The issue of food waste has garnered much attention globally due to its adverse impacts on the economy, food security, natural resources, the environment, and human health. Despite this, the academic literature lacks systematic, historical, and synthesising investigations on healthcare food waste. This bibliometrics analysis study aims to summarise the growing trends of food waste publications and highlight common and potential research topics of food waste in healthcare settings. The Scopus database analysed 193 journal articles published between 1952 and 2022. We identified several common and potential research topics for future research in the area, including food waste and malnutrition, related intervention strategies, the impact of healthcare food service systems on food waste, and their economic and environmental impact. Healthcare food waste research in developing nations is still limited. Thus, it is recommended that policymakers support its development as one of the steps to encounter food waste.

BACKGROUND/OBJECTIVES: Dietitians frequently use nutrition education tools to facilitate dietary counselling sessions. Nevertheless, these tools may require adaptation to keep pace with technological advancements. This study had a 2-fold purpose: first, to identify the types of nutrition education tools currently in use, identify their limitations, and explore dietitians’ perspectives on the importance of these tools; second, to investigate the features that dietitians prefer in digital nutrition education tools. SUBJECTS/METHODS: A semi-structured face-to-face interview was conducted among 15 dietitians from selected public hospitals, primary care clinics, and teaching hospitals in Malaysia.Inductive thematic analysis of the responses was conducted using NVivo version 12 software. RESULTS: Most dietitians used physical education tools including the healthy plate model, pamphlets, food models, and flip charts. These tools were perceived as important as they facilitate the nutrition assessment process, deliver nutrition intervention, and are time efficient. However, dietitians described the current educational tools as impersonal, outdated, limited in availability due to financial constraints, unhandy, and difficult to visualise. Alternatively, they strongly favoured digital education tools that provided instant feedback, utilised an automated system, included a local food database, were user-friendly, developed by experts in the field, and seamlessly integrated into the healthcare system. CONCLUSION Presently, although dietitians have a preference for digital educational tools, they heavily rely on physical nutrition education tools due to their availability despite the perception that these tools are outdated, impersonal, and inconvenient. Transitioning to digital dietary education tools could potentially address these issues.

Introduction: This methodological research study aimed to measure content validity and reliability of a newly developed questionnaire of knowledge, attitudes, and self-reported practices towards pureed diet preparation (KAP DYS Puree) among hospital food handlers for dysphagia management. Methods: The study was conducted through face validation, content validation, content reliability and construct validation. A cross-sectional design with convenience sampling was carried out involving 4 panels for face validation, 10 raters for content validity and 161 food handlers participated for Exploratory Factor Analysis (EFA), while 30 food handlers were involved for test-retest reliability. The questionnaire which consisted of 40 items distributed into 3 domains and was assessed and analyzed using modified kappa (k*) for reliability. Results: Content Validity Index revealed the following I-CVI values: knowledge = 0.915, attitudes = 0.922 and self-reported practices = 0.900 and modified kappa values (k*) knowledge = 0.983, attitudes = 0.9214 and self-reported practices = 0.899. The EFA was employed for two dimensions which were self-reported practices and attitudes based on principal axis of factoring with varimax rotation. The factor analysis yielded two factors with a total of 10 items in the attitudes domain and two factors with a total of 9 items in the self-reported practices domain that had satisfactory factor loading (> 0.3). The Kaiser-Meyer-Olkin (KMO) values for attitudes = 0.816 and self-reported practices = 0.776. Bartlett’s test of sphericity was significant at p < 0.0001 for attitudes and self-reported practices indicating the suitability of this data for factor analysis. Interclass Correlation Index (ICC) values for attitudes = 0.739 and self-reported practices = 0.789. Conclusion: This instrument can be used as a need assessment tool in the development of a comprehensive training module for pureed diet preparations in dysphagia management.

