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INTRODUCTION: Gestational weight gain (GWG) is influenced by various factors during pregnancy. This study attempts to explore the relationship between environmental factors i.e., sunlight exposure and psychological health i.e. psychological well-being and sleep quality during pregnancy with total gestational weight gain. METHODS: This was a prospective observational study conducted in government maternity clinics in Kuala Lumpur. Pregnant women aged 19-39 years without comorbidities were recruited during second trimester and followed up until birth. The participants were required to wear a UVB dosimeter for a total of three consecutive days (2 weekdays and 1 weekend) to determine sunlight exposure (SED) during their second trimester. The PSQI and DASS-21 were used to determine sleep quality and psychological wellbeing, respectively. GWG data were collected from clinic health records. The association of sun exposure and psychological health with total GWG was determined using multiple linear regression. RESULTS: A total of 73 pregnant women aged 27.9 ± 3.3 years were included in the analysis. The prevalence of pregnant women exhibiting stress, anxiety, and depression symptoms was 11%, 40%, and 16% respectively. The global PSQI median score was 5 (IQR = 3), with 59% having poor sleep quality. Median sleep duration was 7 h (IQR = 2) while median sleep efficiency was 92% (IQR = 14). The median SED was 0.04 (IQR = 0.09), with 51% of them being under the 50th percentile. The majority had adequate GWG (58%). Sleep parameters were not found to be correlated with total GWG except for sleep latency (ρ = -0.356, p = 0.002). Sunlight exposure was found to have no significant relationship with sleep and total GWG. Adjusted multiple linear regression showed that greater depression is associated with higher total GWG (ß = 0.239, p = 0.039) while controlling for sleep quality. CONCLUSION: Depression was associated with total GWG when sleep quality was controlled for while sunlight exposure had no significant association with GWG. Future studies should study the complex relationship between factors of mental health, sleep, and weight gain during pregnancy. Healthcare providers may be better equipped to develop interventions aimed to prevent negative maternal and fetal health outcomes.
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Ganho de Peso na Gestação , Feminino , Humanos , Gravidez , Saúde Mental , Estudos Prospectivos , Sono , Aumento de Peso , Adulto Jovem , AdultoRESUMO
OBJECTIVE: This paper aims to report South East Asian Nutrition Surveys (SEANUTS) II Malaysia data on nutritional status, dietary intake, and nutritional biomarkers of children aged 6 months to 12 years. DESIGN: Cross-sectional survey conducted in 2019-2020. SETTING: Multistage cluster sampling conducted in Central, Northern, Southern, and East Coast regions of Peninsular Malaysia. PARTICIPANTS: 2989 children aged 0.5-12.9 years. RESULTS: Prevalences of stunting, thinness, overweight, and obesity among children aged 0.5-12.9 years were 8.9%, 6.7%, 9.2%, and 8.8%, respectively. Among children below 5 years old, 11.4% were underweight, 13.8% had stunting, and 6.2% wasting. Data on nutritional biomarkers showed a small proportion of children aged 4-12 years had iron (2.9%) and vitamin A deficiencies (3.1%). Prevalence of anaemia was distinctly different between children below 4 years old (40.3%) and those aged 4 years and above (3.0%). One-fourth of children (25.1%) had vitamin D insufficiency, which was twice as prevalent in girls (35.2% vs. boys: 15.6%). The majority of children did not meet the recommended dietary intake for calcium (79.4%) and vitamin D (94.8%). CONCLUSIONS: Data from SEANUTS II Malaysia confirmed that triple burden of malnutrition co-exists among children in Peninsular Malaysia, with higher prevalence of overnutrition than undernutrition. Anaemia is highly prevalent among children below 4 years old, while vitamin D insufficiency is more prevalent among girls. Low intakes of dietary calcium and vitamin D are also of concern. These findings provide policymakers with useful and evidence-based data to formulate strategies that address the nutritional issues of Malaysian children.
