MJN 2023 Issues
Malaysian Journal of Nutrition (Mal J Nutr)
Volume 29 No.1, 2023
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Table of Content
Growth patterns of urban Malaysian children under 24
months of age in Selangor, Malaysia
Heng Yaw Yong, Zalilah Mohd Shariff & Chee Yen Wong
doi: https://doi.org/10.31246/mjn-2021-0103
ABSTRACT
Introduction: To identify the growth patterns of young children during the first two years of life according to gestational age, birth weight, and growth status at 24 months of age.
Methods: This was a retrospective cohort study of 4,570 young children in Selangor. Data were extracted from children’s health records in government health clinics. Growth data were analysed using the Anthro Plus software that utilises the World Health Organization growth standards.
Results: Generally, wasting prevalence was the highest at birth and 24 months, but stunting was more predominant from 1 to 21 months. Weight-for-age z-scores (WAZ), lengthfor- age z-scores (LAZ), and weight-for-length z-scores (WLZ) from birth to 24 months were within -3.00 to 0.00 standard deviation (SD) for pre-term low birth weight children, –1.50 to 0.00 SD for pre-term normal birth weight children, and –2.50 to 0.50 SD for full-term low birth weight children. While WAZ, LAZ, and WLZ from birth to 24 months for underweight/stunted/wasted children were within –2.50 to 0.50 SD, the values for overweight/obese (OV/OB) children were within –1.00 to 2.00 SD. For normal children, WAZ, LAZ, and WLZ exhibited comparable trends, with values within –1.00 to 0.00 SD from birth to 24 months.
Conclusion: While stunting and wasting persisted as the most common forms of malnutrition in this sample of young children, the prevalence of OV/OB increased by 24 months. Interventions to promote child growth should focus not only on the prevention of undernutrition, but also on OV/OB.
Key words: Malaysia, malnutrition, obesity, overweight, retrospective studies
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Introduction: To identify the growth patterns of young children during the first two years of life according to gestational age, birth weight, and growth status at 24 months of age.
Methods: This was a retrospective cohort study of 4,570 young children in Selangor. Data were extracted from children’s health records in government health clinics. Growth data were analysed using the Anthro Plus software that utilises the World Health Organization growth standards.
Results: Generally, wasting prevalence was the highest at birth and 24 months, but stunting was more predominant from 1 to 21 months. Weight-for-age z-scores (WAZ), lengthfor- age z-scores (LAZ), and weight-for-length z-scores (WLZ) from birth to 24 months were within -3.00 to 0.00 standard deviation (SD) for pre-term low birth weight children, –1.50 to 0.00 SD for pre-term normal birth weight children, and –2.50 to 0.50 SD for full-term low birth weight children. While WAZ, LAZ, and WLZ from birth to 24 months for underweight/stunted/wasted children were within –2.50 to 0.50 SD, the values for overweight/obese (OV/OB) children were within –1.00 to 2.00 SD. For normal children, WAZ, LAZ, and WLZ exhibited comparable trends, with values within –1.00 to 0.00 SD from birth to 24 months.
Conclusion: While stunting and wasting persisted as the most common forms of malnutrition in this sample of young children, the prevalence of OV/OB increased by 24 months. Interventions to promote child growth should focus not only on the prevention of undernutrition, but also on OV/OB.
Key words: Malaysia, malnutrition, obesity, overweight, retrospective studies
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Effect of date palm cultivars on chemical and
phytochemical properties of date vinegars
Wilawan Boonsupa, Chananthon Thammajit, Thidarat Sittisumran, Onanong
Thiansai & Tharakorn Kaewsura
doi: https://doi.org/10.31246/mjn-2022-0035
ABSTRACT
Introduction: Phoenix dactylifera, commonly known as date or date palm, is a flowering plant species in the palm family Arecaceae, cultivated for its edible sweet fruit called dates. Dates are high in dietary fibre and antioxidant compounds, known for preventing cancer and cardiovascular diseases. This research studied the chemical properties, antioxidant activities, and total phenolic content of fermented date vinegars from Phoenix dactylifera L. fruits, which had three cultivars - Barhi, Siam S1, and KL1.
Methods: The first step was making date wines by using Saccharomyces cerevisiae (0.75% v/v of date juice content) to produce alcohol; the second step was making date vinegars by using Acetobacter pasteurianus (10% v/v of inoculum). Thereafter, the wines and vinegars were analysed for their chemical properties [high performance liquid chromatography (HPLC)], antioxidant activities [2,2-Diphenyl-1-picrylhydrazyl (DPPH) assay], and total phenolic content (folin ciocalteu method).
Results: Results showed that the highest alcohol content was 9.35% (v/v) in Siam S1 wine. The highest acetic acid was 7% (v/v) in Siam S1 vinegar. From the phytochemical analysis of vinegars, the highest antioxidant activity was found to be 24.96 mg/mL in Siam S1 vinegar, while the highest total phenolic content was found to be 208.35 mg GAE/L in KL1 vinegar.
Conclusion: This novel research showed that the Siam S1 date had the highest acetic acid and antioxidant activity in vinegar. Thus, this cultivar could be processed to make new, healthy products that can further lead to income generation for the people in Thailand.
Key words: antioxidant activity, chemical properties, date fruits, vinegar, wine
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Introduction: Phoenix dactylifera, commonly known as date or date palm, is a flowering plant species in the palm family Arecaceae, cultivated for its edible sweet fruit called dates. Dates are high in dietary fibre and antioxidant compounds, known for preventing cancer and cardiovascular diseases. This research studied the chemical properties, antioxidant activities, and total phenolic content of fermented date vinegars from Phoenix dactylifera L. fruits, which had three cultivars - Barhi, Siam S1, and KL1.
Methods: The first step was making date wines by using Saccharomyces cerevisiae (0.75% v/v of date juice content) to produce alcohol; the second step was making date vinegars by using Acetobacter pasteurianus (10% v/v of inoculum). Thereafter, the wines and vinegars were analysed for their chemical properties [high performance liquid chromatography (HPLC)], antioxidant activities [2,2-Diphenyl-1-picrylhydrazyl (DPPH) assay], and total phenolic content (folin ciocalteu method).
Results: Results showed that the highest alcohol content was 9.35% (v/v) in Siam S1 wine. The highest acetic acid was 7% (v/v) in Siam S1 vinegar. From the phytochemical analysis of vinegars, the highest antioxidant activity was found to be 24.96 mg/mL in Siam S1 vinegar, while the highest total phenolic content was found to be 208.35 mg GAE/L in KL1 vinegar.
Conclusion: This novel research showed that the Siam S1 date had the highest acetic acid and antioxidant activity in vinegar. Thus, this cultivar could be processed to make new, healthy products that can further lead to income generation for the people in Thailand.
Key words: antioxidant activity, chemical properties, date fruits, vinegar, wine
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Eating self-regulatory skill, diet quantity, and diet
quality of Malaysian healthcare university students:
A cross-sectional study
Ching Li Lee, Jamilah Abd Jamil, Jia Tian Chang, Kar Xsin Yap, Hsin Yuen
Yap & Wei Jin Khoo
doi: https://doi.org/10.31246/mjn-2022-0025
ABSTRACT
Introduction: The ability to self-regulate eating can improve health. This study aimed to determine the relationship between eating self-regulatory skills, diet quantity, and diet quality among Malaysian university students.
Methods: This cross-sectional study involved 132 university students. Eating self-regulatory skill was assessed using the Self-Regulation of Eating Behaviour Questionnaire (SREBQ). Dietary intakes from two 24-hour dietary recalls were used to assess diet quantity and quality. Diet quantity was measured as energy and macronutrient intakes, analysed using NutritionistPro. Diet quality was measured using the Malaysian Healthy Eating Index (M-HEI). The relationship between eating self-regulatory skills, diet quantity, and diet quality were evaluated using tests for differences between means and multiple linear regression.
Results: Male participants (n=47) consumed more energy than female participants (n=85) (Male: 1850±570 kcal/day, Female: 1596±567 kcal/day, p=0.015). Participants from the Nutrition and Dietetics (N&D) course (n=49) had better M-HEI scores than participants from other health courses (n=83) (N&D course: 52.7±10.5, non-N&D course: 47.2±10.7, p=0.005). The predictors of energy intake were gender (β=-0.193, p=0.023) and SREBQ score (β=- 0.223, p=0.009). Being female and having higher eating self-regulatory skills were associated with lower energy intake. The predictors of diet quality were university course (β=0.240, p=0.005) and SREBQ score (β=0.181, p=0.033). Studying N&D and having higher eating self-regulatory skills were associated with higher M-HEI scores.
Conclusion: Higher self-regulation of eating behaviour score is a factor that contributes to lower daily energy intake and higher diet quality score.
Key words: diet quality, diet quantity, self-regulation, university students
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Introduction: The ability to self-regulate eating can improve health. This study aimed to determine the relationship between eating self-regulatory skills, diet quantity, and diet quality among Malaysian university students.
Methods: This cross-sectional study involved 132 university students. Eating self-regulatory skill was assessed using the Self-Regulation of Eating Behaviour Questionnaire (SREBQ). Dietary intakes from two 24-hour dietary recalls were used to assess diet quantity and quality. Diet quantity was measured as energy and macronutrient intakes, analysed using NutritionistPro. Diet quality was measured using the Malaysian Healthy Eating Index (M-HEI). The relationship between eating self-regulatory skills, diet quantity, and diet quality were evaluated using tests for differences between means and multiple linear regression.
