Introduction: South Sumatra Province in Indonesia has a relatively high prevalence of stunting and there is limited research about this phenomenon in this area. The study aimed to identify what factors affected stunting in children aged 6-23 months in the province. Methods: Using a comparative cross-sectional design involving 139 mothers with children aged 6-23 months, the study collected data from September to December 2022 via anthropometric measurements and interviews using a questionnaire. Data on parental, child, socioeconomic, and environmental factors were analysed using chi-square test and logistic regression analysis. Results: Overall, there were significant relationships among the following variables: child’s age (p=0.031), birth length (p=0.017), and weight-for-age (WAZ) status (p<0.001) with stunting. Children in the underweight and severely underweight categories were 28.7 times at risk of stunting compared to those in the normal category of WAZ status; children aged 12-23 months had a 2.8 times risk of stunting compared to children aged 6-11 months, while stunted birth length showed a 4.6 times risk of stunting compared to that of normal birth length. Conclusion: This research found that child age, birth length, and WAZ status were significant factors affecting stunting in the South Sumatra Province. Given these results, this study offers recommendations for the provincial government to focus on intervention programmes that provide additional food for pregnant women with chronic energy deficiency, monitor the growth of toddlers, and manage toddlers with nutritional problems in this province.

Introduction: Poor appetite is prevalent among older adults and may negatively impact on their overall health. This is especially true for institutionalised residents. Despite this, there is a paucity of research on appetite and its associated factors among institutionalised residents, which signified the present study. Methods: A cross-sectional study was conducted among elderly residents at long-term care facilities in the state of Selangor, Malaysia to ascertain their appetite status and its associated factors. Results: A total of 97 residents with mean age of 74.2±8.4 years old were recruited. They comprised 61.9% females and 38.1% males. More than 50% had poor appetite with early satiety. There were 63.0%, 82.4%, and 94.8% who had poor oral health, poor sleep quality, and depression, respectively. Ethnicity (OR=2.73; 95% CI=1.00-7.44; p=0.049) was the only factor that predicted poor appetite among older adults in long-term care facilities, with Malay residents having poorer appetite than their Chinese and Indian counterparts. Conclusion: The prevalence of poor appetite was high among residents staying at long-term care facilities in Selangor, Malaysia, especially among Malays. This issue deserves further studies to identify the specific underlying factors contributing to poor appetite among older adults from different ethnicities. Acknowledging the high prevalence of poor appetite among older adults and its possible unfavourable outcomes, appropriate nutrition interventions are therefore needed to address this issue among institutionalised elderly.

Introduction: Health and nutrition interventions in developing countries have been linked to better thriving and survival of children. Identifying programmes with significant effect on the nutritional status of Filipino preschool children may aid in identifying impactful interventions in addressing malnutrition. This study evaluated the association between nutritional status of preschool children and government programme participation based on the 2018 Expanded National Nutrition Survey (ENNS) results. Methods: Secondary data analysis of 12,949 preschool children was performed from the 2018 ENNS. The selected data included socioeconomic, anthropometric, and self-reported household-level and individual-level government programme participation. Chi-square test for association and multiple logistic regression were conducted using Stata version 16. Results: Participation in immunisation programme, growth monitoring, household food production, and awareness and usage of iodised salt were negatively associated with at least one type of undernutrition. Consequently, participation in deworming programme was positively associated with both underweight and stunting. Regression analysis showed that preschool children who underwent growth monitoring were less likely to be stunted (OR=0.58), while those who underwent newborn screening were less likely to be underweight (OR=0.53) and stunted (OR=0.62). On the contrary, dewormed children were more likely to be stunted (OR=1.63) and those from 4Ps households were more likely to be wasted (OR=2.24). Conclusion: There is a need to re-evaluate programme strategies to maximise the benefits provided. Programmes showing significant associations with nutritional status including immunisation, growth monitoring, deworming, household food production, and awareness and usage of iodised salt should be continued and sustained with updated policies.

