Food insecurity, eating behaviour, and relative weight change among young adults in the aftermath of the COVID-19 lockdown.

This study aims to investigate the association between food insecurity, eating behaviour and relative weight change among Malaysian young adults in the aftermath of the pandemic-led lockdown. Socio-demographics, body height, and body weight were self-reported by the young adults. Food security was assessed using the 8-item validated Food Insecurity Experience Scale (FIES), while the Three-Factor Eating Questionnaire-Revised 18-item (TFEQ-R18) was adopted to evaluate the eating behaviour of young adults. Of the 447, 45.9% maintained the same body weight as before the pandemic-led lockdown. While almost half of the young adults (47.2%) were food secure, about one-fourth (24.8%) suffered moderate-to-severe food insecurity. Meanwhile, the standardised raw scores for all the eating behaviour subscales were in the ascending order of cognitive restraint (49.37 ± 18.60) < uncontrolled eating (50.61 ± 20.37) < emotional eating (50.68 ± 24.50). The findings of the Sobel test indicated that the mediation effects of eating behaviour were not statistically significant (p > 0.05), suggesting that eating behaviour (cognitive restraint, uncontrolled eating and emotional eating) did not mediate the relationship between moderate-to-severe food insecurity and relative weight change. Health promotion interventions such as introducing food assistance programs, offering incentives for nutritious food purchases, and re-emphasising healthy eating are essential to rectify food insecurity and disordered eating among Malaysians.

Major dietary patterns in the United Kingdom Women's Cohort Study showed no evidence of prospective association with pancreatic cancer risk.

Diet is a modifiable risk factor for pancreatic cancer. We hypothesized that specific dietary patterns would increase/decrease pancreatic cancer risk. We evaluated the association of dietary patterns with pancreatic cancer risk in the UK Women's Cohort Study. Dietary patterns were assessed at enrollment using: (1) self-reported practice of vegan/vegetarian dietary habits, (2) diet quality indices (World Health Organization Healthy Diet Indicator and Mediterranean Diet Score), and (3) principal component analysis-derived dietary patterns. The association of dietary patterns with pancreatic cancer incidence was quantified using Cox regression survival analysis. Over a median follow-up of 19 years of 35,365 respondents, there were 136 incident cases of pancreatic cancer. No association between dietary habits/quality and pancreatic cancer incidence was evident after adjustments (hazard ratio (95% confidence interval): self-reported omnivores vs vegan/vegetarian dietary habit: 1.13 (0.73-1.76); per-unit increase in World Health Organization Healthy Diet Indicator scores: 0.99 (0.91-1.09); per-unit increase in Mediterranean Diet Score: 0.92 (0.83-1.02). Similarly, no association of principal component analysis-derived dietary patterns with pancreatic cancer risk was evident ("prudent:" 1.02 [0.94-1.10]; ``meat-based:'' 1.00 [0.92-1.09]; ``fast-food, sugar-sweetened beverages, and carbohydrate-rich snacks:'' 0.96 [0.86-1.07]; ``cereal and dairy-rich:'' 1.04 [0.94-1.16], and ``low-diversity and lowfat:'' 1.00 [0.89-1.13]). In this prospective cohort of women, several major dietary patterns were of poor quality. There was no evidence of a prospective association between any of the dietary patterns explored and pancreatic cancer incidence.

Do Right, Be Bright: A Protocol on the Development of an Inter-Professional Health Intervention Model for Pre-School Children Through a Community-Based Service-Learning Initiative.

An inter-professional project with a collaborative endeavor between the programs of Dentistry, Nutrition and Medicine was carried out with the aim to emphasise oral health maintenance, making the right nutritional choices and effective hand washing among pre-school children. The purpose of this paper is to share a detailed description of the design, development process, implementation, and planned evaluation of an interprofessional school-based health promotion intervention model "Do Right, Be Bright". This model is part of a quasi-experimental study, targeting pre-school children as the "Targets of Change" through the empowerment of school teachers as the "Agents of Change". The program design was based on Bartholomew's Intervention Mapping Approach, which proposes a direction for developing a theory-based health promotion intervention and on the most extensively applied theories of health behavior, the Health Belief Model. Therefore, based on a thorough literature review and needs assessment, three key areas of needs were identified for the targeted preschool children: oral hygiene, hand hygiene and nutrition. The efficacy of this model will be pilot tested in a preschool in Kuala Lumpur Malaysia.

Association of Serum Beta-Carotene with Metabolic Risk Factors among a Work Cohort in Malaysia.

