1.Food Insecurity Situation In Malaysia: Findings From Malaysian Adult Nutrition Survey (MANS) 2014
Mohamad Hasnan Ahmad ; Rusidah Selamat ; Ruhaya Salleh ; Nur Liana Abdul Majid ; Ahmad Ali Zainuddin ; Wan Azdie Mohd Abu Bakar ; Tahir Aris
Malaysian Journal of Public Health Medicine 2020;20(1):167-174
Food insecurity affects food intake, and it could prevent an individual from consuming enough nutritious food to support and maintain health. The aim of this paper is to determine the prevalence and factors influencing food insecurity among Malaysian households. In 2014, the Malaysian Adult Nutrition Survey (MANS) was carried out, and one of the components measured was food insecurity. Six out of sixteen questions from the food security core-module questionnaire were adopted and answered by 2962 adults. The results showed that about 25.0% adult experienced food quantity insufficiency, 25.5% had food variety insufficiency, 21.9% practised reduced size of the meal, and 15.2% skipped main meal due to lack of money to spend on. For the parents, 23.7% only rely on cheap food to feed children, and 20.8% could not afford to purchase various foods to feed their children. Location, strata, race, level of education, working status and household income shows significant difference while none of the nutritional status components found to be difference in all six parameters of food insecurity measured. Logistic regression with adjusted odds ratios discovered race, education level and household income were related to risk to all six parameters of food insecurity. In conclusion, food insecurity can be a serious problem in Malaysia. An effective and comprehensive effort by the government in terms of policy solution is required to increase education level and ensure an adequate income for every household. Therefore, future research should focus on some of those promising policy solutions and at the same time, study the other possible underlying factors that may lead to food insecurity.
Food Insecurity
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Malaysia
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Adult
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Nutrition Survey
2.Prevalence Of Carbonated Soft Drink Consumption And Associated Factors Among Malaysian Adolescents: A Nationwide Cross-Sectional Study 2017
Ruhaya Salleh ; Rashidah Ambak ; S. Maria Awaluddin ; Mohamad Hasnan Ahmad ; Noor Safiza Mohamad Noor ; Syafinaz Mohd Sallehuddin ; Norlida Zulkafly
Malaysian Journal of Public Health Medicine 2020;20(3):156-162
Carbonated soft drinks (CSD) consumption is one of the contributing factors to weight gain, dental caries and non-communicable diseases among adolescents. This study aims to determine CSD consumption among Malaysian adolescents and their associated factors. The Adolescent Health Survey 2017, was a nationally representative survey sampled school-going adolescents aged 13 to 17 years. Findings reported that 36.9% of adolescents reported CSD consumption at least once daily in the past 30 days, and the prevalence was higher than a similar study conducted in 2012. Boys, schools in rural areas, lower secondary schoolers, not physically active, consuming fast food, having food insecurity, and truancy problem reported significantly higher odds of consuming CSD compared to their counterparts. By ethnicity, Bumiputera Sarawak adolescents showed the highest odds of consuming CSD and followed by Bumiputera Sabah. Thus, interventions to limit CSD consumption among Malaysian adolescents should consider the factors highlighted in this study.
3.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.
4.Calcium and iron intakes of adolescents in Malaysia and their relationships with body mass index (BMI): Findings from the Adolescent Nutrition Survey 2017
Syafinaz Mohd Sallehuddin ; Ruzita Abd. Talib ; Ruhaya Salleh ; Rashidah Ambak ; Munawara Pardi ; Nur Shahida Abdul Aziz ; Norazizah Ibrahim Wong ; Mohd Azahadi Omar
Malaysian Journal of Nutrition 2021;27(No.2):317-326
Introduction: Adolescent health is a priority considering they represent the future generation. Data from the Adolescent Nutrition Survey 2017 were analysed to determine the prevalence of micronutrient inadequacy, particularly calcium and iron, and the relationship with body mass index (BMI) among Malaysian secondary school students. Methods: This cross-sectional study included students aged 13 to 17 years old studying at public and private schools. Twenty-four hours dietary recall via face-to-face interview was conducted by trained nutritionists to obtain data on dietary intake. For nutritional status, BMI-for-age z-score (BAZ) was analysed using WHO Anthroplus software. Results: From 999 respondents, 449 were boys and 550 were girls. Overall findings indicated that both boys and girls had inadequate intakes of calcium and iron in their daily diet. Mean intakes of calcium (695.7±463.2 mg/day) and iron (23.4±21.0 mg/day) were higher among boys aged 16 to 17 years old. Mean intake of iron were higher among the older age groups. Majority of the respondents (boys: 94%; girls: 97%) did not meet the recommended nutrient intake (RNI) for calcium and more than half (boys: 50%; girl: 80%) did not achieve the RNI for iron. Current findings also found significant positive but weak correlations between calcium (r=0.112, p=0.001) and iron (r=0.084, p=0.008) intakes with BMI-for-age. Conclusion: BMI-for-age was related to calcium and iron intakes among secondary school students in Malaysia. Thus, intervention strategies should focus on early screening and nutrition education on food choices of high calcium and high iron contents, including iron supplementation programmes, if needed.
