1.Determination of the prevalence of hypertension and factors associated with blood pressure among hospitalised elderly in Hospital Serdang, Selangor, Malaysia
Siti Nurhaliza Hashidi ; Noraida Omar ; Siti Nur &rsquo ; Asyura Adznam
Malaysian Journal of Nutrition 2021;27(No.1):93-105
Introduction: Increasing trends of hypertension has been recognised as a common
disease among the elderly. This study aimed to determine the prevalence of
hypertension and factors associated with blood pressure among hospitalised elderly.
Methods: This was a cross-sectional study involving 124 patients in Hospital
Serdang, Selangor, Malaysia. Data on socio-demography, medical background,
anthropometry, blood biochemistry and lifestyle were collected through face-to-face
interviews and medical records. Dietary intake was obtained through two days of
food history. Malnutrition risks and stress level were determined using the Mini
Nutritional Assessment Short-Form (MNA-SF) and the Geriatric Depression Scale
(GDS). Results: There were 59.7% males and 40.3% females with mean age of
66.81±5.35 years. Majority were found to have hypertension (72.6%). Approximately
38.7% had normal body mass index (BMI). Most of them reported insufficient dietary
intakes except for trans fats, sodium, and caffeine. Nearly 62.1% were engaged with
physical activity, 23.4% were smoking, and 4.8% were taking alcohol. Approximately
66.1% and 86.3% were classified as having normal nutritional status and normal
stress levels. In this study, the prevalence of hypertension among elderly patients
warded in Hospital Serdang, Selangor was 72.6% and factors such as length of
stay, number of co-morbidities, number of medications, having co-morbidities of
hypertension, dyslipidaemia and diabetes mellitus, polypharmacy, height, BMI,
fibre, polyunsaturated fat, dietary cholesterol, caffeine, and duration of physical
activity were found to be associated with blood pressure. Conclusion: The present
study found that majority of patients (72.6%) had hypertension. Future studies
regarding factors associated with blood pressure are recommended.
2.Energy and protein intakes are associated with stunting among preschool children in Central Jakarta, Indonesia: a case-control study
Sandra Fikawati ; Ahmad Syafiq ; Rienzy Kholifatur Ririyanti ; Syilga Cahya Gemily
Malaysian Journal of Nutrition 2021;27(No.1):81-91
Introduction: Stunting is a major nutritional problem in Indonesia. The prevalence
of stunting in DKI Jakarta province was relatively high at 27.5% in 2013 and 17.7%
in 2018. This study aims to describe nutrient intakes of children aged 25-30 months
and to determine the proportional differences in nutrient intakes between stunting
and normal children in Central Jakarta, Indonesia. Methods: A case-control study
with a total sample of 121 children aged 25-30 months was conducted in Gambir and
Sawah Besar sub-districts, Central Jakarta, where the prevalence of stunting was
high. All children were exclusively breastfed for at least four months and had similar
socio-economic levels. Data collected included height measurement, questionnairebased interview, and 24-hour food recall. T-test and chi-square test were used to
investigate the differences between two groups and logistic regression was used in
multivariate analysis. Results: Factors associated with stunting were energy intake
(AOR=6.0; 95% CI=1.0-35.0) and protein intake (AOR=4.0; 95% CI=1.1-15.5) after
controlling for fat, carbohydrate, vitamin C, iron, and zinc intakes. The percentage of
children with energy intake below the recommendation was much higher in stunted
children (86.1%) compared to normal children (43.5%). Similarly, the percentage
of children with protein intake below the recommendation was very much higher
among stunted children (30.6%) compared to 8.2% in normal children. Conclusion:
Children who lacked energy and protein intakes were at a higher risk of stunting
than children who had sufficient intakes. Macronutrient intakes are important and
should be consumed in sufficient quantities every day to prevent stunting.
