MJN 2022 Issues

Malaysian Journal of Nutrition (Mal J Nutr)

Volume 28 No.1, 2022



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Table of Content


Farmers’ expenditures associated with children’s nutritional status in areas affected by Indonesia’s Sinabung eruption
Sadar Ginting, Nithra Kitreerawutiwong & Sunsanee Mekrungrongwong

doi: https://doi.org/10.31246/mjn-2021-0077

Vitamin Farmers’ expenditures associated with children’s nutritional status in areas affected by Indonesia’s Sinabung eruption
ABSTRACT

Introduction: During the time of volcano eruptions, farmers have to harvest their crops before the stipulated harvest time, which leads to quality and quantity loss. Besides, farmers also have to continue their farming activities, including purchasing farming necessities. These unaddressed issues of the agricultural restoration could be one of the key factors to malnutrition. Therefore, this study assessed the associations between farmers’ expenditures and the nutritional status of children in areas affected by Indonesia’s Sinabung eruption.
Methods: A cross-sectional study was carried out among 444 (158 farmers, 228 farmers cum farm labourers, and 58 farm labourers) households headed by farmers. The questionnaire used for data collection was the Indonesian Family Life Survey questions (IFLS).
Results: Non-food expenditures had a huge impact on household livelihoods, which was significantly associated with children’s nutritional status. Among the three groups of farmers, children of farmers and farmers cum farm labourers were prone to malnutrition. This was because these two groups had to limit food expenditures over their farming necessities and cigarettes expenditure, which took more than half of their income. However, the prevalence of malnutrition was highest in children of farmers. Children of farm labourers had better nutritional status compared to children of the other two groups.
Conclusion: Children of farmers and farmers cum farm labourers were prone to malnutrition due to limited expenditure on food. This study suggests that policymakers in Indonesia should provide food and nutrition security to children who were impacted by the Sinabung eruption.
Key words: farmers’ expenditures, child nutrition, volcano eruption

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Association of household food security and dietary diversity of mother-child pairs in the Philippines
Mildred O. Guirindola, Ma. Lynell V. Maniego* & Cristina G. Malabad

doi: https://doi.org/10.31246/mjn-2021-0046

Vitamin Association of household food security and dietary diversity of mother-child pairs in the Philippines
ABSTRACT

Introduction: The majority of Filipino households experience food insecurity. Mothers and children are among the population groups suffering from poor diet quality. This study aimed to determine the extent of the association of household food security (HFS) to mothers’ and children’s dietary diversity score (DDS), and to identify the significant factors associated with meeting the DDS of these vulnerable groups.
Methods: The study was a cross-sectional, population-based study utilising secondary data from the 2015 Updating Survey. From a total of 6,692 mother-child pairs, the association between HFS and meeting the DDS of mothers and children, as well as the potential predictors for meeting the DDS were tested using descriptive and logistic regression analyses.
Results: The findings showed that HFS was significantly associated with meeting the DDS of mothers and children aged 6-36 months (p<0.001). The proportion of meeting the DDS among mothers and children was significantly higher in food-secure than in food-insecure households (20.7% vs. 14.4%). Furthermore, meeting the DDS decreased with increasing levels of food insecurity. Household food security status, education background, employment, child’s age, and wealth status were significantly associated with meeting the DDS.
Conclusion: This study showed the extent of how food security was associated with meeting the DDS of mothers, children, and mother-child pairs, and the factors associated with meeting the DDS. Results can be used to strengthen the formulation of appropriate, evidence-based policies to address household food insecurity and low DDS among mothers and young children.
Key words: household food security, dietary diversity, mother-child pairs, Philippines, NNS

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Exploring the norms of eating-out practice among adults in Malaysia
Lydiatul Shima Ashari, Ainaa Almardhiyah Abd Rashid, Mohd Razif Shahril, Yeong Yeh Lee, Yee Cheng Kueh, Bibi Nabihah Abdul Hakim, Nor Hamizah Shafiee, Raja Affendi Raja Ali & Hamid Jan Jan Mohamed

doi: https://doi.org/10.31246/mjn-2021-0008

Exploring the norms of eating-out practice among adults in Malaysia
ABSTRACT

Introduction: Eating-out is common in almost all countries, including Malaysia, but this frequent practice may affect human health. In Malaysia, data on eating-out is limited. This study aimed to assess the proportion of eating-out, to assess the association between socio-demographic factors and eating patterns, and to compare energy and nutrient intakes between people eating-out and eating-in.
Methods: This cross-sectional study was conducted among 100 adults aged 30 to 70 years old. Three-day food diaries were used to collect data on dietary intake. Eating-out was defined as eating foods prepared outside the home. Respondents who ate outside for at least one meal per day, for two or three days per week were considered as those who frequently practised eating-out.
Results: A total of 84% of respondents who ate out had significantly higher sodium intake than those who ate at home (2934 mg/day vs. 2165 mg/day, p=0.025). Foods and drinks that were most commonly consumed outside were nasi lemak, roti canai, rice, ayam masak kicap, vegetable soup, tomyam, rice vermicelli soup (mee-hoon soup), hot teh-o, iced tea, and orange juice. Occupation (p=0.004) and location type (p=0.001) were associated with eatingout. Government and semi-government workers (61%) and urban population (57%) had higher percentage of eating-out compared to eating at home (19% and 12%, respectively).
Conclusion: More than two-thirds of our respondents ate out and this habit was related to poor diet quality with excessive intake of sodium. Interventions are needed to improve the diet quality of the overall eating-out behaviour among targeted population.
Key words: eating pattern, eating-out, factors, nutrients, Malaysia

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Sociodemographic factors associated with consumption of high-sodium foods: Evidence from Malaysia
Yong Kang Cheah, Sharifah Nazeera Syed Anera, Chee Cheong Kee, Kuang Hock Lim & Mohd Azahadi Omar

doi: https://doi.org/10.31246/mjn-2021-0088

Vitamin Sociodemographic factors associated with consumption of high-sodium foods: Evidence from Malaysia
ABSTRACT

Introduction: The objective of the present study was to investigate the influences of sociodemographic factors on consumption of high-sodium foods among adults in Malaysia.
Methods: Data were extracted from the Malaysian Community Salt Survey (MyCoSS) (n=1046). A seemingly unrelated regression (SUR) was utilised to assess factors associated with the number of servings of high-sodium foods (nasi lemak, roti canai, fried rice, fried noodles, and fried vermicelli) consumed per week. The independent variables were sociodemographic factors.
Results: Younger individuals consumed more high-sodium foods than their older counterparts. Adults with secondary level education consumed more high-sodium foods compared with those with tertiary level education. Consumption of high-sodium foods was higher among males and Malays compared to females and non-Malays.
Conclusion: Consumption of high-sodium foods was common in the population. Sociodemographic factors, such as age, education level, gender, and ethnicity, play an important role in influencing the decisions of people to consume high-sodium foods.
Key words: age, food, gender, Malaysia, population study, salt, sodium

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Anaemia and its associated factors among pregnant women in Malaysia
Halimatus Sakdiah Minhat & Puganeswary Thangarajah

doi: https://doi.org/10.31246/mjn-2021-0047

Vitamin Anaemia and its associated factors among pregnant women in Malaysia
ABSTRACT

Introduction: Despite remarkable improvement in maternal health, anaemia during pregnancy remains a significant public health threat to Malaysian women. This study aimed to determine the prevalence, severity, and associated factors of anaemia in pregnancy among pregnant mothers in Seremban, Negeri Sembilan.
Methods: A total of 482 pregnant mothers were recruited using cluster sampling. Data were collected using a validated and pre-tested self-administered questionnaire consisting of four sections, namely socio-demographic and socioeconomic details, obstetric history, nutritional factors, and iron supplementation status. In this study, anaemia in pregnancy was defined as haemoglobin (Hb) <11.0 g/dL, which was based on blood test taken during the first trimester. The data were analysed using IBM SPSS version 23.0. Multiple logistic regression analysis was conducted to determine the predictive model for anaemia during pregnancy among the respondents.
Results: The prevalence of anaemia in pregnancy among the respondents was 22.0%, with 95.3% respondents mildly anaemic. Respondents with an intake of iron supplementation of once daily (AOR=0.191, 95% CI: 0.074- 0.914), more than once daily (AOR=0.149, 95%CI: 0.091-0.248), and low intake of seafood (AOR=0.320, 95% CI: 0.187-0.526) were less likely to develop anaemia during pregnancy.
Conclusion: The findings revealed moderate level of anaemia in pregnancy, which was dominated by those in the mild category, with increased risk predicted among young mothers. Iron supplementation (once daily or more) and low intake of seafood protected mothers from developing anaemia during pregnancy.
Key words: anaemia, pregnancy, maternal health

