MJN 2024 Issues
Malaysian Journal of Nutrition (Mal J Nutr)
Volume 30 No.1, 2024
Table of Content
Factors associated with poor appetite among residents
at selected long-term care facilities in Selangor,
Malaysia
Duaa Al-junid, Chan Yoke Mun, Siti Nur Asyura Adznam, Chin Yit Siew, Zalilah
Mohd Shariff, Lim Poh Ying, Sazlina Shariff-Ghazali & Tanti Irawati Rosli
doi: https://doi.org/10.31246/mjn-2023-0035
Vitamin Factors associated with poor appetite among residents at selected long-term care facilities in Selangor, Malaysia
ABSTRACT
Introduction: Poor appetite is prevalent among older adults and may negatively impact on their overall health. This is especially true for institutionalised residents. Despite this, there is a paucity of research on appetite and its associated factors among institutionalised residents, which signified the present study.
Methods: A cross-sectional study was conducted among elderly residents at long-term care facilities in the state of Selangor, Malaysia to ascertain their appetite status and its associated factors.
Results: : A total of 97 residents with mean age of 74.2±8.4 years old were recruited. They comprised 61.9% females and 38.1% males. More than 50% had poor appetite with early satiety. There were 63.0%, 82.4%, and 94.8% who had poor oral health, poor sleep quality, and depression, respectively. Ethnicity (OR=2.73; 95% CI=1.00-7.44; p=0.049) was the only factor that predicted poor appetite among older adults in long-term care facilities, with Malay residents having poorer appetite than their Chinese and Indian counterparts.
Conclusion: The prevalence of poor appetite was high among residents staying at long-term care facilities in Selangor, Malaysia, especially among Malays. This issue deserves further studies to identify the specific underlying factors contributing to poor appetite among older adults from different ethnicities. Acknowledging the high prevalence of poor appetite among older adults and its possible unfavourable outcomes, appropriate nutrition interventions are therefore needed to address this issue among institutionalised elderly
Key words: appetite, depressive, institutionalised residents, older adults, sleep quality
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Introduction: Poor appetite is prevalent among older adults and may negatively impact on their overall health. This is especially true for institutionalised residents. Despite this, there is a paucity of research on appetite and its associated factors among institutionalised residents, which signified the present study.
Methods: A cross-sectional study was conducted among elderly residents at long-term care facilities in the state of Selangor, Malaysia to ascertain their appetite status and its associated factors.
Results: : A total of 97 residents with mean age of 74.2±8.4 years old were recruited. They comprised 61.9% females and 38.1% males. More than 50% had poor appetite with early satiety. There were 63.0%, 82.4%, and 94.8% who had poor oral health, poor sleep quality, and depression, respectively. Ethnicity (OR=2.73; 95% CI=1.00-7.44; p=0.049) was the only factor that predicted poor appetite among older adults in long-term care facilities, with Malay residents having poorer appetite than their Chinese and Indian counterparts.
Conclusion: The prevalence of poor appetite was high among residents staying at long-term care facilities in Selangor, Malaysia, especially among Malays. This issue deserves further studies to identify the specific underlying factors contributing to poor appetite among older adults from different ethnicities. Acknowledging the high prevalence of poor appetite among older adults and its possible unfavourable outcomes, appropriate nutrition interventions are therefore needed to address this issue among institutionalised elderly
Key words: appetite, depressive, institutionalised residents, older adults, sleep quality
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Association between nutritional status of Filipino
preschool children and participation in government
programmes at the household and individual levels
Frances Pola S. Arias
& Eldridge B. Ferrer
https://doi.org/10.31246/mjn-2022-0111
Vitamin Association between nutritional status of Filipino preschool children and participation in government programmes at the household and individual levels
ABSTRACT
Introduction: Health and nutrition interventions in developing countries have been linked to better thriving and survival of children. Identifying programmes with significant effect on the nutritional status of Filipino preschool children may aid in identifying impactful interventions in addressing malnutrition. This study evaluated the association between nutritional status of preschool children and government programme participation based on the 2018 Expanded National Nutrition Survey (ENNS) results.
Methods: Secondary data analysis of 12,949 preschool children was performed from the 2018 ENNS. The selected data included socioeconomic, anthropometric, and self-reported household-level and individual-level government programme participation. Chi-square test for association and multiple logistic regression were conducted using Stata version 16
Results: Participation in immunisation programme, growth monitoring, household food production, and awareness and usage of iodised salt were negatively associated with at least one type of undernutrition. Consequently, participation in deworming programme was positively associated with both underweight and stunting. Regression analysis showed that preschool children who underwent growth monitoring were less likely to be stunted (OR=0.58), while those who underwent newborn screening were less likely to be underweight (OR=0.53) and stunted (OR=0.62). On the contrary, dewormed children were more likely to be stunted (OR=1.63) and those from 4Ps households were more likely to be wasted (OR=2.24).
Conclusion: There is a need to re-evaluate programme strategies to maximise the benefits provided. Programmes showing significant associations with nutritional status including immunisation, growth monitoring, deworming, household food production, and awareness and usage of iodised salt should be continued and sustained with updated policies.
Key words: government programmes, nutritional status, preschool children
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Introduction: Health and nutrition interventions in developing countries have been linked to better thriving and survival of children. Identifying programmes with significant effect on the nutritional status of Filipino preschool children may aid in identifying impactful interventions in addressing malnutrition. This study evaluated the association between nutritional status of preschool children and government programme participation based on the 2018 Expanded National Nutrition Survey (ENNS) results.
Methods: Secondary data analysis of 12,949 preschool children was performed from the 2018 ENNS. The selected data included socioeconomic, anthropometric, and self-reported household-level and individual-level government programme participation. Chi-square test for association and multiple logistic regression were conducted using Stata version 16
Results: Participation in immunisation programme, growth monitoring, household food production, and awareness and usage of iodised salt were negatively associated with at least one type of undernutrition. Consequently, participation in deworming programme was positively associated with both underweight and stunting. Regression analysis showed that preschool children who underwent growth monitoring were less likely to be stunted (OR=0.58), while those who underwent newborn screening were less likely to be underweight (OR=0.53) and stunted (OR=0.62). On the contrary, dewormed children were more likely to be stunted (OR=1.63) and those from 4Ps households were more likely to be wasted (OR=2.24).
Conclusion: There is a need to re-evaluate programme strategies to maximise the benefits provided. Programmes showing significant associations with nutritional status including immunisation, growth monitoring, deworming, household food production, and awareness and usage of iodised salt should be continued and sustained with updated policies.
Key words: government programmes, nutritional status, preschool children
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Eating behaviour and lifestyle changes among college
students in Malaysia during the Movement Control
Order (MCO)
Anis Suraya Muhamad Azmi, Nur Islami Mohd Fahmi Teng & Norsham
Juliana
https://doi.org/10.31246/mjn-2022-0054
Vitamin Eating behaviour and lifestyle changes among college students in Malaysia during the Movement Control Order (MCO)
ABSTRACT
Introduction: COVID-19 lockdown has been linked to alterations in eating behaviour and a sedentary lifestyle. As human-to-human transmission rapidly increased, the Movement Control Order (MCO) was put in place as an attempt to minimise the risk of the virus spreading in the community. This study aimed to determine whether eating behaviour was associated with sleep quality and physical activity among college students in Malaysia during MCO.
Methods: This was a cross-sectional study among Malaysian students aged between 20 to 34 years old. A simple random sampling method was applied and the participants had to complete an online survey consisting of a validated Dutch Eating Behaviour Questionnaire (DEBQ), Pittsburgh Sleep Quality Index (PSQI), and International Physical Activity Questionnaire–Short Form (IPAQ-SF), distributed via an online platform.
Results: A total of 370 students participated, with 22.4% emotional eaters, 58.6% external eaters, and 23.0% restrained eaters. In addition, 64.3% had poor sleep quality, while 57.6% claimed to be physically active. However, no correlations were found between all eating behaviour subscales with sleep quality and physical activity.
Conclusion: More than half of college students presented with external eating behaviours. Early screening and further investigations should be done, especially with the high rate of poor sleepers, to promote and sustain a healthy lifestyle during and beyond COVID-19.
Key words: COVID-19, eating behaviour, lifestyle, movement control order
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Introduction: COVID-19 lockdown has been linked to alterations in eating behaviour and a sedentary lifestyle. As human-to-human transmission rapidly increased, the Movement Control Order (MCO) was put in place as an attempt to minimise the risk of the virus spreading in the community. This study aimed to determine whether eating behaviour was associated with sleep quality and physical activity among college students in Malaysia during MCO.
Methods: This was a cross-sectional study among Malaysian students aged between 20 to 34 years old. A simple random sampling method was applied and the participants had to complete an online survey consisting of a validated Dutch Eating Behaviour Questionnaire (DEBQ), Pittsburgh Sleep Quality Index (PSQI), and International Physical Activity Questionnaire–Short Form (IPAQ-SF), distributed via an online platform.
Results: A total of 370 students participated, with 22.4% emotional eaters, 58.6% external eaters, and 23.0% restrained eaters. In addition, 64.3% had poor sleep quality, while 57.6% claimed to be physically active. However, no correlations were found between all eating behaviour subscales with sleep quality and physical activity.
Conclusion: More than half of college students presented with external eating behaviours. Early screening and further investigations should be done, especially with the high rate of poor sleepers, to promote and sustain a healthy lifestyle during and beyond COVID-19.
Key words: COVID-19, eating behaviour, lifestyle, movement control order
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Association between dietary diversity and
complications during pregnancy in a South-West
District of Bangladesh
Sabrina Zaman, Tamsel Ahammed & Md. Abu Bashar
https://doi.org/10.31246/mjn-2023-0052
Vitamin Association between dietary diversity and complications during pregnancy in a South-West District of Bangladesh
ABSTRACT
Introduction: Poor dietary diversity is one of the key factors that increases the rate of complications during pregnancy. Pregnancy complications significantly increase the risk of maternal mortality. The aim of this study was to explore the associated factors between dietary diversity and complications during pregnancy.
Methods: A cross-sectional study was conducted among 450 randomly selected pregnant women. Individual dietary diversity score (IDDS) was used to assess dietary diversity based on Food Frequency Questionnaire (FFQ). IDDS was derived from 24-hour recalls from nine food groups.
Results: Most of the pregnant women (48.9%) included in this study were in their second trimester; 19.3% and 31.8% were in first trimester and third trimester, respectively. About 83.8% of respondents included in this study experienced pregnancy complications. According to IDDS, most participants (77.1%) consumed a medium-diversified diet. Only 4.4% and 18.4% of pregnant women had low and highly diversified dietary intakes, respectively. Mean IDDS was 5.62±0.93, which indicated medium diversity of dietary intake. Dietary diversity had a statistically significant correlation with age (p=0.003), monthly income (p=0.003), education level (p=0.001), and respondent’s employment (p=0.004). The study exposed that pregnancy complications had a negative correlation with food diversity (r=-0.223), marriage age (r=-0.066), and education level (r=-0.163).
Conclusion: The study concluded that pregnancy complications can be alleviated by improving dietary diversity practices during pregnancy.
Key words: dietary diversity, maternal mortality, pregnancy complications
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Introduction: Poor dietary diversity is one of the key factors that increases the rate of complications during pregnancy. Pregnancy complications significantly increase the risk of maternal mortality. The aim of this study was to explore the associated factors between dietary diversity and complications during pregnancy.
Methods: A cross-sectional study was conducted among 450 randomly selected pregnant women. Individual dietary diversity score (IDDS) was used to assess dietary diversity based on Food Frequency Questionnaire (FFQ). IDDS was derived from 24-hour recalls from nine food groups.
Results: Most of the pregnant women (48.9%) included in this study were in their second trimester; 19.3% and 31.8% were in first trimester and third trimester, respectively. About 83.8% of respondents included in this study experienced pregnancy complications. According to IDDS, most participants (77.1%) consumed a medium-diversified diet. Only 4.4% and 18.4% of pregnant women had low and highly diversified dietary intakes, respectively. Mean IDDS was 5.62±0.93, which indicated medium diversity of dietary intake. Dietary diversity had a statistically significant correlation with age (p=0.003), monthly income (p=0.003), education level (p=0.001), and respondent’s employment (p=0.004). The study exposed that pregnancy complications had a negative correlation with food diversity (r=-0.223), marriage age (r=-0.066), and education level (r=-0.163).
Conclusion: The study concluded that pregnancy complications can be alleviated by improving dietary diversity practices during pregnancy.
Key words: dietary diversity, maternal mortality, pregnancy complications
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Socio-demographic factors and parental feeding
practices predicted body mass index of Malaysian
children with learning disabilities
Siti Fathiah Mohamed, Divya Vanoh & Soo Kah Leng
https://doi.org/10.31246/mjn-2023-0081
Vitamin Socio-demographic factors and parental feeding practices predicted body mass index of Malaysian children with learning disabilities
ABSTRACT
Introduction: Overweight and obesity have emerged as significant global health concerns among children. Previous studies have provided evidence that children with intellectual and learning disabilities (LD) are at a higher risk of obesity compared to their peers without disabilities.
Methods: This study aimed to predict body weight status of children with LD who attended Special Education Integration Program in Kelantan, located on East Coast of Peninsular Malaysia. Parents completed a self-administered questionnaire in Malay language, which included “Screening Tool of Feeding Problems” children’s version (STEP-CHILD) and Comprehensive Feeding Practice Questionnaire (CFPQ). The children’s body weight and height were measured to determine body mass index (BMI). Research hypothesis was tested through stepwise multiple linear regression analysis.
Results: This study recruited 245 subjects with mean age of 10.5±1.7 years and mean BMI of 18.5±4.9 kg/m2. Prevalence of underweight, thinness and severe thinness was 12.2%, while overweight and obesity was 29.0%. Male children with LD (β=0.109, p<0.044), older age (β=0.226, p<0.001), higher child birth weight (β=0.119, p<0.029), lack of parental modelling (β=-0.170, p=0.004), lower parental pressure (β=-0.266, p<0.001), and higher restriction for weight control (β=0.361, p<0.001) were found to predict higher BMI values.
Conclusion: Positive parental feeding practices during mealtime are crucial for addressing the poor nutritional status of children with LD.
Key words: BMI, children, learning disabilities, parental feeding practices
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Introduction: Overweight and obesity have emerged as significant global health concerns among children. Previous studies have provided evidence that children with intellectual and learning disabilities (LD) are at a higher risk of obesity compared to their peers without disabilities.
Methods: This study aimed to predict body weight status of children with LD who attended Special Education Integration Program in Kelantan, located on East Coast of Peninsular Malaysia. Parents completed a self-administered questionnaire in Malay language, which included “Screening Tool of Feeding Problems” children’s version (STEP-CHILD) and Comprehensive Feeding Practice Questionnaire (CFPQ). The children’s body weight and height were measured to determine body mass index (BMI). Research hypothesis was tested through stepwise multiple linear regression analysis.
Results: This study recruited 245 subjects with mean age of 10.5±1.7 years and mean BMI of 18.5±4.9 kg/m2. Prevalence of underweight, thinness and severe thinness was 12.2%, while overweight and obesity was 29.0%. Male children with LD (β=0.109, p<0.044), older age (β=0.226, p<0.001), higher child birth weight (β=0.119, p<0.029), lack of parental modelling (β=-0.170, p=0.004), lower parental pressure (β=-0.266, p<0.001), and higher restriction for weight control (β=0.361, p<0.001) were found to predict higher BMI values.
