1.Juara Sihat™: Study Design Of A School-Based Childhood Obesity Nutrition Education Programme In Kuala Lumpur, Malaysia
Devanthini Dewi GUNASEKARAN ; Razinah SHARIF ; Poh Bee KOON ; Ruzita Abd TALIB ; Nik Shanita SAFII ; Mahadir AHMAD
Malaysian Journal of Health Sciences 2018;16(Special Issue (Article)):119-127
The global prevalence of overweight and obesity among children has increased rapidly in the recent decades, includingin Malaysia. Thus, development of effective interventions to prevent childhood obesity in Malaysia is urgently needed.This paper describes the study design of a 12-week multi-component, school-based nutrition education programme aimedat managing childhood obesity. The objective of Juara Sihat™ is to determine the effectiveness of a nutrition educationprogramme in improving anthropometric status, knowledge, attitude and practice (KAP) of nutrition, eating habits andphysical activity level among overweight and obese children. This quasi-experimental study involves two primary schoolsin Kuala Lumpur with similar demographic characteristics. Eligibility criteria of research participants are overweightand obese children aged 9 to 11 years. The main components of the Juara Sihat™ intervention are nutrition educationclasses on healthy eating and active lifestyle; physical activity sessions; and active involvements of parents and teachers.The control school does not receive any interventions. The primary outcome is BMI-for-age z-score, while other outcomesinclude waist circumference, body fat percentage, KAP of nutrition score, dietary intake, physical activity level, sedentarybehaviour and biochemical profile. Outcome measures will be assessed at three intervals: baseline, post-intervention 1(3-month follow-up), and post-intervention 2 (6-month follow-up). The Juara Sihat™ programme represents a promisingapproach to examining the effectiveness of a school-based childhood obesity intervention with strong empowerment ofParents’ and Teachers’ Association (PTA). We anticipate that this study may provide insights towards the development ofmore effective strategies in formulating childhood obesity interventions.
2.Nutrition Knowledge Among Malaysian Elderly
Norimah A. Karim ; Nik Shanita Safii ; Safiah Mohd Yusof ; Norazliana Mohd Noor ; Zawiah Ahmad ; Tee E Siong
Malaysian Journal of Health Sciences 2008;6(2):43-54
This paper reports the nutrition knowledge of Malaysian elderly, as part of a nationwide study to evaluate the status of nutrition knowledge, attitude and
practice (KAP) of food and nutrition among various communities in Malaysia.
A total of 906 elderly, age ranging between 60 to 96 years old, with mean age 67.4 ± 6.7 years representing all states in Malaysia participated in the study.
An interview administered questionnaire was used to assess the nutrition knowledge and to collect demographic data of the elderly. Subjects were in the 60-65 years (51%) and more than 65 years (49%) age category. There were
46% Malays, 32% Chinese, 6% Indians while the remaining 16% comprised of other minority groups in Malaysia such as Iban, Kadazan, Melanau, Orang Asli and others. More than half of the elderly (54%) had no formal education,
36% completed primary schooling and only 9% finished secondary education. Overall 73% elderly were categorized as having poor nutrition knowledge,
18% moderate and only 9% good. The minority groups had the highest percentage of poor nutrition knowledge (91%) while the Chinese had the highest percentage of good nutrition knowledge (11%). More female (78%) than male (67%) had poor nutrition knowledge, in contrast to more male
(10%) than female (8%) with good nutrition knowledge. Chi square test showed that there was a significant correlation between educational status
and nutrition knowledge. This was reflected in the results which showed that 81% elderly with no formal education were categorized in the poor nutrition
knowledge group. Majority of the elderly did not know about foods to be consumed most (88%), or to be eaten least (87%). Only a quarter to a third of
the elderly responded correctly to questions on nutrient function and content.
The question on foods with high salt was well responded by the elderly (65%). It is quite discouraging to show that a majority of Malaysian elderly had poor nutrition knowledge. This study indicated that appropriate nutrition education interventions need to be implemented to improve the shortcomings of nutrition knowledge among the Malaysian elderly.