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Evaluation of in vitro lipid-lowering properties of ‘Saba’ banana [Musa acuminata x balbisiana (BBB group) ‘Saba’] peel pectin from different extraction methods
Estribillo Abbie Glenn M, Gaban Prince Joseph V, Rivadeneira Joel P, Villanueva Jeric C, Torio Mary Ann O & Castillo-Israel Katherine Ann T

doi: https://doi.org/10.31246/mjn-2020-0121

Vitamin Evaluation of in vitro lipid-lowering properties of ‘Saba’ banana [Musa acuminata x balbisiana (BBB group) ‘Saba’] peel pectin from different extraction methods
ABSTRACT

Introduction: This study was conducted to investigate the in-vitro lipid-lowering properties of ‘Saba’ banana peel pectin (SBP) extracted using three methods for its possible use as a dietary fibre ingredient.
Methods: Pectin from ‘Saba’ banana peels were extracted using acid extraction (citric acid), enzymatic extraction (cellulase), and microwave-assisted extraction. In-vitro lipid-lowering assays were performed using spectrophotometry for pancreatic lipase inhibition and cholesterol binding, while liquid chromatography was used for bile acid-binding capacity.
Results: Results revealed that all SBPs were not able to inhibit pancreatic lipase activity. However, all SBPs can notably bind to cholesterol and bile acids, taurocholate, and glycocholate. Acid-extracted pectin had the highest binding capacity to cholesterol (51.36%–55.07%) and glycocholate (27.37%), whereas all SBPs were similarly bound to taurocholate.
Conclusion: The results of this study showed that acidextracted SBPs can significantly bind to cholesterol and bile acids, glycocholate and taurocholate, thereby indicating a possible reduction in lipid metabolism.
Key words: saba, pectin, pancreatic lipase inhibition, cholesterol-binding capacity, bile acid binding capacity

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Implications of undernutrition in children with acute lymphoblastic leukaemia during induction therapy – experience from a developing country
Latha M Sneha, Lakshmanan SakthiKumar, Apurva Kadiyala, Julius Scott & Dhaarani Jayaraman

doi: https://doi.org/10.31246/mjn-2020-0131

Vitamin Implications of undernutrition in children with acute lymphoblastic leukaemia during induction therapy – experience from a developing country
ABSTRACT

Introduction: Undernutrition is an important prognostic factor in children with acute lymphoblastic leukaemia (ALL) and higher incidences of mortality are reported during induction remission in severely undernourished children. This study was conducted to assess the prevalence and implications of malnutrition among ALL children during induction therapy.
Methods: All children ≤18 years diagnosed and treated for ALL at our institution, between June 2010 to July 2016 were included in this retrospective cohort study. Nutrition was assessed by body mass index-forage z-scores calculated using World Health Organization’s Anthro (<5 years) and Anthro-Plus Software (≥5 years). Children with a z-score of <-2 standard deviation (SD) were classified as undernourished. All events and outcomes were compared between undernourished and adequately nourished children.
Results: A total of 72 children were included in this study. Nineteen (26.4%) were undernourished at the time of diagnosis. Twenty-eight (38.8%) children had significant weight loss. Sixty-seven of them attained remissions by the end of induction chemotherapy. Five children who died had significant weight loss. Children with significant weight loss during induction phase had a higher risk of developing complications such as febrile neutropenia, pneumonia, mucositis, and drug interruptions. Those with a deteriorating nutritional status had a higher chance of poor treatment outcome (p=0.05, CI=95%).
Conclusion: It is important to assess and monitor the nutrition status of children and timely nutritional intervention is essential. A simple, cost effective nutritional intervention that will decrease morbidity and mortality associated with the disease must be devised.
Key words: acute lymphoblastic leukaemia, induction therapy, outcome, undernutrition

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Relationship between 6-n-propylthiouracil (PROP) taster status, dietary intake and dental caries among young adult subjects
Syathirah Hanim Azhar Hilmy, Ruhaya Hasan, Norkhafizah Saddki & Marina Abdul Manaf

doi: https://doi.org/10.31246/mjn-2021-0079

Vitamin Relationship between 6-n-propylthiouracil (PROP) taster status, dietary intake and dental caries among young adult subjects
ABSTRACT

Introduction: Previous studies have established an association between 6-n-propylthiouracil (PROP) taster and dietary intake. However, those studies mostly emphasised on macronutrients. The present study examined the dietary intake, including macro- and micronutrients, and caries experience among university students according to their PROP taster status.
Methods: A total of 158 university students participated in this study. PROP taster status was determined using filter paper method. Dietary intake was collected using 24-hour diet recall method. Oral health examination was conducted to determine dental caries experience.
Results: The results showed that majority of subjects were supertasters. No significant differences (p>0.05) were found in the macronutrient intakes among supertasters, medium tasters, and non-tasters. Significant differences (p<0.05) were found in the intakes of micronutrients, namely pantothenic acid, vitamin D, magnesium, manganese, and fluoride. There were no significant differences among group tasters in the dental caries experience scores of decayed (D), missing (M), and filled (F) teeth.
Conclusion: In general, this study indicated that all group tasters had no difference in macronutrients intake and caries experience, but supertasters had significantly lower intakes of some micronutrients as compared to non-tasters and medium tasters. This suggested that PROP taster status could have some influence on micronutrient intakes.
Key words: caries, dietary intake, macronutrients, micronutrients, PROP, young adults

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Effectiveness of school-based obesity prevention programme among elementary school children in Jakarta
Felicia Kurniawan, Yayi Suryo Prabandari, Djauhar Ismail & Fatwasari Tetra Dewi

doi: https://doi.org/10.31246/mjn-2020-0101

Effectiveness of school-based obesity prevention programme among elementary school children in Jakarta
ABSTRACT

Introduction: Prevention and treatment of overweight and obesity are easier in children than in adults. This study was conducted to evaluate the Smart Eating and Healthy Activity (SEHAT) programme, an intervention programme involving parents, teachers, and students in Indonesia to prevent obesity at schools. The intervention was conducted in the form of seminars and leaflets distribution to parents, training of teachers, training of student health cadres, training of students by trained teachers, health promotion to school canteen vendors, and promoting healthy home food weekly.
Methods: This non-randomised controlled trial study was conducted from January to May 2016 in North Jakarta. The primary outcome was body mass index (BMI) changes measured with SECA® digital scale for weight and microtoise for height measurements. The secondary outcomes were changes in children’s knowledge, self-efficacy and behaviours, measured using self-made questionnaires, and physical activity using the Physical Activity Questionnaire for Older Children (PAQ-C). A total of 278 fourth and fifth-grade elementary school students aged 9 to 11 years old were recruited and grouped into intervention group (121 students) and control group (157 students).
Results: The study reported a significant change between intervention and control groups on knowledge (1.28 vs 0.31), attitude (1.85 vs 0.06), physical activity (0.14 vs -0.32), eating fruits and vegetables (0.02 vs -0.78), and BMI (0.33 vs 0.71).
Conclusion: The five-month SEHAT intervention programme effectively promoted knowledge on healthy eating and physical activity for obesity prevention by increasing physical activity, eating fruits and vegetables, and maintaining students’ BMI.
Key words: body mass index, children, healthy eating, physical activity, schoolbased intervention

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Validation of questionnaire for assessing perceived benefits and barriers of vegetable consumption in Japanese adults
Yaeko Kawaguchi, Junichiro Somei, Chikana Kawaguchi, Akiko Suganuma & Naoki Sakane

doi: https://doi.org/10.31246/mjn-2021-0051

Validation of questionnaire for assessing perceived benefits and barriers of vegetable consumption in Japanese adults
ABSTRACT

Introduction: This study aimed to develop and validate a diet consultation tool that assesses the perceived benefits and barriers of vegetable consumption attached to the stage of change in Japanese adults.
Methods: A web-based survey was conducted among university and vocational school students, medical staffs, and local residents in the Aichi, Osaka, and Kyoto prefectures of Japan between September 2017 and January 2018. Participants comprised of 379 adults aged 20–70 years (mean age: 30.5±12.6 years; men: 21.4%). The scale for decisional balance of vegetable consumption contained 15 benefit items and 15 barrier items. The internal consistency of the scale was examined using Cronbach’s alpha and construct validity was examined using an exploratory factor analysis with Promax rotation.
Results: The developed questionnaire had 12 items across two domains for benefits and 12 items across three domains for barriers that were structured with high internal consistencies (Cronbach’s alpha: 0.82, 0.79, 0.82, 0.76 and 0.76, respectively). The intraclass correlation coefficient in the test-retest reliability study was substantial (0.77). We found a very clear association between decreasing barrier score with increasing vegetable consumption and progress in the stage of change. The decisional balance score (benefits score minus barriers score) was positively correlated with the number of vegetable servings as an external parameter (Spearman’s correlation: 0.461; p<0.001).
Conclusion: The developed questionnaire was a valid, reliable, and useful tool for diet consultants to assess the perceived benefits and barriers of vegetable consumption in Japanese adults.
Key words: balance, benefits and barriers, diet consultation, questionnaire, vegetable

