Introduction: Poor feeding practices can result in malnutrition, which may have long-term negative effects on children’s physical and cognitive development. There is limited qualitative research exploring feeding practices among caregivers of urban poor, even though their children are highly vulnerable to undernutrition. Aim: This qualitative study aimed to explore and compare the feeding practices, barriers and coping strategies of caregivers of well-nourished and undernourished children aged three to five years living in public low-cost housing in Kuala Lumpur, Malaysia. Methods: Semi-structured in-depth interviews were conducted among 27 caregivers. Caregivers were purposively selected using purposive sampling and categorized into two groups based on their children’s growth status: families with well-nourished children (FWWC; n=15) and families with undernourished children (FWUC; n=12). Thematic analysis was conducted. Results: Two main themes emerged: feeding practices and barriers and coping strategies to feed children. FWWC caregivers demonstrated certain unique yet beneficial practices. They emphasized responsive feeding techniques, such as using nutritious snacks, promising outdoor activities, and involving children in meal preparation at home as effective strategies to increase children’s food intake. Contrarily, FWUC caregivers practiced less responsive feeding techniques, such as forcing, ignorance, and distraction. Caregivers from both groups experienced similar barriers (child barriers and family barriers) and applied comparable coping strategies (ignorance, distraction, pressure and force, compromise, and creativity). Conclusion: Understanding feeding practices of caregivers of healthy and undernourished children can guide the development of culturally tailored interventions and policies. These efforts can help address barriers and improve child nutrition through responsive feeding, ultimately preventing undernutrition.

Introduction: The growing population of international students in Malaysia has underscored the need to better understand their food preferences. Despite this, local studies addressing this topic have remained scarce. This study aimed to determine relationships between nutrition knowledge and food environment and their respective contributions to food preferences among international students at a Malaysian public university. Methods: This cross-sectional study included 619 international students. A structured questionnaire was used to assess general nutrition knowledge and food environment. Students were asked to rate their preferences for 77 food items using a five-point Likert scale, ranging from “dislike a lot” (1) to “like a lot” (5). The food items were categorised into six groups, namely animal foods (14 items), starches (12 items), dairy products (8 items), fruits (15 items), vegetables (20 items), and snacks (8 items). Results: A significant negative relationship was observed between dairy preference and affordability (r=-0.115, p=0.005). Students who lived off campus reported significantly greater preference for vegetables (M=75.49) than those who lived on campus (M=72.84). Nutrition knowledge related to diet, disease, and weight management emerged as the strongest predictor of fruit preference (β=0.257, p<0.001). Conclusion: General nutrition knowledge and food accessibility emerged as significant predictors of food preferences. Nutrition intervention programmes and efforts to improve access to fresh food options on campus may help encourage healthier food preferences among international students.

Introduction: COVID-19 pandemic has impacted the livelihood of Malaysians and gardening activities have contributed positively to the diet quality. This study aimed to determine the factors associated with diet quality among adults in AU2 Keramat, Kuala Lumpur. Methods: The cross-sectional study involved adults aged 18 to 59 via convenience sampling. The socio-demographic, physical activity level and involvement status in gardening were obtained through a questionnaire, while food intake was from a single-day 24-hour diet recall. The diet quality was determined through Malaysian Healthy Eating Index (MHEI) and dietary misreporting was calculated using the Goldberg cut-off method. Results: A total of 117 respondents (65.8% females, 35.2% males) with a mean age of 40.98 were involved in this study. Findings showed that most respondents did not engage in gardening activities (72.6%) and the prevalence of poor diet quality in this study was 89.7%, with a mean score of 44.51. The older respondents (r= 0.20, p= 0.034) and community gardeners (t= -2.63, p= 0.011) had a significantly higher diet quality but not home gardeners (t= 0.12, p= 0.902). The respondents involved in gardening activity also had a significantly higher fruit serving intake, Mann-Whitney U= 1045.00, p= 0.036) and lower total fat intake (t= 2.27, p= 0.025). Conclusion: The diet quality of the respondents remains poor but community gardeners had significantly higher diet quality and fruit intake while lower total fat intake. Interventions need to be developed to address the persistent poor diet quality of adults in the community.