Conclusion: Positive parental feeding practices during mealtime are crucial for addressing the poor nutritional status of children with LD.
Key words: BMI, children, learning disabilities, parental feeding practices
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Development and validation of the Salt Intake-Related
Knowledge, Attitude, and Practice Questionnaire for
Malaysian adults
Zainorain Natasha Zainal Arifen, Ngoh Wan Hwah, Hng Jie Wei, Siti Aishah
Ismail, Maryam Hanis Fairuzam & Hasnah Haron
https://doi.org/10.31246/mjn-2022-0134
Vitamin Development and validation of the Salt Intake-Related Knowledge, Attitude, and Practice Questionnaire for Malaysian adults
ABSTRACT
Introduction: Malaysian adults consume excessive amounts of salt daily, which could lead to hypertension. Understanding knowledge, attitudes, and practices (KAP) surrounding salt intake is crucial for designing effective interventions to reduce excessive consumption and its associated health risks. Therefore, this study aimed to adapt an existing salt intake-related KAP questionnaire that was previously employed in a local population-based survey and to validate and test its reliability.
Methods: This cross-sectional study comprised two phases: (1) adaptation, content validation (CV), and face validation (FV); (2) pilot testing and reliability testing. CV and FV involved a total of seven experts and ten Malaysian adults from the Klang Valley, respectively. Pilot testing involved 139 Malaysian adults to determine the questionnaire’s reliability. Content validity index (CVI) and Face validity index (FVI) values were calculated to analyse CV and FV. Reliability of each domain was analysed by obtaining Cronbach’s alpha (α) values.
Results: : A self-administered questionnaire comprising six items each for knowledge, attitude, and practice was developed. The questionnaire demonstrated acceptable item-level CVI (I-CVI) and item-level FVI (I-FVI) values of at least 0.83, indicating that the items were relevant, clear, non-ambiguous, and simple. Reliability test showed acceptable α values of at least 0.70 for each domain, suggesting that the questionnaire was reliable.
Conclusion: This tool could be considered valid and reliable for assessing the level of KAP towards salt intake among adults in Malaysia.
Key words: adults, awareness, questionnaire, salt intake, validation
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Introduction: Malaysian adults consume excessive amounts of salt daily, which could lead to hypertension. Understanding knowledge, attitudes, and practices (KAP) surrounding salt intake is crucial for designing effective interventions to reduce excessive consumption and its associated health risks. Therefore, this study aimed to adapt an existing salt intake-related KAP questionnaire that was previously employed in a local population-based survey and to validate and test its reliability.
Methods: This cross-sectional study comprised two phases: (1) adaptation, content validation (CV), and face validation (FV); (2) pilot testing and reliability testing. CV and FV involved a total of seven experts and ten Malaysian adults from the Klang Valley, respectively. Pilot testing involved 139 Malaysian adults to determine the questionnaire’s reliability. Content validity index (CVI) and Face validity index (FVI) values were calculated to analyse CV and FV. Reliability of each domain was analysed by obtaining Cronbach’s alpha (α) values.
Results: : A self-administered questionnaire comprising six items each for knowledge, attitude, and practice was developed. The questionnaire demonstrated acceptable item-level CVI (I-CVI) and item-level FVI (I-FVI) values of at least 0.83, indicating that the items were relevant, clear, non-ambiguous, and simple. Reliability test showed acceptable α values of at least 0.70 for each domain, suggesting that the questionnaire was reliable.
Conclusion: This tool could be considered valid and reliable for assessing the level of KAP towards salt intake among adults in Malaysia.
Key words: adults, awareness, questionnaire, salt intake, validation
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Associations between quantity and quality of dietary
intake with haemoglobin concentration among female
adolescents in Tasikmalaya, West Java, Indonesia
Lilik Hidayanti, Dian Saraswati & Iseu Siti Aisyah
https://doi.org/10.31246/mjn-2023-0073
Vitamin Associations between quantity and quality of dietary intake with haemoglobin concentration among female adolescents in Tasikmalaya, West Java, Indonesia
ABSTRACT
Introduction: An imbalance in diet can lead to anaemia in young women, which can impact not only themselves, but also the next generation. This study aimed to determine associations between quantity and quality of dietary intake with haemoglobin (Hb) concentration among female adolescents in Tasikmalaya, West Java, Indonesia.
Methods: A cross-sectional study was conducted on 347 young women aged 12-18 years from ten districts in Tasikmalaya City, selected by simple random sampling. Quantity and quality of dietary intake were measured by 2-repeated 24-hour dietary recalls, while portable haemoglobinometer (HemoCue® Hb 201+) was used to measure Hb concentration. Linear regression model predicted associations between quantity and quality of dietary intake with Hb concentration in female adolescents.
Results: The proportion of subjects suffering from anaemia were 47.3%. Average intake of dietary iron was 6.7±3.0 mg and average dietary quality score was 32.6%. Dietary quality score and days of menstrual bleeding contributed as much as 12.7% to the variation in Hb concentration among female adolescents.
Conclusion: Anaemia in female adolescents in Tasikmalaya, West Java, Indonesia is a serious public health problem. Diet quality score was associated with female adolescents’ Hb concentration; therefore, improving the quality of diet is important to reduce anaemia.
Key words: anaemia, dietary quality, dietary quantity, female adolescents, haemoglobin
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Introduction: An imbalance in diet can lead to anaemia in young women, which can impact not only themselves, but also the next generation. This study aimed to determine associations between quantity and quality of dietary intake with haemoglobin (Hb) concentration among female adolescents in Tasikmalaya, West Java, Indonesia.
Methods: A cross-sectional study was conducted on 347 young women aged 12-18 years from ten districts in Tasikmalaya City, selected by simple random sampling. Quantity and quality of dietary intake were measured by 2-repeated 24-hour dietary recalls, while portable haemoglobinometer (HemoCue® Hb 201+) was used to measure Hb concentration. Linear regression model predicted associations between quantity and quality of dietary intake with Hb concentration in female adolescents.
Results: The proportion of subjects suffering from anaemia were 47.3%. Average intake of dietary iron was 6.7±3.0 mg and average dietary quality score was 32.6%. Dietary quality score and days of menstrual bleeding contributed as much as 12.7% to the variation in Hb concentration among female adolescents.
Conclusion: Anaemia in female adolescents in Tasikmalaya, West Java, Indonesia is a serious public health problem. Diet quality score was associated with female adolescents’ Hb concentration; therefore, improving the quality of diet is important to reduce anaemia.
Key words: anaemia, dietary quality, dietary quantity, female adolescents, haemoglobin
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Effects of nut and legume powder substitution in
crackers prepared with wheat flour on postprandial
plasma glucose response among healthy Thai adults
Wongdokmai Rossukon, Sridonpai Pimnapanut & Prachansuwan Aree
https://doi.org/10.31246/mjn-2023-0056
Effects of nut and legume powder substitution in crackers prepared with wheat flour on postprandial plasma glucose response among healthy Thai adults
ABSTRACT
Introduction: Crackers, one of the most consumed baked products, primarily contain refined wheat flour and have a moderate glycaemic index (GI). Nut and legume powders are used in baked goods to help regulate postprandial glycaemia; however, their glycaemic responses remain controversial. Our study aimed to compare the postprandial glycaemic responses between crackers with 30% wheat flour substitution by white kidney beans, cashew nuts, and almonds versus standard wheat crackers.
Methods: Twelve adults were recruited for a five-session randomised controlled crossover study. In each session, they were randomly assigned to receive 50g carbohydrates from either a glucose solution or one of the four crackers. Plasma glucose levels were measured at baseline and 15, 30, 45, 60, 90, and 120 minutes after consumption. Satiety and hunger were evaluated using 100mm visual analogue scales at baseline and every 30 minutes until 120 minutes.
Results: Mean incremental area under the curve (IAUC) for plasma glucose did not differ between the alternatives and wheat crackers, but was lowest for almond crackers. Compared with GI value of glucose solution, that of wheat, cashew nut, white kidney bean, and almond crackers were 39.97±23.13, 37.66±24.66, 35.85±10.86, and 28.09±17.92, respectively. Almond cracker consumption resulted in the highest mean IAUC for satiety and lowest for hunger, though non-significant.
Conclusion: Crackers with 30% wheat flour substitution by nut and legume powders tended to improve postprandial glycaemia more than the standard crackers; however, acute responses on insulin and glucagon-like peptide-1 require further examination.
Key words: cracker biscuit, flour substitutes, glycaemic response
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Introduction: Crackers, one of the most consumed baked products, primarily contain refined wheat flour and have a moderate glycaemic index (GI). Nut and legume powders are used in baked goods to help regulate postprandial glycaemia; however, their glycaemic responses remain controversial. Our study aimed to compare the postprandial glycaemic responses between crackers with 30% wheat flour substitution by white kidney beans, cashew nuts, and almonds versus standard wheat crackers.
Methods: Twelve adults were recruited for a five-session randomised controlled crossover study. In each session, they were randomly assigned to receive 50g carbohydrates from either a glucose solution or one of the four crackers. Plasma glucose levels were measured at baseline and 15, 30, 45, 60, 90, and 120 minutes after consumption. Satiety and hunger were evaluated using 100mm visual analogue scales at baseline and every 30 minutes until 120 minutes.
Results: Mean incremental area under the curve (IAUC) for plasma glucose did not differ between the alternatives and wheat crackers, but was lowest for almond crackers. Compared with GI value of glucose solution, that of wheat, cashew nut, white kidney bean, and almond crackers were 39.97±23.13, 37.66±24.66, 35.85±10.86, and 28.09±17.92, respectively. Almond cracker consumption resulted in the highest mean IAUC for satiety and lowest for hunger, though non-significant.
Conclusion: Crackers with 30% wheat flour substitution by nut and legume powders tended to improve postprandial glycaemia more than the standard crackers; however, acute responses on insulin and glucagon-like peptide-1 require further examination.
Key words: cracker biscuit, flour substitutes, glycaemic response
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Correlation between body mass index and haemoglobin
level of adolescent girls in a stunting locus area at
Tangerang, Indonesia
Nadiyah* & Idrus Jus’at
https://doi.org/10.31246/mjn-2023-0064
Vitamin Correlation between body mass index and haemoglobin level of adolescent girls in a stunting locus area at Tangerang, Indonesia
ABSTRACT
Introduction: In Indonesia, anaemia is known to be extremely common in female adolescents. In addition, the problem of overweight/obesity in teenagers is becoming more prevalent, even in stunting locus areas. This study aimed to examine the correlation between body mass index (BMI) and haemoglobin levels among adolescent girls in Tangerang’s stunting locus area.
Methods: This crosssectional study included 171 adolescent girls attending four junior and senior high schools in Tangerang’s stunting locus area. Adolescents who matched the inclusion criteria— healthy, having lived in Sukamantri for more than six months, and willing to participate were chosen by a multistage cluster sampling procedure. Body weight and fat were measured, and Z-score for BMI-for-age was determined. Haemoglobin levels were measured by the Mission Hb Testing System. Multiple linear regression test was applied for the analysis.
Results: The prevalences of thinness/severe thinness, normal, and overweight/obesity were 5.3%, 70.8%, and 23.9%, respectively. There were 20% of anaemic girls. Among anaemic girls, there were 26% overweight/obese and no thin/very thin girls. A weak, negative correlation between BMI with haemoglobin levels was observed (R2=0.054, p<0.001).
Conclusion: The correlation between BMI and haemoglobin level was weak in our sample of adolescent girls in the stunting locus area. The current study emphasised the importance of additional research that includes several haematological and inflammatory biomarkers to better understand the complex relationship between nutritional status and haemoglobin level.
Key words: adolescent girls, anaemia, body fat, body mass index
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Introduction: In Indonesia, anaemia is known to be extremely common in female adolescents. In addition, the problem of overweight/obesity in teenagers is becoming more prevalent, even in stunting locus areas. This study aimed to examine the correlation between body mass index (BMI) and haemoglobin levels among adolescent girls in Tangerang’s stunting locus area.
Methods: This crosssectional study included 171 adolescent girls attending four junior and senior high schools in Tangerang’s stunting locus area. Adolescents who matched the inclusion criteria— healthy, having lived in Sukamantri for more than six months, and willing to participate were chosen by a multistage cluster sampling procedure. Body weight and fat were measured, and Z-score for BMI-for-age was determined. Haemoglobin levels were measured by the Mission Hb Testing System. Multiple linear regression test was applied for the analysis.
Results: The prevalences of thinness/severe thinness, normal, and overweight/obesity were 5.3%, 70.8%, and 23.9%, respectively. There were 20% of anaemic girls. Among anaemic girls, there were 26% overweight/obese and no thin/very thin girls. A weak, negative correlation between BMI with haemoglobin levels was observed (R2=0.054, p<0.001).
Conclusion: The correlation between BMI and haemoglobin level was weak in our sample of adolescent girls in the stunting locus area. The current study emphasised the importance of additional research that includes several haematological and inflammatory biomarkers to better understand the complex relationship between nutritional status and haemoglobin level.
Key words: adolescent girls, anaemia, body fat, body mass index
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Online training needs assessment (TNA) among
Municipal Nutrition Action Officers (MNAOs) in the
Philippines
Idelia G. Glorioso*, Milflor S. Gonzales & Trina Mae B. Santos
https://doi.org/10.31246/mjn-2023-0164
Vitamin Online training needs assessment (TNA) among Municipal Nutrition Action Officers (MNAOs) in the Philippines
ABSTRACT
Introduction: A training needs assessment (TNA) was conducted by the Department of Science and Technology, Food and Nutrition Research Institute (DOST-FNRI) to design appropriate and relevant trainings for Municipal Nutrition Action Officers (MNAOs). In the Philippines, MNAO is a nutrition officer who serves at the municipal level and is tasked to ensure the localisation of the Philippine Plan of Action for Nutrition (PPAN) in Local Government Units (LGU) to ensure proper implementation of activities on Public Health Nutrition (PHN).
Methods: A total of 162 MNAOs in the country answered the online TNA survey conducted from April to May 2023.
Results: Based on the results of the TNA survey, there was a need for DOST-FNRI to design and conduct trainings related to the top three core competencies identified by MNAOs: Creating policies and standards related to food and nutrition; advocating legislation, regulation, and nutrition policies; and designing appropriate nutrition information education and communication (IEC) materials.
Conclusion: Based on the study results, it is recommended that LGUs allocate funds for capacity building of the public health workforce to create a skilled workforce in the community that will coordinate the formulation, implementation, monitoring, and evaluation of nutrition plans at the municipal level. For future consideration, curriculum design for professional development in public health nutrition should include core competencies on food and nutrition policy programme, nutrition programme management, and IEC development.
Key words: capacity-building, competency, training needs assessment
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Introduction: A training needs assessment (TNA) was conducted by the Department of Science and Technology, Food and Nutrition Research Institute (DOST-FNRI) to design appropriate and relevant trainings for Municipal Nutrition Action Officers (MNAOs). In the Philippines, MNAO is a nutrition officer who serves at the municipal level and is tasked to ensure the localisation of the Philippine Plan of Action for Nutrition (PPAN) in Local Government Units (LGU) to ensure proper implementation of activities on Public Health Nutrition (PHN).
Methods: A total of 162 MNAOs in the country answered the online TNA survey conducted from April to May 2023.
