Online First
Malaysian Journal of Nutrition (Mal J Nutr)
Online first articles will appear here as and when they are published
Malnutrition and quality of life among Malaysian community-dwelling older persons during COVID-19 pandemic
Sakinah Harith, Nur Kamilah Mohd Fauzy, Nur Hazierah Abd Razak & Almira Sitasari
doi: https://doi.org/10.31246/mjn-2025-0040
Malnutrition and quality of life among Malaysian community-dwelling older persons during COVID-19 pandemic
ABSTRACT
Introduction: The COVID-19 pandemic affected nutrition among older persons due to disruptions in food supply and shortages of essential medicines, supplements, and food, leading to malnutrition or unhealthy diets. While unhealthy body mass index (BMI) and malnutrition may influence quality of life (QoL), evidence is limited. This cross-sectional study aimed to determine the association between BMI and malnutrition towards QoL among older persons in Malaysia during the COVID-19 pandemic.
Methods: Data were obtained through an online questionnaire consisting of self-reported anthropometry, malnutrition assessment using the Malnutrition Risk Screening Tool-Hospital (MRST-H) and Mini Nutritional Assessment-Short Form (MNA-SF), and the Short Form-36 Health Survey (SF-36) for QoL evaluation.
Results: A total of 169 respondents [median age = 64.0 (62.0, 69.5) years], with a mean BMI of 25.5±4.9 kg/m2, participated in the study. Prevalence of malnutrition was 4.2% based on MNA-SF; 30.2% and 33.1% of respondents were identified as being at high risk of malnutrition according to MNASF and MRST-H, respectively. Median score for QoL was 61.1±27.0, indicating good QoL. No significant association was found between BMI and QoL. Higher MNA-SF scores, indicating better nutritional status, were associated with higher QoL. Higher MRST-H scores, indicating higher malnutrition risk, were significantly associated with lower social functioning in QoL.
Conclusion: Addressing malnutrition in older persons is crucial, as it significantly impacts their QoL, especially in the social functioning domain. However, it is still unclear whether malnutrition is a cause or an effect, or perhaps a third potential factor, such as functional status, which acts as a mediator.
Key words: body mass index, malnutrition, older persons, quality of life
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Introduction: The COVID-19 pandemic affected nutrition among older persons due to disruptions in food supply and shortages of essential medicines, supplements, and food, leading to malnutrition or unhealthy diets. While unhealthy body mass index (BMI) and malnutrition may influence quality of life (QoL), evidence is limited. This cross-sectional study aimed to determine the association between BMI and malnutrition towards QoL among older persons in Malaysia during the COVID-19 pandemic.
Methods: Data were obtained through an online questionnaire consisting of self-reported anthropometry, malnutrition assessment using the Malnutrition Risk Screening Tool-Hospital (MRST-H) and Mini Nutritional Assessment-Short Form (MNA-SF), and the Short Form-36 Health Survey (SF-36) for QoL evaluation.
Results: A total of 169 respondents [median age = 64.0 (62.0, 69.5) years], with a mean BMI of 25.5±4.9 kg/m2, participated in the study. Prevalence of malnutrition was 4.2% based on MNA-SF; 30.2% and 33.1% of respondents were identified as being at high risk of malnutrition according to MNASF and MRST-H, respectively. Median score for QoL was 61.1±27.0, indicating good QoL. No significant association was found between BMI and QoL. Higher MNA-SF scores, indicating better nutritional status, were associated with higher QoL. Higher MRST-H scores, indicating higher malnutrition risk, were significantly associated with lower social functioning in QoL.
Conclusion: Addressing malnutrition in older persons is crucial, as it significantly impacts their QoL, especially in the social functioning domain. However, it is still unclear whether malnutrition is a cause or an effect, or perhaps a third potential factor, such as functional status, which acts as a mediator.
Key words: body mass index, malnutrition, older persons, quality of life
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Exploring the role of parental food environment in shaping the eating habits of children aged 3-5 years old: A qualitative study
Raden Roro Dwi Agustine Maulianti, Judhiastuty Februhartanty & Nisrina Hanisa
doi: https://doi.org/10.31246/mjn-2025-0052
Exploring the role of parental food environment in shaping the eating habits of children aged 3-5 years old: A qualitative study
ABSTRACT
Introduction: Processed food consumption—including sweet snacks, sugary beverages, salty snacks, fatty foods, and instant noodles—remains prevalent among children under five in Jakarta. The 2023 Indonesian Health Survey and 2022 Indonesian Nutritional Status Survey reported high rates of consumption and a significant number of wasting cases, potentially linked to poor dietary intake. These trends are especially concerning in urban areas like Jakarta, where children are increasingly exposed to a complex food environment filled with highly accessible and aggressively marketed unhealthy foods. Understanding the role of parental food environment is critical to addressing early childhood nutrition challenges.