3.Associations of eating behaviours, fast food purchasing and availability with BMI-for-age z-score among adolescents in Labuan, Malaysia
Ho Shu Fen ; Chin Yit Siew ; Abdul Rashid Bin Mohamed Shariff ; Lim Poh Ying
Malaysian Journal of Nutrition 2021;27(No.1):107-122
Introduction: A cross-sectional study was conducted to determine the associations
of socio-demographic factors, eating behaviours, fast food purchasing by parents for
family meals, and availability of neighbourhood fast-food outlets with BMI-for-age
z-score (BAZ) among adolescents. Methods: Through multi-stage stratified cluster
sampling method, a total of 420 adolescents from five selected public secondary
schools participated in the current study. Data on socio-demographic factors,
eating behaviours, and parent’s purchases of fast food were obtained through selfadministered questionnaires. The availability of fast-food outlets was assessed using
Geographic Information System (GIS). Body weight and height of the adolescents
were measured. Results: The prevalence of overweight, obesity, thinness and
severe thinness among adolescents in the present study were 17.6%, 15.5%,
3.1% and 0.7%, respectively. The current findings showed that a higher monthly
household income (rs
=0.12, p=0.02) and less purchases of fast food by parents for
family meals (rs
=-0.11, p=0.03) were significantly associated with higher BAZ of the
adolescents. However, there were no significant associations between eating outside
of home, eating at fast-food restaurants, buying delivery fast food, and availability
of neighbourhood fast-food outlets with BAZ. Multiple linear regression showed that
less purchases of fast food by parents for family meals significantly contributed
towards higher BAZ (β=−0.25, p=0.02). Conclusion: A higher household income and
less fast food purchasing by parents were associated with higher BAZ. Fast food
purchasing of adolescents were not associated with BAZ. Therefore, an appropriate
obesity intervention programme should focus on adolescents and their parents from
middle- and high-income households in Labuan.
4.Risk factors of stunting during the complementary feeding period 6-23 months in the Philippines
Mildred O. Guirindola ; Eva A. Goyena ; Ma. Lynell V. Maniego
Malaysian Journal of Nutrition 2021;27(No.1):123-140
Introduction: Stunting persists as a public health problem in the Philippines,
affecting 30% of under-five children. This study aimed to identify the drivers of
stunting in young Filipino children aged 6-23 months. Methods: Data were
extracted from the cross-sectional Updating Survey conducted in 2015 by the Food
and Nutrition Research Institute of the Department of Science and Technology
(FNRI-DOST). Potential predictors of stunting, which were categorised into childrelated characteristics, feeding practices, maternal socio-demographic status and
health practices, and household economic and food security status, were examined
using descriptive and regression analyses. Results: Of the 2,275 children aged 6-23
months, 18.7% were stunted and 8.3% were severely stunted. The risk of stunting
increased significantly among older children aged 12-23 months (relative risk ratio,
RRR 3.04), males within 6-23 months of age (RRR 1.99), and low-birth-weight
infants (RRR 2.19). Children born from teenage mothers (RRR 1.90), mothers with
short stature (RRR 2.33), and mothers with low education (RRR 1.59) posed higher
risks of becoming stunted relative to their counterparts. Mothers with >4 children
(RRR 2.44), coming from the poorest households (RRR 4.27), having untimely
introduction of complementary foods (RRR 4.44), and not meeting the minimum
meal frequency (RRR 2.30) increased the risks of severe stunting. Conclusion: The
study illustrated the multi-factorial nature of stunting among Filipino children aged
6-23 months old. Therefore, a multi-sectoral approach is needed to address the
underlying factors of stunting among young Filipino children to help achieve the
country’s nutrition targets by 2025.