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BACKGROUND: Body mass index (BMI) is a widely used surrogate tool to screen for obesity/adiposity, but it cannot differentiate between lean and fat mass. Thus, alternative tools to detect excess adiposity should be identified. AIM: This study aimed to compare the performance of BMI, waist circumference (WC) and waist-to-height ratio (WtHR) in predicting Malaysians with excess body fat defined by dual-energy X-ray absorptiometry (DXA). SUBJECTS AND METHODS: A total of 399 men and women aged ≥40 years were recruited from Klang Valley, Malaysia. The body composition of the subjects, including body fat percentage, was measured by DXA. The weight, height, WC and WHtR of the subjects were also determined. RESULTS: BMI [sensitivity = 55.7%, specificity = 86.1%, area under curve (AUC) = 0.709] and WC (sensitivity = 62.7%, specificity = 90.3%, AUC = 0.765) performed moderately in predicting excess adiposity. Their performance and sensitivity improved with lower cut-off values. The performance of WHtR (sensitivity = 96.6%, specificity = 36.1, AUC = 0.664) was optimal at the standard cut-off value and no modification was required. CONCLUSION: The performance of WC in identifying excess adiposity was greater than BMI and WHtR based on AUC values. Modification of cut-off values for BMI and WC could improve their performance and should be considered by healthcare providers in screening individuals with excess adiposity.
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Adiposidade , Obesidade , Masculino , Humanos , Feminino , Índice de Massa Corporal , Circunferência da Cintura , Obesidade/diagnóstico , Composição Corporal , Razão Cintura-EstaturaRESUMO
BACKGROUND: A good understanding of the bi-directional relationship between diabetes and periodontitis is essential to ensure the successful management of both diseases. This study aimed to develop and evaluate an integrated diabetes-periodontitis nutrition and health education module. METHODS: The module was developed as an iterative and review process by five experts in nutrition and dietetics, periodontics, and dental public health. It consisted of three phases: (i) needs assessment on module contents and characteristics, (ii) module development and (iii) module evaluation by experts. Twelve healthcare professionals aged between 30 and 53 years (average 13.5 years of working experience) validated the module contents and its comprehensibility using the Patient Education Materials Assessment Tool for printable materials (PEMAT-P) and audio-visual materials (PEMAT-A/V). Scores of 0 (disagree) or 1 (agree) were given for sets of understandability and actionability statements and presented as a total percentage. RESULTS: Seventeen infographic-flip charts and 13 short-videos were developed in the Malay language and grouped into four topics: (i) Introduction to Diabetes and Periodontitis, (ii) Diabetes and Periodontitis Care, (iii) Lifestyle Modification, and (iv) Myths and Facts. Flip charts were rated between 76-100% for understandability and 80-100% for actionability, while videos rated between 90-100% for understandability and 100% for actionability, respectively. CONCLUSION: Overall, the newly developed module ranked high median scores for understandability and actionability. This finding reflects positive acceptance of the integrated module among the various healthcare professionals involved in managing patients with diabetes and periodontitis.