Results: Male participants (n=47) consumed more energy than female participants (n=85) (Male: 1850±570 kcal/day, Female: 1596±567 kcal/day, p=0.015). Participants from the Nutrition and Dietetics (N&D) course (n=49) had better M-HEI scores than participants from other health courses (n=83) (N&D course: 52.7±10.5, non-N&D course: 47.2±10.7, p=0.005). The predictors of energy intake were gender (β=-0.193, p=0.023) and SREBQ score (β=- 0.223, p=0.009). Being female and having higher eating self-regulatory skills were associated with lower energy intake. The predictors of diet quality were university course (β=0.240, p=0.005) and SREBQ score (β=0.181, p=0.033). Studying N&D and having higher eating self-regulatory skills were associated with higher M-HEI scores.
Conclusion: Higher self-regulation of eating behaviour score is a factor that contributes to lower daily energy intake and higher diet quality score.
Key words: diet quality, diet quantity, self-regulation, university students
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Associations between body mass index and physical
activity level with mindful eating behaviour among
undergraduate medical students of Universiti Sains
Malaysia
Nurul Zulaikha Talib, Shu Qing Ang, Juliana Shamsudin & Zafirah Mohd Nor
doi: https://doi.org/10.31246/mjn-2022-0040
ABSTRACT
Introduction: Mindful eating is being fully present in the moment of eating and it is critical in preventing poor eating habits. The main objective for this study was to determine the associations of body mass index (BMI) and physical activity level with mindful eating behaviour among undergraduate medical students of Universiti Sains Malaysia (USM), Health Campus, Kubang Kerian, Kelantan.
Methods: A cross-sectional study was conducted among 158 students (Years 1-5; 69% females and 31% males) by using a self-administered online questionnaire consisting of socio-demographic data, anthropometric data, short version of the International Physical Activity Questionnaire (IPAQ), and Mindful Eating Questionnaire (MEQ). The associations between BMI and physical activity with MEQ were determined by Spearman’s Correlation and One-Way ANOVA or Kruskal-Wallis Test, respectively.
Results: Majority of the students had normal BMI (66.4%, n=105), and 39.9% (n=63) had low physical activity levels. The mean MEQ summary score of the students was considered high (2.82±0.26). There was a significant negative association between MEQ summary score (r=-0.191; p=0.016) and disinhibition subscale score (r=-0.340; p<0.001) with BMI, whereby MEQ summary and disinhibition subscale scores increased as BMI decreased. However, there was no significant association between physical activity level with MEQ score (p>0.05).
Conclusion: A student with positive mindful eating behaviour has the potential to lower his/her BMI. However, further research is required to verify this finding.
Key words: body mass index (BMI), medical students, mindful eating behaviour, physical activity
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Introduction: Mindful eating is being fully present in the moment of eating and it is critical in preventing poor eating habits. The main objective for this study was to determine the associations of body mass index (BMI) and physical activity level with mindful eating behaviour among undergraduate medical students of Universiti Sains Malaysia (USM), Health Campus, Kubang Kerian, Kelantan.
Methods: A cross-sectional study was conducted among 158 students (Years 1-5; 69% females and 31% males) by using a self-administered online questionnaire consisting of socio-demographic data, anthropometric data, short version of the International Physical Activity Questionnaire (IPAQ), and Mindful Eating Questionnaire (MEQ). The associations between BMI and physical activity with MEQ were determined by Spearman’s Correlation and One-Way ANOVA or Kruskal-Wallis Test, respectively.
Results: Majority of the students had normal BMI (66.4%, n=105), and 39.9% (n=63) had low physical activity levels. The mean MEQ summary score of the students was considered high (2.82±0.26). There was a significant negative association between MEQ summary score (r=-0.191; p=0.016) and disinhibition subscale score (r=-0.340; p<0.001) with BMI, whereby MEQ summary and disinhibition subscale scores increased as BMI decreased. However, there was no significant association between physical activity level with MEQ score (p>0.05).
Conclusion: A student with positive mindful eating behaviour has the potential to lower his/her BMI. However, further research is required to verify this finding.
Key words: body mass index (BMI), medical students, mindful eating behaviour, physical activity
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Coeliac disease knowledge and treatment: Potential
factors associated with adherence to gluten-free diet
Najla Alorayyidh, Maram H. Alswaji, Elham Almujammay, Bander Alhujairy,
Nada Benajiba & Abeer Salman Alzaben
doi: https://doi.org/10.31246/mjn-2022-0082
ABSTRACT
Introduction: Lack of adherence to a strict gluten-free diet (GFD) is the main reason for poorly controlled disease in patients with coeliac disease (CD). This study aimed to assess the association between knowledge of CD and its medical diet to the adherence of GFD among adult patients with CD.
Methods: A cross-sectional study was carried out with a total of 90 adult patients with CD (aged between 18-65 years). The data collecting instruments were a combination of four questionnaires as follows: assessment of knowledge of coeliac disease (AKCD), gluten-free diet knowledge scale (GFD-KS), coeliac disease adherence test (CDAT), and questions on potential factors influencing GFD adherence among patients.
Results: An average knowledge score of five points out of seven was obtained from 46 participants (51%). Mean score for knowledge on gluten-free diet was seven points out of 17 in 59 participants (65%). Adequate adherence to GFD was observed in 56% of the participants. No association was found between knowledge of CD and GFD to the adherence of GFD (p>0.050). Participants who had higher adherence scores were discussing GFD with a specialist, obtaining educational materials, had enhanced symptoms associated with CD, and did not complain about the taste of GFD (p<0.050).
Conclusion: Patients with CD has adequate knowledge of CD and adherence of GFD. No association was found between the knowledge of CD and GFD to the adherence of GFD. Further research might explore other potential factors influencing the adherence to GFD.
Key words: adherence, coeliac disease, gluten-free diet, knowledge
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Introduction: Lack of adherence to a strict gluten-free diet (GFD) is the main reason for poorly controlled disease in patients with coeliac disease (CD). This study aimed to assess the association between knowledge of CD and its medical diet to the adherence of GFD among adult patients with CD.
Methods: A cross-sectional study was carried out with a total of 90 adult patients with CD (aged between 18-65 years). The data collecting instruments were a combination of four questionnaires as follows: assessment of knowledge of coeliac disease (AKCD), gluten-free diet knowledge scale (GFD-KS), coeliac disease adherence test (CDAT), and questions on potential factors influencing GFD adherence among patients.
Results: An average knowledge score of five points out of seven was obtained from 46 participants (51%). Mean score for knowledge on gluten-free diet was seven points out of 17 in 59 participants (65%). Adequate adherence to GFD was observed in 56% of the participants. No association was found between knowledge of CD and GFD to the adherence of GFD (p>0.050). Participants who had higher adherence scores were discussing GFD with a specialist, obtaining educational materials, had enhanced symptoms associated with CD, and did not complain about the taste of GFD (p<0.050).
Conclusion: Patients with CD has adequate knowledge of CD and adherence of GFD. No association was found between the knowledge of CD and GFD to the adherence of GFD. Further research might explore other potential factors influencing the adherence to GFD.
Key words: adherence, coeliac disease, gluten-free diet, knowledge
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Government-Industry-Academia Alliance: A multisectoral
collaboration for improved nutrition of
children and well-being of mothers
Divorah V. Aguila, Julieta B. Dorado & Mario V. Capanzana
doi: https://doi.org/10.31246/mjn-2022-0019
ABSTRACT
Introduction: Consistent with the Sustainable Development Goal 17 highlighting partnership to achieve development, this study demonstrated the convergence among government, industry and academe in carrying out a nutrition intervention to improve the nutritional status, knowledge, attitude and behaviour of school community (school children and mothers).
Methods: A school-based intervention study comprising of school lunch feeding and nutrition lessons was conducted. Quasi-experimental design was used in the intervention research. Data were analysed using Stata 12.0. Descriptive statistics were generated using the survey module (svy) of Stata. The food and nutrition intervention mix composed of the governmentpartner School Feeding Programme (SFP) and the nutrition education campaign. The government-partner SFP involved lunch feeding of 7 to 9 years old students based on the standardised Pinggang Pinoy® recipes. The government-partner nutrition education component involved teaching of the developed modules to students and their mothers.
Results: The intervention resulted in improvements in nutritional status, knowledge, attitude and behaviour of students. Investing an average of Php 15.00 or USD 0.29 (as of 2017) in a school feeding programme following the government-partner food and nutrition intervention mix improved nutritional status and shifted the number of underweight children to normal nutritional status by 25.3% after 120 feeding days. This intervention was implemented through a multisectoral collaboration during the pre-implementation, implementation, and post-implementation phases of the study.
Conclusion: Partnerships among stakeholders provided the context towards healthier children as demonstrated by improved nutritional status, knowledge, attitude and behaviour of participants.
Key words: Filipino school children, multi-sectoral collaboration, nutrition, partnership, school feeding programme
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Introduction: Consistent with the Sustainable Development Goal 17 highlighting partnership to achieve development, this study demonstrated the convergence among government, industry and academe in carrying out a nutrition intervention to improve the nutritional status, knowledge, attitude and behaviour of school community (school children and mothers).
Methods: A school-based intervention study comprising of school lunch feeding and nutrition lessons was conducted. Quasi-experimental design was used in the intervention research. Data were analysed using Stata 12.0. Descriptive statistics were generated using the survey module (svy) of Stata. The food and nutrition intervention mix composed of the governmentpartner School Feeding Programme (SFP) and the nutrition education campaign. The government-partner SFP involved lunch feeding of 7 to 9 years old students based on the standardised Pinggang Pinoy® recipes. The government-partner nutrition education component involved teaching of the developed modules to students and their mothers.
