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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Malaysian Journal of Nutrition (Mal J Nutr)
Volume 29 No.3, 2023
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Table of Content
Association between frequency of processed and ultraprocessed
food consumption with lifestyle habits score
for cancer prevention among adults in Malaysia
Nur Mahirah Amani Mohammad, Nur Ridzwana Ramli & Razinah Sharif
https://doi.org/10.31246/mjn-2021-0139
ABSTRACT
Introduction: Cancer is the second leading cause of mortality globally. Processed and ultra-processed foods are reported to be high in energy, sugar, and unhealthy fats, while low in fibre, vitamins and minerals, that can increase the risk of cancer.
Methods: A cross-sectional study involving adults aged 18-59 years was conducted in Peninsular Malaysia (n=122). Sociodemographic data were obtained through a questionnaire and lifestyle habits score for cancer prevention was assessed using MyGenomSihat©. The food frequency questionnaire used had four groups (i.e., unprocessed or minimally processed foods, processed culinary ingredients, processed foods, and ultra-processed foods) containing 53 food items to evaluate the frequency of food consumption. All data obtained were self-reported by the participants.
Results: Mean age was 27.6±8.1 years with a majority (76.2%) having household income of less than
Conclusion: Most subjects had
satisfactory lifestyle habits scores for cancer prevention. Interventions are needed
to improve lifestyle habits among the targeted population for cancer prevention.
Key words: adult, cancer, MyGenomSihat©, NOVA, ultra-processed food
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Introduction: Cancer is the second leading cause of mortality globally. Processed and ultra-processed foods are reported to be high in energy, sugar, and unhealthy fats, while low in fibre, vitamins and minerals, that can increase the risk of cancer.
Methods: A cross-sectional study involving adults aged 18-59 years was conducted in Peninsular Malaysia (n=122). Sociodemographic data were obtained through a questionnaire and lifestyle habits score for cancer prevention was assessed using MyGenomSihat©. The food frequency questionnaire used had four groups (i.e., unprocessed or minimally processed foods, processed culinary ingredients, processed foods, and ultra-processed foods) containing 53 food items to evaluate the frequency of food consumption. All data obtained were self-reported by the participants.
Results: Mean age was 27.6±8.1 years with a majority (76.2%) having household income of less than
Key words: adult, cancer, MyGenomSihat©, NOVA, ultra-processed food
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Potential risk of stunting in children under five years
living by the riverside: A systematic review
Ridha Restila, Bambang Wispriyono, Ririn Arminsih, Umar Fahmi
Achmadi, Tri Yunis Miko, Defriman Djafri & Miko Hananto
https://doi.org/10.31246/mjn-2022-0143
ABSTRACT
Introduction: Stunting, or linear growth failure, is defined by a height-for-age z-score of below -2SD according to WHO growth standard. Stunting can have short-, medium-, and long-term consequences. Rivers have an important role in human life. In several riverside areas, households still depend on the river for their livelihoods and health. This study aimed to explore the prevalence of stunting in children living by the riverside and its related factors.
Methods: Epidemiological studies published from PUBMED, MEDLINE via EBSCOHost, Science Direct, ProQuest, and Research Gate databases were systematically searched. The publication period was not restricted. Only open-access and English articles were examined.
Results: A total of 20 from 1200 studies were reviewed. The prevalence of stunting ranged from 20% to 48.3%. The other outcomes besides stunting were wasting and underweight status. There were 83 risk factors studied, and the most studied variables were age, gender, diarrhoea, water source, parent’s education, immunisation, and inappropriate complementary feeding practices (6 to 13 studies). Household water sources from rivers and economic status were consistently correlated with stunting. Majority of the risk factors studied were related to nutrition. From the environmental aspect, the most studied risk factors were water sources and sanitation.
Conclusion: Children living by the riverside face a significant risk of stunting attributed to the consistent correlation between household water sources from rivers and economic status, affecting various aspects of daily life beyond drinking water. Future research is needed to examine the impact of environmental factors and the behaviours of riverside communities.
Key words: children, risk factor, river, riverside, stunting
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Introduction: Stunting, or linear growth failure, is defined by a height-for-age z-score of below -2SD according to WHO growth standard. Stunting can have short-, medium-, and long-term consequences. Rivers have an important role in human life. In several riverside areas, households still depend on the river for their livelihoods and health. This study aimed to explore the prevalence of stunting in children living by the riverside and its related factors.
Methods: Epidemiological studies published from PUBMED, MEDLINE via EBSCOHost, Science Direct, ProQuest, and Research Gate databases were systematically searched. The publication period was not restricted. Only open-access and English articles were examined.
Results: A total of 20 from 1200 studies were reviewed. The prevalence of stunting ranged from 20% to 48.3%. The other outcomes besides stunting were wasting and underweight status. There were 83 risk factors studied, and the most studied variables were age, gender, diarrhoea, water source, parent’s education, immunisation, and inappropriate complementary feeding practices (6 to 13 studies). Household water sources from rivers and economic status were consistently correlated with stunting. Majority of the risk factors studied were related to nutrition. From the environmental aspect, the most studied risk factors were water sources and sanitation.
Conclusion: Children living by the riverside face a significant risk of stunting attributed to the consistent correlation between household water sources from rivers and economic status, affecting various aspects of daily life beyond drinking water. Future research is needed to examine the impact of environmental factors and the behaviours of riverside communities.
Key words: children, risk factor, river, riverside, stunting
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Characteristics of dietary intakes including NOVA foods
among pre-adolescents living in urban Kuala Lumpur –
Findings from the PREBONE-Kids study
Wai Yew Yang, Soon Yee Wong, Shu Hwa Ong, Kanimolli Arasu, Chung Yuan
Chang, Megan Hueh Zan Chong, Meenal Mavinkurve, Erwin Jiayuan Khoo,
Karuthan Chinna, Connie M. Weaver & Winnie Siew Swee Chee
https://doi.org/10.31246/mjn-2022-0068
ABSTRACT
Introduction: Evidence showed considerable variability of health risk factors within different socioeconomic groups. This study aimed to characterise dietary intakes by total household income among a sample of Malaysian pre-adolescents in urban Kuala Lumpur.