3.Determination of Macronutrient Compositions in Three Local Sweet Kuih: Calculated vs Analysed
Hasnah Haron ; Nik Shanita Safii ; Nurul Hidayah Aminudin ; Khairunizah Hazila Khalid
Malaysian Journal of Health Sciences 2013;11(1):19-24
This study was carried out to compare the macronutrient contents in three types of local sweet kuih; kuih seri muka (SM), kuih bakar (B) dan kuih wajik (W) which recipes were developed using calculation according to the Malaysian Food Composition Table (MFCT) and proximate analysis technique. The contents of the macronutrients were identified using proximate analyses while determination of energy and total carbohydrate were based on calculation. Results from proximate analysis showed that W contained significantly higher (p < 0.05) total carbohydrate content (61.5 ± 1.6%) compared to B (39.3 ± 1.5%) and SM (38.7 ± 1.5%). SM contained significantly higher (p < 0.05) of water (46.7 ± 1.6%) compared to B (42.5 ± 6.6%) and W (30.2 ± 0.4%). The protein content in B was 6.1 ± 0.9% and significantly higher than that in W (3.0 ± 0.3%). There were no significant difference of fat content between B (12.8 ± 1.8%), SM (9.9 ± 0.2%) and W (8.2 ± 2.6%). Total calorie for W was the highest (332 kcal/100g), followed by B (299 kcal/100g) and SM (262 kcal/100g). In general, macronutrients content determined based on proximate analyses were lower compared to the calculation method based on MFCT. This was because calculation of macronutrient based on MFCT was based on raw material while the proximate analysis was based on the prepared cooked kuih
4.Sugar intake and metabolic syndrome among older adults in Peninsular Malaysia
NurZetty Sofia Zainuddin ; Suzana Shahar ; Nik Shanita Safii ; Hasnah Haron ; Mohd Azahadi Omar
Malaysian Journal of Nutrition 2018;24(2):163-174
Introduction: Sugar is widely consumed and excessive intake has been associated
with increased risk of weight gain, diabetes mellitus and cardiovascular diseases,
leading to metabolic syndrome (MetSyn). However, the association between sugar
intake and MetSyn has seldom been studied among multi-ethnic Malaysian older
adults. Methods: A total of 1,057 respondents aged ≥60 years were recruited through
multistage random sampling from selected states. Anthropometric parameters, blood
pressure, blood test for sugar and lipid profile were determined. Dietary intake was
derived using a 7-day dietary history questionnaire (DHQ) and a semi-quantitative
food frequency questionnaire (FFQ) for added sugar intake. Results: Prevalence of
MetSyn was 39.9%, 30.9% and 42.2% using the harmonised definition, International
Diabetes Federation (IDF) and National Cholesterol Education Program’s Adult
Treatment Panel III (NCEP-ATPIII) definitions respectively. Mean total sugar intake
was 40.5±32.0 g (8 tsp) and added sugar intake was 33.0±31.0 g (6 tsp). Excessive
added sugar consumption at 100th percentile increased risks of high total cholesterol
by two-fold (p<0.001) and triglyceride by 1.8 fold (p<0.001). Total sugar intake at
50th percentile increased risk of high blood pressure by 0.68 fold (p<0.05) and total
sugar intake at 50th, 75th and 100th percentile increased total cholesterol risk by
1.7 fold (p<0.01), 1.5 fold (p<0.05) and 2.3 fold (p<0.001) respectively. Conclusion:
Excessive sugar consumption among older adults showed no association with
MetSyn but revealed significant associations with blood pressure and lipid profiles.
Effects of long term excessive consumption of sugar on health outcomes in older
persons should be investigated.
5.Predicting basal metabolic rates in Malaysian adult elite athletes.
Jyh Eiin WONG ; Bee Koon POH ; Safii Nik SHANITA ; Mohd Mohamad IZHAM ; Kai Quin CHAN ; Meng De TAI ; Wei Wei NG ; Mohd Noor ISMAIL
Singapore medical journal 2012;53(11):744-749
INTRODUCTIONThis study aimed to measure the basal metabolic rate (BMR) of elite athletes and develop a gender specific predictive equation to estimate their energy requirements.
METHODS92 men and 33 women (aged 18-31 years) from 15 sports, who had been training six hours daily for at least one year, were included in the study. Body composition was measured using the bioimpedance technique, and BMR by indirect calorimetry. The differences between measured and estimated BMR using various predictive equations were calculated. The novel equation derived from stepwise multiple regression was evaluated using Bland and Altman analysis.