Results: Based on the results of the TNA survey, there was a need for DOST-FNRI to design and conduct trainings related to the top three core competencies identified by MNAOs: Creating policies and standards related to food and nutrition; advocating legislation, regulation, and nutrition policies; and designing appropriate nutrition information education and communication (IEC) materials.
Conclusion: Based on the study results, it is recommended that LGUs allocate funds for capacity building of the public health workforce to create a skilled workforce in the community that will coordinate the formulation, implementation, monitoring, and evaluation of nutrition plans at the municipal level. For future consideration, curriculum design for professional development in public health nutrition should include core competencies on food and nutrition policy programme, nutrition programme management, and IEC development.
Key words: capacity-building, competency, training needs assessment
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Malaysian Journal of Nutrition (Mal J Nutr)
Volume 30 No.2, 2024
Table of Content
Factors affecting stunting in children aged 6-23 months
in South Sumatra Province, Indonesia
Ria Andreinie, Rini Sekartini, Dian Novita Chandra & Ninik Mudjihartini
doi: https://doi.org/10.31246/mjn-2023-0101
Vitamin Factors affecting stunting in children aged 6-23 months in South Sumatra Province, Indonesia
ABSTRACT
Introduction: South Sumatra Province in Indonesia has a relatively high prevalence of stunting and there is limited research about this phenomenon in this area. The study aimed to identify what factors affected stunting in children aged 6-23 months in the province.
Methods: Using a comparative cross-sectional design involving 139 mothers with children aged 6-23 months, the study collected data from September to December 2022 via anthropometric measurements and interviews using a questionnaire. Data on parental, child, socioeconomic, and environmental factors were analysed using chi-square test and logistic regression analysis.
Results: Overall, there were significant relationships among the following variables: child’s age (p=0.031), birth length (p=0.017), and weight-for-age (WAZ) status (p<0.001) with stunting. Children in the underweight and severely underweight categories were 28.7 times at risk of stunting compared to those in the normal category of WAZ status; children aged 12-23 months had a 2.8 times risk of stunting compared to children aged 6-11 months, while stunted birth length showed a 4.6 times risk of stunting compared to that of normal birth length.
Conclusion: This research found that child age, birth length, and WAZ status were significant factors affecting stunting in the South Sumatra Province. Given these results, this study offers recommendations for the provincial government to focus on intervention programmes that provide additional food for pregnant women with chronic energy deficiency, monitor the growth of toddlers, and manage toddlers with nutritional problems in this province.
Key words: birth length, child age, stunting, WAZ status
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Introduction: South Sumatra Province in Indonesia has a relatively high prevalence of stunting and there is limited research about this phenomenon in this area. The study aimed to identify what factors affected stunting in children aged 6-23 months in the province.
Methods: Using a comparative cross-sectional design involving 139 mothers with children aged 6-23 months, the study collected data from September to December 2022 via anthropometric measurements and interviews using a questionnaire. Data on parental, child, socioeconomic, and environmental factors were analysed using chi-square test and logistic regression analysis.
Results: Overall, there were significant relationships among the following variables: child’s age (p=0.031), birth length (p=0.017), and weight-for-age (WAZ) status (p<0.001) with stunting. Children in the underweight and severely underweight categories were 28.7 times at risk of stunting compared to those in the normal category of WAZ status; children aged 12-23 months had a 2.8 times risk of stunting compared to children aged 6-11 months, while stunted birth length showed a 4.6 times risk of stunting compared to that of normal birth length.
Conclusion: This research found that child age, birth length, and WAZ status were significant factors affecting stunting in the South Sumatra Province. Given these results, this study offers recommendations for the provincial government to focus on intervention programmes that provide additional food for pregnant women with chronic energy deficiency, monitor the growth of toddlers, and manage toddlers with nutritional problems in this province.
Key words: birth length, child age, stunting, WAZ status
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Plasma amino acid profiles in thalassaemia major with
iron overload
Ina Susianti Timan, Pustika Amalia Wahidiyat, Damayanti Rusli Sjarif,
Merci Monica br Pasaribu, Fransisca Putri & Lukito Widjaja
doi: https://doi.org/10.31246/mjn-2023-0085
Vitamin Plasma amino acid profiles in thalassaemia major with iron overload
ABSTRACT
Introduction: Iron overload in thalassaemia major patients mainly occurs due to periodic transfusions. When iron exceeds transferrin capacity, non-transferrin bound iron accumulates and causes tissue damage, including in the gastrointestinal tract, resulting in impaired enterocyte function and amino acid absorption. The aim of this study was to evaluate amino acid profiles in patients with thalassaemia major after repeated transfusions and chelation.
Methods: Whole blood amino acids were analysed from dried blood spots using liquid chromatography tandem mass spectrometry. This study consisted of two parts: a cross-sectional and a cohort study in thalassaemia-β-major patients. In the cross-sectional study, amino acid profiles were analysed in 219 thalassaemia patients who received routine transfusion and chelation therapy, and 60 healthy control subjects. The cohort study included 21 subjects, from whom blood samples were taken at pre-transfusion, 1-day posttransfusion, one and three months post-chelation to evaluate changes in amino acid levels.
Results: There were significant differences between amino acid levels in thalassaemia subjects and controls. Positive correlations were found between serum iron and transferrin with age, also between transferrin with proline, valine, phenylalanine, aspartic acid, and glutamic. Phenylalanine and aspartic acid were significantly lower in subjects with transferrin lower than 180 μg/dL. Significant correlations were found between haemoglobin with essential and non-essential amino acid groups. From the cohort study, significant changes were observed in glycine, alanine, leucine, and aspartic acid.
Conclusion: Amino acid profiles in thalassaemia patients differed compared to healthy controls, even after transfusion and chelation. Phenylalanine and aspartic acid were significantly lower in subjects with low transferrin levels.
Key words: amino acid, chelation, iron overload, thalassaemia, transfusion
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Introduction: Iron overload in thalassaemia major patients mainly occurs due to periodic transfusions. When iron exceeds transferrin capacity, non-transferrin bound iron accumulates and causes tissue damage, including in the gastrointestinal tract, resulting in impaired enterocyte function and amino acid absorption. The aim of this study was to evaluate amino acid profiles in patients with thalassaemia major after repeated transfusions and chelation.
Methods: Whole blood amino acids were analysed from dried blood spots using liquid chromatography tandem mass spectrometry. This study consisted of two parts: a cross-sectional and a cohort study in thalassaemia-β-major patients. In the cross-sectional study, amino acid profiles were analysed in 219 thalassaemia patients who received routine transfusion and chelation therapy, and 60 healthy control subjects. The cohort study included 21 subjects, from whom blood samples were taken at pre-transfusion, 1-day posttransfusion, one and three months post-chelation to evaluate changes in amino acid levels.
Results: There were significant differences between amino acid levels in thalassaemia subjects and controls. Positive correlations were found between serum iron and transferrin with age, also between transferrin with proline, valine, phenylalanine, aspartic acid, and glutamic. Phenylalanine and aspartic acid were significantly lower in subjects with transferrin lower than 180 μg/dL. Significant correlations were found between haemoglobin with essential and non-essential amino acid groups. From the cohort study, significant changes were observed in glycine, alanine, leucine, and aspartic acid.
Conclusion: Amino acid profiles in thalassaemia patients differed compared to healthy controls, even after transfusion and chelation. Phenylalanine and aspartic acid were significantly lower in subjects with low transferrin levels.
Key words: amino acid, chelation, iron overload, thalassaemia, transfusion
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Infant feeding practices and associated factors during
the COVID-19 pandemic: Findings from an online crosssectional
study in Indonesia
Judhiastuty Februhartanty, Cahya Ayu Agustin & Athiya Fadlina
doi: https://doi.org/10.31246/mjn-2023-0097
Infant feeding practices and associated factors during the COVID-19 pandemic: Findings from an online crosssectional study in Indonesia
ABSTRACT
Introduction: COVID-19 pandemic presents a challenge to ensuring optimal infant feeding practices. This study aimed to assess infant feeding practices and investigate potential factors associated with exclusive and continued breastfeeding practices during the COVID-19 pandemic in Indonesia.
Methods: An online survey was conducted during December 2020 – August 2021. A total of 817 Indonesian mothers aged ≥18 years old with infants aged <18 months were obtained through convenience sampling. Exclusive breastfeeding was the practice at the time of the survey among infants <6 months old; continued breastfeeding was considered when infants aged >6 months received any type of breastfeeding in the previous day.
Results: Most subjects were aged 25-34 years old (81.3%), had a high education level (85.7%), with middle household income level (40.5%), and lived in Java Island (81.6%). Infants’ age and sex were comparable between younger vs. older infants and boys vs. girls, respectively. Exclusive breastfeeding was 81.3%. Continued breastfeeding was 93.4%, with 74.3% meeting the minimum acceptable diet. Breastfeeding intention (92.9%) and husband’s support for infant feeding (67.2%) were reported during the COVID-19 pandemic. Multivariate analyses showed that breastfeeding intention was one of the factors associated with exclusive breastfeeding [aOR=12.6; 95%CI (4.1-39.1)] and continued breastfeeding [10.9 (4.4-27.0)].
Conclusion: The study suggested that mothers’ intention to breastfeed during the COVID-19 pandemic provided affirmation of good breastfeeding experiences by allowing mothers to have more time for childcare activities and more opportunities to develop meaningful coparenting practices while staying at home.
Key words: breastfeeding intention, COVID-19 pandemic, continued breastfeeding, exclusive breastfeeding, minimum acceptable diet
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Introduction: COVID-19 pandemic presents a challenge to ensuring optimal infant feeding practices. This study aimed to assess infant feeding practices and investigate potential factors associated with exclusive and continued breastfeeding practices during the COVID-19 pandemic in Indonesia.
Methods: An online survey was conducted during December 2020 – August 2021. A total of 817 Indonesian mothers aged ≥18 years old with infants aged <18 months were obtained through convenience sampling. Exclusive breastfeeding was the practice at the time of the survey among infants <6 months old; continued breastfeeding was considered when infants aged >6 months received any type of breastfeeding in the previous day.
Results: Most subjects were aged 25-34 years old (81.3%), had a high education level (85.7%), with middle household income level (40.5%), and lived in Java Island (81.6%). Infants’ age and sex were comparable between younger vs. older infants and boys vs. girls, respectively. Exclusive breastfeeding was 81.3%. Continued breastfeeding was 93.4%, with 74.3% meeting the minimum acceptable diet. Breastfeeding intention (92.9%) and husband’s support for infant feeding (67.2%) were reported during the COVID-19 pandemic. Multivariate analyses showed that breastfeeding intention was one of the factors associated with exclusive breastfeeding [aOR=12.6; 95%CI (4.1-39.1)] and continued breastfeeding [10.9 (4.4-27.0)].
Conclusion: The study suggested that mothers’ intention to breastfeed during the COVID-19 pandemic provided affirmation of good breastfeeding experiences by allowing mothers to have more time for childcare activities and more opportunities to develop meaningful coparenting practices while staying at home.
Key words: breastfeeding intention, COVID-19 pandemic, continued breastfeeding, exclusive breastfeeding, minimum acceptable diet
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Predictors for 25-hydroxyvitamin D concentration in
early pregnancy
Erni Yusnita Lalusu, Ratna Djuwita Hatma, Mondastri Korib Sudaryo,
Dwiana Ocviyanti & Rimbawan
doi: https://doi.org/10.31246/mjn-2023-0015
Predictors for 25-hydroxyvitamin D concentration in early pregnancy
ABSTRACT
Introduction: There are very few studies of vitamin D deficiency in Indonesia. Since vitamin D deficiency is indicated by the level of 25-hydroxyvitamin D (25(OH) D) in blood, the present study aimed to analyse the predictive factors of 25(OH) D concentration in early pregnancy.
Methods: The present study was a crosssectional observational study. The sample consisted of 67 pregnant women in their 1st trimester of pregnancy. Parameters assessed included levels of 25(OH)D, glucose, and haemoglobin in the blood. Demographic information such as parity, family history of diabetes mellitus (DM), exposure to cigarette smoke, physical activity level, dietary intake, and anthropometric measurements were recorded. Linear regression analysis was employed.
Results: Mean concentration of 25(OH)D was 16.5 (6.6-34.1) ng/ml. Majority of the participants (77.6%) were deficient in vitamin D (25(OH)D <20ng/mL); only 1.5% had normal vitamin D levels (25(OH)D >30 ng/ mL). Bivariate analysis performed revealed that vitamin D intake (p=0.002) and family history of DM (p=0.043) played a significant role in determining 25(OH)D concentration. Additionally, dietary vitamin D intake, blood glucose level, exposure to cigarette smoke, and parental DM history served as predictors of 25(OH)D concentration in 54.5% of cases.
Conclusion: The findings indicate that vitamin D deficiency was high in the target population. Thus, it is critical to ensure that for pregnant women to take vitamin D supplements, since nearly 80% of pregnant mothers are vit D deficient. Vitamin D supplementation can be included in national pregnancy programmes
Key words: cigarette, diabetes mellitus, pregnant women, vitamin D concentration, vitamin D intake.
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Introduction: There are very few studies of vitamin D deficiency in Indonesia. Since vitamin D deficiency is indicated by the level of 25-hydroxyvitamin D (25(OH) D) in blood, the present study aimed to analyse the predictive factors of 25(OH) D concentration in early pregnancy.
Methods: The present study was a crosssectional observational study. The sample consisted of 67 pregnant women in their 1st trimester of pregnancy. Parameters assessed included levels of 25(OH)D, glucose, and haemoglobin in the blood. Demographic information such as parity, family history of diabetes mellitus (DM), exposure to cigarette smoke, physical activity level, dietary intake, and anthropometric measurements were recorded. Linear regression analysis was employed.
Results: Mean concentration of 25(OH)D was 16.5 (6.6-34.1) ng/ml. Majority of the participants (77.6%) were deficient in vitamin D (25(OH)D <20ng/mL); only 1.5% had normal vitamin D levels (25(OH)D >30 ng/ mL). Bivariate analysis performed revealed that vitamin D intake (p=0.002) and family history of DM (p=0.043) played a significant role in determining 25(OH)D concentration. Additionally, dietary vitamin D intake, blood glucose level, exposure to cigarette smoke, and parental DM history served as predictors of 25(OH)D concentration in 54.5% of cases.
Conclusion: The findings indicate that vitamin D deficiency was high in the target population. Thus, it is critical to ensure that for pregnant women to take vitamin D supplements, since nearly 80% of pregnant mothers are vit D deficient. Vitamin D supplementation can be included in national pregnancy programmes
Key words: cigarette, diabetes mellitus, pregnant women, vitamin D concentration, vitamin D intake.
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Effect of vitamin D supplementation on serum 25(OH)
D levels and blood pressure among the elderly in a
nursing house: A double-blind, randomised placebocontrolled
trial
Ferawaty, Diana Sunardi, Noto Dwimartutie, Dian Novita Chandra, Ninik
Mudjihartini & Nurul Ratna Mutu Manikam
doi: https://doi.org/10.31246/mjn-2023-0136
Effect of vitamin D supplementation on serum 25(OH) D levels and blood pressure among the elderly in a nursing house: A double-blind, randomised placebocontrolled trial
ABSTRACT
Introduction: Hypertension is the most common cardiovascular disease, especially in the elderly. Previous studies have reported that vitamin D plays a role in blood pressure. This study aimed to analyse the effect of vitamin D supplementation on serum 25(OH)D levels and blood pressure.
