Association between dietary patterns and overweight risk among Malaysian adults: evidence from nationally representative surveys.

OBJECTIVE: To investigate the association between dietary patterns (DP) and overweight risk in the Malaysian Adult Nutrition Surveys (MANS) of 2003 and 2014. DESIGN: DP were derived from the MANS FFQ using principal component analysis. The cross-sectional association of the derived DP with prevalence of overweight was analysed. SETTING: Malaysia. PARTICIPANTS: Nationally representative sample of Malaysian adults from MANS (2003, n 6928; 2014, n 3000). RESULTS: Three major DP were identified for both years. These were 'Traditional' (fish, eggs, local cakes), 'Western' (fast foods, meat, carbonated beverages) and 'Mixed' (ready-to-eat cereals, bread, vegetables). A fourth DP was generated in 2003, 'Flatbread & Beverages' (flatbread, creamer, malted beverages), and 2014, 'Noodles & Meat' (noodles, meat, eggs). These DP accounted for 25·6 and 26·6 % of DP variations in 2003 and 2014, respectively. For both years, Traditional DP was significantly associated with rural households, lower income, men and Malay ethnicity, while Western DP was associated with younger age and higher income. Mixed DP was positively associated with women and higher income. None of the DP showed positive association with overweight risk, except for reduced adjusted odds of overweight with adherence to Traditional DP in 2003. CONCLUSIONS: Overweight could not be attributed to adherence to a single dietary pattern among Malaysian adults. This may be due to the constantly morphing dietary landscape in Malaysia, especially in urban areas, given the ease of availability and relative affordability of multi-ethnic and international foods. Timely surveys are recommended to monitor implications of these changes.

Association between dietary folate intake and blood status of folate and homocysteine in Malaysian adults.

Folate is of prime interest among investigators in nutrition due to its multiple roles in maintaining health, especially in preventing neural tube defects and reducing the risk of cardiovascular diseases. We investigated the effect of dietary folate intake on blood folate, vitamin B(12), vitamin B(6), and homocysteine status. One hundred subjects consisting of Chinese and Malay subjects volunteered to participate in this cross-sectional study. Dietary folate intake was assessed by 24-h dietary recall and a food-frequency questionnaire (FFQ). Serum and red blood cell folate were analyzed using a microbiological assay, while serum vitamin B(12) was determined by electrochemiluminescence immunoassay (ECLIA), and high-performance liquid chromatography (HPLC) was used for the determination of serum vitamin B(6) and homocysteine. The mean folate intake, serum folate, RBC folate, serum vitamin B(12), and B(6), were higher in female subjects, with the exception of serum homocysteine. The Chinese tended to have higher folate intake, serum folate, RBC folate, and vitamin B(12). A positive association was found between folate intake and serum folate while a negative association was found between folate intake and serum homocysteine. Stepwise linear regression of serum folate showed a significant positive coefficient for folate intake whilst a significant negative coefficient was found for serum homocysteine when controlling for age, gender, and ethnicity. In conclusion, high dietary folate intake helps to increase serum folate and to lower the homocysteine levels.

Nutritional assessment of pre-school children in rural villages of the family dynamics, lifestyles and nutrition study (1997-2001) I. Socio-economic status of households.

This paper presents the socio-economic profile of households in the Family Dynamics Study (FDS) (1997-2001) and makes comparisons with the earlier Functional Groups Study (FGS) (1992-1996). For the current study, FGS villages with a high prevalence of child malnutrition were purposively selected. In each village selected, all households were included, and interviews with a structured questionnaire were conducted in April-May 1998. Incomes were generally low and incidence of poverty was high; 49.6% of the households were under the poverty line income, of which 37.2% were poor and 12.4% were hard core poor. Overall, only 23.2% of heads of households were in agricultural occupations, others being primarily waged workers and petty traders. Livestock rearing was widespread (57.8%), and most households (90.4%) owned at least one motorised vehicle, the most common being the motorcycle. The majority of households had refrigerators (73.6%), washing machines (58.8%), and televisions (91.1%); but telephones (42.2%), mobile phones (6.1%) and computers (2.3%) were less common. Although 99.7% of households had electricity supply and 95.1% had either a flush or pour flush latrine, only 57.4% had piped water supply. In comparison to the FGS, poverty in the current study is lower (49.6% of FDS households are poor compared to 55.2% of FGS households), the proportion of household heads in agricultural occupations is also lower (26.9% compared to 55.3%), while all other socioeconomic indicators were better, except for piped water supply, which remains inadequate for households in the current study.

Nutritional Assessment of Pre-School Children in Rural Villages of the Family Dynamics, Lifestyles and Nutrition Study (1997-2001) II. Prevalence of Undernutrition and Relationship to Household Socio-Economic Indicators.

This paper describes the nutritional status of pre-school children and analyzes its relationship to various household socio-economic indicators. Padi, rubber and fishing villages from the Functional Groups Study (1992-1996) were selected for having a high prevalence of child undernutrition, and all children between the ages of 12 and 72 months were measured for their weights and heights in April-May 1998. The NCHS reference values were used to calculate z-scores, which were categorised according to WHO (1983) recommendations. Children between minus 2SD and minus 1SD of reference median were classified as mildly malnourished. Prevalence of underweight was higher (30.5%) than stunting (22.3%), while wasting was only 9.7%. Padi villages had the highest prevalence of undernutrition, followed by fishing, and then rubber villages. Mean household incomes were found to be significantly lower for children with worse nutritional status, and undernutrition was higher in households below the poverty line income. The odds ratios for having stunted children were significantly higher for households whose heads were agricultural own-account workers (OR 3.66, 95% CI = 1.37-9.79), agricultural waged workers (OR 2.75, 95% CI = 1.06-7.10), and non-agricultural manual workers (OR 2.49, 95% CI = 1.04-6.00) compared to non-manual workers. Various household socio-economic indicators showed significantly higher odds ratios for underweight, stunting and wasting. After adjusting for confounding effects by logistic regression analysis, however, only mother's education was found to be a significant predictor for stunting, while poverty level and access to piped water supply were significant predictors for both underweight and stunting. Households without livestock were significant predictors for wasting. Thus, this study identified specific socio-economic factors that should be prioritized for policy and research towards the amelioration of childhood malnutrition in rural areas.

Gender Differences in Eating Behavior and Social Self Concept among Malaysian University Students.

University students may encounter personal, family, social, and financial stresses while trying to cope with their academic challenges. Such constraints could affect their eating behavior and health status which, in turn may have negative effects on their studies. In light of little information in Malaysia on this subject, this study was undertaken on a sample of 180 students pursuing different academic programs in a Malaysian university. The study objectives were to determine the students' eating behavior including body weight control and the extent of fear of being fat, their social self concept that reflects the five selves namely, the psychological self, the social self, the sexual self, the family self and the physical self. Eating behavior and social self concept were determined based on various methods previously validated in studies on young adults in Asia and Australia. This article focuses on gender comparisons for these determinants. The results showed that psychological and emotional factors have a significant bearing on the eating behavior of university students. Uninhibited eating behavior of both the males and females showed significant and negative correlations with feelings pertaining to personal worth, the physical self, and their relationships with peers and families. Gender differences were manifested for some determinants. The females showed more restrained eating behavior than the males; the females have a significantly higher score for family relationship, which appears to be a significant factor on male students' eating behavior. Future studies on a larger sample size may help to unravel the extent to which psychological factors influence eating behavior of students, and the underlying psychosocial basis for some of the gender differences reported in this study.