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@#Introduction: This methodological research study aimed to measure content validity and reliability of a newly developed questionnaire of knowledge, attitudes, and self-reported practices towards pureed diet preparation (KAP DYS Puree) among hospital food handlers for dysphagia management. Methods: The study was conducted through face validation, content validation, content reliability and construct validation. A cross-sectional design with convenience sampling was carried out involving 4 panels for face validation, 10 raters for content validity and 161 food handlers participated for Exploratory Factor Analysis (EFA), while 30 food handlers were involved for test-retest reliability. The questionnaire which consisted of 40 items distributed into 3 domains and was assessed and analyzed using modified kappa (k*) for reliability. Results: Content Validity Index revealed the following I-CVI values: knowledge = 0.915, attitudes = 0.922 and self-reported practices = 0.900 and modified kappa values (k*) knowledge = 0.983, attitudes = 0.9214 and self-reported practices = 0.899. The EFA was employed for two dimensions which were self-reported practices and attitudes based on principal axis of factoring with varimax rotation. The factor analysis yielded two factors with a total of 10 items in the attitudes domain and two factors with a total of 9 items in the self-reported practices domain that had satisfactory factor loading (> 0.3). The Kaiser-Meyer-Olkin (KMO) values for attitudes = 0.816 and self-reported practices = 0.776. Bartlett’s test of sphericity was significant at p < 0.0001 for attitudes and self-reported practices indicating the suitability of this data for factor analysis. Interclass Correlation Index (ICC) values for attitudes = 0.739 and self-reported practices = 0.789. Conclusion: This instrument can be used as a need assessment tool in the development of a comprehensive training module for pureed diet preparations in dysphagia management.
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@#Introduction: Malaysians are exposed to a high salt diet, which is one of the contributors to the prevalence of hypertension among them. This study aimed to identify the salt content in selected food products of fast food restaurants and to determine the salt intake awareness among fast food consumers. Methods: Salt content data were collected through online survey from the official websites of selected restaurants (Kentucky Fried Chicken, McDonald’s, Subway® and Texas Chicken). The food products were classified into eight food categories (chickenbased, potato-based, rice-based, sandwich, salad, bread, dessert, and sauce). The cross-sectional study on salt intake awareness was conducted among 108 Malaysian adults from these restaurants. A knowledge, attitude and practice (KAP) questionnaire was disseminated online. The salt content and the consumers’ salt intake awareness were analysed using Statistical Products and Service Solution (SPSS) software version 25.0. Results: A total of 105 food products were surveyed in this study. Sauce products contained the highest salt content (1.9±0.8 g/100g), followed by bread (1.2±0.3 g/100g), potato-based (1.2±0.4 g/100g), chicken-based (1.2±0.3 g/100g), sandwich (1.1±0.6 g/100g), rice-based (0.7±0.3 g/100g), salad (0.4±0.2 g/100g), and dessert (0.3±0.4 g/100g). For the KAP study, a total of 108 consumers had participated and mostly (48.2%) had a fair level of salt intake awareness. Conclusion: Most food products of fast food restaurants contained high salt content and majority of fast food consumers had a fair level of salt intake awareness. More strategic interventions are needed to control the salt intake among adults in Malaysia.
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@#Introduction: Many people are seeking knowledge and skills about preparing healthy meals at home. This study aimed to determine the content of nutrients in 60 healthy dishes prepared for the recipe book Mudah, Sihat, Sedap used in the F.E.A.T nutrition intervention programme. The recipe book was developed as an educational material to guide participants in preparing healthy meals at home. Methods: A needs assessment survey was done to identify food preferences for breakfast, lunch and dinner of obese and overweight respondents. Recipes for these foods were then modified to reduce the calorie, fat, and sugar contents, while adding in fibre sources. Proximate analysis was done based on standard methods of AOAC, while total carbohydrate and calorie contents were calculated using the differentiation and Atwater methods, respectively. Mineral content was determined using atomic absorption spectrophotometer, while fatty acids content was analysed by gas chromatography using the FAME method. Results: Proximate analysis results showed that Kobis Goreng had the most calories (305 kcal/100g) (p<0.05) in all categories. Mineral analysis showed that sodium was significantly highest (p<0.05) in Asam Pedas Daging (554 mg/100g). For fatty acid analysis, Masak Lemak Telur Itik had the highest amount of MUFA (45.1%), Masak Lemak Sotong had the highest amount for SFA (71.8%), and Masak Lemak Cili Api Udang had the highest amount of PUFA (33.7%). Conclusion: This study successfully modified original recipes of selected cuisines used in the recipe book, which contained lower calories compared to original recipes. The calorie and nutrient values for each recipe will be included as nutrition composition information in the recipe book.
