A Short Dietary Assessment Instrument to Evaluate Protein Quality and the Diversity of Protein Sources in Malaysian Diets.

The diversity of protein food sources, animal and plant, may be a proxy measure of protein quality and adequate protein nutrition. A population-based sample of 1604 Malaysians aged ≥18 y completed one 24-h dietary recall and a new 29-item protein diversity indicator (PDI). Socio-demographic data were obtained by self-report. Mean total protein intakes were 75.2 g/d from 24-h recalls and 74.9 g/d from PDI. Protein diversity indicator-estimated protein intakes were 36.2% from meat and poultry, 8.8% from fish, 16.0% from eggs and dairy, and 39.0% from plants. Intakes of animal proteins varied with socioeconomic status and ethnicity and were associated with higher protein quality, defined as the adequacy of essential amino acids (EAAs) relative to protein requirements. Protein intakes and protein quality in Malaysia were generally adequate. Protein diversity indicator metrics can complement current methods of dietary assessment and may be useful for monitoring protein diversity and quality in other countries currently undergoing nutrition transition.

Diversity of protein food sources, protein adequacy and amino acid profiles in Indonesia diets: Socio-Cultural Research in Protein Transition (SCRiPT).

The ongoing nutrition transition in lower- and middle-income countries (LMIC) in South East Asia may have a positive impact on protein nutrition. This study assessed the diversity of plant and animal protein food sources in relation to essential amino acid (EAA) adequacy in a population-based sample (N 1665) in Indonesia. Dietary intakes from in-person 24 h recalls provided data on energy and protein intakes (in g/d) from plants (grains, legumes), meat, poultry and fish, and eggs and dairy. Protein diversity scores were based on the number of protein food sources over 24 h. EAA scores were the ratio of amino acid intakes to recommended values. Protein diversity and EAA scores were then compared across multiple socio-demographic indices. Analysis of variance and χ 2 tests were used to test for differences among groups. Energy intakes were 1678 kcal/d for men and 1435 kcal/d for women. Average protein intakes (and prevalence of inadequacy) were 59⋅4 g/d (41⋅7 %) for men and 51⋅5 g/d (51⋅1 %) for women. In regression analyses, higher protein diversity scores were associated with higher protein intakes, more animal protein and less plant protein and with higher EAA scores. Lower protein diversity scores were associated with lower intakes of lysine, leucine and valine relative to requirements, as well as with lower EAA, rural settings, less wealth and less modernisation. Greater diversity of animal protein food sources, observed among groups of higher socio-economic status, was linked to better amino acid adequacy and protein nutrition.

Animal and Plant Protein Food Sources in Indonesia Differ Across Socio-Demographic Groups: Socio-Cultural Research in Protein Transition in Indonesia and Malaysia.

BACKGROUND: Plant-based diets in lower-income countries are often associated with inadequate protein nutrition and adverse health outcomes. OBJECTIVE: To examine the diversity of protein food sources, in both animal and plant, across diverse socio-demographic groups in Indonesia as compared to Malaysia. DESIGN: The SCRiPT (Socio Cultural Research in Protein Transition) study was based on population-based samples recruited in Indonesia (N = 1665) and in Malaysia (N = 1604). Data from 24-h in-person dietary recalls in each country were used to construct the frequency counts of protein sources by food group. Protein sources were defined as fish, poultry, red meat (beef, pork, and mutton), eggs, dairy, and plants (cereals, pulses, and tubers). The percent reported frequencies for animal and plant proteins were compared across socio-demographic strata and by country. Analyses were based on one-way Anovas and general linear model regressions adjusting for covariates. RESULTS: Animal protein frequency counts were 34% of total in Indonesia, but 50% in Malaysia's. Higher reported consumption frequencies for poultry and red meat in both countries were associated with urban living, greater modernization, and higher socioeconomic status, with stronger social gradients observed in Indonesia. Reported fish consumption was higher in Indonesia than in Malaysia. Fish was more likely to be listed by rural island populations in Indonesia and was associated with lower education and incomes. Consumption frequencies for plant-based proteins were associated with lower socio-economic status in Indonesia and in Malaysia. CONCLUSIONS: More affluent groups in both countries reported higher frequencies for meat, eggs, and dairy as opposed to fish. Greater economic development in Southeast (SE) Asia is associated with more animal protein, particularly from poultry, which may displace fish, the traditional source of high quality protein for the region.