5.Malnutrition and its associated factors among children under 5 years old in Putrajaya: a study protocol
Mohamad Hasnan Ahmad ; Nor Azian Mohd Zaki ; Fatimah Othman ; Azli Baharudin ; Ruhaya Salleh ; Cheong Siew Man ; Adibah Huda Mohd Zainul Arifien ; Nurin Iman Ahmad Kamal ; Noor Ani Ahmad ; Hazizi Abu Saad ; Poh Bee Koon ; Mohd Azahadi Omar ; Tahir Aris
Malaysian Journal of Nutrition 2021;27(No.1):141-151
Introduction: Prevalence of malnourished children in Putrajaya was unexpectedly
high in 2016. This paper describes the study protocol for a case-control study
conducted to identify the associated factors of malnutrition among children under
5 years old in Putrajaya. Methods: This study involved two phases. Phase I
was ‘screening’ where all children aged 6-59 months in 118 preschools and four
government health clinics were measured for their weight and height. The World
Health Organization Anthro software was used to determine the nutritional status
of these children. Phase II was the ‘interview’ where children from screening were
sampled into four pairs of case and control. The optimum sample size for the case
of stunted, wasted, underweight, and overweight were 380, 335, 318, and 308,
respectively. The same number of controls were recruited. Parents/caregivers of
selected children were approached to obtain data on parental factors, children factors,
food intake factors, and environmental factors that contributed to malnutrition.
Data analysis was performed by multiple logistic regression in SPSS version 26.
Results: Screening phase successfully measured 8,261 (50.1%) children from an
estimated 16,500 children under 5 years old in Putrajaya. The number of children
who were stunted, wasted, underweight, and overweight were 2,105 (25.5%), 512
(6.2%), 1,516 (18.4%), and 248 (3.0%), respectively. As overweight was undersampled, the number of controls for overweight was doubled to increase the power
of the study. Parents/caregivers of selected cases and controls were interviewed in
their household or any other venues at their convenience. Conclusion: This protocol
promises beneficial outputs to stakeholders and policy makers that can be used for
combating malnutrition in children.
6.The effect of Hylocereus polyrhizus (red dragon fruit) on whole gut transit time of young Malaysian adults
Lim Kean Ghee ; Ling Chian Voon
Malaysian Journal of Nutrition 2021;27(No.1):153-158
Introduction: The red dragon fruit (Hylocereus polyrhizus) is a popular fruit, not
only where it originated from, in Central America, but across the world including in
Asia. It contains healthy minerals, vitamins and antioxidants, and has been shown
to have gut motility action in animals. Methods: To determine the effect of red
dragon fruit on whole gut transit time, a cross-sectional study of whole gut transit
time using two different stool markers was conducted among 128 young Malaysian
adults. Results: Red dragon fruit, in a half fruit serving of 225±25 grams, reduced
mean whole gut transit time from 26.0±12.9 hours to 21.9±12.8 hours (p<0.001)
when colour change in stools was used as an indicator. The tests also showed that
14.8-17.3% of individuals had whole gut transit time ≥40 hours with carbon as a
stool marker compared to only 7.8-8.6% when red dragon fruit was consumed and
used as a marker. Conclusion: This study demonstrated a laxative effect of red
dragon fruit among young adults.
7.Effect of high-intensity interval training and pre-meal water consumption on lipid profile in overweight and obese students
Nazhif Gifari ; Hardinsyah ; Drajat Martianto ; Mury Kuswari
Malaysian Journal of Nutrition 2021;27(No.1):159-168
Introduction: Obesity and overweight in adolescents and adults are associated
with chronic diseases. The objective of this study was to determine the effect of
high-intensity interval training and pre-meal water intake on the lipid profile of
overweight and obese students. Methods: This was a pre-post experimental study.
Twenty-seven overweight and obese students (mean BMI 26.0±3.1 kg/m2 and mean
age 19.7±0.7 years) were divided randomly into three groups. The first group (n=9;
BMI=26.6±3.6 kg/m2) received Plain Water Intake (PWI) intervention, whereby
students received three bottles of plain water (600 mL) per mealtime (total 1.8 L/
day) and consumed ad libitum 30 to 45 minutes before mealtime (breakfast, lunch,
and dinner). The second group (n=9; BMI=25.9±2.4 kg/m2) received High-Intensity
Interval Training (HIIT) intervention and underwent three exercise sessions per
week (18 minutes/day; 70–85% of HRmax) that was introduced through a video
recording. The last group (n=9; BMI= 25.7±3.4 kg/m2) received a combination of
PWI+HIIT intervention. Nutritional status, nutrient intake, and lipid profile [total
cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C),
and low-density lipoprotein cholesterol (LDL-C)] were assessed before and after
the interventions. Data were analysed using paired sample t-test and Analysis of
Variance (ANOVA). Results: The PWI group showed a significant increase in HDL-C,
while the HIIT group showed a significant reduction in TC (p<0.05). On the other
hand, the PWI+HIIT group showed significant improvements in lipid profile (TC, TG
and HDL-C) (p<0.05). Conclusion: A combination of PWI+HIIT intervention may be
effective in improving lipid profile.
