Introduction: This study aimed to determine the risk factors of CHD among the Malaysian adult population. Methods: Using a cross- sectional observational study design, this study involved 365 adult patients aged between 30-64 years, attending clinics from eight government hospitals and four health clinics in Terengganu, Pahang, Selangor, Putrajaya, Penang, Kedah, Johor and Sabah from February 2018 until September 2020. Sociodemographic characteristics, clinical and dietary data, physical activity and stress level were recorded using a structured questionnaire. Multiple logistic regression was used to analyse CHD risk factors. Results: The overall response rate was 99.2%. The adjusted odds ratio of CHD was greater for age (AOR; [%95 CI]) (1.043;[ 1.009,1.078]); waist circumference (1.033;[1.009, 1.057]); total fat intake (1.035;[1.021, 1.050]); full cream dairy products intake (1.004;[1.001, 1.008]); smokers vs non-smokers (4.691;[2.399, 9.176]); individual with family history of CHD vs without family history (2.705;[ 1.496, 4.891]); married vs single (0.434;[ 0.217,0.867]); and lower for HDL cholesterol (0.185;[0.052, 0.662]); Chinese vs Malays (10.619;[ 2.255, 49.995]); and third lowest income (0.197;[ 0.073, 0.532]) and forth lowest income (0.167;[ 0.056, 0.499]) vs lowest income. Conclusion: Age, race, income, smoking and marital status, family history of CHD, waist circumference, HDL cholesterol, total fat intake, full cream dairy products intake were significantly associated with CHD among this population. This finding is particularly important to the primary health carers to identify at-risk CHD individuals thus appropriate intervention could be provided.

Obesity and overweight problems are serious global health issues today and despite many efforts, the prevalence has continued to rise for decades. Interestingly, hypnotherapy has been gaining recognition as an effective treatment for obesity and overweight problems. This review compiles contemporary scientific research on the effectiveness of hypnotherapy for weight reduction. Scopus, PubMed and EBSCO Host databases were applied in the study. The search identified 119 articles, of which seven met the inclusion criteria. A total of 539 respondents (82.7% women and 17.3% men) between the ages of 17 and 67 years were represented in the seven studies. Most studies incorporated lifestyle changes, such as changes of dietary habit and behavioral recommendations in the hypnotic procedure. Their results suggested that the use of hypnotherapy not only promoted weight reduction during the treatment period but also after treatment cessation, and in some cases, one to ten kilograms were lost during follow-up periods. In addition, one study even showed increased physical activity among the hypnotised individuals. This use of hypnotherapy also improved respondents' eating behavior and quality of life. However, a definitive conclusion could not be drawn due to several methodological flaws and the limited number of published studies in this area. Therefore, further well-designed studies are needed to substantiate the effectiveness of hypnotherapy for this modern-day health problem.

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.

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.

Purpose::Malnutrition is a common problem among hospitalized patients, especially among traumatic brain injury (TBI) patients. It is developed from hypermetabolism and the condition may worsen under the circumstance of underfeeding or incompatible dietary management. However, the data of nutrient intake especially calorie and protein among TBI patients were scarce. Hence, this study aimed to determine the calorie and protein intake among acute and sub-acute TBI patients receiving medical nutrition therapy in hospital Sultanah Nur Zahirah, Terengganu.Methods::This observational study involved 50 patients recruited from the neurosurgical ward. Method of 24 h dietary recall was utilized and combined with self-administered food diaries for 2-8 days. Food consumptions including calorie intake and protein intake were analyzed using Nutritionist PRO? (Woodinville, USA) and manual calculation based on the Malaysian food composition database (2015).Results::Patients consisted of 56% males and 44% females with the median age of 28.0 (IQR = 22.8-36.5) years, of which 92% were diagnosed as mild TBI and the remaining (8%) as moderate TBI. The Glasgow coma scale (GCS) was adopted to classify TBI severity with the score 13-15 being mild and 9-12 being moderate. The median length of hospital stay was 2 (IQR = 2.0-3.3) days. Calorie and protein intake improved significantly from day 1 to discharge day. However, the intake during discharge day was still considered as suboptimal, i.e. 75% of calorie requirement, whilst the median protein intake was only 61.3% relative to protein requirement. Moreover, the average percentages of calorie and protein intakes throughout hospitalization were remarkably lower, i.e. 52.2% and 41.0%, respectively.Conclusion::Although the calorie and protein intakes had increased from baseline, hospitalized TBI patients were still at a risk to develop malnutrition as the average intakes were considerably low as compared to their requirements. Optimum nutrient intakes especially calorie and protein are crucial to ensure optimum recovery process as well as to minimize risks of infection and complications.

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.

