ABSTRACT

Introduction: Chronic exposure to aflatoxin can lead to complications such as liver failure and cancer. There are many factors that affect aflatoxin occurrence. This study aimed to assess the association between sociodemographic factors and the knowledge, attitude and practice towards aflatoxin with urinary aflatoxin M1 occurrence among residents in Hulu Langat district, Malaysia.
Methods: This was a cross-sectional study conducted among healthy Malaysian adults aged 18 to 60 years residing in Hulu Langat district, Malaysia. Socio-demographic background and the knowledge, attitude and practice of respondents towards aflatoxin were assessed through questionnaires. Non-fasting urine sample (15 ml) was collected in the morning and urinary aflatoxin M1 level was quantified.
Results: Of the 444 healthy Malaysian adults, 199 urine samples were detected with aflatoxin M1. From 37 positive samples with aflatoxin M1 level above detection limit (0.64 ng/ml), mean value was 1.23±0.91 ng/ml (range = 0.65-5.34 ng/ml). Urinary aflatoxin M1 occurrence was significantly different across ethnicity, age group, monthly household income, attitude and practice towards aflatoxin. Binomial logistic regression confirmed ethnicity and monthly household income as factors contributing to urinary aflatoxin M1 occurrence. Chinese were 3.20 times more likely to have aflatoxin exposure than non-Chinese. Detected urinary aflatoxin M1 was more common among household with a monthly income above RM1,500.
Conclusion: The results provided an insight to explain the variation in aflatoxin occurrence among the population.
Key words: aflatoxin, attitude, ethnicity, household income, practice

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ABSTRACT

Introduction: Malaysians are exposed to a high salt diet, which is one of the contributors to the prevalence of hypertension among them. This study aimed to identify the salt content in selected food products of fast food restaurants and to determine the salt intake awareness among fast food consumers.
Methods: Salt content data were collected through online survey from the official websites of selected restaurants (Kentucky Fried Chicken, McDonald’s, Subway® and Texas Chicken). The food products were classified into eight food categories (chickenbased, potato-based, rice-based, sandwich, salad, bread, dessert, and sauce). The cross-sectional study on salt intake awareness was conducted among 108 Malaysian adults from these restaurants. A knowledge, attitude and practice (KAP) questionnaire was disseminated online. The salt content and the consumers’ salt intake awareness were analysed using Statistical Products and Service Solution (SPSS) software version 25.0.
Results: A total of 105 food products were surveyed in this study. Sauce products contained the highest salt content (1.9±0.8 g/100g), followed by bread (1.2±0.3 g/100g), potato-based (1.2±0.4 g/100g), chicken-based (1.2±0.3 g/100g), sandwich (1.1±0.6 g/100g), rice-based (0.7±0.3 g/100g), salad (0.4±0.2 g/100g), and dessert (0.3±0.4 g/100g). For the KAP study, a total of 108 consumers had participated and mostly (48.2%) had a fair level of salt intake awareness.
Conclusion: Most food products of fast food restaurants contained high salt content and majority of fast food consumers had a fair level of salt intake awareness. More strategic interventions are needed to control the salt intake among adults in Malaysia.
Key words: salt, sodium chloride, fast foods, awareness

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Introduction: Elderly population is more likely to suffer from malnutrition, thereby requiring appropriate nutrition education as part of nutrition intervention to overcome this issue. This review aims to identify content suitable for developing a nutrition resource kit that provides nutritional guidance to combat malnutrition among malnourished and at-risk elderly in health clinics setting, particularly in Malaysia.
Methods: A literature search was conducted up to 15th December 2019 in four databases: PubMed, Scopus, COCHRANE, and ProQuest Health & Medical Collection. Potential literature on nutrition education, suitable dietary guidelines and existing educational materials for elderly in the community, in English and Malay languages, were searched to identify suitable content for the nutrition resource kit. All relevant documents were included based on inclusion and exclusion criteria. Data were extracted and analysed according to the PRISMA-ScR guidelines.
Results: A total of 27 documents consisting of articles, printed materials and guidelines were included for analysis. Suitable content included information related to malnutrition such as definition, signs and symptoms, cause-consequences, and nutrition management, which included food plate, serving size, menu suggestion, examples of recipes, tips to increase energy and protein intakes through food or drink, texture modification, a guide to using oral nutritional supplements, tips for maintaining nutrient content in food and drink, tips to encourage to eat, and oral health.
Conclusion: A nutrition resource kit tailored for malnourished and at-risk elderly would be a beneficial nutrition intervention. There is a need to incorporate these information in the development of a nutrition resource kit to improve their dietary intake.
Key words: malnutrition, elderly, community, nutrition education, scoping review