Introduction: COVID-19 lockdown has been linked to alterations in eating behaviour and a sedentary lifestyle. As human-to-human transmission rapidly increased, the Movement Control Order (MCO) was put in place as an attempt to minimise the risk of the virus spreading in the community. This study aimed to determine whether eating behaviour was associated with sleep quality and physical activity among college students in Malaysia during MCO. Methods: This was a cross-sectional study among Malaysian students aged between 20 to 34 years old. A simple random sampling method was applied and the participants had to complete an online survey consisting of a validated Dutch Eating Behaviour Questionnaire (DEBQ), Pittsburgh Sleep Quality Index (PSQI), and International Physical Activity Questionnaire–Short Form (IPAQ-SF), distributed via an online platform. Results: A total of 370 students participated, with 22.4% emotional eaters, 58.6% external eaters, and 23.0% restrained eaters. In addition, 64.3% had poor sleep quality, while 57.6% claimed to be physically active. However, no correlations were found between all eating behaviour subscales with sleep quality and physical activity. Conclusion: More than half of college students presented with external eating behaviours. Early screening and further investigations should be done, especially with the high rate of poor sleepers, to promote and sustain a healthy lifestyle during and beyond COVID-19.

Introduction: Poor dietary diversity is one of the key factors that increases the rate of complications during pregnancy. Pregnancy complications significantly increase the risk of maternal mortality. The aim of this study was to explore the associated factors between dietary diversity and complications during pregnancy. Method: A cross-sectional study was conducted among 450 randomly selected pregnant women. Individual dietary diversity score (IDDS) was used to assess dietary diversity based on Food Frequency Questionnaire (FFQ). IDDS was derived from 24-hour recalls from nine food groups. Results: Most of the pregnant women (48.9%) included in this study were in their second trimester; 19.3% and 31.8% were in first trimester and third trimester, respectively. About 83.8% of respondents included in this study experienced pregnancy complications. According to IDDS, most participants (77.1%) consumed a medium-diversified diet. Only 4.4% and 18.4% of pregnant women had low and highly diversified dietary intakes, respectively. Mean IDDS was 5.62±0.93, which indicated medium diversity of dietary intake. Dietary diversity had a statistically significant correlation with age (p=0.003), monthly income (p=0.003), education level (p=0.001), and respondent’s employment (p=0.004). The study exposed that pregnancy complications had a negative correlation with food diversity (r=-0.223), marriage age (r=-0.066), and education level (r=-0.163). Conclusion: The study concluded that pregnancy complications can be alleviated by improving dietary diversity practices during pregnancy.

Introduction: Overweight and obesity have emerged as significant global health concerns among children. Previous studies have provided evidence that children with intellectual and learning disabilities (LD) are at a higher risk of obesity compared to their peers without disabilities. Methods: This study aimed to predict body weight status of children with LD who attended Special Education Integration Program in Kelantan, located on East Coast of Peninsular Malaysia. Parents completed a self-administered questionnaire in Malay language, which included “Screening Tool of Feeding Problems” children’s version (STEP-CHILD) and Comprehensive Feeding Practice Questionnaire (CFPQ). The children’s body weight and height were measured to determine body mass index (BMI). Research hypothesis was tested through stepwise multiple linear regression analysis. Results: This study recruited 245 subjects with mean age of 10.5±1.7 years and mean BMI of 18.5±4.9 kg/m2. Prevalence of underweight, thinness and severe thinness was 12.2%, while overweight and obesity was 29.0%. Male children with LD (β=0.109, p<0.044), older age (β=0.226, p<0.001), higher child birth weight (β=0.119, p<0.029), lack of parental modelling (β=-0.170, p=0.004), lower parental pressure (β=-0.266, p<0.001), and higher restriction for weight control (β=0.361, p<0.001) were found to predict higher BMI values. Conclusion: Positive parental feeding practices during mealtime are crucial for addressing the poor nutritional status of children with LD.

Introduction: Malaysian adults consume excessive amounts of salt daily, which could lead to hypertension. Understanding knowledge, attitudes, and practices (KAP) surrounding salt intake is crucial for designing effective interventions to reduce excessive consumption and its associated health risks. Therefore, this study aimed to adapt an existing salt intake-related KAP questionnaire that was previously employed in a local population-based survey and to validate and test its reliability. Methods: This cross-sectional study comprised two phases: (1) adaptation, content validation (CV), and face validation (FV); (2) pilot testing and reliability testing. CV and FV involved a total of seven experts and ten Malaysian adults from the Klang Valley, respectively. Pilot testing involved 139 Malaysian adults to determine the questionnaire’s reliability. Content validity index (CVI) and Face validity index (FVI) values were calculated to analyse CV and FV. Reliability of each domain was analysed by obtaining Cronbach’s alpha (α) values. Results: A self-administered questionnaire comprising six items each for knowledge, attitude, and practice was developed. The questionnaire demonstrated acceptable item-level CVI (I-CVI) and item-level FVI (I-FVI) values of at least 0.83, indicating that the items were relevant, clear, non-ambiguous, and simple. Reliability test showed acceptable α values of at least 0.70 for each domain, suggesting that the questionnaire was reliable. Conclusion: This tool could be considered valid and reliable for assessing the level of KAP towards salt intake among adults in Malaysia.

