MJN 2020 Issues

Malaysian Journal of Nutrition (Mal J Nutr)

Volume 26 No.1, 2020


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Table of Content


EDITORIAL

Nutrition, Immunity and COVID-19
Hamid Jan B. Jan Mohamed & Tee E Siong Download PDF

Malaysian Food Barometer (MFB): a study of the impact of compressed modernisation on food habits
Jean-Pierre Poulain, Cyrille Laporte, Laurence Tibère, Elise Mognard, Neethianhantan Ari Ragavan, Anis Ashraf Zadeh & Ismail Mohd Noor

doi: https://doi.org/10.31246/mjn-2019-0042

ABSTRACT

Introduction: The Malaysian society is undergoing rapid modernisation. The emerging middle class in Malaysia is influencing the lifestyles and traditional food habits of the main three ethnics (i.e. Malays, Chinese, and Indians). This article studied the impact of compressed modernisation on food in a multicultural context. The Malaysian Food Barometer (MFB), published in the year 2014, focuses on the socio-cultural determinants of food habits in Malaysia.
Methods: The methods applied in the study were qualitative and quantitative surveys of the food barometers developed at the national level to study the transformation of eating habits. The surveys studied the socio-economic, demographic, and cultural determinants of food consumption, as well as identifying their possible influences on health issues.
Results: The results showed two major distinguishing characteristics of Malaysian food patterns, i.e. linking with Malaysia’s multi-ethnicity background and the high frequency of foods consumed outside of home by the urban population.
Conclusion: The article concluded that like many societies in transition, Malaysia has to face a rise in the prevalence of overweight. However, with its multicultural characteristics, it becomes a privileged empirical field of observation for the analysis of modernisation modalities of diet models among different ethnic groups.
Key words: Compressed modernity, eating out, social norms, meal, food cultures, food studies

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Understanding barriers towards the use of food labels among Saudi female college students
Al-Barqi R, Al-Salem Y, Mahrous L, Abu Abat E, Al-Quraishi R & Benajiba N

doi: https://doi.org/10.31246/mjn-2019-0117

ABSTRACT

Introduction: A food label is an important tool that provides nutritional information which influences consumers by promoting awareness on their diet and improving health status. This study aimed to assess nutrition knowledge level, food label usage, and the barriers that hinder the use of food labels among students in Health Colleges at the Princess Nourah Bint Abdulrahman University (PNU).
Methods: A cross-sectional study was conducted among Health College students at PNU in Riyadh (Saudi Arabia). A total of 572 participants were interviewed through a validated questionnaire on social demographic characteristics, nutrition knowledge level, food label use, and barriers that hinder food label use. Statistical analysis was performed using SPSS (version 21), with statistical significance set at p-value <0.05.
Results: Only 27.4% of the participants stated that they always or usually use food labels when purchasing food products. Majority of the participants (59.4%) had moderate nutrition knowledge. Factors significantly associated to food label use were nutrition knowledge (R2=0.21), attitude towards health value of the products (R2=0.35), and taste (R2=-0.22). About 41.0% of the participants indicated that time constraint was the main barrier for not using food labels, followed by no interest (31.3%), no need (27.8%), and difficult to use (24.8%).
Conclusion: This study found that food label use was low among the participants. Nutrition knowledge supported food label use while time constraint was the main barrier that hindered the use of food label among them. Raising students’ nutrition knowledge level through nutrition education programmes could promote food label use.
Key words: Food label use, female university students, barriers, Saudi Arabia

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The role of public health dietary messages and guidelines in tackling overweight and obesity issues
Yi Yi Lee, David Tan, José Siri, Barry Newell, Yi Gong, Katrina Proust & Terry Marsden

doi: https://doi.org/10.31246/mjn-2019-0084

ABSTRACT

Overweight and obesity in Malaysia pose serious threats to health. Prevalence has escalated to alarming levels in recent decades despite a multitude of public health dietary messages geared towards obesity prevention and health promotion. Gaps between health messages, messengers, and the public must be identified and closed to effectively combat obesity and overweight. This review article aims to examine public health dietary messages, guidelines, and programmes for the prevention of obesity in Malaysia, and explore potential reasons for the continued rise in its prevalence. Public health dietary communication in Malaysia has progressed and improved substantially over the years. However, most messages have been designed for the general audience, with little consideration of differences in physical, social, cultural, and environmental backgrounds, and varying levels of comprehension. We offer several recommendations to increase the effectiveness of public health dietary messages in fighting the obesity epidemic, based on a cross-sectoral, place-based approach that recognise the complexity of the underlying causes of obesity.
Key words: Public health dietary messaging; obesity; Malaysia; place-based approach; cross-sectoral approaches