5.Associations of Gender and BMI-for-age Status (BAZ) With Nutrient Intake Among Adolescents in Malaysia: Findings From Adolescent Nutrition Survey (ANS) 2017
Lalitha Palaniveloo ; Ruhaya Salleh ; Azli Baharudin ; Cheong Siew Man ; Mohamad Hasnan Ahmad ; Nur Shahida Abd Aziz ; Syafinaz Sallehudin
Malaysian Journal of Medicine and Health Sciences 2021;17(No.1):10-16
Introduction: Adolescence is an important growth period for individuals. High prevalence of obesity among adolescents in Malaysia in recent years is worrying. This study aims to assess associations of gender and BMI-for-age status
(BAZ) with nutrient intake of adolescents between 13-17 years old in Malaysia. Methods: Data of 999 respondents
were drawn from Adolescent Nutrition Survey 2017; a cross-sectional school-based survey involving adolescents
aged 10 to 17 years old. Respondents were selected using multistage stratified cluster sampling from 13 states and
three federal territories in Malaysia to ensure nationally representative data. Data collection was undertaken from
March until May 2017. Dietary intake was assessed using a single 24-hours dietary recall conducted via face-to-face
interview by trained nutritionists. Nutritionist ProTM Diet Analysis Software was used to calculate nutritional intake
values. Anthropometric measurements were measured using validated equipment. Nutritional status of the respondents was assessed using BMI-for-Age z-score and categorised based on WHO Growth Reference 2007. Results:
The mean energy intake of the adolescents was 1972 kcal/day. Majority of the adolescents had normal BMI (74.6%)
while overweight, obese and thinness were 12.0%, 7.2% and 6.2% respectively. Boys had significantly higher intakes of energy, carbohydrate, protein, fat, sugar, cholesterol, thiamin, Vitamin A, calcium, iron, sodium and potassium compared to the girls. Obese adolescents had significantly higher energy, carbohydrate, fat, sugar, Vitamin A
and calcium intakes compared to other BMI groups. Conclusion: The findings highlighted the need for cultivating
self-awareness on healthy eating among adolescents.
6.A Scoping Review on Salt Reduction Intervention
Lalitha Palaniveloo ; Fatimah Othman ; Ruhaya Salleh ; Azli Baharudin ; Cheong Siew Man ; Mohamad Hasnan Ahmad ; Nur Shahida Abd Aziz ; Syafinaz Sallehudin ; Nor Azian Mohd Zaki ; Suhaila Abdul Ghaffar
Malaysian Journal of Medicine and Health Sciences 2021;17(No.4):341-349
Excessive salt intake has been linked to the development of hypertension and non-communicable diseases. This
study aims to explore the different types of salt reduction intervention implemented among adults aged ≥18 years
and to identify the suitable settings, duration and tools used for effective salt reduction interventions. This review
adapted the established structured scoping review framework by Arksey and O’Malley. Related articles from the
year 2008 to 2018 were retrieved based on the study objectives using keywords in electronic databases and through
a bibliographic search of books, reports, conference proceedings, posters and summaries. Out of 130 potentially
relevant full-text articles assessed, 14 articles were included in the review. Suitable salt reduction initiatives for the
community who regularly consume home-cooked food are through cooking and usage of a tool such as a salt-restriction spoon, together with awareness on the benefits of salt reduction in their daily diet. Healthy catering initiative
should be implemented in the workplace or institution-based settings. Policy development targeting the source of
salts such as mandatory usage of salt-substitutes or Front-of-Pack labelling of salt content in all food products suitable
for population-level intervention.
7.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.