Physical Activity Levels of Malaysian Vegetarians and Its Associated Factors: A Cross-Sectional Study

@#Introduction: Literatures suggest that insufficient physical activity as one of the contributors to non-communicable chronic diseases; nevertheless, data on the physical activity level is sparsely reported among individuals practising a vegetarian diet in Malaysia. The current study aims to determine the prevalence of insufficient physical activity and its association with socio-demographic factors, lifestyle factors and body weight status among 273 individuals practising a vegetarian diet in Klang Valley, Malaysia. Methods: A set of self-administered questionnaire was distributed to all vegetarians and their data on physical activity was determined using the Global Physical Activity Questionnaire (GPAQ). Results: The average years of practising vegetarianism was 14.2±9.6 years, and most of the vegetarians were practised ovo-vegetarian diet (44.0%). A majority of them were Chinese (54.9%) and female (64.8%), with an average age of 47.5 ± 13.1 years. The prevalence of overweight and obesity were 27.5% and 8.1%, respectively. According to GPAQ, about two in five vegetarians (46.2%) were having insufficient physical activity. Being females, older age, Chinese, married individuals, and those with high total household income level were found to be significantly associated with low physical activity level among Malaysian vegetarians (p<0.05). Conclusion: Since insufficient physical activity is one of the factors contributing to non-communicable chronic diseases, it is crucial to educate the importance of physical activity on overall health status, specifically for those who at risk of physically inactive. In addition, future studies can focus the causal associations based on the currently identified factors and physical activity levels, which can help to develop an effective intervention program among Malaysia vegetarians.

Associations of Sociodemographic Factors and Body Image With Body Weight Status Among Yemeni Adolescents in Selangor and Putrajaya, Malaysia

@#Introduction: Despite the high prevalence of malnutrition in Yemen, little is known on malnourished Yemeni adolescents in Malaysia. This study aimed to assess the body weight status among Yemeni adolescents in Malaysia and its association with sociodemographic factors and body image. Methods: A cross-sectional study involving 364 Yemeni adolescents aged between 12 to 18 years were recruited from four schools in Selangor and Putrajaya, Malaysia. Sociodemographic factors and body image data were collected through face to face interview. Height and body weight were measured and body mass index (BMI) was calculated. Results: The prevalence of overweight and obesity was 23.6%, with 5.2% of thinness. Multivariable logistic regression revealed that a family income greater than RM5,001 (OR = 3.77, p = 0.004), body shape dissatisfaction (OR = 3.54, p = 0.001) and perception of overweight/obesity (OR = 5.75, p = 0.001) were associated with an increased risk of being overweight and obese. Whereas a positive perception of underweight (OR = 0.23, p = 0.009) was found to be a significant protective factor against overweight and obesity. Conclusion: Overweight and obesity are prevalent among Yemeni adolescents in Malaysia. These findings highlight the need for regular weight status assessments amongst adolescents. Additionally, an obesity intervention program that incorporates body image perception may improve the children’s body weight status.

Effectiveness of a Nutrition Education Intervention for Primary School Children: the Healthy Kids Programme, Malaysia

@#Introduction: This paper discussed the effectiveness of “Healthy Kids Programme (HKP)”, specifically in improving the body weight status as well as knowledge, attitude and practice (KAP) of the children. Methods: In this longitudinal intervention study, a total of 12 primary schools in Klang Valley were randomly selected and divided into intervention and control groups. There were 386 standard three children participated at baseline. All children in the intervention group participated in the HKP that was conducted by nutritionists. The evaluations included the pre- and post-Immediate Impact survey (IIS) (every topic), and changes in nutrition KAP survey and anthropometric assessment of the children at the beginning and end of every year for three years. Results: School children in intervention group reported with an increased in the IIS score for each topic and achieved a significantly higher mean nutrition knowledge score than those in the control group over time. There were no significant differences in mean attitude and practice scores between two groups after the intervention. Children in the intervention group had lower rates of overweight and obesity (pre-test: 27.3%; post-test: 32.5%) than their counterpart (pre-test: 26.6%; post-test: 44.0%). Conclusions: The HKP is effective in improving nutrition knowledge of the children. A lower rate of overweight and obesity was observed in intervention group than control group. This approach will contribute towards inculcating healthy eating and active lifestyle habits among Malaysian children that bring about long-term health benefits.