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Development of a new questionnaire to assess childcare providers’ KAP regarding infant and young child feeding
Najihah Mahfuzah Zakria, Tengku Alina Tengku Ismail, Wan Nor Arifin Wan Mansor, Zaharah Sulaiman & Tengku Fatimatul Tengku Hassim

doi: https://doi.org/10.31246/mjn-2019-0113

ABSTRACT

Introduction: The integration of infant and young child feeding into childcare settings is important to the overall wellbeing of a community. To our knowledge, there is no questionnaire at the national context specifically on the knowledge, attitude and practice (KAP) of infant and young child feeding among childcare providers. Preexisting questionnaires are unsatisfactory due to different target populations and validation approaches. This study aims to develop a new questionnaire for assessing the KAP regarding infant and young child feeding among childcare providers in Malaysia.
Methods: A new questionnaire on childcare providers’ KAP was developed using literature review, expert opinions, and a theoretical framework. It was developed using a modified Delphi technique in five phases: 1. Identification of the domains, 2. Verification of the identified domains, 3. Definition of the domains, 4. Identification of relevant and representative items for each domain, and 5. Final verification of the domains and items, followed by a pre-survey evaluation.
Results: The final items were verified by experts with references to relevant literatures, other questionnaires, and experts’ experiences. A total of 236 items were selected after consideration of their relevancy and representativeness: 104, 90, 42 items addressing knowledge, attitude, and practice, respectively. The questionnaire was named Borang Kaji Selidik Pemakanan Bayi dan Kanak-kanak dalam kalangan Pengasuh, or IYCF-CCPQ.
Conclusion: The IYCF-CCPQ is a newly developed questionnaire to measure childcare providers’ KAP regarding infant and young child feeding.
Key words: KAP, infant feeding, childcare provider, questionnaire, development

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Determination of glycaemic response of a novel cane sugar product incorporated with Phyllanthus emblica and Zingiber officinale extracts
Chathuranga Hasithi Samarasinghe, Madhura Arunoda Jayasinghe, Senadheera Pathirannehelage Anuruddhika Subhashinie Senadheera, Isuru Wijesekara, Binosha Fernando, Kamburawala Kankanamge Don Somathilaka Ranaweera & Nirodha Heshan Bandara Wilamune

doi: https://doi.org/10.31246/mjn-2019-0063

ABSTRACT

Introduction: The use of natural plant extracts to reduce blood glucose response has been practised from ancient times, although their industrial applications are rare. For the convenience of typical cane sugar consumers, selected tropical plant extracts were incorporated with cane sugar to make a low glycaemic sugar product.
Methods: This study compared the glycaemic responses of a commercially available product (Product 1) containing seven herbal extracts; fenugreek (Trigonella foenumgraecum), turmeric (Curcuma longa), black pepper (Piper nigrum), ginger (Zingiber officinale), cinnamon (Cinnamomum verum), gooseberry (Phyllanthus emblica) and pomegranate (Punica granatum) against a novel product (Product 2) that was made by incorporating only two plant extracts that were cheaper and readily available in the local market - gooseberry (Phyllanthus emblica) and ginger (Zingiber officinale). Extracts were incorporated with cane sugar to make a series of crystallised solid sugar products and the formulae with the best sensory attributes was selected (Product 2). The glycaemic indices of both products were determined by standardised methodology using 12 healthy volunteers in a randomised crossover study.
Results: The mean glycaemic index (GI) value for sugar in Product 1 was 49±9 and in Product 2 was 38±9. Both results elicited significantly (p<0.05) lower GI values than normal cane sugar (GI=65). The novel cane sugar product (Product 2) was far more superior compared to the commercially available product (Product 1) in reducing blood glucose response.
Conclusion: Incorporation of suitable herbal extracts to cane sugar and foods like rice and wheat flour may be a suitable option to reduce their glycaemic impact.
Key words: Cane sugar, diabetes, ginger, glycaemic index, gooseberry

