Mohd Taib Mohd Nasir

Child feeding practices, food habits, anthropometric indicators and cognitive performance among preschoolers in Peninsular Malaysia ☆

This study aimed to determine the relationship between child feeding practices, food habits, and anthropometric indicators with cognitive performance of preschoolers aged 4-6 years in Peninsular Malaysia (n=1933). Parents were interviewed on socio-demographic background, nutrition knowledge, child feeding practices and food habits. Height and weight of the preschoolers were measured; BMI-for-age, weight-for-age and height-for-age were determined. Cognitive performance was assessed using Ravens Colored Progressive Matrices. The mean monthly household income was RM3610 and 59.6% of parents attained secondary education. Thirty-three percent of parents had good knowledge on nutrition, 39% satisfactory and 28% poor. For child feeding practices, perceived responsibility had the highest mean score (M=3.99, SD=0.72), while perceived child weight had the lowest (M=2.94, SD=0.38). The prevalence of possible risk of overweight, being overweight, and obesity were 3.9%, 7.9% and 8.1%, respectively, whereas the prevalence of underweight and stunting were 8.0% and 8.4%, respectively. Breakfast was the second most frequently skipped meal (16.8%) after dinner (18.1%). The mean cognitive score was 103.5 (SD=14.4). Height-for-age and consumption of dinner were found to contribute significantly towards cognitive performance after controlling for socio-demographic background and parents nutrition knowledge.

Direct and indirect effects of sociocultural influences on disordered eating among Malaysian male and female university students. A mediation analysis of psychological distress.

This study aimed to examine the role of psychological distress in the relationships between sociocultural influences (social pressure to be thin and weight teasing) and disordered eating. Data were collected from 584 university students (59.4% females and 40.6% males), aged 18-24 years old (M=20.6, SD=1.4), selected from four universities in the Klang Valley, Malaysia. Participants completed four standardized questionnaires which measured social pressure to be thin, weight-related teasing, psychological distress and disordered eating. A good fit structural equation modeling (SEM) model was developed for both sexes. For males, the SEM model revealed that sociocultural influences showed an indirect effect on disordered eating through psychological distress. For females, the model showed an indirect effect of sociocultural influences on disordered eating through psychological distress, as well as a direct effect of sociocultural influences on disordered eating. In conclusion, psychological distress mediated the relationships between sociocultural influences and disordered eating in both males and females. Our results suggest that disordered eating intervention programs on reducing psychological distress in university students may be beneficial.

Nutritional supplement use among fitness club participants in Tehran, Iran

The aim of this study was to assess nutritional supplement use among fitness club participants in Tehran, Iran. A cross sectional study was conducted in 24 fitness clubs throughout the city of Tehran, Iran. A total of 1625 fitness club participants were recruited to participate in this study. They were asked to complete a self-administered pre-tested questionnaire. Descriptive statistics and chi-square test were performed to determine the characteristics of participants, reasons for supplement use, sources of information and also the influential advisors regarding nutritional supplement use. A high prevalence rate of nutritional supplement use (66.7%) was reported. Overall, multivitamin-mineral (43.8%) and iron tablets (30.5%) were the common nutritional supplements used and only a small number of participants used illegal substances (0.5%). Younger participants were more likely to use ergogenic aids, whereas, older participants were more likely to use vitamin D. Males were more likely than females to use creatine and amino acids, whereas, iron tablets and mint water were more common among females. Also, males were more likely to use nutritional supplements for increasing energy, whereas, females were more likely to use nutritional supplements for nutritional deficiencies. In conclusion, a high prevalence rate of nutritional supplement use was seen among participants.

Psychological distress as a mediator in the relationships between biopsychosocial factors and disordered eating among Malaysian university students

The mechanism linking biopsychosocial factors to disordered eating among university students is not well understood especially among Malaysians. This study aimed to examine the mediating role of psychological distress in the relationships between biopsychosocial factors and disordered eating among Malaysian university students. A self-administered questionnaire measured self-esteem, body image, social pressures to be thin, weight-related teasing, psychological distress, and disordered eating in 584 university students (59.4% females and 40.6% males). Body weight and height were measured. Structural equation modeling analysis revealed that the partial mediation model provided good fit to the data. Specifically, the relationships between self-esteem and weight-related teasing with disordered eating were mediated by psychological distress. In contrast, only direct relationships between body weight status, body image, and social pressures to be thin with disordered eating were found and were not mediated by psychological distress. Furthermore, multigroup analyses indicated that the model was equivalent for both genders but not for ethnic groups. There was a negative relationship between body weight status and psychological distress for Chinese students, whereas this was not the case among Malay students. Intervention and prevention programs on psychological distress may be beneficial in reducing disordered eating among Malaysian university students.

