Online First
Malaysian Journal of Nutrition (Mal J Nutr)

Volume 30 No.3, 2024




Development of a touchscreen-based nutrition learning tool to promote healthy eating practices among early elderly Thai people
Nathakamon Padawech, Cholrit Luangjinda, Chanisa Tantixalerm & Chatrapa Hudthagosol

doi: https://doi.org/10.31246/mjn-2023-0177

Development of a touchscreen-based nutrition learning tool to promote healthy eating practices among early elderly Thai people
ABSTRACT

Introduction: In Thailand, rapid demographic ageing is closely linked to an increased incidence of non-communicable diseases (NCDs). Effective nutritional management is essential to mitigate NCD risks and delay progression. Given the widespread use of touchscreen devices among older adults, this study focused on developing a nutrition app tailored to enhance knowledge, attitudes, and practices regarding healthy eating among Thai elderly people.
Methods: The project consisted of two main phases, namely content preparation and application development. Initial drafts and storyboards were refined through consultations with experts and discussions. The use of healthy menus was approved by a professional chef and nutritionists. The app prototype underwent comprehensive evaluations in terms of content accuracy, design, usability, and acceptability by experts. It was also field tested by elderly volunteers for four weeks.
Results: The developed “YoungYou” app features tools such as body mass index assessment, updates on elderly health, and dietary recommendations tailored to Thai elderly individuals based on the nutrition flag system. It includes 60 healthy recipes, 30 cooking tutorials, and an interactive community board. The app allows users to modify and recalibrate the nutritional content of recipes, which can then be saved or shared. Evaluations of the app showed high levels of agreement on its effectiveness across all metrics. The use of rice, vegetables, and meat by 41 elderly volunteers led to increased healthy eating behaviours.
Conclusion: The “YoungYou” app has demonstrated potential as a viable tool for promoting healthier eating habits among Thai elderly people, thereby addressing critical public health issues related to ageing and disease prevention.The “YoungYou” app has demonstrated potential as a viable tool for promoting healthier eating habits among Thai elderly people, thereby addressing critical public health issues related to ageing and disease prevention.
Key words: elderly people; healthy eating; nutrition app; tool development; touchscreen

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Dietary intake, diet quality and nutritional status of homeless children: A cross-sectional study
Kar Wen Yong, Asma’ Ali, Hayati Mohd Yusof, Aziz Yusof & Michelle Mun Chieng Tan

doi: https://doi.org/10.31246/mjn-2023-0065

Dietary intake, diet quality and nutritional status of homeless children: A cross-sectional study
ABSTRACT

Introduction: The increasing number of homeless children is concerning. This study aimed to assess the dietary intake, diet quality, and nutritional status of homeless children in Klang Valley, as well as the relationship between diet quality and nutritional status.
Methods: Approximately 120 homeless children aged 7 to 12 years from four locations in Klang Valley were enrolled. Their dietary intake and nutritional status were assessed using a two-day 24-hour dietary recall and body mass index-for-age, respectively. The Healthy Eating Index (HEI) was used to examine diet quality.
Results: Prevalence of normal weight respondents was 58.3% (mean±SD: -0.79±1.80), with 25.0% classified as moderately and severely thin. Mean energy intake was significantly lower than recommended nutrient intakes (RNI) (p<0.050), while protein intake was higher (p<0.050). Calcium and zinc intakes were also significantly lower (p<0.001). Boys aged 7-9 years had significantly higher iron intake (median=11.6, IQR=8.7 mg, p=0.003), whereas girls aged 10-12 years had significantly lower intakes of iron (mean±SD=11.4±5.1, 11.1±4.7) and vitamin A (median=416.6, IQR=450.4 µgRE, p<0.001 for both). Mean HEI score was 51.30±6.78, indicating a need for diet quality improvement. No significant association between diet quality and nutritional status was observed (p=0.380).
Conclusion: This study provided insights into dietary intake, diet quality, and nutritional status of homeless children. Further research is vital to shape evidence-based nutrition interventions.
Key words: dietary intake, diet quality, homeless children, Malaysia, nutritional status

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Nutritional profile among vegetarians and non-vegetarians in Denpasar, Indonesia
Komang Trisna Sumadewi, Ni Putu Diah Witari, Luh Gede Evayanti, Dewa Ayu Agung Alit Suka Astini, Fransiscus Fiano Anthony Kerans & Anak Agung Ayu Asri Prima Dewi

doi: https://doi.org/10.31246/mjn-2023-0086

Nutritional profile among vegetarians and non-vegetarians in Denpasar, Indonesia
ABSTRACT