Methods: This qualitative study was conducted in two densely populated subdistricts of Central Jakarta. In-depth interviews were carried out with 16 mothers of children under five, while triangulation was achieved through additional interviews with three grandmothers. To enrich the narratives, mothers were asked to recall their children’s snack consumption over the past month, and observations of nearby food outlets were also recorded. All data were analysed thematically using NVivo 14.
Results: Most mothers allowed processed food consumption due to children’s preferences or difficulty refusing requests. Local shops and mini markets frequently tempted children with sweets, leading some mothers to attempt restrictions. However, inconsistent enforcement, particularly by fathers and grandmothers, undermined these efforts. Marketing strategies such as mascots, discounts, and repeated exposure further reinforced children’s demands.
Conclusion: Mothers struggled to manage children’s snack demands due to high accessibility, but regulating purchases with consistent support from all household caregivers can help reduce unhealthy food consumption.
Key words: child nutrition, food environment, parental strategies, processed foods, snack consumption
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Introduction: Processed food consumption—including sweet snacks, sugary beverages, salty snacks, fatty foods, and instant noodles—remains prevalent among children under five in Jakarta. The 2023 Indonesian Health Survey and 2022 Indonesian Nutritional Status Survey reported high rates of consumption and a significant number of wasting cases, potentially linked to poor dietary intake. These trends are especially concerning in urban areas like Jakarta, where children are increasingly exposed to a complex food environment filled with highly accessible and aggressively marketed unhealthy foods. Understanding the role of parental food environment is critical to addressing early childhood nutrition challenges.
Methods: This qualitative study was conducted in two densely populated subdistricts of Central Jakarta. In-depth interviews were carried out with 16 mothers of children under five, while triangulation was achieved through additional interviews with three grandmothers. To enrich the narratives, mothers were asked to recall their children’s snack consumption over the past month, and observations of nearby food outlets were also recorded. All data were analysed thematically using NVivo 14.
Results: Most mothers allowed processed food consumption due to children’s preferences or difficulty refusing requests. Local shops and mini markets frequently tempted children with sweets, leading some mothers to attempt restrictions. However, inconsistent enforcement, particularly by fathers and grandmothers, undermined these efforts. Marketing strategies such as mascots, discounts, and repeated exposure further reinforced children’s demands.
Conclusion: Mothers struggled to manage children’s snack demands due to high accessibility, but regulating purchases with consistent support from all household caregivers can help reduce unhealthy food consumption.
Key words: child nutrition, food environment, parental strategies, processed foods, snack consumption
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Breakfast eating practices and diet quality among urban and rural Indonesian adults
Vina Hasna Arifa, Helda Khusun, Luh Ade Ari Wiradnyani & Judhiastuty Februhartanty
doi: https://doi.org/10.31246/mjn-2025-0041
Breakfast eating practices and diet quality among urban and rural Indonesian adults
ABSTRACT
Introduction: Diet quality is an important determinant of health; however, many Indonesian adults have poor dietary intake, with low fruit and vegetable consumption and high intake of fats and fried foods. Breakfast plays a crucial role in shaping diet quality and health outcomes, but practices vary widely across populations. Urban adults are more exposed to processed foods and eating out, while rural adults rely on staple-based diets. This study explored the association between breakfast practices and overall diet quality among Indonesian adults in urban and rural areas.
Methods: Data from the Indonesia Food Barometer 2018 were analysed for 770 adults aged 26–45 years from six provinces. Breakfast practices, including consumption, location, companion, activity, and preparation, were assessed alongside socioeconomic characteristics (age, gender, job, education level, and wealth index). Diet quality was measured using the Diet Quality Index-International. Statistical analyses included chi-square, Mann–Whitney, and Kruskal–Wallis tests and linear regression.
Results: In rural areas, gender and breakfast activity were significantly associated with diet quality (p<0.05). In urban areas, age and breakfast consumption were significant factors (p<0.05). Across both settings, breakfast-related practices showed significant associations with diet quality.
Conclusion: Associations between breakfast practices and diet quality differed between urban and rural adults, underscoring the importance of contextspecific strategies. Interventions to improve diet quality should therefore be tailored to local dietary behaviours and environments.