Methods: This was a double-blind, randomised placebo-controlled trial (RCT) on elderly subjects. Serum 25(OH)D levels were examined using chemiluminescent immunoassay (CLIA) method, while blood pressure was checked using a digital sphygmomanometer. Supplementation was given once per day for eight weeks; the control group was given a placebo, while the treatment group was given 2,000 IU vitamin D3 for subjects with insufficiency and 4,000 IU for subjects with deficiency.
Results: A total of 62 subjects aged 60-89 years participated and were randomised into 30 control and 32 treatment group subjects. Data analysis showed that vitamin D supplementation significantly increased 25(OH)D levels in treatment group (D=18.2±5.2 ng/mL) compared to control group (D=4.2±2.5 ng/mL) (p<0.001). However, vitamin D supplementation did not cause significant reduction in systolic blood pressure (D=-4.6(-25 - -0.5) mmHg for control group and D=-9.2(-20 - -27) mmHg for treatment group; p=0.109), and diastolic blood pressure (D=-7.2(-16 - -2) mmHg for control group and D=-8.4(-14.5 - -8.5) mmHg for treatment group; p=0.559).
Conclusion: Vitamin D supplementation significantly increased serum 25(OH)D levels, but did not significantly reduce systolic and diastolic blood pressures in the elderly. Elderly people need to regularly check their vitamin D levels so that the provision of supplementation can be timely and their quality of life can be improved.
Key words: blood pressure, elderly, serum 25(OH)D level, vitamin D supplementation
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Introduction: Hypertension is the most common cardiovascular disease, especially in the elderly. Previous studies have reported that vitamin D plays a role in blood pressure. This study aimed to analyse the effect of vitamin D supplementation on serum 25(OH)D levels and blood pressure.
Methods: This was a double-blind, randomised placebo-controlled trial (RCT) on elderly subjects. Serum 25(OH)D levels were examined using chemiluminescent immunoassay (CLIA) method, while blood pressure was checked using a digital sphygmomanometer. Supplementation was given once per day for eight weeks; the control group was given a placebo, while the treatment group was given 2,000 IU vitamin D3 for subjects with insufficiency and 4,000 IU for subjects with deficiency.
Results: A total of 62 subjects aged 60-89 years participated and were randomised into 30 control and 32 treatment group subjects. Data analysis showed that vitamin D supplementation significantly increased 25(OH)D levels in treatment group (D=18.2±5.2 ng/mL) compared to control group (D=4.2±2.5 ng/mL) (p<0.001). However, vitamin D supplementation did not cause significant reduction in systolic blood pressure (D=-4.6(-25 - -0.5) mmHg for control group and D=-9.2(-20 - -27) mmHg for treatment group; p=0.109), and diastolic blood pressure (D=-7.2(-16 - -2) mmHg for control group and D=-8.4(-14.5 - -8.5) mmHg for treatment group; p=0.559).
Conclusion: Vitamin D supplementation significantly increased serum 25(OH)D levels, but did not significantly reduce systolic and diastolic blood pressures in the elderly. Elderly people need to regularly check their vitamin D levels so that the provision of supplementation can be timely and their quality of life can be improved.
Key words: blood pressure, elderly, serum 25(OH)D level, vitamin D supplementation
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Effect of apple peel flour addition on physicochemical
characteristics and fatty acid profile of reduced-fat
mayonnaise
Herly Evanuarini & Agus Susilo
doi: https://doi.org/10.31246/mjn-2023-0020
Vitamin Effect of apple peel flour addition on physicochemical characteristics and fatty acid profile of reduced-fat mayonnaise
ABSTRACT
Introduction: Mayonnaise is popular throughout the world and contains various types of processed products. While reduced-fat mayonnaise (RFM) contains less than 50% oil, the drawback is the potential to reduce the physical quality of mayonnaise. The use of apple peel in the form of flour added to mayonnaise is predicted to enhance its physicochemical quality.
Methods: The research comprised laboratory experiments using randomised design with four treatments and six repetitions. Apple peel flour was added to the treatments in the following proportions: 0% (RFA0), 1% (RFA1), 2% (RFA2), and 3% (RFA3). Analysis of variance (ANOVA) was used to obtain average values and standard deviations.
Results: Addition of 3% apple peel flour to RFM showed highly significant effect (p≤0.01) on droplet size (2.15–9.49µm), viscosity (3965.00cP), colours L (71.93), a* (15.75), and b* (50.65), protein content (1.44%), and fat content (50.93%). It also produced an organoleptic quality that was acceptable to semi-trained panellists and fatty acid profiles containing various types of fatty acids.
Conclusion: The use of 3% apple peel flour in RFM represented the best treatment, with potential for further improvement.
Key words: apple peel flour, reduced-fat mayonnaise, stabiliser
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Introduction: Mayonnaise is popular throughout the world and contains various types of processed products. While reduced-fat mayonnaise (RFM) contains less than 50% oil, the drawback is the potential to reduce the physical quality of mayonnaise. The use of apple peel in the form of flour added to mayonnaise is predicted to enhance its physicochemical quality.
Methods: The research comprised laboratory experiments using randomised design with four treatments and six repetitions. Apple peel flour was added to the treatments in the following proportions: 0% (RFA0), 1% (RFA1), 2% (RFA2), and 3% (RFA3). Analysis of variance (ANOVA) was used to obtain average values and standard deviations.
Results: Addition of 3% apple peel flour to RFM showed highly significant effect (p≤0.01) on droplet size (2.15–9.49µm), viscosity (3965.00cP), colours L (71.93), a* (15.75), and b* (50.65), protein content (1.44%), and fat content (50.93%). It also produced an organoleptic quality that was acceptable to semi-trained panellists and fatty acid profiles containing various types of fatty acids.
Conclusion: The use of 3% apple peel flour in RFM represented the best treatment, with potential for further improvement.
Key words: apple peel flour, reduced-fat mayonnaise, stabiliser
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Factors related to complementary feeding practices
during the COVID-19 pandemic in Indonesia
Herwinda Kusuma Rahayu, Yhona Paratmanitya, Herni Dwi Herawati, Eka
Nurhayati & Rindi Nuryani
doi: https://doi.org/10.31246/mjn-2023-0135
Vitamin Factors related to complementary feeding practices during the COVID-19 pandemic in Indonesia
ABSTRACT
Introduction: Complementary feeding practice is critical for adequate growth and development in children. Appropriate practices should be maintained, especially during the COVID-19 pandemic.
Methods: This cross-sectional study aimed to analyse complementary feeding practices and their related factors, including the impact of the COVID-19 pandemic on household economic aspects. Data were collected via online questionnaires involving 574 mothers of children aged 6–23 months in Indonesia from April to May 2022.
Results: In total, 63.6%, 64.6%, 86.6%, and 57.7% of children met the criteria for timely introduction of complementary feeding (INTRO), minimum dietary diversity (MDD), minimum meal frequency (MMF), and minimum acceptable diet (MAD), respectively. Households that had no impact on their ability to provide food during the pandemic had higher odds of meeting MDD and MAD. Having a high household income level, high maternal education, and being a housewife increased the odds of INTRO. The odds of MDD increased in children who lived in Java, had older age, and whose mother had high education level. Older children had higher odds of having appropriate MMF. MAD was associated with mother’s high education level and being a housewife.
Conclusion: Several factors during the pandemic, including economic aspects, influenced complementary feeding practices. To prevent child malnutrition, besides ensuring household food security, other strategies to increase complementary feeding quality are also needed.
Key words: complementary feeding, COVID-19, minimum acceptable diet, minimum dietary diversity, minimum meal frequency
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Introduction: Complementary feeding practice is critical for adequate growth and development in children. Appropriate practices should be maintained, especially during the COVID-19 pandemic.
Methods: This cross-sectional study aimed to analyse complementary feeding practices and their related factors, including the impact of the COVID-19 pandemic on household economic aspects. Data were collected via online questionnaires involving 574 mothers of children aged 6–23 months in Indonesia from April to May 2022.
Results: In total, 63.6%, 64.6%, 86.6%, and 57.7% of children met the criteria for timely introduction of complementary feeding (INTRO), minimum dietary diversity (MDD), minimum meal frequency (MMF), and minimum acceptable diet (MAD), respectively. Households that had no impact on their ability to provide food during the pandemic had higher odds of meeting MDD and MAD. Having a high household income level, high maternal education, and being a housewife increased the odds of INTRO. The odds of MDD increased in children who lived in Java, had older age, and whose mother had high education level. Older children had higher odds of having appropriate MMF. MAD was associated with mother’s high education level and being a housewife.
Conclusion: Several factors during the pandemic, including economic aspects, influenced complementary feeding practices. To prevent child malnutrition, besides ensuring household food security, other strategies to increase complementary feeding quality are also needed.
Key words: complementary feeding, COVID-19, minimum acceptable diet, minimum dietary diversity, minimum meal frequency
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Relationship between macro- and micronutrient intakes
with undernutrition among toddlers aged 12-23 months
in Aceh, Indonesia
Suryana, Sri Anna Marliyati, Ali Khomsan & Cesilia Meti Dwiriani
doi: https://doi.org/10.31246/mjn-2023-0118
Relationship between macro- and micronutrient intakes with undernutrition among toddlers aged 12-23 months in Aceh, Indonesia
ABSTRACT
Introduction: Foods consumed contain macro- and micronutrients necessary for the growth and development of children. This study aimed to analyse the relationship between macronutrient and micronutrient intakes with undernutrition in toddlers aged 12-23 months.
Methods: This cross-sectional study was conducted in 18 Integrated Healthcare Centres (Posyandu) in Simpang Tiga, Aceh Besar Regency. A total of 138 toddlers were selected using simple random sampling technique. Data collected included family demographics, characteristics, nutritional status of children, and food consumption for macro- and micronutrient intake analyses.
Results: Prevalence of malnutrition in toddlers was relatively high – severe underweight and underweight totaled 23.2%, severe wasting and wasting 18.1%, and severe stunting and stunting 27.5%. Significant associations (p<0.05) were found between underweight and intakes of energy, protein, carbohydrates, fat, calcium, phosphorus, zinc, thiamin, and niacin. Wasting was significantly associated (p<0.05) with intakes of energy, protein, and vitamin A. Stunting was significantly associated (p<0.05) with intakes of energy, protein, carbohydrates, fat, calcium, phosphorus, iron, calcium, zinc, vitamin A, thiamine, riboflavin, niacin, and vitamin C.
Conclusion: Certain macro- and micronutrient intakes were correlated with undernutrition in toddlers. The results of this study can be used as a reference for planning the development of supplementary feeding programmes for children aged 12-23 months, considering that the critical period of child growth and development is in the first 1000 days of life.
Key words: macronutrient intake, micronutrients, toddlers, undernutrition
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Introduction: Foods consumed contain macro- and micronutrients necessary for the growth and development of children. This study aimed to analyse the relationship between macronutrient and micronutrient intakes with undernutrition in toddlers aged 12-23 months.
Methods: This cross-sectional study was conducted in 18 Integrated Healthcare Centres (Posyandu) in Simpang Tiga, Aceh Besar Regency. A total of 138 toddlers were selected using simple random sampling technique. Data collected included family demographics, characteristics, nutritional status of children, and food consumption for macro- and micronutrient intake analyses.
Results: Prevalence of malnutrition in toddlers was relatively high – severe underweight and underweight totaled 23.2%, severe wasting and wasting 18.1%, and severe stunting and stunting 27.5%. Significant associations (p<0.05) were found between underweight and intakes of energy, protein, carbohydrates, fat, calcium, phosphorus, zinc, thiamin, and niacin. Wasting was significantly associated (p<0.05) with intakes of energy, protein, and vitamin A. Stunting was significantly associated (p<0.05) with intakes of energy, protein, carbohydrates, fat, calcium, phosphorus, iron, calcium, zinc, vitamin A, thiamine, riboflavin, niacin, and vitamin C.
Conclusion: Certain macro- and micronutrient intakes were correlated with undernutrition in toddlers. The results of this study can be used as a reference for planning the development of supplementary feeding programmes for children aged 12-23 months, considering that the critical period of child growth and development is in the first 1000 days of life.
Key words: macronutrient intake, micronutrients, toddlers, undernutrition
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Implementation of nutrition care process in Indonesian
athletes and its effect on nutritional status and aerobic
capacity performance
Mirza Hapsari Sakti Titis Penggalih, Zaenal Mutaqqien Sofro, Laksono
Trisnantoro, Edi Nurinda Susila, Ernawaty, Bayu Rahadian, Margono, Dadi
Sujadi, Raden Isnanta, Kurnia Mar’atus Solichah, Rahadyana Muslichah,
Naila Alfi Syarifah & Veronika Dewi Pratanjani Prasasta
doi: https://doi.org/10.31246/mjn-2023-0096
Vitamin Implementation of nutrition care process in Indonesian athletes and its effect on nutritional status and aerobic capacity performance
ABSTRACT
Introduction: Despite the critical function of a nutritionist, only a few sports training centres for students in Indonesia have one. This study aimed to determine the effect of the nutrition care process (NCP) on athletes’ nutritional status and aerobic capacity performance.
Methods: This cohort study was conducted in 2022 (May–August) in four training centres (TC) in Indonesia. Subjects were athletes who have been dwelling in TC for at least three months, excluding those absent for >14 days due to a competition or other commitments during the data collection period. NCP included the assistance of trained sports nutritionists. In total, 114 athletes participated in this study: 90 strength athletes and 24 endurance athletes. The participants were aged 14-19 years old with approximately (mean+SD) 6+2.5 years of experience in specific sports.
Results: After three months of NCP, knowledge of nutrition (p=0.013), body fat composition (p<0.001), skinfold thickness scores (p<0.001), and performance (p<0.001) of athletes significantly improved. In spite of good intakes of protein and fat, none of the intakes showed significant changes (p>0.05). Furthermore, improved knowledge of sports nutrition and exercise science had a positive impact on dormitory meal choices.
Conclusion: Overall, three months of NCP had a significant effect on athletes’ knowledge of nutrition, body fat composition, skinfold thickness, and also VO2Max.
Key words: athlete, nutrition care process, sports
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Introduction: Despite the critical function of a nutritionist, only a few sports training centres for students in Indonesia have one. This study aimed to determine the effect of the nutrition care process (NCP) on athletes’ nutritional status and aerobic capacity performance.
Methods: This cohort study was conducted in 2022 (May–August) in four training centres (TC) in Indonesia. Subjects were athletes who have been dwelling in TC for at least three months, excluding those absent for >14 days due to a competition or other commitments during the data collection period. NCP included the assistance of trained sports nutritionists. In total, 114 athletes participated in this study: 90 strength athletes and 24 endurance athletes. The participants were aged 14-19 years old with approximately (mean+SD) 6+2.5 years of experience in specific sports.
Results: After three months of NCP, knowledge of nutrition (p=0.013), body fat composition (p<0.001), skinfold thickness scores (p<0.001), and performance (p<0.001) of athletes significantly improved. In spite of good intakes of protein and fat, none of the intakes showed significant changes (p>0.05). Furthermore, improved knowledge of sports nutrition and exercise science had a positive impact on dormitory meal choices.
Conclusion: Overall, three months of NCP had a significant effect on athletes’ knowledge of nutrition, body fat composition, skinfold thickness, and also VO2Max.