Metabolic syndrome (MetS) poses increased risks for non-communicable diseases, increasing all-cause mortality, disability, and healthcare costs. Beta-carotene as the major carotenoid is identified to play an important role in the pathophysiology of MetS. The present study aimed to investigate the association between serum beta-carotene levels with metabolic syndrome and metabolic risk factors among a cohort of teachers in Peninsular Malaysia. This cross-sectional study investigated a sub-sample of 645 serum samples which were randomly selected for beta-carotene determination. Socio-demographic, lifestyle and metabolic risk factors were measured following standard protocols. There were equal proportions of males and females, with majority Malays (69%) followed by the Chinese (24%) and Indians (6.5%). The prevalence of MetS was 24.8% with abnormal waist circumference and high blood pressure as the most commonly reported metabolic risk factors. The median serum beta-carotene was 5.15 (5.07) µmol/L. Serum beta-carotene in the lowest quartile (Q1) was found to be significantly associated with MetS (OR: 5.81; 95% CI: 2.96, 11.38) and metabolic risk factors, namely triglycerides (OR: 6.38; 95% CI: 3.04, 13.35), fasting blood sugar (OR: 3.32; 95% CI: 1.48, 7.43), HDL-cholesterol (OR: 2.88; 95% CI: 1.58, 5.26) and waist circumference (OR: 2.94; 95% CI: 1.73, 5.01), after adjusted for potential confounders. In summary, participants with lower serum beta-carotene had higher odds for MetS and the above-mentioned metabolic risk factors.

Knowledge, attitudes, and practices towards COVID-19 among undergraduates during emergency remote learning.

Background: The coronavirus disease 2019 (COVID-19) pandemic paralyzes the education sector. To minimize the interruption of teaching and learning, most universities in Malaysia shifted to virtual mode during this unprecedented period of the pandemic. With an ever-increasing number of Malaysians fully vaccinated against COVID-19, the education system is expected to switch back to face-to-face mode this year. It is crucial to assess the knowledge, attitudes, and practices (KAP) of COVID-19 among emergency remote learning undergraduates before reverting to physical teaching and learning. Hence, a study was conducted with this aim in mind. Methods: A total of 299 Malaysian undergraduates were recruited through a snowball sampling approach. The online questionnaire encompassed three main segments: informed consent, sociodemographic information, and KAP questions on COVID-19. Results: The mean scores for knowledge, attitude, and practice were 4.05/6, 11.14/12, and 5.07/7, respectively. The results of the present study showed that year 1 respondents had significantly higher levels (p < 0.05) of KAP scores than year 4 respondents. In addition, the attitude score of science majors respondents was significantly greater (p < 0.05) than those of nonscience majors. The KAP scores showed no significant difference among groups with different sexes, ethnicities, and COVID-19 histories. Partial correlation analysis revealed that the overall knowledge score was positively correlated with attitude (r = 0.193, p = 0.001) and practice (r = 0.343, p < 0.001) scores whereas the total attitude score was positively correlated with the total practice score (r = 0.149, p = 0.010). Conclusion: Our current results suggest that COVID-19 workshops, seminars, or training programs for year 4 students could be conducted to enhance their KAP levels.

Changes in Dietary Intake Patterns and Weight Status during the COVID-19 Lockdown: A Cross-Sectional Study Focusing on Young Adults in Malaysia.

INTRODUCTION: The coronavirus disease 2019 (COVID-19) isolation has altered individuals' food purchasing behaviour and dietary intake patterns. Therefore, this study aims to investigate the changes in dietary intake patterns and their impacts on the weight status of young adults in Malaysia during the COVID-19 lockdown. METHODS: This cross-sectional study involved 1045 young adults in Malaysia. The changes in dietary intake patterns were assessed using the Dietary Diversity Questionnaire with slight modifications, while anthropometric measurements including body height, body weight before the pandemic and current body weight were self-reported. RESULTS: Overall, nearly half of the respondents (48.8%) gained weight during the confinement, with an average increment of 4.06 ± 3.23 kg. Of 1045, 45.3% reported consuming more fruits and 60.2% had higher plain water intake during the pandemic. It is observed that 41.0% to 66.8% of the young adults changed their dietary intake patterns during the pandemic. Increased consumption in cereals and grains (ß = 0.084, p = 0.015, 95% CI = 0.017-0.160), as well as oils and fats (ß = 0.123, p = 0.001, 95% CI = 0.059-0.241), was positively associated with weight gain during the pandemic. On the contrary, an increased plain water intake was negatively associated with weight gain during the lockdown (ß = -0.100, p = 0.003, 95% CI = -0.171--0.034). Findings in the current study also suggested that cutting back cereals and grains (ß = 0.156, p < 0.001, 95% CI = 0.122-0.288), as well as oils and fats (ß = 0.091, p = 0.012, 95% CI = 0.022-0.183), contributed significantly to weight loss during the pandemic confinement. CONCLUSION: In conclusion, the enforcement of the Movement Control Order (MCO) drove up the prevalence of overweight/obesity among young adults in Malaysia. Increased consumption of cereals and grains and oils and fats contributed to weight gain in the pandemic lockdown. Nonetheless, a noticeable proportion of young adults in Malaysia shifted to a healthier food choice by increasing the consumption of fruits and vegetables.