Bodyweight status misperception among reproductive-aged women in primary care settings

@#Introduction: It is common, and many international and local studies confirm this, that women of reproductive age misperceive their body-weight status. This phenomenon can lead to their being less likely to adopt a healthy lifestyle which later exposes them to increased health problems and risks including those of a gynecological and obstetric nature. Generally, there have been inconsistent findings concerning the association between the self-perceived weight status and sociodemographic factors, physical activities, and previous weight loss attempts of women of reproductive age in an Asian population like Malaysia. Objective: This study aimed to determine the factors associated with body weight status misperception among reproductive-aged women at a primary care setting in Malaysia. Methods: This is a cross-sectional study conducted at Klinik Kesihatan Durian Tunggal in 2016-2017. The questionnaire included questions on the perception of weight status, sociodemographic factors, smoking status, level of physical activity, and weight loss attempts. Logistic regressions were used for statistical analysis to examine the association between body weight status misperception and related factors. Results: The study recruited 630 reproductive-aged women. The mean age and SD of the respondents was 32.7 + 8.9 years, and 84% of the respondents were Malays. More than three-quarters of the respondents (75.5%, n = 476) had received up to a secondary level of education. The majority of the respondents were in the overweight/obese group (59.4%, n = 374). The mean BMI of the respondents was 27.1 kg/m2 + 6.61. Approximately 65.4% (n = 412) of the respondents had an inactive lifestyle. However, 60% (n = 378) of the respondents reported that they had attempted to reduce their weight in the last year. A total of 141 respondents (22.4%) misperceived their weight status with 113 (80.1% ) of them underestimating their weight status. Women with primary-level education (OR: 3.545, 95% CI: 1.530-8.215, p = 0.003) and secondary-level education (OR: 1.933, 95% CI: 1.065-3.510, p = 0.030) had a greater likelihood of misperceiving their body weight status as compared to those who have a tertiary level of education. Women with no weight loss attempts were also at risk of body weight status misperception (OR: 1.850, 95% CI: 1.195, 2.865, p = 0.006). Conclusion: Bodyweight status misperception among reproductive-aged women was associated with a low level of education and with those who had made no weight loss attempts. Identifying women who are at risk of misperceiving their weight status would enable early counseling on weight management.

Sleep quality and body weight status of Malaysian university students

@#Introduction: Inadequate sleep duration is a modifiable behaviour linked with body weight, yet limited is known on the role of sleep quality with body weight status among university students. The study aimed to determine sleep quality and its association with body weight status among university students. Methods: A crosssectional study was conducted among 240 university students (24.6% males, 75.4% females) with a mean age of 21.22±1.24 years. Subjects were recruited from four faculties of University Putra Malaysia (UPM). Information on socio-demographic, sleep quality and anthropometric measurements were collected. Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality, whereby a summation score from seven components yielded a global score on sleep quality, with higher scores indicating poor sleep quality. Results: Majority of subjects were Malay (79.2%) with a mean body mass index of 22.6kg/m2. A majority (61.3%) had normal body weight, with the prevalences of underweight (UW), overweight (OW), and obesity (OB) at 12.9%, 19.6% and 6.3%, respectively. The mean global PSQI score was 5.76±2.64, with half of the respondents (50.4%) experiencing poor sleep quality. OW-OB experienced poorer sleep quality (6.53±2.79, p=0.004) and longer sleep latency (1.34±0.10, p=0.008) relative to UW-NW. OB subjects had substantially more frequent sleep disturbances compared to non-OB subjects (1.53±0.64, p=0.012). Conclusion: Findings suggest that OW-OB students at university are at a greater risk of having reduced sleep quality with longer sleep latency and frequent sleep disturbances. There is a need for a wellness initiative to reduce the incidence of obesity while fostering healthier sleeping habits among university students.

Health-related physical fitness and weight status in 13- to 15-year-old Latino adolescents. A pooled analysis / Aptidão física relacionada à saúde e status do peso em adolescentes latinos de 13 a 15 anos de idade. Uma análise em conjunto

Abstract Objective: The aim of this study was to investigate the relation between health-related physical fitness and weight status in 13- to 15-year-old Latino adolescents. Method: The final sample consisted of 73,561 adolescents aged 13 -15 years (35,175 girls) from Chile (n = 48,771) and Colombia (n = 24,790). Cardiorespiratory and musculoskeletal fitness were measured using 20-m shuttle run (relative peak oxygen uptake - VO2peak) and standing broad jump test (lower body explosive strength), respectively. The International Obesity Task Force definition was used to define weight status (i.e., underweight, normal weight, overweight, and obese). Results: The present study found an inverted J-shape relationship between body mass index, cardiorespiratory fitness, and musculoskeletal fitness in both genders and all age groups (p < 0.01). Results also suggest that underweight adolescents, and not just overweight and obese adolescents, have lower odds of having a healthy cardiorespiratory fitness (based on new international criterion-referenced standards) profile when compared with their normal weight peers, except in girls aged 14 (p = 0.268) and 15 years (p = 0.280). Conclusions: The present results indicate low cardiorespiratory fitness and musculoskeletal fitness levels in underweight, overweight, and obese adolescents when compared with their normal weight peers. The findings appear to suggest that exercise programs should to decrease fat mass in overweight/obese adolescents and increase muscle mass in underweight adolescents.