Physical Activity, Sitting Time, and Quality of Life among Breast and Gynaecology Cancer Survivors.

BACKGROUND: Increasing physical activity and reducing sitting time was recommended to cancer survivors after cancer treatment for sustained health and to enhance the quality of life. This study aimed to determine the association of physical activity and sitting time with quality of life among the Malay breast and gynaecological cancer survivors. METHODS: A cross-sectional study was conducted among 95 breast and gynaecology cancer survivor subjects. The Malay International Physical Activity Questionnaire (IPAQ) was used to assess physical activity and sitting time. Quality of life was assessed using the Malay EORTC QLQ-C30 questionnaire. Sociodemographic, clinical characteristics and anthropometric measurements were also obtained in this study. RESULTS: The mean age of the subject was 51.8 ± 7.7 years old and the duration of survivorship was 4.3 ± 3.4 years. A total of 76.8% of subjects were categorized as having low physical activity level with a mean MET 403.5 ± 332.7 minutes/week and sitting time of 416.9 ± 151.0 minutes/day. Overall, subjects aged 50 years and above (p=0.006), widowed (p=0.032), retired (p=0.029) and had other non-communicable diseases (p=0.005) showed lower levels of physical activity. Increased physical activity had a positive effect on physical function (r=0.2, p=0.038), reduced insomnia (r=-0.3, p <0.001) and constipation symptoms (r=-0.3, p=0.012) domains of quality of life. The longer the sitting period showed more severe insomnia symptoms (r=0.2, p=0.03) but improved social function (r=0.2, p=0.012). CONCLUSIONS: Increasing physical activity and reducing sitting time have a positive effect on the quality of life of cancer survivors. The focus of health education should be prioritized to older adults (50 years and above), widows, retirees, and those with other comorbidities as they are at risk of being not physically active.
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Dietary Changes and Its Impact on Quality of Life among Malay Breast and Gynaecological Cancer Survivors in Malaysia.

OBJECTIVE: Fear of cancer recurrent, side effects of treatment and belief in food taboos encourage cancer survivors to make changes in their dietary practices after diagnosis of cancer. The objective of this study was to determine the impact of dietary changes on quality of life (QoL) among Malay breast and gynaecological cancer survivors. METHODS: Questionnaire of dietary changes was modified from WHEL study and adapted to typical Malay's food intake in Malaysia. A total of 23 items were listed and categorized by types of food and cooking methods.  Four categories of changes "increased", "decreased", "no changes" or "stopped" were used to determine the changes in dietary practices. Score one (+1) is given to positive changes by reference to WCRF/AICR and Malaysia Dietary Guideline healthy eating recommendations. Malay EORTC QLQ-C30 were used to determine the QoL. Sociodemographic, clinical characteristics and anthropometric measurement were also collected. RESULTS: The mean age of the subjects (n=77) was 50.7±7.8 years old with duration of survivorship 4.0±3.1 years. Subjects mean BMI was 27.8±4.9 kg/m2 which indicate subjects were 31.2% overweight and 32.5% obese. The percentage score of positive dietary changes was 34.7±16.4%. Positive dietary changes were increased intake of green leafy vegetable (49.4%), cruciferous vegetable (46.8%) and boiling cooking methods (45.5%). Subjects reduced their intake of red meat (42.9%), sugar (53.2%) and fried cooking method (44.2%). Subjects stopped consuming milk (41.6%), c 2008-5862 heese (33.8%) and sweetened condensed milk (33.8%). With increasing positive dietary changes, there was a significant improvement on emotional function (rs=0.27; p=0.016) and reduced fatigue symptoms (rs=-0.24; p=0.033). CONCLUSION: Positive changes in dietary intake improved emotional function and reduced fatigue symptoms after cancer treatment. By knowing the trend of food changes after cancer treatment, enables the formation of healthy food intervention implemented more effective.