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Diabetes Mellitus , Letramento em Saúde , Periodontite , Adulto , Compreensão , Diabetes Mellitus/terapia , Educação em Saúde , Humanos , Pessoa de Meia-Idade , Periodontite/complicações , Periodontite/terapiaRESUMO
Objectives: Metabolic syndrome (MetS) is a cluster of metabolic abnormalities that elevates the individual risk of cardiovascular diseases. These abnormalities are also known to alter bone remodelling. Therefore, MetS may be associated with osteoporosis. This study aims to determine the association between MetS and its components and bone mineral density (BMD) assessed by dual-energy X-ray absorptiometry (DXA) among Malaysians. Methods: 400 Malaysians aged ≥ 40 years (52.5% women) residing in Klang Valley, Malaysia, were recruited. Subjects' demographic and lifestyle details were collected using a questionnaire, and blood pressure and body anthropometry were measured. Subjects' lumbar spine and total hip BMD were measured by DXA. Their fasting blood was collected for blood glucose level and lipid profile analysis. Regression analysis was used to analyze the relationship between MetS or its components and BMD. Results: Subjects with MetS had higher BMD compared to subjects without MetS in models unadjusted for BMI (spine p=0.008; hip p<0.001). This difference was attenuated with BMI adjustment (spine p=0.625; hip p=0.478). Waist circumference was associated positively with BMD in models unadjusted for BMI (spine p=0.012; hip p<0.001), but the association became negative with BMI adjustment (spine p=0.044; hip p=0.021). Systolic blood pressure was associated positively with total hip BMD (p=0.019) but BMI adjustment attenuated the relationship (p=0.080). Triglyceride level was associated with osteoporosis in a fully adjusted model (p=0.001). Overall, MetS was associated with osteoporosis (p=0.019) but lifestyle (p=0.188) and BMI adjustment attenuated the relationship (p=0.904). Conclusion: MetS is positively associated with BMD, and this relationship is predominantly mediated by BMI. Although MetS is not a significant risk factor for osteoporosis, the inverse relationship between waist circumference, a marker of central obesity, and BMD highlights the need to prevent adiposity to improve metabolic and skeletal health.
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Densidade Óssea/fisiologia , Síndrome Metabólica/complicações , Obesidade Abdominal/epidemiologia , Osteoporose/epidemiologia , Absorciometria de Fóton/estatística & dados numéricos , Idoso , Índice de Massa Corporal , Estudos Transversais , Feminino , Humanos , Malásia/epidemiologia , Masculino , Síndrome Metabólica/fisiopatologia , Pessoa de Meia-Idade , Obesidade Abdominal/etiologia , Obesidade Abdominal/fisiopatologia , Osteoporose/diagnóstico , Osteoporose/etiologia , Osteoporose/fisiopatologia , Medição de Risco/estatística & dados numéricos , Fatores de Risco , Circunferência da CinturaRESUMO
BACKGROUND: This study aimed to compare the nutritional and bone health status between young men with mild-to-moderate intellectual disability and those without intellectual disability and to determine predictors for their bone health status. METHOD: A total of 95 men (47 men with intellectual disability; 48 men without intellectual disability), aged 20-39 years, participated in this study. Anthropometric profile, dietary intake, physical activity level and calcaneal speed of sound (SOS) were collected. RESULTS: The men with intellectual disability had moderate diet quality whilst the men without intellectual disability had poor diet quality. More participants with intellectual disability (97.9%) were inactive compared with their counterparts (10.4%). The SOS value was similar between groups and was lower than the reference. Increasing age and low physical activity level were negative predictors for bone health status. CONCLUSION: Both young men with and without intellectual disability have suboptimal nutritional and bone health status. Strategies to improve their nutritional and bone health status are warranted.
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Densidade Óssea , Dieta , Exercício Físico , Nível de Saúde , Deficiência Intelectual , Adulto , Estudos Transversais , Humanos , Deficiência Intelectual/epidemiologia , Malásia/epidemiologia , Masculino , Estado Nutricional , Adulto JovemRESUMO
BACKGROUND: 1Little is known of the extent of workplace bullying in Malaysia, despite its growing recognition worldwide as a serious public health issue in the workplace. Workplace bullying is linked to stress-related health issues, as well as socioeconomic consequences which may include absenteeism due to sick days and unemployment. We sought to examine the prevalence of workplace bullying and its association with socioeconomic factors and psychological distress in a large observational study of Malaysian employees. METHODS: This study employed cross-sectional, self-reported survey methodology. We used the 6-item Kessler screening scale (K6) to assess psychological distress (cutoff score ≥ 13, range 0-24, with higher scores indicating greater psychological distress). Participants self-reported their perceptions of whether they had been bullied at work and how frequently this occurred. A multivariate logistic regression was conducted with ever bullying and never bullying as dichotomous categories. RESULTS: There were a total of 5235 participants (62.3% female). Participant ages ranged from 18 to 85, mean ± standard deviation (M ± SD): 33.88 ± 8.83. A total of 2045 (39.1%) participants reported ever being bullied. Of these, 731 (14.0%) reported being subject to at least occasional bullying, while another 194 (3.7%) reported it as a common occurrence. Across all income strata, mean scores for psychological distress were significantly higher for ever bullied employees (M ± SD: 8.69 ± 4.83) compared to those never bullied (M ± SD: 5.75 ± 4.49). Regression analysis indicated significant associations (p < 0.001) between workplace bullying with being female (Adjusted OR (aOR) = 1.27, 95% CI 1.12-1.44), higher individual income levels of between RM4,000 to RM7,999 (aOR =1.24, 95% CI 1.06-1.45) and RM8,000 and above (aOR = 1.31, 95% CI 1.10-1.56), and psychological distress (aOR = 1.15, 95% CI 1.13-1.16). CONCLUSIONS: More than one in three employees reported having experienced workplace bullying, which was found to be specifically associated with being female, drawing a higher income, and greater psychological distress. In general, low individual income was associated with greater psychological distress. However, higher income employees were far more likely to report experiencing workplace bullying. Findings from this study offer relevant insight into the associations between socioeconomic status and psychological distress in workplace bullying.