Resumo Objetivo: Investigar a relação entre a aptidão física relacionada à saúde e o status do peso em adolescentes latinos de 13 a 15 anos. Método: A amostra final consistiu em 73.561 adolescentes entre 13 e 15 anos (35.175 meninas) do Chile (n = 48.771) e da Colômbia (n = 24.790). As aptidões cardiorrespiratória e musculoesquelética foram medidas com a corrida vaivém de 20 m (consumo máximo de oxigênio relativo - VO2máx.) e o teste de impulso horizontal (menor força explosiva do corpo), respectivamente. A definição Força-Tarefa Internacional de Obesidade foi usada para definir o status do peso (ou seja, abaixo do peso, peso normal, sobrepeso e obeso). Resultados: O presente estudo encontrou uma relação na forma de J invertido entre o índice de massa corporal, a aptidão cardiorrespiratória e a aptidão musculoesquelética em ambos os sexos e em todas as faixas etárias (p < 0,01). Os resultados também sugerem que os adolescentes abaixo do peso e não somente os adolescentes acima do peso e obesos têm menor chance de ter um perfil de aptidão cardiorrespiratória saudável (com base em novos padrões internacionais referenciados a critério) em comparação com os pares com peso normal, exceto em meninas de 14 (p = 0,268) e 15 anos (p = 0,280). Conclusões: Nossos resultados mostram baixos níveis de aptidão cardiorrespiratória e aptidão musculoesquelética em adolescentes abaixo do peso, acima do peso e obesos em comparação com os pares com peso normal. Os achados parecem sugerir que os programas de exercícios devam ser voltados para reduzir a massa gorda em adolescentes com sobrepeso/obesos e aumentar a massa muscular em adolescentes abaixo do peso.

Body fat percentage is better than indicators of weight status to identify children and adolescents with unfavorable lipid profile / Percentual de gordura corporal é melhor que indicadores da condição do peso para identificar crianças e adolescentes com perfil lipídico desfavorável

Abstract Objective: To assess whether the indicators of weight status body mass index and waist-to-height ratio are similar to body fat percentage to identify obese children and adolescents with unfavorable lipid profile. Methods: This was a cross-sectional study involving 840 children and adolescents (6-18 years). The same individuals were classified as non-obese (<P95) or obese (≥P95) according to body fat percentage and indicators of weight status, body mass index, and waist-to-height ratio. Body fat percentage was obtained by multi-frequency bioelectrical impedance. Linear association between obesity and increased lipid fractions was tested by ANCOVA. Normal distribution curves of non-HDL cholesterol were designed for obese and non-obese. To provide the proportion of obese individuals with elevated non-HDL-c across all indicators, Z-score was calculated. Results: Obese boys presented higher non-HDL cholesterol when compared with those non-obese, classified by body mass index (107 ± 28 vs. 94 ± 25 mg/dL, p = 0.001), waist-to-height ratio (115 ± 29 vs. 94 ± 25 mg/dL, p < 0.001) and body fat percentage (119 ± 33 vs. 94 ± 24 mg/dL, p < 0.001). Differently, obese girls presented with higher non-HDL cholesterol when compared with those non-obese only according to the body fat percentage classification (118 ± 24 vs. 96 ± 26 mg/dL, p = 0.001). A large shift to the right in the distribution curve of non-HDL cholesterol among obese girls compared with non-obese was observed only when body fat percentage was used to discriminate between obese and non-obese. Conclusion: Body fat percentage was better than the indicators of weight status to identify children and adolescents with unfavorable lipid profile, mainly among girls.