Socio-Cultural and Economic Drivers of Plant and Animal Protein Consumption in Malaysia: The SCRiPT Study.

Countries in South East Asia are undergoing a nutrition transition, which typically involves a dietary shift from plant to animal proteins. To explore the main drivers of protein consumption, the SCRiPT (Socio Cultural Research in Protein Transition) study recruited a population sample in Malaysia (N = 1604). Participants completed in-person 24 h dietary recalls and socio-demographic surveys. Energy and nutrient intakes were estimated using Nutritionist Pro. A novel recipe-based frequency count coded protein sources as meat (chicken, beef, pork, and mutton), fish, eggs, dairy, and plants (cereals, pulses, tubers). Dietary intakes and frequencies were examined by gender, age, income, education, ethnicity, religion, and family status, using ANOVAs and general linear models. Energy intakes were 1869 kcal/d for men and 1699 kcal/d for women. Protein intakes were 78.5 g/d for men and 72.5 g/d for women. Higher energy and protein intakes were associated with Chinese ethnicity, higher education and incomes. Frequency counts identified plant proteins in 50% of foods, followed by meat (19%), fish (12%), eggs (12%), and dairy (7%). Most frequent source of meat was chicken (16%) rather than pork or beef (1.5% each). In bivariate analyses, animal protein counts were associated with younger age, higher education and incomes. In mutually adjusted multivariate regression models, animal proteins were associated with education and ethnicity; plant proteins were associated with ethnicity and religion. Protein choices in Malaysia involve socio-cultural as well as economic variables.

Food and Nutrition in Malaysian Children.

Two nationwide studies, namely the South East Asian Nutrition Survey (SEANUTS Malaysia) and MyBreakfast study showed that 13-17% of children aged between 6 and 12 years were either overweight or obese. From dietary assessment, the majority of children achieved the Malaysian recommended nutrient intake (RNI) for energy and protein, but more than 50% did not fulfill the RNI for calcium and vitamin D. The majority of children consumed breakfast regularly; however, 20-30% of children skipped breakfast. The MyBreakfast study showed that 17.7% of the children consumed ready-to-eat cereal (RTEC) at breakfast, while among non-RTEC consumers, bread (44.2%), eggs (31.8%), and nasi lemak (23.9%) were the most common foods consumed. RTEC was the major contributor of whole grain (68.6%), followed by hot cereal (18.6%), biscuits (8.7%), and bread (1.8%). In the SEANUTS Malaysia, among children aged 7-9 years, 13.4 and 9.5% met the Malaysian Dietary Guideline (MDG) for fruits and vegetables while among children aged 10-12 years, only 19.6 and 16.1%, respectively, met the MDG for fruits and vegetables. For the milk group, only 5.5% of 7- to 9-year-old children and 3.7% of those 10-12 years old met the MDG for milk/dairy products per day.

Effects of iron supplementation and nutrition education on haemoglobin, ferritin and oxidative stress in iron-deficient female adolescents in Palestine: randomized control trial.