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Bullying/estatística & dados numéricos , Doenças Profissionais/epidemiologia , Classe Social , Estresse Psicológico/epidemiologia , Absenteísmo , Adulto , Bullying/psicologia , Estudos Transversais , Emprego/psicologia , Emprego/estatística & dados numéricos , Feminino , Humanos , Modelos Logísticos , Malásia/epidemiologia , Masculino , Pessoa de Meia-Idade , Doenças Profissionais/psicologia , Prevalência , Autorrelato , Estresse Psicológico/psicologia , Local de Trabalho/psicologia , Adulto JovemRESUMO
BACKGROUND: Organization productivity is strongly linked to employees' socioeconomic characteristics and health which is marked by absenteeism and presenteeism. This study aims to identify anteceding factors predicting employees' absenteeism and presenteeism by income, physical and mental health. METHODS: An online health survey was conducted between May to July 2017 among employees from 47 private companies located in urban Malaysia. A total of 5235 respondents completed the 20-min online employee health survey on a voluntary basis. Chi-Square or Fisher's exact tests were used to determine association between income with demographic and categorical factors of absenteeism and presenteeism. Multivariate linear regression was used to identify factors predicting absenteeism and presenteeism. RESULTS: More than one third of respondents' monthly income were less than RM4,000 (35.4%), 29.6% between RM4,000-RM7,999 and 35.0% earned RM8,000 and above. The mean age was 33.8 years (sd ± 8.8) and 49.1% were married. A majority were degree holders (74.4%) and 43.6% were very concerned about their financial status. Mean years of working was 6.2 years (sd ± 6.9) with 68.9% satisfied with their job. More than half reported good general physical health (54.5%) (p = 0.065) and mental health (53.5%) (p = 0.019). The mean hours of sleep were 6.4 h (sd ± 1.1) with 63.2% reporting being unwell due to stress for the past 12 months. Mean work time missed due to ill-health (absenteeism) was 3.1% (sd ± 9.1), 2.8% (sd ± 9.1) and 1.8% (sd ± 6.5) among employees whose monthly income was less than RM4,000, RM4,000-RM7,999 and over RM8,000 respectively (p = 0.0066). Mean impairment while working due to ill-health (presenteeism) was 28.2% (sd ± 25.3), 24.9% (sd ± 25.5) and 20.3% (sd ± 22.9) among employees whose monthly income was less than RM4,000, RM4,000-RM7,999 and over RM8,000 respectively (p < 0.0001). Factors that predict both absenteeism and presenteeism were income, general physical health, sleep length and being unwell due to stress. CONCLUSIONS: A combination of socioeconomic, physical and mental health factors predicted absenteeism and presenteeism with different strengths. Having insufficient income may lead to second jobs or working more hours which may affect their sleep, subjecting them to stressful condition and poor physical health. These findings demand holistic interventions from organizations and the government.
