Introduction: Breakfast skipping is an unhealthy eating behaviour reportedly common among adolescents. A cross-sectional study was carried out to determine the differences in body weight status, socio-demographic, behavioural, and psychological characteristics between daily breakfast takers and breakfast skippers. Methods: Data were collected from form four students of four randomly selected secondary schools in Sibu, Sarawak using a self-administered questionnaire. Body weight and height were measured using standard procedures and BMI-for-age z-scores were determined. Results: A total of 375 students were recruited (male: 32.0%, female: 68.0%; Chinese: 39.5%, than: 26.4%, Malay: 17.1% and Melanau: 17.1%; mean age = 16.45 � 0.53 years). The prevalence rate of breakfast skippers at 40.3% was higher compared to the national prevalence of 32.7%. About 19.7% of the students were found to be at risk of eating disorders. In addition, the prevalence rates of overweight and obesity were 10.9% and 7.7%, respectively. Significant associations were found between breakfast skipping with sex, lunch skipping, dinner skipping, eating attitudes, and body weight status. Binary logistic regression analysis showed that female students and those who skipped lunch or dinner were more likely to skip breakfast. Conclusion: Breakfast skipping was quite common in this sample of adolescents in Sarawak. As frequent breakfast skipping has negative health and academic performance implications, increased nutrition education and health awareness campaigns on the importance of breakfast taking among school students should be undertaken.

Introduction: A cross-sectional study was conducted to determine physical activity, eating behaviour, body weight management knowledge, perception of body image and their association with body weight status of adolescents. Methods: Respondents were 360 adolescents, aged between 13 to 14 years, from six randomly selected secondary schools in Kuantan, Pahang. Physical activity, eating behaviour, body weight management knowledge and perception of body image were measured by the Physical Activity Questionnaire for Older Children (PAQ-C), Eating Attitude Test-26 (EAT-26), Weight Management Knowledge Inventory (WMKI) and Contour Drawing Rating Scale (CDRS), respectively. Results: Almost half of the respondents were categorised as having a normal BMI, while 30.3% were severely thin and thin and 20.3% were overweight and obese. Mean physical activity score was 2.06+0.45 with more males (35.0%) being physically active than females (17.3%). Mean eating behaviour score was 15.41+10.37, with 27.8% of the respondents being at-risk for eating disorders. Mean weight management knowledge score was 5.35+1.80, with more females (77.7%) having higher mean scores than males (42.3%). Further, mean discrepancy score for body image perception was 1.24+0.99, with 78.1% of the respondents being dissatisfied with their current body size. Positive associations were found between eating behaviour (r=0.28, p<0.05) and body image (r=0.35, p<0.05) with BMI. Respondents with high eating behaviour scores and body image discrepancy scores were more likely to have greater BMI. Conclusion: This study shows the need for healthy eating and body image intervention programmes to prevent overweight and obesity problems among adolescents.

Introduction: Findings from the National Health and Morbidity Survey III (MOH, 2008) indicate a 43.7% prevalence of physical inactivity among Malaysian adults. This sedentary lifestyle can also be observed among children and adolescents. Methodology: A cross-sectional study was conducted to determine factors associated with physical activity levels of four hundred, 13 year-old adolescents in Kuantan, Pahang. Data on socio-demographic, health-related, and psychosocial factors were collected using a self-administered questionnaire while physical activity level was assessed using the Physical Activity Questionnaire for Older Children (PAQ-C). Results: About one-third of the respondents were in the low physical activity level category, 61.5% were in the moderate category and only 3.0% of the adolescents were in the high physical activity level category. Males were more physically active than females (χ2=23.667, p=0.0001) with female adolescents (45.1%) twice as likely as male adolescents (22.1%) to be in the low physical activity level category. The associations between physical activity level with socio-demographic and health-related factors, perception of weight status and body parts satisfaction were not significant. However, physical activity was found to be positively correlated with physical activity self-efficacy (r=0.496, p=0.0001), peer influence (r=0.468, p=0.0001), family influence (r=0.298, p=0.0001) and beliefs in physical activity outcomes (r=0.207, p=0.0001). Negative relationships were found between physical activity with depression (r=-0.116, p=0.021) and body size discrepancy (r=-0.143, p<0.01). Respondents who had a better perception of their current health status were more physically active (χ2=21.062, p=0.0001). Multivariate analyses for the prediction of physical activity showed that physical activity self-efficacy, sex and peer influence were the most significant contributors in explaining physical activity among adolescents. Conclusion: Physical activity interventions should include psychosocial components as mediator variables in interventions designed to promote regular physical activity in adolescence.

