Socio-economic Status, Food Security Status and its Coping Strategies among ‘The Lost Food Project’ (TLFP) Recipients in Klang Valley during COVID-19 Pandemic

@#Introduction: The Lost Food Project (TLFP) is a non-profit organization who continuously working on their strategic plan in combating the food insecurity problem by distributing food surplus to low income households within Klang Valley. This cross-sectional study aims to determine the socioeconomic status, food security status and its coping strategies among TLFP recipients in Klang Valley during COVID-19 pandemic. Methods: This study was conducted from April to June 2021. There were 88 respondents recruited through convenience sampling. A set of questionnaires regarding food assistance, nutrition knowledge, food security and its coping strategies was prepared, and the respondents were interviewed either by phone, face-to-face or self-administered questionnaire. Results: The prevalence of food insecurity among households in this study was 59.1%. Most of them have moderate (37.5%) to good (27.5%) nutrition knowledge. The coping strategy that most of the respondents applied was ‘using less expensive food’ (58.3%) with at least once per week within the past one month. Food insecure households tend to adopt more coping strategies compared to those food secure households (p<0.001). Moreover, households who rent their house (p<0.01), low household income (p<0.05) and high monthly food and drinks expenditure (p<0.01) were associated with the food insecurity among TLFP recipients. Conclusion: The study concluded that lower household income, higher food and drinks expenditure and those who rent the house have negative impacts on household’s food security status. Thus, the situation forced them to apply more food-related coping strategies in their daily life. Further research should be conducted on the effectiveness of TLFP in helping them to improve Malaysian’s food security status.

Validation of the Malay version of Food Insecurity Experience Scale (M-FIES) using Rasch analysis

@#Introduction: Food security can be defined as the availability of and accessibility to food, acquired in an acceptable means at any given time and place in a way that could maintain health and wellbeing. One critical dimension of food security is continued access to adequate food. To measure this dimension, the Food and Agriculture Organization (FAO) developed the latest measurement tool, namely the Food Insecurity Experience Scale (FIES), the first instrument to measure people who experience food insecurity globally. This study aimed to validate the construct validity and reliability of the Malay version of FIES (M-FIES) for Malaysians. Methods: This cross-sectional study was conducted among 145 households in Kuantan, Pahang. Rasch analysis was used to analyse the construct validity of FIES. Results: FIES met the Rasch model assumptions with all items having an infit value of between 0.7- 1.3 and an outfit value of <2.0. The item and person reliability were 0.97 and 0.71, respectively; while the item and person separation were 5.59 and 1.58, respectively. The FIES item severity indicated that the items “few food”, “healthy”, “skipped”, “ate less”, and “runout” were disordered. Conclusion: The M-FIES is a valid and reliable measurement tool for the food insecurity situation among households based on its construct validity assessed using the Rasch model. Furthermore, the severity of item in M-FIES was different in terms of order from the original FIES, suggesting that the same items may be interpreted differently due to cultural or societal differences.

Association between Socio-demographic Factors, Involvement Status in Gardening and Diet Quality among B40 Households in Taman Keramat, Kuala Lumpur

@#Introduction: COVID-19 pandemic has impacted the livelihood of Malaysians and gardening activities have contributed positively to the diet quality. This study aimed to determine the factors associated with diet quality among adults in AU2 Keramat, Kuala Lumpur. Methods: The cross-sectional study involved adults aged 18 to 59 via convenience sampling. The socio-demographic, physical activity level and involvement status in gardening were obtained through a questionnaire, while food intake was from a single-day 24-hour diet recall. The diet quality was determined through Malaysian Healthy Eating Index (MHEI) and dietary misreporting was calculated using the Goldberg cut-off method. Results: A total of 117 respondents (65.8% females, 35.2% males) with a mean age of 40.98 were involved in this study. Findings showed that most respondents did not engage in gardening activities (72.6%) and the prevalence of poor diet quality in this study was 89.7%, with a mean score of 44.51. The older respondents (r= 0.20, p= 0.034) and community gardeners (t= -2.63, p= 0.011) had a significantly higher diet quality but not home gardeners (t= 0.12, p= 0.902). The respondents involved in gardening activity also had a significantly higher fruit serving intake, Mann-Whitney U= 1045.00, p= 0.036) and lower total fat intake (t= 2.27, p= 0.025). Conclusion: The diet quality of the respondents remains poor but community gardeners had significantly higher diet quality and fruit intake while lower total fat intake. Interventions need to be developed to address the persistent poor diet quality of adults in the community.

