Online First

Vitamin A knowledge and household consumption frequency of vitamin A – rich foods in Tangail, Bangladesh
Rokeya Begum, Md. Nannur Rahman, Robiul Islam, Md. Rakibul Hasan, Md. Yusuf Jamil & Sanjida Anjom Tamanna

doi: https://doi.org/10.31246/mjn-2020-0063

ABSTRACT

Introduction: Vitamin A deficiency is one of the most serious health problems in developing countries. This study aims to explore the comparative figure of vitamin A knowledge, household consumption frequency of vitamin A-rich foods, and association of socio-demographic factors with knowledge and consumption in four residential areas in Tangail district, Bangladesh.
Methods: This study used a population-based cross-sectional design with 400 study participants selected using purposive sampling technique. Knowledge and consumption frequency were assessed by a structured questionnaire along with food frequency table. Data were analysed using descriptive statistics.
Results: Only 33.5% participants had primary vitamin A knowledge, where most from urban (48.5%) and semi-urban (30.6%) areas had comparatively higher knowledge than those from rural (11.2%) and slum (9.7%) areas. Specific knowledge level was also poorer in rural and slum areas than urban and semi-urban areas. Most of the participants received knowledge through commercial advertisements (65.7%). Household consumption frequency of vitamin A-rich foods (plant and animal) was comparatively lower in rural and slum areas than in urban and semi-urban areas. Different socio-demographic factors (place of residence, education and household income) significantly influenced participant’s vitamin A knowledge and household consumption of vitamin A-rich foods (p<0.05).
Conclusion: In general, the study population lacked knowledge regarding the importance of vitamin A. Consumption frequency of vitamin A-rich foods was still poorer in slum and rural areas than in urban and semi-urban areas.
Key words: Vitamin A knowledge, consumption frequency, plant sources, animal sources, socio-demographic factors

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Determinants of fathers’ involvement in breastfeeding practices in Kuala Selangor
Nurul Izyan Mat Nawi & Syahrul Bariah Abdul Hamid

doi: https://doi.org/10.31246/mjn-2020-0070

ABSTRACT

Introduction: Fathers’ knowledge, attitude, and involvement in breastfeeding practices are crucial factors to determine the success of breastfeeding outcomes such as decision-making on breastfeeding, successfulness of exclusive breastfeeding, and continuation of breastfeeding practices. This study aimed to identify the determinants of fathers’ involvement in breastfeeding practices.
Methods: This cross-sectional study involved 203 fathers attending Maternal and Child Health Clinics in Kuala Selangor. Self-administered questionnaires were used to obtain information regarding fathers’ sociodemography, breastfeeding knowledge, attitudes, and involvement towards breastfeeding practices.
Results: Mean age of the fathers was 32.1±5.9 years, ranging between 21 to 50 years. Findings showed that majority of the fathers were involved in breastfeeding practices (52.7%; n=107, 57.0±6.2), had fair knowledge in breastfeeding (62.6%; n=127, 13.8±3.2), and showed low attitude towards breastfeeding (68.0%; n=138, 61.9±6.7). Multiple logistic regression analysis revealed factors with significant influence on fathers’ involvement towards breastfeeding practices were: (1) fathers’ breastfeeding knowledge, (2) fathers’ attitudes towards breastfeeding practices, and (3) mode of infant delivery.
Conclusion: These significant predictors may help healthcare professionals to establish effective strategies by advocating the role of fathers in the breastfeeding process such as by offering continuous support, active involvement, and effective participation.
Key words: Breastfeeding support, paternal involvement, breastfeeding knowledge, breastfeeding attitude, involvement

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REVIEW

Malnutrition and its risk factors among children and adolescents with intellectual disability (ID) in Asian countries: A scoping review
Siti Fathiah Mohamed, Soo Kah Leng & Divya Vanoh