RESULTSThe predictive equations of Cunningham and the Food and Agriculture Organization/World Health Organization/United Nations University either over- or underestimated the measured BMR by up to ± 6%, while the equations of Ismail et al, developed from the local non-athletic population, underestimated the measured BMR by 14%. The novel predictive equation for the BMR of athletes was BMR (kcal/day) = 669 + 13 (weight in kg) + 192 (gender: 1 for men and 0 for women) (R2 0.548; standard error of estimates 163 kcal). Predicted BMRs of elite athletes by this equation were within 1.2% ± 9.5% of the measured BMR values.
CONCLUSIONThe novel predictive equation presented in this study can be used to calculate BMR for adult Malaysian elite athletes. Further studies may be required to validate its predictive capabilities for other sports, nationalities and age groups.
Adolescent ; Adult ; Asian Continental Ancestry Group ; Athletes ; Basal Metabolism ; Body Composition ; Body Weight ; Calorimetry, Indirect ; Energy Metabolism ; Female ; Humans ; Malaysia ; Male ; Regression Analysis ; Sports ; Young Adult
6.Development and Validation of Culinary Nutrition Questionnaire to Assess Chefs’ Culinary Nutrition Knowledge, Attitude and Practice (KAP)
Maisara Salah ; Hanis Mastura Yahya ; Nik Shanita Safii
Malaysian Journal of Medicine and Health Sciences 2022;18(No.3):24-29
Introduction: Culinary nutrition is a science that aims to apply nutritional concepts into culinary art to serve healthier
foods. This study aimed to develop and validate a newly developed culinary nutrition questionnaire to assess chefs’
culinary nutrition knowledge, attitude and practice (KAP). Methods: The KAP questionnaire was developed to be
consistent with the Malaysian Dietary Guideline (2010) and Malaysian ingredients. It consisted of 31 items and tested
its content validity among four experts using Content Validity Index (CVI), followed by back-to-back-translation process. Finally, 180 chefs answered the questionnaire followed by statistical analysis to evaluate the construct validity
using Exploratory Factor Analysis (EFA) and reliability using Cronbach alpha. Results: One item was deleted after
content validity and four items were omitted after testing the construct validity because their lower factor loading
value. The Kaiser-Meyer-Olkin (KMO) value was derived from (EFA) for knowledge section is 0.631 with total variance 34.7%, attitude is 0.665 with total variance 53.1%, and practice section is 0.841 with total variance 54.6%.
The total Cronbach alpha value was 0.712. The Cronbach alpha value for knowledge, attitude, and practice domains
were 0.77, 0.73, and 0.88 respectively. Conclusion: The final draft of the questionnaire consisted of 26 items. The
questionnaire is valid and reliable. This questionnaire is suitable to be used to assess chefs’ culinary nutrition knowledge, attitude and practice (KAP).
7.Does an Asian-based Diet Sufficient to Meet the Nutritional Demands of Endurance Athletes?: A Cross-sectional Study
Zaini Bahari ; Nik Shanita Safii ; Ahmad Munir Che Muhamed
Malaysian Journal of Medicine and Health Sciences 2023;19(No.6):51-61
Introduction: Limited studies have examined the dietary intake pattern of Malaysian endurance athletes. Differences in the types of foods consumed between Malaysian and Western population leads to varying nutritional intake
values. This study aimed to characterise the dietary intake of Malaysian endurance athletes as compared to sports
nutrition recommendations, and to determine the associations between participants’ backgrounds and macronutrients intake status. Methods: A total of 85 endurance-trained Malaysian athletes participated in a cross-sectional
study. Dietary intake for three days throughout the training season was evaluated using 24-hour dietary recall. The
macronutrients and micronutrients intakes were compared to the nutritional recommendation for athletes and the
Recommended Nutrient Intakes (RNI), respectively. The food serving size was compared to the Malaysian Food Pyramid 2020. Results: Of all participants, 51% met the minimum recommendations for carbohydrate (CHO) intake (6g/
kg/day). For protein intake, 88% of participants had surpassed the lower limit of 1.2g/kg/day. The lower limit of fat
intake (20% of total daily energy intake) was met by 99% of the participants. Most of the participants had a suboptimal intake of calcium, vitamin A, and vitamin E, while all had inadequate vitamin D intake. The athletes’ institution
was significantly associated with the CHO intake status. Also, the athletes’ institution and the highest education level
were significantly associated with the protein intake status. Conclusion: Athletes who practised Asian-based diets
were able to achieve the energy, protein, and fat intake recommendations. However, there was a suboptimal intake
of the CHO and micronutrients as compared to the recommendations.