Introduction: Dietary inflammation is a significant risk factor for age-related cognitive impairments among older adults. However, information related to the relationship between Empirical Dietary Inflammatory Index (eDII) score and cognitive frailty (CF) among Malaysian community-dwelling older adults is still limited. The objective of this study is to determine the association between dietary inflammatory risk and CF among community-dwelling older adults. Method: This is a cross sectional study involving community-dwelling older adults in Klang Valley. The Fried’s Criteria and Clinical Dementia Rating (CDR) were used to determine CF status. Subjects were also interviewed using the Dietary History Questionnaire (DHQ) and eDII food checklist to assess the food intake and dietary inflammatory risk. Data collected was analyzed using SPSS version 26.0. Results: A total of 158 older adults (66.7 ± 5.2 years old) residing in Klang Valley were involved. Energy and macronutrients have a weak positive association with pro-inflammatory score (p<0.05). There is no significant mean difference between CF older adults consumed a more pro-inflammatory diet (mean 2.07 ± 1.10) compared to non CF (mean 2.06 ± 1.14). However, white rice food item significantly consumed by CF people (22.4%) than non CF (8.5%) (p<0.05). Conclusion: CF older adults were more likely to consume a pro-inflammatory diet particularly from the rice food group. There is a need to further assess the risk of consuming a pro-inflammatory diet using larger sample size and appropriate biomarkers.

In this study, we aimed to determine gender specific age-related decline in anthropometry status, physical performance (PP) and physical activity (PA) in older persons with and without mild cognitive impairment (MCI) prospectively over 3 years. Within-group changes across three time points (baseline-Wave 1, 18 months-Wave 2, 36 months-Wave 3) based on gender and cognitive status were determined. Data was collected at Wave 3 of a longitudinal study: “Neuroprotective Model for Health Longevity among Elderly”. Secondary data from Wave 1 and 2 was obtained for analysis. Older persons with MCI were categorised to have subjective memory problems (answered ‘yes’ on item 10 of Geriatric Depression Scale), scored at least 1.5 SD below mean average on Rey Auditory Verbal Learning Test and Digit Span, no dementia, no problems with activities in daily living, intact global cognition (>19/30: Mini Mental State Examination) and without depression (Geriatric Depression Scale 15-items,≤4). Anthropometry measurements and a battery of PP tests were performed. PA was measured using Physical Activity Scale for the Elderly questionnaire. Data from 779 older persons (67.7 ± 5.3 years) consisting of 372 men (68.0 ± 5.2 years) and 407 women (67.4 ± 5.4) who completed all tests from Wave 1 to Wave 3 were analysed. There was a decline in PP (-0.7% to -14.1% per year), PA levels (-0.7% to -14.1% per year) and anthropometry status (-0.1% to -6.3% per year), except for percentage body fat (+9.9% per year) with advancing age. Within-group changes over the three years showed significant differences (p<0.05) in height and PA in non-MCI and MCI men and lower body flexibility in non-MCI and MCI women. Specifically, tailored physical and nutritional health prevention and promotion strategies for older persons based on gender and cognitive status may be beneficial to support person-centered care.

Introduction: Sarcopenia is one of the geriatric syndromes affecting the ability of older adults to lead an independent living. However, its risk factors among Malaysian older adults are yet to be determined. This study investigated the prevalence and risk factors of sarcopenia among community-dwelling older adults in Klang Valley. Methods: This cross-sectional study involved 393 Malaysians aged 60 and above, residing in urban areas of Klang Valley recruited through convenience sampling. Socio-demographic and food intake information were obtained using validated questionnaires. Cut-off points for sarcopenia screening were obtained from the Asian Working Group of Sarcopenia(AWGS) while body impedance analysis(BIA) was employed to determine skeletal muscle index. A handgrip dynamometer was used to assess dominant handgrip strength and a 6-meter gait speed test was used to determine walking speed. Binary logistic regression analysis was used to determine the risk factors of sarcopenia. Results: Prevalence of sarcopenia was 33.6% and women(35.9%) were more affected compared to men(30.1%). The mean age of women assessed to have sarcopenia(69.1±6.5 years old) was higher compared to men(68.3±5.8 years old) (p<0.05). After adjusting for confounding factors, older adults with one year increased in age and one mg decreased in habitual dietary iron intake were estimated to be 1.08 times and 0.93 times the chances to have sarcopenia respectively. Conclusion: Approximately one-third of community-dwelling older adults in Klang Valley were assessed to have sarcopenia. Older adults aged 60 years and above and those with low dietary iron intake were at an increased risk of developing sarcopenia.