Translation and validation of Food Insecurity Experience Scale (FIES)

@#Introduction: Food insecurity has a complex and multifaceted concept and definition, thus assessing it has been an ongoing challenge for researchers, health practitioners, and policy makers. Previous studies reported inconsistent findings on the prevalence and severity of food insecurity, depending on the measuring tools used. To overcome this limitation, this study aimed to translate and validate the Food Insecurity Experience Scale (FIES) for Malaysians, which has been used as a standard measurement by Food and Agriculture Organization (FAO). Methods: Two forward and backward translations involving experts in food insecurity studies and experts in language were done, as well as the pre-test and cognitive interview stipulated in World Health Organization (WHO) translation guidelines. Content and face validity were conducted as part of the validation process. Content Validity Index (CVI) was done to analyse content validity. Results: The harmonised Malay version of FIES was produced with 1.0 CVI, which was above the 0.8 criteria. Face validity showed good understandability and clarity of FIES. Conclusion: The translated Malay version of FIES had good acceptability, as well as good face validity when tested among the target audience. Thus, a full validation study of the Malay version FIES should be done before it is widely used to measure food insecurity in the population, specifically the Malaysian population.

Financial problems associated with food insecurity among public university students in Peninsular Malaysia

@#Introduction: Food is a necessity for students. Yet, students’ food expenditure is anticipated to be restrained by their financial status. This cross-sectional study aims to determine the prevalence of food insecurity and its determinants among university students attending public universities in Peninsular Malaysia. Methods: Multistage random sampling was used to select respondents from public universities in Peninsular Malaysia. A total of 427 undergraduate students completed a selfadministered questionnaire at four randomly selected universities (Universiti Utara Malaysia, Universiti Kebangsaan Malaysia, Universiti Malaysia Pahang and Universiti Teknologi Malaysia). The questionnaire consisted of information concerning demographic and socioeconomic backgrounds, food security status, eating behaviour, financial literacy, and financial problem among university students. Frequency, chi-square, and logistic regression were used to analyse the variables. Results: Mean age of the respondents was 21.6 years, and 60.9% were found to be food insecure. Gender (χ2=5.415), origin (χ2=3.871), number of siblings (χ2=4.521), financial problem (χ2=42.364), and regular breakfast intake (χ2=5.654) were associated with food security status (p<0.05). Male respondents had 1.5 times (AOR=1.547, 95% CI: 1.006-2.380) the risk of having low food security status. Those with higher financial problems (AOR=3.575, 95% CI: 2.332-5.481) were 3.5 times more likely to be food insecure. Conclusion: The prevalence of food insecurity among public university students in Peninsular Malaysia was significantly high. Thus, intervention studies should focus on students with financial problems. Moreover, establishing a better system for an on campus food pantry or food bank is needed to counter the high prevalence of food insecurity among university students.

Anthropometry Measurements to Determine Nutritional Status Among Cerebral Palsy Children: A Scoping Review

@#This article aimed to review the available anthropometry measurements used in the assessment of nutritional status among Cerebral Palsy (CP) children. Searched journals were from Medline, PubMed and Ovid published from 2015 to 2018. The search identified 443 articles, and eight studies met the criteria. Anthropometric measurements included weight, height, recumbent length, knee height, tibia length, Dual-energy X-ray absorptiometry (DXA), Bioelectrical impedance (BIA), Mid arm circumference (MUAC) subscapular skinfold (SFT), Triceps skinfold (TSF) and prediction equations. Body fat composition can be obtained by DXA, BIA, skinfold measurement, and also prediction equation. The predictive equation is the most reported method to determine nutritional status among CP. This review found that TSF and SFT are more accurate to determine body fat percentage when using together with the predictive equation. Besides, predictive equations using segmental length are reliable in estimating the height and can be used to evaluate the nutritional status using the specific CP growth chart.

Demographic and Socio-economic Characteristics, Household Food Security Status and Academic Performance Among Primary School Children in North Kinta, Perak, Malaysia

@#Introduction: Good academic performance is important for children to ensure their personal well-being. This cross-sectional study investigated the associations between demographic and socio-economic characteristics, household food security status and academic performance among primary school children at North Kinta, Perak, Malaysia. Methods: Two national primary schools were selected randomly and all Standard 5 and 6 students were invited to participate in this study. Self-administered questionnaire on demographic and socio-economic characteristics and food security status was completed by parents. The results from last year examination were acquired from the teacher to evaluate students’ academic performance. Results: Overall, 140 respondents were involved, in which 51.4% were male. A majority of the household (80.7%) displayed food insecurity. Multiple logistic regression revealed that students from well-off households were more likely to have higher marks in English Language Comprehension (OR=8.28, 95%CI: 1.49, 45.91), Writing (OR=25.02, 95%CI: 2.36, 265.69) and Mathematics (OR=7.79, 95% CI: 1.44, 42.11). Female students showed high odds to pass English Language Comprehension (OR=3.47, 95% CI: 1.49, 8.16) and Writing (OR=4.16, 95%CI: 1.51, 11.45) compared to male students. Conclusion: This study unveiled that gender and low household income results in the low achievement in students’ academic. Therefore, for the upcoming intervention programmes should focusing more on helping students from poor households in order to enhance students’ academic performance.