Resumo Objetivo: Investigar se os indicadores da condição do peso, índice de massa corporal e razão cintura/estatura são semelhantes ao percentual de gordura corporal para identificação de crianças e adolescentes obesos com perfil lipídico desfavorável. Métodos: Estudo transversal que envolveu 840 crianças e adolescentes (6‐18 anos). Os mesmos indivíduos foram classificados em não obesos (p < 95) ou obesos (p ≥ 95) de acordo com o percentual de gordura corporal e os indicadores da condição do peso, índice de massa corporal e razão cintura/estatura. O percentual de gordura corporal foi obtido por bioimpedância multifrequencial tetrapolar. A associação linear entre obesidade e aumento das frações lipídicas foi tesada por ANCOVA. As curvas de distribuição normal de colesterol não HDL foram construídas para obesos e não obesos. Para fornecer a proporção de indivíduos obesos com colesterol não HDL elevado para todos os indicadores, o escore z foi calculado. Resultados: Os meninos obesos apresentaram maior colesterol não HDL em comparação com não obesos de acordo com a classificação fornecida pelo índice de massa corporal (107 ± 28 em comparação com 94 ± 25 mg/dL, p = 0,001), razão cintura/estatura (115 ± 29 em comparação com 94 ± 25 mg/dL, p < 0,001) e percentual de gordura corporal (119 ± 33 em comparação com 94 ± 24 g/dL, p < 0,001). Diferentemente, as meninas obesas apresentaram maior colesterol não HDL em comparação com as não obesas, somente de acordo com a classificação fornecida pelo percentual de gordura corporal (118 ± 24 em comparação com 96 ± 26 mg/dL, p = 0,001). Um grande deslocamento para a direita na curva de distribuição de colesterol não HDL entre meninas obesas em comparação com não obesas foi observado somente quando o percentual de gordura corporal foi utilizado para discriminar obesas e não obesas. Conclusão: O percentual de gordura corporal é melhor do que os indicadores da condição do peso na identificação de crianças e adolescentes com perfil lipídico desfavorável, principalmente entre meninas.

Dietary and Lifestyle Factors Associated with Weight Status among Korean Adolescents from Multicultural Families: Using Data from the 2017–2018 Korea Youth Risk Behavior Surveys / 대한지역사회영양학회지

OBJECTIVES: This study investigated dietary and lifestyle factors associated with the weight status among Korean adolescents in multicultural families.METHODS: This cross-sectional study analyzed 1,751 multicultural families' adolescents who participated in the 2017–2018 Korea Youth Risk Behavior Surveys. Information on dietary and lifestyle factors was self-reported using a web-based questionnaire and this information included breakfast and foods consumption, perceived health status, alcohol drinking, smoking, physical activity, and weight control efforts. Body mass index (BMI) was calculated based on the self-reported height and body weight (kg/m²). Weight status was assessed according to the 2017 Korean National Growth Chart: underweight (weight-for-age <5(th) percentiles), overweight (85(th)≤ BMI-for-age <95(th) percentiles), and obese (BMI-for-age ≥95(th) percentiles). Multiple logistic regression analysis was performed to examine the dietary and lifestyle factors associated with weight status after adjustment for covariates.RESULTS: Among Korean adolescents from multicultural families, the prevalence of overweight/obesity was 20.9%, whereas about 7% of adolescents were underweight. The weight status did not show differences according to gender, school level, area of residence, and household income. Compared to adolescents who did not have breakfast during the previous week, those who had breakfast 3–4 days/week and ≥5 days/week had a 42% (p=0.021) and a 37% (p=0.009) lower prevalence of overweight/obesity, respectively. The adolescents who frequently consumed carbonated soft drinks (≥5 times/week) showed an odds ratio (OR) of 1.69 (95% CI=1.01–2.83) for overweight/obesity relative to those adolescents who did not consume carbonated soft drinks. The OR of being underweight for adolescents who ate fast food ≥3 times/week was 1.97 (95% CI=1.04–3.71) compared to those adolescents who had not eaten fast food during the previous week.CONCLUSIONS: Dietary and lifestyle factors were associated with overweight/obesity as well as underweight among Korean adolescents in multicultural families. Our findings could be used to design and provide nutrition interventions for this specific population.

Comparing the nutritional status of vegetarians and non-vegetarians from a Buddhist Organisation in Kuala Lumpur, Malaysia

Introduction: A vegetarian diet is generally considered as healthy for preventing metabolic-related diseases. There is lack of studies in Malaysia comparing the nutritional status of vegetarians and non-vegetarians. This cross-sectional study aims to compare body weight status, dietary intake and blood pressure level between these two groups. Methods: A total of 131 vegetarians and 135 non-vegetarians were recruited using convenience sampling from a Buddhist organisation in Kuala Lumpur. Body weight, height, waist circumference, percentage of body fat, and blood pressure measurements were taken, while dietary intake was assessed using a 2-day 24-hour dietary recall. Results: More vegetarians were underweight than non-vegetarians (31.3% vs 15.6%), while prevalence of overweight and obesity was higher among the non-vegetarians (23.7% vs 9.9%). A higher proportion of nonvegetarians (34.1%) had an unhealthy range of body fat percentage and significantly higher risk of abdominal obesity (24.4%) than the vegetarians (19.1% body fat; 13.7% abdominal obesity). Mean intakes for protein and fat were significantly lower among the vegetarians, while no significant differences were observed in the mean intake for energy and carbohydrate. Vegetarians had significantly higher intakes of vitamins C, D and E, calcium, potassium and folate, while vitamin B12 intake was significantly higher in the non-vegetarians. More non-vegetarians presented with unhealthy blood pressure status. Conclusion: Vegetarians in this study generally showed healthier dietary intake and lower body fatness than the non-vegetarians. Studies are suggested to be undertaken on a bigger sample size of vegetarians to confirm these findings.

