorized
in the same quartile, 78.5% in identical and contiguous quartiles, with only 3.2% in the opposite quartiles. Regression
analysis showed that all categories in FFQ signifi cantly account for the inter-variance for dietary polyphenol intake after
controlling for the other variables (R2 = 1.000, p < 0.001). In conclusion, the newly developed FFQ is considered valid
and has the potential to be used as a tool to estimate polyphenol intake among elderly individuals in Malaysia
2.Inhibitory Effects of Phytate to Bioavailability of Calcium, Ferum and Zinc in Local Soy Products
Hasnah Haron ; Norfasihah Raob ; Tan Mei Chen
Malaysian Journal of Health Sciences 2013;11(2):19-27
This study was carried out to determine the inhibitory effects of phytate on the bioavalaibility of calcium (Ca), ferum (Fe)
dan zink (Zn) in selected soy-based products. Phytate exerts its inhibitory effects on the absorption of minerals such as
Ca, Fe and Zn by forming insoluble and undigestible complexes. The inhibitory effect of phytate on the bioavailability
of minerals like Ca, Fe and Zn was estimated by measuring their molar ratios. Phytate content was determined by using
anion-exchange method while mineral contents were determined by Atomic Absorption Spectrophotometer (AAS). Soybased
products were bought from the night markets and food stall located at Cheras and Sri Rampai, Kuala Lumpur.
Each samples from both location was analysed in duplicates. Results from this study showed that soy cake and all dishes
containing tempe did not contain phytate content. This may due to the presence of R. oligosporus that produces phytase
and hydrolysed the phytate content during the fermentation process of tempe. There were fi ve food samples that have a
phytate/ Ca molar ratio > 0.24, ten food samples with a phytate/ Fe molar ratio > 1, eight food samples have a phytate/
Zn molar ratio >15 and one food sample has a [phytate x Ca]/ Zn molar ratio > 200. The result of molar ratio phytate/
mineral in this study estimated the low bioavailability of Ca, Fe and Zn. In conclusion, soy cake and all dishes containing
tempe contained high bioavailability of minerals, while tau-hoo pok contained low bioavailability of minerals
3.Evaluation of Total Phenolic Content, Antioxidant Activities and Sugar Content of Fresh Mixed Fruit and Vegetables Juices
Hasnah Haron ; Salsabila Hassan ; Chan Boon Keng
Malaysian Journal of Health Sciences 2017;15(2):53-58
The notion of fruit and vegetables (FV) in preventing chronic diseases has long been discerned. To meet the recommended
FV intake, FV juices have emerged as a convenient and healthy choice. Mixed fruit and vegetable juices (MFVJ) cater the
blend of desirable flavor and taste of consumers. This study was carried out to determine the total phenolic content (TPC),
antioxidant activities and sugar content of selected MFVJ. Folin-Ciocalteu assay was employed to quantify TPC, whereas
DPPH and FRAP assays were used to evaluate the antioxidant activities of MFVJ. The sugar content was determined using
phenol-sulfuric acid method. MFVJ extracted from bitter gourd, green apple and orange (BGO) had the highest TPC content
(76.4 ± 4.2 mg GAE/100 ml). Celery and green apple (CG) juice showed the highest DPPH value (522.3 ± 7.6 mg TE/100
ml) whereas carrot and starfruit (AS) juice have the highest FRAP value (419.6 ± 21.6 mg TE/100 ml). The sugar content
of MFVJ was within the range of 5.7-13.3 g/100 ml. MFVJ can be considered as healthy beverages with considerable
amounts of phenolic compounds and low sugar content. This study provides some useful reference for consumers who
consume juices with combinations of FV. Future studies need to discover more combinations of FV juices, providing more
data pertaining to MFVJ. Identification of individual phenolic compounds should also be part of future research using
various instrumental analyses.