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Absenteísmo , Saúde Ocupacional/estatística & dados numéricos , Presenteísmo/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Adulto , Feminino , Inquéritos Epidemiológicos , Humanos , Malásia/epidemiologia , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Fatores SocioeconômicosRESUMO
Introduction: Orchidectomy is currently the preferred method to induce bone loss in preclinical male osteoporosis model. Gonadotropin-releasing hormone (GnRH) agonists used in prostate cancer treatment can induce testosterone deficiency but its effects on bone in preclinical male osteoporosis model are less studied. Objective: This study aimed to evaluate the skeletal effect of buserelin (a GnRH agonist) in male rats and compare it with orchidectomy. Methods: Forty-six three-month-old male Sprague-Dawley rats were divided into three experimental arms. The baseline arm (n=6) was sacrificed at the onset of the study. In the buserelin arm, the rats received a daily subcutaneous injection of either normal saline (n=8), buserelin acetate at 25 µg/kg (n=8) or 75 µg/kg (n=8). In the orchidectomy arm, the rats were either sham-operated (n=8) or orchidectomized (n=8). All groups underwent in-vivo X-ray micro-computed tomography scanning at the left proximal tibia every month. Blood was collected at the beginning and the end of the study for testosterone level evaluation. The rats were euthanized after the three-month treatment. The femurs were harvested for biomechanical strength and bone calcium determination. Results: The results showed that buserelin at both doses caused a significant decline in testosterone level and deterioration in bone microstructure (p<0.05), but did not affect bone calcium content (p>0.05). Buserelin at 25 µg/kg decreased displacement and strain of the femur significantly (p<0.05). Similar changes were observed in the orchidectomized group compared to the sham-operated group but without any significant changes in biomechanical strength (p>0.05). Conclusion: Buserelin can induce testosterone deficiency and the associated deterioration of bone microarchitecture similar to orchidectomy in three months. However, it may require a longer time to show significant effects on bone strength and mineral content.
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Reabsorção Óssea/tratamento farmacológico , Busserrelina/administração & dosagem , Osteoporose/tratamento farmacológico , Neoplasias da Próstata/tratamento farmacológico , Animais , Reabsorção Óssea/sangue , Reabsorção Óssea/fisiopatologia , Cálcio/sangue , Modelos Animais de Doenças , Hormônio Liberador de Gonadotropina/agonistas , Hormônio Liberador de Gonadotropina/sangue , Humanos , Masculino , Orquiectomia , Osteoporose/sangue , Osteoporose/induzido quimicamente , Osteoporose/fisiopatologia , Neoplasias da Próstata/complicações , Ratos , Testosterona/sangue , Testosterona/deficiênciaRESUMO
OBJECTIVE: To compare the contributions of UVB exposure and diet to total vitamin D among Asians living in Kuala Lumpur (KL) and Aberdeen (AB). DESIGN: Longitudinal study. SETTING: UVB exposure (using polysulfone film badges) and skin colour and dietary vitamin D intake (by web-based questionnaire) were measured at each season in AB and during south-west (SWM) and north-east monsoons (NEM) in KL. SUBJECTS: One hundred and fifteen Asians in KL and eighty-five Asians in AB aged 20-50 years. RESULTS: Median summer UVB exposure of Asians in AB (0·25 SED/d) was higher than UVB exposure for the KL participants (SWM=0·20 SED/d, P=0·02; NEM= 0·14 SED/d, P<0·01). UVB exposure was the major source of vitamin D in KL year-round (60%) but only during summer in AB (59%). Median dietary vitamin D intake was higher in AB (3·50 µg/d (140 IU/d)), year-round, than in KL (SWM=2·05 µg/d (82 IU/d); NEM=1·83 µg/d (73 IU/d), P<0·01). Median total vitamin D (UVB plus diet) was higher in AB only during summer (8·45 µg/d (338 IU/d)) compared with KL (SWM=6·03 µg/d (241 IU/d), P=0·04; NEM=5·35 µg/d (214 IU/d), P<0·01), with a comparable intake across the full year (AB=5·75 µg/d (230 IU/d); KL=6·15 µg/d (246 IU/d), P=0·78). CONCLUSIONS: UVB exposure among Asians in their home country is low. For Asians residing at the northerly latitude of Scotland, acquiring vitamin D needs from UVB exposure alone (except in summer) may be challenging due to low ambient UVB in AB (available only from April to October).
