Is fast-food consumption a problem among adolescents in Malaysia? An analysis of the National School-Based Nutrition Survey, 2012.

BACKGROUND: Fast-food consumption is an unhealthy dietary behaviour because it increases the risk of diet-related chronic diseases. We aimed to investigate factors associated with fast-food consumption, namely sociodemographic characteristics, body mass index-for-age, meal away from home habit, and intake of various food groups among adolescents in Malaysia. METHODS: We analysed data from the National School-Based Nutrition Survey (NSNS). The NSNS was a nationwide, cross-sectional survey. Multiple-stage stratified cluster random sampling method was applied to obtain a representative sample of adolescents' population. This study recruited adolescents aged 10-18 years who were attending schools. Pre-tested self-administered questionnaires in Malay language were used to obtain relevant information. Frequency of fast-food consumption per week was classified into three groups: "consumed fast-food four to seven days", "consumed fast-food one to three days", and "did not consume fast-food". Intake of food groups was assessed by self-administered food frequency questionnaire. Descriptive and complex sample multinomial logistic regression analyses were performed in data analysis. RESULTS: A total of 26,383 from 40,012 selected adolescents completed all the relevant questions for this study. Of those surveyed, 13.5% of the respondents consumed fast-food 4 to 7 days, 69.3% of the respondents consumed fast food 1 to 3 days, and 17.2% of them did not consume fast-food in a typical week. Frequency of fast-food consumptions (4 to 7 days and 1 to 3 days per week) was significantly associated with age; sex; ethnicity; locality of schools; frequency of eating out; and not consuming recommended intake of cereals or grains, vegetables, and meat or poultry or eggs. CONCLUSION: In conclusion, age; sex; ethnicity; locality of schools; frequency of eating out per week; imbalanced intake of cereals or grains, meat, or poultry or eggs; and inadequate vegetable intake were significantly associated with fast-food consumption among adolescents in Malaysia. The findings of this study will be useful for policy makers in promoting healthy food choices among adolescents in Malaysia.

Prevalence and factors associated with secondhand smoke exposure among Malaysian adolescents.

INTRODUCTION: Exposure to secondhand smoke (SHS) has been proven to be detrimental to health. However, there is little information on SHS exposure among Malaysian adolescents. This study aims to assess the magnitude of and factors associated with SHS exposure among school-going adolescents in Malaysia. METHODS: We performed secondary analysis on data from 25461 respondents of the Global School Health Survey in Malaysia. Descriptive analyses and multivariable logistic regression were performed to determine factors associated with SHS exposure. RESULTS: Respondents were adolescents of mean age 14.84 (SD=1.45) years, 50.2% of which were male and 49.8% female. Approximately four in ten respondents were exposed to SHS in the past week (41.5%). SHS exposure was significantly higher among respondents who smoked than among non-smokers (85.8% vs 35.7%, p<0.001). The likelihood of exposure to SHS was higher among smoking adolescents (Adjusted OR=1.66, 95% CI: 1.07-2.56) and non-smoking adolescents (AOR=3.15, 95% CI: 1.48-4.71) who had at least one smoking parent/guardian regardless of their own smoking status. Male adolescents had higher risk of SHS exposure compared to their female counterparts (current smoker AOR=1.66, 95% CI: 1.07-2.56; non-smoker AOR=1.50, 95% CI: 1.12-2.00) and increased with age, regardless of their smoking status. CONCLUSIONS: Our findings suggest that prevalence of exposure to SHS among school-going adolescents in Malaysia is high. Parents should be advised to stop smoking or abstain from smoking in the presence of their children. Education programmes are recommended to increase awareness on avoidance of SHS as well as smoking cessation interventions for both adolescents and their parents.

Sociodemographic factors associated with multiple cardiovascular risk factors among Malaysian adults.

