Introduction: In Malaysia, the undiagnosed diabetes prevalence has increased. Socio-demographic characteristics and nutritional status play a crucial role in prediabetes development. Hence, this cross-sectional study aimed to identify the socio-demographic characteristics and nutritional status of adults at risk of T2DM in Kuala Nerus, Terengganu. Methods: A total of 30 participants at risk of T2DM aged 18 to 59 years old were recruited from Kuala Nerus using a convenience sampling method. Information on socio-demographic, anthropometric, fasting plasma glucose (FPG) level, clinical profile, Finnish Type 2 Diabetes Risk Assessment Tool (FINDRISC) score, dietary intake, and physical activity level were obtained. Results: The participants (mean age: 36.1 ± 8.7 years) were mostly female (76.7%), Malay (96.7%), married (43.3%), had a tertiary degree (60.0%), and were working (83.3%) with a monthly salary of less than RM 1000. Half of the participants were from the obese class I category. Their FPG level was 5.6 ± 0.5 mmol/L and half of them were classified as having optimal blood pressure. Also, they had a mean FINDRISC score of 6.3 ± 1.8. The participants consumed 2073 ± 247 kcal/day, which was comprised of 50.8% carbohydrate, 16.1% protein, and 33.1% fat. Most of them (63.3%) were minimally active. Conclusion: The participants had moderate T2DM risk with normal FPG level, blood pressure, and heart rate. They had excessive energy and fat intake with insufficient dietary fibre intake. It is vital to examine the socio-demographic characteristics and nutritional status, which can provide important information for planning future cost-effective T2DM preventive strategies.

Introduction: Eating-out is common in almost all countries, including Malaysia, but this frequent practice may affect human health. In Malaysia, data on eating-out is limited. This study aimed to assess the proportion of eating-out, to assess the association between socio-demographic factors and eating patterns, and to compare energy and nutrient intakes between people eating-out and eating-in. Methods: This cross-sectional study was conducted among 100 adults aged 30 to 70 years old. Three-day food diaries were used to collect data on dietary intake. Eating-out was defined as eating foods prepared outside the home. Respondents who ate outside for at least one meal per day, for two or three days per week were considered as those who frequently practised eating-out. Results: A total of 84% of respondents who ate out had significantly higher sodium intake than those who ate at home (2934 mg/day vs. 2165 mg/day, p=0.025). Foods and drinks that were most commonly consumed outside were nasi lemak, roti canai, rice, ayam masak kicap, vegetable soup, tomyam, rice vermicelli soup (mee-hoon soup), hot teh-o, iced tea, and orange juice. Occupation (p=0.004) and location type (p=0.001) were associated with eatingout. Government and semi-government workers (61%) and urban population (57%) had higher percentage of eating-out compared to eating at home (19% and 12%, respectively). Conclusion: More than two-thirds of our respondents ate out and this habit was related to poor diet quality with excessive intake of sodium. Interventions are needed to improve the diet quality of the overall eating-out behaviour among targeted population.

Individual dietary patterns may be influenced by diet-related behaviours, which may eventually play a significant role in contributing to colorectal cancer risk. As nearly half of colorectal cancer cases can be prevented through diet and lifestyle modification, in this study, we aimed to present an overview of the literature on diet-related behaviour and its effect on colorectal cancer risk among adults. Articles published from 2011 until July 2021 were selected. Out of the 1,198 articles retrieved, 25 were analyzed. There were 16 case-control studies, and nine of them were cohort studies. As a finding, the instruments used in this review were food frequency questionnaires (n = 23), followed by a semi-structured interview (n = 1), and diet records (n = 1). We demonstrated that unhealthy diet-related behaviours are linked to an increased risk of colorectal cancer in adults and those food frequency questionnaires or food records are common instruments used to collect diet-related behaviours. This article imparts the research trends and directions of colorectal cancer risk factors and shows that diet-related behaviour varies and changes over time.