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@#Background: Decline in mental health and cognitive status starts to show its sign during middle-age and is affected by dietary factors, namely the polyphenols intake. Polyphenols have received attention in improving health issues related to aging, including decline in mental health and cognitive. The aim of this study is to determine the prevalence of poor mental health and cognitive status among middle-aged adults and its predictors in relation to polyphenols intake. Methods: Subjects’ food intakes were calculated by using dietary history questionnaire and food frequency questionnaire for polyphenols. The subjects’ mental health and cognitive status were measured by general health questionnaire-28 (GHQ-28) and Rey’s auditory verbal learning test (RAVLT). Results: More than 40% of middle-aged adults were identified as having signs of poor mental health. A total of 67.9% of the subjects had poor cognitive status according to RAVLT immediate recall. Hierarchical binary logistic regression indicated that fat intake was associated with somatic symptoms for both men [adjusted odds ratio (AOR) = 1.04; P < 0.05] and women (AOR = 1.06; P < 0.05). Intake of lignan (AOR = 1.071; P < 0.05) was associated with better RAVLT immediate recall among women. Additionally, high cholesterol (AOR = 3.14; P < 0.05) was associated with poor score of RAVLT delayed recall for women. Conclusions: Early detection of poor mental health and cognitive is crucial to prevent Alzheimer’s disease in old age.
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@#Introduction: Intake of soy isoflavones has been shown to be beneficial in reducing blood pressure, a known cardiovascular risk factor. This study investigated the association between intake of soy isoflavones and blood pressure among multiethnic Malaysian adults. Methods: A total of 230 non-institutionalised Malaysians aged 18-81 years were recruited through multi-stage random sampling from urban and rural areas in four conveniently selected states. Participants were interviewed on socio-demographics, medical history, smoking status, and physical activity. Measurements of height, weight, waist circumference (WC), and blood pressure (BP) were taken. Information on usual intake of soy foods was obtained using a validated semi-quantitative food frequency questionnaire. Results: The mean intake of soy protein of both urban (3.40g/day) and rural participants (3.01g/day) were lower than the USFDA recommended intake level of soy protein (25.00g/day). Urban participants had significantly higher intake of isoflavones (9.35±11.31mg/ day) compared to the rural participants (7.88±14.30mg/day). Mean BP levels were significantly lower among urban (136/81mmHg) than rural adults (142/83mmHg). After adjusting for age, gender, educational level, household income, smoking status, physical activity, BMI and WC, soy protein intake was significantly associated with both SBP (R2=0.205, β=-0.136) and DBP (R2=0.110, β=-0.104), whilst soy isoflavones intake was significantly associated with SBP (β=-0.131). Intake of 1 mg of isoflavone is estimated to lower SBP by 7.97 mmHg. Conclusion: Higher consumption of isoflavones among the urban participants showed an association with lower levels of SBP. Use of biological markers for estimating isoflavones levels is recommended to investigate its protective effects on blood pressure.
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@#Introduction: Sugar is widely consumed and excessive intake has been associated with increased risk of weight gain, diabetes mellitus and cardiovascular diseases, leading to metabolic syndrome (MetSyn). However, the association between sugar intake and MetSyn has seldom been studied among multi-ethnic Malaysian older adults. Methods: A total of 1,057 respondents aged ≥60 years were recruited through multistage random sampling from selected states. Anthropometric parameters, blood pressure, blood test for sugar and lipid profile were determined. Dietary intake was derived using a 7-day dietary history questionnaire (DHQ) and a semi-quantitative food frequency questionnaire (FFQ) for added sugar intake. Results: Prevalence of MetSyn was 39.9%, 30.9% and 42.2% using the harmonised definition, International Diabetes Federation (IDF) and National Cholesterol Education Program’s Adult Treatment Panel III (NCEP-ATPIII) definitions respectively. Mean total sugar intake was 40.5±32.0 g (8 tsp) and added sugar intake was 33.0±31.0 g (6 tsp). Excessive added sugar consumption at 100th percentile increased risks of high total cholesterol by two-fold (p<0.001) and triglyceride by 1.8 fold (p<0.001). Total sugar intake at 50th percentile increased risk of high blood pressure by 0.68 fold (p<0.05) and total sugar intake at 50th, 75th and 100th percentile increased total cholesterol risk by 1.7 fold (p<0.01), 1.5 fold (p<0.05) and 2.3 fold (p<0.001) respectively. Conclusion: Excessive sugar consumption among older adults showed no association with MetSyn but revealed significant associations with blood pressure and lipid profiles. Effects of long term excessive consumption of sugar on health outcomes in older persons should be investigated.