Adolescent self-report and parent proxy-report of health-related quality of life: an analysis of validity and reliability of PedsQL™ 4.0 among a sample of Malaysian adolescents and their parents

BackgroundThe Pediatric Quality of Life Inventory™ Generic Core Scales (PedsQL™) 4.0 is a generalized assessment of health-related quality of life (HRQoL) based on adolescent self-report and parent proxy-report. This study aims to determine the construct validity and reliability of PedsQL™ 4.0 among a sample of Malaysian adolescents and parents.MethodsA cross-sectional study was carried out at three selected public schools in the state of Selangor. A total of 379 Malaysian adolescents completed the PedsQL™ 4.0 adolescent self-report and 218 (55.9%) parents completed the PedsQL™ 4.0 parent proxy-report. Weight and height of adolescents were measured and BMI-for-age by sex was used to determine their body weight status.ResultsThere were 50.8% male and 49.2% female adolescents who participated in this study (14.25 ± 1.23 years). The prevalence of overweight and obesity (25.8%) was four times higher than the prevalence of severe thinness and thinness (6.1%). Construct validity was analyzed using Confirmatory Factor Analysis (CFA). Based on CFA, adolescent self-report and parent proxy-report met the criteria of convergent validity (factor loading > 0.5, Average Variance Extracted (AVE) > 0.5, Construct Reliability > 0.7) and showed good fit to the data. The adolescent self-report and parent proxy-report exhibited discriminant validity as the AVE values were larger than the R2 values. Cronbach’s alpha coefficients of the adolescent self-report (α = 0.862) and parent proxy-report (α = 0.922) showed these instruments are reliable. Parents perceived the HRQoL of adolescents was poorer compared to the perception of the adolescent themselves (t = 5.92, p < 0.01). There was no significant difference in total HRQoL score between male and female adolescents (t = 0.858, p > 0.05). Parent proxy-report was negatively associated with the adolescents’ BMI-for-age (r = -0.152, p < 0.05) whereas no significant association was found between adolescent self-report and BMI-for-age (r = 0.001, p > 0.05).ConclusionAdolescent self-report and parent proxy-report of the PedsQL™ 4.0 are valid and reliable to assess HRQoL of Malaysian adolescents. Future studies are recommended to use both adolescent self-report and parent-proxy report of HRQoL as adolescents and parents can provide different perspectives on HRQoL of adolescents.

Breakfast consumption among Malaysian primary and secondary school children and relationship with body weight status - Findings from the MyBreakfast Study

BACKGROUND AND OBJECTIVES This study aimed to determine the relationship between breakfast consumption and body weight status among primary and secondary school children in Malaysia. METHODS AND STUDY DESIGN This nationwide cross-sectional study involved 5,332 primary school children aged 6 to 12 years and 3,000 secondary school children aged 13 to 17 years. Height and weight were measured and BMI-for-age was determined. Socio-demographic backgrounds, breakfast habits and physical activity levels were assessed using questionnaires. Breakfast frequency was defined as follows: breakfast skippers (ate breakfast 0-2 days/week), irregular breakfast eaters (ate breakfast 3-4 days/week) and regular breakfast eaters (ate breakfast ≥5 days/week). RESULTS The overall prevalence of breakfast skippers and irregular breakfast eaters was 11.7% and 12.7% respectively. Breakfast skipping was related to age, sex, ethnicity, income and physical activity level. Among primary school boys and secondary school girls, the proportion of overweight/obesity was higher among breakfast skippers (boys: 43.9%, girls: 30.5%) than regular breakfast eaters (boys: 31.2%, girls: 22.7%). Among primary school children, only boys who skipped breakfast had a higher mean BMI-for-age z-score than regular breakfast eaters. Among secondary school boys and girls, BMI-for-age z-score was higher among breakfast skippers than regular breakfast eaters. Compared to regular breakfast eaters, primary school boys who skipped breakfast were 1.71 times (95% CI=1.26-2.32, p=0.001) more likely to be overweight/obese, while the risk was lower in primary school girls (OR=1.36, 95% CI=1.02-1.81, p=0.039) and secondary school girls (OR=1.38, 95% CI=1.01-1.90, p=0.044). CONCLUSION Regular breakfast consumption was associated with a healthier body weight status and is a dietary behaviour which should be encouraged.

Association between behavioural factors and BMI-for-age among early adolescents in Hulu Langat district, Selangor, Malaysia

OBJECTIVE This paper investigates the association between behavioural factors and BMI-for-age among early adolescents (10-11 years old) in Hulu Langat district, Selangor. METHODS This cross-sectional study was conducted among 333 primary school students. Body weight and height of the students were measured and their BMI-for-age was calculated. Eating behaviours, energy intake, energy expenditure, physical activity, and screen time were assessed using the Eating Behaviours Questionnaire and a 2-day dietary and physical activity recall, respectively. Data were analysed using multiple linear regression analysis. RESULTS The prevalence of overweight and obesity (28.2%) was about twice the prevalence of thinness (11.1%). The mean energy intake and energy expenditure of the students was 1772±441kcal/day and 1705±331kcal/day, respectively. Three in five of the students (60.1%) skipped at least one meal and 98.2% snacked between meals daily. A majority of them (55.3%) were sedentary. Low energy intake (p<0.05) and low energy expenditure (p<0.05) were associated with high BMI-for-age. Energy expenditure (β=-0.033) and energy intake (β=-0.090) significantly explained 65.1% of the variances in BMI-for-age (F=119.170, p<0.05). CONCLUSION These findings suggested that promoting healthy eating and active lifestyle should be targeted in the prevention and management of obesity among early adolescents.