Introduction: Despite the many health benefits of a well-balanced vegetarian or vegan diet providing, vegetarians are at increased risk of deficiency in certain nutrients, such as calcium and iron, which could lead to health issues. Our study aimed to assess nutrient intakes and nutritional status between dietary patterns that include or do not include meat consumption.
Methods: This cross-sectional study was conducted in Denpasar, Bali, Indonesia. One hundred sixty respondents (80 vegetarians and 80 non-vegetarians) participated. Data were collected from interviews, a semi-quantitative food frequency questionnaire, and Nutrisurvey tools. Nutrient intakes were also assessed, including energy, carbohydrates, fat, protein, calcium, iron, zinc, and vitamin C. Body mass index (BMI) was used to determine nutritional status.
Results: There were no appreciable difference (p>0.05) in carbohydrate intake between vegetarian and non-vegetarian groups. In contrast, the vegetarian group’s energy, protein, and fat intakes significantly differed from that of non-vegetarians (p<0.05). No significant differences (p>0.05) were found in calcium, zinc, vitamin C, vitamin D, vitamin B12, folic acid, and magnesium between the two groups. However, it was discovered that the two groups’ iron intake and BMI were significantly different (p<0.05).
Conclusion: Vegetarians and non-vegetarians demonstrated differences in BMI, energy intake, protein consumption, fat consumption, and iron consumption. With a well-curated variety of food options and efficient administration of vegetarian meal plans, it is possible to effectively meet the nutritional requirements of individuals in terms of both essential vitamins and minerals, as well as carbohydrates, protein, and fats.
Key words: non-vegetarian, nutrient intake, nutritional status, vegetarian

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Determinants of knowledge, attitude, and practice towards aflatoxin contamination in food and aflatoxin biomarker levels among healthy Malaysian adults
Chang Wei Lin, Rosita Jamaluddin, Hazizi Abu Saad & Mohd Redzwan Sabran

doi: https://doi.org/10.31246/mjn-2023-0089

Determinants of knowledge, attitude, and practice towards aflatoxin contamination in food and aflatoxin biomarker levels among healthy Malaysian adults
ABSTRACT

Introduction: Limited information exists regarding the factors that determine the levels of knowledge, attitude, and practice (KAP) towards aflatoxin contamination in food, including aflatoxin biomarker levels in populations at risk. This study examined the associations between KAP levels with sociodemographic characteristics and weight status of 359 healthy Malaysian adults.
Methods: The study was conducted among residents and workers in Selangor, Malaysia. Sociodemographic characteristics and KAP levels were collected using a self-administered questionnaire, and body weight was measured. Urine and fasting blood samples were collected for aflatoxin M 1 and aflatoxin B1 analyses, respectively.
Results: Most respondents were females, Chinese, aged 25–44 years, with poor knowledge but positive attitudes and acceptable practices in controlling aflatoxin contamination in food. Univariate and multivariate analyses revealed that the knowledge level was remarkably high among females, unemployed, underweight or normal weight individuals, and those with a monthly income of >RM 10,000. The attitude score was high in those with tertiary education and those who were unemployed, while the practice score was high in those with tertiary education. The levels of aflatoxin biomarkers varied significantly according to ethnicity or age.
Conclusion: These findings demonstrated that sociodemographic characteristics and body weight status partly determined the levels of KAP and aflatoxin biomarkers; this may aid in identifying populations that would benefit from educational interventions to prevent aflatoxin contamination.
Key words: aflatoxins, attitude, healthy Malaysian adults, knowledge, practice

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Effect of a dietary iron education programme on iron status and intelligence quotient score among schoolchildren in Phatthalung province, southern Thailand
Witchada Simla, Carol Hutchinson, Supreya Tansukul, Mathuros Tipayamongkholgul & Supannee Pruksa

doi: https://doi.org/10.31246/mjn-2023-0104

Effect of a dietary iron education programme on iron status and intelligence quotient score among schoolchildren in Phatthalung province, southern Thailand
ABSTRACT