8.Risk factors of hospital-acquired malnutrition in children: A study in a rural hospital of West Borneo, Indonesia
Damar Prasetya ; Sri Haryanti ; Neti Nurani
Malaysian Journal of Nutrition 2021;27(No.1):169-176
Introduction: Hospital-acquired malnutrition (HAM) is prevalent among hospitalised
children in developing countries. This condition relates to worse clinical outcomes,
prolongs length of stay in hospitals, and increases mortality. A multidisciplinary
approach should be performed to prevent and manage this problem. However, HAM
is often underdiagnosed, especially in rural hospitals with limited human resources.
This study aims to delineate the risk factors of HAM among hospitalised children
in a rural hospital. Methods: This nested case-control study derived from the
implementation of a nutritional screening programme in Parindu Hospital, Sanggau,
West Borneo, was conducted from December 2018 to February 2019. HAM was
defined as a loss of body weight of >2% after hospitalisation. Independent variables
such as the age of patients, fever, gastrointestinal loss, pre-existing malnutrition,
length of stay, and grade of disease were analysed in univariate and multivariate
analyses using logistic regression. Risk factors were expressed as odds ratio and
adjusted odds ratio (aOR) with 95% confidence interval (CI). Results: Thirty-three
patients were analysed as cases with 59 controls. Median age was younger in the
case group (49 months, IQR 14-72.5) than control group (88 months, IQR 43-116).
After adjustment for other covariates, age <5 years old (aOR 5.50, 95% CI 1.95-
15.59) and moderate-to-severe grade of disease (aOR 3.50, 95% CI 1.09-11.09) were
significant risk factors of HAM in our study. Conclusion: Risk factors of HAM in
children hospitalised in a rural hospital were age <5 years old and moderate-tosevere grade of disease.
9.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.
10.Factors influencing malnutrition in Filipino elderly
Nancy A. Tandang ; Reanne Len C. Arlan ; Gerard C. Navarro
Malaysian Journal of Nutrition 2020;26(No.3):317-322
Introduction: The elderly population is susceptible to malnutrition due to the
physiological and functional changes caused by ageing. Hence, to prevent the
degenerative nutritional conditions of the elderly and improve their quality of life,
this study aimed to determine the influencing factors of malnutrition among Filipino
elderly. Methods: Anthropometric component data from the 8th National Nutrition
Survey (NNS) were utilised along with the nutritional status of Filipino elderly,
based on body mass index as the dependent variable and variables from the clinical
and health, dietary, and socioeconomic components of NNS as explanatory factors.
Multinomial logistic regression analysis was then performed in fitting models.
Results: High magnitude and severity of malnutrition were observed among
Filipino elderly – 20.2% were underweight and 24.8% were overweight. Significant
influencing factors in estimating an elderly’s odds of being underweight were the
elderly’s age group, presence of hypertension, presence of anaemia, and adequacy of
vitamin A intake. Whereas, significant influencing factors in estimating an elderly’s
odds of being overweight/obese included highest educational attainment, presence
of anaemia, hypertension, diabetes, and dyslipidaemia. Conclusion: Knowing
the influencing factors may help the elderly become more aware and conscious of
their health, as well as to promote nutrient intakes to prevent malnutrition that
can worsen their health conditions. Additionally, concerned institutions in the
country could use the findings of this study as one of the bases in strengthening
their approach and implementation or even provide relevant and timely policies and
programmes that address malnutrition in the elderly of this country.