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Development of nutrition screening guideline content for use by healthcare staffs in older adults in health clinic setting: A scoping review
Siti Nur Amirah Sheikh Hishamuddin, Aliza Haslinda Hamirudin, Sakinah Harith, Mohd Aznan Md Aris, Karimah Hanim Abd Aziz, Iman Nabihah Noor Azam & Nurul Syaireen A Rashid

doi: https://doi.org/10.31246/mjn-2020-0117

Vitamin Development of nutrition screening guideline content for use by healthcare staffs in older adults in health clinic setting: A scoping review
ABSTRACT

Introduction: Malnutrition, specifically undernutrition, in community-dwelling older adults reduces their well-being and predisposes to diseases. Therefore, timely malnutrition identification through nutrition screening is needed to identify at risk and malnourished patients. This study aimed to develop the content of nutrition screening guideline to facilitate healthcare staffs in health clinics to administer a validated nutrition screening tool specifically for older adults.
Methods: A scoping review was conducted electronically using SCOPUS, PubMed, ProQuest Health & Medical Complete, and Cochrane databases. The systematic search was performed up to 31st December 2021. Search terms were created for identification of eligible and related articles. Inclusion and exclusion criteria were determined for the systematic search. The search was limited to English and Malay languages, and full text articles with no limitation of years. All data were extracted and analysed, guided by the PRISMA extension for scoping reviews (PRISMA-ScR).
Results: From 728 identified articles, 18 articles were included in the analysis. Identified information for the guideline content were: introduction, aims and objectives, definition of malnutrition, prevalence of malnutrition, implementation of nutrition screening, guidance on administering items in validated tools, and guidance on anthropometric measurements. Meanwhile, format and flow charts from established guidelines served as references for the guideline development process.
Conclusion: Appropriate content to develop a nutrition screening guideline has been identified based on this review. Development of a guideline based on this content can facilitate healthcare staffs to perform timely nutrition screening in older adults.
Key words: healthcare staffs, malnutrition, nutrition screening guideline, older adults, scoping review

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Knowledge, attitude, and behaviour towards nutrition radio programmes in mothers of children under five years with severe acute malnutrition in Northern Nigeria
Oyeduntan Adewunmi Enoch, Anorue Luke Ifeanyi, Idowu Olayinka Olajumoke, Balogun Bidemi Mutairu, Lasisi Bukola Fatima & Okunbo Victor

doi: https://doi.org/10.31246/mjn-2021-0022

Vitamin Knowledge, attitude, and behaviour towards nutrition radio programmes in mothers of children under five years with severe acute malnutrition in Northern Nigeria
ABSTRACT

Introduction: Although the mass media are increasingly becoming a platform for disseminating health messages to promote attitude and behavioural changes, little is known about how radio programmes influence safe child feeding practices among mothers of infants and children. Consequently, this study examined the knowledge, attitude and behaviour towards food and nutrition radio programmes in mothers of children under five years with severe acute malnutrition in Northern Nigeria.
Methods: This study employed a survey research design using data derived from a structured questionnaire undertaken with mothers (N=402) of children suffering from severe acute malnutrition (SAM) and who have been listening to radio programmes on tackling malnutrition within six months to the time of the fieldwork.
Results: Findings revealed that while mothers appeared to have a higher comprehension of child feeding programmes on the radio, their attitude and actual uptake of the messages were not encouraging. Furthermore, being young, having few children, having a primary education, and frequent listening to SAM-related messages on the radio were associated with mothers’ positive knowledge, attitude and actual uptake of the messages disseminated.
Conclusion: The findings provided a link between demographic characteristics of mothers and how they comprehend, believe and act on the messages they received from these radio programmes. It is therefore argued that the understanding of this link might inform the focus of future intervention aimed at promoting best child feeding practices in Northern Nigeria.
Key words: health education, intervention, malnutrition, mothers, radio programmes

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Malaysian Journal of Nutrition (Mal J Nutr)

Volume 28 No.2, 2022



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Table of Content


Soy flour snack bars lower glycaemic response in type 2 diabetes mellitus subjects: A randomised cross-over design
Naufal Muharam Nurdin, Hana Fitria Navratilova, Karina Rahmadia Ekawidyani & Mohamad Yulianto Kurniawan

doi: https://doi.org/10.31246/mjn-2021-0054

Soy flour snack bars lower glycaemic response in type 2 diabetes mellitus subjects: A randomised cross-over design
ABSTRACT

Introduction: Low glycaemic snacks may help to improve blood glucose control. However, data on the effect of soybean snack bars on postprandial glucose levels of the diabetic population is scarce. Therefore, the current study aimed to examine the effect of consuming soy flour snack bars on glycaemic response (GR) over a 180-minute period in individuals with diabetes by estimating postprandial glucose levels variation and total area under the curve (AUC).
Methods: Nine subjects (age: 54.6±4.0 years; BMI: 25.0±2.5 kg/m2) with type 2 diabetes mellitus (T2DM) diagnoses without complication enrolled in this randomised, open-label, cross-over trial. On three separate sessions, they consumed glucose standard solution, soy flour snack bar (SF), and wheat flour snack bar (WF) containing 25 g of available carbohydrate, respectively. Finger prick capillary method was executed to measure blood glucose levels at 30, 60, 90, 120, 150, 180 minutes after test product ingestion.
Results: Overall, significantly lower postprandial glucose levels were observed at 30, 60, 90, and 120 minutes (122.3±17.6, 136.3±24.9, 125.7±25.3, and 107.2±24.1 mg/dL; p<0.001) in those who consumed SF snack bars than WF snack bars (147.9±41.3, 168.0±43.6, 152.6±30.0, and 140.6±33.4 mg/dL). The AUC level after the ingestion of SF snack bar was 2044.8±503.1 mg.min/dL, >20% lower compared to ingestion of WF snack bar (4735.0±666.8 mg.min/dL), p<0.001. These glycaemic control benefits can be explained due to the high fibre and protein content linked to the physicochemical properties of SF.
Conclusion: With high nutritional properties, SF snack bar has a low GR and might help control blood glucose in T2DM subjects.
Key words: glycaemic response, hyperglycaemia, snack, soy food, T2DM diet

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Determinants of diet quality among mothers of young children in an urban slum area in Jakarta: Mother’s age, vegetables availability, and eating out frequency
Fitya Safira Birahmatika, Dian Novita Chandra & Luh Ade Ari Wiradnyani

doi: https://doi.org/10.31246/mjn-2021-0031

Vitamin Determinants of diet quality among mothers of young children in an urban slum area in Jakarta: Mother’s age, vegetables availability, and eating out frequency
ABSTRACT

Introduction: Poor diet quality is a major issue, and health concerns may be related to diet. Mothers with young children usually have their meals at home; thus, home food environment plays a role in determining dietary behaviours. This study examined the association between health concerns and diet quality among mothers; additionally, the effect of home food environment on this relationship was assessed.
Methods: This cross-sectional study comprising 229 mothers (aged 19–49 years) with young children was conducted in an urban slum area in North Jakarta. Data were collected via interviews using a structured questionnaire. The General Health Interest Scale and Consumer Behaviour Questionnaire were used to assess health concern and home food environment, respectively. The 24-hour dietary recall method was used to calculate the Diet Quality Index-International (DQI-I) score. Spearman’s correlation, multiple linear regression, and path analysis were used to analyse the data.
Results: Majority of the mothers had poor diet quality (mean DQI-I score, 41.44/100). No significant correlation between health concern and diet quality was observed. After adjusting for age, the relationship between health concern and diet quality was not mediated by vegetables availability or eating out frequency (indirect effect=0.012; p=0.096). Multiple linear regression analysis revealed age as a significant predictor of diet quality (B=0.196; p=0.024).
Conclusion: Diet quality among mothers of young children differed with age and was related to both health concerns and home food environment. Thus, the development of strategies to promote healthy eating based on different age groups is warranted.
Key words: diet quality, healthy diet, home environment, mothers

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Milk supplementation increases mid-upper arm circumference and haemoglobin level among pregnant women in Kupang, Indonesia: Evidence from a regression discontinuity design
Ahmad Syafiq, Sandra Fikawati, Nindhita Priscillia Muharrani & Mardatillah

doi: https://doi.org/10.31246/mjn-2021-0023

Vitamin Milk supplementation increases mid-upper arm circumference and haemoglobin level among pregnant women in Kupang, Indonesia: Evidence from a regression discontinuity design
ABSTRACT

