1.Prevalence, Smoking Habit and Factors Related to Smoking and Nicotine Addiction among Lower Secondary School Male Students in Kota Tinggi District, Johor, Malaysia
Lim KH ; Sumarni MG ; Kee CC ; Norhamimah A ; Wan Rozita WM ; Amal NM
Malaysian Journal of Public Health Medicine 2010;10(1):28-37
Many studies on adolescent smoking have been conducted in Malaysia, but very limited information is available on smoking amongst lower secondary school male students (Forms 1 and 2). We present data from a baseline study in Kota Tinggi District, Johor on the psychosocial factors, stages of smoking acquisition and susceptibility to smoking initiation and their relationship to adolescent smoking. The study is the first wave of a 3-year longitudinal study which was conducted from March 2007 to May 2009, aimed to describe the prevalence of smoking among students in the lower secondary classes. A three stage stratified sampling was performed to obtain a sample. The Bogus Pipeline Method was employed to confirm smoking status. Prevalence of smoking was 35.5%. Smoking prevalence among students of schools located in the Federal Land Development Authority (FELDA) settlement areas (42.9%) was two-fold higher than in the rural and town schools combined (20.29%). Using the Fagerstrom scale, 90% of current smokers had lower addiction to nicotine. Smoking was associated with peer smoking [OR, 4.19 (95% CI, 2.57-6.82)], having a brother smoking [2.17 (1.31-3.61)], parental smoking [1.73 (1.17-2.80)] and locality where respondents attend school [1.94(1.11-3.39)]. The study indicates that, the prevalence of smoking was high in all areas especially FELDA settlement areas. Measures such as teaching of skills to resist social pressure to smoke, establishment of peer support groups and involvement of parents in anti-smoking programs are recommended to curb the high prevalence of smoking among lower secondary school students in Kota Tinggi.
2.Physical Activity and Sedentary Behaviour among Adolescents in Petaling District, Selangor, Malaysia
CC Kee ; K H Lim ; MG Sumarni ; MN Ismail ; BK Poh ; NM Amal
Malaysian Journal of Medicine and Health Sciences 2011;7(1):83-94
Physical inactivity is strongly associated with obesity and an increased risk of cardiovascular disease in
children and adolescents. A cross-sectional study using multistage random sampling was conducted to
determine associations between demographic characteristics, sedentary behaviours and physical activity
among adolescents. Data were collected from 785 (414 males and 371 females) Form four students
attending 15 schools in Petaling District, Selangor using an adapted self-administered questionnaire.
Results showed that more females (50.1%) were physically inactive compared to males (39.6%) (Adjusted
odds ratio (OR): 1.55, 95% confidence interval (CI): 1.12-2.15). Physically inactive adolescents were
less likely to participate in intramural/house league sports (OR: 1.71, 95% CI: 1.19-2.44), school team
sports (OR: 1.45, 95% CI: 1.03-2.04) and individual physical activities outside school (OR: 1.53, 95%
CI: 1.11-2.12) compared to their physically active counterparts. Physically inactive adolescents were
also less engaged in sedentary activities, such as television watching (OR: 0.69, 95% CI: 0.50-0.94),
playing computer/video game (OR: 0.44, 95% CI: 0.28-0.72), talking on the telephone/mobile phone
text messaging (OR: 0.47, 95% CI: 0.32-0.69) and reading (OR:0.45, 95% CI: 0.24-0.86) compared
to those who were physically active. In this study, physical activity coexists with sedentary behaviour
in adolescents. Sedentary activities may not necessarily displace physical activity among youth. In
addition, these data suggest that promoting organised sports in school and outside the school among
youths may be a potential strategy for increasing physical activity in this population.