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Effect of Morus alba (white mulberry) leaf on HbA1c of patients with type II diabetes mellitus
Zoha Sohail, Nighat Bhatty, Saima Naz, Amna Iram & Saghir Ahmad Jafri

doi: https://doi.org/10.31246/mjn-2019-0055

ABSTRACT

Introduction: Diabetes mellitus is a wide spread metabolic disorder characterized by hyperglycemia. In Pakistan, many traditional or medicinal plants are being used to treat ailments or disorders, both in children and adults. To date, there has been no research study done to investigate the effect of Morus alba (white mulberry) leaves on blood glucose levels of individuals with type II diabetes mellitus in Pakistan. The present study was conducted to determine the effect of Morus alba (white mulberry) leaf powder on glycated haemoglobin (HbA1c) of patients with type II diabetes mellitus.
Methods: The study design of this study was a randomised controlled trial. Eighty patients with type II diabetes mellitus were randomly selected from the Fatima Memorial Hospital and were equally divided into two groups - control group and experimental group. Patients in the control group were asked to follow their regular hypoglycaemic medications, while patients in the experimental group were administered with 500mg of Morus alba leaf tablet twice a day, 15 minutes before breakfast and dinner, along with their regular hypoglycaemic medications. HbA1c of patients in both groups were assessed on day zero before the study and on the ninetieth day at study completion.
Results: HbA1c of patients in the control group at baseline was 8.92% and 8.91% at final, whereas HbA1c of patients in the experimental group at baseline was 9.13% and 8.59% at final.
Conclusion: The results of this study concluded that Morus alba leaves had a significant effect in lowering high blood sugar levels.
Key words: Deoxynojirimycin-1, diabetes mellitus, Morus alba, HbA1c

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Identification of dietary diversity associated with stunting in Indonesia
Laksmi Trisasmita, Trini Sudiarti, Ratu Ayu Dewi Sartika & Asih Setiarini

doi: https://doi.org/10.31246/mjn-2019-0128

ABSTRACT

Introduction: Stunting has become one of the world’s most discussed health topics. Dietary diversity takes on an important role in increasing the nutrition fulfilment of young children aged 6–59 months for their optimal growth. This study aims to understand the association between dietary diversity and stunting in children aged 6–59 months old in Babakan Madang subdistrict, Bogor district of West Java, Indonesia.
Methods: This study used a cross-sectional design and was conducted in May 2019 in Babakan Madang subdistrict. The subjects chosen for this study were 200 children aged 6–59 months, and they were selected using the probabilityproportional- to-size sampling technique. Individual dietary diversity was assessed by minimum dietary diversity with the consumption of four or more food groups out of the total seven groups. Data were analysed using descriptive statistics and chi-square test.
Results: Poor dietary diversity was significantly related with stunting (p=0.023; OR=2.182; 95% CI: 1.152–4.134). In addition, age <2 years was a significant protective factor against stunting (p=0.011; OR=0.445; 95% CI: 0.246– 0.806).
Conclusion: The risk of stunting in children can be reduced by providing a variety of foods in their diets, which includes at least four food groups a day. There is a need to increase awareness among the population about appropriate nutrition through dietary education.
Key words: Stunting, dietary diversity, child nutrition

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Nutritional composition of indigenous durian varieties
Parunya Thiyajai, Somsri Charoenkiatkul, Kasem Kulpradit, Sasivimon Swangpol, Piyanut Sridonpai & Kunchit Judprasong