This article aimed to review the design features of web-based or online FFQ developed for adults and statistical analysis used in the validation, comparison, or reproducibility studies. The search identified 863 articles, and 29 studies met the criteria. The number of food list ranges from 12 to 279 items. The food portion size was estimated using images or a standard portion size using household measurement. Web-based FFQ was validated with other dietary assessment tools, Block FFQ and biomarker. Comparison study of web-based FFQ was done using paper-based FFQ and interviewed-administered FFQ. Two studies conducted validation and comparison study using other dietary assessment methods, biomarker and paper-based FFQ. Seven studies conducted reproducibility studies. Overall, webbased FFQs showed acceptable validity with the respective reference method and good reproducibility. Strategies to improve the application of current evidence on best practices in designing and validating a web-based FFQ can improve nutritional epidemiology studies.

Introduction: Obesity rate among school children has increased globally. Parental perception plays a significant role in the management of obesity among children. Previous studies indicated that parents who accurately perceived their child’s body weight status (BWS) tended to encourage healthy behaviours as compared to parents who overlooked the problem. Therefore, this study aimed to determine the association between socio-demographic factors with parental perceptions of their child’s BWS among school children in Terengganu, Malaysia. Methods: Using a cross-sectional study design, 389 school children aged 9 to 11 years old were recruited. Height and weight were measured using calibrated tools and inputted into the World Health Organization AnthroPlus software for body mass index z-score calculation. Parental perceptions of their child’s BWS were explored using a selfadministered questionnaire together with their socio-demographic background. Results: Of 389 subjects, 53.2% of school children were from rural and 46.8% were from urban schools. Overall, mean BMI-for-age z-score between school locations showed no significant difference, with higher means reported in urban (-0.2±1.6SD) than in rural (-0.4±1.6SD). Significant association was found between parents’ perceptions and actual BWS (p<0.001). Logistic regression analysis showed that parents of overweight children and parents in rural schools were more likely to misperceive their child’s BWS. Conclusion: This finding suggests that parents from rural areas and having overweight children were more likely to have misperceptions of their child’s BWS. Therefore, knowledge-based intervention programmes among parents specifically in the rural areas are needed to increase the level of awareness to assist in obesity prevention.

Treatment effectiveness depends on the knowledge, attitude, and practice (KAP) of osteoarthritis (OA) patients towards their assigned treatment. This study aimed to explore the KAP towards non-surgical intervention among OA patients. A methodological framework proposed by Arksey and O’Malley (2005) was implemented. An electronic database search of English-language academic articles was conducted using PubMed and ScienceDirect databases encompassing 1998 to 2018 period of time, resulting in a total of 26 studies. OA patients were knowledgeable about the disease and exercise management. However, they were lack of knowledge on drug therapy and complementary strategies. The attitude towards non-surgical interventions was ambivalence. Lastly, the practice section mainly focused on patients’ compliance and behaviour towards different conservative managements, namely physiotherapy, medications, and complementary and alternative medicines (CAMs) which influenced by both knowledge level and attitudes. In conclusion, a higher knowledge level and positive attitude will result in good practice.

Introduction: The number of breast cancer survivors in developing Asian countries is still lacking compared to Western countries. Health-related quality of life (HRQoL) of cancer patients is one of the significant predictors of survival. Hence, this study was conducted to determine HRQoL status among breast cancer survivors of different diagnosis duration in East Coast of Peninsular Malaysia. Methods: Cross-sectional data were collected for 128 breast cancer survivors, aged 37 to 72 years who were recruited by using purposive sampling method at two main government hospitals in Kelantan (n=67) and Terengganu (n=61). The validated European Organization for Research and Treatment of Cancer Quality of Life Questionnaires (EORTC QLQ–C30) and Breast Cancer Supplementary Measure (EORTC QLQ-BR23) which had been translated into the Malay language were used to measure HRQoL. Independent t-test was used to compare HRQoL status among short term (≤5 years duration since diagnosis) and long term (>5 years duration since diagnosis) breast cancer survivors. Results: Overall, our breast cancer survivors reported good HRQoL, with high scores for global health status, functional status and low symptoms scores. Long term breast cancer survivors had better social functioning compared to short term survivors (p=.038). Nevertheless, there was no significant difference found for other HRQoL status between short and long term breast cancer survivors. Conclusion: Breast cancer survivors in East Coast of Peninsular Malaysia generally experienced good HRQoL. The relatively similar HRQoL status between long-term and short-term survivors indicated a constant HRQoL profile among survivors throughout their survivorship.