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Povo Asiático , Clima , Dieta , Estações do Ano , Luz Solar , Deficiência de Vitamina D , Vitamina D , Adulto , Feminino , Humanos , Estudos Longitudinais , Malásia , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Chuva , Escócia , Pigmentação da Pele , Inquéritos e Questionários , Vitamina D/administração & dosagem , Vitamina D/biossíntese , Deficiência de Vitamina D/etiologia , Vitaminas/administração & dosagem , Vitaminas/biossíntese , Adulto JovemRESUMO
Background: Improved bone health during adolescence can have lifelong implications, reducing the risk of bone fragility. Objective: This study aims to evaluate the effectiveness of an e-book in increasing knowledge about and promoting healthy practices related to bone health among Malay adolescents in Kuala Lumpur, Malaysia. Methods: A total of 72 adolescents (female: n=51, 71%; age: mean 15, SD 0.74 y) were recruited from selected secondary schools. The participants answered a pretest web-based questionnaire on sociodemographic data, knowledge about osteoporosis, and physical activity. A video call was conducted to assess dietary calcium intake. Participants were provided with a link to an e-book on bone health and instructed to read it within 2 weeks. Postintervention assessments included those for knowledge, physical activity, dietary calcium intake, and acceptance of the e-book. Results: There was a significant increase in the median knowledge score, which was 40.6% (IQR 31.3%-46.9%) during the pretest and 71.9% (IQR 53.9%-81.3%) during the posttest (P<.001). However, no changes were observed in dietary calcium intake or physical activity levels. Most participants did not meet the recommended calcium requirements (61/62, 98%) and exhibited sedentary behavior (pretest: 51/62, 82%; posttest: 48/62, 77%). The e-book, however, was well accepted, with the majority reporting that they understood the contents (70/72, 97%), liked the graphics (71/72, 99%), and approved of the layout (60/72, 83%) and font size (66/72, 92%) used. Conclusions: The developed e-book effectively increases knowledge levels related to bone health and is well accepted among participants. However, this educational material did not improve bone health practices. Additional strategies are necessary to bridge the gap between knowledge and behavior change.
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BACKGROUND/OBJECTIVES: Dietitians frequently use nutrition education tools to facilitate dietary counselling sessions. Nevertheless, these tools may require adaptation to keep pace with technological advancements. This study had a 2-fold purpose: first, to identify the types of nutrition education tools currently in use, identify their limitations, and explore dietitians' perspectives on the importance of these tools; second, to investigate the features that dietitians prefer in digital nutrition education tools. SUBJECTS/METHODS: A semi-structured face-to-face interview was conducted among 15 dietitians from selected public hospitals, primary care clinics, and teaching hospitals in Malaysia. Inductive thematic analysis of the responses was conducted using NVivo version 12 software. RESULTS: Most dietitians used physical education tools including the healthy plate model, pamphlets, food models, and flip charts. These tools were perceived as important as they facilitate the nutrition assessment process, deliver nutrition intervention, and are time efficient. However, dietitians described the current educational tools as impersonal, outdated, limited in availability due to financial constraints, unhandy, and difficult to visualise. Alternatively, they strongly favoured digital education tools that provided instant feedback, utilised an automated system, included a local food database, were user-friendly, developed by experts in the field, and seamlessly integrated into the healthcare system. CONCLUSION: Presently, although dietitians have a preference for digital educational tools, they heavily rely on physical nutrition education tools due to their availability despite the perception that these tools are outdated, impersonal, and inconvenient. Transitioning to digital dietary education tools could potentially address these issues.