Association of Socio-Demographics and Home Food Environment Factors on Body Weight Status Among Primary School Children

@#Introduction: Obesity in children is a global epidemic issue. Home food environment is an important aspect that may influence children’s body weight status. The aim of this study is to identify the association between socio-demographics and home food environment (HFE) factors with body weight status in primary school children in Bangi, Selangor. Methods: There were 398 children (43.5% males and 56.5% females) aged 7-11 years old (mean age of 9.04±1.41 years) and their parents (66.6% mothers and 33.4% fathers) from eight randomly selected primary schools participated in this study. Parents were asked to complete a self-administered questionnaire on socio-demographic background, feeding practices and food availability, while children were interviewed to obtain information on parental styles and physical activity level. Weight and height of children were assessed, and BMI-for-age z-score (BAZ) was calculated by using WHO Anthroplus Software. Results: Overweight and obesity prevalence was 17.8% and 13.1% respectively. A majority of the parents (61.3%) in this study practiced authoritative parenting style. The increased odds of childhood obesity has been found to be associated with an increasing age (OR=1.239, p<0.05). The risk for overweight or obese was greater for male students than for female students (OR=1.619, p<0.05). Parent’s increasing restriction for weight control (OR=1.080, p<0.05) and decreasing pressure to eat (OR=0.913, p<0.05) increased childhood overweight and obesity risk. Conclusion: This study emphasizes the importance of involving parents in the obesity intervention programs for children.

Overweight and Obesity Among Children: A Relationship Between Maternal Beliefs and Feeding Practices With Children’s Body Mass Index-for-Age in Bandar and Jugra Kuala Langat Selangor

@#Introduction: Childhood obesity is one of the major public concerns as prevalence was showing an increasing trend in Malaysia. This study aimed to determine the associations between maternal beliefs, attitudes and feeding practices with children’s Body Mass Index-for-age (BMI-for-age). Method: A cross-sectional study was carried out in Bandar and Jugra, Kuala Langat, Selangor in two-phase. The first phase was conducted to determine the prevalence of children’s body weight status involving 209 pairs of mothers and children. The second phase of the study aims to determine the socio-demographic characteristics, maternal beliefs, maternal attitudes and feeding practices with childhood obesity involving 148 pairs of mothers and children whose BMI-for-age are normal, overweight and obese only. A set of self-administered questionnaire was answered by the mothers and anthropometric measurements of children were taken. Results: Overall, about 24.9% of the children were overweight and obese. Maternal employment status (X2 = 9.135, p<0.05), perceived child weight status (r=0.267, p<0.05) and food restriction (r=0.186, p<0.05) were positively correlated with children’s BMI-for-age. The pressure to eat (r= -0.177, p<0.05) was negatively associated with children’s BMI-for-age. From multiple linear regression, maternal employment status, perceived child weight status and pressure to eat was shown to be factors associated with children’s BMI-for-age. Conclusion: In conclusion, the findings showed that maternal employment status, perceived on child weight status, restriction on food and pressure to eat were linked to children’s BMI-for-age. Therefore, mothers should be educated on appropriate feeding practices to help to maintain healthy BMI-for-age among younger children.

Consumer awareness and understanding of front-of-pack (FOP) energy icon labelling in Negeri Sembilan, Malaysia

@# Introduction: Adequate, nutritive and safe foods are crucial for growth and healthy living. Adolescents are vulnerable to food insecurity. This study was aimed at determining the demographic factors, food security status, health-related quality of life (HRQOL) and body weight status of adolescents in Mentakab, Pahang, Malaysia. Methods: This study involved 160 households that comprised pairs of mothers and children aged 13-17 years. Face-to-face interviews were conducted with the mothers to assess their demographic and food security status (Radimer/Cornell Hunger and Food Insecurity Instrument). Meanwhile, the children answered a self-administered HRQOL questionnaire (Pediatric Quality of Life Inventory, PedsQL). Body weight and height were measured to obtain the body mass index (BMI). Results: About 48.8% of the adolescents were from households with food insecurity. The number of school-going siblings, occupation status of mother, occupation status of father, household income and house ownership status were predictors of food security status (p<0.05). After controlling for covariates, the HRQOL score and BMI were higher in adolescents from food-secure households than adolescents from food- insecure households (p<0.01). Conclusion: The prevalence of food insecurity was high and multifactorial. Food insecurity was further associated with HRQOL and BMI. Food assistance programmes are recommended to directly alleviate food insecurity. Concurrently, monetary and educational aids are advocated to reduce the economic burden, especially in low-income households.