Results: The intervention resulted in improvements in nutritional status, knowledge, attitude and behaviour of students. Investing an average of Php 15.00 or USD 0.29 (as of 2017) in a school feeding programme following the government-partner food and nutrition intervention mix improved nutritional status and shifted the number of underweight children to normal nutritional status by 25.3% after 120 feeding days. This intervention was implemented through a multisectoral collaboration during the pre-implementation, implementation, and post-implementation phases of the study.
Conclusion: Partnerships among stakeholders provided the context towards healthier children as demonstrated by improved nutritional status, knowledge, attitude and behaviour of participants.
Key words: Filipino school children, multi-sectoral collaboration, nutrition, partnership, school feeding programme
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Association of dietary pattern and childhood obesity
with cardiovascular disease in patients from Tangail
city, Bangladesh
Khan Md. Murtaja Reza Linkon, Nur-E-Safa Meem, Ssm. Habibullah
Noory, Md. Hanif Hossain, Rehnova Mustafa Nitu, Md. Faridu Islam, Md.
Shyfullah, Sharmin Jalil, Md. Esrafil & Md. Abdul Alim
doi: https://doi.org/10.31246/mjn-2022-0063
ABSTRACT
Introduction: Obesity in childhood is a major cause for developing cardiovascular diseases (CVD) at adulthood. The present study was a cross-sectional research aimed to examine the relationship between childhood obesity and dietary pattern with CVD in patients (n=100) from Tangail City, Bangladesh.
Methods: Dietary patterns, laboratory tests, demographic, and anthropometric interrelated data were measured in patients with stroke and heart attack from five hospitals. The research also used 24-hour recall method and a food frequency questionnaire for assessing daily energy and macronutrient intakes.
Results: Weight (p=0.004), body mass index (BMI) (p=0.001), mid-upper arm circumference (MUAC) (p=0.009), and waist circumference (WC) (p=0.030) was significantly different between males and females whereas lipid profile was not significantly different between genders. There were no significant associations between intakes of red meat, salt, fast food, fish, egg, nuts and seeds with heart attack and stroke. On the contrary, there were significant associations between fried food intake with heart attack and stroke (p=0.080 and p=0.020). The results indicated that there was a significant relationship between carbohydrate (p=0.001), protein (p=0.001), and fat (p=0.001) intakes with the total energy intake of respondents. The findings also showed that there was a significant relationship between carbohydrate (p=0.003), protein (p=0.001), and fat (p=0.001) intakes with body mass index of the respondents.
Conclusion: CVD diagnosis in adult patients was found to be associated with fried food intake but not with childhood obesity.
Key words: body mass index, cardiovascular disease, childhood obesity, dietary pattern, lipid profile
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Introduction: Obesity in childhood is a major cause for developing cardiovascular diseases (CVD) at adulthood. The present study was a cross-sectional research aimed to examine the relationship between childhood obesity and dietary pattern with CVD in patients (n=100) from Tangail City, Bangladesh.
Methods: Dietary patterns, laboratory tests, demographic, and anthropometric interrelated data were measured in patients with stroke and heart attack from five hospitals. The research also used 24-hour recall method and a food frequency questionnaire for assessing daily energy and macronutrient intakes.
Results: Weight (p=0.004), body mass index (BMI) (p=0.001), mid-upper arm circumference (MUAC) (p=0.009), and waist circumference (WC) (p=0.030) was significantly different between males and females whereas lipid profile was not significantly different between genders. There were no significant associations between intakes of red meat, salt, fast food, fish, egg, nuts and seeds with heart attack and stroke. On the contrary, there were significant associations between fried food intake with heart attack and stroke (p=0.080 and p=0.020). The results indicated that there was a significant relationship between carbohydrate (p=0.001), protein (p=0.001), and fat (p=0.001) intakes with the total energy intake of respondents. The findings also showed that there was a significant relationship between carbohydrate (p=0.003), protein (p=0.001), and fat (p=0.001) intakes with body mass index of the respondents.
Conclusion: CVD diagnosis in adult patients was found to be associated with fried food intake but not with childhood obesity.
Key words: body mass index, cardiovascular disease, childhood obesity, dietary pattern, lipid profile
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Dietary patterns associated with the risk of type
2 diabetes in women with and without a history of
gestational diabetes mellitus: A pilot study
Farah Yasmin Hasbullah, Barakatun Nisak Mohd Yusof, Rohana Abdul
Ghani, Geeta Appannah, Zulfitri ’Azuan Mat Daud & Faridah Abas
doi: https://doi.org/10.31246/mjn-2022-0056
ABSTRACT
Introduction: There is limited evidence on dietary patterns and the risk of type 2 diabetes (T2D) in women with a history of gestational diabetes mellitus (GDM) compared to their non-GDM counterparts, especially in the Asian population. The pilot study investigated dietary patterns in women with a history of GDM (HGDM) and without a history of GDM (non-HGDM), and the association with T2D risk.
Methods: This comparative cross-sectional study involved 64 women (32 HGDM, 32 non-HGDM). Food intake was assessed using a validated food frequency questionnaire. Principal component analysis derived the dietary patterns. T2D risk score was determined using the Finnish Diabetes Risk Score tool.
Results: HGDM group had significantly higher proportion of first-degree family history of diabetes; higher risk of T2D and better diabetes knowledge; lower gestational weight gain and postpartum weight retention; and consumed more fast food than non- HGDM. ‘Rice-noodle-pasta-meat’ dietary pattern was significantly associated with increased T2D risk after adjusting for age (β=0.272, p=0.032). ‘Bread-cereals-fast food-meat’ dietary pattern was positively and significantly associated with T2D risk after adjusting for confounders, including age, education level, family history of diabetes, diabetes knowledge score, gestational weight gain, and postpartum weight retention (β=0.251, p=0.012).
Conclusion: Dietary patterns high in bread, cereals and cereal products, fast food and meat, as well as rice, noodle, pasta and meat were associated with an elevated T2D risk. A more extensive study is warranted to establish the association between dietary patterns and risk of T2D, focusing on women with a history of GDM.
Key words: dietary patterns, gestational diabetes mellitus, type 2 diabetes
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Introduction: There is limited evidence on dietary patterns and the risk of type 2 diabetes (T2D) in women with a history of gestational diabetes mellitus (GDM) compared to their non-GDM counterparts, especially in the Asian population. The pilot study investigated dietary patterns in women with a history of GDM (HGDM) and without a history of GDM (non-HGDM), and the association with T2D risk.
Methods: This comparative cross-sectional study involved 64 women (32 HGDM, 32 non-HGDM). Food intake was assessed using a validated food frequency questionnaire. Principal component analysis derived the dietary patterns. T2D risk score was determined using the Finnish Diabetes Risk Score tool.
Results: HGDM group had significantly higher proportion of first-degree family history of diabetes; higher risk of T2D and better diabetes knowledge; lower gestational weight gain and postpartum weight retention; and consumed more fast food than non- HGDM. ‘Rice-noodle-pasta-meat’ dietary pattern was significantly associated with increased T2D risk after adjusting for age (β=0.272, p=0.032). ‘Bread-cereals-fast food-meat’ dietary pattern was positively and significantly associated with T2D risk after adjusting for confounders, including age, education level, family history of diabetes, diabetes knowledge score, gestational weight gain, and postpartum weight retention (β=0.251, p=0.012).
Conclusion: Dietary patterns high in bread, cereals and cereal products, fast food and meat, as well as rice, noodle, pasta and meat were associated with an elevated T2D risk. A more extensive study is warranted to establish the association between dietary patterns and risk of T2D, focusing on women with a history of GDM.
Key words: dietary patterns, gestational diabetes mellitus, type 2 diabetes
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Validity and reliability of online questionnaire on
awareness, knowledge, attitude and self-efficacy
(AKAS) on healthy eating for nutrition education and
promotion
Milflor S. Gonzales, Idelia G. Glorioso, Celina Ann J. Navarro & Theresa Krista
B. Jolejole
doi: https://doi.org/10.31246/mjn-2021-0099
ABSTRACT
Introduction: This study entailed the process of developing an online questionnaire to determine awareness, knowledge, attitude and self-efficacy (AKAS) on healthy eating for nutrition education. Currently, there is no local validated questionnaire that can be used to assess AKAS on healthy eating among Filipino adults.
Methods: The study developed the questionnaire based on theoretical frameworks and literature review. The draft questionnaire underwent three stages of development: (1) online modified Delphi technique composing of seven subject matter experts (SME) for content validity; (2) online cognitive debriefing with 32 participants (14 nutrition experts and 18 general public) for construct validity; and (3) online pre-testing with 35 participants (non-nutritionists) using test-retest method.
Results: For first stage, the questionnaire contained 16 questions for awareness, 17 questions for knowledge, 17 questions for attitude, and 15 questions for self-efficacy. For second stage, significantly different scores (p-value<0.00) between nutritionist experts and general public were observed, showing good construct validity. For third stage, Spearman’s correlation of test-retest method was 0.640. The questionnaire yielded Cronbach’s alpha of 0.467 to 0.923 (round 1) and 0.435 to 0.923 (round 2). A second analysis was done to improve the internal consistency of the questionnaire. By combining two question categories (awareness and knowledge), the Cronbach’s alpha increased to 0.659 (round 2), and by deleting three questions in attitude category, the Cronbach’s alpha improved to 0.626 (round 2).