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BACKGROUND: My E-Diary for Activities and Lifestyle (MEDAL) is a web-based time-use diary developed to assess the diet and movement behaviors of Asian school children. OBJECTIVE: This study aims to determine the accuracy of MEDAL in assessing the dietary intake of Malaysian school children, using photographs of the children's meals taken by their parents as an objective reference. METHODS: A convenience sample of 46 children aged 10 to 11 years recorded their daily meals in MEDAL for 4 days (2 weekdays and 2 weekend days). Their parents took photographs of the meals and snacks of their children before and after consumption during the 4-day period and sent them along with a brief description of food and drinks consumed via an instant SMS text messaging app. The accuracy of the children's reports of the food they had consumed was determined by comparing their MEDAL reports to the photographs of the food sent by their parents. RESULTS: Overall, the match, omission, and intrusion rates were 62% (IQR 46%-86%), 39% (IQR 16%-55%), and 20% (IQR 6%-44%), respectively. Carbohydrate-based items from the food categories "rice and porridge"; "breads, spreads, and cereals"; and "noodles, pasta, and potatoes" were reported most accurately (total match rates: 68%-76%). "Snack and dessert" items were omitted most often (omission rate: 54%). Furthermore, side dishes from "vegetables and mushrooms," "eggs and tofu," "meat and fish," and "curry" food groups were often omitted (omission rates: 42%-46%). Items from "milk, cheese, and yogurt"; "snacks and desserts"; and "drinks" food groups intruded most often (intrusion rates: 37%-46%). Compared to the items reported by the boys, those reported by the girls had higher match rates (69% vs 53%) and lesser omission rates (31% vs 49%; P=.03, respectively). CONCLUSIONS: In conclusion, children aged 10 to 11 years can self-report all their meals in MEDAL, although some items are omitted or intruded. Therefore, MEDAL is a tool that can be used to assess the dietary intake of Malaysian school children.
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Achieving optimum peak bone mass during adolescence is crucial for lifetime bone health. This study is aimed at developing and assessing an e-book designed for adolescent bone health knowledge and osteoporosis education. A needs assessment was conducted among 43 adolescents, aged 13-16 years, living in urban areas in Malaysia to determine their needs and preference for health educational material. The researchers also searched for relevant guidelines and articles regarding adolescent bone health. Subsequently, an e-book was developed based on the needs assessment and literature search. Five expert panelists (mean work experience = 11.3 years) validated the e-book contents and assessed its understandability and actionability using the Patient Educational Materials Assessment Tool for Audio-Visual Material (PEMAT-A/V). The internet (72.1%), parents (44.2%), television (41.9%), and teachers (39.5%) were the top four sources of health information among the respondents. Magazines (4.6%) and newspapers (11.6%) were the least preferred resources. Most adolescents were interested in cartoon-themed educational materials, and they perceived that including a short video, quiz, and infographic in the educational material would make it much more interactive for users. The developed e-book includes seven infographic chapters, a link to a quiz, and a summary video. The topics cover basic information on bones and the formation and resorption processes, osteoporosis and its risk factors, key nutrients for bone health (calcium and vitamin D), along with their sources and recommended amounts, physical activity and exercise for bone health, and tips for healthy lifestyle practices for bone health. All chapters and the video were rated with a median score of 100% for understandability and actionability, respectively. Some of the comments received from evaluators included that the e-book made good use of infographics, was easy to understand and interesting, and contained well-organized content. Some suggestions for improvement included adding take-home messages relevant to the topic, using colors to highlight keywords, and narrating all points presented in the video. Overall, the newly developed e-book on adolescent bone health was highly rated by expert panelists. However, the acceptance and effectiveness of the e-book in increasing bone health and osteoporosis knowledge among adolescents are yet to be evaluated. The e-book could be used as one of the educational tools to promote bone health in adolescents.