School-based health programs implemented by the Malaysian Ministry of Education (MOE) through the National Physical Fitness Standard (SEGAK) assessments provided an important platform in health status monitoring among schoolchildren. However, to date, there is still no reliability study conducted on this method. Therefore, this study aimed to determine the reliability of the anthropometric data collected by physical education (PE) teachers in the SEGAK assessments. Anthropometry measurements of standard six school adolescents involved in the Health of Adolescents in Terengganu study were taken by trained researchers using a standardised protocol. The anthropometrics data were then compared with PE teachers’ measurements from the SEGAK assessments obtained from the specifically developed Health Monitoring System database. Reliability of the anthropometric measurements were analysed using Pearson’s correlation test, Intraclass Correlation Coefficients (ICC), Bland-Altman plot and Cohen’s Kappa statistics. Intraclass correlation coefficient between teacher-measured and researcher-measured values shows good correlation in weight (ICC = 0.93), height (ICC = 0.98) and BMI (ICC = 0.91). The Bland-Altman plot showed a relatively small difference in mean of weight, height, and BMI between teacher-measured and researcher-measured value. The mean difference between teacher-measured and researcher-measured value of weight, height, and BMI were 1.8kg, 0.1cm, and 0.8kg/m2 respectively. Overall, Cohen’s Kappa statistics showed substantial agreement (κ = 0.642) in BMI categorisation between the two measurements. Findings from reliability analysis conducted affirmed that anthropometrics assessments conducted by PE teachers in SEGAK assessments are reliable to be used for identification of body weight status among school children and adolescents particularly in Terengganu, Malaysia.

Despite being effective in promoting healthy dietary behaviour, smartphone apps are scarcely available for our local communities and the majority of nutritional-related information is based on western food selections. Our new innovation aims to provide specific educational advice about recommended food intake, types, nutritional qualities and weight issues for cancer patients and survivors who suffer appetite problems and nutritional deficits. The Cancer Dietary (CanDiTM) app was developed as a convenient, flexible and attractively engaging smartphone app containing healthy tips which are uniquely tailored to the local food choices, preferences and ingredients. This helps customise users’ dietary needs besides permitting constant information up-dating. Features are broadly categorised into Healthy Eating Guide (advice from healthy eating to eating problems, weight loss prevention and increasing proteins and calories intake) and Malaysian Recipes For Cancer Patients (focusing on common Malaysian dishes, ingredients, treatment-based recipes and special diets). An additional Symptom Diary allows user’s personal profile to be recorded and stored virtually online. Its feasibility and acceptability were further tested among 30 cancer patients, family caregivers and dieticians recruited from a public hospital in Terengganu, Malaysia. Very good feasibility (> 80%) and excellent acceptability (> 90%) were reported regarding its ease of operation, suitability of language used, attractiveness, knowledge enhancement and perceived usefulness. With this scientific yet creative innovation, routine dietary habits related to cancer conditions could be easily facilitated for both patients/survivors as well as family caregivers for their independent and healthy living.
Cancer dietary app ; Smartphone app ; Malaysian dishes

Obese children had impaired psychosocial status as they generally tend to be socially isolated, have poor self-esteem, anxiety, mood disorder (depression and bipolar disorder) and eating disorder. The aim of this study was to investigate the child-report and parent-report of HRQoL among 9-11 years old obese school children in Malaysia and to determine the associated factors of HRQoL among obese children in Malaysia. This study was a cross-sectional study involving 101 obese Malay primary school children aged 9-11 years old from eleven primary schools in Kuala Terengganu which were selected via convenience sampling. Height and weight of the respondents were measured and their BMI was calculated. Health-related quality of life (HRQoL) was measured using PedsQL version 4.0. The mean age of the respondents was 10.02 ± 0.82 years old with mean BMI z-score was 3.01 ± 0.60. There were significance differences between boys and girls in; 1) emotional domain score for child-report QoL (p=0.019) using paired t-test and 2) psychosocial domain score for parent-report QoL (p=0.025). Regression analysis found that age and gender were the associated factors for Psychological Health for obese children (p<0.005). Being obese had negative effects on children’s quality of life. Various strategies interventions should be done to improve the HRQoL of these obese children. A multidisciplinary approach in schools must be organized to encourage a healthy lifestyle as part of routine among the school children.
Health-related quality of life ; obese ; children ; pedsQL