MJN 2025 Issues
Malaysian Journal of Nutrition (Mal J Nutr)
Volume 31 No.1, 2025

Table of Content
Demographic status, eating behaviour, and fruit and
vegetable intake in children aged 4 to 6 years
Nurfarhana Diana Mohd Nor & Che Nur Hasniza Che Rahim
doi: https://doi.org/10.31246/mjn-2023-0142
Demographic status, eating behaviour, and fruit and vegetable intake in children aged 4 to 6 yearsIntroduction: Fruits and vegetables (FV) are packed with nutrients; high consumption of FV offers various health benefits. However, consumption is reported to be below recommendation among children worldwide. Current evidence related to environmental and personal factors on FV intake in Malaysia is limited. Therefore, this study aimed to determine environmental and personal factors associated with FV intake among children aged 4 to 6 years in Malaysia.
Methods: 278 children participated and questionnaires were distributed to seven preschools in Setiu, Terengganu. Parents were asked to complete the questionnaire to assess demographic data, children’s eating behaviour, FV intake and liking.
Results: Girls consumed more vegetables than boys (p=0.041). Parental education was significantly associated with vegetable intake. Frequency of purchasing FV had a significant association with fruit (p=0.014) and vegetable (p<0.001) intakes among children. Meanwhile, frequency of family mealtimes was associated with vegetable intake. Furthermore, children’s eating behaviour was found to be related to FV intake. Three eating behaviour characteristics, namely food responsiveness, satiety responsiveness, and food fussiness, were significantly associated with vegetable intake, while enjoyment of food, food responsiveness, and emotional overeating had significant associations with fruit intake. Additional robust regression analyses demonstrated that only frequency of purchasing FV was a significant predictor of both FV intakes (p=0.018; p=0.001), while gender was a predictor of vegetable intake (p=0.011), but not fruit intake.
Conclusion: Demographic status and children’s eating behaviour were among the factors involved in determining FV intake among children.
Key words: children, child eating behaviour, fruit intake, predictors, vegetable intake
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Evaluation of commercial probiotic supplements in
Malaysia for registration status, labelling compliance,
and probiotic contents
Shin Yuh Lee, Siok Koon Yeo & Caroline Lin Lin Chua
doi: https://doi.org/10.31246/mjn-2024-0030
Evaluation of commercial probiotic supplements in Malaysia for registration status, labelling compliance, and probiotic contentsIntroduction: The global probiotics market is growing rapidly due to increasing consumer demands for functional foods and increased awareness of the importance of gut health. However, previous studies have raised concerns about the labelling, quality, and safety of commercial probiotic products available worldwide. There are limited studies focusing on probiotic supplements sold in Malaysia. Therefore, this study aimed to determine if these probiotic supplements are registered and labelled according to the guidelines by the National Pharmaceutical Regulatory Agency (NPRA), Ministry of Health Malaysia, and to identify common probiotic strains found in these products.
Methods: A total of 103 probiotic products sold at pharmacies in Klang Valley, Malaysia and online shopping platforms were included in this study. Product labels were examined for the presence of holographic security labels and other labelling requirements set by NPRA. Data were collected between January and March 2022.
Results: 81.6% of probiotic supplements sold in Malaysia were registered with NPRA; 70% were fully labelled according to NPRA guidelines, while the rest lacked one or more standard labelling criteria. Mislabelling of probiotic contents was found in 44.7% of probiotic supplements sold in Malaysia, whereby errors were detected in the probiotic nomenclature. The most common probiotic species in these supplements were Lactobacillus acidophilus (61.2%), followed by Bifidobacterium animalis subsp. lactis (50.5%), and Lactobacillus rhamnosus (46.6%).
Conclusion: While most probiotic supplements sold in Malaysia were registered under NPRA and properly labelled, the availability of unregistered products warrants consumers to make more informed choices about the selection of their purchases.
Key words: labelling compliance, National Pharmaceutical Regulatory Agency (NPRA), probiotics, probiotic supplements, registration
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Diet quality and its correlation with blood cholesterol levels in young adults in Indonesia
Hesti Permata Sari, Apoina Kartini, Yudhi Dharmawan, Nurjazuli Nurjazuli, Afina Rachma Sulistyaning, Elok Widyaningtyas
doi: https://doi.org/10.31246/mjn-2023-0144
Diet quality and its correlation with blood cholesterol levels in young adults in IndonesiaIntroduction: The prevalence of hypercholesterolaemia is increasing, especially in young adults. Poor diet quality can lead to increased blood cholesterol levels. This study aimed to describe diet quality and investigate the correlation of its components with blood cholesterol levels.
Methods: gate the correlation of its components with blood cholesterol levels. Methods: The design of this study was cross-sectional, involving 100 young adults (males and females) aged 19-22 years, chosen using purposive sampling based on inclusion criteria. Diet quality data were collected using a 3x24-hour food record and assessed using the USAadapted Alternate Healthy Eating Index (AHEI) comprising 11 components. Data of AHEI’s components were analysed using Pearson’s Product Moment, Spearman’s rank test, and multiple linear regression.
Results: All young adults’ diet quality (100%) had a score in the ‘needed improvement’ category (<76.2). There were no significant correlations between fruits (r=-0.129, p=0.200), tubers and cereals (r=-0.071, p=0.482), nuts and legumes (r=0.169, p=0.093), red processed meat (r=-0.043, p=0.670), omega-3 (r=0.022, p=0.831), polyunsaturated fatty acids (r=-0.056, p=0.581), sodium (r=-0.061, p=0.544), and alcohol with blood cholesterol levels. However, there was a significant correlation between vegetables (r=-0.226, p=0.024), sugar-sweetened beverages (SSB) (r=0.388, p<0.001), and trans fat (r=0.237, p=0.018) with blood cholesterol levels.
Conclusion: Consumption of vegetables was associated with decreased blood cholesterol levels, while SSB and trans fat consumption were associated with increased blood cholesterol levels.