Conclusion: The process used ensured the questionnaire’s validity and reliability. Hence, this online questionnaire may be adopted by parties interested in developing and assessing nutrition education.
Key words: cognitive debriefing, Delphi technique, nutrition education
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Introduction: This study entailed the process of developing an online questionnaire to determine awareness, knowledge, attitude and self-efficacy (AKAS) on healthy eating for nutrition education. Currently, there is no local validated questionnaire that can be used to assess AKAS on healthy eating among Filipino adults.
Methods: The study developed the questionnaire based on theoretical frameworks and literature review. The draft questionnaire underwent three stages of development: (1) online modified Delphi technique composing of seven subject matter experts (SME) for content validity; (2) online cognitive debriefing with 32 participants (14 nutrition experts and 18 general public) for construct validity; and (3) online pre-testing with 35 participants (non-nutritionists) using test-retest method.
Results: For first stage, the questionnaire contained 16 questions for awareness, 17 questions for knowledge, 17 questions for attitude, and 15 questions for self-efficacy. For second stage, significantly different scores (p-value<0.00) between nutritionist experts and general public were observed, showing good construct validity. For third stage, Spearman’s correlation of test-retest method was 0.640. The questionnaire yielded Cronbach’s alpha of 0.467 to 0.923 (round 1) and 0.435 to 0.923 (round 2). A second analysis was done to improve the internal consistency of the questionnaire. By combining two question categories (awareness and knowledge), the Cronbach’s alpha increased to 0.659 (round 2), and by deleting three questions in attitude category, the Cronbach’s alpha improved to 0.626 (round 2).
Conclusion: The process used ensured the questionnaire’s validity and reliability. Hence, this online questionnaire may be adopted by parties interested in developing and assessing nutrition education.
Key words: cognitive debriefing, Delphi technique, nutrition education
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Effects of chocolate milk consumption on muscle
recovery following rowing exercise: A randomised
crossover study
Anna Fitriani, Asih Setiarini, Engkus Kusdinar Ahmad, Desiani Rizki
Purwaningtyas & Fitria
doi: https://doi.org/10.31246/mjn-2022-0086
ABSTRACT
Introduction: For athletes, an excessive increase in blood urea nitrogen (BUN) after multiple endurance exercises indicates muscle glycogen depletion that induces a diminution in performance. Our study aimed to examine the efficacy of chocolate milk (CM) compared with carbohydrate-protein replacement drink (CHOPRO) in suppressing the increase in BUN level following multiple rowing exercises among national male rowing athletes aged 18–23 years.
Methods: Seven male athletes from the Rowing National Training Centre, Pengalengan, West Java, participated in this single-blind, randomised crossover study. They received CM or CHOPRO during four hours of recovery between two endurance exercises. Before (pre) and after (post) multiple exercises, a venous blood sample was collected to measure the increase in BUN level. The effects of each beverage on BUN level were compared using an independent t-test.
Results: The increase in pre-post BUN level was significantly lower for CM trial compared to CHOPRO trial (164.0±61.3 mmol/L vs 293.5±88.3 mmol/L, p=0.012).
Conclusion: It was observed that CM reduced rate of increase in BUN level following multiple rowing exercises. Thus, CM can be useful for athletes during intense training regimen with multiple exercise sessions. Future studies should investigate the effect of CM in various types of sports, using convenient, non-invasive, and real-time measurement.
Key words: athletes, glycogen, milk, muscles, water sports
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Introduction: For athletes, an excessive increase in blood urea nitrogen (BUN) after multiple endurance exercises indicates muscle glycogen depletion that induces a diminution in performance. Our study aimed to examine the efficacy of chocolate milk (CM) compared with carbohydrate-protein replacement drink (CHOPRO) in suppressing the increase in BUN level following multiple rowing exercises among national male rowing athletes aged 18–23 years.
Methods: Seven male athletes from the Rowing National Training Centre, Pengalengan, West Java, participated in this single-blind, randomised crossover study. They received CM or CHOPRO during four hours of recovery between two endurance exercises. Before (pre) and after (post) multiple exercises, a venous blood sample was collected to measure the increase in BUN level. The effects of each beverage on BUN level were compared using an independent t-test.
Results: The increase in pre-post BUN level was significantly lower for CM trial compared to CHOPRO trial (164.0±61.3 mmol/L vs 293.5±88.3 mmol/L, p=0.012).
Conclusion: It was observed that CM reduced rate of increase in BUN level following multiple rowing exercises. Thus, CM can be useful for athletes during intense training regimen with multiple exercise sessions. Future studies should investigate the effect of CM in various types of sports, using convenient, non-invasive, and real-time measurement.
Key words: athletes, glycogen, milk, muscles, water sports
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Weight cycling among Indonesian college students in
West Java province during the COVID-19 pandemic
Boyke Mulyana, Asti Dewi Rahayu Fitrianingsih, Syifa F. Syihab & Novriza
Achmad Novan
doi: https://doi.org/10.31246/mjn-2021-0125
ABSTRACT
Introduction: Changes in our bodies can cause several problems, particularly for students who are concerned about maintaining an ideal body shape. Many of them try to diet, but their body returns to its previous weight or even increases in weight. Thus, this study aimed to determine the factors that influence the incidence of weight cycling in Indonesian students during the COVID-19 pandemic.
Methods: This cross-sectional study used purposive sampling to collect data. Three hundred college students from West Java province, Indonesia, participated. Weight cycling was the dependent variable and the independent variables were physical activity, sex, and weight management. Multivariate logistic regression analysis was used to determine the factors influencing the incidence of weight cycling.
Results: Sex, physical activity, skipping meals, and snacking were determinants related to weight cycling incidence. Females had a 0.7 times higher risk of experiencing weight cycling than males. Inactive students were 4.7 times more likely to become weight cyclers, and those who rarely skipped mealtime had lower risk of being weight cyclers. Students who sometimes and always consumed snacks had higher risk of becoming weight cyclers by 3.3 and 2.7 times, respectively, compared to those who rarely consumed snacks.
Conclusion: Regular physical activity, not skipping meals, especially breakfast, and practising a healthy diet every day are recommended strategies to avoid weight cycling during a pandemic.
Key words: dietary habits, physical activity, weight cycling, weight management
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Introduction: Changes in our bodies can cause several problems, particularly for students who are concerned about maintaining an ideal body shape. Many of them try to diet, but their body returns to its previous weight or even increases in weight. Thus, this study aimed to determine the factors that influence the incidence of weight cycling in Indonesian students during the COVID-19 pandemic.
Methods: This cross-sectional study used purposive sampling to collect data. Three hundred college students from West Java province, Indonesia, participated. Weight cycling was the dependent variable and the independent variables were physical activity, sex, and weight management. Multivariate logistic regression analysis was used to determine the factors influencing the incidence of weight cycling.
Results: Sex, physical activity, skipping meals, and snacking were determinants related to weight cycling incidence. Females had a 0.7 times higher risk of experiencing weight cycling than males. Inactive students were 4.7 times more likely to become weight cyclers, and those who rarely skipped mealtime had lower risk of being weight cyclers. Students who sometimes and always consumed snacks had higher risk of becoming weight cyclers by 3.3 and 2.7 times, respectively, compared to those who rarely consumed snacks.
Conclusion: Regular physical activity, not skipping meals, especially breakfast, and practising a healthy diet every day are recommended strategies to avoid weight cycling during a pandemic.
Key words: dietary habits, physical activity, weight cycling, weight management
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Diabetes prevention through digital therapy for highrisk
individuals: Study protocol for the Malaysia
Diabetes Prevention Programme (MyDiPP)
Nurul Fatihah Mohd Fauzi, Sharifah Wajihah Wafa Syed Saadun Tarek Wafa,
Naresh Bhaskar Raj, Mohd Ibrahim Abdullah, Norkhairani Abdul Rawi,
Nurulhuda Mat Hassan & Rohayah Husain
doi: https://doi.org/10.31246/mjn-2022-0015
ABSTRACT
Introduction: Intervention approaches that integrate human coaching into technology are considered as a convenient, accessible and scalable method to reach a larger population at risk. The objective of this paper is to present the protocol for a randomised controlled trial that evaluates the efficacy of a lifestyle intervention programme via a mobile phone app (MyDiPP), which aims to prevent diabetes among adults at risk of developing diabetes.
Methods: MyDiPP intervention is to be delivered for 12 months with multiple approaches (weight loss, dietary modification, physical activity, and quality of life). Eligible adults aged 18-65 years, overweight/obese (body mass index, BMI ≥ 23kg/m2), and at high risk of type 2 diabetes [American Diabetes Association (ADA) Diabetes Risk Score ≥5, or haemoglobin A1c (HbA1c) of 5.6-6.2%], will be randomly assigned to one of two study groups (intervention or usual care control groups) in a 1:1 ratio using simple randomisation.
Results: Changes in weight and HbA1c level (primary outcomes), and changes in physical activity level, dietary intake, and quality of life (secondary outcomes) will be assessed at 6 and 12 months.
Conclusion: This study protocol describes the first digital therapy for diabetes prevention in Malaysia, which will determine whether the effect of this intervention is larger than the effect of usual care in reducing body weight and HbA1c level, and improving dietary intake, physical activity, and quality of life of high-risk individuals. Results from this trial may be useful for preventing type 2 diabetes mellitus in Malaysia.