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Introduction: Stunting is the most prevalent form of child malnutrition worldwide, and is the best overall indicator of growth. This study aimed to determine the relationship between maternal characteristics and nutritional status of children aged 0-23 months based on their length/height-for-age.
Methods: The study used data from the 2015 Updating Survey conducted by the Philippines’ Food and Nutrition Research Institute – Department of Science and Technology. It employed a stratified multi-stage sampling technique covering all regions in the Philippines. Mothers (n=5,254) of sampled children 0-23 months were the respondents of the Maternal Health and Nutrition survey. The length-for-age z-scores (LAZ) of children and maternal characteristics were analysed. Rao-Scott Chi-square test was used for association analysis. Logistic regression was performed for model fitting.
Results: A quarter (25.2%) of children aged 0-23 months in the Philippines at the time of the survey were stunted, with the highest prevalence (36.2%) observed among 12-23 months. Children being stunted or normal in height was associated with prenatal services, maternal nutritional status, education, and duration of lactation. Maternal education (OR: 0.39; p=0.012), age-appropriate breastfeeding (OR: 0.63; p=0.042), and prenatal services like tetanus toxoid vaccination (OR: 0.67; p=0.011) and ultrasound (OR: 0.71; p=0.025) lowered the likelihood of a child being stunted.
Conclusion: It is recommended to strengthen and intensify service delivery among pregnant and lactating women because of the implication of maternal factors to the length-for-age status of children 0-23 months.
Key words: stunting, maternal factors, length-for-age, education, young children

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Introduction: The Janani Shishu Suraksha Karyakram (JSSK) is a government of India initiative for all pregnant women visiting public health facilities, with many free entitlements – free diet being one. After an in-depth study of existing dietary provisions in all community health centres, an elaborate cyclic-weekly nutritious menu was designed taking into consideration the latest recommendations (2019) by the Ministry of Family and Child Welfare, India to improve maternal health nutrition.
Methods: The health functionaries from all ten community health centres of rural Vadodara were chosen for an in-depth estimation of the different meals served in the facilities. Standard measuring cups and spoons were used to measure the exact serving sizes for each person. Each meal served was supervised, checked and quantified in triplicate, while macro- and micronutrients were calculated using the Indian Food Composition Tables 2017 (Longvah et al. 2017). To bridge the gap in service delivery, two new models of cyclic-weekly menu were developed, keeping in mind the amount per mother per day as one hundred Indian rupees.
Results: On average the foods served in the community health centres provided 69% of recommended energy intake, while mean recommended dietary allowance met for protein was 51%, calcium 18%, iron 50%, and fat 267%.
Conclusion: The recommendations specified in this paper would improve the nutritional status of all pregnant and lactating women availing the services in rural health facilities, which would go a long way in ensuring safe and healthy motherhood.
Key words: institutional delivery, nutrition, pregnant women, lactating women, public health facility, weekly cycle menu

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ABSTRACT

Introduction: Undernutrition among children has become a major public health issue due to the high risk of morbidity and mortality involving this vulnerable age group. This study focused on the rural population, especially among the Dayak children in Sarawak, Malaysia.
Methods: This community-based cross-sectional study was conducted in Sarawak’s rural areas using a multistage stratified cluster sampling technique. Data were collected through face-to-face interviews using an interviewer-guided questionnaire. The nutritional status of the under-five children was measured according to the World Health Organization guidelines. The nutritional indicators were calculated as z-scores. Multivariate logistic regression analyses were performed using SPSS to identify the factors associated with nutritional status.
Results: The prevalence of undernutrition among the under-five Dayak children in the rural areas of Sarawak was 39.6%. The analysis suggested that wasting was predominantly associated with parental education levels of primary and below, poor wealth index, environmental and sanitation issues, children with history of low birth weight, shorter duration of exclusive breastfeeding, and poor appetite. Stunting was high within the age group of <3 years old and was associated with parents’ occupation and household wealth index. Low parental education, poor wealth index, environmental and sanitation issues, poor appetite, and the children’s recent illness predicted underweight.
Conclusion: These findings imply that a multi-sectoral and multi-dimensional approach is essential to address undernutrition in rural settings. Improvement on households’ socioeconomy, environment and sanitation should be emphasised to reduce undernutrition among the children.
Key words: undernutrition, wasting, stunting, underweight, under-five children, Dayak, Sarawak

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