Introduction: Older persons are more susceptible to malnutrition. However, malnutrition identification through nutrition screening is not routinely performed in Malaysia’s health clinics due to no specific nutrition screening guideline and validated tool in this setting. This study aimed to develop a nutrition screening guideline for older patients and assess its feasibility for use by healthcare staff in health clinic setting. Methods: This study was conducted in three phases. In Phase I, needs assessment was conducted amongst healthcare staff. Development of nutrition screening guideline in Phase II involved scoping review and validation amongst six experts and twelve healthcare staff. In Phase III, twenty-two healthcare staff participated in feasibility assessment using in-depth interviews after completing nutrition screening in older patients. Interview data was analysed thematically using NVivo Software 12.0. Results: A Malay language version of nutrition screening guideline in A4-sized with 31 pages was developed and validated. Items with a content validity index ≥0.83 from experts review were retained, while <0.83 were revised accordingly. Validation amongst healthcare staff showed positive responses. The guideline was then assessed for feasibility, where 110 older patients (mean age= 68.7±6.1 years) were screened by healthcare staff using the newly developed nutrition screening guideline. Four themes emerged from in-depth interviews: 1) Ease of use; 2) Identification and management of malnutrition; 3) Acceptability; and 4) Implementation of nutrition screening. Conclusion: The newly developed and validated nutrition screening guideline is well-accepted and feasible for healthcare staff to screen older patients in health clinic setting for timely malnutrition identification and management.

Malnutrition and poor quality of life (QoL) in older adults are becoming a public health concern. Therefore, this review article summarised significant studies which investigated the assessment of malnutrition and QoL and its relation. A literature research on academic journals published from 2011 to 2021 was conducted by using electronic databases, which were Google Scholar, PubMed, Science Direct and SCOPUS. A total of 21 studies with 26,569 participants were identified and included in this review. The prevalence of malnutrition ranged from 1.6% to 26.5%, and poor QoL was significant amongst malnourished older adults. In conclusion, malnutrition is associated with poor QoL amongst older adults. Future studies regarding factors that influence malnutrition and its relation towards the QoL amongst older adults are needed as it will help in assisting the healthcare professions to combat these health problems.

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.

Polyunsaturated fatty acids (PUFAs) intake may be beneficial in many aspects during the early phase of life. This scoping review aims to examine the beneficial outcomes and intakes of omega-3 and omega-6 PUFA among children. An electronic database search on academic journals published from 2017 to 2021 was conducted using Science Direct, PubMed, and Google Scholar. A total of 35 studies were identified and included in this scoping review. Majority of the findings found that PUFAs intake has a beneficial impact on the growth development, mental and cognitive health among children whether they are malnourished, sick or healthy individuals. Overall, this review may provide additional information on the benefits and recommended intake of supplementing PUFAs on children. More detailed research on this topic is needed to support these findings since it will contribute to the formation of the dietary intervention.

Introduction: COVID-19 is a disease caused by a new strain of coronavirus spreading rapidly over the globe, and the older population has had a larger impact as the fatality rate increases with age. This pandemic caused them to reduce their physical activity (PA). COVID-19 also resulted in food supply disruption and led to unhealthy dietary changes, which are usually associated with weight gain and affecting the body mass index (BMI). PA and BMI can influence the quality of life (QoL) of the older people. Therefore, this study aimed to determine the association between PA, BMI, and QoL amongst the older people in Malaysia during COVID-19. Methods: A cross-sectional study was conducted amongst community-dwelling older people from all states in Malaysia. An online survey consisting of self-reported anthropometry, Global Physical Activity Questionnaire- Malay version (GPAQ-M) and Short Form-36 Health (SF-36) Survey were collected. Statistical analysis chi-square test was used to identify the association between BMI, PA, and QoL. Results: This study included data from 180 individuals with a median age of 64.0 ± 9.8 years. The results showed that participants aged 60-69 years were significantly associated with better QoL, meanwhile, those who practice low PA levels were significantly associated with poor QoL. Conclusion: The findings revealed that age and PA were associated with QoL. Thus, the healthcare profession must emphasise regular PA to accomplish a better QoL amongst older people in the future.

Introduction: The elderly population is highly vulnerable to malnutrition, including those in the community. The use of nutrition education as part of nutrition intervention is able to improve their nutritional status. Hence, provision of a nutrition resource kit addressing the needs of at-risk and malnourished elderly would be advantageous. This research aimed to develop, validate and evaluate the acceptance of a newly developed nutrition resource kit, which served as an educational material among at-risk and malnourished elderly in Malaysian health clinics. Methods: This study was conducted in three phases: Phase I comprised of qualitative needs assessment to identify the types of nutrition resource kit needed; Phase II was the development and validation of the nutrition resource kit; while Phase III was acceptance evaluation, which involved individual in-depth interview and triangulation. Results: An A5-sized booklet with incorporation of an educational video in a QR code was developed. Both printed material and educational video had excellent content and face validity. Suggestions by experts and elderly from validation were considered and revision was done accordingly. Acceptance evaluation revealed four themes: 1) positive acceptance, 2) elderly-friendly, 3) valuable, and 4) individual preference. Triangulation data revealed that all elderly positively evaluated both resources. Additional suggestions given by elderly were considered for improvement. Conclusion: This newly developed nutrition resource kit, both in the printed and electronic format, was well-accepted among the at-risk and malnourished elderly. It could be used as an important reference for the elderly, especially those attending health clinics, in treating and preventing malnutrition.