doi: https://doi.org/10.31246/mjn-2020-0067

ABSTRACT

Introduction: Children with intellectual disability (ID) have higher probability of experiencing poor health status due to their limited ability to understand and assess information about nutrition and health. Malnutrition remains a significant health problem as it is prevalent among both typically developing and disabled children. This scoping review aims to discuss the prevalence of malnutrition among children and adolescents with ID in Asian countries.
Methods: The review was based on the PRISMA-ScR method. A systematic electronic search was conducted using databases namely PUBMED, Science Direct, Scopus, and Google Scholar for articles published from 2006-2019, written in English and involved studies in Asian countries.
Results: A total of 255,100 article’s titles were identified and only 17 articles that met the inclusion criteria were included for further analysis. The findings revealed that the range of prevalence for underweight was 5.7%-76.3% and 28.9%-45.0% for stunting. The prevalence estimated for overweight was 3.9%-46.6%, while obesity was 1.6%- 26.6%. The body mass index values ranged from 17.4±4.3kg/m2-23.0±6.3kg/m2. There were several risk factors related to malnutrition such as co-morbidity factors, behavioural factors, and parental factors.
Conclusion: This review demonstrated concern regarding the prevalence of malnutrition among children and adolescents with ID, which is high in certain Asian countries. It was varied and thus difficult to compare due to different reference standards and definitions used for malnutrition. Establishing nutrition and health-related intervention programmes can help to prevent further rise in the prevalence of malnutrition in this group.
Key words: Intellectual disability, malnutrition, overweight, obesity, underweight

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Effect of resistance training exercise combined with high protein diet on body weight and muscle mass in underweight adolescent males
Wittawas Sajjapong, Preeya Leelahagul, Sitha Pongphibool & Narupon Thongsuk

doi: https://doi.org/10.31246/mjn-2020-0039

ABSTRACT

Introduction: Many underweight males take commercial protein supplements to increase their body weight and build muscle. Nonetheless, commercial protein supplements may cause adverse effects. This study aimed to determine the effects of resistance training exercise combined with a high protein diet on body weight and muscle mass in underweight adolescent males.
Methods: A repeated measures design study was conducted on nine males aged 12-15 years with low body weight. Energy and protein requirements were calculated, and energy and protein consumptions were measured for each meal during the high protein diet without exercise (HP) period and the high protein diet with resistance exercise (HPE) period. Subjects engaged in three resistance training sessions each week during HP-E period, for eight weeks. Dietary intake, body composition, blood biochemistry, physical fitness, and self-esteem were assessed.
Results: In HP-E period, resistance training exercise combined with a high protein intake (2.14 g/kg/d) increased body weight and lean tissue mass (LTM) by 0.5 kg and 0.5 kg, respectively. Resistance training during HP-E period increased arm, leg, and trunk muscle strength by 20.2%, 7.2%, and 14.5%, respectively, more than high protein diet alone during HP period. High protein intake in HP-E period did not affect blood urea nitrogen (BUN) and creatinine levels (11.0 mg/dL and 0.70 mg/dL, respectively).
Conclusion: Eight weeks of resistance training combined with a high protein diet increased body weight and LTM without adverse effects. In particular, resistance exercise predominantly increased muscle strength. Kidney function was not affected by high protein consumption throughout this study.
Key words: High protein diet, resistance exercise, adolescent male, body weight, muscle strength

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The acceptability of weekly iron-folic acid supplementation and its influencing factors among adolescent school girls in Yogyakarta city: a mixmethods study
Muhammad Ridwan Ansari, BJ Istiti Kandarina, Nuraini Kusmayanti, Destriyani, Masfufah & Rizka Fikrinnisa

doi: https://doi.org/10.31246/mjn-2020-0019

ABSTRACT

Introduction: Indonesia has initiated the weekly iron-folic acid supplementation programme (WIFS) among adolescent school girls since 2016. However, its acceptability needs to be investigated. This study aimed to assess the acceptability of WIFS and its influencing factors.
Methods: A mixed-methods study was conducted in six schools in Yogyakarta from January-April 2018. Totally, 211 participants aged 12-18 years were involved in the cross-sectional survey, followed by four focus group discussions (FGDs) and in-depth interviews (IDIs). Body mass index-for-age, haemoglobin, serum ferritin, habitual intake, and acceptability (defined as selfreported iron-folic acid tablet consumption) were assessed.
Results: This study reported that 22.3% and 12.4% of the participants were categorised as iron deficient and anaemic, respectively. Almost 90% of participants had received the tablet, but only 62.0% of them reported consuming it. Logistic regression test indicated that the participants were more likely to take the tablet if it tasted good [OR (95%CI): 4.66 (1.90-11.43)]. Meanwhile, motivation for tablet consumption declined when respondents perceived the odour of tablet was unpleasant, reported forgetfulness, lacked peer support, and experienced side effects, with OR (95%CI) of 0.23 (0.07- 0.77), 0.35 (0.13-0.95), 0.30 (0.08-0.58), and 0.04 (0.04-0.39), respectively. The results from FGD and IDIs strengthened the findings that the experience of nausea, organoleptic properties of iron-folic acid tablet, forgetfulness, and mother’s support play important roles in students’ acceptability.
Conclusion: This study found moderate acceptability towards the WIFS programme. The inhibiting and reinforcing factors of WIFS acceptability in this study could be considered as inputs for programme improvements in the future.
Key words: Adolescent girls, Indonesia, programme acceptability, school-based programmes, weekly iron-folic acid supplementation