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 study aimsto determine the reliability and validity and optimal cut-off scores of the Malay version of Montreal Cognitive Assessment for visually impaired (MoCA-BM-blind) among older adults with cognitive decline. Participants for this study were recruited from the population-based longitudinal study on neuroprotective model for healthy longevity (LRGS TUA) among Malaysian older adults. A total of 220 participants, aged 60 years and above, from Selangor were included in this study. Cognitive functions were assessed using MoCA-BM-blind and Malay version of Mini-Mental State Examination for visually impaired (M-MMSE-blind). Habitual distance VA was measured monocularly using the Early Treatment Diabetic Retinopathy Study chart. Cronbach’s alpha and Pearson correlation coefficient were used to determine reliability and validity of MoCA-BM-blind, respectively. Receiver operating characteristic (ROC) analysis was conducted to determine the optimal cut-off score for MoCA-BM-blind. Reliability (Cronbach’s alpha: 0.76) and validity (Pearson correlation: r = 0.77) of MoCA-BM-blind were high. The optimal cutoff for MoCA-BM-blind in detecting cognitive decline was 9 with 86.8% sensitivity and 72.7% specificity. With this cut-off, 35.0% visually impaired participants were classified as having cognitive decline. MoCA-BM-blind is a valid and reliable screening tool to assess cognitive function among visually impaired older adults.
Aging

Introduction: Pressure ulcers (PUs) are a leading health problem among spinal cord injury(SCI) patients. Therefore, this comprehensive study was aimed at determining the association between potential factors and the occurrence of PUs among SCI adults in community settings. Methods: A cross-sectional study was conducted among adults with SCI aged 18 years and above from five selected locations in Kuala Lumpur, Malaysia. The study was carried out through interviews based on validated questionnaires such as the Dietary History Questionnaire (DHQ), Spinal Nutrition Screening Tool (SNST), Physical Activity Scale for Individuals with Physical Disabilities (PASIPD), Barthel Index for Activities of Daily Living (ADL), and Instrumental Activities of Daily Living (IADL). Estimated weight and height were obtained using recumbent formula. The stages of their PUs were assessed based on National Pressure Ulcer Advisory Panel (NPUAP) grading system. Results: A total of 40 subjects participated in the study, 25% of whom were having PUs. Their nutritional inadequacies were identified, whereby 90%, 70% and 85.5% of them were receiving below their daily requirement of energy, carbohydrate and protein, respectively. The fat and sodium intakes of 55% of them were above the Malaysian Recommended Nutrient Intakes(RNI). It was successfully found that physical activity could decrease the risk of PUs(R2=0.654, OR=0.310, p<0.05). Conclusion: Overall, 25% of the subjects had PUs that were associated with physical inactivity. The majority of the subjects did not meet their nutrient requirements. Therefore, there is a need for increased physical activity and improved nutrient intake in order to reduce the risk of pressure ulcers among SCI adults in communities.

Undernutrition is the result of complex interplay of factors such as household food security, childcare, feeding practices, nutrition and sanitation. Therefore, this study aimed to determine the prevalence of stunting, wasting, underweight based on WHO child growth standards 2006 and undernutrition based on Composite Index Anthropometric Failure (CIAF) and its association with the biological, behavioural, socio-economic and physical environment factors among children under-5 years. This was a cross sectional study involving children aged between 6 and 59 months recruited through stratified random sampling from the Tenom district. Sociodemographic background was obtained from mothers via a questionnaire. Height and weight measurements were measured using standardised instrument. The height-for-age, weight-for-age and BMI-for-age were classified according to the WHO Child Growth Standard 2006. Bivariate analysis and multivariate logistic regression analysis were conducted. The prevalence of undernutrition based on CIAF was 42.3%, underweight 34.7%, stunting 33.3% and wasting 10.0%. After adjusting for all confounders, childhood undernutrition was significantly associated with unimproved sanitation (adjusted OR 2.98, 95% CI: 1.082 to 8.225) and frequent illness (adjusted OR 2.07, 95% CI: 1.015 to 3.274). These findings support the association of biological and physical environmental factors with the nutritional status of children under-5 years old.