Introduction: The Lost Food Project (TLFP) is a non-profit organization who continuously working on their strategic plan in combating the food insecurity problem by distributing food surplus to low income households within Klang Valley. This cross-sectional study aims to determine the socioeconomic status, food security status and its coping strategies among TLFP recipients in Klang Valley during COVID-19 pandemic. Methods: This study was conducted from April to June 2021. There were 88 respondents recruited through convenience sampling. A set of questionnaires regarding food assistance, nutrition knowledge, food security and its coping strategies was prepared, and the respondents were interviewed either by phone, face-to-face or self-administered questionnaire. Results: The prevalence of food insecurity among households in this study was 59.1%. Most of them have moderate (37.5%) to good (27.5%) nutrition knowledge. The coping strategy that most of the respondents applied was ‘using less expensive food’ (58.3%) with at least once per week within the past one month. Food insecure households tend to adopt more coping strategies compared to those food secure households (p<0.001). Moreover, households who rent their house (p<0.01), low household income (p<0.05) and high monthly food and drinks expenditure (p<0.01) were associated with the food insecurity among TLFP recipients. Conclusion: The study concluded that lower household income, higher food and drinks expenditure and those who rent the house have negative impacts on household’s food security status. Thus, the situation forced them to apply more food-related coping strategies in their daily life. Further research should be conducted on the effectiveness of TLFP in helping them to improve Malaysian’s food security status.

Introduction: Food security can be defined as the availability of and accessibility to food, acquired in an acceptable means at any given time and place in a way that could maintain health and wellbeing. One critical dimension of food security is continued access to adequate food. To measure this dimension, the Food and Agriculture Organization (FAO) developed the latest measurement tool, namely the Food Insecurity Experience Scale (FIES), the first instrument to measure people who experience food insecurity globally. This study aimed to validate the construct validity and reliability of the Malay version of FIES (M-FIES) for Malaysians. Methods: This cross-sectional study was conducted among 145 households in Kuantan, Pahang. Rasch analysis was used to analyse the construct validity of FIES. Results: FIES met the Rasch model assumptions with all items having an infit value of between 0.7- 1.3 and an outfit value of <2.0. The item and person reliability were 0.97 and 0.71, respectively; while the item and person separation were 5.59 and 1.58, respectively. The FIES item severity indicated that the items “few food”, “healthy”, “skipped”, “ate less”, and “runout” were disordered. Conclusion: The M-FIES is a valid and reliable measurement tool for the food insecurity situation among households based on its construct validity assessed using the Rasch model. Furthermore, the severity of item in M-FIES was different in terms of order from the original FIES, suggesting that the same items may be interpreted differently due to cultural or societal differences.

Introduction: Food insecurity has a complex and multifaceted concept and definition, thus assessing it has been an ongoing challenge for researchers, health practitioners, and policy makers. Previous studies reported inconsistent findings on the prevalence and severity of food insecurity, depending on the measuring tools used. To overcome this limitation, this study aimed to translate and validate the Food Insecurity Experience Scale (FIES) for Malaysians, which has been used as a standard measurement by Food and Agriculture Organization (FAO). Methods: Two forward and backward translations involving experts in food insecurity studies and experts in language were done, as well as the pre-test and cognitive interview stipulated in World Health Organization (WHO) translation guidelines. Content and face validity were conducted as part of the validation process. Content Validity Index (CVI) was done to analyse content validity. Results: The harmonised Malay version of FIES was produced with 1.0 CVI, which was above the 0.8 criteria. Face validity showed good understandability and clarity of FIES. Conclusion: The translated Malay version of FIES had good acceptability, as well as good face validity when tested among the target audience. Thus, a full validation study of the Malay version FIES should be done before it is widely used to measure food insecurity in the population, specifically the Malaysian population.