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The notion of fruit and vegetables (FV) in preventing chronic diseases has long been discerned. To meet the recommended FV intake, FV juices have emerged as a convenient and healthy choice. Mixed fruit and vegetable juices (MFVJ) cater the blend of desirable flavor and taste of consumers. This study was carried out to determine the total phenolic content (TPC), antioxidant activities and sugar content of selected MFVJ. Folin-Ciocalteu assay was employed to quantify TPC, whereas DPPH and FRAP assays were used to evaluate the antioxidant activities of MFVJ. The sugar content was determined using phenol-sulfuric acid method. MFVJ extracted from bitter gourd, green apple and orange (BGO) had the highest TPC content (76.4 ± 4.2 mg GAE/100 ml). Celery and green apple (CG) juice showed the highest DPPH value (522.3 ± 7.6 mg TE/100 ml) whereas carrot and starfruit (AS) juice have the highest FRAP value (419.6 ± 21.6 mg TE/100 ml). The sugar content of MFVJ was within the range of 5.7-13.3 g/100 ml. MFVJ can be considered as healthy beverages with considerable amounts of phenolic compounds and low sugar content. This study provides some useful reference for consumers who consume juices with combinations of FV. Future studies need to discover more combinations of FV juices, providing more data pertaining to MFVJ. Identification of individual phenolic compounds should also be part of future research using various instrumental analyses.
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Polyphenol is a non-nutrient phytochemical compound existed abundantly in plant-based diet which has the properties to prevent age related oxidative damage induced diseases. However, there are diffi culties in quantifying its intake and local food frequency questionnaire (FFQ) for the assessment is not available. Therefore, this study aimed to develop and validate FFQ for estimation of dietary polyphenol intake among 93 individuals aged 60 years and above recruited from several senior citizen clubs in Klang Valley. Phase I of the study involved the development of FFQ consisted of 117 items under 9 categories and formation of the database extracted from PHENOL-EXPLORER. In Phase II, the intake of polyphenol estimated using FFQ was compared with reference method consisted of 2-day diet records and diet history questionnaire (DHQ). The mean dietary polyphenol intake estimated from FFQ and the reference method was 2770.7 ± 1552.4 mg/d and 2171.4 ± 898.8 mg/d, respectively. Spearman’s rho and Kendall’s tau-b analysis indicated that there was a signifi cant positive correlation between polyphenol intake estimated from FFQ and reference method (r = 0.41, p < 0.001; r = 0.28, p < 0.001). For Bland-Altman plot, 95.7% of scattered plot fell within ± 1.96 SD limits of agreement revealed that there was good agreement between the two methods used. Cross-classifi cation analysis showed that 36.6% was categorized in the same quartile, 78.5% in identical and contiguous quartiles, with only 3.2% in the opposite quartiles. Regression analysis showed that all categories in FFQ signifi cantly account for the inter-variance for dietary polyphenol intake after controlling for the other variables (R2 = 1.000, p < 0.001). In conclusion, the newly developed FFQ is considered valid and has the potential to be used as a tool to estimate polyphenol intake among elderly individuals in Malaysia
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Literature review suggests that polyphenols in particular fl avonoids, are benefi cial for mental health during aging process. This review examines the effect of consumption of all polyphenols groups on mental health and cognitive status during aging process. The keywords searched were “mental health,” “depression,” “anxiety,” “stress” and “cognitive” combined with “dietary,” and “polyphenols.” The databases including PubMed, Web of Science and CAB Abstracts were searched for a period of 10 years. A total of 11 studies were identifi ed to fulfi ll the inclusion criteria. From this review, polyphenols may confer benefi cial effects towards mental health, in particular the decline in cognitive functions during aging process, however, some studies showed contradictory results. Polyphenols have been proven to improve language and verbal ability, which is among the main vulnerable aspects in cognitive decline in pathological brain aging. In contrast, polyphenols intake did not seem to affect executive functioning. The effects of polyphenols towards cognitive status were more prominent among the elderly as compared to young and middle-aged adults. This review also shows that fl avonoids is the main type of polyphenols that confer positive effects towards cognitive status during aging. This review provides evidence that consumption of polyphenols may lead to cognitive and mental health benefi ts. Further clinical trials involving human subjects are required with carefully designed methodology to elucidate the potential mechanisms underlying the relationship between polyphenols consumption and improvement in cognitive and mental health status