doi: https://doi.org/10.31246/mjn-2019-0083

ABSTRACT

Introduction: Data on nutrients of indigenous durians are useful for selecting suitable varieties for future cultivation and conservation. The objective of this study is to investigate the nutrient composition (proximate composition, dietary fibre, minerals, sugars, and fatty acids) of 17 indigenous durian varieties from Thailand.
Methods: The edible part of each variety was collected, freeze dried, and kept in a freezer until analysis. All parameters were analysed by International Organization for Standardization (ISO) 17025 accredited laboratories using the Association of Official Analytical Chemists (AOAC) standards or well-validated methods.
Results: All varieties of durian contained protein, fat [2.2-3.4g and 2.6-6.1g/100g fresh weight (FW), respectively], and carbohydrate (20.0-39.5g/100g FW). Sugars were predominantly found (14.2-21.8g/100g FW) and sucrose was the major form of sugars (50.0-90.0%). For the most part, all varieties contained considerable amounts of potassium, sulphur, and phosphorus. Oleic acid (C18:1n9) was the major monounsaturated fatty acid and palmitic acid (16:0) was the major saturated fatty acid (27.9-51.9% and 35.6-48.3%, respectively) in all varieties.
Conclusion: Varieties of Kob-wat-kuay, Kob-sao-noi, and Kob-wai provided several beneficial compounds but also had unhealthy nutrients in small amounts. This food composition database information is beneficial for selecting good varieties for the purpose of conservation, healthy consumption, and export promotion.
Key words: Durian, food composition, nutrient, fatty acid

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Mango seed kernel flour (Mangifera indica): nutrient composition and potential as food
Fajriyati Mas’ud, Akhmad Rifai & Muhammad Sayuti

doi: https://doi.org/10.31246/mjn-2019-0082

ABSTRACT

Introduction: Mango seed kernel flour (MSKF) is a potential source of nutrition and antioxidant. In the present paper, we provide a complete data on the nutrient compositions of seven varieties of MSKF that are grown in Indonesia. The data can be used as a reference when MSKF is used for further processing in a variety of products.
Methods: Seven varieties of MSKF were analysed for their proximate composition, antioxidant components, mineral content, and fatty acid profile.
Results: Carbohydrate, crude protein, total lipid, crude fibre, and ash contents of MSKF were found to be 36.2-39.3%, 5.2-6.6%, 5.9-7.2%, 2.2-2.5%, and 2.9-5.5%, respectively. MSKF contained a considerable amount of antioxidant components at 62.4-72.9mg total polyphenols/g, carotenoid of 1.3-2.4mg/100g, vitamin E of 131.1-142.0mg/100g, and ascorbic acid of 66.8-73.1mg/100g. They also contained important minerals such as calcium at 25.2-36.8mg/100g, magnesium at 82.7-124.2mg/100g, potassium at 94.3-142.7mg/100g, phosphorus at 72.7-95.3mg/100g, and sodium at 21.7-37.5mg/100g. Stearic acid was the main saturated fatty acid, while oleic acid was the major unsaturated fatty acid.
Conclusion: MSKF has the potential to be a good source of nutrition for humans.
Key words: Mango, proximate, antioxidant, fatty acid, minerals

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Association between adiposity indicators and cardiorespiratory fitness among rural northeastern Thai adolescents
Weerachat Srichan, Tippawan Pongcharoen, Kunchit Judprasong, Pattanee Winichagoon, Sueppong Gowachirapant & Wanphen Wimonpeerapattana

doi: https://doi.org/10.31246/mjn-2019-0092

ABSTRACT

Introduction: Obesity or high adiposity is known to be associated with various medical consequences, such as diabetes mellitus, hypertension, coronary heart disease and metabolic syndrome. High adiposity and poor cardiorespiratory fitness (CRF) have been found to be related with higher risks of developing cardiovascular disease (CVD). However, previous studies in Asia reported inconsistent findings on the association between obesity or high adiposity, based on various indicators, with impaired CRF. This study investigated the association between adiposity indicators and CRF in terms of maximal oxygen uptake (VO2 max) in adolescents from rural northeastern Thailand.
Methods: This study was performed among 486 adolescents aged 14-15 years old in Khon Kaen province, Thailand. Adiposity indicators included body mass index-for-age z-scores (BAZ), waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) and percent body fat (%BF) based on deuterium dilution technique.
Results: Male adolescents had higher WHR and VO2 max than female adolescents, while female adolescents had higher %BF and WHtR. Adolescents who had higher adiposity tended to have lower VO2 max, especially among females in which the lowest VO2 max was found in the highest quintile of adiposity indicators, including BAZ, WC, WHtR and %BF.
Conclusion: Adolescents with higher adiposity tended to have poorer CRF. Based on previous knowledge that both high adiposity and poor CRF may lead to higher risks of developing CVD, this suggests that obese adolescents should be considered and managed at an early age in order to maintain optimal CRF.
Key words: Adiposity, cardiorespiratory fitness, adolescent