3.Do Adolescents Overestimate The Prevalence Of Smoking Among Their Peers? Findings From A Study In Petaling District, Selangor, Malaysia
Lim KH ; Kee CC ; Sumarni MG ; Lim KK ; Tee EO ; Christopher VM ; Noruiza Hana M ; Amal NM
Malaysian Journal of Public Health Medicine 2011;11(2):6-12
Adolescents who overestimate the prevalence of smoking among their peers or other teens are at higher risk to take up smoking. The purpose of this study is to elucidate the factors which are related to adolescents’ overestimation of smoking. We surveyed form four (16 years old) students in Petaling District, Selangor. A sample was selected using two-stage stratified sampling, and data were collected using standardised, self-administered questionnaires. A response rate of 80.4% (n=1045/1298) was obtained, and a total of 943 students were included in the final analysis. About 73 percent (n=688/943) of the respondents overestimated the prevalence of smoking among their peers. The odds of overestimating increased as the number of close friends who smoke increased [Two close friends, OR=3.10(1.67-5.75), three close friends OR=10.81(4.44-26.3) and four-five close friends OR= 12.91(5.31-31.43)]. Those who had an elder brother who smoked (OR=1.95 (1.18-3.24)) and females [2.08(1.37-3.33) were more likely to overestimate peer smoking prevalence. Intervention programmes to correct the misperception of peer smoking prevalence are recommended, in addition to measures to modify the other factors that are amenable to intervention, so as to reduce the risk of smoking initiation among adolescents.
4.Nutritional Status of Children below Five Years in Malaysia: Anthropometric Analyses from the Third National Health and Morbidity Survey III (NHMS, 2006)
Khor GL ; Noor Safiza MN ; Jamalludin AB ; Jamaiyah H ; Geeta A ; Kee CC ; Rahmah R ; Alan Wong N F ; Suzana S ; Ahmad AZ ; Ruzita AT ; Ahmad FY
Malaysian Journal of Nutrition 2009;15(2):121-136
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.
5.Abdominal Obesity in Malaysian Adults: National Health and Morbidity Survey III (NHMS III, 2006)
Kee CC ; Jamaiyah H ; Noor Safiza MN ; Geeta A ; Khor GL ; Suzana S ; Jamalludin AR ; Rahmah R ; Ahmad AZ ; Ruzita AT ; Wong NF ; Ahmad Faudzi Y
Malaysian Journal of Nutrition 2008;14(2):125-135
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.
6.Comparison of Fruits and Vegetables Intake and Physical Activity between Hypercholesterolemic Adults and Nonhypercholesterolemic Adults in Malaysia
Chan YY ; Teh CH ; Yeo PS ; Lim KK ; Lim KH ; Kee CC ; Azli B ; Tee GH ; Gurpreet K ; Mohd Azahadi O
Malaysian Journal of Nutrition 2014;20(2):221-235
Hypercholesterolemia is an important modifiable risk factor for coronary heart disease. Lifestyle changes in diet and physical activity can improve cholesterol levels. This study aimed to compare the fruits and vegetables (FV)
intake and physical activity (PA) between hypercholesterolemic adults and nonhypercholesterolemic
adults in Malaysia, and to investigate factors associated
with meeting the recommended levels of FV intake and PA in a hypercholesterolemic population. Methods: This study was based on 17,988 participants (response rate 98.7%) aged 18 years and above who responded to the hypercholesterolemia questionnaire in the 2011 Malaysian National Health and
Morbidity Survey (NHMS), a cross-sectional study with two-stage stratified sampling design. Data were obtained by trained enumerators via face-to-face interviews and were analysed by descriptive analysis, chi-square test, and
univariable and multivariable logistic regression. Results: Out of the total population assessed, 39.0% had hypercholesterolemia. The prevalence of consuming five or more servings of FV per day is low (7.8%) while 36.0% were
physically inactive among the hypercholesterolemic adults. No significant differences were observed in FV intake and PA between hypercholesterolemic and non-hypercholesterolemic populations. Gender, age and educational levels were associated with FV intake and PA among hypercholesterolemic adults. Hypercholesterolemic adults who were underweight or obese were less likely
to consume FV, while those who were former smokers and those who had diabetes and heart disease were less likely to be physically active. Conclusion: These findings are relevant for future health promotion strategies, suggesting
that more intensive interventions are needed to increase FV intake and PA level in hypercholesterolemic population and in the general population.
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