BACKGROUND: Iron deficiency and iron-deficiency anaemia are associated with oxidative stress, but their role is largely unclear. Information is scarce on the effects of iron supplementation on biomarkers of oxidative stress in humans. AIMS: This study evaluated the effectiveness of iron supplementation and nutrition education on improving the levels of haemoglobin and ferritin, and decreasing oxidative stress among iron-deficient female adolescents in Gaza, Palestine. METHODS: A total 131 iron-deficient female adolescents were recruited and allocated randomly into 3 different groups. The iron supplementation group (A) received 200 mg of ferrous fumarate weekly during the 3-month intervention, the iron supplementation with nutrition education group (B) received iron supplements with nutrition education sessions, and the control group (C) did not receive any intervention. The levels of haemoglobin, ferritin and malonyl dialdehyde were measured at baseline, after 3 months (at which point the intervention was stopped), and then 3 months later. Trial registration number: ACTRN12618000960257. RESULTS: Haemoglobin levels increased significantly after supplementation in both groups A and B. At the follow-up stage (3 months after stopping the intervention), iron and haemoglobin levels in group B continued to increase and malonyl dialdehyde decreased. In Group A, haemoglobin, ferritin and malonyl dialdehyde levels decreased after 3 months of stopping the intervention. No changes were seen in Group C. CONCLUSIONS: A nutrition programme should be adopted and integrated into comprehensive intervention programmes to target iron-deficiency anaemia among female adolescents in Palestine.

Prevalence and risk factor analysis of iron deficiency and iron-deficiency anaemia among female adolescents in the Gaza Strip, Palestine.

OBJECTIVE: The present study aimed to determine the prevalence of anaemia, iron deficiency (ID) and iron-deficiency anaemia (IDA) among female adolescents in the Gaza Strip, Palestine, as well as the risk factors involved in these conditions. DESIGN: The study was conducted using the quantitative descriptive method with a cross-sectional design. Data were collected using an FFQ and sociodemographic, sedentary behaviour and physical activity questionnaires. Anthropometric measurements and blood analyses were also conducted. SETTING: The study population included all Palestinian female adolescents enrolled in secondary schools in the academic years 2015-2016. Five female secondary schools were selected randomly from five governorates of the Gaza Strip. SUBJECTS: Female adolescents (n 330) aged 15-19 years in the selected secondary schools were enrolled randomly. RESULTS: Prevalence of anaemia, ID and IDA among female adolescents in the Gaza Strip, Palestine, was 35·8, 40·3 and 26·0 %, respectively. A significant association (P<0·05) existed between ID, anaemia and IDA and dietary habits, including skipping breakfast and amount of junk food intake. Also, low consumption of fruits and vegetables was associated with IDA in the female adolescents. A statistically significant association was found between mother's education and ID but not with the other sociodemographic factors. CONCLUSIONS: The study shows that there is an alarming problem of anaemia and IDA in the Gaza Strip, Palestine. This may indicate that there are insufficient nutrition education programmes, particularly inside schools or by the mass media.

The impact of self-efficacy education based on the health belief model in Iranian patients with type 2 diabetes: a randomised controlled intervention study.

BACKGROUND AND OBJECTIVES: Type 2 diabetes is a chronic illness which can be managed by patients' commitment to self-care and self-efficacy behaviors. METHODS AND STUDY DESIGN: A randomized controlled intervention study was carried out to determine the impact of self-efficacy education based on the Health Belief Model (HBM) in 240 patients with type 2 diabetes at the Golestan Hospital, Ahvaz, Iran between October 2014 and August 2015. The education duration was three months followed by a 24-week follow-up visit to determine the progress of the subjects. In this study, reliable and validated diabetes educational booklet and questionnaires based on knowledge, health beliefs and quality of life were used. The participants were randomly allocated to either the intervention group (n=120) or to the conventional dietary counseling group as controls (n=120), and assessed at the baseline, week 12 and week 36. The study was divided into primary outcome measurements consisting of glycated hemoglobin A1c (HbA1c), fasting blood glucose, lipid profile, and anthropometric levels. Secondary outcome measures were related to nutrition knowledge, health beliefs and quality of life. RESULTS: The results showed that subjects in the intervention group had significantly better metabolic and glycemic profiles compared with those in the control group. It also showed that knowledge, health belief and quality of life significantly increased in the intervention group. CONCLUSIONS: Findings indicate that through tailored self-efficacy education, the quality of life and metabolic profile of diabetes patients can be improved.