Key words: AHEI, cholesterol, diet quality, young adult
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Female athlete triad syndrome: A bibliometric analysis
Maria Ulfa, Meiky Fredianto, Roslee Rajikan, Merve Ilhan-Esgin & Esti Widiasih
doi: https://doi.org/10.31246/mjn-2024-0016
Female athlete triad syndrome: A bibliometric analysisIntroduction: Menstrual disruption, lack of energy availability (with or without an eating disorder), and decreased bone mineral density are collectively known as the female athlete triad. It is common among young women who engage in athletic activities. This study aimed to identify the female athlete triad patterns and provide nutritional recommendations for female athletes to prevent triad syndrome.
Methods: This study used a quantitative method with a bibliometric study approach. The inclusion criteria were document type ‘Article,’ publication stage ‘Fully published articles,’ source type ‘Journal,’ and language ‘English,’ from 2018-2024. Data were analysed using Scopus, VOSviewer, Nvivo 12 Plus, and Rstudio.
Results: Research on female athlete triad syndrome showed a notable increase in 2014 and 2022. The United States (52 papers), Canada (ten papers), and Japan (nine papers) were the leading contributors. Five key clusters were identified: energy and metabolism, bone mineral density, menstrual disorders, sports injuries, and athlete performance. To effectively address the nutritional needs of female athletes and mitigate the risk of triad syndrome, it is essential to consider these five key clusters. The development of the triad in female athletes is primarily due to insufficient nutrition and calorie intakes, leading to a negative energy balance.
Conclusion: There is still much to learn, but recent research has focused on minimising risks and maximising benefits for young female athletes by addressing the key clusters identified in this study. Healthcare professionals should educate patients, parents, and coaches about female athletes’ potential challenges and the best strategies to support them.
Key words: female athletes, nutrition, triad syndrome
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Development of value-added ragi barfi by incorporating mudakathan (Cardiospermum halicacabum) and evaluation of its sensory, shelf life and nutrient analysis
Saraswathi Srinivasan, Hema Thirvangam Henry & Hemamalini Arambakkam Janardhanam
doi: https://doi.org/10.31246/mjn-2024-0053
Development of value-added ragi barfi by incorporating mudakathan (Cardiospermum halicacabum) and evaluation of its sensory, shelf life and nutrient analysisIntroduction: Insufficient dietary calcium intake has resulted in calcium deficiency affecting half of the population, which has implications for bone strength and an increased risk of osteoporosis in post-menopausal women. Barfi made from ragi flour and mudakathan leaves powder provides various benefits, including antioxidants, anti-arthritic, anticancer, and anti-inflammatory properties. The present research aimed to develop ragi barfi incorporating mudakathan (Cardiospermum halicacabum) and to evaluate its sensory acceptability, as well as to analyse the micronutrient (calcium and vitamin D) and macronutrient contents of the developed products.
Methods: Barfis were prepared using standard procedures, with one group made without mudakathan leaves powder (T0 Control) and three variations (T1, T2, and T3) made with mudakathan leaves powder in proportions of 5 grams, 10 grams, and 15 grams. These barfis were then evaluated by thirty panellists using a nine-point hedonic scale. The accepted product underwent nutrient analysis, microbial analysis for shelf life, and cost analysis. The samples were compared using one-way analysis of variance (ANOVA).
Results: In the sensory evaluation, three variations (T1, T2, T3) were considered; T3 was ultimately selected based on sensory and nutritional analysis. The barfi prepared with 15 grams of mudakathan was found to be highly acceptable in all quality attributes and demonstrated good storage ability with a shelf life of one month.
Conclusion: This indicated that the efficient combination of mudakathan and “poor man’s millet” can be utilised to reach households and address public health by promoting bone strength.
Key words: barfi, calcium, finger millet, mudakathan (Cardiospermum halicacabum), sensory evaluation
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Zinc deficiency and its correlates among infants aged 6-11 months in rural areas of Thanh Hoa province, Vietnam
Van Doanh Pham, Thi Minh Nguyet Tran, Thi Thuy Dung Le, Van Chuyen Hoang, Tuyet Thi Le & Thuy Nga Tran
doi: https://doi.org/10.31246/mjn-2024-0097
Zinc deficiency and its correlates among infants aged 6-11 months in rural areas of Thanh Hoa province, VietnamIntroduction: Zinc deficiency remains prevalent among children in developing countries and is associated with stunting, which negatively impacts children’s growth and development. This study describes zinc deficiency status among infants in selected communes in Thanh Hoa province, Vietnam, in April 2020.
Methods: A descriptive cross-sectional study was conducted, with random selection of 360 children aged 6 to 11 months. General information was collected through interviews with mothers/caregivers using pre-designed questionnaire. Zinc and ferritin concentrations were analysed using laboratory quantitative tests. Multivariate logistic regression was used to identify factors associated with zinc deficiency.
Results: Mean zinc concentration was 9.0 mmol/L, with proportion of zinc deficiency at 71.7% (95% CI: 66.7%–76.3%), iron deficiency 16.4% (95% CI: 12.5%–20.0%) and stunting 17.8% (95% CI: 14.0%–22.1%). Several factors were found to be significantly associated with zinc deficiency: non-exclusively breastfed children aged under 6 months (OR=1.88; 95% CI: 1.09–3.24); children with diarrhoea (OR=2.33; 95% CI: 1.01–5.35); children with acute respiratory infections (OR=2.35; 95% CI: 1.04– 5.30); and mothers who did not take micronutrient supplements during pregnancy (OR=2.02; 95% CI: 1.19–3.44), (p<0.05).
Conclusion: Zinc deficiency was common in infants 6–11 months old in this study. Therefore, early interventions through dietary diversification and supplementation are warranted. Collaboration with public health programmes is vital to educate caregivers on better child nutrition and care practices, and enhance the effectiveness of prevention.
Key words: infant aged 6 to 11 months, rural area, zinc deficiency status
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Evaluating the effects of goat’s milk on inflammatory responses in rat model with gastritis
Atun Farihatun, Kusmardi Kusmardi, Ari Estuningtyas & Mohd Nazil Salleh
doi: https://doi.org/10.31246/mjn-2024-0059
Evaluating the effects of goat’s milk on inflammatory responses in rat model with gastritisIntroduction: Gastritis is a health issue that can lead to various complications, including chronic atrophic gastritis, gastric metaplasia/dysplasia, iron deficiency anaemia, gastric bleeding, gastric perforation, and gastric cancer. Goat’s milk contains bioactive ingredients, particularly proteins, that offer significant health benefits. This study aimed to examine the potential of goat’s milk as an antiinflammatory agent in gastritis rat models.