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This study was carried out to determine the inhibitory effects of phytate on the bioavalaibility of calcium (Ca), ferum (Fe) dan zink (Zn) in selected soy-based products. Phytate exerts its inhibitory effects on the absorption of minerals such as Ca, Fe and Zn by forming insoluble and undigestible complexes. The inhibitory effect of phytate on the bioavailability of minerals like Ca, Fe and Zn was estimated by measuring their molar ratios. Phytate content was determined by using anion-exchange method while mineral contents were determined by Atomic Absorption Spectrophotometer (AAS). Soybased products were bought from the night markets and food stall located at Cheras and Sri Rampai, Kuala Lumpur. Each samples from both location was analysed in duplicates. Results from this study showed that soy cake and all dishes containing tempe did not contain phytate content. This may due to the presence of R. oligosporus that produces phytase and hydrolysed the phytate content during the fermentation process of tempe. There were fi ve food samples that have a phytate/ Ca molar ratio > 0.24, ten food samples with a phytate/ Fe molar ratio > 1, eight food samples have a phytate/ Zn molar ratio >15 and one food sample has a [phytate x Ca]/ Zn molar ratio > 200. The result of molar ratio phytate/ mineral in this study estimated the low bioavailability of Ca, Fe and Zn. In conclusion, soy cake and all dishes containing tempe contained high bioavailability of minerals, while tau-hoo pok contained low bioavailability of minerals
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This study was carried out to compare the macronutrient contents in three types of local sweet kuih; kuih seri muka (SM), kuih bakar (B) dan kuih wajik (W) which recipes were developed using calculation according to the Malaysian Food Composition Table (MFCT) and proximate analysis technique. The contents of the macronutrients were identified using proximate analyses while determination of energy and total carbohydrate were based on calculation. Results from proximate analysis showed that W contained significantly higher (p < 0.05) total carbohydrate content (61.5 ± 1.6%) compared to B (39.3 ± 1.5%) and SM (38.7 ± 1.5%). SM contained significantly higher (p < 0.05) of water (46.7 ± 1.6%) compared to B (42.5 ± 6.6%) and W (30.2 ± 0.4%). The protein content in B was 6.1 ± 0.9% and significantly higher than that in W (3.0 ± 0.3%). There were no significant difference of fat content between B (12.8 ± 1.8%), SM (9.9 ± 0.2%) and W (8.2 ± 2.6%). Total calorie for W was the highest (332 kcal/100g), followed by B (299 kcal/100g) and SM (262 kcal/100g). In general, macronutrients content determined based on proximate analyses were lower compared to the calculation method based on MFCT. This was because calculation of macronutrient based on MFCT was based on raw material while the proximate analysis was based on the prepared cooked kuih
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This case study was conducted to determine the level of personal hygiene among food handlers and its relationship to cafeteria hygiene Universiti Kebangsaan Malaysia (UKM). 75 respondents were involved in this study. The data shows that 32% of respondents are not vaccinated for typhoid while 49.3% do not acquire food handlers’ course certificate. The data also shows that 50.7% of the respondents are not Malaysian citizen. In term of personal hygiene practices, the findings show that 7 items are higher in percentage (70.3% – 87.5%) while another 7 items are lower in percentage (26.4% – 68%). The findings also show that 12 items related to cafeteria sanitary are conformed while 9 items are not. The statistical analysis shows that personal hygiene practices are significantly different (U = 472, p = 0.01) between Malaysian citizen food handlers and the non-Malaysian food handlers. The findings show that Malaysian citizen food-handlers practice better personal hygiene in comparison to non-Malaysian food-handlers. It is also observed that the relationship between is positive and statistically significant (χ2 = 6.432, p = 0.011), although the association between food-handlers personal hygiene and cafeteria sanitary is medium (Φ = 0.29). The findings imply that Malaysian citizen food handlers are better in personal hygiene practices and in promoting cafeteria sanitary in comparison to non-Malaysian food-handlers