Key words: athlete, nutrition care process, sports
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Therapeutic diet plate waste and satisfaction among
adult patients
Jaysrina Mahalinga Moorthy, Raudhatul Syahirah binti Ruzalee, Dewiana
Malisa Putri binti Hafizon & Nurul Huda binti Razalli
doi: https://doi.org/10.31246/mjn-2023-0128
Vitamin Therapeutic diet plate waste and satisfaction among adult patients
ABSTRACT
Introduction: There are limited studies on plate waste and satisfaction levels among adult patients receiving therapeutic diets in hospitals, particularly in the local context. Therefore, this study aimed to determine the percentage of plate waste and the level of satisfaction among adult patients receiving therapeutic diets, as well as the contributing factors.
Methods: This cross-sectional study was conducted at a university hospital during lunch and dinner hours on eleven types of therapeutic diets. Food weighing and photography-assisted visual estimation by the Comstock scale were used to measure plate waste. Interviews were conducted with patients using the Acute Care Hospital Foodservice Patient Satisfaction Questionnaire (ACHFPSQ) to collect information about their satisfaction towards food quality and service.
Results: Mean overall plate waste rate for 96 patients receiving therapeutic diets was 43.6% (40.0% for lunch, 47.3% for dinner), with the highest rate of wastage in a combined diet low in fat and salt. Overall score for patient satisfaction was 3.7 out of 5. Patients had higher satisfaction levels with staff and food service (4.0) compared to food quality (3.4). Food quality negatively contributed to the rate of plate waste in terms of taste (r=-0.107, p=0.035), presentation (r=-0.078, p=0.043), and texture (r=-0.052, p=0.020).
Conclusion: Therapeutic diet plate waste among adult patients in this study was high and primarily attributable to food quality. Efforts to minimise therapeutic diet plate waste should be made by improving food quality for the best possible outcomes for patients.
Key words: food service, hospital, plate waste, satisfaction level, therapeutic diet
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Introduction: There are limited studies on plate waste and satisfaction levels among adult patients receiving therapeutic diets in hospitals, particularly in the local context. Therefore, this study aimed to determine the percentage of plate waste and the level of satisfaction among adult patients receiving therapeutic diets, as well as the contributing factors.
Methods: This cross-sectional study was conducted at a university hospital during lunch and dinner hours on eleven types of therapeutic diets. Food weighing and photography-assisted visual estimation by the Comstock scale were used to measure plate waste. Interviews were conducted with patients using the Acute Care Hospital Foodservice Patient Satisfaction Questionnaire (ACHFPSQ) to collect information about their satisfaction towards food quality and service.
Results: Mean overall plate waste rate for 96 patients receiving therapeutic diets was 43.6% (40.0% for lunch, 47.3% for dinner), with the highest rate of wastage in a combined diet low in fat and salt. Overall score for patient satisfaction was 3.7 out of 5. Patients had higher satisfaction levels with staff and food service (4.0) compared to food quality (3.4). Food quality negatively contributed to the rate of plate waste in terms of taste (r=-0.107, p=0.035), presentation (r=-0.078, p=0.043), and texture (r=-0.052, p=0.020).
Conclusion: Therapeutic diet plate waste among adult patients in this study was high and primarily attributable to food quality. Efforts to minimise therapeutic diet plate waste should be made by improving food quality for the best possible outcomes for patients.
Key words: food service, hospital, plate waste, satisfaction level, therapeutic diet
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Effects of LED treatments on the growth and
nutritional content of lettuce (Lactuca sativa) in a
hydroponic vertical farming system
Mei Xin Koh & Ajit Singh
doi: https://doi.org/10.31246/mjn-2023-0107
Vitamin Effects of LED treatments on the growth and nutritional content of lettuce (Lactuca sativa) in a hydroponic vertical farming system
ABSTRACT
Introduction: LED-integrated hydroponic vertical farming system (HVFS) may address food security challenges arising from urbanisation, while antioxidants in vegetables may prevent cardiovascular disease. This study aimed to explore the LED effects on yield, antioxidant properties, and vitamin C content in Butterhead lettuce (BL) and Italian lettuce (IL).
Methods: Three LED combinations were used: 77% red, 14% green, and 9% blue lights (77R:14G:9B); 7% red, 41% green, and 52% blue lights (7R:41G:52B); and 25% red, 67% green, and 8% blue lights (25R:67G:8B). The concentration and pH of nutrient solution in HVFS ranged from 0.878-2.061ppm and 6.0-6.6, respectively, with a 12:12 light-dark cycle. Chlorophyll and anthocyanin contents were measured using chlorophyll and anthocyanin meters, respectively. Total phenolic and vitamin C content were measured using Folin-Ciocalteu colorimetric assay. Total flavonoid and antioxidant activity were determined through aluminium chloride colorimetric assay and 2,2-diphenyl-1-picrylhydrazyl (DPPH) colorimetric assay, respectively. Completely randomised design was adapted with three replications.
Results: BL exhibited greater yield, anthocyanin and chlorophyll contents, while IL had higher vitamin C content. Significantly (p<0.001) higher yields were produced under 77R:14G:9B and 25R:67G:8B. Significantly higher phenolic (p<0.001) and flavonoid (p=0.003) contents were produced under 25R:67G:8B. Vitamin C was significantly (p=0.037) higher under 25R:67G:8B than 7R:41G:52B.
Conclusion: LED treatment with higher proportion of red light generated greater yield, whereas higher proportion of green light gave higher phenolic, flavonoids, and vitamin C accumulation. This study provided preliminary data on boosting crop yield and phytochemical contents, which may improve food self-production and population health.
Key words: antioxidant, butterhead, food security, phytochemicals, yield
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Introduction: LED-integrated hydroponic vertical farming system (HVFS) may address food security challenges arising from urbanisation, while antioxidants in vegetables may prevent cardiovascular disease. This study aimed to explore the LED effects on yield, antioxidant properties, and vitamin C content in Butterhead lettuce (BL) and Italian lettuce (IL).
Methods: Three LED combinations were used: 77% red, 14% green, and 9% blue lights (77R:14G:9B); 7% red, 41% green, and 52% blue lights (7R:41G:52B); and 25% red, 67% green, and 8% blue lights (25R:67G:8B). The concentration and pH of nutrient solution in HVFS ranged from 0.878-2.061ppm and 6.0-6.6, respectively, with a 12:12 light-dark cycle. Chlorophyll and anthocyanin contents were measured using chlorophyll and anthocyanin meters, respectively. Total phenolic and vitamin C content were measured using Folin-Ciocalteu colorimetric assay. Total flavonoid and antioxidant activity were determined through aluminium chloride colorimetric assay and 2,2-diphenyl-1-picrylhydrazyl (DPPH) colorimetric assay, respectively. Completely randomised design was adapted with three replications.
Results: BL exhibited greater yield, anthocyanin and chlorophyll contents, while IL had higher vitamin C content. Significantly (p<0.001) higher yields were produced under 77R:14G:9B and 25R:67G:8B. Significantly higher phenolic (p<0.001) and flavonoid (p=0.003) contents were produced under 25R:67G:8B. Vitamin C was significantly (p=0.037) higher under 25R:67G:8B than 7R:41G:52B.
Conclusion: LED treatment with higher proportion of red light generated greater yield, whereas higher proportion of green light gave higher phenolic, flavonoids, and vitamin C accumulation. This study provided preliminary data on boosting crop yield and phytochemical contents, which may improve food self-production and population health.
Key words: antioxidant, butterhead, food security, phytochemicals, yield
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Effect of Bambara groundnut (Vigna subterranea) on
Firmicutes and Bacteroidetes, FGF21 gene expression,
and liver histopathology in mice with low-protein diet
Rimonta Febby Gunanegara, Agung Dewanto & Sunarti
doi: https://doi.org/10.31246/mjn-2024-0012
Vitamin Effect of Bambara groundnut (Vigna subterranea) on Firmicutes and Bacteroidetes, FGF21 gene expression, and liver histopathology in mice with low-protein diet
ABSTRACT
Introduction: The number of Firmicutes and Bacteroidetes in the intestine is influenced by diet. Gut microbiota and fibroblast growth factor 21 (FGF21) form a liver-gut axis that mediates the body’s response to protein restriction. Bambara groundnut (Vigna subterranea), which contains high levels of amino acids, has the potential to be a source of protein. This study aimed to determine the effect of Bambara groundnut on the number of Firmicutes and Bacteroidetes, FGF21 gene expression, and liver histopathology in mice fed with a low-protein diet.
Methods: A total of 25 mice were divided into five groups: normal protein diet (N), lowprotein diet (LP), and low-protein diet with supplementation of 100 g (LPLB), 200 g (LPMB), and 300 g (LPHB) of Bambara groundnut, respectively. After 2 months of intervention, mice were sacrificed, the number of Firmicutes and Bacteroidetes in the intestines and faeces, as well as FGF21 gene expression were analysed, while liver histopathology was visualised.
Results: Results showed that Bambara groundnut supplementation increased the growth of Firmicutes and Bacteroidetes, decreased FGF21 gene expression, and reduced liver inflammation caused by a lowprotein diet.
Conclusion: Bambara groundnut supplementation has the potential to increase the amount of Firmicutes and Bacteroidetes, decrease the expression of adaptive stress gene FGF21, and improve the degree of liver inflammation in a lowprotein diet.
Key words: Bacteroidetes, bambara groundnut, FGF21, Firmicutes, low-protein diet
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Introduction: The number of Firmicutes and Bacteroidetes in the intestine is influenced by diet. Gut microbiota and fibroblast growth factor 21 (FGF21) form a liver-gut axis that mediates the body’s response to protein restriction. Bambara groundnut (Vigna subterranea), which contains high levels of amino acids, has the potential to be a source of protein. This study aimed to determine the effect of Bambara groundnut on the number of Firmicutes and Bacteroidetes, FGF21 gene expression, and liver histopathology in mice fed with a low-protein diet.
Methods: A total of 25 mice were divided into five groups: normal protein diet (N), lowprotein diet (LP), and low-protein diet with supplementation of 100 g (LPLB), 200 g (LPMB), and 300 g (LPHB) of Bambara groundnut, respectively. After 2 months of intervention, mice were sacrificed, the number of Firmicutes and Bacteroidetes in the intestines and faeces, as well as FGF21 gene expression were analysed, while liver histopathology was visualised.
Results: Results showed that Bambara groundnut supplementation increased the growth of Firmicutes and Bacteroidetes, decreased FGF21 gene expression, and reduced liver inflammation caused by a lowprotein diet.
Conclusion: Bambara groundnut supplementation has the potential to increase the amount of Firmicutes and Bacteroidetes, decrease the expression of adaptive stress gene FGF21, and improve the degree of liver inflammation in a lowprotein diet.
Key words: Bacteroidetes, bambara groundnut, FGF21, Firmicutes, low-protein diet
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Malaysian Journal of Nutrition (Mal J Nutr)
Volume 30 No.3, 2024
Table of Content
Development of a touchscreen-based nutrition learning
tool to promote healthy eating practices among early
elderly Thai people
Nathakamon Padawech, Cholrit Luangjinda, Chanisa Tantixalerm &
Chatrapa Hudthagosol
doi: https://doi.org/10.31246/mjn-2023-0177
Development of a touchscreen-based nutrition learning tool to promote healthy eating practices among early elderly Thai people
ABSTRACT
Introduction: In Thailand, rapid demographic ageing is closely linked to an increased incidence of non-communicable diseases (NCDs). Effective nutritional management is essential to mitigate NCD risks and delay progression. Given the widespread use of touchscreen devices among older adults, this study focused on developing a nutrition app tailored to enhance knowledge, attitudes, and practices regarding healthy eating among Thai elderly people.
Methods: The project consisted of two main phases, namely content preparation and application development. Initial drafts and storyboards were refined through consultations with experts and discussions. The use of healthy menus was approved by a professional chef and nutritionists. The app prototype underwent comprehensive evaluations in terms of content accuracy, design, usability, and acceptability by experts. It was also field tested by elderly volunteers for four weeks.
Results: The developed “YoungYou” app features tools such as body mass index assessment, updates on elderly health, and dietary recommendations tailored to Thai elderly individuals based on the nutrition flag system. It includes 60 healthy recipes, 30 cooking tutorials, and an interactive community board. The app allows users to modify and recalibrate the nutritional content of recipes, which can then be saved or shared. Evaluations of the app showed high levels of agreement on its effectiveness across all metrics. The use of rice, vegetables, and meat by 41 elderly volunteers led to increased healthy eating behaviours.
Conclusion: The “YoungYou” app has demonstrated potential as a viable tool for promoting healthier eating habits among Thai elderly people, thereby addressing critical public health issues related to ageing and disease prevention.The “YoungYou” app has demonstrated potential as a viable tool for promoting healthier eating habits among Thai elderly people, thereby addressing critical public health issues related to ageing and disease prevention.
Key words: elderly people; healthy eating; nutrition app; tool development; touchscreen
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Introduction: In Thailand, rapid demographic ageing is closely linked to an increased incidence of non-communicable diseases (NCDs). Effective nutritional management is essential to mitigate NCD risks and delay progression. Given the widespread use of touchscreen devices among older adults, this study focused on developing a nutrition app tailored to enhance knowledge, attitudes, and practices regarding healthy eating among Thai elderly people.
Methods: The project consisted of two main phases, namely content preparation and application development. Initial drafts and storyboards were refined through consultations with experts and discussions. The use of healthy menus was approved by a professional chef and nutritionists. The app prototype underwent comprehensive evaluations in terms of content accuracy, design, usability, and acceptability by experts. It was also field tested by elderly volunteers for four weeks.
Results: The developed “YoungYou” app features tools such as body mass index assessment, updates on elderly health, and dietary recommendations tailored to Thai elderly individuals based on the nutrition flag system. It includes 60 healthy recipes, 30 cooking tutorials, and an interactive community board. The app allows users to modify and recalibrate the nutritional content of recipes, which can then be saved or shared. Evaluations of the app showed high levels of agreement on its effectiveness across all metrics. The use of rice, vegetables, and meat by 41 elderly volunteers led to increased healthy eating behaviours.
Conclusion: The “YoungYou” app has demonstrated potential as a viable tool for promoting healthier eating habits among Thai elderly people, thereby addressing critical public health issues related to ageing and disease prevention.The “YoungYou” app has demonstrated potential as a viable tool for promoting healthier eating habits among Thai elderly people, thereby addressing critical public health issues related to ageing and disease prevention.
Key words: elderly people; healthy eating; nutrition app; tool development; touchscreen
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Dietary intake, diet quality and nutritional status of
homeless children: A cross-sectional study
Kar Wen Yong, Asma’ Ali, Hayati Mohd Yusof, Aziz Yusof & Michelle Mun
Chieng Tan
doi: https://doi.org/10.31246/mjn-2023-0065
Dietary intake, diet quality and nutritional status of homeless children: A cross-sectional study
ABSTRACT
Introduction: The increasing number of homeless children is concerning. This study aimed to assess the dietary intake, diet quality, and nutritional status of homeless children in Klang Valley, as well as the relationship between diet quality and nutritional status.
Methods: Approximately 120 homeless children aged 7 to 12 years from four locations in Klang Valley were enrolled. Their dietary intake and nutritional status were assessed using a two-day 24-hour dietary recall and body mass index-for-age, respectively. The Healthy Eating Index (HEI) was used to examine diet quality.