Introduction: This study aimed to ascertain the effects of a Facebook-based physical activity intervention on improvements in step counts and metabolic syndrome. Methods: Government employees with metabolic syndrome were randomly assigned by cluster to the Facebook group (n = 44) or the control group (n = 103). All participants were asked to complete self-administered questionnaires at baseline, after the first and second phases. Data from anthropometric (weight, body mass index, fat mass, body fat percentage, waist circumference, hip circumference and waist-to-hip ratio), biochemical (total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides and fasting glucose) and clinical examinations (systolic blood pressure and diastolic blood pressure) were collected. The number of steps per day was determined by a Lifecorder e- STEP accelerometer. Results: A significant difference in the number of steps per day between the baseline and the first phase (p<0.001) was observed in both the Facebook and control groups. A significant group main effect (p<0.001) was found for the number of steps per day; the Facebook group had a significantly greater increase in the number of steps per day than the control group. Overall, a significant strong to very strong correlation was found between the changes in the number of steps per day and the changes in the other variables. Conclusion: The Facebook-based intervention approach has the potential to increase physical activity among government employees with metabolic syndrome.

Introduction: University students are potentially important targets for the promotion of healthy lifestyles as this may reduce the risks of lifestyle-related disorders later in life. This cross-sectional study examined differences in eating behaviours, dietary intake, weight status, and body composition between male and female university students. Methodology: A total of 584 students (59.4% females and 40.6% males) aged 20.6±1.4 years from four Malaysian universities in the Klang Valley participated in this study. Participants completed the Eating Behaviours Questionnaire and two-day 24-hour dietary recall. Body weight, height, waist circumference and percentage of body fat were measured. Results: About 14.3% of males and 22.4% of females were underweight, while 14.0% of males and 12.3% of females were overweight and obese. A majority of the participants (73.8% males and 74.6% females) skipped at least one meal daily in the past seven days. Breakfast was the most frequently skipped meal. Both males and females frequently snacked during morning tea time. Fruits and biscuits were the most frequently consumed snack items. More than half of the participants did not meet the Malaysian Recommended Nutrient Intake (RNI) for energy, vitamin C, thiamine, riboflavin, niacin, iron (females only), and calcium. Significantly more males than females achieved the RNI levels for energy, protein and iron intakes. Conclusion: This study highlights the presence of unhealthy eating behaviours, inadequate nutrient intake, and a high prevalence of underweight among university students. Energy and nutrient intakes differed between the sexes. Therefore, promoting healthy eating among young adults is crucial to achieve a healthy nutritional status.

Introduction: The life of an adolescent in a school hostel is well-managed with respect to daily food intake and physical activity. These adolescents are likely to be physically active and are assumed to consume nutritious food. However, little is known about malnutrition and factors related to it. Thus, this study determined the association between malnutrition (thinness & overweight) and socio-demographic characteristics of these adolescents living in day-school hostels. Methods: Data from Program Cara Hidup Sihat (Healthy Lifestyle Program), comprising a total of 4189 13-year-old school-going adolescents were used. A multi-stage stratified cluster sampling method was applied. Information on socio-demographic characteristics was collected using self-administered questionnaires. Body weights and heights were measured. Body mass index (BMI)-for-age (z-score), or BAZ, was determined using the World Health Organization's (WHO) Growth Reference. Results: The prevalence of overweight (23.3%, 95% CI: 22.1, 24.7) was about six times higher than thinness (4.3%, 95% CI: 3.7, 5.0). Males had higher prevalence of thinness (5.6%, 95% CI: 4.6, 6.9) compared to females (3.4%, 95% CI: 3.7, 4.2). A higher prevalence of overweight was observed in the central zone than in the other five zones. Complex samples logistic regression showed that adolescents from the central zone and those with monthly parental incomes a RM 5000 were 2.5 times (adjusted odds ratio [OR]=2.5, 95% confidence interval [CI]: 1.6, 3.9) and 2.0 times (adjusted OR=2.0, 95% CI: 1.3, 2.9), respectively, more likely to be at risk of overweight compared to adolescents from the other five zones and with parents whose monthly incomes were less than RM 5000. Conversely, male adolescents were 1.7 times more likely to be at risk of thinness (adjusted OR=1.7, 95% CI: 1.2, 2.3) compared to female adolescents. Conclusion: The dual forms of malnutrition co-existed, with over-nutrition being more prevalent than under-nutrition. Future healthy body weight intervention programs should consider sex, monthly parental incomes and geographic zones of adolescents living in day-school hostels.

Personality traits are divided into five basic dimensions: extraversion, neuroticism, conscientiousness, agreeableness and openness. These influence our attitudes and behaviours. Studies show that differences in personality traits may influence the dietary intake. Methods: A cross-sectional study aimed at determining the association between personality traits and body weight status with energy intake was conducted among adolescents in Hulu Langat district of Selangor. Height, weight and waist circumference were measured and respondents completed a pre-tested self-administered questionnaire. Personality traits were assessed using the Malay version of USM Personality (USMaP-i). A single 24-h dietary recall was used to assess dietary intake. Results: A total of 430 adolescents aged 13-16 years (46% male and 54% female) was recruited. Female respondents tended to be more neurotic and agreeable compared to male respondents. A majority of the respondents (67%) were in the normal weight category, 26.7% were overweight and obese, while 19.0% had a high risk of developing abdominal obesity with a mean waist circumference of 72.65 ± 10.93cm. Males significantly had a higher intake of energy (1425±583 kcal), compared to females (1232±462 kcal). Conscientiousness trait (r=-0.158, p<0.01), BMI-for-age (r=-0.147, p<0.01) and waist circumference (r=-0.108, p<0.05) were inversely related to the energy intake of the respondents. Conclusion: Leaner adolescents and individuals with low conscientiousness were significantly consuming more energy than their counterparts. Understanding the personality traits that may regulate caloric intake is essential in order to develop effective interventions towards modifying obesity-inducing eating patterns.

