Association between Knowledge, Attitude, and Practice of Nutrition and Food Labels among Selected Higher Educational Institution Students in Klang Valley (Hubungan antara Pengetahuan, Sikap dan Amalan terhadap Pemakanan dan Label Makanan dalam Kalangan Pelajar Institusi Pengajian Tinggi di Lembah Klang) / Jurnal Sains Kesihatan Malaysia

@#Nutrition information on food labels guides consumers to purchase healthier food choices. Besides nutrition information, other factors influence a purchase. This study aims to determine the association between the knowledge, attitude, and practice (KAP) among tertiary students on nutrition and food labels. In this cross-sectional study, a total of 190 students from three tertiary institutions within Klang Valley completed an online survey. Self-administered questionnaires on sociodemographic profiles and KAP questions, available in Malay and English, were distributed. Association between KAP was determined using Spearman's Rho test, while multiple linear regression was used to assess predictors of KAP scores. Mean body mass index (BMI) of the respondents were 20.8 kg/m2. The total mean score for knowledge on food labels was 8.93, followed by attitude and practice with 3.86 and 3.11, respectively. There was a significant correlation between attitude and practice (p<0.005). Nutrient and total calorie information on food labels influenced purchases, with 56.3% of respondents reported looking at the total calorie content, followed by 55.7% and 49.5% checking on sugar and fats, respectively. In addition, other factors such as expiry date (60.9%) and price (59.9%) also influenced purchases. Overall, respondents have a positive attitude on food selection, but male respondents have better knowledge levels than females. However, female respondents interpret food labelling effectively compared to male respondents. Despite having good knowledge and attitude towards nutrition, respondents were still making poor choices. A more extensive range of healthier food options and targeted healthy eating campaigns may empower students to choose more nutritious foods.

The interaction between energy intake, physical activity and UCP2 -866G/A gene variation on weight gain and changes in adiposity: an Indonesian Nutrigenetic Cohort (INDOGENIC).

The present study aimed to investigate an interaction between energy intake, physical activity and UCP2 gene variation on weight gain and adiposity changes in Indonesian adults. This is a prospective cohort study conducted in 323 healthy adults living in the city of Yogyakarta, Indonesia. Energy intake, physical activity, body weight, BMI, percentage body fat and waist:hip ratio (WHR) were measured at baseline and after 2 years while UCP2 -866G/A gene variation was determined at baseline. We reported that after 2 years subjects had a significant increment in body weight, BMI, body fat and reduction in WHR (all P < 0·05). In all subjects, total energy intake was significantly correlated with changes in body weight (ß = 0·128, P = 0·023) and body fat (ß = 0·123, P = 0·030). Among subjects with the GG genotype, changes in energy intake were positively correlated with changes in body weight (ß = 0·232, P = 0·016) and body fat (ß = 0·201, P = 0·034). These correlations were insignificant among those with AA + GA genotypes (all P > 0·05). In summary, we show that UCP2 gene variation might influence the adiposity response towards changes in energy intake. Subjects with the GG genotype of UCP2 -866G/A gene were more responsive to energy intake, thus more prone to weight gain due to overeating.

Associations between self-reported and objectively measured physical activity and overweight/obesity among adults in Kota Bharu and Penang, Malaysia.

BACKGROUND: For the past decades, Malaysia has seen an increased prevalence of overweight and obesity which leads to significant health threats. Physical activity is beneficial in maintaining healthy body weight. The objective of this study was to measure physical activity of adults in Malaysia using objective measurement (accelerometer) and self-reported methods, as well as to determine their associations with (body mass index (BMI) and waist circumference (WC) measurements. METHODS: Four-hundred and ninety Malaysian adults (n = 490) aged 20 to 65 years old participated in this cross-sectional study. Their body weight, height, and WC measurements were measured according to standard procedures. Physical activity was assessed objectively with accelerometers for five to seven consecutive days. The International Physical Activity Questionnaire (IPAQ) was used to estimate the amount of time spent on various domains of physical activity. Mixed models were used to determine the associations between physical activity variables and both BMI and WC. RESULTS: The mean value of objectively measured moderate-to-vigorous physical activity (MVPA) was 13.5 min per day, in which male participants recorded a significantly higher amount of time compared to females. On the other hand, the mean self-reported total physical activity was 380 min per week; male participants reported a significantly higher amount of time on physical activity in the occupation/work and leisure/recreation domains while female participants spent significantly more time in the domestic/household chores domain. We also observed that the mean values of objectively measured total MVPA, self-reported time spent on walking for leisure/recreation, and total time amount of time spent on MVPA for leisure/recreation were significantly higher among participants with BMI of less than 25 kg/m2. The final statistical model yielded a significant negative association between objectively measured total MVPA and BMI, but not with WC measurement. No significant association was reported between self-reported total physical activity with BMI and WC measurement. CONCLUSIONS: Objectively measured MVPA was inversely associated with BMI, but not WC measurement. No significant association was observed between self-reported total physical activity and physical activity time measures across domains with both BMI and WC measurement.

