1.Under-reporting of energy and nutrient intake is a persistent issue in the Malaysian Adult Nutrition Surveys
Ahmad Ali Zainuddin ; Norazmir Md. Nor ; Safiah Md Yusof ; Adriana Irawati Adriana Irawati ; Tahir Aris Tahir Aris ; Foo Leng Huat
Malaysian Journal of Nutrition 2019;25(2):261-271
Introduction: Under-reporting of energy intake is a common cause of bias in nutritional studies. This study was aimed at examining the extent of under- reporting of energy intake and its related characteristics among respondents in the Malaysian Adult Nutrition Survey (MANS) 2003 and MANS 2014.
Methods: The present study analysed energy intakes of 9,624 adults aged 18-59 years from the MANS in year 2014 (2,890 respondents) and 2003 (6,734 respondents) using a single 24-hour diet recall. Basal metabolic rates (BMR) were calculated from the age- and gender-specific equations of Schofield. Under-reporting was defined as an energy intake:BMR ratio of <1.2 as proposed by Goldberg.
Results: Under-reporting was found to have increased significantly from 53% in 2003 to 61% in 2014. In both surveys, under-reporting increased with higher body mass index (BMI) and older age groups. It was higher among women than men, lowest among those with primary schooling or below, and those living in Peninsular Malaysia. It was higher among rural respondents in 2014 but higher among urban respondents in 2003. The intake of energy and micronutrients increased when under-reporters were excluded.
Conclusion: Under-reporting was prevalent in both the nationwide MANS, and is associated with BMI, age, gender, education level, location strata, zone. It is important to take this factor into account when assessing dietary intake in population-based studies.
2.Changes in energy and nutrient intakes among Malaysian adults: findings from the Malaysian Adult Nutrition Survey (MANS) 2003 and 2014
Ahmad Ali Zainuddin ; Norazmir Md. Nor ; Safiah Md Yusof ; Adriana Irawati Nur Ibrahim ; Tahir Aris ; Foo Leng Huat
Malaysian Journal of Nutrition 2019;25(2):273-285
Introduction: Monitoring changes in energy and nutrient intakes of the population over the course of time is essential to help healthcare providers develop effective dietary policies. The aim of this study was to assess the changes in the nutrient intake and Recommended Nutrient Intake (RNI) achievements by using the data obtained from the Malaysian Adult Nutrition Surveys (MANS) that were carried out in 2003 and 2014. Mis-reporting of energy intake was taken into account.
Methods: Dietary data were obtained from MANS 2003 and MANS 2014, which involved a combined total of 4,044 randomly selected respondents, aged 18-59 years, using a single 24-hour diet recall. Energy and nutrients calculations were based on the Malaysian Food Composition database using the Nutritionist Pro software. The results were compared against the RNI for Malaysia to assess dietary adequacy.
Results: The proportions of calories derived from macronutrients were within the recommendations for a healthy diet. The consumption of protein, fat, calcium, iron and vitamin A was significantly higher in 2014 than in 2003. The consumption of protein, iron, vitamin C, and vitamin A was found to exceed the RNIs in 2014. However, carbohydrate and sodium intakes had significantly decreased. Despite the decrease, sodium intake still exceeded RNI recommendations.
Conclusion: Signs of changing energy and nutrient intakes were found, including increases in protein and fat intakes since 2003, and decreased carbohydrates. This could be an alarming indicator of the tendency to eat energy dense food among the population.
