The aim was to determine the differences in parents' perceptions of boys' and girls' body shapes and the explanations for the emphasis on body shape care of children. Subjects were low-income parents (n = 158) of preschoolers attending preschools in Kuala Lumpur, Malaysia. Parental perceptions of children's body shapes were assessed based on their rankings (scale of 1 to 7) of four attributes (ideal, healthy, fat and thin) for boy and girl figures. Parental responses to five questions on the importance of body shape were also obtained. Parental rankings of ideal and healthy body shapes were significantly lower for girls than boys (p < 0.001). However, mothers' and fathers' rankings of boys' and girls' body shapes were not significantly different. for both boys and girls, parental ratings for ideal body shape were significantly lower than for healthy body shape (p < 0.001). The majority of parents indicated that children's body shape is important for their future health, self enhancement, social interaction and career. With the increasing prevalence of body dissatisfaction among Malaysian children, these findings contribute to the understanding of parental roles in the development of body image and perhaps, in the etiology of body dissatisfaction among children.
*Body Image ; *Child, Preschool ; Parents/*psychology

The Rohingya is a group of refugees from Myanmar who have been residing in Malaysia since the 1980s. At present, there is no published information on health and nutritional status of refugee children in Malaysia. This study was conducted to assess nutritional status of the Rohingya children aged 6 months to 12 years old (N=87) and to determine the associations between nutritional status with socio-demographic, dietary diversity and health (birth weight, immunization and childhood illness) variables. Children were measured for weight and height while their guardians were interviewed for socio-demographic, dietary diversity and health information. About 27.5% of the Rohingya children were underweight, 11.5% stunted, 16.1% thin and 12.6% at risk of overweight and overweight. The percentage of children with low birth weight (< 2.5 kg) and no immunization was 17.8% and 11.5%, respectively. Fever (67.8%) and flu (62.1%) were the most common childhood illnesses reported in previous month with 44-75% of the children with these illnesses did not receive any medical treatment. The mean dietary diversity score was 8.9+3.2 out of a possible 14, with a higher score indicating a more diverse diet. There were significant correlations between frequency of immunization received by the children with weight-for-age-z score (rs=0.27, p<0.05), height-for-age-z score (rs=0.25, p<0.05) and BMI-for-age-Z score (rs=0.24, p<0.05). Height-for-age-z score was also positively correlated with childhood illness score (rp=0.24, p<0.05) and dietary diversity score (rp=0.23, p<0.05) in that children with less common childhood illnesses and variety of foods in the diets had better linear growth. As refugees have limited access to health care services, they are at greater risk of health and nutritional problems.

Introduction: The use of email and website as channels for workplace health information delivery is not fully explored. This study aims to describe the rationale, design, and baseline findings of an email-linked website intervention to improve modifiable cancer risk factors. Methods: Employees of a Malaysian public university were recruited by systematic random sampling and randomised into an intervention (n=174) or control group (n=165). A website was developed for the intervention and educational modules were uploaded onto the website. The intervention group received ten consecutive weekly emails with hypertext links to the website for downloading the modules and two individual phone calls as motivational support whilst the control group received none. Diet, lifestyle, anthropometric measurements, psychosocial factors and stages of change related to dietary fat, fruit and vegetable intake, and physical activity were assessed. Results: Participants were predominantly female and in non-academic positions. Obesity was prevalent in 15% and 37% were at risk of co-morbidities. Mean intake of fats was 31%, fruit was ~1 serving/day and vegetable was <1 serving/day. Less than 20% smoked and drank alcohol and about 40% were physically inactive. The majority of the participants fell into the Preparation stage for decreasing fat intake, eating more fruit and vegetables, and increasing physical activity. Self-efficacy and perceived benefits were lowest among participants in the Precontemplation/Contemplation stage compared to the Preparation and Action/Maintenance stages. Conclusion: Baseline data show that dietary and lifestyle practices among the employees did not meet the international guidelines for cancer prevention. Hence the findings warrant the intervention planned.

Introduction: Findings from the National Health and Morbidity Survey III (MOH, 2008) indicate a 43.7% prevalence of physical inactivity among Malaysian adults. This sedentary lifestyle can also be observed among children and adolescents. Methodology: A cross-sectional study was conducted to determine factors associated with physical activity levels of four hundred, 13 year-old adolescents in Kuantan, Pahang. Data on socio-demographic, health-related, and psychosocial factors were collected using a self-administered questionnaire while physical activity level was assessed using the Physical Activity Questionnaire for Older Children (PAQ-C). Results: About one-third of the respondents were in the low physical activity level category, 61.5% were in the moderate category and only 3.0% of the adolescents were in the high physical activity level category. Males were more physically active than females (χ2=23.667, p=0.0001) with female adolescents (45.1%) twice as likely as male adolescents (22.1%) to be in the low physical activity level category. The associations between physical activity level with socio-demographic and health-related factors, perception of weight status and body parts satisfaction were not significant. However, physical activity was found to be positively correlated with physical activity self-efficacy (r=0.496, p=0.0001), peer influence (r=0.468, p=0.0001), family influence (r=0.298, p=0.0001) and beliefs in physical activity outcomes (r=0.207, p=0.0001). Negative relationships were found between physical activity with depression (r=-0.116, p=0.021) and body size discrepancy (r=-0.143, p<0.01). Respondents who had a better perception of their current health status were more physically active (χ2=21.062, p=0.0001). Multivariate analyses for the prediction of physical activity showed that physical activity self-efficacy, sex and peer influence were the most significant contributors in explaining physical activity among adolescents. Conclusion: Physical activity interventions should include psychosocial components as mediator variables in interventions designed to promote regular physical activity in adolescence.