Overweight and obesity among Orang Asli adults in Krau Wildlife Reserve, Pahang: a four-year follow-up study

@# Introduction: Obesity and excess weight gain in adults are linked to an increased risk of cardiometabolic abnormalities. The changing lifestyle experienced by the Orang Asli predisposes the population to the risk of obesity and non-communicable diseases. This study aimed to describe the prevalence of overweight and obesity as well as body-weight change over a period of four years among Orang Asli adults. Methods: Data were collected from Orang Asli adults aged ≥18 years, who were enrolled in the 2011-2012 and 2015-2016 surveys, and who were residing within the Krau Wildlife Reserve. Weight and height of the adults (N2011-2012=828; N2015- 2016=662) were measured at both time points. Follow-up data were available for 378 adults (male:113; female:265). Results: The prevalence of overweight and obesity were 18.8% and 7.4% in 2011-2012 and 26.1% and 9.5% in 2015-2016. In the follow-up group, significant differences in body weight and body mass index (BMI) were observed in men and women, respectively. More than one-third (35.5%) of the adults had weight gain of more than 5.0%. The increasing percentage of body weight change was associated with being female, younger age, more years of schooling and reduced household income. Conclusion: Obesity is a growing health problem in the Orang Asli adult population. Weight gain was associated with socioeconomic indicators and it was more prominent in women. Effective strategies are needed to address the increasing prevalence of overweight and obesity in this population to further reduce adverse health outcomes.

Household food insecurity, diet quality, and weight status among indigenous women (Mah Meri) in Peninsular Malaysia

BACKGROUND/OBJECTIVES: This cross-sectional study assessed household food security status and determined its association with diet quality and weight status among indigenous women from the Mah Meri tribe in Peninsular Malaysia. SUBJECTS/METHODS: The Radimer/Cornell Hunger and Food Insecurity Instrument and the Malaysian Healthy Eating Index (HEI) were used to assess household food security status and diet quality, respectively. Information on socio-demographic characteristics and 24-hour dietary recall data were collected through face-to-face interview, and anthropometric measurements including weight, height, and body mass index (BMI) were obtained from 222 women. RESULTS: Majority of households (82.9%) experienced different levels of food insecurity: 29.3% household food insecurity, 23.4% individual food insecurity, and 30.2% fell into the child hunger group. The food-secure group had significantly fewer children and smaller household sizes than the food-insecure groups (P < 0.05). The mean household income, income per capita, and food expenditure significantly decreased as food insecurity worsened (P < 0.001). The food-secure group had significantly higher Malaysian HEI scores for grains and cereals (P < 0.01), as well as for meat, poultry, and eggs (P < 0.001), than the food-insecure groups. The child-hunger group had significantly higher fat (P < 0.05) and sodium (P < 0.001) scores than the food-secure and household food-insecure groups. Compared to the individual food-insecure and child-hunger groups, multivariate analysis of covariance showed that the food-secure group was significantly associated with a higher Malaysian HEI score while the household food-insecure group was significantly associated with a higher BMI after controlling for age (P < 0.025). CONCLUSIONS: The majority of indigenous households faced food insecurity. Food insecurity at the individual and child levels was associated with lower quality of diet, while food insecurity at the household level was associated with higher body weight. Therefore, a substantial effort by all stakeholders is warranted to improve food insecurity among poorer households. The results suggest a pressing need for nutritional interventions to improve dietary intake among low income households.

Prevalence of food insecurity and associated factors among freeliving older persons in Selangor, Malaysia

@#Introduction: Older persons are vulnerable to food insecurity. This study aimed to determine the prevalence of food security and associated factors among free-living older persons in Petaling District, Selangor. Methods: A total of 220 free-living older persons aged 60-87 years were selected by using the cluster sampling method in this cross-sectional study. Faceto-face interviews were conducted to obtain information concerning the demographic and socioeconomic background, food security, oral health, and psychosocial status. Chi-square test and binary logistic regression analysis were used to analyse the studied variables. Results: The median age of the respondents was 65.5 years, and 19.5% were found as food insecure. There were significant associations between marital status (χ2=6.818), education level (χ2=6.242), occupation status (χ2=7.540), monthly income (χ2=9.940,), and oral health status (χ2=9.627) with food security status. Those with a low monthly income (AOR=2.449, 95% CI: 1.046-5.732), poor oral health status (AOR: 3.306, 95% CI: 1.387-7.889) and living in rented accommodation (AOR=6.218, 95% CI: 1.458-26.518) were more likely to be food insecure. Conclusion: Respondents with an income lower than the poverty line income (PLI), living in rented accommodation and poor oral health status face increased risk of food insecurity. A nutrition assistance programme is suggested to improve the socioeconomic and food security status of older persons. Regular oral check-ups are recommended to improve the oral health status of the elderly.