Key words: lifestyle intervention, prediabetes, protocol, randomised controlled trial, T2DM
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Introduction: Intervention approaches that integrate human coaching into technology are considered as a convenient, accessible and scalable method to reach a larger population at risk. The objective of this paper is to present the protocol for a randomised controlled trial that evaluates the efficacy of a lifestyle intervention programme via a mobile phone app (MyDiPP), which aims to prevent diabetes among adults at risk of developing diabetes.
Methods: MyDiPP intervention is to be delivered for 12 months with multiple approaches (weight loss, dietary modification, physical activity, and quality of life). Eligible adults aged 18-65 years, overweight/obese (body mass index, BMI ≥ 23kg/m2), and at high risk of type 2 diabetes [American Diabetes Association (ADA) Diabetes Risk Score ≥5, or haemoglobin A1c (HbA1c) of 5.6-6.2%], will be randomly assigned to one of two study groups (intervention or usual care control groups) in a 1:1 ratio using simple randomisation.
Results: Changes in weight and HbA1c level (primary outcomes), and changes in physical activity level, dietary intake, and quality of life (secondary outcomes) will be assessed at 6 and 12 months.
Conclusion: This study protocol describes the first digital therapy for diabetes prevention in Malaysia, which will determine whether the effect of this intervention is larger than the effect of usual care in reducing body weight and HbA1c level, and improving dietary intake, physical activity, and quality of life of high-risk individuals. Results from this trial may be useful for preventing type 2 diabetes mellitus in Malaysia.
Key words: lifestyle intervention, prediabetes, protocol, randomised controlled trial, T2DM
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Malaysian Journal of Nutrition (Mal J Nutr)
Volume 29 No.2, 2023
Table of Content
SPECIAL INVITED REVIEW: Review of recommended energy and nutrient intake
values in Southeast Asian countries
E Siong Tee, Rodolfo F Florentino, Nalinee Chongviriyaphan, Hardinsyah
Ridwan, Mahenderan Appukutty & Truong Tuyet Mai
doi: https://doi.org/10.31246/mjn-2023-29-2-rni-rda-sea-review
ABSTRACT
This review summarises the officially published recommended energy and nutrient intake values in five Southeast Asia (SEA) countries namely Indonesia, Malaysia, Philippines, Thailand and Vietnam. The background information, general approaches and references used for setting up recommendations and the recommended intakes levels for energy, protein, fat and carbohydrate, dietary fibre, sugars,14 vitamins and 15 minerals of these countries were tabulated and compared. The recommended intake values show remarkable similarities in terms of approaches and principles taken, as well as references used as the basis for the recommendations development and the application of the recommendations in respective country. There are nevertheless some differences in age groupings, reference height and weight used, as well as the final recommendations of the intake levels for some nutrients, after adjustment to suit local situations. All five countries had provided recommendations in terms of recommended nutrient intakes (RNI) or recommended dietary allowance (RDA) for almost all the nutrients. Due to the limited availability of local data and resources, countries in the region have referred to several references, including those from Food and Agriculture Organization/World Health Organization (FAO/WHO) consultation report and recommendations from research organisations in United States and Europe and adapted the values for local uses. Opportunities should be created to enable closer dialogue and collaboration regarding future developments in nutrient recommendations for populations in the region. These could include consideration of establishing more appropriate nutrient recommendations and the call for setting up harmonised approaches to establishing recommended nutrient intake values for the region.
Key words: nutrients, recommended energy intake, recommended nutrient intakes, Southeast Asia
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This review summarises the officially published recommended energy and nutrient intake values in five Southeast Asia (SEA) countries namely Indonesia, Malaysia, Philippines, Thailand and Vietnam. The background information, general approaches and references used for setting up recommendations and the recommended intakes levels for energy, protein, fat and carbohydrate, dietary fibre, sugars,14 vitamins and 15 minerals of these countries were tabulated and compared. The recommended intake values show remarkable similarities in terms of approaches and principles taken, as well as references used as the basis for the recommendations development and the application of the recommendations in respective country. There are nevertheless some differences in age groupings, reference height and weight used, as well as the final recommendations of the intake levels for some nutrients, after adjustment to suit local situations. All five countries had provided recommendations in terms of recommended nutrient intakes (RNI) or recommended dietary allowance (RDA) for almost all the nutrients. Due to the limited availability of local data and resources, countries in the region have referred to several references, including those from Food and Agriculture Organization/World Health Organization (FAO/WHO) consultation report and recommendations from research organisations in United States and Europe and adapted the values for local uses. Opportunities should be created to enable closer dialogue and collaboration regarding future developments in nutrient recommendations for populations in the region. These could include consideration of establishing more appropriate nutrient recommendations and the call for setting up harmonised approaches to establishing recommended nutrient intake values for the region.
Key words: nutrients, recommended energy intake, recommended nutrient intakes, Southeast Asia
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A bibliometric analysis of coconut sap research
Anis Fadhlina, Hassan I. Sheikh, Maryana Mohamad Nor, Noor Hafizoh
Saidan & Nurul Amira Zainurin
doi: https://doi.org/10.31246/mjn-2022-0079
ABSTRACT
Introduction: Coconut sap is a sweet, fragrant liquid obtained from the inflorescence of coconut tree. In this study, a literature search was conducted using the Scopus database to study the trends of coconut sap research.
Methods: Data extracted from the Scopus database were analysed and visualised using VOSviewer to determine top authors, papers, countries, collaborations, and research areas. A total of 76 publications up to year 2021 were identified and refined using keywords of “coconut sap”, “coconut sugar”, “coconut inflorescence”, “coconut inflorescence sap”, “coconut neera”, and “Cocos nucifera”.
Results: Based on the analysis, research on coconut sap started in 1984, with a total of 53 authors, nine countries, and 12 sources that had published more than two documents. The analysis of countries and sources revealed that India and IOP Conference Series: Earth and Environmental Science (EES) were the most prolific country and sources, respectively. The most influential document was on the chemical compositions and bacteriology of coconut sap. The results also showed that research on coconut sap was in the field of food processing during the early years, followed by fermentation, agriculture, and bacteriology of coconut sap. Research on coconut sap’s bacteriology started in 1986 and became a major interest, especially among high impact journals.
Conclusion: Overall, coconut sap is a potential target for the development of nutraceutical products, especially in the food and beverage industry.
Key words: bibliometric, coconut sap, nutraceutical
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Introduction: Coconut sap is a sweet, fragrant liquid obtained from the inflorescence of coconut tree. In this study, a literature search was conducted using the Scopus database to study the trends of coconut sap research.
Methods: Data extracted from the Scopus database were analysed and visualised using VOSviewer to determine top authors, papers, countries, collaborations, and research areas. A total of 76 publications up to year 2021 were identified and refined using keywords of “coconut sap”, “coconut sugar”, “coconut inflorescence”, “coconut inflorescence sap”, “coconut neera”, and “Cocos nucifera”.
Results: Based on the analysis, research on coconut sap started in 1984, with a total of 53 authors, nine countries, and 12 sources that had published more than two documents. The analysis of countries and sources revealed that India and IOP Conference Series: Earth and Environmental Science (EES) were the most prolific country and sources, respectively. The most influential document was on the chemical compositions and bacteriology of coconut sap. The results also showed that research on coconut sap was in the field of food processing during the early years, followed by fermentation, agriculture, and bacteriology of coconut sap. Research on coconut sap’s bacteriology started in 1986 and became a major interest, especially among high impact journals.
Conclusion: Overall, coconut sap is a potential target for the development of nutraceutical products, especially in the food and beverage industry.
Key words: bibliometric, coconut sap, nutraceutical
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SHORT COMMUNICATION: Sugar craving and stress levels during different phases
of menstrual cycle among university students
Nor Azwani Mohd Shukri, Riyadhina Husniyati Syafie & Wan Fathin Fariza
Wan Mahmood
doi: https://doi.org/10.31246/mjn-2022-0094
ABSTRACT
Introduction: The menstrual cycle in women is often associated with appetite control, mood, and behavioural changes due to hormonal imbalance. However, levels of sugar craving and stress during pre- and post-menstrual periods have not been thoroughly studied. This cross-sectional study aimed to compare levels of stress and sugar cravings during different phases of menstrual cycle among university students.
Methods: Participants aged 19–25 years were assessed for sugar craving and stress during pre- and post-menstrual periods. They were requested to fill out the Sugar Craving Assessment Tool (SCAT) and Perceived Stress Scale (PSS-10) questionnaires on the first day of menses (the pre-menses phase) by recalling how they felt throughout the past seven days. The participants completed the same set of questionnaires again two days after their menses ended (post-menses phase) by recalling how they felt within the previous two days.
Results: Ninety-three students participated in the study. Pre-menstrual SCAT score (40.0±19.6) was higher than post-menstrual SCAT score (32.1±19.4), t(91)=4.82, p<0.001. Mean PSS-10 score was also higher before menstruation (22.8±6.2) than after menstruation (17.5±6.1), t(91)=6.26, p<0.001. There was no significant difference in mean sugar craving scores of different stress categories, either during pre-menses [F(2,90)=1.39, p=0.256] or post-menses [F(2,90)=0.89, p=0.415].
Conclusion: The findings indicate that levels of sugar craving and stress were higher during pre-menstrual phase compared to post-menstrual phase in young adults. However, whether sugar cravings are linked to stress during the menstrual cycle is inconclusive and requires further investigation.
Key words: menstrual cycle, post-menses, pre-menses, stress, sugar cravings
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Introduction: The menstrual cycle in women is often associated with appetite control, mood, and behavioural changes due to hormonal imbalance. However, levels of sugar craving and stress during pre- and post-menstrual periods have not been thoroughly studied. This cross-sectional study aimed to compare levels of stress and sugar cravings during different phases of menstrual cycle among university students.