Introduction: An imbalance in diet can lead to anaemia in young women, which can impact not only themselves, but also the next generation. This study aimed to determine associations between quantity and quality of dietary intake with haemoglobin (Hb) concentration among female adolescents in Tasikmalaya, West Java, Indonesia. Methods: A cross-sectional study was conducted on 347 young women aged 12-18 years from ten districts in Tasikmalaya City, selected by simple random sampling. Quantity and quality of dietary intake were measured by 2-repeated 24-hour dietary recalls, while portable haemoglobinometer (HemoCue® Hb 201+) was used to measure Hb concentration. Linear regression model predicted associations between quantity and quality of dietary intake with Hb concentration in female adolescents. Results: The proportion of subjects suffering from anaemia were 47.3%. Average intake of dietary iron was 6.7±3.0 mg and average dietary quality score was 32.6%. Dietary quality score and days of menstrual bleeding contributed as much as 12.7% to the variation in Hb concentration among female adolescents. Conclusion: Anaemia in female adolescents in Tasikmalaya, West Java, Indonesia is a serious public health problem. Diet quality score was associated with female adolescents’ Hb concentration; therefore, improving the quality of diet is important to reduce anaemia.

Introduction: Crackers, one of the most consumed baked products, primarily contain refined wheat flour and have a moderate glycaemic index (GI). Nut and legume powders are used in baked goods to help regulate postprandial glycaemia; however, their glycaemic responses remain controversial. Our study aimed to compare the postprandial glycaemic responses between crackers with 30% wheat flour substitution by white kidney beans, cashew nuts, and almonds versus standard wheat crackers. Methods: Twelve adults were recruited for a five-session randomised controlled crossover study. In each session, they were randomly assigned to receive 50g carbohydrates from either a glucose solution or one of the four crackers. Plasma glucose levels were measured at baseline and 15, 30, 45, 60, 90, and 120 minutes after consumption. Satiety and hunger were evaluated using 100mm visual analogue scales at baseline and every 30 minutes until 120 minutes. Results: Mean incremental area under the curve (IAUC) for plasma glucose did not differ between the alternatives and wheat crackers, but was lowest for almond crackers. Compared with GI value of glucose solution, that of wheat, cashew nut, white kidney bean, and almond crackers were 39.97±23.13, 37.66±24.66, 35.85±10.86, and 28.09±17.92, respectively. Almond cracker consumption resulted in the highest mean IAUC for satiety and lowest for hunger, though non-significant. Conclusion: Crackers with 30% wheat flour substitution by nut and legume powders tended to improve postprandial glycaemia more than the standard crackers; however, acute responses on insulin and glucagon-like peptide-1 require further examination.

Introduction: In Indonesia, anaemia is known to be extremely common in female adolescents. In addition, the problem of overweight/obesity in teenagers is becoming more prevalent, even in stunting locus areas. This study aimed to examine the correlation between body mass index (BMI) and haemoglobin levels among adolescent girls in Tangerang’s stunting locus area. Methods: This crosssectional study included 171 adolescent girls attending four junior and senior high schools in Tangerang’s stunting locus area. Adolescents who matched the inclusion criteria— healthy, having lived in Sukamantri for more than six months, and willing to participate were chosen by a multistage cluster sampling procedure. Body weight and fat were measured, and Z-score for BMI-for-age was determined. Haemoglobin levels were measured by the Mission Hb Testing System. Multiple linear regression test was applied for the analysis. Results: The prevalences of thinness/severe thinness, normal, and overweight/obesity were 5.3%, 70.8%, and 23.9%, respectively. There were 20% of anaemic girls. Among anaemic girls, there were 26% overweight/obese and no thin/very thin girls. A weak, negative correlation between BMI with haemoglobin levels was observed (R2=0.054, p<0.001). Conclusion: The correlation between BMI and haemoglobin level was weak in our sample of adolescent girls in the stunting locus area. The current study emphasised the importance of additional research that includes several haematological and inflammatory biomarkers to better understand the complex relationship between nutritional status and haemoglobin level.