Introduction: The high prevalence of chronic energy deficiency (CED) and anaemia among pregnant women in Indonesia is worrying. Nusa Tenggara Timur (NTT) is one of the provinces in Indonesia with the highest prevalence of CED. This study aimed to determine the effect of fortified milk supplementation on changes in mid-upper arm circumference (MUAC) and haemoglobin level among pregnant women.
Methods: This quasi-experimental study was conducted in three locations of Community Health Centers in NTT from May to August 2019. Purposive sampling was used to recruit 69 pregnant women who were divided into two groups based on haemoglobin levels; the intervention group consisted of 31 pregnant women with haemoglobin levels below 11 g/dL, and control group consisted of 38 pregnant women with haemoglobin levels above 11 g/dL. Intervention group was provided with fortified milk supplementation, while control group received education about prevention of CED and anaemia. Data were analysed using regression discontinuity design with haemoglobin of 11 g/dL as cut-off.
Results: Using regression discontinuity method, we were able to determine the effect of milk supplementation based on haemoglobin levels and confirm the result that milk supplementation significantly increased MUAC by 4.69 cm. Despite no discontinuity found, a positive increase of 0.98 g/dL in haemoglobin level was important to note.
Conclusion: Milk supplementation of 300 kcal/day for three months significantly increased MUAC and to some extent, increased haemoglobin level. Thus, it should be considered when planning nutrition programmes to improve the nutritional status of pregnant women.
Key words: haemoglobin level, milk supplementation, MUAC, pregnant women, regression discontinuity design

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Knowledge, attitude and practices (KAP) towards anaemia among female university students in Malaysia: A cross-sectional survey
Cheryl Huong, Jing Lin Chua, Rui Yi Ng, Dhanashri Kshitij Panse, Snigdha Misra & Afshan Sumera

doi: https://doi.org/10.31246/mjn-2021-0067

Vitamin Knowledge, attitude and practices (KAP) towards anaemia among female university students in Malaysia: A cross-sectional survey
ABSTRACT

Introduction: Anaemia is a common health problem in Malaysia, most common being iron deficiency anaemia (IDA). This study aimed to assess knowledge, attitude, practices (KAP), and health-seeking behaviour (HSB) towards anaemia among undergraduate female students.
Methods: A cross-sectional study was conducted among 180 female university students from a medical university in Malaysia. Data were collected using an online questionnaire comprising KAP and HSB. SPSS version 25.0 was used for statistical analysis.
Results: Most participants (60%) had an appropriate level of knowledge about anaemia. A positive attitude was shown with adequate awareness of anaemia. A total of 55.5% of participants reported having good health practices. However, 52.9% of the participants consumed less iron-rich foods and 81.7% reported skipping meals. The overall observed healthseeking behaviour was good. A statistically significant relationship was found between knowledge with attitude (p=0.003) and practice (p=0.005). This study observed that the study population had poor nutritional status, long menstrual duration, and vegetarianism. Moreover, infrequent consumption of vitamin C-rich fruits and low iron-folate supplementation were also observed.
Conclusion: A good level of knowledge on IDA among students was noted. However, most of the students showed a lack of positive attitude and good practices towards preventing anaemia. University students are prone to IDA due to a lack of KAP, which can significantly affect health-seeking behaviour. This issue should not be neglected; therefore, implementing intervention programmes to educate students on the preventive measures against the risk factors of IDA is recommended.
Key words: anaemia, health-seeking behaviour, knowledge attitude practice

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Formulation of local food multimix sprinkle to enhance nutritional adequacy of preschool children in southernmost provinces of Thailand
Laksana Chaimongkol & Bisri Soison

doi: https://doi.org/10.31246/mjn-2021-0102

Vitamin Formulation of local food multimix sprinkle to enhance nutritional adequacy of preschool children in southernmost provinces of Thailand
ABSTRACT

Introduction: This study aimed to formulate an effective Food Multimix-Sprinkle (FMM-S) by using locally available materials.
Methods: Fish (Threadfin bream), cow liver, and orange fleshed sweet potato (OSP) were cooked and dried by using applicable household (HH) method and drum drying (DD). Then, the dried materials were milled and sieved through a 20 mesh screen. Fish, cow liver, and OSP sprinkles were mixed in various proportions to meet nutrient level targets [at least 30% of Thai Recommended Dietary Allowance (RDA) for 1-3 years old children per 15 g serving size].
Results: Six alternative mixes were formulated. The mixture of 3 g of liver, 7 g of fish, and 5 g of OSP (3:7:5) when processed by HH method, and the mixture of 4 g of liver, 8 g of fish, and 3 g of OSP (4:8:3) when processed by DD method, had significant advantage in preference scores in all attributes over the others. Nutritional values of these formulas were 37-55% RDA of protein, 146-194% RDA of vitamin A, and 30-40% RDA of iron for a serving size.
Conclusion: This study demonstrated that household preparation, as well as preparation using drum drying could be used to process raw fish, cow liver, and OSP into a sprinkle mix. The FMM-S provided appropriate amounts of protein, vitamin A, and iron to supplement nutrient intake in pre-schoolers. However, a consumer test is needed to ensure acceptance by the target population.
Key words: food multimix, nutritional formulation, sprinkle

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Comparative amino acid composition and quality parameters of Moringa oleifera testa and cotyledon
Emmanuel Ilesanmi Adeyeye, Abdul Ademola Olaleye, Oluwajumoke Tolulope Idowu, Habibat Omolara Adubiaro & Kikelomo Elizabeth Ayeni

doi: https://doi.org/10.31246/mjn-2020-0130

Comparative amino acid composition and quality parameters of Moringa oleifera testa and cotyledon
ABSTRACT

Introduction: Moringa oleifera is a drought-resistant plant, widely used in the tropical region. The leaves and stems have been extensively utilised in foods and neutraceuticals preparation, with less attention to the seeds. In this study, amino acid (AA) compositions of M. oleifera testa and cotyledon were examined comparatively.
Methods: Samples were separately defatted, hydrolyed, and neutralised. The AA solution was purified by cation-exchange solid-phase extraction, derivatised and analysed by gas chromatography.
Results: Glutamic (acidic amino acid) and phenylalanine (essential amino acid, EAA) were the most concentrated in both samples. Total EAA (g/100g crude protein, cp) was higher in cotyledon (51.0) than testa (41.9). Predicted protein efficiency ratios (P-PERs) were higher in testa (0.605-1.530) than cotyledon 0.286-1.460). EAA index ranged between 0.951-1.13 (soybean comparison) and 83.0-96.9 (egg comparison) with corresponding biological value of 78.7-93.9. The following AA had scores >1.0 in comparison to whole hen’s egg, testa: glycine (Gly), glutamic acid (Glu), phenylalanine (Phe), histidine (His), and cysteine (Cys); cotyledon (Gly), proline (Pro), Glu, Phe, His, arginine (Arg) and Cys. In comparison with requirements of pre-school children, six AA (6/9 or 66.7%) had scores >1.0 in each sample. In provisional AA scoring pattern, isoleucine (Ile) (1.25) and Phe + tyrosine (Tyr) (1.68) had scores >1.0 in testa while methionine (Met) + Cys, Phe+Tyr, and tryptophan (Trp) in cotyledon. However, tryptophan and lysine were the limiting AAs in testa and cotyledon, respectively.
Conclusion: The study showed that both anatomical parts would complement each other in terms of amino acid supply.
Key words: amino acid scores, derivatisation, essential amino acid, hydrolysis, isoelectricpoint

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Combined effects of bee pollen supplementation and resistance training on aerobic capacity, muscular performance, antioxidant status, and bone metabolism markers in young men: A randomised controlled trial
Nurathirah Na’aim, Chee Keong Chen, Foong Kiew Ooi & Mahaneem Mohamed

doi: https://doi.org/10.31246/mjn-2021-0072

Vitamin Combined effects of bee pollen supplementation and resistance training on aerobic capacity, muscular performance, antioxidant status, and bone metabolism markers in young men: A randomised controlled trial
ABSTRACT