Methods: Baseline data of 243 healthy, pre-adolescent children between 9 and 11 years old including socio-demographic background (gender, ethnicity, and total household monthly income), anthropometry (body weight and height), and 7-day diet histories were collected. Secondary analysis was performed on dietary intakes to quantify food groups based on the Malaysian Dietary Guidelines and NOVA classification systems besides nutrients. Differences and associations between total monthly household income categories with anthropometry and dietary intakes were tested using independent t-test/Mann-Whitney U (depending on normality) and chi-square tests, respectively.
Results: Most children in this study population had dietary intakes below the recommended serving sizes for five food groups, except meat/poultry (195.2±107.2%) and fish (110.1±106.3%) and consumed about 32% of energy from ultra-processed foods (NOVA food group 4). While there was no difference in dietary intake between the bottom 40% with the middle 40% and high 20% household income groups, the percentage of energy contributed by NOVA food group 4 (processed fats/oils, condiments, and sauces) was higher in the bottom 40% households (p=0.024).
Conclusion: Most pre-adolescent children in this study, regardless of household income, did not meet dietary recommendations and ate diets comprised of less nutritious foods. Comprehensive approaches that aim to improve dietary patterns and reduce the risk of diet-related chronic diseases are warranted.
Key words: children; dietary intake; income; Malaysian; NOVA group
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Introduction: Evidence showed considerable variability of health risk factors within different socioeconomic groups. This study aimed to characterise dietary intakes by total household income among a sample of Malaysian pre-adolescents in urban Kuala Lumpur.
Methods: Baseline data of 243 healthy, pre-adolescent children between 9 and 11 years old including socio-demographic background (gender, ethnicity, and total household monthly income), anthropometry (body weight and height), and 7-day diet histories were collected. Secondary analysis was performed on dietary intakes to quantify food groups based on the Malaysian Dietary Guidelines and NOVA classification systems besides nutrients. Differences and associations between total monthly household income categories with anthropometry and dietary intakes were tested using independent t-test/Mann-Whitney U (depending on normality) and chi-square tests, respectively.
Results: Most children in this study population had dietary intakes below the recommended serving sizes for five food groups, except meat/poultry (195.2±107.2%) and fish (110.1±106.3%) and consumed about 32% of energy from ultra-processed foods (NOVA food group 4). While there was no difference in dietary intake between the bottom 40% with the middle 40% and high 20% household income groups, the percentage of energy contributed by NOVA food group 4 (processed fats/oils, condiments, and sauces) was higher in the bottom 40% households (p=0.024).
Conclusion: Most pre-adolescent children in this study, regardless of household income, did not meet dietary recommendations and ate diets comprised of less nutritious foods. Comprehensive approaches that aim to improve dietary patterns and reduce the risk of diet-related chronic diseases are warranted.
Key words: children; dietary intake; income; Malaysian; NOVA group
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Examining the relationship between fast-food and sitdown
restaurant consumption frequency and dietary
patterns among adults in Riyadh City, Saudi Arabia
Enas Alwagait, Arwa Alhassoun, Salma Abulkhair, Shahad Altwijry, Haya
Alajlan, Hajer Alaali & Nahla Mohammed Bawazeer
https://doi.org/10.31246/mjn-2022-0078
ABSTRACT
Introduction: This study assessed the association between dietary patterns and the frequency of eating at fast-food or sit-down restaurants.
Methods: A crosssectional study, with a sample of adults living in Riyadh, Saudi Arabia (SA), was conducted between January and March 2021. An online, self-administered survey was conducted using social media and WhatsApp. A total of 399 adults living in Riyadh were included; 40.4% were males, with a mean age of 35 and standard deviation (SD) of 12 years, and had no significant health problems.
Results: Using principal component analysis to analyse 15 food groups based on the food items consumed, four dietary patterns were extracted: Western, unhealthy, plant-based, and healthy. After adjusting for potential covariates, a higher frequency of eating at fast-food restaurants was significantly associated with unhealthy dietary patterns [odds ratio (OR) = 4.85, 95.0% confidence interval (CI) = 1.80, 12.59]. In contrast, participants in the highest tercile of the frequency of eating at fast-food restaurants showed lower odds of adhering to a healthy dietary pattern (OR = 0.29, 95.0% CI = 0.11, 0.71). No significant association was found between participants in the highest tercile of the frequency of eating at sit-down restaurants and their dietary patterns.
Conclusion: Frequently eating at fast-food restaurants was associated with increased odds of adherence to less healthy dietary patterns and negatively associated with adherence to a healthy pattern. No association was found between sit-down restaurants and any of the identified dietary patterns. The present findings can assist stakeholders and policymakers in developing strategic plans and policies for targeted interventions for this population.
Key words: dietary pattern, fast-food restaurants, principal component analysis, Saudi Arabia, sit-down restaurants
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Introduction: This study assessed the association between dietary patterns and the frequency of eating at fast-food or sit-down restaurants.
Methods: A crosssectional study, with a sample of adults living in Riyadh, Saudi Arabia (SA), was conducted between January and March 2021. An online, self-administered survey was conducted using social media and WhatsApp. A total of 399 adults living in Riyadh were included; 40.4% were males, with a mean age of 35 and standard deviation (SD) of 12 years, and had no significant health problems.
Results: Using principal component analysis to analyse 15 food groups based on the food items consumed, four dietary patterns were extracted: Western, unhealthy, plant-based, and healthy. After adjusting for potential covariates, a higher frequency of eating at fast-food restaurants was significantly associated with unhealthy dietary patterns [odds ratio (OR) = 4.85, 95.0% confidence interval (CI) = 1.80, 12.59]. In contrast, participants in the highest tercile of the frequency of eating at fast-food restaurants showed lower odds of adhering to a healthy dietary pattern (OR = 0.29, 95.0% CI = 0.11, 0.71). No significant association was found between participants in the highest tercile of the frequency of eating at sit-down restaurants and their dietary patterns.
Conclusion: Frequently eating at fast-food restaurants was associated with increased odds of adherence to less healthy dietary patterns and negatively associated with adherence to a healthy pattern. No association was found between sit-down restaurants and any of the identified dietary patterns. The present findings can assist stakeholders and policymakers in developing strategic plans and policies for targeted interventions for this population.