4.Dietary Polyphenols Consumption and Its Relation with Cognitive and Mental Health in Aging: A Review
Hanisah Rosli ; Suzana Shahar ; Normah Che Din ; Hasnah Haron
Malaysian Journal of Health Sciences 2014;12(2):1-8
Literature review suggests that polyphenols in particular fl avonoids, are benefi cial for mental health during aging
process. This review examines the effect of consumption of all polyphenols groups on mental health and cognitive status
during aging process. The keywords searched were “mental health,” “depression,” “anxiety,” “stress” and “cognitive”
combined with “dietary,” and “polyphenols.” The databases including PubMed, Web of Science and CAB Abstracts were
searched for a period of 10 years. A total of 11 studies were identifi ed to fulfi ll the inclusion criteria. From this review,
polyphenols may confer benefi cial effects towards mental health, in particular the decline in cognitive functions during
aging process, however, some studies showed contradictory results. Polyphenols have been proven to improve language
and verbal ability, which is among the main vulnerable aspects in cognitive decline in pathological brain aging. In
contrast, polyphenols intake did not seem to affect executive functioning. The effects of polyphenols towards cognitive
status were more prominent among the elderly as compared to young and middle-aged adults. This review also shows that
fl avonoids is the main type of polyphenols that confer positive effects towards cognitive status during aging. This review
provides evidence that consumption of polyphenols may lead to cognitive and mental health benefi ts. Further clinical
trials involving human subjects are required with carefully designed methodology to elucidate the potential mechanisms
underlying the relationship between polyphenols consumption and improvement in cognitive and mental health status
5.The Relationship between Food Handlers Personal Hygiene Practices and Cafetaria Sanitary
Hukil Sino ; Zurina Mahadi ; Hasnah Haron ; Muhammad Aizat Misrin ; Nurul’izzah Ismail ; Mohd Hasamizi Mustapa
Malaysian Journal of Health Sciences 2013;11(1):1-8
This case study was conducted to determine the level of personal hygiene among food handlers and its relationship to cafeteria hygiene Universiti Kebangsaan Malaysia (UKM). 75 respondents were involved in this study. The data shows that 32% of respondents are not vaccinated for typhoid while 49.3% do not acquire food handlers’ course certificate. The data also shows that 50.7% of the respondents are not Malaysian citizen. In term of personal hygiene practices, the findings show that 7 items are higher in percentage (70.3% – 87.5%) while another 7 items are lower in percentage (26.4% – 68%). The findings also show that 12 items related to cafeteria sanitary are conformed while 9 items are not. The statistical analysis shows that personal hygiene practices are significantly different (U = 472, p = 0.01) between Malaysian citizen food handlers and the non-Malaysian food handlers. The findings show that Malaysian citizen food-handlers practice better personal hygiene in comparison to non-Malaysian food-handlers. It is also observed that the relationship between is positive and statistically significant (χ2 = 6.432, p = 0.011), although the association between food-handlers personal hygiene and cafeteria sanitary is medium (Φ = 0.29). The findings imply that Malaysian citizen food handlers are better in personal hygiene practices and in promoting cafeteria sanitary in comparison to non-Malaysian food-handlers
6.Determination of Macronutrient Compositions in Three Local Sweet Kuih: Calculated vs Analysed
Hasnah Haron ; Nik Shanita Safii ; Nurul Hidayah Aminudin ; Khairunizah Hazila Khalid
Malaysian Journal of Health Sciences 2013;11(1):19-24
This study was carried out to compare the macronutrient contents in three types of local sweet kuih; kuih seri muka (SM), kuih bakar (B) dan kuih wajik (W) which recipes were developed using calculation according to the Malaysian Food Composition Table (MFCT) and proximate analysis technique. The contents of the macronutrients were identified using proximate analyses while determination of energy and total carbohydrate were based on calculation. Results from proximate analysis showed that W contained significantly higher (p < 0.05) total carbohydrate content (61.5 ± 1.6%) compared to B (39.3 ± 1.5%) and SM (38.7 ± 1.5%). SM contained significantly higher (p < 0.05) of