Introduction: In most Asian countries, stroke is one of themajor causes of mortality. A stroke event is life-changing forstroke survivors, which results in either mortality ordisability. Therefore, this study comprehensively focuses onprevalence, risk factors, and secondary prevention forstroke recurrence identified in South, East, and SoutheastAsian countries. Methods: This scoping review uses themethodological framework of Arksey and O’Malley. Acomprehensive search of academic journals (English) onthis topic published from 2007 to 2017 was conducted. Atotal of 22 studies were selected from 585 studies screenedfrom the electronic databases.Results: First-year stroke recurrence rates are in the rangeof 2.2% to 25.4%. Besides that, modifiable risk factors aresignificantly associated with pathophysiological factors(hypertension, ankle-brachial pressure index, atherogenicdyslipidaemia, diabetes mellitus, metabolic syndrome, andatrial fibrillation) and lifestyle factors (obesity, smoking,physical inactivity, and high salt intake). Furthermore, age,previous history of cerebrovascular events, and strokesubtype are also significant influence risk factors forrecurrence. A strategic secondary prevention method forrecurrent stroke is health education along with managingrisk factors through a combination of appropriate lifestyleintervention and pharmacological therapy.Conclusion: To prevent recurrent stroke, health interventionshould be geared towards changing lifestyle to embody ahealthier approach to life. This is of great importance topublic health and stroke survivors’ quality of life.

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

A balanced dietary intake plays an important role in the prognosis of breast cancer and is one of the modifiable factors in preventing cancer recurrence. This study aims to determine the dietary intake among breast cancer survivors in East Coast of Peninsular Malaysia. A total of 125 breast cancer survivors, aged 37 to 72 years, with mean duration of survivorship of 6.1 ± 3.9 years were recruited from two main referral hospitals in Terengganu and Kelantan. Majority ofthe respondents were Malay (94.4%) with a mean BMI of 27.7 ± 5.07 kg/m², and were diagnosed with stage II cancer (66.0%). Dietary intake was estimated using a semi-quantitative food frequency questionnaire (FFQ). The results show that the mean daily intake of energy was 1764 ± 378 kcal/day, protein was 72.38 ± 33.6 g/day (16.5% of energy), carbohydrate was 243.0 ± 62.2 g/day (55% of energy) and fat was 55.8 ± 15.6 g/day (28% of energy). Overall, breast cancer survivors in this study had an adequate daily intake of vitamins and minerals according to Malaysian Recommended Nutrient Intakes (RNI) except for dietary fibre (10.6 ± 4.2 g/day), monounsaturated fatty acids (20.7 ± 5.7 g/day), polyunsaturated fatty acids (8.0 ± 2.2 g/day), calcium (561.0 ± 257.1 mg/day), iron (18.3 ± 7.2 mg/day) and potassium (1813.4 ± 531.1 mg/day) which was lower than the recommendation. Meanwhile, intake of sodium (2592 ± 1697 mg/day), protein (80.4 ± 33.6 g/day), saturated fatty acids (26.9 ± 14.2 g/day), vitamin B2 (1.9 ± 1.1 mg/day) and vitamin C (151.1 ± 149.3 mg/day) exceeded the recommendation by 135.0%, 139.0%, 166.9%, 154.6% and 152.0%, respectively. There was no significant difference in dietary intake between cancer survivors who were diagnosed in the past five years and those who were diagnosed more than five years ago (p>0.05) except for fat (p<0.001), saturated fatty acid (p=0.006), monounsaturated fatty acid (p=0.005) and polyunsaturated fatty acid (p=0.003). As a conclusion, breast cancer survivors in East Coast of Peninsular Malaysia had an adequate intake of most nutrients except for dietary fibre, monounsaturated fatty acids, polyunsaturated fatty acids, calcium, iron and potassium which was below the recommendation and sodium, protein, saturated fatty acids, vitamin B2, vitamin C which was above the recommendation. The intakes between long-term and short-term survivors were also comparable showing sustained dietary intake throughout survivorship.
Dietary intake ; nutrient ; breast cancer ; survivors ; food frequency questionnaire

The main objective of the study was to determine the factors associated with blood cholesterol level among staff in Universiti Sains Malaysia (USM). The study was a cross-sectional. One-hundred staff between 23 and 59 years of age were recruited in this study using convenient sampling at USM Health Campus. A questionnaire which includes sociodemographic characteristics, medical history, and red meat intake was used in the study. Anthropometric and biochemical assessment were measured. Blood cholesterol level was divided into two categories which were known as healthy range (<5.2mmol/L) and slight risk/high risk range (≥5.2mmol/L). The gender distribution of respondents for this study comprised of 40 male and 60 female. The age group (18 to 39) years and (40 to 59) years had a total of 40.3% and 63.2% of slightly risk or high risk blood cholesterol respectively; with the significant association between age group and blood cholesterol level (χ²=4.916,p=0.027). Besides, normal BMI group had 66.7% of respondents achieved healthy blood cholesterol level whereas underweight, overweight and obese group had 39.7% achieved healthy blood cholesterol with the significant association between BMI and blood cholesterol level (χ²=7.112,p=0.008). Moreover, daily or weekly intake of red meat showed that 65.0% of total respondents had a healthier blood cholesterol level compared to 51.0% of monthly, rarely, or none red meat intake group which achieved healthy blood cholesterol level. The result also showed a significant association between red meat intake and blood cholesterol (χ²=5.229, p=0.022), which indicating less red meat consumption is linked to high level of blood cholesterol level. Therefore, further investigation and future studies are needed to gain a clearer understanding of the association between these variables and blood cholesterol level.
nutritional status ; blood cholesterol level ; red meat intake