Key words: dietary pattern, fast-food restaurants, principal component analysis, Saudi Arabia, sit-down restaurants
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Sports nutrition knowledge, attitude, and practice
among male gymnasium users in Jordan
Mohammad Al-Quran, Ayu Suzailiana Muhamad, Nur Syamsina Ahmad &
Foong Kiew Ooi
https://doi.org/10.31246/mjn-2022-0112
ABSTRACT
Introduction: Proper nutrition is important for the health and performance of athletes. However, a lack of knowledge might lead to negative attitude and poor dietary practices. This study aimed to determine the levels of nutrition knowledge, attitude, and practice (KAP) among male gymnasium users in Jordan.
Methods: A total of 138 male gymnasium users (21.1±2.8 years) from Jordan were recruited. Their height, weight, body mass index, and age were recorded. The KAP-Sports nutrition questionnaire that contains 25 questions regarding knowledge on basic sports nutrition, 12 questions regarding usual food choices and practices, and 20 questions on attitude towards nutrition and sports-enhancing diet were administrated. Descriptive and Pearson correlation analyses were used to analyse the data.
Results: Majority of the participants had moderate knowledge on sports nutrition (77.6%), neutral attitude (84.7%), and fair dietary practice (67.4%). Mean score for knowledge, attitude and practice were 18.1±2.6, 58.8±6.2, and 29.7±3.6, respectively. There was significant, weak correlation between knowledge and attitude (r=0.18, p=0.048), as well as between knowledge and practice (r=0.20, p=0.018).
Conclusion: Knowledge is important to affect positive attitude and good dietary practices. However, gymnasium users in Jordan did not have a high level of knowledge that could lead to their positive attitude and good dietary practices. Thus, sports nutrition education is recommended to ensure that adequate and correct knowledge are disseminated to gymnasium users.
Key words: exercise, gym goers, KAP, physically active
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Introduction: Proper nutrition is important for the health and performance of athletes. However, a lack of knowledge might lead to negative attitude and poor dietary practices. This study aimed to determine the levels of nutrition knowledge, attitude, and practice (KAP) among male gymnasium users in Jordan.
Methods: A total of 138 male gymnasium users (21.1±2.8 years) from Jordan were recruited. Their height, weight, body mass index, and age were recorded. The KAP-Sports nutrition questionnaire that contains 25 questions regarding knowledge on basic sports nutrition, 12 questions regarding usual food choices and practices, and 20 questions on attitude towards nutrition and sports-enhancing diet were administrated. Descriptive and Pearson correlation analyses were used to analyse the data.
Results: Majority of the participants had moderate knowledge on sports nutrition (77.6%), neutral attitude (84.7%), and fair dietary practice (67.4%). Mean score for knowledge, attitude and practice were 18.1±2.6, 58.8±6.2, and 29.7±3.6, respectively. There was significant, weak correlation between knowledge and attitude (r=0.18, p=0.048), as well as between knowledge and practice (r=0.20, p=0.018).
Conclusion: Knowledge is important to affect positive attitude and good dietary practices. However, gymnasium users in Jordan did not have a high level of knowledge that could lead to their positive attitude and good dietary practices. Thus, sports nutrition education is recommended to ensure that adequate and correct knowledge are disseminated to gymnasium users.
Key words: exercise, gym goers, KAP, physically active
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Nutrient intake, oral symptoms, and oral health-related
quality of life among antenatal mothers in Sarawak
Tiong Ing Teck, Ruhaya Hasan, Norkhafizah Saddki & Tham Hui Ling
https://doi.org/10.31246/mjn-2022-0118
ABSTRACT
Introduction: This study aimed to determine the association between nutrient intake, oral symptoms, and oral health-related quality of life (OHRQoL) among antenatal mothers in the Sri Aman district, Sarawak.
Methods: A total of 124 antenatal mothers in the second and third trimesters, through systematic random sampling, participated in this cross-sectional study. A validated selfadministered questionnaire was used to collect their socioeconomic and obstetric profiles, perceived oral health status, and OHRQoL. Three days 24-hour diet recall assessment involving two weekdays and one weekend day was used for nutrient intake assessment.
Results: Most mothers (75.0%) had at least one oral symptom: cavitated tooth (51.6%), bleeding gum (32.3%), halitosis (27.4%), gum pain (13.7%), toothache (12.1%), and swollen gum (6.5%). Most mothers also had inadequate intakes of energy, vitamin D, iodine, calcium, zinc, fluoride, and iron. The most affected OHRQoL domain was psychological discomfort, followed by functional limitation and physical pain. Nutrient intake was not significantly different between antenatal mothers with and without oral symptoms. Antenatal mothers with at least one oral symptom, presence of toothache, cavitated tooth, bleeding gum, and halitosis had significantly lower OHRQoL.
Conclusion: Most antenatal mothers had inadequate nutrient intake, particularly vitamin D and calcium. Nutrient intake was not significantly associated with oral symptoms. The oral symptoms of dental caries and periodontal disease were prevalent; and the presence of toothache, cavitated tooth, bleeding gum, and halitosis were associated with poor OHRQoL.
Key words: antenatal mothers, nutrient intake, oral health-related quality of life, oral symptoms
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Introduction: This study aimed to determine the association between nutrient intake, oral symptoms, and oral health-related quality of life (OHRQoL) among antenatal mothers in the Sri Aman district, Sarawak.
Methods: A total of 124 antenatal mothers in the second and third trimesters, through systematic random sampling, participated in this cross-sectional study. A validated selfadministered questionnaire was used to collect their socioeconomic and obstetric profiles, perceived oral health status, and OHRQoL. Three days 24-hour diet recall assessment involving two weekdays and one weekend day was used for nutrient intake assessment.
Results: Most mothers (75.0%) had at least one oral symptom: cavitated tooth (51.6%), bleeding gum (32.3%), halitosis (27.4%), gum pain (13.7%), toothache (12.1%), and swollen gum (6.5%). Most mothers also had inadequate intakes of energy, vitamin D, iodine, calcium, zinc, fluoride, and iron. The most affected OHRQoL domain was psychological discomfort, followed by functional limitation and physical pain. Nutrient intake was not significantly different between antenatal mothers with and without oral symptoms. Antenatal mothers with at least one oral symptom, presence of toothache, cavitated tooth, bleeding gum, and halitosis had significantly lower OHRQoL.