water (46.7 ± 1.6%) compared to B (42.5 ± 6.6%) and W (30.2 ± 0.4%). The protein content in B was 6.1 ± 0.9% and significantly higher than that in W (3.0 ± 0.3%). There were no significant difference of fat content between B (12.8 ± 1.8%), SM (9.9 ± 0.2%) and W (8.2 ± 2.6%). Total calorie for W was the highest (332 kcal/100g), followed by B (299 kcal/100g) and SM (262 kcal/100g). In general, macronutrients content determined based on proximate analyses were lower compared to the calculation method based on MFCT. This was because calculation of macronutrient based on MFCT was based on raw material while the proximate analysis was based on the prepared cooked kuih
7.Sugar intake and metabolic syndrome among older adults in Peninsular Malaysia
NurZetty Sofia Zainuddin ; Suzana Shahar ; Nik Shanita Safii ; Hasnah Haron ; Mohd Azahadi Omar
Malaysian Journal of Nutrition 2018;24(2):163-174
Introduction: Sugar is widely consumed and excessive intake has been associated
with increased risk of weight gain, diabetes mellitus and cardiovascular diseases,
leading to metabolic syndrome (MetSyn). However, the association between sugar
intake and MetSyn has seldom been studied among multi-ethnic Malaysian older
adults. Methods: A total of 1,057 respondents aged ≥60 years were recruited through
multistage random sampling from selected states. Anthropometric parameters, blood
pressure, blood test for sugar and lipid profile were determined. Dietary intake was
derived using a 7-day dietary history questionnaire (DHQ) and a semi-quantitative
food frequency questionnaire (FFQ) for added sugar intake. Results: Prevalence of
MetSyn was 39.9%, 30.9% and 42.2% using the harmonised definition, International
Diabetes Federation (IDF) and National Cholesterol Education Program’s Adult
Treatment Panel III (NCEP-ATPIII) definitions respectively. Mean total sugar intake
was 40.5±32.0 g (8 tsp) and added sugar intake was 33.0±31.0 g (6 tsp). Excessive
added sugar consumption at 100th percentile increased risks of high total cholesterol
by two-fold (p<0.001) and triglyceride by 1.8 fold (p<0.001). Total sugar intake at
50th percentile increased risk of high blood pressure by 0.68 fold (p<0.05) and total
sugar intake at 50th, 75th and 100th percentile increased total cholesterol risk by
1.7 fold (p<0.01), 1.5 fold (p<0.05) and 2.3 fold (p<0.001) respectively. Conclusion:
Excessive sugar consumption among older adults showed no association with
MetSyn but revealed significant associations with blood pressure and lipid profiles.
Effects of long term excessive consumption of sugar on health outcomes in older
persons should be investigated.
8.Association between intake of soy isoflavones and blood pressure among urban and rural Malaysian adult
Nurul Fatin Malek Rivan ; Suzana Shahar ; Hasnah Haron ; Rashidah Ambak ; Fatimah Othman
Malaysian Journal of Nutrition 2018;24(3):381-393
Introduction: Intake of soy isoflavones has been shown to be beneficial in reducing blood pressure, a known cardiovascular risk factor. This study investigated the association between intake of soy isoflavones and blood pressure among multiethnic Malaysian adults.
Methods: A total of 230 non-institutionalised Malaysians aged 18-81 years were recruited through multi-stage random sampling from urban and rural areas in four conveniently selected states. Participants were interviewed on socio-demographics, medical history, smoking status, and physical activity. Measurements of height, weight, waist circumference (WC), and blood pressure (BP) were taken. Information on usual intake of soy foods was obtained using a validated semi-quantitative food frequency questionnaire.
Results: The mean intake of soy protein of both urban (3.40g/day) and rural participants (3.01g/day) were lower than the USFDA recommended intake level of soy protein (25.00g/day). Urban participants had significantly higher intake of isoflavones (9.35±11.31mg/ day) compared to the rural participants (7.88±14.30mg/day). Mean BP levels were significantly lower among urban (136/81mmHg) than rural adults (142/83mmHg). After adjusting for age, gender, educational level, household income, smoking status, physical activity, BMI and WC, soy protein intake was significantly associated with both SBP (R2=0.205, β=-0.136) and DBP (R2=0.110, β=-0.104), whilst soy isoflavones intake was significantly associated with SBP (β=-0.131). Intake of 1 mg of isoflavone is estimated to lower SBP by 7.97 mmHg.
