Food insecurity, exacerbated by socioeconomic disadvantage, is a critical determinant of nutritional inadequacy and psychological distress. However, localised data on this relationship and coping mechanisms among lowincome populations remain limited. This study investigated the prevalence of food insecurity, coping strategies and psychological health among low-income (B40) households in Taiping, Perak, Malaysia. A cross-sectional study was conducted online using convenience and snowball sampling among 115 women of reproductive age (18-49 years) from B40 families. Food security status was assessed using 18-item U.S. Household Food Security Survey Module (HFSSM). Depression and anxiety status were measured with Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) scale, respectively. Coping strategies were recorded using a structured checklist. Overall, 81.7% of households were food-secure, while 18.3% were food-insecure. The prevalence of clinically significant depression (PHQ-9 ≥10) and anxiety (GAD-7 ≥10) was 4.3% and 2.6%, respectively. Significant association were found between food insecurity and psychological distress, with food-insecure women reporting higher levels of depressive and anxiety symptoms (p<0.001). Common coping strategies included food-related actions (such as prioritising children’s food intake) and financial rationing (such as stringent budgeting), while income-generating strategies were less frequently adopted. In conclusion, most households were food-secure, and a minority experienced food insecurity, which was strongly associated with depression and anxiety. This highlights the need for integrated public health interventions that address both economic vulnerability and mental health, moving beyond short-term food assistance toward sustainable social support strategies.

Introduction: Writing a research paper is a fundamental skill for researchers, yet many early-career scientists face challenges due to limited formal training in scientific writing. This paper serves as a practical guide for graduate students and early-career researchers preparing their first research manuscript. Methods: Drawing on published guidance, editorial perspectives and best practices in scientific communication, this paper outlines the key components of a research manuscript, including the title, abstract, introduction, methods, results, discussion, conclusion and references. Emphasis is placed on the IMRaD (Introduction, Methods, Results and Discussion) structure, effective manuscript organisation and appropriate writing techniques. Results: This guide provides practical recommendations to support the preparation of clear, coherent and publication-ready manuscripts. By systematically explaining the purpose and structure of each manuscript section, it helps novice researchers develop confidence in scientific writing. Additional considerations related to manuscript revision, journal selection, submission procedures, cover letter preparation, plagiarism screening, responsible use of artificial intelligence tools and ethical conduct are also discussed. Common pitfalls that may hinder publication, including poorly defined research questions, inadequate reporting and non-compliance with journal requirements, are highlighted together with strategies to avoid them. Conclusion: Successful scientific writing requires clarity, organisation, methodological rigour and ethical integrity. By understanding the purpose and structure of each manuscript section and adopting best practices in writing and publication, early-career researchers can communicate their findings more effectively and contribute meaningfully to the advancement of knowledge in their respective fields.

eToyBox is a learning management system for preschool teachers to improve their health literacy, which ultimately aims to improve children’s obesity-related behaviour. As part of the development process of eToyBox, assessment on digital literacy, acceptance of digitization of education materials, and perceived barriers in adopting online learning is needed. Fifty-four preschool teachers under the Community Development Department (KEMAS) in Kuala Lumpur, Selangor, and Sarawak, who participated in ToyBox Study Malaysia intervention in 2018, took part in this cross-sectional study. An online self-administered questionnaire was used to assess sociodemographic background, use of communication tools and media, and teacher’s views on adapting the ToyBox modules to digital education materials. Respondents were contacted, and questionnaire link was shared through WhatsApp messages. Most participants (74.0%) were Malay females aged 31 to 40 years old. Most participants had internet access (94.4%) and owned at least a smart phone, laptop or tablet (94.4%). Participants perceived their computer skills to be average (75.0%). Majority of respondents (65.0%) reported advanced and higher abilities in word processing and email, but only 22.0% in spreadsheet skills. The main barrier to accessing online material was unstable internet connection (74.1%). Most respondents (90.0%) agree that adapting effective modules to online learning will be beneficial for professional development and teaching practices. In conclusion, most participants supported digitizing Toybox Study Malaysia educational content and were comfortable 72 with its implementation via an online learning platform. The findings from this study can advise future development of online learning materials for preschool teachers in Malaysia.

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.

Introduction: Designing an effective and comprehensive weight reduction intervention requires an understanding of the motivating factors and barriers to losing weight. This study explored the motivating factors and barriers to weight reduction through the experiences, emotions and ideas shared among suburban overweight and obese Malay adults. Methods: In this qualitative study, 23 overweight or obese Malay adults aged 30-59 years old were divided into three focus group discussion (FGD). The Socio-Ecological Model (SEM), consisting of four levels (intrapersonal, interpersonal, community, and policy) was utilised in this study. Results: The motivating factors were: (1) Intrapersonal level: self-awareness, health concern, self-confidence, and desire to have good physical appearance, (2) Interpersonal level: social support from family and friends, (3) Community level: availability and accessibility of physical activity facilities and health information, and (4) Policy level: healthy lifestyle programme. The barriers were: (1) Intrapersonal level: lack of knowledge about diet, physical limitations, lack of self-control, and emotion/mood, (2) Interpersonal level: spouse and children, career or housework commitment, (3) Community level: lack of neighbourhood safety, and availability and accessibility of outside foods, and (4) Policy level: availability and accessibility of outside foods. Conclusion: Eight factors were identified as motivating factors and barriers for weight reduction practices. Support from family and friends should be considered when developing an effective and comprehensive weight loss programme as it was both a motivating factor as well as a barrier.