Methods: This research used a preclinical experimental design. A total of 25 rats were divided into five groups (n=5 per group): three groups received goat’s milk at doses of 0.5 ml, 1 ml, and 1.5 ml daily for 30 days, followed by ethanol administration (80%, 1 ml) for three consecutive days; one group received no treatment and was not exposed to ethanol; and one group received ethanol without prior goat’s milk administration. Interleukin-6 (IL-6), tumour necrosis factor alpha (TNF-α), and interleukin-10 (IL-10) cytokines were analysed using the Luminex Multiplex Bead Assay.
Results: Administering 1.0 ml and 1.5 ml of goat’s milk for 30 days increased IL-10 and inhibited the increase in IL-6 and TNF-α in gastritis rat models compared with administering 0.5 ml of goat’s milk. Histological examination revealed a marked improvement in integrity of gastric mucosal layer, with reduced signs of cellular damage, less infiltration of inflammatory cells, and an increase in thickness of mucosal layer. These histological findings correlated with observed cytokine changes, suggesting that goat’s milk exerts a protective effect on gastric mucosa, potentially through immunomodulatory mechanisms.
Conclusion: Goat’s milk showed protective and anti-inflammatory effects in a rat model of gastritis, indicating its potential as a supportive dietary component for gastric health, pending further research.
Key words: cytokines, ethanol, gastritis, goat milk, inflammatory
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Determinants of energy availability and nutrient intakes among overweight and obese Malaysian adults during COVID-19 lockdown: A cross-sectional study
Norsuriani Samsudin, Nur Syamsina Ahmad, Foong Kiew Ooi, Azidah Abdul Kadir & Nur Karyatee Kassim
doi: https://doi.org/10.31246/mjn-2024-0062
Determinants of energy availability and nutrient intakes among overweight and obese Malaysian adults during COVID-19 lockdown: A cross-sectional studyIntroduction: Unhealthy lifestyle, especially during COVID-19, contributed to weight gain. This study investigated energy availability and nutrient intakes in overweight and obese Malaysian adults during lockdown.
Methods: Fifty participants (overweight: 30.2±0.9 years old, body mass index (BMI) 27.7±0.2 kg.m-2; obese: 27.9±1.9 years old, BMI 30.0±0.2 kg.m-2) recorded their food intake using 24-hour diet recall. Total energy, macronutrient, and micronutrient intakes were analysed with independent t-test.
Results: Energy intake exceeded expenditure across all groups. Overweight males and females consumed 3376±55 kcal/day and 3293±68 kcal/day, while obese males and females consumed 3442±70 kcal/ day and 2915±48 kcal/day, respectively. Overweight males expended 2223–2299 kcal/day, while obese males expended 2312–2431 kcal/day. Overweight females expended 1901–1960 kcal/day and obese females expended 1971–2139 kcal/day. Energy availability varied, with overweight males at 24–26 kcal/kg fat-free mass (FFM)/day and obese males at 19–22 kcal/kg FFM/day, while female values ranged from 15 to 31 kcal/kg FFM/day. Fat intake exceeded recommended values, while vitamin D, C, and K intakes were inadequate. Sugar and phosphorus intakes surpassed recommendations.
Conclusion: During COVID-19 lockdown, overweight and obese Malaysian adults had higher energy intake than energy expenditure, contributing to positive energy balance and potential weight gain. Fat intake exceeded recommendations, while micronutrients, such as vitamins D, C, and K, were deficient. Energy intake (measured) and energy expenditure (calculated) were significant determinants of energy availability.
Key words: COVID-19, energy availability, nutrients intake, obesity, overweight
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Utilising mHealth to improve health literacy on chronic kidney disease among diabetics: Malaysian Nutritional, Emotional and Physical Health literacy for optimal Renal Outcome (My-NEPHRO) randomised controlled trial protocols
Nurulhuda Mat Hassan, Yuzana Mohd Yusop, Sharifah Wajihah Wafa Syed Saadun Tarek Wafa, Ahmad Kamal Ariffin Abdul Jamil, Norwati Daud, Siti Norazlina Juhari1, Nurul Izza Yunus1, Nur Aiza Idris1 & Nurul Azreen Yusof
doi: https://doi.org/10.31246/mjn-2024-0086
Utilising mHealth to improve health literacy on chronic kidney disease among diabetics: Malaysian Nutritional, Emotional and Physical Health literacy for optimal Renal Outcome (My-NEPHRO) randomised controlled trial protocolsIntroduction: Technology-integrated intervention approaches are considered convenient, accessible, and a more scalable way to engage a larger population. The objective of this paper is to present the protocols for a randomised controlled trial that evaluates the efficacy of a health literacy intervention module (MyNEPHRO) via a mobile application, which aims to improve health literacy, quality of life, and medical outcomes among diabetes patients with chronic kidney disease (CKD).
Methods: This will be a randomised controlled interventional trial. MyNEPHRO module will be developed, validated, and integrated within a mobile application. The mobile app intervention is to be delivered for six months with multiple approaches. Eligible adults aged more than 18 years old with diabetes and non-dialysis chronic kidney disease will be assigned to one of the two study groups (intervention or usual care control groups) in a 1:1 ratio using simple randomisation. Repeated measures analysis of covariance (ANCOVA) will be used to examine the changes over time within and between groups.
Results: Changes in health literacy level (primary outcomes), and changes in haemoglobin A1c (HbA1C), renal function, and quality of life (secondary outcomes) will be assessed at three and six months.
Conclusion: This study protocol describes a digital health literacy intervention for CKD among diabetics in Malaysia, determining the effect of this intervention on health literacy, HbA1c level, renal disease progression, and quality of life in diabetics with CKD. Results from this trial will provide insights in improving health literacy regarding CKD among diabetics in Malaysia.