Introduction: Malnutrition, specifically undernutrition, in community-dwelling older adults reduces their well-being and predisposes to diseases. Therefore, timely malnutrition identification through nutrition screening is needed to identify at risk and malnourished patients. This study aimed to develop the content of nutrition screening guideline to facilitate healthcare staffs in health clinics to administer a validated nutrition screening tool specifically for older adults. Methods: A scoping review was conducted electronically using SCOPUS, PubMed, ProQuest Health & Medical Complete, and Cochrane databases. The systematic search was performed up to 31st December 2021. Search terms were created for identification of eligible and related articles. Inclusion and exclusion criteria were determined for the systematic search. The search was limited to English and Malay languages, and full text articles with no limitation of years. All data were extracted and analysed, guided by the PRISMA extension for scoping reviews (PRISMA-ScR). Results: From 728 identified articles, 18 articles were included in the analysis. Identified information for the guideline content were: introduction, aims and objectives, definition of malnutrition, prevalence of malnutrition, implementation of nutrition screening, guidance on administering items in validated tools, and guidance on anthropometric measurements. Meanwhile, format and flow charts from established guidelines served as references for the guideline development process. Conclusion: Appropriate content to develop a nutrition screening guideline has been identified based on this review. Development of a guideline based on this content can facilitate healthcare staffs to perform timely nutrition screening in older adults.

Introduction: This study explored stroke survivors’ understanding regarding stroke, the perceived facilitators and barriers of healthy lifestyle changes, and provision of secondary prevention education. Methods: Semi-structured interviews were conducted with 22 stroke patients (13 males and nine females; aged 34-80 years) who were attending rehabilitation clinics in three Malaysian hospitals. Each interview was audiotaped, transcribed, and analysed using the framework approach. Results: Six themes were reported: understanding of stroke; facilitators of healthy lifestyle changes; barriers of healthy lifestyle changes; food taboos; recovery; and provision of secondary stroke prevention. A third of them were uncertain about the cause of stroke and the perception towards risk of recurrent stroke varied widely. The lack of secondary prevention education was obvious although many had received general verbal advices. Several personal, social, and environmental factors were identified as the facilitators or barriers in healthy lifestyle participation. Food taboos were common and had become one of the barriers in practising healthy eating practices. Families had a strong influence on the patient’s belief and behaviour changes, both in positive and negative ways. Besides, patients tended to have a problem in information recall, while some faced confusion during the early stages of stroke recovery. Conclusion: More efforts to improve knowledge regarding cause of stroke and secondary prevention strategies are needed. Use of appropriate behavioural changes strategies, family-centred approach and continuous health education are necessary to facilitate patients’ efforts at making successful lifestyle modification after stroke event.

Introduction: Elderly population is at high-risk to suffer from malnutrition and nutritional inadequacy. The use of nutrition resource kit which provides nutritional guidance could be helpful to improve their dietary intake. There is no study performed previously on the type of nutrition resource kit that can be used to overcome and prevent malnutrition among Malaysian elderly. Therefore, this study aimed to identify the types of nutrition resource kit needed by community living elderly in Malaysian health clinic setting. Methods: Qualitative study was conducted to explore the types of nutrition resource kit needed by community living elderly in health clinics. Recruitment for in-depth individual interview targeted elderly aged ≥60 years old who met the inclusion and exclusion criteria and received primary healthcare services in four health clinics in Kuantan, Pahang. Interview questions addressed the knowledge on existing nutrition educational materials, preference for types of nutrition resource kit and opinion on technology-based materials. Data were audiotaped, transcribed verbatim and thematically analyzed using NVivo software version 12. Results: 21 participants involved in this study (mean age=67.24 ±6.98 years). Five key themes identified from the data: provision of nutrition resource kit; preference for printed version; eye-friendly; facilitate understanding with diagram; and support for technology-based materials. This study also found that majority of elderly preferred for A5-sized booklet for nutrition resource kit. Conclusion: Future development of nutrition resource kit tailored to the need of elderly is needed to deliver nutritional guidance effectively and served as an important reference for them to overcome malnutrition.

Introduction: The elderly population are susceptible to malnutrition due to many factors. Hence, timely malnutrition identification through nutrition screening needs to be performed routinely in health clinics. However, the nutrition screening practice in health clinics need to be improvised for malnutrition identification among the elderly population. This study identifies barriers and opportunities for nutrition screening in elderly patients in health clinic settings. Method: A qualitative study was conducted among healthcare staff from urban and rural health clinics in Kuantan, Pahang, Malaysia. In-depth individual interviews were performed, audio-recorded and transcribed verbatim. Non-participant observations that act as triangulation were conducted among elderly patients (aged ≥60 years) attending the sampled health clinics. Both data from the interviews and observations were analysed thematically using NVivo software. Results: Twenty healthcare staff participated in the interviews were medical officers (n=6), medical assistants (n=8), staff nurses (n=4), and community nurses (n=2) with a mean age of 33.7±6.3 years. Twenty- one elderly patients were involved in non-participant observations. The four themes that emerged as barriers and opportunities were: time, patient factors, organisation factors and nutrition screening knowledge. Time constituted the main barrier, whilst incorporating a validated nutrition screening tool into current health screening practices was identified as the most practical approach to performing nutrition screening. Staff also highlighted the need for appropriate guidelines for implementing nutrition screening. Conclusion: This study identified appropriate approaches to implementing nutrition screening among elderly patients in health clinics. Developing a comprehensive nutrition screening guideline may facilitate healthcare staff in performing nutrition screening.