Methods: Participants aged 19–25 years were assessed for sugar craving and stress during pre- and post-menstrual periods. They were requested to fill out the Sugar Craving Assessment Tool (SCAT) and Perceived Stress Scale (PSS-10) questionnaires on the first day of menses (the pre-menses phase) by recalling how they felt throughout the past seven days. The participants completed the same set of questionnaires again two days after their menses ended (post-menses phase) by recalling how they felt within the previous two days.
Results: Ninety-three students participated in the study. Pre-menstrual SCAT score (40.0±19.6) was higher than post-menstrual SCAT score (32.1±19.4), t(91)=4.82, p<0.001. Mean PSS-10 score was also higher before menstruation (22.8±6.2) than after menstruation (17.5±6.1), t(91)=6.26, p<0.001. There was no significant difference in mean sugar craving scores of different stress categories, either during pre-menses [F(2,90)=1.39, p=0.256] or post-menses [F(2,90)=0.89, p=0.415].
Conclusion: The findings indicate that levels of sugar craving and stress were higher during pre-menstrual phase compared to post-menstrual phase in young adults. However, whether sugar cravings are linked to stress during the menstrual cycle is inconclusive and requires further investigation.
Key words: menstrual cycle, post-menses, pre-menses, stress, sugar cravings
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Access to and use of health information technology
among obese and non-obese Americans: Analysis of the
Health Information National Trends Survey data
Jacksaint Saintila, Cristian Ramos-Vera, Yaquelin E. Calizaya-Milla,
Veronica Ileana Hidalgo Villarreal, Antonio Serpa-Barrientos & Wilter C.
Morales-García
doi: https://doi.org/10.31246/mjn-2022-0058
ABSTRACT
Introduction: Health information technology (HIT) is essential in the prevention, management, and treatment of obesity due to the medical data and information available to health care providers and patients. However, exploration of HIT access and use among obese individuals remains limited. Objective: The purpose of this study was to compare access to and use of HIT among obese and non-obese Americans.
Methods: We considered cross-sectional secondary data from 3,865 United States adults that were collected through the Health Information National Trends Survey in 2020. Contingency tables were performed stratifying between men and women to assess whether they differed according to body mass index (BMI) levels with respect to HIT categories.
Results: Elevated BMI in women was associated with the use of a computer, smartphone, or other electronic device to e-mail or use the Internet to communicate with a doctor or a doctor’s office. In addition, elevated BMI in both genders was associated with sharing information from a smartphone/electronic device with a health professional. Finally, the use of an electronic device to monitor or track health or activity was found to be more prevalent among women with elevated BMI compared to those with normal BMI.
Conclusion: Future studies should expand research in terms of interventions linked to health information technology in adults with obesity by considering the gender factor. Moreover, the expansion of research into electronic health (eHealth) interventions is particularly important because it would favour the prevention, management, control, and treatment of obesity.
Key words: BMI, eHealth, obesity, smartphone, telemedicine
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Introduction: Health information technology (HIT) is essential in the prevention, management, and treatment of obesity due to the medical data and information available to health care providers and patients. However, exploration of HIT access and use among obese individuals remains limited. Objective: The purpose of this study was to compare access to and use of HIT among obese and non-obese Americans.
Methods: We considered cross-sectional secondary data from 3,865 United States adults that were collected through the Health Information National Trends Survey in 2020. Contingency tables were performed stratifying between men and women to assess whether they differed according to body mass index (BMI) levels with respect to HIT categories.
Results: Elevated BMI in women was associated with the use of a computer, smartphone, or other electronic device to e-mail or use the Internet to communicate with a doctor or a doctor’s office. In addition, elevated BMI in both genders was associated with sharing information from a smartphone/electronic device with a health professional. Finally, the use of an electronic device to monitor or track health or activity was found to be more prevalent among women with elevated BMI compared to those with normal BMI.
Conclusion: Future studies should expand research in terms of interventions linked to health information technology in adults with obesity by considering the gender factor. Moreover, the expansion of research into electronic health (eHealth) interventions is particularly important because it would favour the prevention, management, control, and treatment of obesity.
Key words: BMI, eHealth, obesity, smartphone, telemedicine
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Malaysian Healthy Diet Online Survey (MHDOS): Study
rationale and methodology
Jyh Eiin Wong, Fui Chee Woon, Yit Siew Chin, Wai Siew Teh, Rusidah
Selamat, Ahmad Ali Zainuddin, Gilly A Hendrie & E Siong Tee
doi: https://doi.org/10.31246/mjn-2022-0101
ABSTRACT
Introduction: Access to accurate and timely dietary information is of paramount importance in evaluating and developing well-targeted public health nutrition interventions. However, nationwide nutrition surveys are conducted infrequently because they are very costly to design, conduct and analyse. Dietary assessment tools, which are quick and cost- effective, are needed for population research and regular monitoring of Malaysians’ dietary habits. This paper describes the rationale and methodology of the Malaysian Healthy Diet Online Survey (MHDOS) project, which aims to bridge this knowledge gap on dietary intake of Malaysian adults. The main objective of the two-year project is to develop MHDOS as a valid tool to measure compliance with the Malaysian Dietary Guidelines 2020.
Methods: The MHDOS project has three study phases, namely (i) adaptation of an online survey and established diet quality scoring system for Malaysia, (ii) usability, validity and reliability testing of the online survey; and (iii) online survey administration in a nationwide study. The survey will be administered to approximately 10,000 Malaysian adults aged 18-59 years.
Discussion: MHDOS consists of 38 questions that measures the quantity, quality and variety of foods consumed. Individuals will receive a diet quality score that reflects their overall compliance with the Malaysian Dietary Guidelines and feedback on how to improve their scores. The findings of the online survey, which serve to complement information between larger surveys, will be useful to measure compliance of Malaysians to national dietary guidelines and inform public health interventions.
Key words: diet quality, dietary guidelines, online survey
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Introduction: Access to accurate and timely dietary information is of paramount importance in evaluating and developing well-targeted public health nutrition interventions. However, nationwide nutrition surveys are conducted infrequently because they are very costly to design, conduct and analyse. Dietary assessment tools, which are quick and cost- effective, are needed for population research and regular monitoring of Malaysians’ dietary habits. This paper describes the rationale and methodology of the Malaysian Healthy Diet Online Survey (MHDOS) project, which aims to bridge this knowledge gap on dietary intake of Malaysian adults. The main objective of the two-year project is to develop MHDOS as a valid tool to measure compliance with the Malaysian Dietary Guidelines 2020.
Methods: The MHDOS project has three study phases, namely (i) adaptation of an online survey and established diet quality scoring system for Malaysia, (ii) usability, validity and reliability testing of the online survey; and (iii) online survey administration in a nationwide study. The survey will be administered to approximately 10,000 Malaysian adults aged 18-59 years.
Discussion: MHDOS consists of 38 questions that measures the quantity, quality and variety of foods consumed. Individuals will receive a diet quality score that reflects their overall compliance with the Malaysian Dietary Guidelines and feedback on how to improve their scores. The findings of the online survey, which serve to complement information between larger surveys, will be useful to measure compliance of Malaysians to national dietary guidelines and inform public health interventions.
Key words: diet quality, dietary guidelines, online survey
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The influence of PROP taster status on habitual sweet
food consumption and dietary intake amongst obese
and non-obese adults
Ahmad Riduan Bahauddin, Zalilah Mohd Shariff, Nazamid Shaari & Roselina
Karim
doi: https://doi.org/10.31246/mjn-2022-0103
ABSTRACT
Introduction: Ability to taste 6-n-propylthiouracil (PROP) predicts both taste sensitivity and food preferences, with PROP tasters being more sensitive to sweet taste in foods, which may lead to less intake of sugary foods. However, when obesity progresses, the individual’s sense of taste and eating patterns may change. The aim of this study was to evaluate if PROP taster status affected habitual sweet food consumption and nutritional intake in obese and non-obese people.
Methods: A total of 88 obese and 92 non-obese Malay male and female participants aged 20-45 years were classified into PROP non-tasters, medium tasters, or supertasters by using PROP filter paper screening procedure. Sweet food consumption was assessed using food frequency questionnaire (FFQ), while dietary intake was measured by using 3-day food diary. Data were analysed using General Linear Model (GLM) Analysis of Covariance (ANCOVA) to compare for differences and associations among variables.
Results: Overall, there was no significant association between body mass index groups and PROP taster status (p>0.05). No significant differences were found on any habitual sweet food intake and dietary intake according to PROP taster status in both obese and non-obese participants (p>0.05). However, there was a significant difference (p<0.05) in fruit intake according to PROP taster status among obese participants.
Conclusion: The findings suggest that PROP taster status does not play a role in nutrient intakes among obese and non-obese individuals.
Key words: dietary intake, obesity, PROP taster status, sweet food consumption
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Introduction: Ability to taste 6-n-propylthiouracil (PROP) predicts both taste sensitivity and food preferences, with PROP tasters being more sensitive to sweet taste in foods, which may lead to less intake of sugary foods. However, when obesity progresses, the individual’s sense of taste and eating patterns may change. The aim of this study was to evaluate if PROP taster status affected habitual sweet food consumption and nutritional intake in obese and non-obese people.