Results: Prevalence of normal weight respondents was 58.3% (mean±SD: -0.79±1.80), with 25.0% classified as moderately and severely thin. Mean energy intake was significantly lower than recommended nutrient intakes (RNI) (p<0.050), while protein intake was higher (p<0.050). Calcium and zinc intakes were also significantly lower (p<0.001). Boys aged 7-9 years had significantly higher iron intake (median=11.6, IQR=8.7 mg, p=0.003), whereas girls aged 10-12 years had significantly lower intakes of iron (mean±SD=11.4±5.1, 11.1±4.7) and vitamin A (median=416.6, IQR=450.4 µgRE, p<0.001 for both). Mean HEI score was 51.30±6.78, indicating a need for diet quality improvement. No significant association between diet quality and nutritional status was observed (p=0.380).
Conclusion: This study provided insights into dietary intake, diet quality, and nutritional status of homeless children. Further research is vital to shape evidence-based nutrition interventions.
Key words: dietary intake, diet quality, homeless children, Malaysia, nutritional status
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Introduction: The increasing number of homeless children is concerning. This study aimed to assess the dietary intake, diet quality, and nutritional status of homeless children in Klang Valley, as well as the relationship between diet quality and nutritional status.
Methods: Approximately 120 homeless children aged 7 to 12 years from four locations in Klang Valley were enrolled. Their dietary intake and nutritional status were assessed using a two-day 24-hour dietary recall and body mass index-for-age, respectively. The Healthy Eating Index (HEI) was used to examine diet quality.
Results: Prevalence of normal weight respondents was 58.3% (mean±SD: -0.79±1.80), with 25.0% classified as moderately and severely thin. Mean energy intake was significantly lower than recommended nutrient intakes (RNI) (p<0.050), while protein intake was higher (p<0.050). Calcium and zinc intakes were also significantly lower (p<0.001). Boys aged 7-9 years had significantly higher iron intake (median=11.6, IQR=8.7 mg, p=0.003), whereas girls aged 10-12 years had significantly lower intakes of iron (mean±SD=11.4±5.1, 11.1±4.7) and vitamin A (median=416.6, IQR=450.4 µgRE, p<0.001 for both). Mean HEI score was 51.30±6.78, indicating a need for diet quality improvement. No significant association between diet quality and nutritional status was observed (p=0.380).
Conclusion: This study provided insights into dietary intake, diet quality, and nutritional status of homeless children. Further research is vital to shape evidence-based nutrition interventions.
Key words: dietary intake, diet quality, homeless children, Malaysia, nutritional status
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Nutritional profile among vegetarians and non-vegetarians in Denpasar, Indonesia
Komang Trisna Sumadewi, Ni Putu Diah Witari, Luh Gede Evayanti, Dewa
Ayu Agung Alit Suka Astini, Fransiscus Fiano Anthony Kerans & Anak Agung
Ayu Asri Prima Dewi
doi: https://doi.org/10.31246/mjn-2023-0086
Nutritional profile among vegetarians and non-vegetarians in Denpasar, Indonesia
ABSTRACT
Introduction: Despite the many health benefits of a well-balanced vegetarian or vegan diet providing, vegetarians are at increased risk of deficiency in certain nutrients, such as calcium and iron, which could lead to health issues. Our study aimed to assess nutrient intakes and nutritional status between dietary patterns that include or do not include meat consumption.
Methods: This cross-sectional study was conducted in Denpasar, Bali, Indonesia. One hundred sixty respondents (80 vegetarians and 80 non-vegetarians) participated. Data were collected from interviews, a semi-quantitative food frequency questionnaire, and Nutrisurvey tools. Nutrient intakes were also assessed, including energy, carbohydrates, fat, protein, calcium, iron, zinc, and vitamin C. Body mass index (BMI) was used to determine nutritional status.
Results: There were no appreciable difference (p>0.05) in carbohydrate intake between vegetarian and non-vegetarian groups. In contrast, the vegetarian group’s energy, protein, and fat intakes significantly differed from that of non-vegetarians (p<0.05). No significant differences (p>0.05) were found in calcium, zinc, vitamin C, vitamin D, vitamin B12, folic acid, and magnesium between the two groups. However, it was discovered that the two groups’ iron intake and BMI were significantly different (p<0.05).
Conclusion: Vegetarians and non-vegetarians demonstrated differences in BMI, energy intake, protein consumption, fat consumption, and iron consumption. With a well-curated variety of food options and efficient administration of vegetarian meal plans, it is possible to effectively meet the nutritional requirements of individuals in terms of both essential vitamins and minerals, as well as carbohydrates, protein, and fats.
Key words: non-vegetarian, nutrient intake, nutritional status, vegetarian
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Introduction: Despite the many health benefits of a well-balanced vegetarian or vegan diet providing, vegetarians are at increased risk of deficiency in certain nutrients, such as calcium and iron, which could lead to health issues. Our study aimed to assess nutrient intakes and nutritional status between dietary patterns that include or do not include meat consumption.
Methods: This cross-sectional study was conducted in Denpasar, Bali, Indonesia. One hundred sixty respondents (80 vegetarians and 80 non-vegetarians) participated. Data were collected from interviews, a semi-quantitative food frequency questionnaire, and Nutrisurvey tools. Nutrient intakes were also assessed, including energy, carbohydrates, fat, protein, calcium, iron, zinc, and vitamin C. Body mass index (BMI) was used to determine nutritional status.
Results: There were no appreciable difference (p>0.05) in carbohydrate intake between vegetarian and non-vegetarian groups. In contrast, the vegetarian group’s energy, protein, and fat intakes significantly differed from that of non-vegetarians (p<0.05). No significant differences (p>0.05) were found in calcium, zinc, vitamin C, vitamin D, vitamin B12, folic acid, and magnesium between the two groups. However, it was discovered that the two groups’ iron intake and BMI were significantly different (p<0.05).
Conclusion: Vegetarians and non-vegetarians demonstrated differences in BMI, energy intake, protein consumption, fat consumption, and iron consumption. With a well-curated variety of food options and efficient administration of vegetarian meal plans, it is possible to effectively meet the nutritional requirements of individuals in terms of both essential vitamins and minerals, as well as carbohydrates, protein, and fats.
Key words: non-vegetarian, nutrient intake, nutritional status, vegetarian
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Determinants of knowledge, attitude, and practice
towards aflatoxin contamination in food and aflatoxin
biomarker levels among healthy Malaysian adults
Chang Wei Lin, Rosita Jamaluddin, Hazizi Abu Saad & Mohd Redzwan
Sabran
doi: https://doi.org/10.31246/mjn-2023-0089
Determinants of knowledge, attitude, and practice towards aflatoxin contamination in food and aflatoxin biomarker levels among healthy Malaysian adults
ABSTRACT
Introduction: Limited information exists regarding the factors that determine the levels of knowledge, attitude, and practice (KAP) towards aflatoxin contamination in food, including aflatoxin biomarker levels in populations at risk. This study examined the associations between KAP levels with sociodemographic characteristics and weight status of 359 healthy Malaysian adults.
Methods: The study was conducted among residents and workers in Selangor, Malaysia. Sociodemographic characteristics and KAP levels were collected using a self-administered questionnaire, and body weight was measured. Urine and fasting blood samples were collected for aflatoxin M 1 and aflatoxin B1 analyses, respectively.
Results: Most respondents were females, Chinese, aged 25–44 years, with poor knowledge but positive attitudes and acceptable practices in controlling aflatoxin contamination in food. Univariate and multivariate analyses revealed that the knowledge level was remarkably high among females, unemployed, underweight or normal weight individuals, and those with a monthly income of >RM 10,000. The attitude score was high in those with tertiary education and those who were unemployed, while the practice score was high in those with tertiary education. The levels of aflatoxin biomarkers varied significantly according to ethnicity or age.
Conclusion: These findings demonstrated that sociodemographic characteristics and body weight status partly determined the levels of KAP and aflatoxin biomarkers; this may aid in identifying populations that would benefit from educational interventions to prevent aflatoxin contamination.
Key words: aflatoxins, attitude, healthy Malaysian adults, knowledge, practice
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Introduction: Limited information exists regarding the factors that determine the levels of knowledge, attitude, and practice (KAP) towards aflatoxin contamination in food, including aflatoxin biomarker levels in populations at risk. This study examined the associations between KAP levels with sociodemographic characteristics and weight status of 359 healthy Malaysian adults.
Methods: The study was conducted among residents and workers in Selangor, Malaysia. Sociodemographic characteristics and KAP levels were collected using a self-administered questionnaire, and body weight was measured. Urine and fasting blood samples were collected for aflatoxin M 1 and aflatoxin B1 analyses, respectively.
Results: Most respondents were females, Chinese, aged 25–44 years, with poor knowledge but positive attitudes and acceptable practices in controlling aflatoxin contamination in food. Univariate and multivariate analyses revealed that the knowledge level was remarkably high among females, unemployed, underweight or normal weight individuals, and those with a monthly income of >RM 10,000. The attitude score was high in those with tertiary education and those who were unemployed, while the practice score was high in those with tertiary education. The levels of aflatoxin biomarkers varied significantly according to ethnicity or age.
Conclusion: These findings demonstrated that sociodemographic characteristics and body weight status partly determined the levels of KAP and aflatoxin biomarkers; this may aid in identifying populations that would benefit from educational interventions to prevent aflatoxin contamination.
Key words: aflatoxins, attitude, healthy Malaysian adults, knowledge, practice
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Effect of a dietary iron education programme on
iron status and intelligence quotient score among
schoolchildren in Phatthalung province, southern
Thailand
Witchada Simla, Carol Hutchinson, Supreya Tansukul, Mathuros
Tipayamongkholgul & Supannee Pruksa
doi: https://doi.org/10.31246/mjn-2023-0104
Effect of a dietary iron education programme on iron status and intelligence quotient score among schoolchildren in Phatthalung province, southern Thailand
ABSTRACT
Introduction: The aim of the study was to determine the effect of a dietary iron education programme (DIEP) on children’s iron status and intelligence quotient (IQ) score.
Methods: This pre-test post-test quasi-experimental study with followup utilised the Health Belief Model (HBM). Participants were children who had iron deficiency (ID) (serum ferritin <30 µg/L), with anaemia (haemoglobin 80.0 – 114.0 g/L) or without, and their caregivers. The DIEP incorporated group talks, presentations, game-based learning, and cooking. Knowledge of ID and dietary iron, caregivers’ perceptions of preventing anaemia and ID in their children, and children’s dietary intake, iron status, and IQ score (based on 60-question items adjusted for age) were determined. Statistical tests (one-way MANOVA, Friedman’s two-way ANOVA by ranks, Wilcoxon signed-rank test, Monte Carlo exact test) determined differences between pre-test, post-test, and follow-up.
Results: A total of 32 child-caregiver dyads completed the study; 6.3% (n=2) of children met the Thai dietary reference intake for iron at pre-test versus 28.1% (n=9) at post-test (p=0.039) and 31.3% (n=10) at follow-up (p=0.021). Almost half of the children (n=15) who had ID at pre-test were iron replete at post-test and half (n=16) were iron replete at follow-up (p<0.001). Median IQ scores improved from pre-test to posttest (109.0 vs. 116.0; p=0.010) and were similar at post-test and follow-up (116.0 vs. 117.0; p=0.952).
Conclusion: Iron status and IQ score improved following the implementation of DIEP. We recommend that this programme serves as a model for similar interventions in other schools.
Key words: cognitive function; dietary iron education; iron deficiency; iron status
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Introduction: The aim of the study was to determine the effect of a dietary iron education programme (DIEP) on children’s iron status and intelligence quotient (IQ) score.
Methods: This pre-test post-test quasi-experimental study with followup utilised the Health Belief Model (HBM). Participants were children who had iron deficiency (ID) (serum ferritin <30 µg/L), with anaemia (haemoglobin 80.0 – 114.0 g/L) or without, and their caregivers. The DIEP incorporated group talks, presentations, game-based learning, and cooking. Knowledge of ID and dietary iron, caregivers’ perceptions of preventing anaemia and ID in their children, and children’s dietary intake, iron status, and IQ score (based on 60-question items adjusted for age) were determined. Statistical tests (one-way MANOVA, Friedman’s two-way ANOVA by ranks, Wilcoxon signed-rank test, Monte Carlo exact test) determined differences between pre-test, post-test, and follow-up.
Results: A total of 32 child-caregiver dyads completed the study; 6.3% (n=2) of children met the Thai dietary reference intake for iron at pre-test versus 28.1% (n=9) at post-test (p=0.039) and 31.3% (n=10) at follow-up (p=0.021). Almost half of the children (n=15) who had ID at pre-test were iron replete at post-test and half (n=16) were iron replete at follow-up (p<0.001). Median IQ scores improved from pre-test to posttest (109.0 vs. 116.0; p=0.010) and were similar at post-test and follow-up (116.0 vs. 117.0; p=0.952).
Conclusion: Iron status and IQ score improved following the implementation of DIEP. We recommend that this programme serves as a model for similar interventions in other schools.
Key words: cognitive function; dietary iron education; iron deficiency; iron status
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Physicochemical characteristics of sawo belanda
(Pouteria Campechiana) flour with blanching process
and drying techniques
Zaida, Hajar Fauziyah Zulfa, Rossi Indarto, Elazmanawati Lembong & Mohd
Nizam Lani
doi: https://doi.org/10.31246/mjn-2022-0138
Physicochemical characteristics of sawo belanda (Pouteria Campechiana) flour with blanching process and drying techniques
ABSTRACT
Introduction: Sawo belanda fruit (Pouteria campechiana), a tropical fruit abundantly found in Southeast Asia, is highly productive and particularly thrives in the warm climates of Malaysia and Indonesia. However, the high fruit output of Sawo belanda contrasts with its limited consumption in Indonesia. The process of converting sawo belanda into flour can significantly enhance its lifetime. The application of blanching methods and proper drying techniques can be a solution to avoid damage to the characteristics of the flour. This study aimed to determine the physicochemical characteristics of Sawo belanda flour that has been treated with blanching and drying techniques.
Methods: The parameters observed were moisture content (%), hygroscopicity (%), colour, antioxidant content (ppm), and carotenoid content (µg/g) with blanching and various drying techniques.
Results: Microwave blanching and food dehydrator technique (C1) produced the best characteristics: moisture content of 7.82%, hygroscopicity of 8.04%, colour values of L* 84.0, a* 8.22, and b* 50.5, as well as functional characteristics including antioxidant content of 142 ppm and carotenoid content of 92.4 µg/g.
Conclusion: Sawo belanda with C1 treatment had a significant impact on the water content, hygroscopicity, colour, antioxidant and total carotenoid contents of Sawo belanda flour. The antioxidant content and incredibly high carotenoid content grant the sawo belanda flour an additional functional value when added to food ingredients.
Key words: antioxidant, blanching, drying, sawo belanda
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Introduction: Sawo belanda fruit (Pouteria campechiana), a tropical fruit abundantly found in Southeast Asia, is highly productive and particularly thrives in the warm climates of Malaysia and Indonesia. However, the high fruit output of Sawo belanda contrasts with its limited consumption in Indonesia. The process of converting sawo belanda into flour can significantly enhance its lifetime. The application of blanching methods and proper drying techniques can be a solution to avoid damage to the characteristics of the flour. This study aimed to determine the physicochemical characteristics of Sawo belanda flour that has been treated with blanching and drying techniques.