Introduction: This study investigated the combined effects of bee pollen and resistance training on aerobic capacity, muscular performance, antioxidant status, and bone metabolism markers among young men.
Methods: Forty young men were randomly assigned into four groups: sedentary control (C), bee pollen supplementation (BP), resistance training (RT), and combined bee pollen supplementation and resistance training (BPRT) groups. Bee pollen was consumed by participants in BP and BPRT groups (1500 mg daily for eight weeks). Resistance training was performed thrice per week for eight weeks in RT and BPRT groups. Participants’ anthropometry, aerobic capacity, isokinetic muscular peak torque (strength), and average power were measured. Concentrations of serum total antioxidant status (TAS), serum superoxide dismutase (SOD), serum alkaline phosphatase (ALP), and serum C-terminal telopeptide of type 1 collagen (1CTP) were determined.
Results: After eight weeks of intervention, there was a significant decrease in 1CTP in BP group. In RT group, significant increases were observed in both muscular strength and power. In BPRT group, significant increases in both muscular strength and power, and a significant decrease in 1CTP were observed after 8 weeks. There were no significant changes in aerobic capacity, serum TAS, SOD, and ALP in all the study groups.
Conclusion: Resistance training using dumbbells and elastic bands seemed to elicit beneficial effects on muscular strength and power, while bee pollen supplementation alone reduced the level of bone resorption marker. In addition, combining bee pollen with resistance training seemed to offer additive benefit in muscular strength and power.
Key words: antioxidant status, bee pollen, bone metabolism markers, muscular performance, resistance training

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Factors related to low birth weight in Indonesia
Nikmatur Rohmah, Masruroh Masruroh, Nur Baharia Marasabesy, Nasrun Pakaya, Joko Prasetyo, Saiful Walid & Agung Dwi Laksono

doi: https://doi.org/10.31246/mjn-2021-0123

Vitamin Factors related to low birth weight in Indonesia
ABSTRACT

Introduction: Previous studies have reported that low birth weight (LBW) correlates with neonatal death and 15 - 20% of all births worldwide are LBW. This research aimed to analyse the factors related to LBW in Indonesia.
Methods: The authors collated secondary data from the 2017 Indonesian Demographic and Health Survey (IDHS). The sample consisted of 17,443 respondents. Besides LBW as the dependent variable, the independent variables consisted of maternal age, residence, wealth, education, employment, marital status, health insurance, antenatal care (ANC) visits, smoking behaviour, and gender of the baby. The final stage employed binary logistic regression.
Results: Women aged 35-39 years were 0.688 times less likely than women aged 15-19 years to give birth to LBW babies. The wealthiest women were 0.712 times less likely than the poorest women to give birth to LBW babies. Women with higher education levels were 0.670 times less likely to have a LBW baby than women with no education level. Women who attended ≥4 ANC visits were 0.829 times less likely to have LBW babies than women who attended <4 ANC visits. Baby girls were 1.161 times more likely than baby boys to be born with LBW
Conclusion: The study concluded that the factors related to LBW in Indonesia were maternal age, wealth, education, ANC, and gender of the baby.
Key words: antenatal care visit, education level, low birth weight, wealth status, women of reproductive age

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The effect of goat’s milk consumption on the clinical health of middle-aged adults with lactose intolerance
Chanchira Phosat, Charupan Phosat, Chatrapa Hudthagosol, Pornpimo Panprathip Phienluphon & Karunee Kwanbunjan

doi: https://doi.org/10.31246/mjn-2021-0087

The effect of goat’s milk consumption on the clinical health of middle-aged adults with lactose intolerance
ABSTRACT

Introduction: People with lactose intolerance are suggested to consume dietary items containing less lactose, such as goat’s milk. This study aimed to investigate the effects of goat’s milk powder on the health of lactose intolerant middle-aged adults.
Methods: A total of 60 subjects were recruited into this randomised controlled trial. They were divided into four groups and received different dietary interventions (goat’s milk, goat’s milk with curcumin, goat’s milk with coffee, lactose-free milk) for five weeks. Health effects were compared between pre- and post-intervention. Anthropometric and biochemical parameters (blood glucose, insulin, lipid profile, C-reactive protein, and lactoferrin) were evaluated. Dietary intake was recorded using a food record.
Results: Fifty-one lactose intolerant subjects completed the study. After ingestion of goat’s milk, there were significant reductions in body fat (p=0.033) and a significant increase in the percentage of muscle (p=0.021). Waist circumference (WC) decreased in both the goat’s milk with curcumin and goat’s milk with coffee groups (p<0.05 for all). Unfortunately, high-density lipoprotein cholesterol (HDL-C) dropped after the five-week intervention in the goat’s milk group (p=0.002). Lactoferrin level of the goat’s milk group was higher than other groups at post-intervention (p<0.001). Besides, the goat’s milk with coffee group seemed to consume more carbohydrates after completing the intervention (p=0.034).
Conclusion: A five-week intake of goat’s milk reduced the risk of abdominal obesity among middle-aged adults. In addition, it resulted in improved lactoferrin levels.
Key words: goat’s milk, lactoferrin, lactose-free, lactose intolerance, middle-aged adults

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Validation of a Sustainable Diet Index among young Malaysian adults
Nur Fadzlina Zulkefli & Foong Ming Moy

doi: https://doi.org/10.31246/mjn-2021-0060

Vitamin Validation of a Sustainable Diet Index among young Malaysian adults
ABSTRACT

Introduction: A sustainable diet which is healthy and environmentally friendly provides the means of climate change mitigation in addition to promoting health of the population. There is an urgent need to have an indicator to measure if one’s diet is sustainable. This paper aimed to validate a newly developed Sustainable Diet Index (SDI) among young Malaysian adults. The SDI was developed based on the dietary guidelines of a sustainable diet.
Methods: Five indicators (rice, animal-based food, plant-based food, food waste, and packaging) were included in the SDI. The index was validated via content validity, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA) among young Malaysian adults. The dietary assessment tool used was an Android application named Sustainable Food Record.
Results: Content validity showed fair to moderate correlations (0.331 - 0.816) between the indicators in the SDI. EFA produced five final factors with eight indicators in the index as follows: 1) fruits and vegetables; 2) dairy, eggs, and meat; 3) rice, cereals, and grain products; 4) food packaging; and 5) food waste management with strong factor loadings (0.760 – 0.984). All five factors with eight indicators were retained and proceeded with CFA. The fit indices from CFA demonstrated that the model was an absolutely fit.
Conclusion: The validated SDI can be used as a tool to measure the sustainability of an individual’s diet in Malaysia, incorporating both health and environment considerations.
Key words: environment, health, sustainable diet index, validation

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Household income, frequency of purchasing outside meals, eating behaviour and body mass index status among undergraduate students during first phase of COVID-19 lockdown
Nur Hazirah Abdul Razak & Divya Vanoh

doi: https://doi.org/10.31246/mjn-2021-0129

Vitamin Household income, frequency of purchasing outside meals, eating behaviour and body mass index status among undergraduate students during first phase of COVID-19 lockdown
ABSTRACT

Introduction: COVID-19 lockdown has changed the eating behaviours of people, which could affect their body mass index (BMI). These changes affected meal purchasing habits of university students, depending on their household income. Thus, the current study aimed to investigate the association between eating behaviour, household income, frequency of purchasing outside meals with BMI among undergraduate students.
Methods: This was a retrospective cross-sectional study conducted among 112 undergraduate students. Subjects recalled information during the first phase of COVID-19 lockdown, which was from March 2020 till July 2020. Questionnaire consisted of socio-demography, anthropometry, frequency of purchasing outside meals, and eating behaviour using the Malay version Dutch Eating Behaviour Questionnaire (DEBQ).
Results: About 64.3% of subjects reported purchasing outside meals 1-2 times per week. Higher restrained eating behaviour score was correlated with purchasing outside meals about 3-4 times and >4 times a week. Normal weight students had significantly higher restrained eating behaviour score [3.0(1.1)] than those in the obese group [2.9(1.1)]. Household income had no association with frequency of purchasing outside meals.
Conclusion: Eating behaviour affected BMI and the frequency of purchasing outside meals during COVID-19 lockdown. COVID-19 lockdown has resulted in tremendous changes in the eating behaviour and physical activity pattern of university students. Future studies should focus on increasing the nutrition knowledge of university students, especially on the aspect of eating out.
Key words: body mass index, COVID-19, eating behaviour, household income, purchasing meals

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Effect of adherence to follow-up on recovery from moderate acute malnutrition among under-fives in a supplementary feeding programme
Ekong Emmanuel Udoh, Rosemary Augustine Umoh, Kevin Bassey Edem, Frances Samue Okpokowuruk, Ekemini Nsikan Udo, Blessing Njideka Nwazuluoke & Olugbemi Oluseyi Motilewa

doi: https://doi.org/10.31246/mjn-2021-0040

Vitamin Effect of adherence to follow-up on recovery from moderate acute malnutrition among under-fives in a supplementary feeding programme
ABSTRACT

