1.A Qualitative Study on Feeding Practices Among Caregivers of Malay Children and Adolescents with Autism
Malaysian Journal of Health Sciences 2019;17(2):25-34
Atypical dietary behaviour of children and adolescents with autism make it challenging for their parents to feed a balance diet to them. This qualitative study aims to explore food practices and source of information regarding food practices among caregivers of Malay children and adolescent with autism. A total of 19 caregivers (aged 35-53 years) of Malay children and adolescents with autism (aged 7-18 years) participated in focus group discussions. Respondents were selected using purposive sampling method from three selected special children's educational centers in Selangor and Negeri Sembilan areas. This focus group discussion was transcribed verbatim and analyzed with the assisted qualitative software (NVivo version 11), which several themes were formed. This study found that majority of respondents offered their children sunnah food, Omega-3 supplements and vitamin and mineral supplements, omitted food additives, gluten and casein, seafood, egg and legumes as they thought these may help in improving their children’s behavior and health. The main sources of information regarding these food practices were Autism Club Malaysia, internet, doctor and religious teacher. Majority of respondents had never consulted both dietitians or nutritionists. Nutritionists or dietitians should provide scientific evidence information on nutritional practices through autism association and internet to ensure that caregivers can manage their children’s nutritional problems more effectively.
2.Relationship between Traditional Malaysian Vegetables (Ulam) Intake and Cognitive Status Among Middle-aged Adults from Low Cost Residential Areas
Malaysian Journal of Health Sciences 2019;17(Special Issue):139-148
Ulam is fresh traditional Malaysian vegetables which normally consumed in raw form or after a short blanching process. It contains high antioxidants and polyphenols. However, there is limited study about the relationship between ulam consumption and cognitive status. Thus, a cross sectional study was conducted to determine the relation with cognitive function among 132 middle-aged Malays adults (45-59 years old), recruited by convenient sampling from low income residences in Klang Valley. Respondents were interviewed to obtain data on sociodemography, dietary intake and total ulam intake and also measured for anthropometric parameters at respective community centres. Cognitive status was measured using Digit Span (attention and working memory), Rey auditory verbal learning test (RAVLT) (verbal memory) and comprehensive trail making test (CTMT) (cognitive flexibility). The average ulam intake by the respondents was 15.1 ± 8.2g/day and the top five highest consumed ulam were petai (68.1%), pucuk paku (62.9%), ulam raja (56.8%), pegaga (54.6%) and kesum (44.7%).There was a significant correlation between ulam intake with Digit Span (r = 0.265, p = 0.006), total immediate recall of RAVLT (r = 0.427, p < 0.001) and CTMT (r = 0.257, p = 0.007). Analysis of multiple regression indicated that total ulam intake was a significant predictor for Digit Span (R2 = 0.152, p < 0.05), RAVLT (R2 = 0.335, p = 0.001) and CTMT (R2 = 0.310, p < 0.001). In conclusion, this study showed that ulam has the potential to protect against cognitive decline, however, randomized control trials should be conducted to determine the efficacy of the ulam as neuroprotective agent.
3.Prevalence and Risk Factors of Sarcopenia Among Community Dwelling Older Adults in Klang Valley
Reshmy Ranee ; Suzana Shahar ; Yee Xing You ; Devinder Kaur Ajit Singh ; Noor Ibrahim Mohamed Sakian
Malaysian Journal of Medicine and Health Sciences 2022;18(No.1):177-186
Introduction: Sarcopenia is one of the geriatric syndromes affecting the ability of older adults to lead an independent
living. However, its risk factors among Malaysian older adults are yet to be determined. This study investigated the
prevalence and risk factors of sarcopenia among community-dwelling older adults in Klang Valley. Methods: This
cross-sectional study involved 393 Malaysians aged 60 and above, residing in urban areas of Klang Valley recruited through convenience sampling. Socio-demographic and food intake information were obtained using validated
questionnaires. Cut-off points for sarcopenia screening were obtained from the Asian Working Group of Sarcopenia(AWGS) while body impedance analysis(BIA) was employed to determine skeletal muscle index. A handgrip
dynamometer was used to assess dominant handgrip strength and a 6-meter gait speed test was used to determine
walking speed. Binary logistic regression analysis was used to determine the risk factors of sarcopenia. Results: Prevalence of sarcopenia was 33.6% and women(35.9%) were more affected compared to men(30.1%). The mean age of
women assessed to have sarcopenia(69.1±6.5 years old) was higher compared to men(68.3±5.8 years old) (p<0.05).
After adjusting for confounding factors, older adults with one year increased in age and one mg decreased in habitual dietary iron intake were estimated to be 1.08 times and 0.93 times the chances to have sarcopenia respectively.
Conclusion: Approximately one-third of community-dwelling older adults in Klang Valley were assessed to have
sarcopenia. Older adults aged 60 years and above and those with low dietary iron intake were at an increased risk
of developing sarcopenia.
4.Factors Associated With Pressure Ulcer Risk Among Spinal Cord Injury Adults in Kuala Lumpur, Malaysia: A Community-based Study
Yee Xing You ; Jing Yi Foo ; Wani Aqilah Mustafa ; Rohana Hussain ; Amaramalar Selvi Naicker ; Ohnmar Htwe ; Zahara Abdul Manaf ; Suzana Shahar
Malaysian Journal of Medicine and Health Sciences 2021;17(No.3):177-184
Introduction: Pressure ulcers (PUs) are a leading health problem among spinal cord injury(SCI) patients. Therefore,
this comprehensive study was aimed at determining the association between potential factors and the occurrence
of PUs among SCI adults in community settings. Methods: A cross-sectional study was conducted among adults
with SCI aged 18 years and above from five selected locations in Kuala Lumpur, Malaysia. The study was carried
out through interviews based on validated questionnaires such as the Dietary History Questionnaire (DHQ), Spinal
Nutrition Screening Tool (SNST), Physical Activity Scale for Individuals with Physical Disabilities (PASIPD), Barthel
Index for Activities of Daily Living (ADL), and Instrumental Activities of Daily Living (IADL). Estimated weight and
height were obtained using recumbent formula. The stages of their PUs were assessed based on National Pressure
Ulcer Advisory Panel (NPUAP) grading system. Results: A total of 40 subjects participated in the study, 25% of
whom were having PUs. Their nutritional inadequacies were identified, whereby 90%, 70% and 85.5% of them
were receiving below their daily requirement of energy, carbohydrate and protein, respectively. The fat and sodium
intakes of 55% of them were above the Malaysian Recommended Nutrient Intakes(RNI). It was successfully found
that physical activity could decrease the risk of PUs(R2=0.654, OR=0.310, p<0.05). Conclusion: Overall, 25% of
the subjects had PUs that were associated with physical inactivity. The majority of the subjects did not meet their
nutrient requirements. Therefore, there is a need for increased physical activity and improved nutrient intake in order
to reduce the risk of pressure ulcers among SCI adults in communities.