Conclusion: Most antenatal mothers had inadequate nutrient intake, particularly vitamin D and calcium. Nutrient intake was not significantly associated with oral symptoms. The oral symptoms of dental caries and periodontal disease were prevalent; and the presence of toothache, cavitated tooth, bleeding gum, and halitosis were associated with poor OHRQoL.
Key words: antenatal mothers, nutrient intake, oral health-related quality of life, oral symptoms
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The effect of photoperiodism on nutritional potency of
Euglena sp. Indonesian strains
Khusnul Qonita Maghfiroh, Tia Erfianti, Istini NurAfifah, Ria Amelia, Dedy
Kurnianto, Brilian Ryan Sadewo, Revata Maggandari, Bambang Retno Aji,
Arief Budiman & Eko Agus Suyono
https://doi.org/10.31246/mjn-2023-0004
ABSTRACT
Introduction: Biomass microalgae functional materials, such as drugs and food supplements, have recently received much attention. Euglena sp. is a particularly appealing microalgae because of its simplicity of culture and capacity to produce a wide range of bioactive compounds. Moreover, it is one of the few microorganisms that produces carbohydrate, lipid, protein, ß-1,3-glucans, antioxidants, phytotoxins, wax esters, and polyunsaturated fatty acids that can be used to make nutraceuticals, pharmaceuticals, and cosmeceuticals. However, the potential utilisation of Euglena sp. for production of food supplements has been exploited only on a limited basis.
Methods: This study was modified by adding protocatechuic acid and photoperiodism for 12:12; 14:10; 16:8; and full dark to affect the metabolite content of Euglena sp.
Results: Results showed that the photoperiod had significant effect on lipid, chlorophyll-a, and carotenoid levels in the control treatment, with the highest levels as follows: 0.52±0.03 g/L, 1.20±0.01 x10-2 g/L, 0.30±0.02 x10-2 g/L; while the others were not significantly affected by the treatment, with the highest protein content at full dark 3.10±0.2 x10-2 g/L; chlorophyll-b at photoperiod 14:10 0.70±0.03 x10-2 g/L; paramylon at photoperiod 12:12 1.90±0.02 x10-1 g/L. The highest carbohydrates were found in control, with a level of 1.20±0.02 g/L.
Conclusion: Photoperiodism is recommended to enhance productivity of protein, paramylon, and chlorophyll-b, while full light is recommended to enhance carbohydrate, lipid, chlorophyll-a, and carotenoid production in Euglena sp. to improve the quality of food nutrition.
Key words: Euglena sp., photoperiod, protocatechuic acid
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Introduction: Biomass microalgae functional materials, such as drugs and food supplements, have recently received much attention. Euglena sp. is a particularly appealing microalgae because of its simplicity of culture and capacity to produce a wide range of bioactive compounds. Moreover, it is one of the few microorganisms that produces carbohydrate, lipid, protein, ß-1,3-glucans, antioxidants, phytotoxins, wax esters, and polyunsaturated fatty acids that can be used to make nutraceuticals, pharmaceuticals, and cosmeceuticals. However, the potential utilisation of Euglena sp. for production of food supplements has been exploited only on a limited basis.
Methods: This study was modified by adding protocatechuic acid and photoperiodism for 12:12; 14:10; 16:8; and full dark to affect the metabolite content of Euglena sp.
Results: Results showed that the photoperiod had significant effect on lipid, chlorophyll-a, and carotenoid levels in the control treatment, with the highest levels as follows: 0.52±0.03 g/L, 1.20±0.01 x10-2 g/L, 0.30±0.02 x10-2 g/L; while the others were not significantly affected by the treatment, with the highest protein content at full dark 3.10±0.2 x10-2 g/L; chlorophyll-b at photoperiod 14:10 0.70±0.03 x10-2 g/L; paramylon at photoperiod 12:12 1.90±0.02 x10-1 g/L. The highest carbohydrates were found in control, with a level of 1.20±0.02 g/L.
Conclusion: Photoperiodism is recommended to enhance productivity of protein, paramylon, and chlorophyll-b, while full light is recommended to enhance carbohydrate, lipid, chlorophyll-a, and carotenoid production in Euglena sp. to improve the quality of food nutrition.
Key words: Euglena sp., photoperiod, protocatechuic acid
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Demographic characteristics are associated with
children’s nutritional status: Findings from a pilot
study on food insecure households in Simunjan district,
Sarawak
Tan Beng Chin, Cheah Whye Lian & Law Leh Shii
https://doi.org/10.31246/mjn-2023-0005
ABSTRACT
Introduction: Food insecurity is a public health concern that may lead to malnutrition in children. The purpose of this study was to determine the relationship between demographic characteristics and food security level with nutritional status among children from food-insecure households in Simunjan District, Sarawak.
Methods: This study involved a total of 171 mother-and-child pairs from two Maternal and Child Health Clinics (Simunjan and Gedong) using non-probability convenience sampling technique. Food insecurity status was determined using Radimer/Cornell Hunger Food Insecurity Instrument, while child’s weight and height were measured following standard procedures. Chi-squared test of independence and binary logistic regression were used during data analysis.
Results: The prevalences for household food insecurity, individual food insecurity, and child hunger were 70.8%, 15.2%, and 14.0%, respectively. The main nutritional problems for children aged 24–59 months were underweight (17.9%) and stunting (17.9%), while for children aged 60–144 months were overweight and obesity (27.5%). Children of mothers over 34 years old (AOR=2.367; 95% CI: 1.085, 5.164), and those aged 60–144 months (AOR=3.619; 95% CI: 1.521, 8.613) had increased odds of being overweight or obese. Meanwhile, children of working mothers (AOR=6.526; 95% CI: 1.108, 38.449) were more likely to have a thinness problem than children of unemployed mothers. However, no association was found between the severity of food insecurity with children’s nutritional status.