Dietary intakes and obesity of Malaysian adults.

BACKGROUND/OBJECTIVES: Over the past few decades, Malaysia has been experiencing an increased prevalence of overweight and obesity that threatens the health of Malaysians. Poor dietary intake is one of the major contributors to the development of obesity and many non-communicable diseases. The dietary intakes of adults in Malaysia were assessed to determine the association between the dietary intake variables and the body mass index (BMI) and waist circumference (WC) measurements. This study examined whether the dietary intake achieved the recommended nutritional guidelines and compared the intakes between both sexes. SUBJECTS/METHODS: The height, weight, and WC of four-hundred-and-ninety adults (n = 490) in Malaysia were measured using standard procedures. The three-day 24-hour dietary recalls were conducted on 422 out of the 490 adults and their dietary intakes were evaluated in detail. The selected dietary intake variables were used to determine the associations with the obesity indicators. RESULTS: Among the participants, 52.8% were overweight or obese. After data analysis, the mean energy intake was 1,550 kcal/day, in which male participants had a significantly higher energy and macronutrients intake than females. Protein consumption and its percentage of energy contribution exceeded the recommended range. The consumption of fruits, vegetables, and milk and milk products were lower than the recommended number of servings for a healthy diet. The male participants consumed significantly more servings of carbohydrate-based foods, meat, and fats, oils, and sweets than females. Among the selected dietary intake variables, only the carbohydrate intake was negatively associated with the BMI (Estimate b = -0.008) and WC measurements (Estimate b = -0.019) after adjusting for covariates. CONCLUSIONS: This study evaluated the dietary intakes of a sample of Malaysian adults and its association with the obesity indicators. The results highlight the need for improvements and modifications of the dietary intake of Malaysians to reduce the overweight and obesity rates.

The Interaction between Coffee: Caffeine Consumption, UCP2 Gene Variation, and Adiposity in Adults-A Cross-Sectional Study.

BACKGROUND: Coffee is suggested as an alternative option for weight loss but the relationship between coffee consumption and adiposity in population-based studies is still controversial. Therefore, this study was aimed at evaluating the relationship between coffee intake and adiposity in adults and to test whether uncoupling protein 2 (UCP2) gene variation was able to affect this relationship. METHODS: This was a cross-sectional study conducted in male and female adults living in the urban area of Yogyakarta, Indonesia. Adiposity was determined based on body weight, body mass index (BMI), percent body fat, and waist and hip circumference. Data on coffee consumption and other dietary components were collected using a semiquantitative food frequency questionnaire along with other caffeine-containing beverages such as tea, chocolate, and other beverages. The -866 G/A UCP2 gene variation was analyzed using polymerase chain reaction-restriction fragment length polymorphism. The correlation between coffee intake and adiposity was tested using linear regression test with adjustment for sex, age, energy intake, table sugar intake, and total caffeine intake. RESULTS: In all subjects, coffee intake was inversely correlated with body weight (ß = -0.122, p=0.028), BMI (ß = -0.157, p=0.005), and body fat (ß = -0.135, p=0.009). In subjects with AA + GA genotypes, coffee intake was inversely correlated with body weight (ß = -0.155, p=0.027), BMI (ß = -0.179, p=0.010), and body fat (ß = -0.148, p=0.021). By contrast, in subjects with GG genotype, coffee intake was not correlated with body weight (ß = -0.017, p=0.822), BMI (ß = -0.068, p=0.377), and body fat (ß = -0.047, p=0.504). CONCLUSION: We showed that coffee intake was negatively correlated with adiposity, and this was independent of total caffeine intake. Additionally, we showed that the -866 G/A UCP2 gene variation influences the relationship between coffee intake and adiposity.