Simultaneous coffee caffeine intake and sleep deprivation alter glucose homeostasis in Iranian men: a randomized crossover trial.

BACKGROUND AND OBJECTIVES: Sleep deprivation and coffee caffeine consumption have been shown to affect glucose homeostasis separately, but the combined effects of these two variables are unknown. METHODS AND STUDY DESIGN: Forty-two healthy Iranian men, aged 20-40 years old, were assigned to three groups in a randomised crossover trial involving three treatments with two-week washout periods. Subjects were moderate coffee consumers (<=3 cups/day), and had a Pittsburgh Sleep Quality Index <=5. Each treatment involved three nights of deprived sleep (4 hrs. in bed) plus 3×150 cc/cup of boiled water (BW treatment), decaffeinated coffee (DC treatment, without sugar, 99.9% caffeine-free), and caffeinated coffee (CC treatment, without sugar, 65 mg caffeine/ cup). DC and CC treatments were blinded. At the end of each treatment, fasting serum glucose (using enzyme assays) and insulin (using electrochemiluminescence immunoassay) were measured and, again, two hours after an oral glucose tolerance test (OGTT). Insulin resistance was quantified with the homeostasis model. RESULTS: Repeated measures ANOVA indicated no significant difference between the treatments in fasting serum glucose (p=0.248) or insulin resistance (p=0.079). However, ANOVA demonstrated differences between treatments in fasting serum insulin (p=0.004) and glucose, as well as insulin after OGTT (p<0.001). Pairwise comparisons test (within subjects) showed that the CC treatment yielded higher serum glucose and insulin after OGTT (p<0.001), higher fasting serum insulin (p=0.001), and increased insulin resistance (p=0.039) as compared to the DC treatment. CONCLUSIONS: Thus caffeinated coffee was more adverse for glucose homeostasis compared to decaffeinated coffee in individuals who were simultaneously sleep deprived.

Characteristics associated with the consumption of malted drinks among Malaysian primary school children: findings from the MyBreakfast study.

BACKGROUND: The consumption of beverages contributes to diet quality and overall nutrition. Studies on malted drinks, one of the widely consumed beverage choices among children in Asia, however, have received limited attention. This study aimed to examine the prevalence of malted drink consumption and explored associations of sociodemographic characteristics, nutrient intakes, weight status and physical activity levels with malted drink consumption among primary school children in Malaysia. METHODS: Data for this analysis were from the MyBreakfast Study, a national cross-sectional study conducted from April to October 2013 throughout all regions in Malaysia. A total of 2065 primary school children aged 6 to 12 years were included in the present analysis. Data on two days 24-h dietary recall or record, anthropometry, physical activity and screen time were recorded. Associations between malted drink consumption and related factors were examined using binary logistic regression, adjusting for region, area, gender, ethnicity and household income. RESULTS: Among children aged 6 to 12 years, 73.5% reported consuming malted drinks for at least once per week. Consumption of malted drinks was significantly associated with region (χ(2) = 45.64, p < 0.001), gender (χ(2) = 4.41, p = 0.036) and ethnicity (χ(2) = 13.74, p = 0.008). Malted drink consumers had similar total energy intake but higher micronutrient intakes compared to non-consumers. High physical activity level (OR = 1.77, 95% CI = 1.06, 2.99) and lower screen time during weekends (OR = 0.93, 95% CI = 0.86, 0.99) were independently associated with malted drink consumption among 6 to 9 year-old children, but not among 10 to 12 year-old children. No association was observed between malted drink consumption and weight status. CONCLUSIONS: Malted drink consumption is prevalent among Malaysian primary school children, particularly higher among boys, indigenous children and those who lived in the East Coast region of Malaysia. Consuming malted drinks is associated with higher micronutrient intakes and higher levels of physical activity, but not with body weight status.