Conclusion: Malnutrition in children remains a public health concern in Simunjan District, and it is linked to mother’s age and employment status. An intervention programme is required to ameliorate the situation.
Key words: children, nutritional status, demographic characteristics, food insecurity
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Introduction: Food insecurity is a public health concern that may lead to malnutrition in children. The purpose of this study was to determine the relationship between demographic characteristics and food security level with nutritional status among children from food-insecure households in Simunjan District, Sarawak.
Methods: This study involved a total of 171 mother-and-child pairs from two Maternal and Child Health Clinics (Simunjan and Gedong) using non-probability convenience sampling technique. Food insecurity status was determined using Radimer/Cornell Hunger Food Insecurity Instrument, while child’s weight and height were measured following standard procedures. Chi-squared test of independence and binary logistic regression were used during data analysis.
Results: The prevalences for household food insecurity, individual food insecurity, and child hunger were 70.8%, 15.2%, and 14.0%, respectively. The main nutritional problems for children aged 24–59 months were underweight (17.9%) and stunting (17.9%), while for children aged 60–144 months were overweight and obesity (27.5%). Children of mothers over 34 years old (AOR=2.367; 95% CI: 1.085, 5.164), and those aged 60–144 months (AOR=3.619; 95% CI: 1.521, 8.613) had increased odds of being overweight or obese. Meanwhile, children of working mothers (AOR=6.526; 95% CI: 1.108, 38.449) were more likely to have a thinness problem than children of unemployed mothers. However, no association was found between the severity of food insecurity with children’s nutritional status.
Conclusion: Malnutrition in children remains a public health concern in Simunjan District, and it is linked to mother’s age and employment status. An intervention programme is required to ameliorate the situation.
Key words: children, nutritional status, demographic characteristics, food insecurity
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Rice bran oil reduces organ-specific fat deposition,
attenuates hyperlipidaemia and abnormal liver function
in Long Evans rats with high fat intake
Md. Jahangir Alam, Md. Kamrul Hasan, Md. Abdul Alim, Shamoli Akter,
Khan Md. Murtaja Reza Linkon & Utpal Kumar Prodhan
https://doi.org/10.31246/mjn-2022-0133
ABSTRACT
Introduction: High-calorie diets, particularly the quality of dietary fats, are regarded as an independent risk factor for developing obesity, hyperlipidaemia, and liver diseases. The present study examined the impact of rice bran oil (RBO) on organ-specific fat deposition, lipid profile, and liver function enzymes in Long Evans rats.
Methods: Long Evans rats (n=24) were fed for six weeks with a controlled high-fat diet (HFD) to induce hyperlipidaemia and abnormal liver function. Rats were then divided into two groups: one group continued feeding on HFD, and the other group was fed with a RBO diet, replacing the fat source. After six weeks of feeding, six rats from each group were sacrificed and required analytical tests were performed. The remaining obese rats (n=12) were divided into continued HFD and RBO diet, and after sacrificing, essential analytical tests were done.
Results: RBO feeding to hyperlipidaemic rats for six weeks significantly reduced brown adipose tissue, abdominal adipose tissue, epididymal adipose tissue, and liver fat compared to continuing HFD group (p<0.05). Similarly, serum levels of total cholesterol, triacylglycerides, and low-density lipoprotein cholesterol were all decreased, whereas high-density lipoprotein cholesterol increased in response to RBO compared to HFD (p<0.05). Additionally, rats fed with RBO showed reduced alanine aminotransferase, aspartate aminotransferase, and gamma-glutamyl transferase levels when compared with continuing HFD-fed rats (p<0.05).
Conclusion: These findings suggest that RBO supports the reduction of fat storage from major fat depots, controls lipid profile, and restores healthy liver functions in rats.
Key words: fat depots, high fat diet, hyperlipidaemia, liver enzymes, rice bran oil
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Introduction: High-calorie diets, particularly the quality of dietary fats, are regarded as an independent risk factor for developing obesity, hyperlipidaemia, and liver diseases. The present study examined the impact of rice bran oil (RBO) on organ-specific fat deposition, lipid profile, and liver function enzymes in Long Evans rats.
Methods: Long Evans rats (n=24) were fed for six weeks with a controlled high-fat diet (HFD) to induce hyperlipidaemia and abnormal liver function. Rats were then divided into two groups: one group continued feeding on HFD, and the other group was fed with a RBO diet, replacing the fat source. After six weeks of feeding, six rats from each group were sacrificed and required analytical tests were performed. The remaining obese rats (n=12) were divided into continued HFD and RBO diet, and after sacrificing, essential analytical tests were done.
Results: RBO feeding to hyperlipidaemic rats for six weeks significantly reduced brown adipose tissue, abdominal adipose tissue, epididymal adipose tissue, and liver fat compared to continuing HFD group (p<0.05). Similarly, serum levels of total cholesterol, triacylglycerides, and low-density lipoprotein cholesterol were all decreased, whereas high-density lipoprotein cholesterol increased in response to RBO compared to HFD (p<0.05). Additionally, rats fed with RBO showed reduced alanine aminotransferase, aspartate aminotransferase, and gamma-glutamyl transferase levels when compared with continuing HFD-fed rats (p<0.05).
Conclusion: These findings suggest that RBO supports the reduction of fat storage from major fat depots, controls lipid profile, and restores healthy liver functions in rats.
Key words: fat depots, high fat diet, hyperlipidaemia, liver enzymes, rice bran oil
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Association between 25-hydroxyvitamin D levels and
incidence of allergy and infection in infants aged 0–6
months
Maria Mexitalia, Yeni Kula Awang, Rina Pratiwi & Agustini Utari
https://doi.org/10.31246/mjn-2022-0059
ABSTRACT
Introduction: Vitamin D levels are known to be related to prevalence of allergy and infection in children. However, vitamin D levels in infants’ umbilical cord blood need to be investigated. Therefore, this study aimed to determine association between 25-hydroxyvitamin D [25(OH)D] levels and incidence of allergy and infection in children.