Introduction: The refeeding programme in government hospitals is aimed at improving the nutritional status of malnourished children with weight-for-height z-score (WHZ) below -2.0, using special therapeutic food. However, there is a lack of data on the nutritional status of indigenous (Orang Asli) children when they return to the community after hospital discharge. Case Presentation: A 3-year-old Temiar boy residing in a tribal village in Hulu Perak was visited to determine his nutritional status following discharge from a refeeding programme in a government hospital. He was admitted to the hospital with a weight of 10.0 kg, height of 85.5 cm and WHZ of -2.09. The boy was later discharged weighing 11.0 kg, and with height unchanged at 85.5 cm and WHZ of -0.87. During our visit to the child’s home three months after discharge, his weight was 9.5 kg, height 86.0 cm, and WHZ –2.91. Discussion: The management of the case in the hospital was based on the Malnourished Orang Asli Protocols of the hospital. Household food insecurity, feeding and care practices, unhealthy household environment and the lack of communication between hospital and community health services were all identified as risk factors for malnutrition. Conclusion: The recurrence of malnutrition in this child, after successful improvement during hospital stay, highlights the importance of identifying factors that may affect nutritional status after hospital discharge. This knowledge will be beneficial in planning specific interventions, especially for Orang Asli children, living in remote villages

Introduction: Obesity and physical inactivity among schoolchildren are among the most challenging health problems inMalaysia. The present study aimed to evaluate the sustainedimpact of Juara Sihat programme on physical activity leveland anthropometric status at 18-month post-intervention.Method: Participants of Juara Sihat (n=55) were followed-upat 18 months after completion of the intervention. JuaraSihat intervention was implemented over 12 weeks andfocused on four key components: (i) five one-hour nutritioneducation classes, (ii) four one-hour physical activityeducation sessions, (iii) family involvement, and (iv)empowerment of Parents and Teachers Association.Anthropometric variables (body mass index, body fatpercentage and waist circumference) were measured andphysical activity level was evaluated by using PhysicalActivity Questionnaire for Children (PAQ-C) at baseline (P0),immediately upon completion of intervention (P1), atthree-month post-intervention (P2), and at 18-month postintervention(P3). Analyses of repeated measures analysisof covariance (ANCOVA) with intention-to-treat principlewere applied.Results: Sustained effects were found in BMI-for-age z-scorewhich showed a reduction (P0 2.41±0.84 vs P3 2.27±0.81)and physical activity level which showed positiveimprovements (P0 2.46±0.62 vs P3 2.87±0.76) at 18 monthsafter intervention was completed. Body fat and waistcircumference had increased over the same time period.Conclusion: Overall, this study successfully demonstratedsustained intervention effects of Juara Sihat intervention onBMI-for-age z-score and physical activity, but not on body fatpercentage and waist circumfere

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.

Childhood obesity is a global epidemic, which leads to the increasing number of studies on genetic locations associated with obesity-related traits. Polymorphisms of insulin (INS) gene have been shown to be associated with obesity-related phenotypes in Europeans; while insulin receptor (INSR) gene has been associated with energy regulation. Therefore, this study was conducted to investigate the association between the INS (rs689) and INSR (rs3745551) gene polymorphisms with childhood obesity risk in a Malay childhood population. Normal weight (538) and overweight or obese (557) children aged 6-12 years old were genotyped using semi-automated Sequenom iPLEX® Gold. Body mass index (BMI) was calculated from measured body weight and height. The rs689 (T/T: 0.006, A/T: 0.159 and A/A: 0.835) and rs3745551 (G/G: 0.054, A/G: 0.378 and A/A: 0.568) genotype distributions were consistent with Hardy Weinberg equilibrium. The T-minor allele frequency for rs689 was 8.6% and G-minor allele frequency for rs3745551 was 24.3%. Minor allele of INS gene polymorphisms significantly increased risk of obesity among Malay children (sex- and age-adjusted OR=1.580; 95%CI: 1.134-2.201). However, INSR gene polymorphisms were not significantly associated with childhood obesity. In conclusion, the polymorphisms of INS gene, rather than INSR gene, were associated with childhood obesity in the Malay population.
Pediatric Obesity ; Receptor, Insulin

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