Introduction: This study was conducted on 215 working women from four private corporate companies in a suburb in Malaysia to determine the factors related to their physical activity levels. Methods: Data were collected using a questionnaire which included socio-demographic characteristics, the International Physical Activity Questionnaire (IPAQ), perceived barriers and benefits to physical activity, self-efficacy to physical activity and an 8-item questionnaire on current behavioral stage of physical activity. Results: The majority of the respondents were Malay (81.9%) with 10.2% being Chinese and 7.9% Indian. Most of the respondents were executives (64.2%), while the rest were non-executives (24.7%) and managers (11.2%). The mean weight, height, BMI and waist circumference were 59.4±13.1 kg, 1.6±0.6 m, 23.7±4.8 kg/m² and 77.0±12.1cm respectively. In this sample, 24.7% and 7.9% were overweight and obese respectively, while 34% were at risk of abdominal obesity. A total of 28.8% of the respondents had low physical activity level, while 48.8% and 22.3% were in the moderate and high physical activity categories respectively. An association was found between monthly income (χ2=110.17; p<0.05) and current behavioral stage of physical activity (χ2=27.527; p<0.05) with physical activity, but no relationship was found between job category and physical activity category (χ2=8.940; p>0.05). Physical activity category was also positively correlated with perceived barriers (r=0.227, p<0.05) and benefits to physical activity (r=0.280, p<0.05). However, physical activity was not associated with self-efficacy to physical activity. Conclusion: In this sample of working women, socio-demographic and psychosocial factors (except self-efficacy to physical activity) were found to have an association with physical activity level of the respondents. Further studies should be conducted to confirm these findings in the general working women population.

Introduction: A cross-sectional study was conducted to determine the familial and socio-environmental predictors of overweight and obesity among 1430, 9- 12 year-old primary school children and their parents in Selangor and Kuala Lumpur. Methodology: Body weight and height were measured and body mass index was calculated. Modified Child Feeding (CFQ) and Determinants of Adolescent Social Well-being and Health (DASH) questionnaires were used to measure familial and socio-environmental factors. Results: A total of 17.9% of the children were overweight while 16.0% were obese. Positive relationships were found between child’s BMI and parent’s BMI (r = 0.129, p < 0.01), concern about child’s weight (r = 0.125, p < 0.01) and restriction (r = 0.057, p < 0.05) to unhealthy foods. However, negative relationships were found between child’s BMI with pressure to eat (r = -0.135, p < 0.01) and neighbourhood safety perception (r = -0.053, p < 0.05). The logistic regression analysis showed that being male (Exp (β) = 0.538; 95% CI = 0.421-0.687), higher parent’s BMI (Exp (β) = 1.055; 95% CI = 1.028-1.082), higher concern about child’s weight (Exp (β) = 1.082; 95% CI = 1.030- 1.127), low pressure to eat (Exp (β) = 0.857; 95% CI = 0.801-0.916) and low perception of neighbourhood safety (Exp (β) = 0.951; 95% CI = 0.913-0.990) were significantly associated with increased risk of overweight. Conclusion: Parents should be the main target for education to modify children’s weight status. Further research should be carried out to understand the mechanism of influence of parents and the socio-environment on child’s health.

Introduction: This study aimed to evaluate the validity and reliability of the Multidimensional Body Image Scale (MBIS), a seven-factor, 62-item scale developed for Malaysian female adolescents. This scale was evaluated among male and female Malaysian university students. Methods: A total of 671 university students (52.2% women and 47.8% men) completed a self-administered questionnaire on MBIS, Eating Attitude Test-26, and Rosenberg Self-Esteem Scale. Their height and weight were measured. Results: Results in confirmatory factor analysis showed that the 62-item MBIS reported poor fit to the data, ²/df = 4.126, p < 0.001, CFI = 0.808, SRMR = 0.070, RMSEA = 0.068 (90% CI = 0.067, 0.070). After re-specification of the model, the model fit was improved with 46 items remaining, ²/df = 3.346, p < 0.001, CFI = 0.903, SRMR = 0.053, RMSEA = 0.059 (90% CI = 0.057, 0.061), and the model showed good fit to the data for men and women separately. This 46-item MBIS had good internal consistency in both men (Cronbach’s alpha = 0.88) and women (Cronbach’s alpha = 0.92). In terms of construct validity, it showed positive correlations with disordered eating and body weight status, but negative correlation with self-esteem. Also, this scale discriminated well between participants with and without disordered eating. Conclusion: The MBIS-46 demonstrated good reliability and validity for the evaluation of body image among university students. Further studies need to be conducted to confirm the validation results of the 46-item MBIS.