BACKGROUND: To determine the prevalence and sociodemographic correlates of multiple risk factors for cardiovascular disease (CVD) among Malaysian adults. METHODS: We analysed data on 1044 men and 1528 women, aged 24-64 years, participants in the Non Communicable Disease Surveillance 2005/2006, a nationally representative, population-based, cross-sectional study. Prevalence of obesity, high blood pressure, dyslipidaemia, hyperglycemia, physical inactivity, smoking, risky drinking, low vegetable and fruit intake were determined and multivariable logistic regression was used to identify sociodemographic factors associated with having ≥3 of these cardiovascular disease risk factors. RESULTS: The response rate was 84.6% (2572/3040). Overall, 68.4% (95% CI: 63.2, 73.1) had at least three risk factors. Among men, older age and Indian ethnicity were independently associated with having ≥3 CVD risk factors; while among women, older age, low education, and housewives were more likely to have ≥3 CVD risk factors. CONCLUSION: The prevalence of cardiovascular risk factors clustering among Malaysian adults is high, raising concerns that cardiovascular disease incidence will rise steeply in the near future if no immediate preventive measures are taken. The current national health education and promotion programmes pertaining to modifiable risk factors can be further improved by taking into account the sociodemographic variation in CVD risk factors clustering.

Prevalence and factors associated with physical inactivity among Malaysian adults.

Using data from the Third National Health and Morbidity Survey (NHMS III) in 2006, this study examined the association between socio-demographic factors and physical inactivity in a sample of 33,949 adults aged 18 years and above by gender. Physical activity levels were measured using the Global Physical Activity Questionnaire (GPAQ vers 1). Physical inactivity was defined as having a total physical activity level of less than 600 metabolic equivalents-minutes per week (METs-minutes/week) contributed by all three different life domains.Logistic regression analyses were conducted.The prevalence of overall physical inactivity was 43.7% (95% CI: 42.9-44.5). The mean total physical activity level was 894.2 METs-minutes/ week. The means METs-minutes/week for the domain of work, travelling, and leisure time were 518.4, 288.1, and 134.8, respectively. Multivariable logistic regression analyses indicated that females were more likely to be physically inactive than males were (aOR=1.62; 95% CI: 1.53-1.72). Among women, being a housewife (aOR = 1.78; 95% CI: 1.56-2.03), widow/divorcee (aOR = 1.23; 95% CI: 1.05-1.43), and those with no formal education (aOR = 1.20; 95% CI: 1.01-1.43) were found to be significantly associated with physical inactivity.Urban residents, older adults aged 65 years and above, private employees, nonworking group, and those with a monthly household income level of MYR5,000 and above appeared to be consistently associated with physical inactivity across men, women, and combined group (both). Specific health intervention strategies to promote physical activity should be targeted on population subgroups who are inactive.

Prevalence and factors associated with smoking intentions among non-smoking and smoking adolescents in Kota Tinggi, Johor, Malaysia.

Intention to smoke is a valid and reliable factor for predicting future smoking habits among adolescents. This factor, however, has received inadequate attention in Malaysia. The present paper elaborates the prevalence and factors associated with intent to initiate or to cease smoking, among adolescent nonsmokers and smokers in Kota Tinggi, Johor, Malaysia. A total of 2,300 secondary school students aged 13-16 years were selected through a two-stage stratified sampling method. A set of standardized questionnaires was used to assess the smoking behavior among adolescents and the inter-personal and intra-personal factors associated with smoking intention (intention to initiate smoking or to cease smoking). Multivariable logistic regression was used to identify factors related to smoking intention. The prevalence of intention to smoke in the future or to cease smoking among non- smoking adolescents and current smokers were 10.7% and 61.7% respectively. Having friends who smoke, social influence, and poor knowledge about the ill effects on health due to smoking showed significant relationships with intention to smoke in the future among non-smokers. Conversely, perceived lower prevalence of smoking among peers, weak contributory social influence, and greater awareness of the ill effects of smoking are factors associated with the intention to cease smoking sometime in the future. The study found that prevalence of intention to initiate smoking is low among non-smokers while the majority of current smokers intended to cease smoking in the future. Existing anti-smoking programmes that integrate the factors that have been identified in the current study should be put in motion to reduce the prevalence of intention to initiate smoking and increase the intention to cease smoking among adolescents.

Prevalence, awareness, treatment and control of Hypertension among the elderly: the 2006 National Health and Morbidity Survey III in Malaysia.