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Fruit and vegetable intake among overweight and obese school children: A cluster randomised control trial
Rusidah Selamat, Junidah Raib, Nur Azlina Abdul Aziz, Norlida Zulkafly, Ainan Nasrina Ismail, W Nurul Ashikin W Mohamad, Muhammad Yazid Jalaludin, Fuziah Md Zain, Zahari Ishak, Abqariyah Yahya & Abdul Halim Mokhtar

doi: https://doi.org/10.31246/mjn-2020-0023

ABSTRACT

Introduction: Adequate daily intake of fruits and vegetables is crucial for the prevention of chronic diseases. This study aimed to determine the effects of My Body is Fit and Fabulous at School (MyBFF@school) with nutrition education intervention (NEI) on the stages of change for fruit and vegetable intake among overweight and obese secondary school children based on the trans-theoretical model (TTM).
Methods: This was a cluster randomised controlled trial involving 15 out of 415 eligible government secondary schools in central Peninsular Malaysia, which were randomly assigned into intervention (six schools; 579 school children) and control (nine schools; 462 school children). The intervention group was given NEI for 24 weeks, while the control group followed the existing school programme by the Ministry of Education.
Results: There was no significant difference between the intervention and control groups for the stages of change, with majority at the maintenance stage after six months (intervention: 34.9%; control: 39.0%). The within group analysis showed a significant reduction after six months for those at the action stage (action and maintenance stage) from 68.0% to 60.4% in the intervention group and from 71.4% to 65.6% in the control group. However, there was a significant increase among those with adequate fruit and vegetable intake in the intervention group and no significant increase in the control group.
Conclusion: MyBFF@school with NEI based on TTM provided acceptable changes in fruit and vegetable intake among overweight and obese secondary school children.
Key words: Trans-theoretical model, nutrition education intervention, childhood obesity, secondary school children, cluster randomised controlled trial

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Energy and protein intakes are associated with stunting among preschool children in Central Jakarta, Indonesia: a case-control study
Sandra Fikawati, Ahmad Syafiq, Rienzy Kholifatur Ririyanti & Syilga Cahya Gemily

doi: https://doi.org/10.31246/mjn-2020-0074

ABSTRACT

Introduction: Stunting is a major nutritional problem in Indonesia. The prevalence of stunting in DKI Jakarta province was relatively high at 27.5% in 2013 and 17.7% in 2018. This study aims to describe nutrient intakes of children aged 25-30 months and to determine the proportional differences in nutrient intakes between stunting and normal children in Central Jakarta, Indonesia.
Methods: A case-control study with a total sample of 121 children aged 25-30 months was conducted in Gambir and Sawah Besar sub-districts, Central Jakarta, where the prevalence of stunting was high. All children were exclusively breastfed for at least four months and had similar socio-economic levels. Data collected included height measurement, questionnairebased interview, and 24-hour food recall. T-test and chi-square test were used to investigate the differences between two groups and logistic regression was used in multivariate analysis.
Results: Factors associated with stunting were energy intake (AOR=6.0; 95% CI=1.0-35.0) and protein intake (AOR=4.0; 95% CI=1.1-15.5) after controlling for fat, carbohydrate, vitamin C, iron, and zinc intakes. The percentage of children with energy intake below the recommendation was much higher in stunted children (86.1%) compared to normal children (43.5%). Similarly, the percentage of children with protein intake below the recommendation was very much higher among stunted children (30.6%) compared to 8.2% in normal children.
Conclusion: Children who lacked energy and protein intakes were at a higher risk of stunting than children who had sufficient intakes. Macronutrient intakes are important and should be consumed in sufficient quantities every day to prevent stunting.
Key words: Stunting, energy intake, protein intake, preschool children, nutrient intake