Key words: chronic kidney disease, diabetes, health literacy, mhealth
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Mothers’ knowledge, attitudes, and practices on infant and young child feeding in selected municipalities in Bangsamoro Autonomous Region in Muslim Mindanao, Philippines: A cross-sectional study
Maria Theresa M Talavera, Angelina R Bustos, Divine Grace C Domingo, Nancy A Tandang, Leila S. Africa, Angelina DR. Felix, Anna Teresa O Orillo, Warren TK Lee & Maria Cecile F. Pastores
doi: https://doi.org/10.31246/mjn-2024-0065
Mothers’ knowledge, attitudes, and practices on infant and young child feeding in selected municipalities in Bangsamoro Autonomous Region in Muslim Mindanao, Philippines: A cross-sectional studyIntroduction: Optimal infant and young child feeding (IYCF) practices are essential for improving the nutritional status of young children. In Maguindanao, Bangsamoro Autonomous Region of Muslim Mindanao (BARMM), there is a high prevalence of malnutrition among infants and young children. Information on mothers’ knowledge, attitudes, and practices (KAP) regarding IYCF is limited. This study aimed to assess the current KAP of mothers regarding IYCF and explore the factors influencing these practices.
Methods: A cross-sectional study was conducted involving 320 mothers of children aged 6 - 23 months using a pre-tested questionnaire. Data were collected by trained researchers.
Results: Mothers showed strong knowledge on breastfeeding, with over 90.0% recognising its importance during illness and proper breastfeeding techniques. They also have positive attitudes, with 99.4% acknowledging breastfeeding’s health benefits, 96.9% its economic value, and 96.8% its role in emotional bonding. Analysis showed significant positive association between education and attitude (p=0.001), while there were no significant association with knowledge (p=0.058) and practice (p=0.091). Income levels showed no significant associations with knowledge (p=0.388), attitude (p=0.061), and practice (p=0.419).
Conclusion: Addressing knowledge and attitude gaps through nutrition messages could enhance IYCF practices among mothers in Maguindanao, BARMM.
Key words: attitudes, Bangsamoro Autonomous Region of Muslim Mindanao, infant and young child feeding, knowledge, practices
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Malaysian Journal of Nutrition (Mal J Nutr)
Volume 31 No.2, 2025

Table of Content
Nurses’ therapeutic nutrition knowledge: A crosssectional survey in Yemen
Khaled Mohammed Al-Sayaghi, Faten Abdo Hassan, Abrar Sadiq Mohammed Ghanim, Haifa Abdulrahman Sultan Noman, Eglal Khaled Ahmed Mohsen, Ayat Abdulaziz Ali Mohammed, Afnan Hassan Hussein
Saeed, Maram Mahmoud Ahmed Ali, Al-anood Saeed Mohammed Basarda, Abeer Mohammed Abdallah Mohammed, Richard Mottershead, Sadeq Abdo Mohammed Alwesabi & Mohammed Musaed Al-Jabri
doi: https://doi.org/10.31246/mjn-2025-0015
Nurses’ therapeutic nutrition knowledge: A crosssectional survey in YemenIntroduction: Nutrition plays a critical role in improving the health of individuals struggling with chronic conditions. Nurses have the potential to reduce morbidity and mortality through effective nutritional counselling and advice. This study aimed to assess level of nurses’ therapeutic nutrition knowledge and factors influencing their knowledge levels.
Methods: A descriptive cross-sectional survey was conducted between December 2023 and February 2024 at two public hospitals in Taiz Governorate, Yemen, using self-administered questionnaire. A convenience sample of 207 nurses participated in the study. The questionnaire comprised two sections: demographic data and 31 items assessing nurses’ therapeutic nutrition knowledge, divided into diabetes, obesity, and cardiovascular diseases.
Results: Total scores for nurses’ therapeutic nutrition knowledge ranged from 2 to 23, with mean total score of 14.43 out of 31 (46.5%). Only 13 out of 31 items were answered correctly by more than 50.0% of nurses, while eight items were answered incorrectly by over 80.0% of nurses. Only 35.5% of nurses had satisfactory knowledge, while 64.5% had unsatisfactory knowledge. Mean scores for therapeutic nutrition knowledge regarding diabetes, obesity, and cardiovascular diseases were 2.82 out of 5 (56.4%), 4.17 out of 9 (46.3%), and 7.44 out of 17 (43.8%), respectively.
Conclusion: The findings revealed low level of nutrition knowledge among nurses, emphasising a critical gap that must be addressed. Integrating comprehensive nutrition content into nursing curricula and implementing targeted education can bridge this gap. Enhancing nurses’ knowledge will improve patient outcomes and support broader public health goals through more effective nutrition policies.
Key words: cardiovascular disease, chronic diseases, diabetes, nurses’ therapeutic nutrition knowledge, obesity
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Food classification using daily sugar intake among Indonesian school-aged children
Wardina Humayrah, Megah Stefani & Athiya Fadlina
doi: https://doi.org/10.31246/mjn-2023-0179
Food classification using daily sugar intake among Indonesian school-aged childrenIntroduction: The increasing prevalence of diabetes and sugary snacking habits among schoolchildren in Indonesia is driving the need for a comprehensive food classification system, particularly based on sugar intake, with potential implications for sugar traffic light labelling. This study aimed to classify foods according to sugar intake in Indonesian children aged 5 to 9 years.
Methods: Using cross-sectional design, the study used secondary data from the 2014 Individual Food Consumption Survey (IFCS), which included 24-hour recalls from 8007 school-aged children (5-9 years). The 1318 food items consumed were aggregated into 61 subgroups and Ward’s hierarchical clustering method (HCWM) was used for classification. Principal component analysis (PCA) and BiPlot visualisation were used to analyse the similarity of the characteristic variables in each food level.
Results: Four levels of food groups based on daily sugar intake: Level 1 (low sugar), Level 2 (moderate sugar), Level 3 (high sugar), and Level 4 (very high sugar). Notable items included instant noodles (Level 1), tea/coffee/cocoa drinks (Level 2), soft drinks/fruit drinks (Level 3), and added sugars/sugary milk (Level 4). Level 4 foods had highest sugar content and were among the most frequently consumed items, significantly contributing to daily sugar intake.
