Introduction: The objective of this cross-sectional study was to determine the body somatotypes, anthropometric characteristics and physical activity levels of young adults. Methods: Using a systematic sampling approach, a total of 180 students were recruited from three institutions of higher learning in the state of Kelantan. Body weight, height and other anthropometric dimensions including skinfold, bone breadth and limb girth were measured to determine their body mass index (BMI) and body somatotypes. Physical activity level was determined using the Short Form - International Physical Activity Questionnaire (IPAQ). Results: Almost half (49.4%) of the respondents were with a mean age of 21.5 (1.5), and mean BMI of 22.1 (4.5) kg/m2. The proportion of overweight and obese respondents based on the World Health Organisation (WHO) classification was 17.2% and 6.7%, respectively. In terms of body somatotype, 57.2% and 18.3% of them were classified as endomorphic and mesomorphic somatotype groups respectively, while another 24.4% were ectomorphic. The IPAQ scoring protocol indicated that 35.0% of them achieved high physical activity levels, while 19.3% reported low physical activity levels. There were significantly more endomorphic females, whereas the males significantly dominated the mesomorphic somatotype group. Conclusion: Respondents with mesomorphic body somatotype (relative muscularity) were categorised as obese under the BMI classification although their body weight could be due to higher skeletal/muscle mass. The somatotyping method can be used as an additional tool to the conventional BMI indicators for assessing adiposity.

Introduction: The increasing prevalence of overweight and obesity among children has become a major public health problem in Malaysia. Parents play an important role in child feeding especially among younger children. Methods: A study was conducted to evaluate the beliefs, attitudes and practices in child feeding among parents of normal weight, as well as overweight and obese primary school children in Kelantan using the Child Feeding Questionnaire (CFQ). This cross-sectional study was carried out on 175 Malay children from three schools in Kota Bharu district in Kelantan. Results: This study showed that 13.1% of the children were overweight and obese. Scores for perceived parent weight (p<0.05) and perceived child weight (p<0.001) were significantly higher among parents of overweight and obese children compared to parents of children with normal body weight. However, the score for pressure to eat among parents of overweight and obese children was significantly lower (p<0.05) than parents of normal weight children. The perceived child weight (r=0.468, p<0.01), perceived parental weight (r=0.190, p<0.05) and food restriction (r=0.179, p<0.05) factors were found to be positively correlated with children’s body mass index (BMI), whereas pressure to eat factor (r=-0.355, p<0.01) was negatively correlated with children’s body mass index (BMI). Conclusion: The findings showed that parental feeding practices were linked to children’s weight status and childhood obesity. Therefore parents should be given education and guidance on appropriate child feeding practices to maintain their child’s nutritional status on a healthy weight range.

Intrduction: Obesity and chronic diseases have been increasing since the last few decades alongside rapid economic development in developed and developing countries. The alarming increase in the prevalence of childhood obesity had been shown by many epidemiological studies worldwide. The aims of this study were to determine the prevalence of overweight and obesity among Chinese school children in Kota Bharu, Kelantan, and to map the association between dietary practices and their nutritional status. Methods: A cross-sectional study was conducted on 278 school children aged 10 to 12 years old (144 boys and 134 girls) studying in a Chinese primary school in Kota Bharu. Results: The survey revealed that while only 1.4% (n=4) were overweight, 23.4% (n=65) of the children were obese. A total of 67.7% (n=44) of the obese children were boys. The overweight and obese children (n=70) were compared with a randomly selected group of normal weight children (n=70). Dietary assessment showed that protein, fat and total calorie intake were significantly higher among the overweight group (p<0.05). A significantly higher proportion of the normal weight children (85.7%) took breakfast daily or at least 4 days per week compared to the overweight groups (59.4%) (p<0.05). Conclusion: The prevalence of obesity among school children in the study is a matter of concern. These findings may be useful in targeting programmes and strategies for prevention and intervention of childhood obesity.

Introduction: The aim of this study was to investigate the relationship between gender, birth weight, nutritional status, and iron status of children with their academic performance and cognitive function. Methods: Two hundred and fortynine children, seven to nine years of age, were recruited by systematic sampling from six primary schools in a rural area in Malaysia. Cognitive function was assessed by using Raven’s Coloured Progressive Matrices (R-CPM). Academic performance of the children was recorded from their school final examination results in four subjects including Malay language, English, Mathematics, and Science. Birth weight was recorded from the birth certificate, and nutritional status was determined by weight-for-age z score and height-for-age z score. Results: Girls had a significantly higher score in all the academic tests, but a lower cognitive score compared to boys. Nutritional status was found to be correlated significantly with academic performance. Academic and cognitive function scores were also found to be correlated significantly with birth weight, parents’ education, and family income. In a multivariate analysis, gender remained the significant predictor of academic function, and iron status and haemoglobin were the significant predictors of cognitive function, after controlling for other variables. Conclusion: The study showed that girls performed better academically than boys in rural Malaysia. Nutritional status, parents’ education and family income could be additional modifiable factors to improve academic performance of the children. More attention is needed to improve academic achievements of boys at their early school years.