Methods: A longitudinal study involving 38 full-term newborns was conducted. Serum 25(OH)D levels in infants’ umbilical cord and venous blood were measured at birth and six months, respectively. 25(OH)D levels were classified as insufficient (<20 ng/mL) and sufficient (>20 ng/mL). Parents filled out questionnaires about their children’s allergy and infection symptoms. Paired t-test was performed to compare the 25(OH)D levels at birth and at six months. Chisquared test was conducted to determine relationship between 25(OH)D levels and incidence of infection and allergy in children.
Results: 25(OH)D levels in venous blood of 6-month-old infants were significantly higher than in umbilical cord blood (50.44±13.59 ng/mL vs. 20.70±6.60 ng/mL, p<0.001). In addition, 25(OH)D level insufficiency in umbilical cord blood was associated with infection (p<0.05). However, there was no incidence of allergy, and exclusive breastfeeding and sun exposure were not associated with vitamin D levels in 6-month-old infants.
Conclusion: We conclude that 25(OH)D level insufficiency in umbilical cord blood was associated with incidence of infection in the first six months of life.
Key words: 25(OH)D, allergy, infants, infection, umbilical cord blood
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Introduction: Vitamin D levels are known to be related to prevalence of allergy and infection in children. However, vitamin D levels in infants’ umbilical cord blood need to be investigated. Therefore, this study aimed to determine association between 25-hydroxyvitamin D [25(OH)D] levels and incidence of allergy and infection in children.
Methods: A longitudinal study involving 38 full-term newborns was conducted. Serum 25(OH)D levels in infants’ umbilical cord and venous blood were measured at birth and six months, respectively. 25(OH)D levels were classified as insufficient (<20 ng/mL) and sufficient (>20 ng/mL). Parents filled out questionnaires about their children’s allergy and infection symptoms. Paired t-test was performed to compare the 25(OH)D levels at birth and at six months. Chisquared test was conducted to determine relationship between 25(OH)D levels and incidence of infection and allergy in children.
Results: 25(OH)D levels in venous blood of 6-month-old infants were significantly higher than in umbilical cord blood (50.44±13.59 ng/mL vs. 20.70±6.60 ng/mL, p<0.001). In addition, 25(OH)D level insufficiency in umbilical cord blood was associated with infection (p<0.05). However, there was no incidence of allergy, and exclusive breastfeeding and sun exposure were not associated with vitamin D levels in 6-month-old infants.
Conclusion: We conclude that 25(OH)D level insufficiency in umbilical cord blood was associated with incidence of infection in the first six months of life.
Key words: 25(OH)D, allergy, infants, infection, umbilical cord blood
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Validation of selected 2021 infant and young child
feeding indicators for appropriate complementary
feeding in relation to dietary adequacy and
anthropometric status
Eva A. Goyena, Ma. Lynell V. Maniego & Antoniette G. Cristobal
https://doi.org/10.31246/mjn-2022-0153
ABSTRACT
Introduction: With the new set of 2021 infant and young child feeding (IYCF) indicators released by WHO and UNICEF, there is a need for its validation in the Philippine setting. The study evaluated the validity of cut-off points used for minimum dietary diversity and minimum feeding frequency in terms of micronutrient and energy intake adequacy, respectively, and minimum acceptable diet (MAD) in relation to anthropometric status.
Methods: The study covered 8360 infants and young children aged 6-23.9 months with complete information on IYCF, anthropometric measurements, maternal information, and household characteristics from the 2018-2019 Expanded National Nutrition Survey (ENNS). Bivariate and correlation analyses using STATA version 15 (Corp LLC, Texas, USA 2017) were performed to determine the association of specific IYCF indicators: dietary diversity and feeding frequency with nutrient and energy intake adequacy, and MAD with anthropometric status. Sensitivity and specificity analyses were performed to evaluate the accuracy of dietary diversity score (DDS) and feeding frequency in identifying children with adequate nutrient and energy intakes, respectively.
Results: Significant associations were found between DDS and micronutrient adequacy, and between feeding frequency and energy intake adequacy, regardless of breastfeeding status. A DDS of 5 and 6 and feeding frequency of 4-5 and 8 maximised sensitivity and specificity in identifying breastfed and non-breastfed children meeting 100% nutrient and energy adequacy, respectively.
Conclusion: The selected 2021 complementary feeding indicators are practical guidelines to reflect dietary adequacy, but may not capture the entire process related to nutritional outcomes, especially stunting.
Key words: complementary feeding, dietary diversity, meal frequency, minimum acceptable diet, nutritional status
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Introduction: With the new set of 2021 infant and young child feeding (IYCF) indicators released by WHO and UNICEF, there is a need for its validation in the Philippine setting. The study evaluated the validity of cut-off points used for minimum dietary diversity and minimum feeding frequency in terms of micronutrient and energy intake adequacy, respectively, and minimum acceptable diet (MAD) in relation to anthropometric status.
Methods: The study covered 8360 infants and young children aged 6-23.9 months with complete information on IYCF, anthropometric measurements, maternal information, and household characteristics from the 2018-2019 Expanded National Nutrition Survey (ENNS). Bivariate and correlation analyses using STATA version 15 (Corp LLC, Texas, USA 2017) were performed to determine the association of specific IYCF indicators: dietary diversity and feeding frequency with nutrient and energy intake adequacy, and MAD with anthropometric status. Sensitivity and specificity analyses were performed to evaluate the accuracy of dietary diversity score (DDS) and feeding frequency in identifying children with adequate nutrient and energy intakes, respectively.
Results: Significant associations were found between DDS and micronutrient adequacy, and between feeding frequency and energy intake adequacy, regardless of breastfeeding status. A DDS of 5 and 6 and feeding frequency of 4-5 and 8 maximised sensitivity and specificity in identifying breastfed and non-breastfed children meeting 100% nutrient and energy adequacy, respectively.
Conclusion: The selected 2021 complementary feeding indicators are practical guidelines to reflect dietary adequacy, but may not capture the entire process related to nutritional outcomes, especially stunting.
Key words: complementary feeding, dietary diversity, meal frequency, minimum acceptable diet, nutritional status
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Effect of processing on resistant starch content of
Indian rice varieties (Sona Masuri and Mogra) and its
impact on postprandial blood glucose levels
Sakshi Mishra, Madhvi Awasthi & Mahak Sharma
https://doi.org/10.31246/mjn-2022-0139
ABSTRACT
Introduction: Resistant starch has elicited new possibilities around the globe due to its plausible health benefits and functional properties. This research aimed to evaluate the effect of processing on the resistant starch content in selected Indian rice varieties and its effect on postprandial blood glucose levels.