Food security during the COVID-19 home confinement: A cross-sectional study focusing on adults in Malaysia.

The surge in coronavirus disease 2019 (COVID-19) transmission cases has led to the decision to execute the Movement Control Order (MCO) by the Federal Government of MalaysiaEconomic activities, psychological wellbeing, and food security may be negatively affected by the implementation of MCO. Therefore, this study aims to assess the prevalence of food insecurity and its associated factors during the enforcement of MCO 1.0. A total of 162 respondents were enrolled in this study using convenience and snowball sampling approaches. Socio-demographic information was self-reported by the respondents. Food security and the presence of depressive symptoms during the MCO 1.0 were assessed with Food Insecurity Experience Scale (FIES) and Patient Health Questionnaire-2 (PHQ-2), respectively. Current findings demonstrated that the prevalence of food insecurity was 43.2%. Ethnicity, marital status, employment status, monthly earned income and being the head of a household were significantly associated (p< 0.05) with food insecurity during the MCO 1.0. A higher odds ratio for food insecurity were observed among Malaysian Indian (OR = 2.541, CI: 1.041-6.205), those with active employment during the MCO 1.0 (OR = 4.175, CI: 1.189-14.660) and those with a monthly income of less than RM4000 during the MCO 1.0 (OR = 5.396, CI: 1.362-21.838). In conclusion, policymakers are urged to pay more attention to these vulnerable populations when formulating economic stimulus plans and coping strategies for food insecurity in the post-COVID-19 era.

Eating Behaviors among Online Learning Undergraduates during the COVID-19 Pandemic.

The outbreak of Coronavirus Disease-2019 (COVID-19) has upended education systems. The pandemic switched traditional face-to-face classes to online classes. Poor eating behaviors in undergraduate students' lives may affect the well-being of their later stages of life. This study aimed to investigate the eating behaviors among online learning undergraduates during the COVID-19 pandemic. A total of 122 students were recruited. The results revealed more than half of the respondents (52.46%) skipped meals. Breakfast (46.72%) was the most skipped meal. The majority of the respondents (94.26%) snacked between meals. Biscuits (88.52%), bread (84.43%), and fruits (80.33%) were the most common snacked foods. Meal skipping was found to be associated with gender (χ2 = 6.83, p < 0.05). In the future, more health interventions program aimed to promote healthy eating behaviors among undergraduates are highly warranted.

Trajectories of Food Choice Motives and Weight Status of Malaysian Youths during the COVID-19 Pandemic.

Stay-at-home orders have abruptly altered food purchasing behaviour, dietary habits, and food choice motives. Therefore, this study aims to investigate the trajectory of food choice motives and their associations with the weight status of Malaysian youths in the time of COVID-19. Socio-demographic information and anthropometric measurements were self-reported by the respondents, while the food choice motives were assessed using a validated 38-item food choice questionnaire (FCQ). Of the 1013 Malaysian youths, 48.6% gained weight due to the confinement, with an average weight gain of 3.90 ± 2.92 kg. On the other hand, 47.0% to 73.0% of the youths changed their food choice motives in the time of COVID-19. Of the 10 motives, convenience (48.5%) had the largest percentage increase, followed by weight control (47.0%) and health (45.3%). Moreover, the mean scores of health (t = -3.324, p = 0.001), convenience (t = -5.869, p < 0.001), weight control (t = -7.532, p < 0.001), natural content (t = -5.957, p < 0.001), ethical concern (t = -4.419, p < 0.001) and price (t = -3.737, p < 0.001) were significantly higher during the pandemic compared to pre-pandemic. Findings from the multinomial regression model revealed that youths highly concerned for weight control were more likely to be in the weight loss category (Adjusted odds ratio (AOR) = 1.633, Confidence Interval (CI) = 1.230-2.168, p = 0.001). Conversely, those who gained weight due to the pandemic confinement highly valued natural content in foods (AOR = 0.653, CI = 0.481-0.886, p = 0.006) when making their food choices in this unprecedented pandemic. In conclusion, Malaysian youths made healthier food choices to mitigate the risk of COVID-19 infection.

Physical Activity, Sedentary Behavior, and Weight Status of University Students during the COVID-19 Lockdown: A Cross-National Comparative Study.