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Microwave cooking enhances glycaemic potential of rice: An in vitro study
Bhupinder Kaur, Joseph Lim, Charoonsri Chusak & Christiani Jeyakumar Henry

doi: https://doi.org/10.31246/mjn-2019-0106

ABSTRACT

Introduction: Rice is the principle staple and energy source for nearly half the world’s population and has significant nutrition and health implications. Most rice varieties are considered high glycaemic index (GI) foods. With rice being a major contributor to the glycaemic load in Asian populations, there is increasing concern of its impact on the development of type 2 diabetes. Devising ways to reduce the glycaemic impact of rice is therefore imperative. Rice is cooked in a variety of ways, such as over an open fire, electric cooker or microwave. We evaluated the impact of the electric cooker and microwave cooking methods on starch digestibility in a variety of rice commonly consumed in Asia.
Methods: Nine rice varieties of varying GIs were cooked in an electric cooker and microwave oven, and the starch digestibility of cooked rice measured using an in vitro digestion method.
Results: High GI white rice (WR) had reduced starch digestibility after microwave cooking compared to electric cooker (p<0.05). There was a significant reduction in incremental area under the curves (iAUC) and rapidly digestible starch of WR cooked using microwave rather than electric cooker (p<0.05). Interestingly, even for low GI rice varieties such as iddly rice and extra long basmati rice, microwaving increased slowly digestible starch.
Conclusion: The results provide indicative data that the glycaemic impact of rice can be reduced when cooked using a microwave oven. These observations have nutritional implications that need to be substantiated using in vivo studies. Microwaving may provide a simple method of reducing the postprandial glycaemia of high GI rice.
Key words: Cooking method, microwave cooking, rice, starch digestibility, glycaemic index

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Vitamin D status is associated with high BMI, working status and gravidity among pregnant Malaysian women
Lalitha Palaniveloo, Yong Heng Yaw, Zalilah Mohd Shariff, Loh Su Peng, Jacques Bindels, Yvonne Yee Siang Tee & Eline M. van der Beek

doi: https://doi.org/10.31246/mjn-2020-0010

ABSTRACT

Introduction: Vitamin D deficiency (VDD) is associated with adverse health outcomes in pregnancy and newborns. This study aims to determine the Vitamin D status among pregnant Malaysian women and its associations with specific maternal & pregnancy characteristics.
Methods: This study utilised cross-sectional data from a prospective cohort study of pregnant women in Seremban district in which 259 pregnant women had available vitamin D data. Blood samples were taken <14th week of gestation. Serum 25-hydroxy Vitamin D [25(OH)D] levels were analysed using chemiluminescent microparticle immunoassay (CMIA) technology on the ARCHITECT iSystem and categorised using the Institute of Medicine (IOM) 2011 cutoffs. A set of pre-tested interviewer-administered questionnaire was used to obtain information on socio-demographics, obstetrics, and anthropometry.
Results: Mean serum 25(OH)D was 32.83±11.37nmol/L. The prevalence of severe and mild VDD was 23.2% (n=60) and 68.3% (n=177), respectively. About 8.5% (n=22) of pregnant women were vitamin D insufficient and none had sufficient serum 25(OH)D (>75nmol/L). Early pregnancy body mass index (AOR=2.95, 95% CI=1.03-8.47), working status (AOR=3.17, 95% CI=1.06–9.50) and gravidity (AOR=0.68, 95% CI=0.48–0.98) were significantly associated with VDD.
Conclusion: The present study showed a high prevalence of VDD among pregnant women in Malaysia, especially among those who were overweight or obese, working in indoor environment and primigravida.
Key words: Vitamin D deficiency (VDD), serum 25(OH)D, BMI, pregnant women, Malaysia

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