Methods: A total of 88 obese and 92 non-obese Malay male and female participants aged 20-45 years were classified into PROP non-tasters, medium tasters, or supertasters by using PROP filter paper screening procedure. Sweet food consumption was assessed using food frequency questionnaire (FFQ), while dietary intake was measured by using 3-day food diary. Data were analysed using General Linear Model (GLM) Analysis of Covariance (ANCOVA) to compare for differences and associations among variables.
Results: Overall, there was no significant association between body mass index groups and PROP taster status (p>0.05). No significant differences were found on any habitual sweet food intake and dietary intake according to PROP taster status in both obese and non-obese participants (p>0.05). However, there was a significant difference (p<0.05) in fruit intake according to PROP taster status among obese participants.
Conclusion: The findings suggest that PROP taster status does not play a role in nutrient intakes among obese and non-obese individuals.
Key words: dietary intake, obesity, PROP taster status, sweet food consumption
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Dietary supplement intakes among adults living in
Kota Kinabalu during the COVID-19 pandemic: A crosssectional
study
Fredrica Li Ling Vun, Yasmin Beng Houi Ooi & Ban-Hock Khor
https://doi.org/10.31246/mjn-2022-0096
ABSTRACT
Introduction: During the coronavirus 2019 (COVID-19) pandemic, the public may seek a non-pharmacological approach, such as dietary supplements, to prevent or manage COVID-19. Therefore, this study aimed to evaluate the use of dietary supplements during the COVID-19 pandemic among adults in Kota Kinabalu.
Methods: This cross-sectional study recruited 213 adults living in Kota Kinabalu through convenient sampling from October 2021 to March 2022. A validated questionnaire was used to evaluate their perception on the use of dietary supplements, and the types of dietary supplements consumed before and during the COVID-19 pandemic.
Results: One-hundred sixty-one (75.6%) adults reported that they were told to consume dietary supplements during the COVID-19 pandemic, primarily from close family members (64.0%) and social media (58.4%). One-hundred and thirty-two (62%) adults were consuming dietary supplements and 46 (34.8%) of them only started taking them during the COVID-19 pandemic. The reasons for taking dietary supplements during the COVID-19 pandemic included enhancing the immune system (83.6%) and for prevention of COVID-19 infection (64.4%). The most common dietary supplements consumed during the COVID-19 pandemic were vitamin C (90.2%), followed by multi-vitamin and mineral (32.6%), and fish oil (25.8%). After adjusting for age, sex, education level, and income level, Kadazan- Dusun adults were most likely to consume dietary supplements (adjusted odds ratio = 2.369, 95% CI: 1.070 - 5.248, p=0.034).
Conclusion: There was an increase in the number of adults consuming dietary supplements during the COVID-19 pandemic, which was likely driven by information sharing via family members and social media.
Key words: COVID-19, dietary supplement, minerals, vitamins
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Introduction: During the coronavirus 2019 (COVID-19) pandemic, the public may seek a non-pharmacological approach, such as dietary supplements, to prevent or manage COVID-19. Therefore, this study aimed to evaluate the use of dietary supplements during the COVID-19 pandemic among adults in Kota Kinabalu.
Methods: This cross-sectional study recruited 213 adults living in Kota Kinabalu through convenient sampling from October 2021 to March 2022. A validated questionnaire was used to evaluate their perception on the use of dietary supplements, and the types of dietary supplements consumed before and during the COVID-19 pandemic.
Results: One-hundred sixty-one (75.6%) adults reported that they were told to consume dietary supplements during the COVID-19 pandemic, primarily from close family members (64.0%) and social media (58.4%). One-hundred and thirty-two (62%) adults were consuming dietary supplements and 46 (34.8%) of them only started taking them during the COVID-19 pandemic. The reasons for taking dietary supplements during the COVID-19 pandemic included enhancing the immune system (83.6%) and for prevention of COVID-19 infection (64.4%). The most common dietary supplements consumed during the COVID-19 pandemic were vitamin C (90.2%), followed by multi-vitamin and mineral (32.6%), and fish oil (25.8%). After adjusting for age, sex, education level, and income level, Kadazan- Dusun adults were most likely to consume dietary supplements (adjusted odds ratio = 2.369, 95% CI: 1.070 - 5.248, p=0.034).
Conclusion: There was an increase in the number of adults consuming dietary supplements during the COVID-19 pandemic, which was likely driven by information sharing via family members and social media.
Key words: COVID-19, dietary supplement, minerals, vitamins
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Binge eating disorder and food addiction occurrences
among adult Jordanian women with obesity
Zainab Zueter & Rima Hussein Mashal
https://doi.org/10.31246/mjn-2022-0073
ABSTRACT
Introduction: The aim of the study was to estimate the occurrences of binge eating disorder (BED) and food addiction (FA) in Jordanian women with obesity and to explore their relationships with selected potential risk factors for obesity.
Methods: A descriptive case series design that involved a total of 842 women with obesity was conducted. The occurrences of BED and FA were evaluated using the Questionnaire on Eating and Weight Patterns-5 (QEWP-5) and Yale Food Addiction Scale 2.0 (YFAS 2.0).
Results: The overlapping of BED and FA (BED+FA) was the most frequent category constituting 53.7%. The second highest category was BED comprising 25.0%, followed by FA comprising 9.0%. Body mass index (BMI) and waist circumference (WC) were significantly higher in the BED+FA group as compared to all other groups. The FA group (41.3%) had significantly the lowest level of sleeping hours. BED (58.0%) and BED+FA (66.1%) groups were significantly higher in consuming more than three snacks per day. BED and/or FA-free group had significantly higher level of water intake of >5 cups/day.
Conclusion: The frequencies of BED and FA were relatively high among obese Jordanian women. The study demonstrated an overlap between BED and FA, highlighting its associations with increased BMI and WC in a selected sample of obese women. The study suggested that BED, FA, and the overlapping of both conditions were associated with greater tendencies towards an unhealthy pattern of eating practices, fluid intake, and sleeping habits.
Key words: binge eating disorder, food addiction, obesity, women
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Introduction: The aim of the study was to estimate the occurrences of binge eating disorder (BED) and food addiction (FA) in Jordanian women with obesity and to explore their relationships with selected potential risk factors for obesity.
Methods: A descriptive case series design that involved a total of 842 women with obesity was conducted. The occurrences of BED and FA were evaluated using the Questionnaire on Eating and Weight Patterns-5 (QEWP-5) and Yale Food Addiction Scale 2.0 (YFAS 2.0).
Results: The overlapping of BED and FA (BED+FA) was the most frequent category constituting 53.7%. The second highest category was BED comprising 25.0%, followed by FA comprising 9.0%. Body mass index (BMI) and waist circumference (WC) were significantly higher in the BED+FA group as compared to all other groups. The FA group (41.3%) had significantly the lowest level of sleeping hours. BED (58.0%) and BED+FA (66.1%) groups were significantly higher in consuming more than three snacks per day. BED and/or FA-free group had significantly higher level of water intake of >5 cups/day.
Conclusion: The frequencies of BED and FA were relatively high among obese Jordanian women. The study demonstrated an overlap between BED and FA, highlighting its associations with increased BMI and WC in a selected sample of obese women. The study suggested that BED, FA, and the overlapping of both conditions were associated with greater tendencies towards an unhealthy pattern of eating practices, fluid intake, and sleeping habits.
Key words: binge eating disorder, food addiction, obesity, women
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The influence of perceived value and gender on local
food consumption intentions in the northeastern
cluster of Thailand
Meesubthong Chatcharawan, Meesuptong Jaruporn & Udomsamuthirun
Pongkaew
https://doi.org/10.31246/mjn-2022-0051
ABSTRACT
Introduction: Local food, which represents a country’s culture, can be gradually forgotten due to various factors. This study investigated the perceived value of local food and the influence of gender on consumer behaviour regarding the intention to eat local food.
Methods: A quantitative survey was conducted using random systematic sampling at a fixed periodic interval. A sample of 2,000 consumers from Thailand’s upper northeastern region was chosen. Structural equation modelling was used to assess the relationships between perceived value, attitude towards eating, and intention to eat.
Results: The relevant parameters identified the positive influence of perceived value and attitude towards eating behaviour on the intention to eat local food. The factor loading of attitude towards eating behaviour moderated the effect of the perceived value of local food on the intention to eat local food. Females had less perceived value for their intention to eat local food than males did.
Conclusion: The perceived value of local food had the greatest positive impact on attitude towards eating behaviour. Moreover, the difference in gender in the eating behaviour of local food showed that females were more likely to control their food consumption than males were. To increase the intention to eat local food, local food vendors should focus on factors that influence attitudes and use food storytelling to increase consumers’ awareness on the benefits of local food.
Key words: food consumption, gender, intention, local food, perceived value
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Introduction: Local food, which represents a country’s culture, can be gradually forgotten due to various factors. This study investigated the perceived value of local food and the influence of gender on consumer behaviour regarding the intention to eat local food.
Methods: A quantitative survey was conducted using random systematic sampling at a fixed periodic interval. A sample of 2,000 consumers from Thailand’s upper northeastern region was chosen. Structural equation modelling was used to assess the relationships between perceived value, attitude towards eating, and intention to eat.
Results: The relevant parameters identified the positive influence of perceived value and attitude towards eating behaviour on the intention to eat local food. The factor loading of attitude towards eating behaviour moderated the effect of the perceived value of local food on the intention to eat local food. Females had less perceived value for their intention to eat local food than males did.