Methods: The parameters observed were moisture content (%), hygroscopicity (%), colour, antioxidant content (ppm), and carotenoid content (µg/g) with blanching and various drying techniques.
Results: Microwave blanching and food dehydrator technique (C1) produced the best characteristics: moisture content of 7.82%, hygroscopicity of 8.04%, colour values of L* 84.0, a* 8.22, and b* 50.5, as well as functional characteristics including antioxidant content of 142 ppm and carotenoid content of 92.4 µg/g.
Conclusion: Sawo belanda with C1 treatment had a significant impact on the water content, hygroscopicity, colour, antioxidant and total carotenoid contents of Sawo belanda flour. The antioxidant content and incredibly high carotenoid content grant the sawo belanda flour an additional functional value when added to food ingredients.
Key words: antioxidant, blanching, drying, sawo belanda
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Associations of socio-demographic, environmental and
parental factors, and nutritional status with fast food
consumption among children aged 7-11 years old in
Selangor
Chong Shao Hui & Zalilah Mohd Shariff
doi: https://doi.org/10.31246/mjn-2023-0138
Associations of socio-demographic, environmental and parental factors, and nutritional status with fast food consumption among children aged 7-11 years old in Selangor
ABSTRACT
Introduction: This cross-sectional study examined fast food consumption and its associated factors among primary school children in Selangor.
Methods: A total of 221 children aged 7-11 years from six randomly selected primary schools in Petaling Perdana, Gombak, and Hulu Langat participated in this study. Parents completed a self-administered questionnaire on socio-demographic characteristics, exposure to fast food advertising, home food availability, parental stress, attitude towards fast food, intake of fast food, and two-day dietary record of children. Height and weight of children were obtained from their school SEGAK records.
Results: Mean age of children was 9±1 years. Mean days per week of fast food consumption among children was 3.2±1.6 days, with 45.7% consuming fast food for >3 days/ week. Factors associated with frequent fast food consumption were children whose fathers had non-tertiary education levels (aOR 2.53, 95% CI 1.18–5.40), children with higher total screen viewing time (aOR 1.21, 95% CI 1.00–1.46), lower home food availability score (aOR 0.87, 95% CI 0.76–0.98), overweight and obese (aOR 2.38, 95% CI 1.23–4.60), requiring dietary improvements (aOR 4.03, 95% CI 1.36–11.98), and with poor diet quality (aOR 5.08, 95% CI 1.57–16.44).
Conclusion: More than one third of the children consumed fast food for >3 days/week. Screen viewing time and home food availability should be considered when promoting healthy diets among children. Future research should consider other potential factors associated with children’s consumption of fast food.
Key words: diet quality, fast food consumption, home food availability, Malaysian children, screen viewing time
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Introduction: This cross-sectional study examined fast food consumption and its associated factors among primary school children in Selangor.
Methods: A total of 221 children aged 7-11 years from six randomly selected primary schools in Petaling Perdana, Gombak, and Hulu Langat participated in this study. Parents completed a self-administered questionnaire on socio-demographic characteristics, exposure to fast food advertising, home food availability, parental stress, attitude towards fast food, intake of fast food, and two-day dietary record of children. Height and weight of children were obtained from their school SEGAK records.
Results: Mean age of children was 9±1 years. Mean days per week of fast food consumption among children was 3.2±1.6 days, with 45.7% consuming fast food for >3 days/ week. Factors associated with frequent fast food consumption were children whose fathers had non-tertiary education levels (aOR 2.53, 95% CI 1.18–5.40), children with higher total screen viewing time (aOR 1.21, 95% CI 1.00–1.46), lower home food availability score (aOR 0.87, 95% CI 0.76–0.98), overweight and obese (aOR 2.38, 95% CI 1.23–4.60), requiring dietary improvements (aOR 4.03, 95% CI 1.36–11.98), and with poor diet quality (aOR 5.08, 95% CI 1.57–16.44).
Conclusion: More than one third of the children consumed fast food for >3 days/week. Screen viewing time and home food availability should be considered when promoting healthy diets among children. Future research should consider other potential factors associated with children’s consumption of fast food.
Key words: diet quality, fast food consumption, home food availability, Malaysian children, screen viewing time
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Influence of vitamin D supplementation on mental
health in collegiate footballers
Ansa Saju, Jolly Roy, Suvarna Jyothi Kantipudi, Thiagarajan Alwar &
Arumugam Sivaraman
doi: https://doi.org/10.31246/mjn-2024-0014
Influence of vitamin D supplementation on mental health in collegiate footballers
ABSTRACT
Introduction: Mental health in athletes has been gaining more attention in recent years. A strong association has been noted between vitamin D and psychiatric outcomes. This study examined the effects of six weeks of vitamin D supplementation on mental health among collegiate footballers.
Methods: Thirtyone footballers (N=31; 18 males and 13 females) were recruited for the study. Serum 25(OH)D was measured to assess vitamin D and mental health was assessed using the Patient Health Questionnaire–9 (PHQ-9) and Generalised Anxiety Disorder-7 (GAD-7). Based on serum 25(OH)D levels, footballers were further categorised as (a) ‘deficient’ (<20.0 ng/mL), (b) ‘insufficient’ (21.0-29.9 ng/ mL), and (c) ‘sufficient’ (>30.0 ng/mL). The deficient and insufficient groups were given 60,000 IU cholecalciferol supplementation per week for six weeks and postintervention assessments were conducted. Paired t-test was used to ascertain the differences within groups.
Results: Prevalences of vitamin D deficiency (48.0%), insufficiency (52.0%), depressive symptoms (13.0%), and anxiety symptoms (26.0%) were observed at baseline among footballers. Supplementation improved vitamin D levels from 20.7±5.4 ng/mL to 38.1±11.4 ng/mL (p<0.001). The rate of footballers with higher than cut-off scores for PHQ-9 and GAD-7 scores increased (32.3% and 29.0%, respectively) from baseline to post-intervention.
Conclusion: Vitamin D supplementation enhanced serum 25(OH)D levels. However, no positive effects were noted regarding mental health symptoms. Additionally, changes in vitamin D levels might require more time to manifest observable effects on mental health.
Key words: collegiate athlete, football, mental health, supplement, vitamin D
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Introduction: Mental health in athletes has been gaining more attention in recent years. A strong association has been noted between vitamin D and psychiatric outcomes. This study examined the effects of six weeks of vitamin D supplementation on mental health among collegiate footballers.
Methods: Thirtyone footballers (N=31; 18 males and 13 females) were recruited for the study. Serum 25(OH)D was measured to assess vitamin D and mental health was assessed using the Patient Health Questionnaire–9 (PHQ-9) and Generalised Anxiety Disorder-7 (GAD-7). Based on serum 25(OH)D levels, footballers were further categorised as (a) ‘deficient’ (<20.0 ng/mL), (b) ‘insufficient’ (21.0-29.9 ng/ mL), and (c) ‘sufficient’ (>30.0 ng/mL). The deficient and insufficient groups were given 60,000 IU cholecalciferol supplementation per week for six weeks and postintervention assessments were conducted. Paired t-test was used to ascertain the differences within groups.
Results: Prevalences of vitamin D deficiency (48.0%), insufficiency (52.0%), depressive symptoms (13.0%), and anxiety symptoms (26.0%) were observed at baseline among footballers. Supplementation improved vitamin D levels from 20.7±5.4 ng/mL to 38.1±11.4 ng/mL (p<0.001). The rate of footballers with higher than cut-off scores for PHQ-9 and GAD-7 scores increased (32.3% and 29.0%, respectively) from baseline to post-intervention.
Conclusion: Vitamin D supplementation enhanced serum 25(OH)D levels. However, no positive effects were noted regarding mental health symptoms. Additionally, changes in vitamin D levels might require more time to manifest observable effects on mental health.
Key words: collegiate athlete, football, mental health, supplement, vitamin D
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Demographic, socioeconomic and dietary factors are
associated with double burden of malnutrition among
indigenous communities in Sarawak
Yolanda Salleh, Cheah Whye Lian, Law Leh Shii, Jeffery Stephen &
Teoh Wan Jool
doi: https://doi.org/10.31246/mjn-2024-0056
Demographic, socioeconomic and dietary factors are associated with double burden of malnutrition among indigenous communities in Sarawak
ABSTRACT
Introduction: Double burden of malnutrition (DBM), encompassing both overnutrition and undernutrition, is a growing global public health issue. Indigenous people are one of the marginalised populations experiencing DBM at varying severity. This study aimed to identify factors contributing to DBM in indigenous households in Sarawak.
Methods: This cross-sectional study utilised multistage random sampling to include 286 indigenous households from six administrative divisions in Sarawak. Mothers aged 20–49 years who had at least one child aged 2–12 years were recruited. Trained interviewers obtained information on demographic and socioeconomic characteristics, food security, and dietary intake via a two-day, 24-hour dietary recall. Height and weight measurements followed World Health Organization protocols. DBM household was identified as having an overnourished (overweight/ obese) mother with an undernourished (underweight/stunting/wasting) child within the same household. Simple and multiple binary logistic regression analyses were performed.
Results: Prevalence of DBM among the indigenous communities in Sarawak was 25.2%. Households with an overweight/obese mother and a stunted child was 12.9%, wasted child (11.9%), and underweight child (9.4%). Households with younger mothers, a household size of >4 persons, and higher income per capita (relative to sample population) were significantly more likely to have DBM. Conversely, households with higher monthly non-food expenditure and greater fish and seafood intake scores in children were significantly less likely to have DBM.
Conclusion: DBM is prevalent among Sarawak’s indigenous communities, affecting 25.2% of households. Further research and targeted interventions are needed to address socioeconomic and dietary factors in these populations.
Key words: dietary, indigenous, malnutrition, Sarawak, stunting
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Introduction: Double burden of malnutrition (DBM), encompassing both overnutrition and undernutrition, is a growing global public health issue. Indigenous people are one of the marginalised populations experiencing DBM at varying severity. This study aimed to identify factors contributing to DBM in indigenous households in Sarawak.
Methods: This cross-sectional study utilised multistage random sampling to include 286 indigenous households from six administrative divisions in Sarawak. Mothers aged 20–49 years who had at least one child aged 2–12 years were recruited. Trained interviewers obtained information on demographic and socioeconomic characteristics, food security, and dietary intake via a two-day, 24-hour dietary recall. Height and weight measurements followed World Health Organization protocols. DBM household was identified as having an overnourished (overweight/ obese) mother with an undernourished (underweight/stunting/wasting) child within the same household. Simple and multiple binary logistic regression analyses were performed.
Results: Prevalence of DBM among the indigenous communities in Sarawak was 25.2%. Households with an overweight/obese mother and a stunted child was 12.9%, wasted child (11.9%), and underweight child (9.4%). Households with younger mothers, a household size of >4 persons, and higher income per capita (relative to sample population) were significantly more likely to have DBM. Conversely, households with higher monthly non-food expenditure and greater fish and seafood intake scores in children were significantly less likely to have DBM.
Conclusion: DBM is prevalent among Sarawak’s indigenous communities, affecting 25.2% of households. Further research and targeted interventions are needed to address socioeconomic and dietary factors in these populations.
Key words: dietary, indigenous, malnutrition, Sarawak, stunting
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Mineral and heavy metal variations and contaminations
in raw honey of stingless bees, Heterotrigona itama,
from selected geographical areas of origin in Malaysia
Bellericter Binjamin, Mohd Iftar Johwan Johny @ Hasbullah, Kimberly Ador,
Januarius Gobilik, Clament Fui Seung Chin, Mok Sam Lum, Nurul’azah Mohd
Yaakub & Suzan Benedick
doi: https://doi.org/10.31246/mjn-2023-0140
ABSTRACT
Introduction: Honey contains a complex matrix of different substances consisting of essential minerals, non-nutritive substances, and toxins, often due to environmental sources. The objectives of this study were i) to investigate the variation of mineral and heavy metal content in honey samples of Heterotrigona itama from different geographical origins, and ii) to evaluate the nutritional quality and safety of honey from different floral sources for human consumption.
Methods: A total of 75 samples of raw H. itama honey were collected from 11 sites in Sabah, two sites in Sarawak, and two sites in Peninsular Malaysia. The mineral and heavy metal contents of honey were determined in triplicate using inductively coupled plasma mass spectrometry (ICP-MS).
Results: There were significant differences in the composition of essential minerals and heavy metals in the honey samples according to geographical origins (p<0.001). All honey samples tested were below the permitted maximum proportion (ML) for cadmium (Cd) and lead (Pb) specified in the Malaysian Food Act 1983 for honey. However, all honey samples exceeded the ML for Pb set by Codex, with samples from bamboo sites having the highest levels for Pb.
Conclusion: The composition of minerals and heavy metals in stingless bee honey was influenced by geographical origin. All measured Pb concentrations were above the ML value set by Codex, which raises concerns about possible toxicological risks to human health. Given the toxic nature of Pb in the environment, the measured concentrations emphasise the importance of monitoring Pb in honey from stingless bees.
Key words: geographical origin, heavy metals, Heterotrigona itama, honey, minerals
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Introduction: Honey contains a complex matrix of different substances consisting of essential minerals, non-nutritive substances, and toxins, often due to environmental sources. The objectives of this study were i) to investigate the variation of mineral and heavy metal content in honey samples of Heterotrigona itama from different geographical origins, and ii) to evaluate the nutritional quality and safety of honey from different floral sources for human consumption.
Methods: A total of 75 samples of raw H. itama honey were collected from 11 sites in Sabah, two sites in Sarawak, and two sites in Peninsular Malaysia. The mineral and heavy metal contents of honey were determined in triplicate using inductively coupled plasma mass spectrometry (ICP-MS).
Results: There were significant differences in the composition of essential minerals and heavy metals in the honey samples according to geographical origins (p<0.001). All honey samples tested were below the permitted maximum proportion (ML) for cadmium (Cd) and lead (Pb) specified in the Malaysian Food Act 1983 for honey. However, all honey samples exceeded the ML for Pb set by Codex, with samples from bamboo sites having the highest levels for Pb.
Conclusion: The composition of minerals and heavy metals in stingless bee honey was influenced by geographical origin. All measured Pb concentrations were above the ML value set by Codex, which raises concerns about possible toxicological risks to human health. Given the toxic nature of Pb in the environment, the measured concentrations emphasise the importance of monitoring Pb in honey from stingless bees.
Key words: geographical origin, heavy metals, Heterotrigona itama, honey, minerals
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Effects of temperature and duration on extraction
process utilising aqueous solvent towards quality of tea
derived from dried roots of Asparagus officinalis L.
Nguyen Thi Ngoc Giang & Tran Van Khai
doi: https://doi.org/10.31246/mjn-2024-0036
ABSTRACT
Introduction: The root of Asparagus officinalis L. stands out as a potential byproduct source for creating value-added food products. Asparagus root is studied for the development of a new herbal tea. The water solvent extraction method is proposed to determine appropriate extraction parameters, including temperature and time, which are crucial and interdependent factors during the extraction process, requiring precise investigation to maximise yield and maintain the quality of the extracted compounds.
Methods: This investigation focused on identifying an advanced extraction method applicable to the tea infusion of desiccated herbal products. The study delved into multiple extraction parameters, encompassing temperatures (80, 85, 90, and 95°C) and durations (15, 30, 45, and 60 minutes), utilising an aqueous solvent to scrutinise their impact on the tea’s extracted solution quality.