The temporary closure of learning institutions during the COVID-19 pandemic has dramatically reduced the physical activity of students across all ages. Therefore, this study aimed to investigate the prevalence of physical inactivity and the patterns of physical activity among university students in confinement. This cross-sectional study involved 147 Malaysian students and 107 Indonesian students. Body weight before the pandemic and during the pandemic was self-reported by the respondents, and the International Physical Activity Questionnaire-Short Form (IPAQ-SF) was used to assess the physical activity and sedentary behavior of the respondents. The findings revealed that 79.6% of Malaysians and 77.6% of Indonesians were physically active during the confinement. There was no significant difference (p < 0.05) in the duration devoted to vigorous-intensity activity (MMalaysian = 0.00 MET minutes/week and MIndonesian = 480.00 MET minutes/week) and moderate-intensity activity (MMalaysian = 0.00 MET minutes/week and MIndonesian = 0.00 MET minutes/week) among the studied population. During the pandemic, Malaysian students (M = 1386.00 MET minutes/week) devoted a significantly higher duration to walking (M = 1386.00 MET minutes/week) and sedentary behavior (9.16 ± 4.47 h/day) than Indonesian students (M = 990.00 MET minutes/week and sedentary behavior = 7.85 ± 4.27 h/day). Overall, no significant difference was noted in the total physical activity of Malaysian and Indonesian students during the pandemic (MMalaysian = 2826.00 MET minutes/week and MIndonesian = 1782.00 MET minutes/week). Findings from Spearman's rank correlation test suggested that there was a weak inverse correlation between the duration engaged in vigorous-intensity activity and weight change among the Malaysian students (rs = -0.199, p = 0.016), after adjusting for gender and age. Overall, the closure of learning institutions and exercise facilities has further prevented individuals from complying with the WHO recommendation of moderate-to-vigorous physical activity during the period of home confinement.

Traditional and Novel Adiposity Indicators and Pancreatic Cancer Risk: Findings from the UK Women's Cohort Study.

(1) Background: We studied the association of both conventional (BMI, waist and hip circumference and waist-hip ratio) and novel (UK clothing sizes) obesity indices with pancreatic cancer risk in the UK women's cohort study (UKWCS). (2) Methods: The UKWCS recruited 35,792 women from England, Wales and Scotland from 1995 to 1998. Cancer diagnosis and death information were obtained from the National Health Service (NHS) Central Register. Cox's proportional hazards regression was used to evaluate the association between baseline obesity indicators and pancreatic cancer risk. (3) Results: This analysis included 35,364 participants with a median follow-up of 19.3 years. During the 654,566 person-years follow up, there were 136 incident pancreatic cancer cases. After adjustments for age, smoking, education and physical activity, each centimetre increase in hip circumference (HR: 1.03, 95% CI: 1.01-1.05, p = 0.009) and each size increase in skirt size (HR: 1.12, 95% CI: 1.02-1.23, p = 0.041) at baseline increased pancreatic cancer risk. Baseline BMI became a significant predictor of pancreatic cancer risk (HR: 1.04, 95% CI: 1.00-1.08, p = 0.050) when latent pancreatic cancer cases were removed. Only baseline hip circumference was associated with pancreatic cancer risk (HR: 1.03, 95% CI: 1.00-1.05, p = 0.017) when participants with diabetes at baseline were excluded to control for reverse causality. (4) Conclusion: Hip circumference and skirt size were significant predictors of pancreatic cancer risk in the primary analysis. Thus, hip circumference is useful to assess body shape relationships. Additionally, standard skirt sizes offer an economical and objective alternative to conventional obesity indices for evaluating pancreatic cancer risk in women.

Temporal Changes in Breast Milk Fatty Acids Contents: A Case Study of Malay Breastfeeding Women.

The composition of human breast milk changes in the first two months of life, adapting itself to the evolving needs of the growing new-born. Lipids in milk are a source of energy, essential fatty acids (FA), fat-soluble vitamins, and vital bioactive components. Information on breast milk FA of Malaysian lactating women is scarce. Based on convenience sampling, a total of 20 Malay breastfeeding women who fulfilled the inclusion criteria were recruited. Breast milk was collected three times from each subject at consecutive intervals of 2-3 weeks apart. A total of 60 breast milk samples were collected and classified into "transitional milk" (n = 8), "early milk" (n = 26) and "mature milk" (n = 26). All milk samples were air freighted to University of Groningen, Netherlands for analysis. The dominant breast milk FA were oleic acid, constituting 33% of total fatty acids, followed by palmitic acid (26%). Both these FA and the essential FA, linoleic acid (10%) and alpha-linolenic acid (0.4%), showed no significant changes from transitional to mature milk. Breast milk ratio of n-6:n-3 polyunsaturated fatty acids (PUFA) was comparatively high, exceeding 10 throughout the lactation period, suggesting a healthier balance of PUFA intake is needed in pregnancy and at postpartum.