INTRODUCTION: The objective of this study was to determine the prevalence and factors associated with the awareness, treatment and control of hypertension among the elderly population in Malaysia. METHODS: Analysis of secondary data from a cross-sectional national population based survey using stratified multistage sampling conducted from April to August 2006 throughout Malaysia National Health and Morbidity Survey III(NHMS III). Adults aged 60 and older who had participated in the survey were included in the study. RESULTS: A total of 4954 respondents (14.3%) were elderly from the 34,539 respondents aged 18 years and above for hypertension module in NHMS III. A total of 4933 elderly had their blood pressure examined (giving a response rate of 99.6%). The overall prevalence of hypertension among elderly was 74.0%, more in elderly female (77.4%) than men (70.1%). Only 49.3% of them were aware of their hypertensive status, 42.4% were currently treated and 22.6% of those being treated were under control. The results of multiple logistic regression showed factors associated with higher awareness and treatment rates were similar i.e. females, young-old age group (age 60-74), urban residents, Chinese ethnic group and higher education. For those elderly who were on treatment, determinants associated with controlled hypertension were Chinese and Indians ethnic groups and higher educational level. CONCLUSIONS: There was a high prevalence of hypertension among the elderly in Malaysia but with poor awareness, treatment and control rate. Reliable information on these aspects is important for the development of patient education programs, health policies to improve disease management and overall health care resource allocation especially among the elderly in Malaysia.

Non-practice of breast self examination and marital status are associated with delayed presentation with breast cancer.

Delay in seeking treatment for breast cancer is a barrier to the early diagnosis and management of the disease, resulting in a poorer prognosis. We here estimated the prevalence of delayed presentation for breast cancer and identified possible influential sociodemographic factors in a cross-sectional study of 250 patients diagnosed with primary breast cancer at the Radiotherapy and Oncology Clinic in Kuala Lumpur Hospital. Data were collected by face-to-face interview using a structured questionnaire and from medical records. We examined associations between delayed presentation (presenting to a physician more than 3 months after self-discovery of a symptom) and sociodemographic characteristics, practice of breast self examination (BSE), history of benign breast disease, family history of breast cancer and type of symptom, symptom disclosure and advice from others to seek treatment using multiple logistic regression. Time from self-discovery of symptom to presentation ranged from tghe same day to 5 years. Prevalence of delayed presentation was 33.1% (95%CI: 27.4, 39.3). A significantly higher proportion of delayers presented with late stages (stage III/IV) (58.3% vs. 26.9%, p<0.001). Divorced or widowed women (OR: 2.23, 95% CI: 1.11, 4.47) had a higher risk of delayed presentation than married women and women who never performed breast self examination were more likely to delay presentation compared to those who regularly performed BSE (OR: 2.74, 95% CI: 1.33, 5.64). Our findings indicate that delayed presentation for breast cancer symptoms among Malaysian women is high and that marital status and breast self examination play major roles in treatment-seeking for breast cancer symptoms.

Correlates of susceptibility to smoking among secondary school students in Kota Tinggi district, Johor, Malaysia.

BACKGROUND: Smoking among adolescents has been linked to a variety of adverse and long term health consequences. "Susceptibility to smoking" or the lack of cognitive commitment to abstain from smoking is an important predictor of adolescent smoking. In 2008, we conducted a study to determine the psycho-sociological factors associated with susceptibility to smoking among secondary school students in the district of Kota Tinggi, Johor. MATERIALS AND METHODS: Two thousand seven hundred students were randomly selected by proportional stratified sampling. Analyses on 1,736 non-smoking students revealed that prevalence of adolescents susceptible to smoking was 16.3%. RESULTS: Male gender (aOR=2.05, 95%CI= 1.23-3.39), poor academic achievement (aOR 1.60, 95%CI 1.05-2.44), ever-smoker (aOR 2.17, 95%CI 1.37-3.44) and having a smoking friend (aOR 1.76, 95%CI 1.10-2.83) were associated with susceptibility to smoking, while having the perception that smoking prohibition in school was strictly enforced (aOR 0.55, 95%CI 0.32-0.94), and had never seen friends smoking in a school compound (aOR 0.59, 95%CI 0.37-0.96) were considered protective factors CONCLUSIONS: These results indicate that follow-up programmes need to capitalise on the modifiable factors related to susceptibility to smoking by getting all stakeholders to be actively involved to stamp out smoking initiation among adolescents.

Prevalence, awareness, treatment and control of Hypertension among the elderly: the 2006 National Health and Morbidity Survey III in Malaysia

The objective of this study was to determine the prevalence and factors associated with the awareness, treatment and control of hypertension among the elderly population in Malaysia.