Dietary Inflammatory Index Score and Its Association with Body Weight, Blood Pressure, Lipid Profile, and Leptin in Indonesian Adults.

It was previously reported that dietary intake is an important trigger for systemic inflammation and one of the lifestyle factors for the development of cardiovascular diseases. The aim of this study was to evaluate the association between Dietary Inflammatory Index (DII) score and body weight, blood pressure, lipid profile and leptin in an Indonesian population. This was a cross-sectional study conducted in 503 Indonesian adults. The DII score was calculated based on data of 30 nutrients and food components. Anthropometric profile, blood pressure, lipid profile, and leptin were measured. The association of these variables with the DII score was analyzed. The DII score was not associated with body weight, body mass index (BMI), body fat, waist circumference, hip circumference, systolic and diastolic blood pressure, triglycerides, and high-density lipoprotein (HDL) (both unadjusted and after adjustment for covariates). However, plasma leptin concentration was significantly associated with the DII score (B = 0.096, p = 0.020). Plasma leptin also increased significantly across tertiles of the DII score (ANCOVA, p = 0.031). This positive association between the DII score and plasma leptin concentration suggests a role for the inflammatory properties of the diet in regulating adipose tissue inflammation.

The Gene-Lifestyle Interaction on Leptin Sensitivity and Lipid Metabolism in Adults: A Population Based Study.

BACKGROUND: Obesity has been associated with leptin resistance and this might be caused by genetic factors. The aim of this study was to investigate the gene-lifestyle interaction between -866G/A UCP2 (uncoupling protein 2) gene polymorphism, dietary intake and leptin in a population based study. METHODS: This is a cross sectional study conducted in adults living at urban area of Yogyakarta, Indonesia. Data of adiposity, lifestyle, triglyceride, high density lipoprotein (HDL) cholesterol, leptin and UCP2 gene polymorphism were obtained in 380 men and female adults. RESULTS: UCP2 gene polymorphism was not significantly associated with adiposity, leptin, triglyceride, HDL cholesterol, dietary intake and physical activity (all p > 0.05). Leptin was lower in overweight subjects with AA + GA genotypes than those with GG genotype counterparts (p = 0.029). In subjects with AA + GA genotypes there was a negative correlation between leptin concentration (r = -0.324; p < 0.0001) and total energy intake and this correlation was not seen in GG genotype (r = -0.111; p = 0.188). CONCLUSIONS: In summary, we showed how genetic variation in -866G/A UCP2 affected individual response to leptin production. AA + GA genotype had a better leptin sensitivity shown by its response in dietary intake and body mass index (BMI) and this explained the protective effect of A allele to obesity.

Accelerometer-Measured Physical Activity and its Relationship with Body Mass Index (BMI) and Waist Circumference (WC) Measurements: A Cross-Sectional Study on Malaysian Adults

Introduction: Physical activity has been shown to be beneficial for the prevention of obesity and non-communicable diseases. Our contemporary way of life that is technology dependent has significantly reduced physical activity. This study aimed to determine accelerometer-measured physical activity (moderate-to-vigorous physical activity (MVPA)) among adults in high and low walkability neighbourhoods in Penang and Kota Bharu, Malaysia. Methods: Participants (n=490) were sampled using multistage sampling method from neighbourhoods with varied levels of walkability using Geographical Information System (GIS). Physical activity was measured objectively using Actigraph GT3X+ accelerometers, worn by the participants on their waists for a period of 5 to 7 days. Results: The participants had a mean of 13.5 min/day of MVPA. Total MVPA was significantly higher among participants in high walkability neighbourhoods (19.7 min/day vs. 9.1 min/ day). Results from t-test showed that the time spent on MVPA per day was significantly lower among participants residing in low walkability neighbourhoods. The final model of the MIXED model statistical tests showed that total MVPA was significantly associated with BMI, but not with WC measurements, after adjusting for covariates. Conclusion: Most of the participants had very low MVPA and did not achieve the current physical activity recommendations, implying that Malaysian adults residing in these two cities were not physically active to achieve health benefits. Results are suggestive of the importance of the walkability concept in neighbourhoods in encouraging physical activity and healthy body weight among Malaysians.