Mohd Nasir Mohd Taib

Food insecurity and the metabolic syndrome among women from low income communities in Malaysia

This cross-sectional study examined the relationship between household food insecurity and the metabolic syndrome (MetS) among reproductive-aged women (n=625) in low income communities. The Radimer/Cornell Hunger and Food Insecurity instrument was utilized to assess food insecurity. Anthropometry, diet diversity, blood pressure and fasting venous blood for lipid and glucose profile were also obtained. MetS was defined as having at least 3 risk factors and is in accordance with the Harmonized criteria. The prevalence of food insecurity and MetS was 78.4% (household food insecure, 26.7%; individual food insecure, 25.3%; child hunger, 26.4%) and 25.6%, respectively. While more food secure than food insecure women had elevated glucose (food secure, 54.8% vs food insecure, 37.3-46.1%), total cholesterol (food secure, 54.1% vs food insecure, 32.1-40.7%) and LDL-cholesterol (food secure, 63.7% vs food insecure, 40.6-48.7%), the percentage of women with overweight/ obesity, abdominal obesity, hypertension, high triglyceride, low HDL-cholesterol and MetS did not vary significantly by food insecurity status. However, after controlling for demographic and socioeconomic covariates, women in food insecure households were less likely to have MetS (individual food insecure and child hunger) (p<0.05), abdominal obesity (individual food insecure and child hunger) (p<0.01), elevated glucose (household food insecure), total cholesterol (child hunger) (p<0.05) and LDL-cholesterol (household food insecure and child hunger) (p<0.05) compared to food secure women. Efforts to improve food insecurity of low income households undergoing nutrition transition should address availability and accessibility to healthy food choices and nutrition education that could reduce the risk of diet-related chronic diseases.

The effect of high lactose–isomaltulose on cognitive performance of young children. A double blind cross-over design study☆

Changes in blood glucose are hypothesized to influence cognitive performance and these changes can be affected by certain nutrients. This double-blind 4-period cross-over study evaluated the effects of a slow-release modified sucrose (isomaltulose) in combination with a high concentration of lactose on cognitive performance of 5-6 year old children. Thirty children received a standard growing upmilk (Std GUM), reformulated growing up milk (Reform GUM), standard growing up milk with lactose-isomaltulose (Iso GUM), and a standard glucose drink (Glucose). The CDR System, a computerised cognitive assessment system, was used to assess various measures of attention and memory of the children at baseline (T=0), 60 (T=1), 120 (T=2), and 180 (T=3) minutes following the intake of test products. Overall, there was a decline in performance over the morning on almost every cognitive task. Children showed better attention following consumption of Iso GUM compared to Std GUM but attention was not significantly different than Reform GUM and glucose. Also, Iso GUM conferred a beneficial effect over both Reform GUM and glucose on sensitivity index of numeric working memory with no difference observed between Iso GUM and Std GUM. Surprisingly, glucose group showed lowest decline in the sensitivity index of spatial working memory and highest speed in picture recognition, although the latter was significantly better than Reform GUM only. For speed of spatial working memory, Reform GUM had the lowest decline but was significantly different only with Std GUM. There was, however, no significant difference among conditions for continuity of attention, speed of numeric working memory and picture recognition sensitivity. Despite the small sample size, the findings are intriguing as carbohydrate composition seems to influence some aspects of cognitive performance such as attention and memory. However, further studies are needed to confirm these findings.

Eating Behaviour, Body Image, and Self-Esteem of Adolescent Girls in Malaysia

This cross-sectional study was undertaken with 489 secondary school girls, ages 15–17 years, to examine disordered eating behaviours of adolescent girls in Malaysia and to estimate associations with body weight, body-size discrepancy, and self-esteem. Dietary restraint, binge eating, body image, and self-esteem were assessed using the Restrained Eating scale of the Dutch Eating Behaviour Questionnaire, the Binge Scale Questionnaire, the Contour Drawing Rating Scale, and the Rosenberg Self-Esteem Scale, respectively. Pearson correlations estimated associations between variables. There were 3.1% underweight, 9.8% at risk of being overweight, and 8.6% overweight girls. A total of 87.3% were dissatisfied with their own body size. Dietary restraint and binge eating were reported by 36.0% and 35.4%, respectively. Body Mass Index (r = .34, p < .01) and body-size dissatisfaction (r = .24, p < .01) were significantly associated with dietary restraint and binge eating, but self-esteem (r = −.20, p < .001) was significantly associated only with binge eating.