Development and validation of a food frequency questionnaire for dietary intake assessment among multi-ethnic primary school-aged children

<p><b>INTRODUCTION</b>This study aimed to develop and validate a food frequency questionnaire (FFQ) to assess habitual diets of multi-ethnic Malaysian children aged 7-12 years.</p><p><b>METHODS</b>A total of 236 primary school children participated in the development of the FFQ and 209 subjects participated in the validation study, with a subsample of 30 subjects participating in the reproducibility study. The FFQ, consisting of 94 food items from 12 food groups, was compared with a three-day dietary record (3DR) as the reference method. The reproducibility of the FFQ was assessed through repeat administration (FFQ2), seven days after the first administration (FFQ1).</p><p><b>RESULTS</b>The results of the validation study demonstrated good acceptance of the FFQ. Mean intake of macronutrients in FFQ1 and 3DR correlated well, although the FFQ intake data tended to be higher. Cross-classification of nutrient intake between the two methods showed that < 7% of subjects were grossly misclassified. Moderate correlations noted between the two methods ranged from r = 0.310 (p < 0.001) for fat to r = 0.497 (p < 0.001) for energy. The reproducibility of the FFQ, as assessed by Cronbach's alpha, ranged from 0.61 (protein) to 0.70 (energy, carbohydrates and fat). Spearman's correlations between FFQ1 and FFQ2 ranged from rho = 0.333 (p = 0.072) for protein to rho = 0.479 (p < 0.01) for fat.</p><p><b>CONCLUSION</b>These findings indicate that the FFQ is valid and reliable for measuring the average intake of energy and macronutrients in a population of multi-ethnic children aged 7-12 years in Malaysia.</p>

Perceived physical activity barriers related to body weight status and sociodemographic factors among Malaysian men in Klang Valley.

BACKGROUND: Physical inactivity has been acknowledged as a public health issue and has received increasing attention in recent years. This cross-sectional study was conducted to determine the barriers to physical activity among Malaysian men. These barriers were analyzed with regards to sociodemographic factors, physical activity level, BMI and waist circumference. METHODS: Subjects in this study included 308 Malay men and 422 Chinese men aged 20 years and older. Subjects completed the International Physical Activity Questionnaire (IPAQ) and a questionnaire on barriers to physical activity, categorized into personal and psychological, physical and social environment barriers. Weight, height and waist circumference were also measured and BMI was calculated. RESULTS: Descriptive analyses showed that 79.3% of subjects were married, 52.1% had secondary educational level, 68.8% were still working, and 39.7% had household income between RM1500 to RM3500. The perception that other recreational activities with family and friends were more fun was the most frequently reported barrier, followed by weather, lack of discipline, lack of free time, lack of money, and lack of friends. Marriage status, educational level, household income, BMI, and physical activity status were shown to be associated with perceived barriers. CONCLUSIONS: To increase participation in physical activity, policy makers should consider significant personal, social and environmental barriers when developing appropriate intervention programmes. Health-promoting strategies that increase awareness, knowledge, skills and motivation related to physical activity are required.

Glycaemic index of four commercially available breads in Malaysia.

This study was carried out to determine the blood glucose response and glycaemic index (GI) values of four types of commercially available breads in Malaysia. Twelve healthy volunteers (six men, six women; body mass index, 21.9±1.6 kg/m(2); age, 22.9±1.7 years) participated in this study. The breads tested were multi-grains bread (M-Grains), wholemeal bread (WM), wholemeal bread with oatmeal (WM-Oat) and white bread (WB). The subjects were studied on seven different occasions (four tests for the tested breads and three repeated tests of the reference food) after an overnight fast. Capillary blood samples were taken immediately before (0 min) and 15, 30, 45, 60, 90 and 120 min after consumption of the test foods. The blood glucose response was obtained by calculating the incremental area under the curve. The GI values were determined according to the standardized methodology. Our results showed that the M-Grains and WM-Oat could be categorized as intermediate GI while the WM and WB breads were high GI foods, respectively. The GI of M-Grains (56±6.2) and WM-Oat (67±6.9) were significantly lower than the reference food (glucose; GI = 100) (P < 0.05). No significant difference in GI value was seen between the reference food and the GI of WM (85±5.9) and WB (82±6.5) (P > 0.05). Among the tested breads, the GI values of M-Grains and WM-Oat were significantly lower (P < 0.05) than those of WM and WB. There was no relationship between the dietary fibre content of the bread with the incremental area under the curve (r = 0.15, P = 0.15) or their GI values (r = 0.17, P = 0.12), indicating that the GI value of the test breads were unaffected by the fibre content of the breads. The result of this study will provide useful nutritional information for dieticians and the public alike who may prefer low-GI over high-GI foods.