Conclusion: The perceived value of local food had the greatest positive impact on attitude towards eating behaviour. Moreover, the difference in gender in the eating behaviour of local food showed that females were more likely to control their food consumption than males were. To increase the intention to eat local food, local food vendors should focus on factors that influence attitudes and use food storytelling to increase consumers’ awareness on the benefits of local food.
Key words: food consumption, gender, intention, local food, perceived value
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Effect of zinc and probiotics supplementation on IL-6
and tissue neutrophil levels in rats exposed to cigarette
smoke
Putu Gita Andryani, Endang Mahati, Kusmiyati Tjahjono, Yan Wisnu
Prajoko, Neni Susilaningsih & Hermawan Istiadi
https://doi.org/10.31246/mjn-2022-0116
ABSTRACT
Introduction: Cigarette smoke exposure can cause inflammation, inducing the release of acute phase cytokines, such as IL-6, that will then trigger the recruitment of neutrophils, which are mostly phagocytic cells. Zinc and probiotics are known to have beneficial effects against inflammation. This study was conducted to investigate the effect of zinc and probiotics supplementation on IL-6 and tissue neutrophil levels in rats exposed to cigarette smoke.
Methods: In a randomised, experimental study with post-test control group design, thirty 2 to 3-month-old male Wistar rats, each weighing 180-220 g, were divided into five groups: control group without treatment (C); exposed to cigarette smoke [C (-)]; exposed to cigarette smoke and received zinc (Z); exposed to cigarette smoke and received probiotics (P); and exposed to cigarette smoke and received a combination of zinc and probiotics (ZP).
Results: Mean tissue neutrophil levels in Z, P, and ZP groups were 43.43±2.01, 34.67±1.32, and 29.77±5.05 cells, respectively. There were significant differences between supplementation intake and tissue neutrophil levels in each group compared to C (-) group (p<0.05). Meanwhile, only IL-6 level in the ZP group (6.02 pg/mL) decreased significantly compared to C (-) group (10.61 pg/mL).
Conclusion: These results suggest that a combination of zinc and probiotics have an anti-inflammatory effect as measured by IL-6 and neutrophil levels.
Key words: cigarette smoke, IL-6, neutrophils, probiotics, zinc
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Introduction: Cigarette smoke exposure can cause inflammation, inducing the release of acute phase cytokines, such as IL-6, that will then trigger the recruitment of neutrophils, which are mostly phagocytic cells. Zinc and probiotics are known to have beneficial effects against inflammation. This study was conducted to investigate the effect of zinc and probiotics supplementation on IL-6 and tissue neutrophil levels in rats exposed to cigarette smoke.
Methods: In a randomised, experimental study with post-test control group design, thirty 2 to 3-month-old male Wistar rats, each weighing 180-220 g, were divided into five groups: control group without treatment (C); exposed to cigarette smoke [C (-)]; exposed to cigarette smoke and received zinc (Z); exposed to cigarette smoke and received probiotics (P); and exposed to cigarette smoke and received a combination of zinc and probiotics (ZP).
Results: Mean tissue neutrophil levels in Z, P, and ZP groups were 43.43±2.01, 34.67±1.32, and 29.77±5.05 cells, respectively. There were significant differences between supplementation intake and tissue neutrophil levels in each group compared to C (-) group (p<0.05). Meanwhile, only IL-6 level in the ZP group (6.02 pg/mL) decreased significantly compared to C (-) group (10.61 pg/mL).
Conclusion: These results suggest that a combination of zinc and probiotics have an anti-inflammatory effect as measured by IL-6 and neutrophil levels.
Key words: cigarette smoke, IL-6, neutrophils, probiotics, zinc
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Assessment of skipping breakfast at home among
adolescent school students in Badia Region, Jordan
Amani Masalha, Mohammad S ALBashtawy, Mohammad N Alshloul, Nisren
Abu Baker, Shereen Hamadneh, Abdullah Alkhawaldeh, Mohammed S
Alyahya, Ma’en Aljezawi, Asem Abdalrahim, Mohammad Suliman & Doha M
Alshloul
https://doi.org/10.31246/mjn-2022-0121
ABSTRACT
Introduction: Healthy meals play an essential role in the healthy physical and mental development of adolescents. Breakfast at home is associated with improved nutritional choices, and skipping breakfast is detrimental. This study assessed prevalence of skipping breakfast at home among adolescent students in the Badia Region of Jordan, identifying the reasons and characteristics associated with such behavioural choice.
Methods: A cross-sectional survey among adolescent students (aged 13-16 years, in 8th-9th grades) from six public schools in Badia Region, Mafraq Governorate, Jordan, was conducted through self-administered questionnaire from February to March 2022.
Results: Results showed that 68.1% of 552 student participants regularly skipped breakfast at home (72.4% boys vs. 61.3% girls; p=0.007). Among those who regularly skipped breakfast, three main rationales for this choice were not feeling hungry (5.3%), lack of time (2.7%), and lack of appetite (3.5%).
Conclusion: The prevalence of skipping breakfast at home among adolescents in Badia Region was high for various reasons, including lack of time, not feeling hungry, seeking to manage weight, and insufficient knowledge on the importance of healthy breakfast. Therefore, understanding the reasons and factors that contribute towards breakfast skipping may help in solving the problem, underscoring that positive beliefs should be reinforced in schools, with parents encouraging adolescents to eat healthy breakfast.
Key words: adolescence, Badia region, breakfast consumption, Jordan, skipping breakfast
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Introduction: Healthy meals play an essential role in the healthy physical and mental development of adolescents. Breakfast at home is associated with improved nutritional choices, and skipping breakfast is detrimental. This study assessed prevalence of skipping breakfast at home among adolescent students in the Badia Region of Jordan, identifying the reasons and characteristics associated with such behavioural choice.
Methods: A cross-sectional survey among adolescent students (aged 13-16 years, in 8th-9th grades) from six public schools in Badia Region, Mafraq Governorate, Jordan, was conducted through self-administered questionnaire from February to March 2022.
Results: Results showed that 68.1% of 552 student participants regularly skipped breakfast at home (72.4% boys vs. 61.3% girls; p=0.007). Among those who regularly skipped breakfast, three main rationales for this choice were not feeling hungry (5.3%), lack of time (2.7%), and lack of appetite (3.5%).
Conclusion: The prevalence of skipping breakfast at home among adolescents in Badia Region was high for various reasons, including lack of time, not feeling hungry, seeking to manage weight, and insufficient knowledge on the importance of healthy breakfast. Therefore, understanding the reasons and factors that contribute towards breakfast skipping may help in solving the problem, underscoring that positive beliefs should be reinforced in schools, with parents encouraging adolescents to eat healthy breakfast.
Key words: adolescence, Badia region, breakfast consumption, Jordan, skipping breakfast
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Acceptance and effectiveness of the Healthier Choice
Logo (HCL) among food industries in Malaysia
Fatimah Sulong, Nazli Suhardi Ibrahim, Nursyukrina Muhamad Norrahim,
Laila Hawariy Abd Aziz, Nur Izzati Aina Ahmad Zawawi & Norazmir Md Nor
https://doi.org/10.31246/mjn-2022-0137
ABSTRACT
Introduction: The Healthier Choice Logo (HCL) was introduced in 2017 by the Ministry of Health Malaysia. This paper analysed acceptance of HCL, effectiveness of HCL in encouraging healthier product reformulation, and factors affecting reformulation among food industries.
Methods: An online self-administered questionnaire consisting of four sections utilising multiple choice and 5-point Likert scale questions was distributed to food industries in Malaysia. Sample size calculation yielded 100 respondents. R
Results: Food industries had a higher acceptance of the processes and requirements involved in HCL implementation. HCL was highly effective in encouraging product reformulation among food industries in Malaysia. Meeting consumer demand, improving brand image, public health, more awareness around nutrition labelling, logo and national nutrition target, more technical knowledge and budget were found to motivate healthier product reformulation. However, product suitability, consumer acceptability, difficulties maintaining taste and shelf life, and limited budget were the challenges faced in product reformulation. There was no correlation between HCL acceptance and factors encouraging or inhibiting reformulation.
Conclusion: These findings are expected to help relevant authorities or stakeholders make changes, if necessary, towards processes and requirements involved in HCL application to ensure wider HCL implementation. Future research should identify the relationship between HCL implementation and public health improvement among the Malaysian population.
Key words: consumer, food industries, food label, healthier choice logo
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Introduction: The Healthier Choice Logo (HCL) was introduced in 2017 by the Ministry of Health Malaysia. This paper analysed acceptance of HCL, effectiveness of HCL in encouraging healthier product reformulation, and factors affecting reformulation among food industries.
Methods: An online self-administered questionnaire consisting of four sections utilising multiple choice and 5-point Likert scale questions was distributed to food industries in Malaysia. Sample size calculation yielded 100 respondents. R
Results: Food industries had a higher acceptance of the processes and requirements involved in HCL implementation. HCL was highly effective in encouraging product reformulation among food industries in Malaysia. Meeting consumer demand, improving brand image, public health, more awareness around nutrition labelling, logo and national nutrition target, more technical knowledge and budget were found to motivate healthier product reformulation. However, product suitability, consumer acceptability, difficulties maintaining taste and shelf life, and limited budget were the challenges faced in product reformulation. There was no correlation between HCL acceptance and factors encouraging or inhibiting reformulation.
Conclusion: These findings are expected to help relevant authorities or stakeholders make changes, if necessary, towards processes and requirements involved in HCL application to ensure wider HCL implementation. Future research should identify the relationship between HCL implementation and public health improvement among the Malaysian population.
Key words: consumer, food industries, food label, healthier choice logo
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