Introduction: Childhood obesity is one of the major public concerns as prevalence was showing an increasing trend in Malaysia. This study aimed to determine the associations between maternal beliefs, attitudes and feeding practices with children’s Body Mass Index-for-age (BMI-for-age). Method: A cross-sectional study was carried out in Bandar and Jugra, Kuala Langat, Selangor in two-phase. The first phase was conducted to determine the prevalence of children’s body weight status involving 209 pairs of mothers and children. The second phase of the study aims to determine the socio-demographic characteristics, maternal beliefs, maternal attitudes and feeding practices with childhood obesity involving 148 pairs of mothers and children whose BMI-for-age are normal, overweight and obese only. A set of self-administered questionnaire was answered by the mothers and anthropometric measurements of children were taken. Results: Overall, about 24.9% of the children were overweight and obese. Maternal employment status (X2 = 9.135, p<0.05), perceived child weight status (r=0.267, p<0.05) and food restriction (r=0.186, p<0.05) were positively correlated with children’s BMI-for-age. The pressure to eat (r= -0.177, p<0.05) was negatively associated with children’s BMI-for-age. From multiple linear regression, maternal employment status, perceived child weight status and pressure to eat was shown to be factors associated with children’s BMI-for-age. Conclusion: In conclusion, the findings showed that maternal employment status, perceived on child weight status, restriction on food and pressure to eat were linked to children’s BMI-for-age. Therefore, mothers should be educated on appropriate feeding practices to help to maintain healthy BMI-for-age among younger children.

Introduction: Obesity in children is a global epidemic issue. Home food environment is an important aspect that may influence children’s body weight status. The aim of this study is to identify the association between socio-demographics and home food environment (HFE) factors with body weight status in primary school children in Bangi, Selangor. Methods: There were 398 children (43.5% males and 56.5% females) aged 7-11 years old (mean age of 9.04±1.41 years) and their parents (66.6% mothers and 33.4% fathers) from eight randomly selected primary schools participated in this study. Parents were asked to complete a self-administered questionnaire on socio-demographic background, feeding practices and food availability, while children were interviewed to obtain information on parental styles and physical activity level. Weight and height of children were assessed, and BMI-for-age z-score (BAZ) was calculated by using WHO Anthroplus Software. Results: Overweight and obesity prevalence was 17.8% and 13.1% respectively. A majority of the parents (61.3%) in this study practiced authoritative parenting style. The increased odds of childhood obesity has been found to be associated with an increasing age (OR=1.239, p<0.05). The risk for overweight or obese was greater for male students than for female students (OR=1.619, p<0.05). Parent’s increasing restriction for weight control (OR=1.080, p<0.05) and decreasing pressure to eat (OR=0.913, p<0.05) increased childhood overweight and obesity risk. Conclusion: This study emphasizes the importance of involving parents in the obesity intervention programs for children.

Introduction: Good academic performance is important for children to ensure their personal well-being. This cross-sectional study investigated the associations between demographic and socio-economic characteristics, household food security status and academic performance among primary school children at North Kinta, Perak, Malaysia. Methods: Two national primary schools were selected randomly and all Standard 5 and 6 students were invited to participate in this study. Self-administered questionnaire on demographic and socio-economic characteristics and food security status was completed by parents. The results from last year examination were acquired from the teacher to evaluate students’ academic performance. Results: Overall, 140 respondents were involved, in which 51.4% were male. A majority of the household (80.7%) displayed food insecurity. Multiple logistic regression revealed that students from well-off households were more likely to have higher marks in English Language Comprehension (OR=8.28, 95%CI: 1.49, 45.91), Writing (OR=25.02, 95%CI: 2.36, 265.69) and Mathematics (OR=7.79, 95% CI: 1.44, 42.11). Female students showed high odds to pass English Language Comprehension (OR=3.47, 95% CI: 1.49, 8.16) and Writing (OR=4.16, 95%CI: 1.51, 11.45) compared to male students. Conclusion: This study unveiled that gender and low household income results in the low achievement in students’ academic. Therefore, for the upcoming intervention programmes should focusing more on helping students from poor households in order to enhance students’ academic performance.

This article aimed to review the available anthropometry measurements used in the assessment of nutritional status among Cerebral Palsy (CP) children. Searched journals were from Medline, PubMed and Ovid published from 2015 to 2018. The search identified 443 articles, and eight studies met the criteria. Anthropometric measurements included weight, height, recumbent length, knee height, tibia length, Dual-energy X-ray absorptiometry (DXA), Bioelectrical impedance (BIA), Mid arm circumference (MUAC) subscapular skinfold (SFT), Triceps skinfold (TSF) and prediction equations. Body fat composition can be obtained by DXA, BIA, skinfold measurement, and also prediction equation. The predictive equation is the most reported method to determine nutritional status among CP. This review found that TSF and SFT are more accurate to determine body fat percentage when using together with the predictive equation. Besides, predictive equations using segmental length are reliable in estimating the height and can be used to evaluate the nutritional status using the specific CP growth chart.