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.

Comparison of Malnutrition Prevalence Between Haemodialysis and Continuous Ambulatory Peritoneal Dialysis Patients: A Cross-sectional Study

Introduction: Introduction: Malnutrition is a serious unresolved nutritional problem amongst dialysis patients associated with increased mortality and morbidity and prevalence differs according to dialysis modalities. This study compared protein- energy malnutrition (PEM) prevalence in haemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) patients. Methods: A total of 155 HD and 90 CAPD patients were enrolled. PEM prevalence was determined using body mass mdex (BMI), serum albumin, Dialysis Malnutrition Score (DM5) and dietary intake. Results: CAPD patients had significantly higher BMI (24.1 � 4.8 kg/m2 vs. 22.7 � 4.8 kg/m2 p=O.024) and mid-arm muscle area (32.1 � 12.4 cm2 vs. 29.5 � 15.9 cm2 p=O.044) than HD patients. They also had significantly lower serum albumin (31 � 5 g/L vs. 35 � 6 g/L; p5 years were independent risk factors of PEM hi dialysis patients. Conclusion: Periodic nutritional assessments, education and dietary counseling should be emphasised in these patients as a preventive measure of PEM.

Calcium Intake, Vitamin D and Bone Health Status of Post-menopausal Chinese Women in Kuala Lumpur

Bone health status was investigated in 178 free-living Chinese post-menopausal women in Kuala Lumpur. Body mass index (BMI), body composition (using whole body DXA), calcium intake and serum 25-OH vitamin D status were measured along with biochemical markers of bone turnover, that is, pro-collagen Type 1 N-terminal peptide (P1NP), osteocalcin (OC) and C-telopeptide ß cross link of Type 1 collagen (CTX- β). Bone mineral density (BMD) was measured using DXA (Hologic, USA) at the lumbar spine, femoral neck and total hip. Results showed that osteopenia was present in 50% of the subjects at the spine and 57.9% at the femoral neck. Osteoporosis was diagnosed in 10% of the subjects at both the femoral neck and spine. A total of 29.3% of the subjects had high levels of CTX- ß. Mean serum level of 25-OH vitamin D was 60.4+15.6 nmol/L and 50.6% of the subjects had hypovitaminosis D (defined as <50 nmol/l). Mean total calcium intake of the subjects was 497 + 233 mg, of which only 14% met the RNI for calcium with the additional intake of calcium supplements. Body fat was also significantly correlated (r=0.181, p<0.05) with BMD at the spine but not BMD at the femoral neck. Lean body mass was positively correlated with BMD at the spine (r=0.289, p<0.001) and femoral neck (r=0.295, p<0.001). CTX-β was negatively correlated with BMD at the spine (r= -0.235, p<0.001), whereas P1NP (r=-0.215, p<0.001) and osteocalcin (r=-0.265, p<0.001) were both negatively correlated with BMD at the femoral neck. Generally, the study found that women with osteopenia had higher levels of bone turnover markers, less lean body mass and lower calcium intake than women with normal BMD. In conclusion, this study demonstrated that the majority of free living Chinese post-menopausal women in Kuala Lumpur have low calcium intake, low 25-OH vitamin D status and low bone mass and elevated biochemical markers of bone turnover.