Effectiveness of physical activity intervention among government employees with metabolic syndrome

Background/Objective Our study aimed to assess the effects of physical activity interventions via standing banners (point-of-decision prompt) and aerobics classes to promote physical activity among individuals with metabolic syndrome. Methods We conducted a cluster randomized controlled intervention trial (16-week intervention and 8-week follow-up). Malaysian government employees in Putrajaya, Malaysia, with metabolic syndrome were randomly assigned by cluster to a point-of-decision prompt group (n = 44), an aerobics group (n = 42) or a control group (n = 103) based on sample size calculation formula. Step counts were evaluated by Lifecorder e-STEP accelerometers for all participants. Metabolic syndrome was defined according to the ‘harmonizing’ definition, in which individuals who have at least three of the five metabolic risk factors (waist circumference, high-density lipoprotein cholesterol, triglycerides, fasting glucose levels, systolic and diastolic blood pressure) will be classified as having metabolic syndrome. A total of 80% of the enrolled government employees with metabolic syndrome completed the programme. Data were analyzed using SPSS for Windows (version 20, SPSS, Chicago, IL). Results There were significantly higher step counts on average in the aerobics group compared to the control group over assessments. Assessments at baseline, post-intervention and follow-up showed a significant difference in step counts between the intervention and control groups. The greatest reductions in the proportions of individuals with metabolic syndrome were observed in the aerobics group with a reduction of 79.4% in the post-intervention assessment compared to the assessment at baseline. Conclusion The findings of this study suggest that physical activity intervention via aerobics classes is an effective strategy for improving step counts and reducing the prevalence of metabolic syndrome.

The Identification of the Factors Related to Household Food Insecurity among Indigenous People (Orang Asli) in Peninsular Malaysia under Traditional Food Systems

Over the course of 16 years, a high percentage of Orang Asli (OA) households in Malaysia has been found to be burdened with food insecurity. Therefore, a study was conducted to improve the understanding of the challenges faced by the OA in Peninsular Malaysia to achieve food security under traditional food systems. In this study, in-depth interview sessions, which were assisted by an interview protocol, were conducted with 61 OA women from nine villages that were selected purposefully across three states (Kelantan, Pahang, and Perak) in Peninsular Malaysia. Furthermore, thematic analysis was performed during data analysis. As a result, four themes were identified, namely (i) the failure in agriculture (sub-themes: threats from wild animals and insufficient land supply), (ii) ineffectiveness of traditional food-seeking activities (sub-themes: exhausting, tiring, dangerous, and time-consuming journey for food-seeking activities, depletion of natural commodities, reduced demands of natural commodities, and lack of equipment), (iii) weather (sub-themes: rainy and dry seasons), and (iv) water issues (subthemes: continuity of water supply and cleanliness of water). The identified modifiable factors of this issue should be incorporated into future schemes of food security intervention in order to efficiently manage the food shortage among the OA.

Psychological Factors and Cardiovascular Disease Risk Factors as Mediators of the Relationship between Overweight/Obesity and Cognitive Function among School Children in Kuala Lumpur, Malaysia

BACKGROUND Recent research suggests that a negative relationship exists between adiposity and cognitive function in children. However, limited information is known on how they are related. This study aimed to examine the mediators of the relationship between overweight/obesity and cognitive function among school children in Kuala Lumpur, Malaysia. METHODS This is a cross-sectional comparison study whereby 225 overweight/obese children matched for age, sex, and ethnicity with 225 normal weight children participated in this study. Body image dissatisfaction, disordered eating, and depressive symptoms were assessed through a self-administered questionnaire. Blood pressure was measured, whereas blood was drawn to determine insulin, high-sensitivity C-reactive protein (hs-CRP), glucose, and lipid profiles. Homeostasis model assessment-estimated insulin resistance (HOMA-IR) was calculated using glucose and insulin levels. Wechslers Intelligence Scale for Children-Fourth Edition (WISC-IV) was used to assess cognitive function in children. Ordinary least square regression analysis was conducted to determine the direct and indirect relationships between weight status and cognitive function. RESULTS A negative relationship was found between overweight/obesity with cognitive function. Overweight/obese children were on average 4.075 units lower in cognitive function scores compared to normal weight children. Such difference was found through mediators, such as body image dissatisfaction, disordered eating, depression, systolic blood pressure, triglycerides, HOMA-IR, and hs-CRP, contributing 22.2% of the variances in cognitive function in children. CONCLUSION Results highlight the important mediators of the relationship between overweight/obesity and cognitive function. Consequently, future interventions should target to improve psychological well-being and reduce cardiovascular disease risk for the prevention of poorer cognitive performance in overweight/obese children.