Results: The research determined that 85°C and 30 minutes were the proper parameters for tea infusion. The extracted solution from dried asparagus root tea exhibited ultimate nutrient contents (saccharose, vitamin C, phenolic compounds, flavonoid, and saponin) and antioxidant capacity (DPPH and FRAP) (in 100 g of dry matter) of 0.81 g, 1.23 g, 0.50 g TAE, 0.12 g QE, 1.10 g SE, 56.10%, and 1.12 M Fe2+, respectively.
Conclusion: This research effectively elucidated the impacts of extraction temperature and duration employing an aqueous solvent on desiccated agricultural commodity, particularly asparagus root. The findings yielded valuable insights aimed at discerning optimal parameters for the extraction procedure based on nutrient content and bioactivity in the extracted solution.
Key words: aqueous solvent, asparagus roots, extraction process
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Introduction: The root of Asparagus officinalis L. stands out as a potential byproduct source for creating value-added food products. Asparagus root is studied for the development of a new herbal tea. The water solvent extraction method is proposed to determine appropriate extraction parameters, including temperature and time, which are crucial and interdependent factors during the extraction process, requiring precise investigation to maximise yield and maintain the quality of the extracted compounds.
Methods: This investigation focused on identifying an advanced extraction method applicable to the tea infusion of desiccated herbal products. The study delved into multiple extraction parameters, encompassing temperatures (80, 85, 90, and 95°C) and durations (15, 30, 45, and 60 minutes), utilising an aqueous solvent to scrutinise their impact on the tea’s extracted solution quality.
Results: The research determined that 85°C and 30 minutes were the proper parameters for tea infusion. The extracted solution from dried asparagus root tea exhibited ultimate nutrient contents (saccharose, vitamin C, phenolic compounds, flavonoid, and saponin) and antioxidant capacity (DPPH and FRAP) (in 100 g of dry matter) of 0.81 g, 1.23 g, 0.50 g TAE, 0.12 g QE, 1.10 g SE, 56.10%, and 1.12 M Fe2+, respectively.
Conclusion: This research effectively elucidated the impacts of extraction temperature and duration employing an aqueous solvent on desiccated agricultural commodity, particularly asparagus root. The findings yielded valuable insights aimed at discerning optimal parameters for the extraction procedure based on nutrient content and bioactivity in the extracted solution.
Key words: aqueous solvent, asparagus roots, extraction process
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Maternal nutrition knowledge, infant feeding practices,
and linear growth of 6-12 months old infants in Kuala
Lumpur and Putrajaya
Koh Su Yuan, Nurliyana Abdul Razak & Satvinder Kaur
doi: https://doi.org/10.31246/mjn-2024-0004
ABSTRACT
Introduction: Stunting is a serious form of childhood undernutrition due to its long-term impact on growth and development. This study aimed to determine the associations between maternal nutrition knowledge, infant feeding practices, and linear growth of infants aged 6-12 months in Kuala Lumpur and Putrajaya.
Methods: This cross-sectional study was conducted on 229 mothers with infants aged 6-12 months. Socio-demographic background, anthropometric measurements, infant feeding practices, and maternal nutrition knowledge were assessed through questionnaires. Length-for-age z-score (LAZ) was calculated using WHO Anthro software and classified based on WHO child growth standards. Infant and Young Child Feeding Index (ICFI) was used to measure infant feeding practices.
Results: Mean total percentage score of maternal nutrition knowledge was 77.90% (SD=7.99), while mean ICFI total score was 6.73 (SD=1.40). Mean LAZ was -0.62 (SD=1.08) and stunting prevalence was 10.9%. Total ICFI score (r=0.162, p=0.014), infant’s age (r=-0.146, p=0.028), maternal height (r=0.310, p<0.001), and birth weight (r=0.370, p<0.001) were significantly associated with LAZ in the bivariate analysis. There was no significant association between maternal nutrition knowledge and linear growth (p>0.05). Multivariate analysis indicated that birth weight (B=0.850, p<0.001), maternal height (B=0.045, p<0.001), infant’s age (B=-0.076, p=0.009), infant’s sex (B=-0.253, p<0.047), and total ICFI score (B=0.094, p=0.048) were significant contributors of infants’ linear growth.
Conclusion: Infant feeding practices were associated with linear growth of infants, but not maternal nutrition knowledge. Therefore, the ability to put knowledge into practices is deemed important.
Key words: Maternal nutrition knowledge, infant feeding practices, linear growth, stunting
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Introduction: Stunting is a serious form of childhood undernutrition due to its long-term impact on growth and development. This study aimed to determine the associations between maternal nutrition knowledge, infant feeding practices, and linear growth of infants aged 6-12 months in Kuala Lumpur and Putrajaya.
Methods: This cross-sectional study was conducted on 229 mothers with infants aged 6-12 months. Socio-demographic background, anthropometric measurements, infant feeding practices, and maternal nutrition knowledge were assessed through questionnaires. Length-for-age z-score (LAZ) was calculated using WHO Anthro software and classified based on WHO child growth standards. Infant and Young Child Feeding Index (ICFI) was used to measure infant feeding practices.
Results: Mean total percentage score of maternal nutrition knowledge was 77.90% (SD=7.99), while mean ICFI total score was 6.73 (SD=1.40). Mean LAZ was -0.62 (SD=1.08) and stunting prevalence was 10.9%. Total ICFI score (r=0.162, p=0.014), infant’s age (r=-0.146, p=0.028), maternal height (r=0.310, p<0.001), and birth weight (r=0.370, p<0.001) were significantly associated with LAZ in the bivariate analysis. There was no significant association between maternal nutrition knowledge and linear growth (p>0.05). Multivariate analysis indicated that birth weight (B=0.850, p<0.001), maternal height (B=0.045, p<0.001), infant’s age (B=-0.076, p=0.009), infant’s sex (B=-0.253, p<0.047), and total ICFI score (B=0.094, p=0.048) were significant contributors of infants’ linear growth.
Conclusion: Infant feeding practices were associated with linear growth of infants, but not maternal nutrition knowledge. Therefore, the ability to put knowledge into practices is deemed important.
Key words: Maternal nutrition knowledge, infant feeding practices, linear growth, stunting
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Predictors of undernutrition among under-five children
in geographically isolated and disadvantaged areas in
the Philippines
Ma. Lynell V. Maniego, Charmaine A. Duante, Mary Bernadette M. Velasquez
& Romalyn L. Tordecilla
doi: https://doi.org/10.31246/mjn-2024-0017
ABSTRACT
Introduction: Geographically isolated and disadvantaged areas (GIDA) are generally characterised by high morbidity and mortality of children. Undernutrition makes under-five children more vulnerable to disease and death. This study aimed to assess nutritional status and determine factors affecting undernourished children under five in GIDA.
Methods: The study utilised data from children aged 0-59 months obtained from the 2018-2021 Expanded National Nutrition Survey (ENNS). GIDA were identified and 5,600 children were included in the analysis. Descriptive and multiple logistic regression analyses were employed to investigate associations between nutritional status of children [including stunting, underweight (UW), and wasting] and various factors including child-related, household-related, and biochemical markers.
Results: Prevalence of UW, stunting, and wasting among children in GIDA were 39.7%, 24.1%, and 6.2%, respectively. Anaemia was of mild public health significance. Multiple logistic analysis revealed significant associations between stunting and vitamin A deficiency (VAD), food insecurity, and unimproved sources of drinking water; underweight and older age, anaemia, VAD, urban residence, and poor wealth; wasting and younger age, being female, and poor wealth.
Conclusion: Existence of all forms of undernutrition in GIDA intensifies risk of mortality and morbidity among children. This study recommends that government sectors prioritise implementation of nutrition and food supplementation programmes in GIDA where the healthcare system continues to be at a disadvantage. The persistent constraints in GIDA should be addressed to improve food accessibility.
Key words: children, disadvantaged populations, GIDA, Philippines, undernutrition
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Introduction: Geographically isolated and disadvantaged areas (GIDA) are generally characterised by high morbidity and mortality of children. Undernutrition makes under-five children more vulnerable to disease and death. This study aimed to assess nutritional status and determine factors affecting undernourished children under five in GIDA.
Methods: The study utilised data from children aged 0-59 months obtained from the 2018-2021 Expanded National Nutrition Survey (ENNS). GIDA were identified and 5,600 children were included in the analysis. Descriptive and multiple logistic regression analyses were employed to investigate associations between nutritional status of children [including stunting, underweight (UW), and wasting] and various factors including child-related, household-related, and biochemical markers.
Results: Prevalence of UW, stunting, and wasting among children in GIDA were 39.7%, 24.1%, and 6.2%, respectively. Anaemia was of mild public health significance. Multiple logistic analysis revealed significant associations between stunting and vitamin A deficiency (VAD), food insecurity, and unimproved sources of drinking water; underweight and older age, anaemia, VAD, urban residence, and poor wealth; wasting and younger age, being female, and poor wealth.
Conclusion: Existence of all forms of undernutrition in GIDA intensifies risk of mortality and morbidity among children. This study recommends that government sectors prioritise implementation of nutrition and food supplementation programmes in GIDA where the healthcare system continues to be at a disadvantage. The persistent constraints in GIDA should be addressed to improve food accessibility.
Key words: children, disadvantaged populations, GIDA, Philippines, undernutrition
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Parenting influences associated with BMI-for-age
z-score of Malaysian children aged 6-36 months: A
cross-sectional study based on an online survey
Wong Hui Juan, Chin Yit Siew, Lim Poh Ying & Tan Cin Cin
doi: https://doi.org/10.31246/mjn-2024-0043
ABSTRACT
Introduction: Malnutrition in early life can contribute to lifelong health consequences. Both fathers and mothers can influence children’s feeding, eating behaviours, and body weight status. This cross-sectional study aimed to determine the association between parental factors and body mass index-for-age z-score (BAZ) of Malaysian children aged 6-36 months.
Methods: An online questionnaire using Google Form, which comprised of socio-demographic factors, parental lifestyle and feeding factors, children’s birth history and eating behaviours, was completed by 282 pairs of fathers and mothers of full-term children during the COVID-19 pandemic. Health records were accessed with parental consent to ensure accurate measurements of children’s weight and length, while both fathers and mothers self-reported their weight and height.
Results: Prevalence of at-risk overweight, overweight, and obesity among children was 10.7%, 2.8%, and 1.1%, respectively, while wasting and severe wasting was 5.7% and 0.4%, respectively. Multiple linear regression analysis found that higher birth weight (β=0.271, p<0.001), less frequent use of food to calm by fathers (β=-0.127, p=0.035), and higher maternal BMI (β=0.136, p=0.021) significantly contributed to higher BAZ among children.
Conclusion: These findings suggest that interventions should involve both fathers and mothers with a focus on nutrition education in promoting responsive feeding, such as minimising use of food, to calm children. Additionally, efforts to ensure good nutrition before and during pregnancy to achieve ideal birth weight are equally important.
Key words: body mass index; children; fathers; feeding behaviours; mothers
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Introduction: Malnutrition in early life can contribute to lifelong health consequences. Both fathers and mothers can influence children’s feeding, eating behaviours, and body weight status. This cross-sectional study aimed to determine the association between parental factors and body mass index-for-age z-score (BAZ) of Malaysian children aged 6-36 months.
Methods: An online questionnaire using Google Form, which comprised of socio-demographic factors, parental lifestyle and feeding factors, children’s birth history and eating behaviours, was completed by 282 pairs of fathers and mothers of full-term children during the COVID-19 pandemic. Health records were accessed with parental consent to ensure accurate measurements of children’s weight and length, while both fathers and mothers self-reported their weight and height.
Results: Prevalence of at-risk overweight, overweight, and obesity among children was 10.7%, 2.8%, and 1.1%, respectively, while wasting and severe wasting was 5.7% and 0.4%, respectively. Multiple linear regression analysis found that higher birth weight (β=0.271, p<0.001), less frequent use of food to calm by fathers (β=-0.127, p=0.035), and higher maternal BMI (β=0.136, p=0.021) significantly contributed to higher BAZ among children.
Conclusion: These findings suggest that interventions should involve both fathers and mothers with a focus on nutrition education in promoting responsive feeding, such as minimising use of food, to calm children. Additionally, efforts to ensure good nutrition before and during pregnancy to achieve ideal birth weight are equally important.
Key words: body mass index; children; fathers; feeding behaviours; mothers
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Sweetened beverage consumption and its association
with overweight and obesity across population groups
in the Philippines
Eva A. Goyena, Josie P. Desnacido, Antoniette G. Cristobal & Apple Joy D.
Ducay
doi: https://doi.org/10.31246/mjn-2024-0035
ABSTRACT
Introduction: The increasing prevalence of overweight and obesity has been a major nutritional concern. Evidence shows that habitual or excessive sweetened beverage (SB) consumption is associated with weight gain and obesity. This study assessed the SB consumption across different age groups and determined its association with overweight and obesity.
Methods: Data of 31,003 preschool children, school-age children, adolescents, and adults from 2018- 2019 Expanded National Nutrition Survey were utilised. Data on SB consumption, type, and quantity were obtained from 24-hour food recalls, and participants’ nutritional status was assessed. Multivariate logistic regression was conducted to evaluate association between SB consumption and obesity using STATA 16.
Results: Mean SB intake per day increased with age. Nearly 48% of preschool children, 33% of schoolchildren, 24% of adolescents, and 21% of adults consumed SBs amounting to >10% of total energy intake. Males, urban dwellers, and those with higher socioeconomic status were more likely to consume SBs. After controlling for sex, age, wealth, and place of residence, children and adults with higher SB intake, and all age groups with higher sugar intake from SB per day were more likely to be overweight and obese.
Conclusion: SB consumption was higher among older age groups, males, urban dwellers, and those with higher socioeconomic status. High consumption of SBs was associated with overweight and obesity. Revisiting current nutrition policies, particularly the food-based dietary guidelines and front-of-pack labelling, and necessary regulations are needed to reduce SB consumption and control obesity in the Philippines.
Key words: obesity, overweight, sweetened beverages
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Introduction: The increasing prevalence of overweight and obesity has been a major nutritional concern. Evidence shows that habitual or excessive sweetened beverage (SB) consumption is associated with weight gain and obesity. This study assessed the SB consumption across different age groups and determined its association with overweight and obesity.
Methods: Data of 31,003 preschool children, school-age children, adolescents, and adults from 2018- 2019 Expanded National Nutrition Survey were utilised. Data on SB consumption, type, and quantity were obtained from 24-hour food recalls, and participants’ nutritional status was assessed. Multivariate logistic regression was conducted to evaluate association between SB consumption and obesity using STATA 16.
Results: Mean SB intake per day increased with age. Nearly 48% of preschool children, 33% of schoolchildren, 24% of adolescents, and 21% of adults consumed SBs amounting to >10% of total energy intake. Males, urban dwellers, and those with higher socioeconomic status were more likely to consume SBs. After controlling for sex, age, wealth, and place of residence, children and adults with higher SB intake, and all age groups with higher sugar intake from SB per day were more likely to be overweight and obese.
Conclusion: SB consumption was higher among older age groups, males, urban dwellers, and those with higher socioeconomic status. High consumption of SBs was associated with overweight and obesity. Revisiting current nutrition policies, particularly the food-based dietary guidelines and front-of-pack labelling, and necessary regulations are needed to reduce SB consumption and control obesity in the Philippines.
Key words: obesity, overweight, sweetened beverages
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