8.Penghasilan Dan Penerimaan Minuman Sukan Isotonik Berkos Rendah Dalam Kalangan Pelajar Universiti
KHOR SIAU YING ; NUR NADIRAH BINTI MOHD SANUSI ; SAREENA HANIM HAMZAH ; HASNAH HARON ; NIK SHANITA SAFII
Malaysian Journal of Health Sciences 2024;22(No.1):83-96
Sports drinks consist of water, carbohydrates, and electrolytes specially formulated for athletes or individuals in need.
However, coaches from the National Coaching Academy division experience budget constraints to obtain commercial
sports drinks on a large scale to meet the needs of all athletes. Therefore, an experimental study was conducted to
produce a low-cost isotonic sports drink (Rose Lemonade) with white sugar and brown sugar and evaluate its acceptance
among university students through sensory evaluation. This study involved 50 panels with 25 students from UKM (nonathletes) and 25 students from UM (athletes). The overall acceptance of brown sugar Rose Lemonade has an average
score of 3.52 ± 0.97 compared to white sugar Rose Lemonade, which is 3.50 ± 1.07. The data analysis showed a nonsignificant difference in the Kruskal Wallis test (p>0.05) for the overall acceptance of both types of sports drinks. In
conclusion, this study showed that both white sugar and brown sugar Rose Lemonade isotonic sports drink formulations
were acceptable to the panels. The findings of this study provide the formulation of cheap, and easy-making sports
drinks. A suggestion for future research is to test the effectiveness of energy supply and electrolytes replacement and
shelf life of this sports drink and produce a variety of flavors to meet individual tastes.
9.Development and validation of a food frequency questionnaire for dietary intake assessment among multi-ethnic primary school-aged children.
Fadil FATIHAH ; Boon Koon NG ; Husin HAZWANIE ; A Karim NORIMAH ; Safii Nik SHANITA ; Abd Talib RUZITA ; Bee Koon POH
Singapore medical journal 2015;56(12):687-694
INTRODUCTIONThis study aimed to develop and validate a food frequency questionnaire (FFQ) to assess habitual diets of multi-ethnic Malaysian children aged 7-12 years.
METHODSA total of 236 primary school children participated in the development of the FFQ and 209 subjects participated in the validation study, with a subsample of 30 subjects participating in the reproducibility study. The FFQ, consisting of 94 food items from 12 food groups, was compared with a three-day dietary record (3DR) as the reference method. The reproducibility of the FFQ was assessed through repeat administration (FFQ2), seven days after the first administration (FFQ1).
RESULTSThe results of the validation study demonstrated good acceptance of the FFQ. Mean intake of macronutrients in FFQ1 and 3DR correlated well, although the FFQ intake data tended to be higher. Cross-classification of nutrient intake between the two methods showed that < 7% of subjects were grossly misclassified. Moderate correlations noted between the two methods ranged from r = 0.310 (p < 0.001) for fat to r = 0.497 (p < 0.001) for energy. The reproducibility of the FFQ, as assessed by Cronbach's alpha, ranged from 0.61 (protein) to 0.70 (energy, carbohydrates and fat). Spearman's correlations between FFQ1 and FFQ2 ranged from rho = 0.333 (p = 0.072) for protein to rho = 0.479 (p < 0.01) for fat.
CONCLUSIONThese findings indicate that the FFQ is valid and reliable for measuring the average intake of energy and macronutrients in a population of multi-ethnic children aged 7-12 years in Malaysia.
Child ; Diet ; Diet Records ; Energy Intake ; Ethnic Groups ; Female ; Food ; Humans ; Malaysia ; Male ; Reference Values ; Reproducibility of Results ; Schools ; Surveys and Questionnaires