Nutritional Status and Food Habits of Middle-aged Adults in Selected Areas of Selangor.

A food habits and health status study was carried out among 100 Malay adults aged 40 years and above. The study protocol incorporated anthropometric measurements, evaluation of food habits and determination of blood glucose, cholesterol and blood pressure. Mean body mass index (BMI) for men and women were 27.2 ± 4.2 kg/m2 and 27.0 ± 5.2 kg/m2 respectively, which on average showed that the subjects were overweight. Food habits evaluation indicated that rice, fish and vegetables were the foods consumed almost everyday by the majority of the subjects. Meat, dairy products and fruits were eaten once to three times per week. Food intake score for sugar and salt demonstrated that a majority of men and women consumed moderate amounts of these foods. Most subjects exercised twice to three times a week for 15 min per session. Blood glucose tests revealed a mean of 5.04 ± 1.60 mmol/l in men and 4.86 ± 2.10 mmol/l for women. Mean cholesterol for men was 5.06 ± 1.22 mmol/l while it was 4.90 ± 1.34 mmol/l in women. Mean systolic and diastolic blood pressure in men was normal of 127.69 ± 13.60 mm Hg dan 85.87 ± 7.97 mm Hg, while in women it was 127.42 ± 17.54 mm Hg, 83.53 ± 9.50 mm Hg. The mean value for glucose, cholesterol and blood pressure increased with age. The food habits of these adults were satisfactory; however blood test for the nutrients of interest exhibited an increasing trend towards blood pressure, blood cholesterol and glucose with age. Middle-aged adults should adapt to a more active lifestyle and be more cautious of their food habits. This is to ensure a healthy well being throughout their life span.

Current status of coronary risk factors among rural Malays in Malaysia.

BACKGROUND: Coronary heart disease (CHD) is the leading cause of death in Malaysia, despite its status as a developing country. The rural population is thought to be at low risk. OBJECTIVE: To investigate the prevalence of risk factors and global risk profile among rural Malays in Malaysia. METHODS: We studied 609 rural Malay subjects (346 females, 263 males; age range 30-65 years). Blood pressure (BP), body mass index (BMI), waist-hip ratio (WHR), smoking habits and family history of premature CHD were documented. Fasting blood samples were analysed for serum lipids, lipoprotein (a), plasma glucose and fibrinogen. Oral glucose tolerance tests were performed using 75 g anhydrous glucose. RESULTS: The prevalence of hypercholesterolaemia for total cholesterol concentrations of > or = 5.2, > or =6.5 and > or =7.8 mmol/l were 67.3, 30.5 and 11.8% respectively. There was a high prevalence of low serum high-density lipoprotein cholesterol (13.1%), hypertension (30.3%), smokers (24.4%), diabetes (6.4%), impaired fasting glucose or glucose tolerance (13.9%), overweight or obesity (44.7%) and increased WHR (48.5%). Global risk assessment showed that 67.3% of the study population were at risk, with 15.9, 18.9 and 32.5% in the mild, moderate and high risk categories respectively. CONCLUSION: Prevalence of risk factors was high in the rural population. Global risk assessment showed a high-risk profile with two-thirds being at risk, and one-third being categorized into the high-risk group. Although rural communities were considered at low risk of developing CHD, this is changing fast, possibly due to the rapid socio-economic development, in addition to underlying genetic predisposition.