Conclusion: This classification system highlighted the significant contribution of specific foods to daily sugar intake of school-aged children. Targeted nutrition interventions and strong food labelling policies are essential to reduce consumption of foods high in sugar and promote healthier dietary choices among children.
Key words: clustering food, school-aged children, sugar intake
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Development and validation of a digital photographic food atlas of Malaysian foods
Jim Mee Sha, Chang Coren Yu Huey, Chong Wan Tong, Khoo Natasha Yuen Teng, Lee Yi Yi & Chong Pei Nee
doi: https://doi.org/10.31246/mjn-2024-0075
Development and validation of a digital photographic food atlas of Malaysian foodsIntroduction: Portion size estimation elements (PSEE), such as food atlas, are utilised to improve portion size estimation accuracy in dietary assessments. Digital food atlases offer advantages like high accuracy, convenience, and portability. This study aimed to develop and validate a digital food atlas comprising commonly consumed Malaysian foods.
Methods: Foods were selected based on national food consumption data. Photographs were taken at 45-degree angle under standard lighting conditions. During validation study, 41 Malaysian university staff and students (mean age 25±9 years) were recruited to estimate the portion of 33 preweighted foods using the atlas. Validity of the atlas was determined by comparing actual versus estimated weight of test foods using Wilcoxon signed-rank test. Subsequently, a usability questionnaire evaluated the atlas’s usefulness.
Results: In total, 91 foods were included in the atlas. Significant differences were present in 23 food items tested in validation study, ranging from 54.9% underestimation to 95.1% overestimation. The digital food atlas received high usability scores, with an average of 3.2/4 for carbohydrate foods, and 3.3/4 for protein and fruit/vegetable sections.
Conclusion: This study developed and validated a digital food atlas of commonly consumed local foods, potentially improving accuracy of portion size estimation in dietary assessments. Further modification by including wider range of foods and validation among diverse ethnic and age groups is warranted before its widespread use. Integration into clinical practice, research, and public health initiatives could further support dietary assessment and portion size education.
Key words: dietary assessment, digital food atlas, portion size estimation
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Socio-demographic factors associated with oral health knowledge, attitude, practice and frequency of cariogenic food consumption among 11- to 12-year-old primary schoolchildren in Pulau Pinang, Malaysia
Oung Stephanie Ker Yue, Ruhaya Hasan*, Norkhafizah Saddki & Kueh Yee Cheng
doi: https://doi.org/10.31246/mjn-2024-0103
Socio-demographic factors associated with oral health knowledge, attitude, practice and frequency of cariogenic food consumption among 11- to 12-year-old primary schoolchildren in Pulau Pinang, MalaysiaIntroduction: This study determined socio-demographic factors associated with oral health knowledge, attitude, practice and frequency of cariogenic food consumption among 11- to 12-year-old primary schoolchildren in Pulau Pinang, Malaysia.
Methods: A cross-sectional study using validated self-administered questionnaire was conducted among 11- to 12-year-old schoolchildren attending government national primary schools in Barat Daya and Seberang Perai Selatan districts of Pulau Pinang, excluding those with intellectual disabilities or visual impairments. A multi-stage sampling method was used.
Results: A total of 218 schoolchildren participated in the study. The majority demonstrated good oral health knowledge (71.1%) and attitude (60.1%), but nearly half (44.5%) had never used dental floss. Cariogenic foods were mostly moderately consumed. Factors significantly associated with schoolchildren’s oral health knowledge were ethnicity (p<0.001) and father’s/male guardian’s education level (p=0.029), whereas attitude was significantly associated with ethnicity (p<0.001), father’s/male guardian’s education level (p=0.046), mother’s/female guardian’s occupation (p=0.036) and monthly household income (p=0.016). Smoking habit was significantly associated with ethnicity (p=0.004) and mother’s/female guardian’s education level (p<0.001). Rural schoolchildren had significantly higher mean cariogenic food frequency score than urban schoolchildren (p=0.039). Oral health knowledge was positively correlated with attitude (r=0.554, p<0.001), while attitude was negatively correlated with frequency of cariogenic food consumption (r=-0.245, p<0.001).
Conclusion: Ethnicity, parents’/guardians’ education level, mother’s/female guardian’s occupation and monthly household income were associated with schoolchildren’s oral health knowledge, attitude and practice. Rural schoolchildren consumed cariogenic foods more frequently compared to urban schoolchildren.
Key words: child, health knowledge, attitudes, practice, oral health
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Effect of dietary fibres present in traditional Japanese vegetables on carbohydrate-digesting enzyme activity
Tsuchiya Yo & Maeda Ai
doi: https://doi.org/10.31246/mjn-2024-0102
Effect of dietary fibres present in traditional Japanese vegetables on carbohydrate-digesting enzyme activityIntroduction: Dietary fibre intake is widely recommended as a nutritional therapy to alleviate hyperglycaemic and diabetic conditions. Inulin is a heteropolysaccharide mainly found in burdock. It is known that inulin intake reduces postprandial glucose level; however, details regarding the mechanism of this action remain unclear. In this study, we investigated the effect of burdock and inulin on glucose metabolism.
Methods: Burdock and inulin were added to a solution containing maltose and α-glucosidase. Glucose produced from digested maltose was measured using mutarotase-glucose oxidase assay as the activity of α-glucosidase. We employed Ostwald viscometer to measure viscosity of inulin solution.
Results: Addition of 0.1-1.0 g raw burdock in 6 mL incubation solution significantly decreased activity of α-glucosidase in an amount-dependent manner. Boiled burdock and its supernatant liquid sample also significantly decreased activity of this enzyme, although degree of suppression in the boiled sample was less than in raw burdock. Addition of inulin, in the range of 0.67 to 6.70%, significantly decreased activity of α-glucosidase. Viscosity of inulin solution depended on its concentration from 0 to 6.70% and the relationship showed an almost direct proportion. α-glucosidase activity significantly decreased in the range of 1.03 to 1.40 in relative viscosity of inulin solution.