Introduction: The aim of the study was to determine the effect of a dietary iron education programme (DIEP) on children’s iron status and intelligence quotient (IQ) score.
Methods: This pre-test post-test quasi-experimental study with followup utilised the Health Belief Model (HBM). Participants were children who had iron deficiency (ID) (serum ferritin <30 µg/L), with anaemia (haemoglobin 80.0 – 114.0 g/L) or without, and their caregivers. The DIEP incorporated group talks, presentations, game-based learning, and cooking. Knowledge of ID and dietary iron, caregivers’ perceptions of preventing anaemia and ID in their children, and children’s dietary intake, iron status, and IQ score (based on 60-question items adjusted for age) were determined. Statistical tests (one-way MANOVA, Friedman’s two-way ANOVA by ranks, Wilcoxon signed-rank test, Monte Carlo exact test) determined differences between pre-test, post-test, and follow-up.
Results: A total of 32 child-caregiver dyads completed the study; 6.3% (n=2) of children met the Thai dietary reference intake for iron at pre-test versus 28.1% (n=9) at post-test (p=0.039) and 31.3% (n=10) at follow-up (p=0.021). Almost half of the children (n=15) who had ID at pre-test were iron replete at post-test and half (n=16) were iron replete at follow-up (p<0.001). Median IQ scores improved from pre-test to posttest (109.0 vs. 116.0; p=0.010) and were similar at post-test and follow-up (116.0 vs. 117.0; p=0.952).
Conclusion: Iron status and IQ score improved following the implementation of DIEP. We recommend that this programme serves as a model for similar interventions in other schools.
Key words: cognitive function; dietary iron education; iron deficiency; iron status

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Physicochemical characteristics of sawo belanda (Pouteria Campechiana) flour with blanching process and drying techniques
Zaida, Hajar Fauziyah Zulfa, Rossi Indarto, Elazmanawati Lembong & Mohd Nizam Lani

doi: https://doi.org/10.31246/mjn-2022-0138

Physicochemical characteristics of sawo belanda (Pouteria Campechiana) flour with blanching process and drying techniques
ABSTRACT

Introduction: Sawo belanda fruit (Pouteria campechiana), a tropical fruit abundantly found in Southeast Asia, is highly productive and particularly thrives in the warm climates of Malaysia and Indonesia. However, the high fruit output of Sawo belanda contrasts with its limited consumption in Indonesia. The process of converting sawo belanda into flour can significantly enhance its lifetime. The application of blanching methods and proper drying techniques can be a solution to avoid damage to the characteristics of the flour. This study aimed to determine the physicochemical characteristics of Sawo belanda flour that has been treated with blanching and drying techniques.
Methods: The parameters observed were moisture content (%), hygroscopicity (%), colour, antioxidant content (ppm), and carotenoid content (µg/g) with blanching and various drying techniques.
Results: Microwave blanching and food dehydrator technique (C1) produced the best characteristics: moisture content of 7.82%, hygroscopicity of 8.04%, colour values of L* 84.0, a* 8.22, and b* 50.5, as well as functional characteristics including antioxidant content of 142 ppm and carotenoid content of 92.4 µg/g.
Conclusion: Sawo belanda with C1 treatment had a significant impact on the water content, hygroscopicity, colour, antioxidant and total carotenoid contents of Sawo belanda flour. The antioxidant content and incredibly high carotenoid content grant the sawo belanda flour an additional functional value when added to food ingredients.
Key words: antioxidant, blanching, drying, sawo belanda

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Associations of socio-demographic, environmental and parental factors, and nutritional status with fast food consumption among children aged 7-11 years old in Selangor
Chong Shao Hui & Zalilah Mohd Shariff

doi: https://doi.org/10.31246/mjn-2023-0138

Associations of socio-demographic, environmental and parental factors, and nutritional status with fast food consumption among children aged 7-11 years old in Selangor
ABSTRACT

Introduction: This cross-sectional study examined fast food consumption and its associated factors among primary school children in Selangor.
Methods: A total of 221 children aged 7-11 years from six randomly selected primary schools in Petaling Perdana, Gombak, and Hulu Langat participated in this study. Parents completed a self-administered questionnaire on socio-demographic characteristics, exposure to fast food advertising, home food availability, parental stress, attitude towards fast food, intake of fast food, and two-day dietary record of children. Height and weight of children were obtained from their school SEGAK records.
Results: Mean age of children was 9±1 years. Mean days per week of fast food consumption among children was 3.2±1.6 days, with 45.7% consuming fast food for >3 days/ week. Factors associated with frequent fast food consumption were children whose fathers had non-tertiary education levels (aOR 2.53, 95% CI 1.18–5.40), children with higher total screen viewing time (aOR 1.21, 95% CI 1.00–1.46), lower home food availability score (aOR 0.87, 95% CI 0.76–0.98), overweight and obese (aOR 2.38, 95% CI 1.23–4.60), requiring dietary improvements (aOR 4.03, 95% CI 1.36–11.98), and with poor diet quality (aOR 5.08, 95% CI 1.57–16.44).
Conclusion: More than one third of the children consumed fast food for >3 days/week. Screen viewing time and home food availability should be considered when promoting healthy diets among children. Future research should consider other potential factors associated with children’s consumption of fast food.
Key words: diet quality, fast food consumption, home food availability, Malaysian children, screen viewing time