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Determination of the prevalence of hypertension and factors associated with blood pressure among hospitalised elderly in Hospital Serdang, Selangor, Malaysia
Siti Nurhaliza Hashidi, Noraida Omar & Siti Nur ’Asyura Adznam

doi: https://doi.org/10.31246/mjn-2020-0086

ABSTRACT

Introduction: Increasing trends of hypertension has been recognised as a common disease among the elderly. This study aimed to determine the prevalence of hypertension and factors associated with blood pressure among hospitalised elderly.
Methods: This was a cross-sectional study involving 124 patients in Hospital Serdang, Selangor, Malaysia. Data on socio-demography, medical background, anthropometry, blood biochemistry and lifestyle were collected through face-to-face interviews and medical records. Dietary intake was obtained through two days of food history. Malnutrition risks and stress level were determined using the Mini Nutritional Assessment Short-Form (MNA-SF) and the Geriatric Depression Scale (GDS).
Results: There were 59.7% males and 40.3% females with mean age of 66.81±5.35 years. Majority were found to have hypertension (72.6%). Approximately 38.7% had normal body mass index (BMI). Most of them reported insufficient dietary intakes except for trans fats, sodium, and caffeine. Nearly 62.1% were engaged with physical activity, 23.4% were smoking, and 4.8% were taking alcohol. Approximately 66.1% and 86.3% were classified as having normal nutritional status and normal stress levels. In this study, the prevalence of hypertension among elderly patients warded in Hospital Serdang, Selangor was 72.6% and factors such as length of stay, number of co-morbidities, number of medications, having co-morbidities of hypertension, dyslipidaemia and diabetes mellitus, polypharmacy, height, BMI, fibre, polyunsaturated fat, dietary cholesterol, caffeine, and duration of physical activity were found to be associated with blood pressure.
Conclusion: The present study found that majority of patients (72.6%) had hypertension. Future studies regarding factors associated with blood pressure are recommended.
Key words: Hypertension, blood pressure, elderly

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Associations of eating behaviours, fast food purchasing and availability with BMI-for-age z-score among adolescents in Labuan, Malaysia
Ho Shu Fen, Chin Yit Siew, Abdul Rashid Bin Mohamed Shariff & Lim Poh Ying

doi: https://doi.org/10.31246/mjn-2020-0026

ABSTRACT

Introduction: A cross-sectional study was conducted to determine the associations of socio-demographic factors, eating behaviours, fast food purchasing by parents for family meals, and availability of neighbourhood fast-food outlets with BMI-for-age z-score (BAZ) among adolescents.
Methods: Through multi-stage stratified cluster sampling method, a total of 420 adolescents from five selected public secondary schools participated in the current study. Data on socio-demographic factors, eating behaviours, and parent’s purchases of fast food were obtained through selfadministered questionnaires. The availability of fast-food outlets was assessed using Geographic Information System (GIS). Body weight and height of the adolescents were measured.
Results: The prevalence of overweight, obesity, thinness and severe thinness among adolescents in the present study were 17.6%, 15.5%, 3.1% and 0.7%, respectively. The current findings showed that a higher monthly household income (rs=0.12, p=0.02) and less purchases of fast food by parents for family meals (rs=-0.11, p=0.03) were significantly associated with higher BAZ of the adolescents. However, there were no significant associations between eating outside of home, eating at fast-food restaurants, buying delivery fast food, and availability of neighbourhood fast-food outlets with BAZ. Multiple linear regression showed that less purchases of fast food by parents for family meals significantly contributed towards higher BAZ (β=−0.25, p=0.02).
Conclusion: A higher household income and less fast food purchasing by parents were associated with higher BAZ. Fast food purchasing of adolescents were not associated with BAZ. Therefore, an appropriate obesity intervention programme should focus on adolescents and their parents from middle- and high-income households in Labuan.
Key words: Obesity, adolescents, household income, fast-food, GIS

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