3.Prevalence and Socio-Demographic Determinant of Overweight and Obesity among Malaysian Adult
Ahmad Ali Zainuddin ; Mala A Manickam ; Azli Baharudin ; Rusidah Selamat ; Kee Chee Cheong ; Noor Ani Ahmad ; Hatta Mutalip ; Rashidah Ambak ; Cheong Siew Man ; Mohamad Hasnan Ahmad ; Safiah Md Yusof ; Tahir Aris
International Journal of Public Health Research 2016;6(1):661-669
Overweight and obesity is a major public health problem in Malaysia. This study aims to determine the prevalence of overweight and obesity among the Malaysian adult population and their association with socio-demographic characteristics (gender, ethnic, and age groups). A total of 17,257 adults aged 18 years and older (8,252 men, 9,005 women) were assessed for BMI status, with a response rate of 97.8%, through a household survey from the National Health and Morbidity Survey (NHMS), conducted in all states of Malaysia in 2011. All socio-demographic factors were consistently associated with higher chance of being overweight (except gender and location) and obesity (except location and household income). The identified risk of overweight were Indian (aOR: 1.8, 95% CI: 1.2-2.8), aged 50-59 years (aOR: 2.8, 95% CI: 2.0-3.9), widower (aOR: 1.6, 95% CI: 1.3-2.0), subject with secondary education (aOR: 1.2, 95% CI: 1.0-1.4), Homemaker/unpaid worker (aOR: 1.3, 95% CI: 1.1-1.4), and with high household income group (aOR: 1.3, 95% CI: 1.2-1.6). The identified risk of obesity were women (aOR: 1.4, 95% CI: 1.2-1.6), Indian (aOR: 1.7, 95% CI: 0.9-3.2), aged 30-39 years (aOR: 3.6, 95% CI: 2.4-5.5), widower (aOR: 1.2, 95% CI: 0.9-1.6), subjects with primary education (aOR: 1.2, 95% CI: 0.9-1.6), Homemaker/unpaid worker (aOR: 1.3, 95% CI: 1.1-1.6), and with middle household income group (aOR: 1.3, 95% CI: 1.2-1.6). Our data indicate a high prevalence of overweight and obesity in the population. Several sociodemographic characteristics are associated with both overweight and obesity. This study highlights the serious problem of overweight and obesity among Malaysia adults. Documentation of these problems may lead to research and policy agendas that will contribute both to our understanding and to the reduction of these problems.
4.Factors associated with sugar-sweetened beverages consumption among Malaysian adolescents: findings from the Adolescent Nutrition Survey 2017
Ruhaya Salleh ; Ahmad Ali Zainuddin ; Safiah Md Yusof ; Cheong Siew Man ; Mohamad Hasnan Ahmad ; Nur Shahida Abd. Aziz ; Lalitha Palaniveloo ; Azli Baharudin ; Norazizah Ibrahim Wong
Malaysian Journal of Nutrition 2021;27(No.1):177-187
Introduction: Childhood obesity is a public health problem in Malaysia. Intake of
sugar-sweetened beverages (SSB) is associated with obesity in children. There is a
lack of studies on factors associated with SSB consumption in Malaysia. This study
aimed to determine the sociodemographic factors associated with SSB consumption
among Malaysian adolescents. Methods: Data of 2,021 students, aged 10-17
years on sociodemographic, SSB intake and anthropometrics were drawn from
the school-based Adolescent Nutrition Survey 2017. A multistage stratified cluster
sampling was used to obtain a nationally representative sample of primary and
secondary school students. Body mass index (BMI)-for-age status was determined
based on calculated z-score using the World Health Organization 2007 reference.
SSB consumption was obtained from a food frequency questionnaire. Results: The
prevalence of overweight and obesity among Malaysian adolescents were 16.6% and
14.7%, respectively. Malaysian adolescents consumed 1.4 cups of SSB per day.
Rural children had a significantly higher SSB intake (1.5 cups) than urban (1.3
cups) children, while males (1.5 cups) had a significantly higher intake than females
(1.3 cups). There were no significant differences in SSB consumption between thin,
normal, overweight and obese adolescents. Conclusion: Almost all Malaysian
adolescents consumed SSB during one month prior to the survey and the average
amount consumed was 1.4 cups per day. Rural locality and male were associated
with higher SSB consumption. There were differences in SSB consumption
between Chinese and Malays, between Chinese and Indians, and between Chinese
and Bumiputra Sarawak. There were no differences in consumption between the
different BMI-for-age categories.