Excess dietary fat intake is associated with many chronic diseases. This crosssectional study determines the differences in nutritional status and diet-related psychosocial factors by accuracy levels of dietary fat intake perceptions among adults. A total of 202 Universiti Putra Malaysia staff (20-55 years old) volunteered to participate in the study. Dietary fat accuracy levels (under-estimate, accurate and over-estimate) were determined by assessing actual fat intake through 24-hour diet recall and self-rated fat intake. Diet-related psychosocial factors assessed were perceived risks, intention to change, outcome expectancies and perceived barriers. About half (49.5%) of the respondents were classified as accurate estimators, while 35.6% and 14.9% were under-estimators and over-estimators, respectively. Dietary fat intake differed significantly between the dietary fat accuracy groups with under-estimators having the highest amount of dietary fat intake (F=17.10; p<0.001) and percentage of fat calories (F=103.99 + 0.533%, p<0.001). Over-estimators had the highest mean BMI (F=3.11, p<0.05) compared to other groups. Among the fat accuracy groups, under-estimators reported the least barriers to eating low fat foods (F= 3.671, p<0.05). There were no significant differences in waist circumference, energy intake, perceived disease risks, intention to change and outcome expectancies among the dietary fat accuracy groups. These findings suggest that inaccurate perceptions of dietary fat intake should not be overlooked as one of the cognitive barriers to dietary change and factors that influence nutritional status among adults.

Introduction: University students are potentially important targets for the promotion of healthy lifestyles as this may reduce the risks of lifestyle-related disorders later in life. This cross-sectional study examined differences in eating behaviours, dietary intake, weight status, and body composition between male and female university students. Methodology: A total of 584 students (59.4% females and 40.6% males) aged 20.6±1.4 years from four Malaysian universities in the Klang Valley participated in this study. Participants completed the Eating Behaviours Questionnaire and two-day 24-hour dietary recall. Body weight, height, waist circumference and percentage of body fat were measured. Results: About 14.3% of males and 22.4% of females were underweight, while 14.0% of males and 12.3% of females were overweight and obese. A majority of the participants (73.8% males and 74.6% females) skipped at least one meal daily in the past seven days. Breakfast was the most frequently skipped meal. Both males and females frequently snacked during morning tea time. Fruits and biscuits were the most frequently consumed snack items. More than half of the participants did not meet the Malaysian Recommended Nutrient Intake (RNI) for energy, vitamin C, thiamine, riboflavin, niacin, iron (females only), and calcium. Significantly more males than females achieved the RNI levels for energy, protein and iron intakes. Conclusion: This study highlights the presence of unhealthy eating behaviours, inadequate nutrient intake, and a high prevalence of underweight among university students. Energy and nutrient intakes differed between the sexes. Therefore, promoting healthy eating among young adults is crucial to achieve a healthy nutritional status.

Introduction: It is known that dietary diversity improves diet quality and nutritional status of young children. This study aimed to determine the relationship between dietary diversity and nutritional status of Orang Asli children in Krau Wildlife Reserve. Methods: A total of 216 children from three Orang Asli sub-tribes (Jah Hut, Temuan and Che Wong) aged 1 to 6 years from 162 households in 16 villages participated in this cross-sectional study. Children and mothers were measured for body weight and height. Mothers were interviewed for household socio-demographic information and diet diversity of children in the last 7 days. Diet diversity score (DDS) was calculated based on 15 food groups. Results: There was a high prevalence of underweight (50.9%) and stunting (61.6%) in Orang Asli children. For mothers, 11.1%, 27.8% and 7.4% were underweight, overweight and obese, respectively. Mean DDS of children was 6.38 [95% CI-6.10, 6.65] of the possible 15. Higher DDS of children was significantly related to older age (p<0.05), the non Jahut sub-tribe (p<0.01) and longer maternal years of schooling (p<0.05). DDS was also positively related to weight-for-age z-scores (p<0.001) and height-for-age z-scores (p<0.05). Conclusion: Undernutrition remains a major nutrition problem among Orang Asli children living within the forest reserve. Efforts to promote dietary diversity should emphasise traditional and nutritious foods that could improve health and nutritional status of the Orang Asli children.

