1.Socio-economic Status, Food Security Status and its Coping Strategies among ‘The Lost Food Project’ (TLFP) Recipients in Klang Valley during COVID-19 Pandemic
Nur Arina Bakeri ; Norhasmah Sulaiman ; Nur Syaqiera Mansor ; Wan Ying Gan ; Seok Kwan Tan
Malaysian Journal of Medicine and Health Sciences 2023;19(No.1):80-88
		                        		
		                        			
		                        			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. 
		                        		
		                        		
		                        		
		                        	
2.Validation of the Malay version of Food Insecurity Experience Scale (M-FIES) using Rasch analysis
Roselawati Mat Ya ; Noraishah Mohamed Nor ; Nurul Hazirah Jaafar ; Suriati Sidek ; Jamalludin Ab Rahman ; Norhasmah Sulaiman ; Wan Azdie Mohd Abu Bakar
Malaysian Journal of Nutrition 2023;29(No.3):529-537
		                        		
		                        			
		                        			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.
		                        		
		                        		
		                        		
		                        	
3.Association between Socio-demographic Factors, Involvement Status in Gardening and Diet Quality among B40 Households in Taman Keramat, Kuala Lumpur
Ang Zheng Feng ; Norhasmah Sulaiman ; Baarathi Balasubramaniam ; Nurakmal Syahirah Mohamed Faidz
Malaysian Journal of Medicine and Health Sciences 2023;19(No.5):175-184
		                        		
		                        			
		                        			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. 
		                        		
		                        		
		                        		
		                        	
4.Translation and validation of Food Insecurity Experience Scale (FIES)
Roselawati Mat Ya ; Suriati Sidek ; Jamalludin Ab Rahman ; Norhasmah Sulaiman ; Noor Atirah Yahya ; Halimatun Saadiah ; Nurul Hazirah Jaafar ; Wan Azdie Mohd Abu Bakar
Malaysian Journal of Nutrition 2021;27(No.3):449-459
		                        		
		                        			
		                        			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.
		                        		
		                        		
		                        		
		                        	
5.Overweight and Obesity Among Children: A Relationship Between Maternal Beliefs and Feeding Practices With Children’s Body Mass Index-for-Age in Bandar and Jugra Kuala Langat Selangor
Asrawati Awalina Aslan ; Norhasmah Sulaiman
Malaysian Journal of Medicine and Health Sciences 2020;16(Supp 6, Aug):11-18
		                        		
		                        			
		                        			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. 
		                        		
		                        		
		                        		
		                        	
6.Association of Socio-Demographics and Home Food Environment Factors on Body Weight Status Among Primary School Children
Rina Syahira Rathuan ; Nurzalinda Zalbahar ; Norhasmah Sulaiman
Malaysian Journal of Medicine and Health Sciences 2020;16(Supp 6, Aug):19-25
		                        		
		                        			
		                        			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.
		                        		
		                        		
		                        		
		                        	
7.Demographic and Socio-economic Characteristics, Household Food Security Status and Academic Performance Among Primary School Children in North Kinta, Perak, Malaysia
Nor Syaza Sofiah Ahmad ; Norhasmah Sulaiman
Malaysian Journal of Medicine and Health Sciences 2020;16(Supp 6, Aug):26-33
		                        		
		                        			
		                        			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. 
		                        		
		                        		
		                        		
		                        	
8.Anthropometry Measurements to Determine Nutritional Status Among Cerebral Palsy Children: A Scoping Review
Mahnon Suria Mokhy ; Rosita Jamaluddin ; Abd Rasyid Ismail ; Woan Yie Siah ; Norhasmah Sulaiman ; Siti Nur &lsquo ; Asyura Adznam ; Intan Hakimah Ismail
Malaysian Journal of Medicine and Health Sciences 2020;16(Supp 6, Aug):213-218
		                        		
		                        			
		                        			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.
		                        		
		                        		
		                        		
		                        	
9.Financial problems associated with food insecurity among public university students in Peninsular Malaysia
Nurulhudha Mohd Jamil ; Norhasmah Sulaiman ; Siti Nur&rsquo ; Asyura Adznam ; Shamsul Azahari Zainal Badari
Malaysian Journal of Nutrition 2020;26(No.3):411-423
		                        		
		                        			
		                        			Introduction: Food is a necessity for students. Yet, students’ food expenditure is 
anticipated to be restrained by their financial status. This cross-sectional study 
aims to determine the prevalence of food insecurity and its determinants among 
university students attending public universities in Peninsular Malaysia. Methods: 
Multistage random sampling was used to select respondents from public universities 
in Peninsular Malaysia. A total of 427 undergraduate students completed a selfadministered questionnaire at four randomly selected universities (Universiti 
Utara Malaysia, Universiti Kebangsaan Malaysia, Universiti Malaysia Pahang 
and Universiti Teknologi Malaysia). The questionnaire consisted of information 
concerning demographic and socioeconomic backgrounds, food security status, 
eating behaviour, financial literacy, and financial problem among university 
students. Frequency, chi-square, and logistic regression were used to analyse the 
variables. Results: Mean age of the respondents was 21.6 years, and 60.9% were 
found to be food insecure. Gender (χ2=5.415), origin (χ2=3.871), number of siblings 
(χ2=4.521), financial problem (χ2=42.364), and regular breakfast intake (χ2=5.654) 
were associated with food security status (p<0.05). Male respondents had 1.5 times 
(AOR=1.547, 95% CI: 1.006-2.380) the risk of having low food security status. Those 
with higher financial problems (AOR=3.575, 95% CI: 2.332-5.481) were 3.5 times 
more likely to be food insecure. Conclusion: The prevalence of food insecurity among 
public university students in Peninsular Malaysia was significantly high. Thus, 
intervention studies should focus on students with financial problems. Moreover, 
establishing a better system for an on campus food pantry or food bank is needed to 
counter the high prevalence of food insecurity among university students.
		                        		
		                        		
		                        		
		                        	
10.Overweight and obesity among Orang Asli adults in Krau Wildlife Reserve, Pahang: a four-year follow-up study
Chua Ee Yin ; Zalilah Mohd Shariff ; Norhasmah Sulaiman ; Geeta Appannah
Malaysian Journal of Nutrition 2019;25(2):199-207
		                        		
		                        			
		                        			
Introduction: Obesity and excess weight gain in adults are linked to an increased risk of cardiometabolic abnormalities. The changing lifestyle experienced by the Orang Asli predisposes the population to the risk of obesity and non-communicable diseases. This study aimed to describe the prevalence of overweight and obesity as well as body-weight change over a period of four years among Orang Asli adults.
Methods: Data were collected from Orang Asli adults aged ≥18 years, who were enrolled in the 2011-2012 and 2015-2016 surveys, and who were residing within the Krau Wildlife Reserve. Weight and height of the adults (N2011-2012=828; N2015- 2016=662) were measured at both time points. Follow-up data were available for 378 adults (male:113; female:265).
Results: The prevalence of overweight and obesity were 18.8% and 7.4% in 2011-2012 and 26.1% and 9.5% in 2015-2016. In the follow-up group, significant differences in body weight and body mass index (BMI) were observed in men and women, respectively. More than one-third (35.5%) of the adults had weight gain of more than 5.0%. The increasing percentage of body weight change was associated with being female, younger age, more years of schooling and reduced household income.
Conclusion: Obesity is a growing health problem in the Orang Asli adult population. Weight gain was associated with socioeconomic indicators and it was more prominent in women. Effective strategies are needed to address the increasing prevalence of overweight and obesity in this population to further reduce adverse health outcomes.
		                        		
		                        		
		                        		
		                        	
            

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