Recent Shift of Body Mass Index Distribution in Korea: a Population-based Korea National Health Insurance Database, 2002–2013

We investigated trends of obesity prevalence among adult Koreans. Data from 110,280,952 participants who underwent medical examination provided by the National Health Insurance System from 2002–2013 were analyzed. The prevalence of moderate obesity (body mass index [BMI] 25.0–29.9 kg/m2) was slightly increased from 2002 (30.7%) through 2010 (33.1%) and reached a plateau since 2010 among men but continuously decreased from 22.5% in 2002 to 20.9% in 2013 among women. However, severe obesity (BMI ≥ 30.0 kg/m2) was rapidly increased and the prevalence in 2013 (4.2%) was almost doubled the prevalence in 2002 (2.5%). We observed a steep rise of severe obesity as well as potentially right shifting of the obese category.

Irregular breakfast habits are associated with children's increased adiposity and children's and parents' lifestyle-related behaviors: a population-based cross-sectional study

BACKGROUND: Skipping meals, especially breakfast, is related to an increase in adiposity indicators, and this behavior is related to metabolic changes that predispose to the development of chronic diseases, recognized as major causes of death worldwide. The objective of the present paper was estimated the association between irregular breakfast habits with adiposity indices in schoolchildren and other lifestyle factors. METHODS: A population-based cross-sectional study was conducted in 2009­2010, including schoolchildren (n=10,243) between 6 and 9 years old (51.3 % girls) from 18 districts of mainland Portugal. Breakfast habits were as certained by asking a yes/no question ("Does your child eat breakfast regularly?"). An index estimated by performing principal component analysis was used to assess body adiposity from three different adiposity indicators (body mass index (BMI), waist circumference (WC), and the triceps, subscapular, and supra iliac skinfolds (used to estimate body fat percentage (BFP))). Multivariate logistic regression and multiple linear regression models were used to estimate the association of irregular breakfast habits with anthropometric indicators (BMI, BMI z score, WC, BFP, and adiposity index) and with children's and parents' lifestyle and socioeconomic characteristics. RESULTS: A total of 3.5 % of the children did not have breakfast regularly (girls 3.9 %; boys 3.1 %; P= 0.02). Among boys, irregular breakfast habits were associated with lower fathers' education level, television time≥2 h/day, and soft drink consumption≥2 times/week. For girls, irregular breakfast habits were associated with lower mothers' education level and physical inactivity, soft drink consumption≥2 times/week, and <1 portion of milk/day. Multivariate linear models revealed a positive association between irregular breakfast habits with increased adiposity indicators among boys (BMI (kg/m2):ß= 1.33; BMI z score:ß= 0.48; WC (cm):ß= 2.00; BFP (%):ß= 2.20; adiposity index:ß= 0.37;P< 0.01 for all). No significant association was found for girls. CONCLUSIONS: Irregular breakfast habits were positively associated with boys' increased global adiposity and were significantly affected by children's and parents' lifestyle-related behaviors.

Obesity is Associated with More Sick Leave and Lower Quality of Life Among Malay Male Security Officers / Jurnal Sains Kesihatan Malaysia

Obesity is a risk factor for chronic diseases which can affect work productivity and physical function of employees particularly among those in security sector. The study aimed to determine the association between obesity with total days of sick leave and health related quality of life (HRQoL) among Malay male security officers. A cross-sectional study was conducted among Malay male security officers working in a Malaysian higher learning institution. Subjects were evaluated using anthropometric measurements, quality of life and number of sick leave taken within two months prior to the study. A total of 194 subjects (mean age 40.12 ± 11.41 years) were recruited. A total of 30.4% were obese, 39.7% were pre-obese and only 29.9% had normal body weight or underweight. Central obesity was observed in 57.7% of them and 87.1% shown excessive body fat percentage. Number of sick leave days was positively correlated with Body Mass Index (BMI) (r = 0.162, p = 0.024) and waist circumference (r = 0.181, p = 0.012). Score of the general health component was negatively correlated with BMI (r = -0.161, p = 0.025), waist circumference (r = -0.194, p = 0.007) and body fat percentage (r = -0.191, p = 0.008). Physical functioning score was lowest in obese subjects than normal and pre-obese subjects (p = 0.046). Score of the bodily pain component was positively correlated with waist circumference (r = 0.156, p = 0.030). Obesity is associated with number of sick leave days and quality of life in the studied group. Hence, body weight of the security staff should be monitored and appropriate intervention should be conducted to improve their work attendance and quality of life.