Introduction: Supplementary feeding programme is a strategy for managing underfives with moderate acute malnutrition (MAM). This study aimed to determine the effect of adherence to follow-up on recovery from MAM among under-fives.
Methods: A clinical trial to evaluate the effectiveness of daily supplementary rations of a standardised milk-based formulation (SMBF), standardised non-milk-based formulation (SNMBF), and hospital-based formulation (HBF) on recovery from MAM over a four months period was conducted among eligible children aged 6 – 59 months. Recovery from MAM among participants was determined based on their status of adherence to follow-up at week 16. It was deemed statistically significant if p-value was <0.05.
Results: Of the 157 children evaluated, 41/54 (75.9%) who received the SMBF, 32/57 (56.1%) who received the SNMBF, and 22/46 (47.8%) who received the HBF had good adherence. Adherence to follow-up was significantly higher with SMBF than SNMBF and HBF (χ²=8.923; p=0.012). In all, 95/157 (60.5%) had good adherence to follow-up with 73/95 (76.8%) recovery from MAM against 42/62 (67.7%) recovery in those with poor adherence (p=0.208).
Conclusion: The status of adherence to scheduled follow-up was not significantly associated with recovery from MAM among under-fives enrolled in the supplementary feeding programme. Nevertheless, efforts at promoting adherence to scheduled follow-up visits should be sustained.
Key words: adherence, clinical, follow-up, malnutrition, nutrition, trial

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Malaysian Journal of Nutrition (Mal J Nutr)

Volume 28 No.3, 2022



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Acknowledgements


Table of Content


Stunting and zinc deficiency among 3-5 years old Kankana-ey children in Kibungan, Benguet, Philippines
Jessielyn S. Pantalone, Normahitta P. Gordoncillo, Leila S. Africa, Corazon VC. Barba, Josefina T. Dizon, Jaidee P. Agne & Kristine V. Montecillo

doi: https://doi.org/10.31246/mjn-2021-0114

Vitamin Stunting and zinc deficiency among 3-5 years old Kankana-ey children in Kibungan, Benguet, Philippines
ABSTRACT

Introduction: There is a dearth of public health and nutrition information available pertaining to the indigenous groups in the Philippines. Hence, this study described the prevalences of stunting and zinc deficiency, as well as factors associated with zinc status of 3-5 years old children among the Kankana-ey people, an indigenous group living in Kibungan, Benguet, Philippines.
Methods: A cross-sectional design was used in the conduct of the study where 63 study participants were randomly selected from a chronological list of names of eligible Kankana-ey children by drawing lots. The mothers/primary caregivers of these children were interviewed to collect their socio-economic and demographic data, and dietary intake was assessed through three non-consecutive days 24-hour food recall. Height and weight of the children were also measured to determine their nutritional status. Lastly, blood samples were collected to determine the zinc status of the children based on serum zinc concentration, analysed through atomic absorption spectrophotometer.
Results: Results showed that 54.0% and 50.8% of the Kankana-ey children had stunting and zinc deficiency, respectively. There was significant positive association between being exclusively breastfed and current zinc status (p=0.001). On the other hand, a statistically significant negative correlation was observed between zinc intake and zinc serum concentration (r=-0.291, p=0.021).
Conclusion: Undernutrition among Kankana-ey children is a major public health concern in Kibungan, Benguet. Preventive actions must be taken to alleviate the severity of both stunting and zinc deficiency, and to mitigate possible consequences by strengthening the current nutrition and health programmes for indigenous groups, especially among young children.
Key words: indigenous peoples, nutritional deficiency, nutritional status, zinc

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Effects of soaking duration and incubation conditions on GABA biosynthesis in MangBuk brown rice of Vietnam
Ho Thi Ngoc Tram, Phan Phuoc Hien & Thi Mong Diep Nguyen

doi: https://doi.org/10.31246/mjn-2021-0115

Vitamin Effects of soaking duration and incubation conditions on GABA biosynthesis in MangBuk brown rice of Vietnam
ABSTRACT

Introduction: Many people are currently interested in improving and maintaining their health status by changing their dietary habits, like eating more natural foods; thus sprout products are becoming increasingly popular. In this context, sprouted brown rice grains are an excellent example of functional food, because besides their nutritive value, they also lower the risk of various diseases and/or exert health- promoting effects. In this paper, we focused on the bioactive compound γ-aminobutyric acid (GABA) in germinated brown rice. GABA is known as an important amino acid that can help reduce hypertension and inhibit cancer cells development.
Methods: We investigated the hydration characteristics of brown rice by drying them in a moisture analyser at 130°C until reaching a constant weight. The effects of soaking (duration and pH of soaking solution), as well as incubation conditions (temperature and time) on GABA biosynthesis in MangBuk brown rice of Vietnam were measured. Quantification of GABA was measured using a spectrophotometer.
Results: GABA content in MangBuk type 1 brown rice was higher than in type 2. GABA content reached its highest value at 691.88 μg/g for type 1 rice and 596.48 μg/g for type 2 rice when MangBuk brown rice was soaked in a pH 7 water at 30°C for 12 hours, and then incubated at 35°C for 30 hours in aerobic condition.
Conclusion: Germination conditions modified the content of biologically active compounds in MangBuk soft and hard rice varieties. GABA was synthesised during germination based on three factors, namely time of incubation, temperature of incubation, and pH of solution.
Key words: gamma-amino butyric acid, germinated grains, hydrolytic enzymes, MangBuk brown rice, soaking duration

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Cathelicidin LL-37 level in presence and absence of vitamin D in cultured macrophages isolated from elderly women
Joyeta Ghosh, Aditi Nag Chaudhuri, Indranil Saha & Debnath Chaudhuri

doi: https://doi.org/10.31246/mjn-2021-0013

Vitamin Cathelicidin LL-37 level in presence and absence of vitamin D in cultured macrophages isolated from elderly women
ABSTRACT

Introduction: Vitamin D deficiency and frequent infections are the two common worldwide phenomenon among elderly. Recent studies have demonstrated that vitamin D regulates the expression of specific endogenous antimicrobial peptides like cathelicidin LL-37 of macrophages and neutrophils, which is active against a broad spectrum of infectious agents. Therefore, the objective of the present study was to determine the level of cathelicidin LL-37 in macrophages of elderly women (classified according to serum 25(OH)D level) after exposure to Vibrio cholera infection and to find out the effect of 1,25(OH)2D added in vitro.
Methods: This study was conducted among 40 randomly selected rural elderly women aged between 60 to 70 years of age. Their vitamin D status was assessed by the estimation of serum 25(OH)D and classified into three groups viz. sufficient (14 members), insufficient (13 members), and deficient (13 members). Later, their peripheral blood mononuclear cells (PBMC) were isolated and cultured from fresh blood. 1,25(OH)2D supplementation was given selectively at a dose of 10 ×10-8 M for 72 hours in the culture media; then exposed to infection and screened according to the objectives of this study.
Results: Macrophages in all groups, except vitamin D deficient group, responded significantly in terms of LL-37 release during exposure to Vibrio cholera infection. Considering in vitro 1,25(OH)2D, supplementation responded significantly (p<0.05) in all three groups.
Conclusion: Vitamin D can be used as a prophylaxis to enhance cathelicidin LL-37 release for all three groups as in the present study.
Key words: cathelicidin LL-37 activity, elderly women, macrophages, peripheral blood mononuclear cells, vitamin D

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Models and theories to support health promotion programmes for overweight and obese adults: A scoping review
Tatiana Suhaimi, Sharifah Wajihah Wafa Syed Saadun Tarek Wafa, Hanif Farhan Mohd Rasdi & Ruzita Abd Talib

doi: https://doi.org/10.31246/mjn-2021-0126

Vitamin Models and theories to support health promotion programmes for overweight and obese adults: A scoping review
ABSTRACT

Introduction: The increasing prevalence of overweight and obesity has been alarming. One approach to address this issue is to implement health promotion programmes. Despite the many health promotion and health intervention programmes held, there is a lack of evidence showing the application of theories and models. This scoping review aimed to explore existing literature and synthesise findings based on models and theories used to support health promotion programmes for overweight and obese adults.
Methods: This review was guided by the Arksey and O’Malley framework. Online databases, such as Ovid, PubMed, Scopus, and Web of Science, were used to search for relevant articles using suitable keywords, from January 2015 until December 2021. Articles were written in English and Malay, and the study subjects were adults aged 18-59 years old. Two reviewers independently screened the articles, and the extracted information were tabulated after analysis.
Results: A total of 13 different theories and models were found in the 27 articles selected. Many studies reported using the Transtheoretical Model, Social Cognitive Theory, and Health Belief Model in health promotion programmes for overweight and obese adults. Most constructs and components focused on changing health-related behaviours starting with the individual, such as self-efficacy and readiness to change. Majority of the articles showed an improvement in health-related behaviours and had great potential for future studies.
Conclusion: When conducting health promotion programmes for overweight and obese adults, researchers should consider models and theories with constructs and components to ensure consistent improvement and potentially significant impacts on health-related outcomes.
Key words: adult, health promotion, model, obesity, theory