Development of multi-dimensional body image scale for malaysian female adolescents

The present study was conducted to develop a Multi-dimensional Body Image Scale for Malaysian female adolescents. Data were collected among 328 female adolescents from a secondary school in Kuantan district, state of Pahang, Malaysia by using a self-administered questionnaire and anthropometric measurements. The self-administered questionnaire comprised multiple measures of body image, Eating Attitude Test (EAT-26; Garner & Garfinkel, 1979) and Rosenberg Self-esteem Inventory (Rosenberg, 1965). The 152 items from selected multiple measures of body image were examined through factor analysis and for internal consistency. Correlations between Multi-dimensional Body Image Scale and body mass index (BMI), risk of eating disorders and self-esteem were assessed for construct validity. A seven factor model of a 62-item Multi-dimensional Body Image Scale for Malaysian female adolescents with construct validity and good internal consistency was developed. The scale encompasses 1) preoccupation with thinness and dieting behavior, 2) appearance and body satisfaction, 3) body importance, 4) muscle increasing behavior, 5) extreme dieting behavior, 6) appearance importance, and 7) perception of size and shape dimensions. Besides, a multidimensional body image composite score was proposed to screen negative body image risk in female adolescents. The result found body image was correlated with BMI, risk of eating disorders and self-esteem in female adolescents. In short, the present study supports a multi-dimensional concept for body image and provides a new insight into its multi-dimensionality in Malaysian female adolescents with preliminary validity and reliability of the scale. The Multi-dimensional Body Image Scale can be used to identify female adolescents who are potentially at risk of developing body image disturbance through future intervention programs.

Dietary factors as the major determinants of overweight and obesity among Iranian adolescents. A cross-sectional study ☆

This study investigated the determinants of overweight/obesity in adolescents. A cross-sectional survey was carried out on 1157 adolescents. Weight and height were measured. Information on socio-economic status (SES), dietary intakes, physical activity, and sedentary behaviours were collected by a self-administered questionnaire. Binary and multivariate binary logistic regressions were used to obtain the relationships and odds-ratios, respectively. The prevalence of overweight and obesity was higher among adolescents in low- or high-income families, adolescents whose mothers worked out of home, adolescents whose parents were both overweight, adolescents who watched a lot of TV or had excessive energy intake, adolescents with lower physical activity or lower intake of dietary fibre, those who skipped breakfast ≥ 4 times per week, and those with low and high fat intake. However, multiple logistic regression analysis showed that only energy intake was associated with increased odds and vegetables and fibre intake were associated with a reduction in the odds of being overweight (all p<0.05). Adolescents from middle SES showed a lower risk of overweight/obesity than low and high SES due to better dietary intakes and less sedentary behaviours. Therefore, in overweight/obesity prevention programs, adolescents with determined risk factors from families with low and high SES should receive attention.

Validation of the Malaysian Coping Strategy Instrument to measure household food insecurity in Kelantan, Malaysia.

Background Food insecurity occurs whenever people are not able to access enough food at all times for an active and healthy life or when adequate and safe food acquired by socially acceptable ways is not available. Objective To validate the Malaysian Coping Strategy Instrument (MCSI) to measure household food insecurity in Kelantan, Malaysia. Methods A cross-sectional study was conducted on 301 nonpregnant, nonlactating Malay women, aged between 19 and 49 years, living in rural and urban areas. The respondents were interviewed with the use of a structured questionnaire to obtain information on their demographic and socioeconomic characteristics, household food security, and dietary intake. Results Demographic and socioeconomic characteristics (household size, number of children, number of children attending school, household income, and per capita income) were significantly associated with household food-security status in rural and urban areas. Energy intake, fat intake, percentage of energy from fat, and number of servings of meat, fish, or poultry and legumes were significantly associated with household food-security status in rural areas. The dietary diversity score was significantly associated with household food-security status in rural and urban areas. Conclusions Validating the MCSI in other areas of Malaysia as well as in similar settings elsewhere in the world before it is used to measure household food insecurity in the population is strongly recommended. In this study, the MCSI was found to be a reliable and valid measure of household food insecurity based on criterion-related validity, particularly in terms of demographic and socioeconomic characteristics and dietary diversity.

Stages of change to increase fruit and vegetable intake and its relationships with fruit and vegetable intake and related psychosocial factors

BACKGROUND/OBJECTIVES Understanding individuals intention, action and maintenance to increase fruit and vegetable intake is an initial step in designing nutrition or health promotion programs. This study aimed to determine stages of change to increase fruit and vegetable intake and its relationships with fruit and vegetable intake, self-efficacy, perceived benefits and perceived barriers. SUBJECTS/METHODS This cross-sectional study was conducted among 348 public university staff in Universiti Putra Malaysia. A pre-tested self-administered questionnaire and two days 24-hour diet recall were used. RESULTS Half of the respondents (50%) were in preparation stage, followed by 43% in action/maintenance, 7% in pre-contemplation/contemplation stages. Respondents in action/maintenance stages had significantly higher self-efficacy (F = 9.17, P < 0.001) and perceived benefits (F = 5.07, P < 0.01) while respondents in pre-contemplation/contemplation and preparation stages had significantly higher perceived barriers (F = 4.83, P < 0.05). Perceived benefits tend to outweigh perceived barriers pre-ceding to taking action. Self-efficacy is important in motivating individuals to increase fruit and vegetable intake as self-efficacy and perceived barriers crossed over between preparation and action/maintenance. Respondents in action/maintenance stages had the highest adjusted mean serving of fruit and vegetable intake (F = 4.52, P < 0.05) but the intake did not meet recommendation. CONCLUSION Intervention strategies should emphasize on increasing perceived benefits and building self-efficacy by providing knowledge and skills to consume a diet high in fruits and vegetables in order to promote healthy changes in having high fruit and vegetable intake.