Methods: Two Indian rice varieties (Sona Masuri and Mogra) were evaluated for resistant starch in raw form, after boiling, steaming, and refrigeration. Thereafter, the increment in resistance starch content by different processing methods was validated by oral glucose tolerance test (OGTT) on ten healthy participants.
Results: Among the two rice varieties, raw Sona Masuri had a higher resistance starch content (10.86%). After processing, resistant starch was observed to be high in steamed Mogra variety (3.52%). In the boiling process, Sona Masuri developed a higher resistant starch content (2.44%) as compared to Mogra variety (1.05%). The assessment done after refrigeration revealed a slight increase in resistant starch content in both rice varieties. Mogra variety had higher resistant starch (3.68%) than the other rice variety (2.56%) after refrigeration. Validation of increase in resistant starch content and its effect on blood glucose responses done through OGTT revealed that Mogra rice (test food) did not cause a swift spike in blood glucose level compared to glucose (reference food). Differences in blood glucose responses by test and reference food at 0, 30, 60, 90, and 120 minutes were statistically significant.
Conclusion: Steamed and refrigerated Mogra rice did not cause significant increase in blood glucose.
Key words: blood glucose, processing, resistant starch, rice
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Introduction: Resistant starch has elicited new possibilities around the globe due to its plausible health benefits and functional properties. This research aimed to evaluate the effect of processing on the resistant starch content in selected Indian rice varieties and its effect on postprandial blood glucose levels.
Methods: Two Indian rice varieties (Sona Masuri and Mogra) were evaluated for resistant starch in raw form, after boiling, steaming, and refrigeration. Thereafter, the increment in resistance starch content by different processing methods was validated by oral glucose tolerance test (OGTT) on ten healthy participants.
Results: Among the two rice varieties, raw Sona Masuri had a higher resistance starch content (10.86%). After processing, resistant starch was observed to be high in steamed Mogra variety (3.52%). In the boiling process, Sona Masuri developed a higher resistant starch content (2.44%) as compared to Mogra variety (1.05%). The assessment done after refrigeration revealed a slight increase in resistant starch content in both rice varieties. Mogra variety had higher resistant starch (3.68%) than the other rice variety (2.56%) after refrigeration. Validation of increase in resistant starch content and its effect on blood glucose responses done through OGTT revealed that Mogra rice (test food) did not cause a swift spike in blood glucose level compared to glucose (reference food). Differences in blood glucose responses by test and reference food at 0, 30, 60, 90, and 120 minutes were statistically significant.
Conclusion: Steamed and refrigerated Mogra rice did not cause significant increase in blood glucose.
Key words: blood glucose, processing, resistant starch, rice
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Validation of the Malay version of Food Insecurity
Experience Scale (M-FIES) using Rasch analysis
Roselawati Mat Ya, Noraishah Mohamed Nor, Nurul Hazirah Jaafar, Suriati
Sidek, Jamalludin Ab Rahman, Norhasmah Sulaiman & Wan Azdie Mohd Abu
Bakar
https://doi.org/10.31246/mjn-2022-0031
ABSTRACT
Introduction: Food security can be defined as the availability of and accessibility to food, acquired in an acceptable means at any given time and place in a way that could maintain health and wellbeing. One critical dimension of food security is continued access to adequate food. To measure this dimension, the Food and Agriculture Organization (FAO) developed the latest measurement tool, namely the Food Insecurity Experience Scale (FIES), the first instrument to measure people who experience food insecurity globally. This study aimed to validate the construct validity and reliability of the Malay version of FIES (M-FIES) for Malaysians.
Methods: This cross-sectional study was conducted among 145 households in Kuantan, Pahang. Rasch analysis was used to analyse the construct validity of FIES.
Results: FIES met the Rasch model assumptions with all items having an infit value of between 0.7- 1.3 and an outfit value of <2.0. The item and person reliability were 0.97 and 0.71, respectively; while the item and person separation were 5.59 and 1.58, respectively. The FIES item severity indicated that the items “few food”, “healthy”, “skipped”, “ate less”, and “runout” were disordered.
Conclusion: The M-FIES is a valid and reliable measurement tool for the food insecurity situation among households based on its construct validity assessed using the Rasch model. Furthermore, the severity of item in M-FIES was different in terms of order from the original FIES, suggesting that the same items may be interpreted differently due to cultural or societal differences.
Key words: FIES, food insecurity, Rasch measurement, reliability, validity
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Introduction: Food security can be defined as the availability of and accessibility to food, acquired in an acceptable means at any given time and place in a way that could maintain health and wellbeing. One critical dimension of food security is continued access to adequate food. To measure this dimension, the Food and Agriculture Organization (FAO) developed the latest measurement tool, namely the Food Insecurity Experience Scale (FIES), the first instrument to measure people who experience food insecurity globally. This study aimed to validate the construct validity and reliability of the Malay version of FIES (M-FIES) for Malaysians.
Methods: This cross-sectional study was conducted among 145 households in Kuantan, Pahang. Rasch analysis was used to analyse the construct validity of FIES.
Results: FIES met the Rasch model assumptions with all items having an infit value of between 0.7- 1.3 and an outfit value of <2.0. The item and person reliability were 0.97 and 0.71, respectively; while the item and person separation were 5.59 and 1.58, respectively. The FIES item severity indicated that the items “few food”, “healthy”, “skipped”, “ate less”, and “runout” were disordered.
Conclusion: The M-FIES is a valid and reliable measurement tool for the food insecurity situation among households based on its construct validity assessed using the Rasch model. Furthermore, the severity of item in M-FIES was different in terms of order from the original FIES, suggesting that the same items may be interpreted differently due to cultural or societal differences.