Conclusion: These results suggested that inulin has a suppressive effect on α-glucosidase activity and that high viscosity of inulin solution may inhibit reaction of digestive enzyme.
Key words: α-glucosidase activity, burdock, dietary fibre, inulin, liquid viscosity
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Dietary patterns and haemoglobin levels in female adolescents living in boarding schools in Tasikmalaya city, Indonesia
Lilik Hidayanti & Retno Murwani
doi: https://doi.org/10.31246/mjn-2024-0127
Dietary patterns and haemoglobin levels in female adolescents living in boarding schools in Tasikmalaya city, IndonesiaIntroduction: Anaemia is prevalent among female adolescents with low dietary intake of iron-rich foods, which is considered a significant risk factor. This study investigated the contribution of main meals and snacks to the total dietary intake and haemoglobin (Hb) levels in female adolescents attending Islamic boarding schools.
Methods: This cross-sectional study involved 323 female adolescents residing fulltime in eight Islamic boarding schools in Tasikmalaya City, West Java, Indonesia. Data collected included dietary intake (total dietary intake, main meals, and snacks) and Hb levels.
Results: The average Hb level was 11.9 g/dL, with 49.2% subjects being anaemic. The average total dietary iron intake in subjects with anaemia (6.7 mg) was lower than those without anaemia (7.5 mg). Anaemic subjects with dietary iron intake <80% Recommended Dietary Allowances (RDA) (50.5%) were more prevalent than those with dietary iron intake ≥ 80% RDA (39.8%). In anaemic subjects, the majority of dietary iron intake came from snacks (55.1%), whereas in nonanaemic it predominantly came from main meals (53.7%). A significant correlation exists between total dietary iron intake and Hb levels (p=0.011), underscoring the importance of adequate dietary iron intake.
Conclusion: The finding indicates that total dietary iron intake contributes to increased Hb levels, therefore it is important to provide awareness regarding iron adequacy in female adolescents.
Key words: anaemia, dietary intake, female adolescents, iron, snacks
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Development and validation of a food frequency questionnaire for iron intake among pregnant women (P-FeFFQ)
Syahrul Bariah Abdul Hamid & Cinderella Anak Ringgit
doi: https://doi.org/10.31246/mjn-2024-0112
Development and validation of a food frequency questionnaire for iron intake among pregnant women (P-FeFFQ)Introduction: Iron deficiency anaemia is common among pregnant women in Malaysia, posing risks to both maternal and foetal health. This study aimed to develop and validate a Food Frequency Questionnaire (FFQ) to assess iron intake among pregnant Malaysian women.
Methods:The Pregnancy-Focused Iron Food Frequency Questionnaire (P-FeFFQ) was created using data from 24-hour dietary recalls and literature reviews on iron-rich foods. An expert panel reviewed an initial list of 74 food items, which was refined to 63 based on content validity index (I-CVI) scores and feedback. Validation was performed against three-day dietary records from 21 pregnant women. Descriptive statistics summarised sociodemographic data and iron intake, while Pearson’s correlation and Bland-Altman plot analyses assessed validity.
Results: Participants had mean age of 29.8 years and prepregnancy body mass index (BMI) of 26.0 kg/m². P-FeFFQ showed excellent content validity (I-CVI score of 0.93) and was culturally relevant. Mean iron intake estimated by P-FeFFQ was 14.09 mg/day compared to 12.38 mg/day from dietary records. Pearson’s correlation coefficient was 0.648 (p=0.001), indicating moderate positive relationship. Bland-Altman analysis showed mean difference of 1.71 mg/day, with most data points within the limits of agreement, suggesting reasonable accuracy.
Conclusion: P-FeFFQ is a valid tool for assessing dietary iron intake among pregnant women in Malaysia.
Key words: anaemia, food frequency questionnaires (FFQ), iron deficiency anaemia, pregnant women
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Therapeutic benefits of white tea: A review of its multifaceted role in health management
Arini Noor Khasanah, Gemala Anjani & Fitriyono Ayustaningwarno
doi: https://doi.org/10.31246/mjn-2024-0122
Therapeutic benefits of white tea: A review of its multifaceted role in health managementIntroduction: White tea, derived from the Camellia sinensis plant, undergoes minimal fermentation, which helps preserve its antioxidant compounds and delicate flavour. This review aimed to comprehensively examine the therapeutic benefits of white tea by analysing its bioactive components, particularly catechins and flavonoids, and their roles in disease prevention and health promotion.
Methods: The review followed the PRISMA framework. A comprehensive electronic search was performed across several databases, including PubMed, Science Direct, and Google Scholar, to identify articles published between the years 2000 and 2024.
Results: A total of 1,008 article titles were initially identified; after applying the inclusion criteria, only 26 articles were selected for further analysis. Extensive research highlights the role of white tea in weight management, oxidative stress reduction, and its anti-ageing, anti-melanogenic, and anti-diabetic effects. Its bioactive components are linked to improved metabolic conditions and reduced risks of chronic diseases, including cancer and cardiovascular diseases. Additionally, white tea shows neuroprotective potential against Alzheimer’s disease and offers hepatic protection. Optimal brewing methods enhance both its health benefits and flavour.
Conclusion: White tea’s rich bioactive profile and diverse health benefits position it as a valuable functional food with potential applications in disease prevention and health promotion. Understanding white tea’s bioactive constituents and its role as a functional food provides valuable insight into its contribution to health and well-being.