Introduction: Despite evidence from various studies on exclusive breastfeeding (EBF) being best for infants, many women do not or are unable to practise EBF. This study aimed to examine perceptions on EBF and its influencing factors among a sample of Malay women in rural and urban areas in Kelantan, Malaysia. Methods: A qualitative study using in-depth interviews was conducted to examine respondents’ views about EBF including their beliefs, experiences and feelings. The interviews were audio-recorded and transcribed verbatim, followed by discussion and identification of emergent concepts. Results: Data saturation was achieved after interviewing a total of 30 women. The mean age of the women was about 30 years with most having at least secondary level schooling; the majority were working women. Thirteen of the 30 women practised EBF. They believed breastfeeding allowed them to fulfill their reproductive role and regarded it as a gift from God. The practice required sacrifice, and was therefore associated with a combination of positive and negative feelings. Differing opinions surfaced with regard to belief in the superiority of breastfeeding and feasibility of practice. Many women accepted breastfeeding practice but found it challenging to practise EBF especially when confronted with low milk production, perceived low nutritional quality breast milk, and work commitments. Conclusion: Women should be educated on the importance of EBF with regard to the nutritional adequacy of breast milk and long term benefits for mother and children.

This paper aims to report the physical activity pattern and energy expenditure of adults aged 18 – 59 years in the Malaysian Adults Nutrition Survey (MANS) carried out between October 2002 and December 2003. The survey included 7349 adults representative of Peninsular Malaysia (Northern, Southern, Central and East Coast), as well as Sabah and Sarawak. A total of 6926 adults, comprising 3343 men and 3583 women, completed the physical activity section of the survey. Physical activity data was obtained using a physical activity questionnaire and 24-hour physical activity recall. Basal metabolic rate (BMR) was calculated from Ismail et al. (1998) predictive equations; total energy expenditure (TEE) was then estimated through factorial calculations based on time allocated and energy cost of various activities. Physical activity level (PAL) was calculated as the ratio of TEE to BMR. It was found that almost three-quarters of Malaysian adults travelled by passive modes of transportation. Only a third reported having ever-exercised, and an even smaller proportion of the population (14%) had adequate exercise. The population also spent the majority of their time (74% of the day) in sedentary activities, such as sleeping or lying down; doing light intensity activities (15% of the day), and doing moderate to vigorous intensity activities (10% of the day). Mean BMR and TEE was significantly higher amongst men than women, while mean PAL values were similar for men [1.6 (1.6 – 1.7)] and women [1.6 (1.6 – 1.6)]. More men (16%) were categorised as having active PAL compared to women (10%), while more women (43%) were categorised as having sedentary PAL compared to their male counterparts (37%). The present study provides the first in-depth report of the physical activity pattern, and national estimates of energy expenditure and physical activity levels of Malaysian adults, and concluded that Malaysian adults are generally sedentary. It is thus important that physical activity be further promoted and integrated into the lives of the population, preferably through various health promotion efforts as well as through the commitment of the authorities in providing a suitable environment for an active lifestyle.

The Malaysian Adults Nutrition Survey (MANS) was carried out between October 2002 and July 2003, involving 6,775 men and 3,441 women aged 18 – 59 years. Anthropometric assessment showed that the overall mean body weight and BMI were 62.65 kg (CI: 62.20, 63.09) and 24.37 kg/m2 (CI: 24.21, 24.53) respectively. Based on the WHO (1998) classification of BMI, 12.15% (CI: 11.26, 13.10) were obese (BMI > 30 kg/m2), and 26.71% (CI: 25.50, 27.96) overweight (BMI > 25 - 29.9 kg/m2). Significantly, more women were obese [14.66% (CI: 13.37, 16.04)] while significantly more men were overweight [28.55% (CI: 26.77, 30.40)]. Ethnicitywise, prevalence of obesity was highest among the Malays [15.28% (CI: 13.91, 16.77)] while overweight was highest for the Indians [31.01% (CI: 26.64, 35.76)]. Both obesity and overweight were highest among those aged 40 - 49 years. Obesity was highest for those whose household income was between RM1,500 - 3,500 while overweight was more prevalent for those whose household income exceeded RM3,500. The prevalence of overweight was highest for those with primary education [31.90% (CI: 29.21, 34.72)]. There was no significant urbanrural differential in both obesity and overweight. The study found 9.02% (CI: 8.82, 10.61) with chronic energy deficiency (CED) (BMI < 18.5 kg/m2). The prevalence of CED was relatively higher in the indigenous population (Orang Asli) [14.53% (CI: 5.14, 34.77)], subjects aged 18-19 years [26.24% (CI: 21.12, 32.09)], and with monthly household income of < RM1,500 [10.85% (CI: 9.63, 12.20)]. The prevalence of CED was not significantly different among the geographical zones and educational levels, and between urban/rural areas and sexes. The results call for priority action to address the serious problem of overweight and obesity among Malaysian adults as it poses a grave burden to the country’s resources and development.