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Comparison of boba pearls made from tapioca starch and other unconventional flours and starches: Their glycaemic response (GR)
Bhupinder Kaur, Rina Yu Chin Quek, Grace Cui Fang Ng, Shalini Ponnalagu & Christiani Jeyakumar Henry

doi: https://doi.org/10.31246/mjn-2021-0091

Vitamin Comparison of boba pearls made from tapioca starch and other unconventional flours and starches: Their glycaemic response (GR)
ABSTRACT

Introduction: Boba milk tea, also recognised as bubble tea, is a popular beverage in Asia. The primary component in bubble tea is “boba” or “pearl” balls, made of tapioca starch. However, much remains to be seen if tapioca boba pearls have a profound impact on blood glucose.
Methods: In a randomised, controlled crossover, single-blinded design study, 12 healthy Chinese male adults (body mass index 21±14 kgm−2) attended four sessions. At each session, bubble tea consisting of boba pearls made from tapioca starch (TS), sago starch (SS), high-amylose starch + sago starch (HA), or kithul flour + sago starch (KF) were served. Boba milk tea was served at breakfast, with volunteers consuming them in a fasted state at each session. The postprandial glycaemic response and insulin response were compared within participants.
Results: There were observed differences at time 180min for incremental glucose between HA and SS (p=0.005), and for TS and SS for incremental insulin (p=0.004). Glucose iAUC was lower for TS compared to the other boba pearl treatments, although not significantly (p=0.093). There was no significant difference in iAUC of insulin (p=0.104) between the four boba pearl milk teas.
Conclusion: With limited scientific research conducted on bubble milk tea, our study was the first to document the glycaemic responses of tapioca starch boba pearls and boba pearls made using unconventional flours and starches. The findings from this study is an important first step for future work to develop healthier boba pearls for bubble tea.
Key words: boba pearls, flours, glycaemic response, insulinaemic response, starches

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Whey protein positively alters inflammatory markers and metabolic parameters of overweight and obese adults
Chanchira Phosat, Charupan Phosat, Chatrapa Hudthagosol, Pornpimol Panprathip Phienluphon & Karunee Kwanbunjan

doi: https://doi.org/10.31246/mjn-2021-0100

Vitamin Whey protein positively alters inflammatory markers and metabolic parameters of overweight and obese adults
ABSTRACT

Introduction: The effects of prolonged consumption of whey protein on health are controversial. This study aimed to determine whether whey protein positively alters health parameters of overweight and obese adults.
Methods: Randomised controlled trial was conducted. Fifty-eight participants, aged 30-50 years, were randomly allocated into four groups and supplemented with 50 g protein for eight weeks (group 1: plant-based protein (PBP), group 2: whey protein isolate (WPI) with cocoa powder, group 3: PBP with whey protein concentrate (WPC), and group 4: WPI with milk powder). Body composition and biochemical parameters (kidney and liver functions, inflammation, oxidative stress, and antioxidant capacity) were evaluated at pre-intervention and 8 weeks after intervention.
Results: At Week 8, group 3 had lower diastolic blood pressure, waist circumference, visceral fat, and risk of insulin resistance (p<0.05 for all). Group 2 had decreased levels of total cholesterol and low-density lipoprotein cholesterol (p<0.05 for all). A drop in triglyceride was seen in group 4 (p=0.026). Whey protein decreased alanine aminotransferase level (p=0.028), while PBP increased aspartate aminotransferase level (p=0.034). PBP or WPI with milk powder increased blood urea nitrogen level (p>0.05 for all). Interleukin-6 and lactoferrin levels fell in all groups (p<0.05), while hs-CRP increased in the PBP group (p=0.043). Group 2 experienced increased antioxidant capacity. However, levels of oxidative stress markers were significantly decreased in the PBP group and WPI with milk powder group.
Conclusion: Whey protein revealed positive effects on anthropometric parameters and biochemical markers of overweight and obese adults. Therefore, proper supplementation of whey protein can potentially promote health.
Key words: inflammatory marker, obesity, overweight, plant-based protein, whey protein

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Telomere length in Thai Buddhist monks and Thai males aged 40 years and above
Pakamas Winson, Preeya Leelahagul, Aruchalean Taweewongsounton, Wutarak Puenputtho, Somchai Bovornkitti & Niphon Poungvarin

doi: https://doi.org/10.31246/mjn-2022-0021

Vitamin Telomere length in Thai Buddhist monks and Thai males aged 40 years and above
ABSTRACT

Introduction: The daily lifestyles of Thai Buddhist monks and Thai males differ due to Buddhist practices, which potentially affect telomere length. Telomeres are DNA compounds located at the ends of chromosomes that shorten with each cell division. This study investigated the difference in telomere length between Thai Buddhist monks and Thai males aged ≥40 years.
Methods: This was a cross-sectional study involving 100 Thai Buddhist monks aged ≥40 years who had been ordained for more than five years and 100 Thai males aged ≥40 years. General information and health information were assessed by questionnaire. Nutritional status was determined by body composition and blood chemistry parameters. Telomere length was measured by Monochrome Multiplex Real- Time Quantitative PCR and expressed as T/S ratio.
Results: Mean telomere length of Thai Buddhist monks was longer than that of Thai males (1.08±0.18 vs. 1.02±0.17; p<0.050). In both groups, the mean telomere length in subjects aged ≥60 years was shorter than that in subjects aged 40-59 years (p<0.010). Alcohol consumption, which affected Thai males (p<0.050), but meditation tend to slow down the shortening of telomeres (r=0.167; p<0.050) in both groups.
Conclusion: Age was the parameter that affected telomere length the most. Furthermore, various factors in the Buddhist monk group, such as a peaceful lifestyle, meditation, non-alcohol consumption, and fewer underlying diseases, could explain for the longer telomere lengths in this group.
Key words: age groups, meditation, nutritional status, telomere length, Thai Buddhist monks

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Relationship of self-regulation and lifestyle behaviour with overweight among male and female adolescents in Selangor
Anu Suria Ganason, Noor Azimah Muhammad, Gunenthira Rao, Hizlinda Tohid, Majmin Sheikh Hamzah & Khairani Omar

doi: https://doi.org/10.31246/mjn-2020-0095

Vitamin Relationship of self-regulation and lifestyle behaviour with overweight among male and female adolescents in Selangor
ABSTRACT

Introduction: The ability of a person to self-regulate and practise healthy lifestyle behaviours determine one’s weight status. The objective of this study was to determine the relationship of self-regulation, dietary practices, and physical activity with overweight status among male and female adolescents.
Methods: This crosssectional study used multistage cluster sampling involving government secondary school students aged between 13 and 14 years old in Hulu Langat, Selangor. Students answered a validated self-administered questionnaire comprising socio-demography, dietary practices, physical activity, and self-regulation items. Their body mass index (BMI) was calculated, and weight status was determined using the Centers for Disease Control and Prevention (CDC) BMI chart.
Results: Among 636 students, 27.0% were “overweight”, affecting more male than female students (p=0.032). Majority of them (96.7%) were motivated to maintain healthy body weight, but only a third of the students took vegetables, fruits and grains (32.4%), and performed vigorous physical activity (31.1%) regularly. Regardless of the “overweight” status, there were no significant differences in dietary practices, physical activity, and autonomous regulation for both genders. Female students showed a higher level of controlled regulation than male students in non-overweight (p=0.005) and overweight (p<0.001) groups. Higher controlled regulation increased the odds of being overweight among female students (AOR=1.04, 95% CI=1.04-1.08, p=0.010).
Conclusion: Thus, health authorities need to develop programmes to assist, particularly female students, in practising higher autonomous regulation to combat overweight and obesity, as this group exhibits a high level of controlled regulation, which increases the likelihood of being overweight.
Key words: school, self-regulation, students, weight status

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Developing and pre-testing of nutrition cartoon video to promote healthy eating among hearing and deaf and mute children
Idelia G. Glorioso, Shannen Faye Q. Arevalo, Maja Bethzaida S. Decena, Theresa Krista B. Jolejole & Milflor S. Gonzales

doi: https://doi.org/10.31246/mjn-2021-0127

Vitamin Developing and pre-testing of nutrition cartoon video to promote healthy eating among hearing and deaf and mute children
ABSTRACT