Key words: antioxidant properties; bioactive compounds; health benefits; therapeutic applications; white tea
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Strengthening data availability and linkage for policies and programmes to improve maternal nutrition and the first 1,000 days of life: Country analysis – Indonesia, Philippines, and Thailand
Nipa Rojroongwasinkul, Pattanee Winichagoon, Emorn Udomkesmalee, Tippawan Pongcharoen, Sirinya Phulkerd, Rina Agustina, Wanda Lasepa, Atmarita, Kun A Susiloretni, Doddy Izwardy, Imelda Angeles-Agdeppa, Luz Tagunicar, Apple Joy D. Ducay & Corazon Barba
doi: https://doi.org/10.31246/mjn-2025-0003
Strengthening data availability and linkage for policies and programmes to improve maternal nutrition and the first 1,000 days of life: Country analysis – Indonesia, Philippines, and ThailandIntroduction: The multiple burden of malnutrition among children and women is a major nutrition challenge for Southeast Asian countries. Maternal malnutrition remains prevalent, hindering optimal maternal and child health outcomes. This project aimed to better understand situations and challenges and identify policy/programme-relevant data to enhance the efforts to improve maternal nutrition.
Methods: Data from large-scale national health, nutrition, and/or food consumption surveys, including key maternal nutrition indicators, relevant policies, and implemented programmes, were compiled from the Philippines, Thailand, and Indonesia. Lessons learnt and data/information gaps to strengthen policy decisions and programme performances were critically analysed.
Results: Indonesia and the Philippines secured high-level policy commitments for the 1,000 Days of Life movement, while Thailand’s Ministry of Public Health implemented the “Miracle of 1,000 Days” policy via its health system. Types and strength of evidence triggering policy decisions differed. Major challenges for all countries included data gathering and complex analyses, which hamper timely decisions. Rapid assessment tools, including digital-based ones, that can collect and analyse action-relevant data/ information in a frontline-orientated, timely, and multi-sectorally relevant manner are needed for actionable policies and programmes. Inclusion of dietary intake data for adolescents, pregnant and lactating women in large-scale surveys, reframing maternal nutrition as central to human capital development, and promoting closer collaboration between researchers and policy/programme planners will help in communication, priority setting, and capacity development.
Conclusion: For effective maternal nutrition improvement, fostering the linkage of policy and programme-relevant data will readily avail them for use by frontline and multisectoral stakeholders, as well as policymakers.
Key words: ASEAN nutrition policies and programmes, first 1,000 days movement, infant and child nutritional status, maternal nutrition
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Attenuating free radical damage with fermented Geoje yuzu in Drosophila
Kyehwan Park, Hoyoung Kim, Jinyoung Park, Myoungsoo Lee & Man Su Kim
doi: https://doi.org/10.31246/mjn-2024-0080
Attenuating free radical damage with fermented Geoje yuzu in DrosophilaIntroduction: Yuzu, a yellow citrus fruit from a plant belonging to the Rutaceae family, is a popular ingredient in many types of processed beverages. However, the long-term consequences of yuzu consumption at the organism level have not been thoroughly studied yet. Post-harvesting methods and cultivation methods may influence the reported health-promoting properties of yuzu, including antioxidant, anti-inflammatory, and anti-cancer effects. Therefore, we chose Drosophila as an animal model to evaluate the beneficial effects of yuzu that is cultivated and processed through fermentation in Geoje, South Korea. We examined in vivo effects of fermented yuzu on Drosophila during its lifetime.
Methods: Using lifespan assay, flies were fed fermented Geoje yuzu (FGY) and their survival was monitored. In healthspan assays, flies fed with FGY were exposed to environmental stresses, such as starvation, hydrogen peroxide, or carbon dioxide (CO2). Effects of FGY on improving ability of flies to withstand these stresses were assayed.
Results: Consumption of yuzu did not increase lifespan of the flies nor their capacity to withstand starvation and CO2 stress. However, it significantly protected the flies from oxidative stress, as evidenced by an increase in the survival rate of flies fed a diet supplemented with FGY when exposed to hydrogen peroxide.
Conclusion: This research found that FGY protects flies from oxidative stress. These results may pave the way for future research on long-term health-promoting properties of yuzu, ultimately fostering collective efforts to maximise health benefits of yuzu.
Key words: Drosophila, fermentation, oxidative stress, yuzu
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Exploring food consumption strategies amidst financial constraints among overweight and obese Malaysian women from low-income households: A qualitative study
Nur Nadia Mohamed & Abdul Jalil Rohana
doi: https://doi.org/10.31246/mjn-2025-0017
Exploring food consumption strategies amidst financial constraints among overweight and obese Malaysian women from low-income households: A qualitative studyIntroduction: Numerous studies have shown that individuals from low-income households are more susceptible to being overweight or obese, despite financial constraints. This study aimed to explore food consumption experiences of overweight and obese women from low-income households amidst financial constraints.
Methods: A qualitative study was conducted among overweight and obese women from low-income households in Peninsular Malaysia. In-depth interviews were audio-recorded and transcribed verbatim. Data were coded manually and analysed using thematic analysis based on Braun & Clarke’s method.
Results: A total of 27 Malay women aged 27–52 years old were interviewed. Four major themes emerged from in-depth interviews related to strategies of food consumption during financial constraints at different levels based on the socio-ecological model.
Conclusion: Multi-level food consumption strategies during financial constraints may contribute to overweight and obesity among individuals from low-income households. Tackling obesity in this demographic requires a holistic, multi-level approach encompassing individual, household, community, and policy interventions.
Key words: Low socioeconomic status, Malaysia, obesity, qualitative research, women
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High-leucine branched-chain amino acid supplementation improves C-reactive protein levels in critically ill patients: A randomised controlled trial
Yohannessa Wulandari, Dita Aditianingsih & Diana Sunardi
doi: https://doi.org/10.31246/mjn-2024-0073
High-leucine branched-chain amino acid supplementation improves C-reactive protein levels in critically ill patients: A randomised controlled trialIntroduction: Higher C-reactive protein (CRP) levels in critically ill patients are associated with increased disease severity and mortality rates. While branchedchain amino acids (BCAAs) have been extensively studied for their potential to enhance immunity in various diseases, research on the relationship between BCAAs and CRP levels in critically ill patients is scarce. This study aimed to assess the effect of BCAA supplementation on CRP levels in critically ill adult patients.
Methods: An experimental randomised controlled trial was performed on 40 critically ill adults between December 2023 and May 2024. All subjects were randomly assigned to BCAA supplementation and control, with a 1:1 comparison. Subjects in the BCAA group were given 40 grams/day of BCAA (19 g/day leucine) supplementation with a leucine:isoleucine:valine ratio of 2:1:1.2 for ten days. No supplementation was given to the control group. CRP was measured from blood serum pre- and postintervention.