Background: School children are at great risk of nutrition-related chronic diseases. Their eating pattern in school is influenced by the availability of food served within the school environment. The purpose of this paper was to determine the effectiveness of a canteen-based food nutrition intervention, designed according to the theory of planned behaviour, on the knowledge, perception and choices of healthy food among primary schoolchildren. Methods: This was a prospective intervention study using a two-group design. Six school canteens from the ninety-eight primary schools were randomly allocated to an intervention group or a control group. All the food handlers in the intervention group were given a twelve-week training course in food nutrition. On the completion of the course, 293 Standard Six students from these schools, were interviewed with a nutritional questionnaire on food in their school canteens. The training programme for the intervention group and the questionnaire for the students were developed and validated for the study, and a power calculation made for the sample size of students.Results: The students in both groups were homogeneous in gender and body mass. The mean body mass index (BMI) was 19.26 (SD: 0.38) and 19.47 (SD: 0.39) for the intervention and the control group respectively. There were more schoolchildren in the intervention group who purchased foods in school canteens (p 0.0036)of milk and milk products (p 0.034), and white rice (p<0.001). Fewer purchased fast food (p<0.001), and more had a better perception towards serving of healthy food (p 0.001). There were no significant differences in the knowledge level (p 0.095) and purchased fruit (p 0.557) between the groups. Conclusion: A school-based nutrition programme was associated with significant improvement in the perception of students towards foods served in school canteens and in their choices of healthy food. The study provided a framework for the design and implementation of future food nutrition intervention in school canteens.

Introduction: Meal patterns have received little attention in nutrition studies. The aim of this study is to present the findings on general meal patterns of Malaysian adults. Methods: The Malaysian Adults Nutrition Survey (MANS), carried out in 2002 and 2003, involved 6,928 adults selected by stratified random sampling from all households by zone in Peninsular Malaysia, Sabah and Sarawak. Results: In general, the results showed that most respondents (74.16%) ate three meals per day; 89.20% of the respondents consumed breakfast, while 88.57% consumed lunch and 91.97% consumed dinner with no significant difference in terms of sex. In Peninsular Malaysia, the Northern Zone had the highest number of people consuming breakfast compared to other zones. Meanwhile, the population in Sarawak had the largest proportion of people consuming lunch and dinner, but the smallest proportion of people consuming breakfast. A significantly higher number of the rural population consumed breakfast and lunch than urbanites; however there was no significant difference in dinner consumption. Generally, breakfast consumption increased with age whereby significant difference existed between the 18 to 19 years age group and the age group of 30 years and older. Lunch intake among the age groups showed no significant difference. In contrast, dinner consumption was significantly lower among the 18 to 19 years age group compared to all other age groups. Comparison among the ethnic groups showed that the Indian population had the lowest percentage of having breakfast and lunch while the Orang Asli had the lowest percentage of consuming dinner. However, the Orang Asli recorded the highest percentage for taking breakfast and lunch while the Chinese had the highest percentage of taking dinner. Conclusion: Considering that Malaysian adults consumed their conventional breakfast, lunch and dinner, these findings indicatethat Malaysians are maintaining their traditional meal patterns.

This study reports the food consumption patterns of adults aged 18 to 59 years in the Malaysian Adults Nutrition Survey (MANS) carried out between October 2002 and December 2003. A total of 6,742 subjects comprising 3,274 men and 3,468 women representing the northern, central , southern and east coast of Peninsular Malaysia as well as Sabah and Sarawak were interviewed. A semiquantitative food frequency questionnaire (FFQ) which consisted of 126 food items was used to evaluate the food consumption pattern (habitual food intake) of the respondents during the previous one- year period. The results demonstrate that nasi putih (cooked rice) was consumed by 97% of the population twice daily (average 2½ plates per day). Other food items consumed daily were marine fish, (one medium fish per day), green leafy vegetables (one cup per day) and sweetened condensed milk (three teaspoons per day. The mean frequencies for daily intake of rice, leafy vegetables, marine fish, local kuih, anchovy(ikan bilis) and biscuits were significantly higher among the rural compared to the urban adults. In contrast, more urban dwellers consumed chicken and eggs more frequently than their rural counterparts. More men than women consumed chicken and eggs more frequently. Malaysian adults showed a satisfactory habit of drinking plain water, with 99% drinking at least six glasses of plain water daily. Other beverages such as tea (47%), coffee (28%), chocolate-based drinks (23%) and cordial syrup (11%) were also consumed on daily basis, however, in a smaller proportion of the population. There were differences in the prevalence of daily consumption of foods when comparing urban and rural population, and also between men and women. The prevalence of daily consumption of marine fish among rural and urban adults was 51% and 34% respectively. For sweetened condensed milk, men and women consumed 43% and 28% respectively; however, more women drank full cream milk than men. Between the age groups, 21% of adults below 20 years old consumed chicken at least once a day, while this pattern of intake was not shown in the older age groups. Our findings show that adults, aged 50 to 59 years old, had the highest prevalence of daily consumption of full cream milk with 24% while those aged 18 to 19 years old had the lowest prevalence of daily consumption at 15%. The food consumption pattern of Malaysian adults appears to be satisfactory. However, some changes in food habits are recommended especially in substituting the less wholesome sweetened condensed milk with the more nutritious full cream or skimmed milk.