Associations between Personality Traits and Body Weight Status with Energy Intake of Adolescents in Hulu Langat District, Malaysia

Personality traits are divided into five basic dimensions: extraversion, neuroticism, conscientiousness, agreeableness and openness. These influence our attitudes and behaviours. Studies show that differences in personality traits may influence the dietary intake. Methods: A cross-sectional study aimed at determining the association between personality traits and body weight status with energy intake was conducted among adolescents in Hulu Langat district of Selangor. Height, weight and waist circumference were measured and respondents completed a pre-tested self-administered questionnaire. Personality traits were assessed using the Malay version of USM Personality (USMaP-i). A single 24-h dietary recall was used to assess dietary intake. Results: A total of 430 adolescents aged 13-16 years (46% male and 54% female) was recruited. Female respondents tended to be more neurotic and agreeable compared to male respondents. A majority of the respondents (67%) were in the normal weight category, 26.7% were overweight and obese, while 19.0% had a high risk of developing abdominal obesity with a mean waist circumference of 72.65 ± 10.93cm. Males significantly had a higher intake of energy (1425±583 kcal), compared to females (1232±462 kcal). Conscientiousness trait (r=-0.158, p<0.01), BMI-for-age (r=-0.147, p<0.01) and waist circumference (r=-0.108, p<0.05) were inversely related to the energy intake of the respondents. Conclusion: Leaner adolescents and individuals with low conscientiousness were significantly consuming more energy than their counterparts. Understanding the personality traits that may regulate caloric intake is essential in order to develop effective interventions towards modifying obesity-inducing eating patterns.

Studying the Family Diet: An Investigation into Association Between Diet, Lifestyle and Weight Status in Malaysian Families

Introduction: The contribution of the family environment to childhood obesity in Malaysia is not well known. This paper describes the study, methodology and results of a pilot study to assess the feasibility of conducting a study on diet and lifestyle factors among Malay primary school children and their main caregiver(s) in regard to body weight status. Methods: The Family Diet Study used a cross-sectional design and targeted a minimum of 200 Malay families at five national primary schools in the Klang Valley, Malaysia using a multi-stage sampling method. Participants were Malay families with children aged 8 to 12 years and their main caregiver(s). Data on socio-demographic, dietary intake, parental child feeding practices, physical activity and anthropometric measures were collected predominantly at schools with follow-up 24-h dietary recalls collected by phone. Details of recruitment, inclusion criteria, assessments and statistical analyses are also discussed. Results: Eleven families provided data by answering questionnaires, recalling diet intake and participating in anthropometric measures. The results showed overall feasibility of the study protocol but required some modifications prior to implementation of the main study. Mothers were the main parent involved in family food procurement, preparation and mealtime supervision. Snacking was not commonly reported and fruit and vegetables intakes were generally infrequent. Conclusion: The most novel component of this study was the comprehensive collection of data from both children and their main caregiver(s) within the context of the family. Detailed information on dietary and lifestyle aspects will help to elucidate factors associated with obesity aetiology in Malay children.

Aptidão cardiorrespiratória em adolescentes de acordo com o estado nutricional: concordância entre dois testes de campo / Cardiorespiratory fitness in adolescents according to the nutritional status: agreement between two field tests

Independente do teste motor e dos pontos de corte utilizados para classificação da aptidão cardiorrespiratória (ACR) em jovens espera-se semelhantes estimativas. O objetivo foi verificar a concordância na classificação da ACR determinada por dois testes de campo em adolescentes com diferentes estados nutricionais. Participaram do estudo 281 adolescentes de ambos os sexos, com idade entre 11 e 13 anos. Foram obtidas medidas antropométricas de massa corporal e estatura. A ACR foi avaliada pelos testes: Shuttle-Run de 20 metros (SR-20m) e Teste de corrida e/ou caminhada de nove minutos (9min). O teste de McNemar comparou as diferenças das proporções e o índice Kappa verificou a força da concordância. Os resultados demonstram diferenças significantes entre as proporções na classificação da ACR de acordo com os pontos de cortes sugeridos pelas baterias dos testes (P<0,001), independente do estado nutricional. Conclui-se que a utilização dos testes de campo SR-20m e 9min, e as classificações sugeridas por suas respectivas baterias, Fitnessgram e Physical Best, para determinar a ACR podem classificar de maneira distinta os mesmos indivíduos, independentemente do sexo e do estado nutricional. Nesse sentido, sugere-se cautela na escolha do teste e da respectiva classificação para determinar a ACR.