School-based intervention to prevent overweight and disordered eating in secondary school Malaysian adolescents: a study protocol

BackgroundObesity, eating disorders and unhealthy weight-loss practices have been associated with diminished growth in adolescents worldwide. Interventions that address relevant behavioural dimensions have been lacking in Malaysia. This paper describes the protocol of an integrated health education intervention namely ‘Eat Right, Be Positive About Your Body and Live Actively’ (EPaL), a primary prevention which aimed to promote healthy lifestyle in preventing overweight and disordered eating among secondary school adolescents aged 13–14 years old.Methods/DesignFollowing quasi-experimental design, the intervention is conducted in two secondary schools located in the district of Hulu Langat, Selangor, Malaysia. Adolescents aged 13–14 years will be included in the study. A peer-education strategy is adopted to convey knowledge and teach skills relevant to achieving a healthy lifestyle. The intervention mainly promoted: healthy eating, positive body image and active lifestyle. The following parameters will be assessed: body weight, disordered eating status, stages of change (for healthy diet, breakfast, food portion size, screen viewing and physical activity), body image, health-related quality of life, self-esteem, eating and physical activity behaviours; and knowledge, attitude and practice towards a healthy lifestyle. Assessment will be conducted at three time points: baseline, post-intervention and 3-month follow-up.DiscussionIt is hypothesized that EPaL intervention will contribute in preventing overweight and disordered eating by giving the positive effects on body weight status, healthy lifestyle behaviour, as well as health-related quality of life of peer educators and participants. It may serve as a model for similar future interventions designed for the Malaysian community, specifically adolescents.Trial registrationUMIN Clinical Trial Registration UMIN000024349 (Date of registration: 11th. October 2016, retrospectively registered).

Body change techniques in Iranian adolescents. Relationship to sex and body weight status

OBJECTIVE Several studies indicated that techniques to change body weight and appearance were prevalent and different among adolescents. The aim of the study, therefore, was to assess differences in frequency and type of body change techniques used among adolescents by sex and body weight status. METHODS A sample of 758 adolescents aged 12-18 years were recruited from private and public schools in Tehran. Information about socio-demographic background and body change techniques were collected via a self-administered questionnaire. RESULTS A high percentage of adolescents used body change techniques frequently to alter their body appearance. Girls changed normal eating pattern significantly (p=0.007) to lose weight more frequently than boys while boys used this method significantly (p=0.01) to gain weight more frequently than girls. Overweight/obese adolescents exercised significantly to change muscle size (p=0.03) and changed normal diet to lose weight (p<0.001) more frequently than normal weight adolescents. The relation between sex and body weight status with body change techniques (p<0.0) implied that male and female adolescents especially overweight/obese adolescents were frequently trying to change their body appearance. CONCLUSION Significant differences existed in using body change techniques according to sex and body weight status and these should be considered in obesity prevention programs for adolescents.

Nutritional Status of Adolescents Attending the Iranian Secondary School in Kuala Lumpur, Malaysia

Introduction: The aim or this study was to determine factors associated with body weight status among Iranian adolescents in the two Secondary Schools run by the Embassy in Kuala Lumpur. Methods: A self administered questionnaire was used to assess socio demographic characteristics, physical activity, and body image. Dietary intake was recorded through individual interviews with the researcher. The Physical Activity Questionnaire for children (PAQ-C) was used to evaluate levels of physical activity of the adolescents. Results: One-third (32.2%) of respondents were of normal weight, 14.5% and 11.1% were overweight and obese respectively, while 18.6% and 23.6% were severe thinness and thinness respectively. While the distribution of obese respondents by gender was almost the same, overweight females (16.4%) exceeded overweight males (12.7%) and although more females were in the thinness category (24.7% compared to 22.7%), more males were severely thin (20.0%) compared to 17.1% of the females. Body weight status was significantly associated with age (p < 0.05), gender (p < 0.05) and grade (p < 0.05). Males had significantly higher physically activity scores than females (p < 0.05). Intake of all micronutrients were higher than Dietary Reference Intake (DRI), except for vitamins B1, B2, C, D and E, Folate, Zinc, Magnesium, Potassium, Calcium and Phosphorus. There was a tendency for the females to overestimate their weight and 72.6% of them expressed their desire to lose weight while 60% of the males wanted to gain weight. There was also significant association between body weight status and perception of ideal body size (p = 0.000) and healthy body size (p = 0.000). Conclusion: This study provides some information for the Iranian Secondary school to design intervention programs to improve the body weight status of their students.