Introduction: A six-minute nutrition cartoon video “The Magical Pinggang Pinoy in Nutrilandia” was developed and pre-tested to encourage hearing and deaf and mute children to eat a variety of foods by following the Pinggang Pinoy® (Healthy Plate). This study described the development process of the nutrition cartoon video and explored the participants’ acceptance towards it.
Methods: The video underwent two levels of pre-testing to ensure comprehensibility, attractiveness, acceptability, and self-involvement. The first level was conducted among three DOST-FNRI experts, while the second level was among six deaf-mute school teachers and 30 mothers/ caregivers of 6-9 years old hearing children. Data were collected through an online self-administered questionnaire. Open-ended questions allowed participants to express themselves freely on the given subjects. Data analysis used thematic analysis.
Results: The video conveyed clear information on the Pinggang Pinoy®, and the inclusion of animation, subtitles, visuals, and voice-over made the video easier to understand. Participants stated that the message of the video was directed to children, teens, adults, malnourished people, and everyone in general. Pre-testing the nutrition cartoon video before final production identified terminologies and concepts that participants found unfamiliar, confusing and unacceptable; offered suggestions for improvement and made pre-tested video appropriate for hearing and deaf-mute children.
Conclusion: Overall, the participants had positive perceptions on the nutrition cartoon video. The video can be used in nutrition education classes among hearing and deaf and mute children, and serves as a tool to measure children’s nutrition knowledge on healthy eating.
Key words: cartoon video, healthy eating, hearing and deaf and mute children, nutrition education, pre-testing

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Adherence to age-appropriate feeding practices among Filipino children under two: An analysis of the 2018- 2019 Expanded National Nutrition Survey
Eva Abille Goyena & Ma. Lynell Valdeabella Maniego

doi: https://doi.org/10.31246/mjn-2022-0037

Vitamin Adherence to age-appropriate feeding practices among Filipino children under two: An analysis of the 2018- 2019 Expanded National Nutrition Survey
ABSTRACT

Introduction: Age-appropriate feeding in the first two years of life is essential to a child’s growth and development, with health implications that persist throughout life. This study examined the adherence to age-appropriate feeding practices among children 0-23.9 months old based on a constructed index, its association with anthropometric growth, and factors affecting adherence.
Methods: A total of 9,138 children aged 0-23.9 months with complete information on infant and young child feeding practices (IYCF), anthropometric measurements, maternal information, and household characteristics were included in the study. Data were extracted from a nationwide survey conducted in 2018-2019.
Results: Among children aged 0-23.9 months, 20.7% adhered to age-appropriate feeding criteria. More than half (57.7%) of children below six months adhered to age-appropriate exclusive breastfeeding practices, while 1.4% of children aged 6-8.9 months old started complementary feeding. Continued breastfeeding at 12 months of age while receiving complementary feeding was uncommon (11%). Significantly higher z-scores for weight-for-age (-0.6±0.04), height-for-age (-0.8±0.05), and weight-for-height (-0.2±0.05) were noted among children who adhered to age-appropriate feeding practices compared to those who did not. Child’s age and birth weight, as well as mother’s age, education, and working status, were found to significantly influence the likelihood of adhering to age-appropriate feeding index.
Conclusion: Filipino infants and young children under two years of age have low adherence to age-appropriate feeding practices, putting them at a higher risk of repeated occurrence of infection that could lead to stunting in early life.
Key words: childhood growth, feeding practices, nutritional status, stunting, wasting

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Dominant factors on food coping mechanism of poor households in Pringsewu Regency, Indonesia
Wuryaningsih Dwi Sayekti, Wan Abbas Zakaria, Tyas Sekartiara Syafani & Abdul Mutolib

doi: https://doi.org/10.31246/mjn-2020-0099

Vitamin Dominant factors on food coping mechanism of poor households in Pringsewu Regency, Indonesia
ABSTRACT

Introduction: In general, poor households do not have sufficient purchasing power to ensure food security, and this has led to the establishment of food coping mechanisms to alleviate this insufficiency. Therefore, this study was aimed at identifying the dominant factors on food coping mechanism of poor households.
Methods: Simple random sampling technique and random tables were used to obtain the data from a sample size of 92 beneficiaries of poor targeted households of prosperous rice (RASTRA) in Pringsewu Regency through interviews and a questionnaire. Four villages, i.e., Fajar Baru, Kemilin of North Pagelaran Sub- District, Wargomulyo, and Tanjung Rusia of Pardasuka Sub-District, were the locations of the study. Data were analysed using descriptive and factor analysis.
Results: Results showed that most households had food coping mechanisms involving buying smaller amounts and cheaper types of foods. Factors forming the poor households’ food coping mechanisms were the households’ social and economic conditions, food coping activities, assets, and heads’ and their wives’ occupations.
Conclusion: In Pringsewu Regency, the dominant factor affecting food coping mechanism was social condition. This condition encompassed the household head’s age, his and his wife’s length of formal education, their nutrition knowledge, and the number of actors on food coping mechanism. Education was the dominant variable on food coping mechanism of poor households and it played the biggest role in affecting the establishment of survival mechanisms for overcoming food insecurity.
Key words: dominant factor, food coping, RASTRA

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Application of STRONGkids method on assessing the risk of malnutrition among hospitalised children in Universitas Sebelas Maret Hospital
Maria Galuh Kamenyangan Sari, Vitri Widyaningsih, Amanda Sari Puspita, Satria Wardana & Asyari Mia Lestari

doi: https://doi.org/10.31246/mjn-2022-0013

Vitamin Application of STRONGkids method on assessing the risk of malnutrition among hospitalised children in Universitas Sebelas Maret Hospital
ABSTRACT

Introduction: Hospital malnutrition (HM) in children augments morbidity and mortality, thus early detection is a preventive measure that may improve a patient’s condition. This study identified the risk factors of HM among children hospitalised in Universitas Sebelas Maret (UNS) Hospital using the STRONGkids method.
Methods: This observational analytical cross-sectional study was performed in children hospitalised at the paediatric ward of UNS Hospital between February and August 2021. The samples were taken by consecutive sampling technique. Subjects meeting the inclusion criteria were assessed for their underlying disease, nutritional status based on World Health Organization Anthro software, and STRONGkids score. Chi-square test and logistic regression analysis were used, with a p-value of <0.05 considered as statistical significance.
Results: A total of 173 children were included in the study, 56% were males, mean age was 62.5 months, 45% had an underlying chronic disease, and 17.9% experienced moderate malnutrition. Based on the STRONGkids score, 39.3% children were at high risk of malnutrition and 60.7% were at moderate risk of malnutrition. Logistic regression analysis showed that high risk of HM was significantly associated with age (OR 2.58, 95% CI 1.38-4.84, p=0.003), chronic disease (OR 7.23, 95% CI 3.3-15.86, p=0.018), and moderate malnutrition (OR 13.5, 95% CI 3.96-45.98, p<0.001).
Conclusion: Children hospitalised in UNS Hospital were at risk of malnutrition. Toddlerhood, chronic disease, and moderate malnutrition significantly increased the risk of HM. Thus, these children need optimal nutritional support to improve their clinical condition. STRONGkids is a convenient and easy method to identify malnutrition risk during hospitalisation.
Key words: children, hospital malnutrition, nutritional status, STRONGkids

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REVIEW: Regulatory status of bioactive non-nutritional food components in Southeast Asian countries
E-Siong Tee & Pauline Chan

doi: https://doi.org/10.31246/mjn-2022-review-28-3

REVIEW: Regulatory status of bioactive non-nutritional food components in Southeast Asian countries
ABSTRACT

A review conducted on the regulatory status of bioactive non-nutritional food components in foods and beverages in eight Southeast Asian countries indicates these components have been recognised for their health benefits. Indonesia and Malaysia have promulgated specific regulations allowing the addition of these bioactive components in foods and beverages, provided a list of the permitted components that may be used, and clear process for the industry to apply for new components. Both countries also have separate regulations that govern the making of function claims which refer to the beneficial physiological or health effects brought about by such bioactive components. The other six countries do not have a specific regulation governing the use of these bioactive components. However, these countries also permit the making of similar function claims, provided they are scientifically substantiated, preferably human clinical trials. Each country has slightly different requirements and process in place for reviewing applications for claims. All countries, except Myanmar, also allow the sale and marketing of foods containing probiotics, another functional food component. Indonesia, Malaysia, Philippines and Thailand have promulgated specific probiotic regulations and, except for Indonesia, have published permitted list of probiotics. All seven countries have provisions for the industry to apply for the use of new probiotics. Malaysia, Philippines, Singapore and Thailand permit the use of a pre-approved generic function claims related to probiotics. The sharing of experiences in regulatory approaches would be beneficial to the advancement of scientific and regulatory development of bioactive non-nutritional food components in the region and would benefit all stakeholders.

Key words: bioactive food components, food regulations, functional components, non-nutritional components

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