Regardless of the motor test and the cutoffs used for classification of cardiorespiratory fitness (CRF) in the young it is expected similar estimates. The aim was to investigate the agreement in the classification of the CRF determined from two field trials in adolescents with different weight status. The study included 281 adolescents of bout sex, aged between 11 and 13 years. We obtained anthropometric measurements of body weight and height. The CRF was evaluated by testing: Shuttle-Run 20 meters (SR-20m) and 9-minute run/walk field test (9min). The McNemar test compared the differences of proportions. Kappa statistics verified the strength of agreement. The results show significant differences between the ratios in the classification between the batteries of tests (P<0.001), independent of weight status. Conclude that the use of field tests SR-20m and 9min, and the classifications suggested by their respective batteries, Physical Best and Fitnessgram, to determine the CRF can rank differently the same individuals, regardless of sex and nutritional status. Accordingly, we suggest caution in the choice of the test and its classification to determine the CRF.

Perception of Weight and Health Status among Women Working at Health Centres of Tehran.

Perception of body-weight status is an important determinant of weight-related behaviours and may affect the burden of weight disturbances as a public-health problem. No study has assessed self-perception of the weight status regarding body-fat distribution among health workers to date. The aim of this study was to evaluate the association of the perception of weight and health status among 542 women working at health centres of Tehran. We assessed their perceived body-weight and health status and measured waist- and hip-circumference, weight, and height to calculate waist-to-hip ratio (WHR) as a measure of fat distribution and body mass index (BMI, kg/m2). Women reported their sociodemographic information, and the perceived weight and health status were compared with their actual fatness status, defined based on WHR and BMI, to determine misperception of weight status. Multivariate logistic regression models were performed to assess the predictive effects of various sociodemographic factors and actual fatness on the perception of weight and health status. The results showed that more than 40% of women with normal BMI overestimated their body-weight status while only 15.8% of these women had central obesity. BMI was the most important variable associated with misperceived weight status as normal-weight women had significantly more misperception (OR 8.16, 95% CI 4.82-13.82) than overweight/obese women. WHR did not show any significant relationships with perceived weight status. In addition, perception of health status was not associated with actual fatness indices. It is concluded, BMI was the main predictor of the perception of weight status in female employees. The importance of using body-fat distribution in the perceptions of weight and health status should be emphasized.

Weight Status and Dietary Factors Associated with Sugar-Sweetened Beverage Intake among Korean Children and Adolescents: Korea National Health and Nutrition Examination Survey, 2008-2011

There has been growing concern about the role of sugar-sweetened beverages (SSBs) in the development of obesity. This study investigated factors associated with SSB intake among Korean children (7-12 years) and adolescents (13-18 years). We examined associations between SSB intake and demographic and dietary factors using nationally representative data from the 2008-2011 Korea National Health and Nutrition Examination Survey, and 3,179 children and 2,242 adolescents were included in the final analysis. We calculated adjusted odds ratios (ORs) for factors associated with high SSB intake (> or = 300 ml/day) by multivariable logistic regression. The mean daily SSB intake of school children was 98.7 ml/day, with a mean of 64.7 ml/day for those aged 7-12 years and 120.2 ml/day for those aged 13-18 years. SSB intake of > or = 300 ml/day was found in 12.0% of the children and adolescents. Factors associated with a greater OR for high SSB intake were high energy intake (> or = 125% of EER; OR = 3.17 for boys aged 7-12 years, OR = 2.74 for girls aged 7-12 years, OR = 3.0 for girls aged 13-18 years), low milk consumption (< 1 cup/day; OR = 1.93 for boys aged 7-12 years; OR = 2.53 for girls aged 7-12 years; OR = 1.83 for boys aged 13-18 years), and not meeting the recommended fruit and vegetable intake (< 400 g/day; OR = 1.71 for boys aged 7-12 years). Being overweight and obese was significantly associated with greater ORs for high SSB intake among boys aged 7-12 years (OR = 1.72). These findings may be used to develop targeted education programs for reducing SSB intake and encouraging healthier food choices.

Obesity-related behaviors of Malaysian adolescents: a sample from Kajang district of Selangor state