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Influence of vitamin D supplementation on mental health in collegiate footballers
Ansa Saju, Jolly Roy, Suvarna Jyothi Kantipudi, Thiagarajan Alwar & Arumugam Sivaraman

doi: https://doi.org/10.31246/mjn-2024-0014

Influence of vitamin D supplementation on mental health in collegiate footballers
ABSTRACT

Introduction: Mental health in athletes has been gaining more attention in recent years. A strong association has been noted between vitamin D and psychiatric outcomes. This study examined the effects of six weeks of vitamin D supplementation on mental health among collegiate footballers.
Methods: Thirtyone footballers (N=31; 18 males and 13 females) were recruited for the study. Serum 25(OH)D was measured to assess vitamin D and mental health was assessed using the Patient Health Questionnaire–9 (PHQ-9) and Generalised Anxiety Disorder-7 (GAD-7). Based on serum 25(OH)D levels, footballers were further categorised as (a) ‘deficient’ (<20.0 ng/mL), (b) ‘insufficient’ (21.0-29.9 ng/ mL), and (c) ‘sufficient’ (>30.0 ng/mL). The deficient and insufficient groups were given 60,000 IU cholecalciferol supplementation per week for six weeks and postintervention assessments were conducted. Paired t-test was used to ascertain the differences within groups.
Results: Prevalences of vitamin D deficiency (48.0%), insufficiency (52.0%), depressive symptoms (13.0%), and anxiety symptoms (26.0%) were observed at baseline among footballers. Supplementation improved vitamin D levels from 20.7±5.4 ng/mL to 38.1±11.4 ng/mL (p<0.001). The rate of footballers with higher than cut-off scores for PHQ-9 and GAD-7 scores increased (32.3% and 29.0%, respectively) from baseline to post-intervention.
Conclusion: Vitamin D supplementation enhanced serum 25(OH)D levels. However, no positive effects were noted regarding mental health symptoms. Additionally, changes in vitamin D levels might require more time to manifest observable effects on mental health.
Key words: collegiate athlete, football, mental health, supplement, vitamin D

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Demographic, socioeconomic and dietary factors are associated with double burden of malnutrition among indigenous communities in Sarawak
Yolanda Salleh, Cheah Whye Lian, Law Leh Shii, Jeffery Stephen & Teoh Wan Jool

doi: https://doi.org/10.31246/mjn-2024-0056

Demographic, socioeconomic and dietary factors are associated with double burden of malnutrition among indigenous communities in Sarawak
ABSTRACT

Introduction: Double burden of malnutrition (DBM), encompassing both overnutrition and undernutrition, is a growing global public health issue. Indigenous people are one of the marginalised populations experiencing DBM at varying severity. This study aimed to identify factors contributing to DBM in indigenous households in Sarawak.
Methods: This cross-sectional study utilised multistage random sampling to include 286 indigenous households from six administrative divisions in Sarawak. Mothers aged 20–49 years who had at least one child aged 2–12 years were recruited. Trained interviewers obtained information on demographic and socioeconomic characteristics, food security, and dietary intake via a two-day, 24-hour dietary recall. Height and weight measurements followed World Health Organization protocols. DBM household was identified as having an overnourished (overweight/ obese) mother with an undernourished (underweight/stunting/wasting) child within the same household. Simple and multiple binary logistic regression analyses were performed.
Results: Prevalence of DBM among the indigenous communities in Sarawak was 25.2%. Households with an overweight/obese mother and a stunted child was 12.9%, wasted child (11.9%), and underweight child (9.4%). Households with younger mothers, a household size of >4 persons, and higher income per capita (relative to sample population) were significantly more likely to have DBM. Conversely, households with higher monthly non-food expenditure and greater fish and seafood intake scores in children were significantly less likely to have DBM.
Conclusion: DBM is prevalent among Sarawak’s indigenous communities, affecting 25.2% of households. Further research and targeted interventions are needed to address socioeconomic and dietary factors in these populations.
Key words: dietary, indigenous, malnutrition, Sarawak, stunting

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