Introduction: This study aimed to evaluate the validity and reliability of the Multidimensional Body Image Scale (MBIS), a seven-factor, 62-item scale developed for Malaysian female adolescents. This scale was evaluated among male and female Malaysian university students. Methods: A total of 671 university students (52.2% women and 47.8% men) completed a self-administered questionnaire on MBIS, Eating Attitude Test-26, and Rosenberg Self-Esteem Scale. Their height and weight were measured. Results: Results in confirmatory factor analysis showed that the 62-item MBIS reported poor fit to the data, ²/df = 4.126, p < 0.001, CFI = 0.808, SRMR = 0.070, RMSEA = 0.068 (90% CI = 0.067, 0.070). After re-specification of the model, the model fit was improved with 46 items remaining, ²/df = 3.346, p < 0.001, CFI = 0.903, SRMR = 0.053, RMSEA = 0.059 (90% CI = 0.057, 0.061), and the model showed good fit to the data for men and women separately. This 46-item MBIS had good internal consistency in both men (Cronbach’s alpha = 0.88) and women (Cronbach’s alpha = 0.92). In terms of construct validity, it showed positive correlations with disordered eating and body weight status, but negative correlation with self-esteem. Also, this scale discriminated well between participants with and without disordered eating. Conclusion: The MBIS-46 demonstrated good reliability and validity for the evaluation of body image among university students. Further studies need to be conducted to confirm the validation results of the 46-item MBIS.

Objectives: There is a lack of current published information on health and nutritional status of Orang Asli children. A study was conducted to assess breastfeeding practices, dietary intake and growth status of Orang Asli children in Sepang and Carey Island, Selangor.Methods: A total of 173 children(88 Temuan and 85 Mah Meri) from 137 households were measured for body weight and height. Information on breastfeeding practices and dietary intake was obtained from their mothers. Results:Most of the mothers (98.9%) breastfed their infants with a high proportion (86.8%) initiating breastfeeding within one hour after delivery.About 53% of the mothers reported discarding colostrum due to various reasons including the perception that colostrum in undesirable and can produce ill-health. Although many of these mothers (58.3%) discarded colostrum on their own initiative, about 25% of them reported that they were advised by health professionals. Among mothers who had stopped breastfeeding at the time of the study (n=48), the mean duration of breastfeeding was 12.1 ± 8.9 months. About 33% of the mothers stopped breastfeeding before their infants were 6 months old and only 31% breastfed their children for more than 1 year. The percentages of significantly underweight, stunted and wasted were 48.9%, 5.2.2% and 4.3% respectively for children aged 1-3 years, whereas among children aged 4-6 years old, 35.8%, 50.6% and 1.3% were underweight, stunted and wasted, respectively. A higher proportion of Mah Meri than Temuan children in both age groups were significantly underweight, stunted and wasted. Despite the adequate intake of energy and most nutrients,the Orang Asli children had insufficient mean number of servings for all food groups-grain and cereals, fruits, vegetables, meat and fish, and milk and dairy products. Conclusion: In this study, undernutrition is a major health and nutrition problem among the Orang Asli children. The problem could be due to many factors that include poor infant and child feeding practices. Concerted efforts by various government and non government agencies are essential to improve the health and nutrition of Orang Asli.

Introduction: Dietitians play an essential role in the management of childhood obesity and consistency in dietetic practices is required to ensure the effectiveness of treatment. This study assessed dietitians’ current practices in the management of childhood obesity, compared the practices with nutrition practice guidelines used by dietitians in other countries and identified practice components for the development of nutrition practice guidelines for the management of childhood obesity in Malaysia. Methods: A cross-sectional study was conducted among 40 dietitians in 16 Ministry of Health hospitals and three teaching hospitals. Information on current dietetic practices in the management of childhood obesity was obtained through a mailed survey questionnaire. The practices included nutritional assessment, determination of energy requirement, dietary prescription and physical activity modification. Emails were sent to 31 dietetic associations in other countries to obtain information on practice guidelines used by dietitians. Results: Frequently used dietary intervention and physical activity modification approaches were high fibre diet (65%), low fat diet (40%), reduction of sedentary pursuits and screen times (67.5%) and an increase in duration of current physical activities (60%). In comparison to other dietetic practice guidelines, the current dietetic practices in Malaysia do not usually include waist circumference, biochemical and blood pressure data. However, similar to other guidelines, the current dietetic practices included low dietary fat, high fibre diet, decreased sedentary activity and increased physical activity level. Conclusions: The dietetic practices in the management of childhood obesity in Malaysia are diverse. A comprehensive nutrition practice guideline for management of childhood obesity is urgently needed for standardisation of dietetic practices in Malaysia.
Dietetics ; Child ; Obesity ; Prevalence