This study aims to determine the association between obesity-related behaviors (dietary practices, physical activity and body image) and body weight status among adolescents. A total of 382 adolescents (187 males and 195 females) aged 13 to 15 years in Kajang, Selangor participated in this study. Majority of the respondents were Malays (56.0%), followed by Chinese (30.1%) and Indians (13.9%). Dietary practices, physical activity and body image of the adolescents were assessed through the eating behaviors questionnaire, two-day dietary record, two-day physical activity record and multi-dimensional body image scale (MBIS), respectively. Body weight and height were measured by trained researchers. The prevalence of overweight and obesity (19.5%) was about twice the prevalence of underweight (10.5%). About two-thirds of the respondents (72.3%) skipped at least one meal and half of them (56.2%) snacked between meals with a mean energy intake of 1,641 +/- 452 kcal/day. More than half of the respondents (56.8%) were practicing sedentary lifestyle with a mean energy expenditure of 1,631 +/- 573 kcal per day. Energy intake (r = 0.153, P < 0.05), physical activity (r = 0.463, P < 0.01) and body image (r = 0.424, P < 0.01) were correlated with BMI. However, meal skipping, snacking and energy expenditure per kg body weight were not associated with body weight status. Multiple linear regression analysis showed that body image, physical activity and energy intake contributed significantly in explaining body weight status of the adolescents. In short, overweight and obesity were likely to be associated not only with energy intake and physical activity, but also body image. Hence, promoting healthy eating, active lifestyle and positive body image should be incorporated in future obesity prevention programmes in adolescents.

Parents perception of weight status of Mexican preschool children using different tools

The aim of this study was to evaluate the ability of parents to estimate the weight status of preschool children attending the Instituto Mexicano del Seguro Social (IMSS) day-care centers using three different tools. A total of 100 parent-child pairs attending to all the existing IMSS day-care centers in Ensenada (n=9) completed a questionnaire on the perception of children’s weight status using verbal description, sketches, and pictures. Chi squared test and univariate logistic regression was applied to assess the difference in perception between the tools used, the factors associated with the weight status perception and to identify predictors of parental underestimation of their child’s weight. The sample size was estimated for a significance level of 0.05 with statistical power of 80%. No significant differences were found in the perception of weight status using different tools. The parents’ underestimation of the child’s weight status ranged from 51 to 59%, this percentage jumps to 79 to 84% in overweight children and 82 to 91% in obese children. Being a young mother and having a daughter increased the risk of underestimation. Higher odds of underestimation were found in > 2BMI z-score. The high underestimation found in this study shows that the ability of parents in signaling an alert to prevent childhood obesity might be highly reduced and preventive health programs should include increasing the weight status perception.

El objetivo de este estudio es evaluar la habilidad de los padres para estimar el peso corporal de niños preescolares que acuden a guarderías del Instituto Mexicano del Seguro Social utilizando tres instrumentos diferentes. Un total de 100 parejas padre-hijo que acudían a todas las guarderías del IMSS en Ensenada (n=9) completó un cuestionario acerca de la percepción del peso corporal utilizando descripción verbal, pictogramas y fotografías. Se usó la prueba de Ji cuadrada y regresión logística univariada para valorar la diferencia en la percepción entre los instrumentos utilizados, los factores asociados con la percepción del peso corporal y para identificar los predictores de la subestimación por parte de los padres del peso corporal de sus hijos. El tamaño de la muestra se estimó para un nivel de significancia de 0.05 con un poder estadístico del 80%. No se encontraron diferencias significativas en la percepción del peso con el uso de las diferentes herramientas. La subestimación de los padres del peso de los niños con las diferentes herramientas osciló entre 51 y 59%, y este porcentaje se incrementó a 79 al 84% en niños con sobrepeso y a 82 al 91% en niños con obesidad. El riesgo a subestimar se incrementa en las niñas, cuando las madres son más jóvenes, y cuando los niños tienen un puntaje z de IMC > 2. El alto grado de subestimación encontrado en este estudio indica que la habilidad de los padres para detectar la obesidad en los niños es muy baja, por lo que los programas de prevención a la salud deben incluir mejorar la percepción del peso.

Relationships of Mental Disorders and Weight Status in the Korean Adult Population

The purpose of this study was to evaluate the associations between weight status and mental disorders, including depressive disorder, anxiety disorder and alcohol use disorder. A total of nationally representative 6,510 subjects aged 18-64 yr was interviewed in face-to-face household survey. Response rate was 81.7%. Mental disorders were diagnosed using the Korean version of the Composite International Diagnostic Interview (K-CIDI). The subjects reported their heights and weights. After adjusting for age and gender, the lifetime diagnosis of depressive disorder had a significant association with only the underweight group (odds ratio [OR], 1.68, 95% confidence interval [CI], 1.19-2.38). The association between underweight and depressive disorder was the strongest for subjects with a high education level (OR, 1.75, 95% CI, 1.2-2.56), subjects with a married/cohabiting status (OR, 1.94, 95% CI, 1.17-3.22) and smokers (OR, 2.58, 95% CI, 1.33-4.98). There was no significant association between obesity and depressive disorder in Korea. But there was a significant association between the underweight group and depressive disorder. The relationship between obesity and mental disorder in a Korean population was different from that in a Western population. These results suggest that the differences of traditional cultures and races might have an important effect on the associations between the weight status and mental disorders.