Key words: eating practices, diet quality, Indonesian adults, urban and rural
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Introduction: Diet quality is an important determinant of health; however, many Indonesian adults have poor dietary intake, with low fruit and vegetable consumption and high intake of fats and fried foods. Breakfast plays a crucial role in shaping diet quality and health outcomes, but practices vary widely across populations. Urban adults are more exposed to processed foods and eating out, while rural adults rely on staple-based diets. This study explored the association between breakfast practices and overall diet quality among Indonesian adults in urban and rural areas.
Methods: Data from the Indonesia Food Barometer 2018 were analysed for 770 adults aged 26–45 years from six provinces. Breakfast practices, including consumption, location, companion, activity, and preparation, were assessed alongside socioeconomic characteristics (age, gender, job, education level, and wealth index). Diet quality was measured using the Diet Quality Index-International. Statistical analyses included chi-square, Mann–Whitney, and Kruskal–Wallis tests and linear regression.
Results: In rural areas, gender and breakfast activity were significantly associated with diet quality (p<0.05). In urban areas, age and breakfast consumption were significant factors (p<0.05). Across both settings, breakfast-related practices showed significant associations with diet quality.
Conclusion: Associations between breakfast practices and diet quality differed between urban and rural adults, underscoring the importance of contextspecific strategies. Interventions to improve diet quality should therefore be tailored to local dietary behaviours and environments.
Key words: eating practices, diet quality, Indonesian adults, urban and rural
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Food environment determinants on the intake of children with Attention-Deficit/Hyperactivity Disorder (ADHD) and Down Syndrome (DS) in Indonesia, Lao PDR and Malaysia
Ahmad Thohir Hidayat, Judhiastuty Februhartanty, Indah Suci Widyahening, Seong Ting Chen, Kiengkay Ounmany, Sombounmy Phomtavong, Mohamad Faris Idham Zainurin, Fazliana Mansor, Ahmad Ali Zainuddin, Aswir Abd Rashed, Hajah Salmah Jopri, Che’ Rozaniza Azizan, Wai Yew Yang, Jesus Corpus Fernandez & Muchtaruddin Mansyur
doi: https://doi.org/10.31246/mjn-2025-0047
Food environment determinants on the intake of children with Attention-Deficit/Hyperactivity Disorder (ADHD) and Down Syndrome (DS) in Indonesia, Lao PDR and Malaysia
ABSTRACT
Introduction: The nutritional status of children with Attention-Deficit/Hyperactivity Disorder (ADHD) and Down Syndrome (DS) is influenced by multiple food environment determinants. However, the precise relationship between food environment determinants and nutritional outcomes in these children remains unclear. This study aimed to understand the food environment determinants that are associated with the intake and nutritional status of these children in Malaysia, Lao PDR, and Indonesia.
Methods: This cross-sectional study involved 7- to 18-year-old students with ADHD and DS in three Southeast Asian countries. Sociodemographic characteristics, dietary habits, and repeated 24-hour food recall data were collected through a structured questionnaire. Anthropometric data were obtained through direct measurements and analysed using the WHO AnthroPlus software. Further analyses were done using descriptive statistics and chi-square tests.
Results: Total participants were 284 children, comprised of 37.7% with ADHD and 62.3% with DS; 62.3% of the children were boys and 37.7% were girls. Among the food environment determinants collected during the study, monthly household income and school food assistance status had significant associations (p<0.05) with BMI-for-age z-score category and total energy, protein, zinc, and calcium intakes. While the country, type of residence, and type of school had significant associations with total energy, protein, zinc, and calcium intakes.
Conclusion: Food environment determinants, particularly household income and access to school food assistance, significantly influence the nutritional status and intake of children with ADHD and Down Syndrome. Thus, strengthening inclusive nutrition programmes may improve outcomes for this vulnerable group in Southeast Asia.
Key words: Attention-Deficit/Hyperactivity disorder, Down Syndrome, food environment, nutrition, Southeast Asian
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Introduction: The nutritional status of children with Attention-Deficit/Hyperactivity Disorder (ADHD) and Down Syndrome (DS) is influenced by multiple food environment determinants. However, the precise relationship between food environment determinants and nutritional outcomes in these children remains unclear. This study aimed to understand the food environment determinants that are associated with the intake and nutritional status of these children in Malaysia, Lao PDR, and Indonesia.
Methods: This cross-sectional study involved 7- to 18-year-old students with ADHD and DS in three Southeast Asian countries. Sociodemographic characteristics, dietary habits, and repeated 24-hour food recall data were collected through a structured questionnaire. Anthropometric data were obtained through direct measurements and analysed using the WHO AnthroPlus software. Further analyses were done using descriptive statistics and chi-square tests.