Results: High CRP was found in all critically ill patients at baseline. Significantly lower CRP levels were found in the BCAA group compared to baseline (p=0.005) and control (p=0.001) post-intervention.
Conclusion: High CRP was common in critically ill patients, and BCAA supplementation improved their CRP levels. This study implied that providing BCAAs for critically ill patients potentially improves their acute inflammation state.
Key words: branched-chain amino acid, C-reactive protein, critical illness
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Optimising pasteurisation conditions to preserve the quality of fermented green asparagus roots (Asparagus officinalis L.) beverage
Nguyen Thi Ngoc Giang & Tran Van Khai
doi: https://doi.org/10.31246/mjn-2024-0091
Optimising pasteurisation conditions to preserve the quality of fermented green asparagus roots (Asparagus officinalis L.) beverageIntroduction: The root of Asparagus officinalis L. stands out as a potential byproduct source for creating value-added food products. Characterised by its high nutritional content and distinctive flavour and fragrance, the green asparagus root was studied for development of a new herbal tea. Pasteurisation is the crucial stage to ensure the quality of the final product, which requires precise investigation to obtain optimal parameters for maintaining quality of fermented drinks made from green asparagus roots.
Methods: This investigation mainly focused on efficiency of different pasteurisation temperatures (80, 85, 90, and 95°C) and durations (15, 30, 45, and 60 minutes) on pasteurisation value, physicochemical properties, and bioactive compounds of the pasteurised product.
Results: Optimal pasteurisation parameters for canned fermented drinks from green asparagus root were identified at a temperature of 90°C for 20 minutes, which ensured that they were microbiologically safe, maintained high levels of bioactive compounds, and were economically beneficial. With this pasteurisation condition, levels of reducing sugar, saccharose, vitamin C, total acidity, and bioactive compounds (phenolic, flavonoid, and saponin) (per litre of product) were 19.84 g, 102.08 g, 2.38 g, 0.064 g, 0.97 g tannic acid graph, 0.35 g quercetin graph, and 2.39 g saponin graph, respectively.
Conclusion: This study not only provided insights into optimal pasteurisation for fermented drinks made from green asparagus roots but also underscored the broader implications for nutrition, health, and sustainable economic developments. This optimised process can lead to development of nutritious beverages for future studies.
Key words: fermentation, microbiological safety, pasteurisation unit
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Food resources management and multilevel determinants of stunting: Insights from a national socio-ecological analysis in Indonesia
Yayuk Farida Baliwati & Akifa Laila Rusyda
doi: https://doi.org/10.31246/mjn-2025-0012
Food resources management and multilevel determinants of stunting: Insights from a national socio-ecological analysis in IndonesiaIntroduction: Factors influencing stunting are multifaceted, particularly at individual, household, and institutional levels. However, Indonesia’s significant research gap regarding integrating these ecological levels in stunting prevention efforts remains. Therefore, the present study analysed individual (children and mothers), household, and healthcare service factors contributing to stunting.
Methods: The study design was an ecological study using secondary data from 2023 Indonesian Health Survey in Numbers report (response rate: 98.74%). The dataset consisted of 38 units of analysis representing Indonesia’s provinces. This study applied the socio-ecological model (SEM), which illustrates United Nations Children’s Fund (UNICEF) Conceptual Framework on Maternal and Child Nutrition. The analysis employed Pearson’s correlation tests, followed by linear regression, with a 95% significance level (α=0.050).
Results: Results showed that stunting in Indonesia remained above the 14% national target for 2024, with a prevalence of 21.5% in 2023. Preventing stunting requires minimising risks within food resource management and public health services. The model explained 99.2% of stunting determinants, aligning with UNICEF’s Conceptual Framework, using SEM to analyse direct, indirect, and fundamental causes. Furthermore, food consumption and infection status were direct causes shaped by regional food ecosystems, while environmental health and public health services were crucial indirect factors. Socio-economic disparities also contributed to better healthcare and economic conditions in Western Indonesia, while stunting prevalence remained higher in Eastern Indonesia.
Conclusion: Strengthening cross-sectoral programme synergies targeting children, mothers, households, and institutions is essential for a comprehensive and sustainable approach to stunting reduction.
Key words: determinant, food resources management, socio-ecological model, stunting
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NutriQuest game: User experience of Grades 2 and 3 children in two Philippine private schools
Idelia G. Glorioso*, Shannen Faye Q. Arevalo, Milflor S. Gonzales & Christelle Lois T. Bayalas
doi: https://doi.org/10.31246/mjn-2024-0115
NutriQuest game: User experience of Grades 2 and 3 children in two Philippine private schoolsIntroduction: This study presents the user experience (UX) of Grades 2 and 3 schoolchildren with a nutrition mobile game, NutriQuest, developed by DOST-Food and Nutrition Research Institute.
Methods: The evaluation of user experience was based on the UX Honeycomb framework developed by Morville (2004). For this study, four aspects of the UX Honeycomb, namely usefulness, usability, findability, and desirability, were determined among study participants through a guided, selfadministered questionnaire.
Results: Study results revealed that approximately two-thirds (33 out of 49) of children were unable to correctly identify the food groups due to unfamiliarity with food items. For usability, children found that the words used and instructions of the game were just right. For findability, the majority of students (76% or 37 out of 49) answered that the buttons were easy to find and the game was easy to use (78% or 38 out of 49). For desirability, the sound effects used were just right (86%), pictures were good (84%), and 88% liked the light colours used. Children cited the lesson or information (57%) learnt through experience or by playing the game.
Conclusion: The NutriQuest game was acceptable to children; it can create awareness and knowledge on healthy eating. The findings provide vital inputs to game design, taking into account user interaction and experience when designing game interfaces. The impact of game-based learning on children’s knowledge of healthy eating can be considered for future research. Additionally, studies can also examine the interplay between conventional teaching modes and game-based strategies.
Key words: game-based learning, game interface, mobile games, schoolchildren
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