Conclusion: Higher consumption of isoflavones among the urban participants showed an association with lower levels of SBP. Use of biological markers for estimating isoflavones levels is recommended to investigate its protective effects on blood pressure.
9.Survey on salt content in selected food products of fast food restaurants and determination of salt intake awareness among fast food consumers in Klang Valley
Zainorain Natasha Zainal Arifen ; Nur Zakiah Mohd Saat ; Hasnah Haron
Malaysian Journal of Nutrition 2021;27(No.3):397-410
Introduction: Malaysians are exposed to a high salt diet, which is one of the contributors to the prevalence of hypertension among them. This study aimed to identify the salt content in selected food products of fast food restaurants and to determine the salt intake awareness among fast food consumers. Methods: Salt content data were collected through online survey from the official websites of selected restaurants (Kentucky Fried Chicken, McDonald’s, Subway® and Texas Chicken). The food products were classified into eight food categories (chickenbased, potato-based, rice-based, sandwich, salad, bread, dessert, and sauce). The cross-sectional study on salt intake awareness was conducted among 108 Malaysian adults from these restaurants. A knowledge, attitude and practice (KAP) questionnaire was disseminated online. The salt content and the consumers’ salt intake awareness were analysed using Statistical Products and Service Solution (SPSS) software version 25.0. Results: A total of 105 food products were surveyed in this study. Sauce products contained the highest salt content (1.9±0.8 g/100g), followed by bread (1.2±0.3 g/100g), potato-based (1.2±0.4 g/100g), chicken-based (1.2±0.3 g/100g), sandwich (1.1±0.6 g/100g), rice-based (0.7±0.3 g/100g), salad (0.4±0.2 g/100g), and dessert (0.3±0.4 g/100g). For the KAP study, a total of 108 consumers had participated and mostly (48.2%) had a fair level of salt intake awareness. Conclusion: Most food products of fast food restaurants contained high salt content and majority of fast food consumers had a fair level of salt intake awareness. More strategic interventions are needed to control the salt intake among adults in Malaysia.
10.Penghasilan Dan Penerimaan Minuman Sukan Isotonik Berkos Rendah Dalam Kalangan Pelajar Universiti
KHOR SIAU YING ; NUR NADIRAH BINTI MOHD SANUSI ; SAREENA HANIM HAMZAH ; HASNAH HARON ; NIK SHANITA SAFII
Malaysian Journal of Health Sciences 2024;22(No.1):83-96
Sports drinks consist of water, carbohydrates, and electrolytes specially formulated for athletes or individuals in need.
However, coaches from the National Coaching Academy division experience budget constraints to obtain commercial
sports drinks on a large scale to meet the needs of all athletes. Therefore, an experimental study was conducted to
produce a low-cost isotonic sports drink (Rose Lemonade) with white sugar and brown sugar and evaluate its acceptance
among university students through sensory evaluation. This study involved 50 panels with 25 students from UKM (nonathletes) and 25 students from UM (athletes). The overall acceptance of brown sugar Rose Lemonade has an average
score of 3.52 ± 0.97 compared to white sugar Rose Lemonade, which is 3.50 ± 1.07. The data analysis showed a nonsignificant difference in the Kruskal Wallis test (p>0.05) for the overall acceptance of both types of sports drinks. In
conclusion, this study showed that both white sugar and brown sugar Rose Lemonade isotonic sports drink formulations
were acceptable to the panels. The findings of this study provide the formulation of cheap, and easy-making sports
drinks. A suggestion for future research is to test the effectiveness of energy supply and electrolytes replacement and
shelf life of this sports drink and produce a variety of flavors to meet individual tastes.