Key words: FIES, food insecurity, Rasch measurement, reliability, validity
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Development of a plant-based culinary nutrition model
for sports science students
Bina Baboo Morji, Sareena Hanim Hamzah & Ahmad Zabidi Abdul Razak
https://doi.org/10.31246/mjn-2022-0144
ABSTRACT
Introduction: Food and fitness levels are key factors required to maintain functional life. Hence, nutrition education is crucial in spreading awareness among Sports Science students. There is a paucity of plant-based nutrition knowledge and plantbased culinary skills for fitness locally. Therefore, this study aimed to develop a valid Plant-Based Culinary Nutrition Model (PBCNM) with nutrition knowledge and basic culinary skills to improve fitness among Sports Science students.
Methods: This exploratory sequential mixed method study consisted of 2 phases. In Phase 1, a three-round modified Delphi method was conducted with 13 experts to generate a questionnaire that was validated. Lawshe worksheet determined the content validity ratio (CVR) for an item. Content validity index (CVI) for each section and the overall instrument was calculated. In Phase 2, quantitative data collection and analysis addressed the research questions and research gaps leading to model development. A total of 271 undergraduate Sports Science students at higher learning institutions were recruited as respondents.
Results: In Phase 1, CVR of the overall survey was 1.0 and CVI was 0.834. Subsequently, the questionnaire was pilot tested for reliability and a Cronbach’s alpha score of 0.836 was obtained for the overall questionnaire. In Phase 2, the respondents’ mean and standard deviation score for the model’s components and needs was 4.21±0.73 for items 1-15. The integration of experts’ perspectives on the need of PBCNM for fitness and feedback from respondents resulted in the development of PBCNM.
Conclusion: This study highlighted PBCNM as a helpful guideline for better fitness management.
Key words: Delphi method, education, fitness, nutritional knowledge, plant-based diet
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Introduction: Food and fitness levels are key factors required to maintain functional life. Hence, nutrition education is crucial in spreading awareness among Sports Science students. There is a paucity of plant-based nutrition knowledge and plantbased culinary skills for fitness locally. Therefore, this study aimed to develop a valid Plant-Based Culinary Nutrition Model (PBCNM) with nutrition knowledge and basic culinary skills to improve fitness among Sports Science students.
Methods: This exploratory sequential mixed method study consisted of 2 phases. In Phase 1, a three-round modified Delphi method was conducted with 13 experts to generate a questionnaire that was validated. Lawshe worksheet determined the content validity ratio (CVR) for an item. Content validity index (CVI) for each section and the overall instrument was calculated. In Phase 2, quantitative data collection and analysis addressed the research questions and research gaps leading to model development. A total of 271 undergraduate Sports Science students at higher learning institutions were recruited as respondents.
Results: In Phase 1, CVR of the overall survey was 1.0 and CVI was 0.834. Subsequently, the questionnaire was pilot tested for reliability and a Cronbach’s alpha score of 0.836 was obtained for the overall questionnaire. In Phase 2, the respondents’ mean and standard deviation score for the model’s components and needs was 4.21±0.73 for items 1-15. The integration of experts’ perspectives on the need of PBCNM for fitness and feedback from respondents resulted in the development of PBCNM.
Conclusion: This study highlighted PBCNM as a helpful guideline for better fitness management.
Key words: Delphi method, education, fitness, nutritional knowledge, plant-based diet
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Dietary pattern, nutrient intake, and oral symptoms in
a sample of pregnant women in Malaysia
Zaidah Ibrahim, Norkhafizah Saddki & Ruhaya Hasan
https://doi.org/10.31246/mjn-2023-0007
ABSTRACT
Introduction: Nutritional requirements of pregnant women differ considerably from those of non-pregnant women. Nutritional status during pregnancy is critical to maintain health, including oral health, and to promote growth and development of the baby. This study assessed dietary pattern, nutrient intake, and oral symptoms among pregnant women.
Methods: Seventy-one women with singleton pregnancy attending a public healthcare centre in Malaysia participated in this cross-sectional study. Dietary pattern and nutrient intake of the women were assessed using food frequency questionnaire and 3-day 24-hour diet recall, respectively. Information on sociodemographic and obstetric profiles, and oral symptoms were obtained from self-administered questionnaire.
Results: White rice, chicken, green leafy vegetables, granulated sugar, and salt were foods most consumed. Intakes of iron, folate, vitamin C, vitamin D, calcium, iodine, zinc, and fluoride for most respondents were below Recommended Nutrient Intake (RNI). Cavitated tooth (46.5%), bleeding gums (35.2%), pain upon eating and drinking (23.9%), and bad breath (23.9%) were common oral symptoms reported. Significant association was found between complaint of brown, yellow, and white spots on tooth surface with vitamin A intake, and between complaint of bleeding gums with zinc intake.
Conclusion: Intake of most nutrients by most respondents in this study was below the RNI. Oral symptoms were common and a few were associated with nutrient intakes.
Key words: dietary intake, nutrients, oral health, pregnancy, pregnant women
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Introduction: Nutritional requirements of pregnant women differ considerably from those of non-pregnant women. Nutritional status during pregnancy is critical to maintain health, including oral health, and to promote growth and development of the baby. This study assessed dietary pattern, nutrient intake, and oral symptoms among pregnant women.
Methods: Seventy-one women with singleton pregnancy attending a public healthcare centre in Malaysia participated in this cross-sectional study. Dietary pattern and nutrient intake of the women were assessed using food frequency questionnaire and 3-day 24-hour diet recall, respectively. Information on sociodemographic and obstetric profiles, and oral symptoms were obtained from self-administered questionnaire.
Results: White rice, chicken, green leafy vegetables, granulated sugar, and salt were foods most consumed. Intakes of iron, folate, vitamin C, vitamin D, calcium, iodine, zinc, and fluoride for most respondents were below Recommended Nutrient Intake (RNI). Cavitated tooth (46.5%), bleeding gums (35.2%), pain upon eating and drinking (23.9%), and bad breath (23.9%) were common oral symptoms reported. Significant association was found between complaint of brown, yellow, and white spots on tooth surface with vitamin A intake, and between complaint of bleeding gums with zinc intake.
Conclusion: Intake of most nutrients by most respondents in this study was below the RNI. Oral symptoms were common and a few were associated with nutrient intakes.
Key words: dietary intake, nutrients, oral health, pregnancy, pregnant women
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