Results: Total participants were 284 children, comprised of 37.7% with ADHD and 62.3% with DS; 62.3% of the children were boys and 37.7% were girls. Among the food environment determinants collected during the study, monthly household income and school food assistance status had significant associations (p<0.05) with BMI-for-age z-score category and total energy, protein, zinc, and calcium intakes. While the country, type of residence, and type of school had significant associations with total energy, protein, zinc, and calcium intakes.
Conclusion: Food environment determinants, particularly household income and access to school food assistance, significantly influence the nutritional status and intake of children with ADHD and Down Syndrome. Thus, strengthening inclusive nutrition programmes may improve outcomes for this vulnerable group in Southeast Asia.
Key words: Attention-Deficit/Hyperactivity disorder, Down Syndrome, food environment, nutrition, Southeast Asian
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Transforming University Nutrition Environments (TUNE): Initial findings on nutritional quality and vendors’ perspectives of foods sold at Universiti Malaya’s residential campus cafeterias
Ai Kah Ng, Juan Carlos Algaba, Ruban Rao, Heng Yaw Yong, Wai Yew Yang, Thangiah Nithiah, Bala Murali Sundram & N Hairi Noran
doi: https://doi.org/10.31246/mjn-2025-0036
Transforming University Nutrition Environments (TUNE): Initial findings on nutritional quality and vendors’ perspectives of foods sold at Universiti Malaya’s residential campus cafeterias
ABSTRACT
Introduction: Cafeteria environments within universities have a significant influence over sustainable and healthy dietary behaviours. Hence, this study aimed to understand the nutritional landscape of food options in university cafeterias and to identify the factors contributing to unhealthy food options from the perspective of food service vendors.
Methods: Using a mixed-methods approach, 122 food options from all 12 residential campus cafeterias in Universiti Malaya (UM) were collected between October and December 2024. All food options were grouped into (i) bread, (ii) meat dishes, (iii) drinks, (iv) Western dishes, and (v) rice- or noodle-based fried food group; they were further analysed for calories, fat, saturated fat, dietary fibre, and salt using the Malaysian Food Composition Database (MyFCD) and the Singapore Food Composition Database (SFCD). Nutrient classification (high vs. low) was based on the criteria outlined in the Labelling Guidelines 2023. Additionally, food service vendors were interviewed to explore operational challenges, with data collection ceasing upon reaching thematic saturation. The interviews were then transcribed and analysed using thematic analysis.
Results: Quantitative findings showed that there were 36 bread-based meals, 16 meat-based dishes, 18 beverages, 30 Westernstyle meals, and 22 rice- or noodle-based fried foods. The study also revealed an over-reliance on high-calorie, high-fat, and low-fibre foods, with limited availability of sustainable and nutritious options. Qualitative findings highlighted the influence of affordability, vendor practices, and student preferences on campus food choices.
Conclusion: The study underscored the need for internal policy intervention, improved vendor education and sustainability practices, and increased accessibility to healthier meals on campus.
Key words: eating environment, food choices, healthy, sustainability, university cafeteria
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Introduction: Cafeteria environments within universities have a significant influence over sustainable and healthy dietary behaviours. Hence, this study aimed to understand the nutritional landscape of food options in university cafeterias and to identify the factors contributing to unhealthy food options from the perspective of food service vendors.
Methods: Using a mixed-methods approach, 122 food options from all 12 residential campus cafeterias in Universiti Malaya (UM) were collected between October and December 2024. All food options were grouped into (i) bread, (ii) meat dishes, (iii) drinks, (iv) Western dishes, and (v) rice- or noodle-based fried food group; they were further analysed for calories, fat, saturated fat, dietary fibre, and salt using the Malaysian Food Composition Database (MyFCD) and the Singapore Food Composition Database (SFCD). Nutrient classification (high vs. low) was based on the criteria outlined in the Labelling Guidelines 2023. Additionally, food service vendors were interviewed to explore operational challenges, with data collection ceasing upon reaching thematic saturation. The interviews were then transcribed and analysed using thematic analysis.
Results: Quantitative findings showed that there were 36 bread-based meals, 16 meat-based dishes, 18 beverages, 30 Westernstyle meals, and 22 rice- or noodle-based fried foods. The study also revealed an over-reliance on high-calorie, high-fat, and low-fibre foods, with limited availability of sustainable and nutritious options. Qualitative findings highlighted the influence of affordability, vendor practices, and student preferences on campus food choices.
Conclusion: The study underscored the need for internal policy intervention, improved vendor education and sustainability practices, and increased accessibility to healthier meals on campus.
Key words: eating environment, food choices, healthy, sustainability, university cafeteria
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