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Densidade Óssea , Osteoporose , Humanos , Adolescente , Osteoporose/prevenção & controle , Materiais de Ensino , Educação em Saúde , Osso e OssosRESUMO
Relative energy deficiency in sport (RED-S), which underpins the concept of low energy availability (LEA), can negatively affect athletes' health and performance. This study aims to investigate the prevalence of RED-S among national athletes in Malaysia. A total of 192 national athletes (97 males, 18-39 years old) responded to an online survey regarding the RED-S risk. Most athletes (67.2%) were classified as having a medium/high RED-S risk. Female (41.2%), weight-class (23.9%), and intermittent sports (20.3%) had the highest prevalence of medium/high RED-S risk. Overall, most athletes spent 2-5 h daily (55.2%) and 6-7 days weekly (53.6%) practicing or playing their sport, and 47.9% reported feeling tired recently. The athletes were also terrified of being overweight (61.5%), worried about what they eat (64.7%), concerned about having fat on their bodies (62.6%), and thinking about burning calories while exercising (69.3%). Only 16.7% of the athletes had a prior history of stress fractures, and 40.6% continued to participate in activities 6-7 days per week while injured. The majority of female athletes (88.3%) had regular menstrual cycles. These findings support the notion that RED-S screening should be addressed in the athletic community. Future research is needed to clinically assess these athletes and investigate the impacts of RED-S on their health and sports performance.
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Desempenho Atlético , Deficiência Energética Relativa no Esporte , Masculino , Humanos , Feminino , Adolescente , Adulto Jovem , Adulto , Prevalência , Malásia/epidemiologia , Metabolismo Energético , AtletasRESUMO
Purpose: To estimate the vitamin D status of participants residing in Malaysia. Methods: PubMed, Scopus, Web of Science, and MyJurnal were searched up to June 2022 without language restrictions. Studies that reported the 25-hydroxyvitamin D [25(OH)D] concentrations and defined their cut-off for deficiency or insufficiency from healthy participants residing in Malaysia were included. The random effects model was used to pool vitamin D status using established cut-offs of <30, <50, and <75 nmol/L according to age group. Results: From 299 studies screened, 32 studies were included in the meta-analysis. The pooled proportion for <30 nmol/L was 21% (95% CI 9-36, n = 2,438 from 10 studies), while the pooled proportion <50 nmol/L was 64% (95% CI 56-72, n = 13,977 from 30 studies), and <75 nmol/L was 85% (95% CI 61-100, n = 1,376 from five studies). Heterogeneity was high (I2 ranged from 98-99%). Higher proportions of vitamin D insufficiency (defined as <50 nmol/L) were found in participants living in the urban areas (compared to rural areas), in females (compared to males), and in Malays and Malaysian Indians (compared to Malaysian Chinese) ethnicities. Conclusion: More than half of Malaysians have insufficient vitamin D levels, despite being a country that is close to the equator. We strongly urge prompt public health measures to improve the vitamin D status in Malaysia. Systematic review registration: [https://www.crd.york.ac.uk/prospero/], identifier [CRD42021260259].
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There were massive interruptions, including patient visits for dietary advice and dental services, during the COVID-19 outbreak. This study assessed the feasibility of an online diabetes wellness programme among periodontitis patients with type II diabetes mellitus. Patients were grouped into the intervention group (IG) and control group (CG). At baseline and week 12, all patients answered online questionnaires on diabetes-related knowledge, physical activity, and oral impacts on daily performances (OIDP). Body weight and waist circumference were self-measured with guided instructions. Diet recalls were used to estimate dietary and added sugar intake. All patients received a weekly educational video, but the IG attended three e-consultation sessions with a dietitian (weeks 1, 3, and 8) and a dentist (week 8) via video call. A semi-structured interview was conducted to collate qualitative feedback among the IG participants at the end of the programme. A total of 24 periodontitis patients (14 IG and 10 CG) participated in this study. Among the IG patients, significant improvements in diabetes knowledge, body weight, BMI, calories, carbohydrates, fat, and added sugar intakes were observed at week 12. The CG patients only had a significant reduction in carbohydrate intake post intervention. No changes were reported in physical activity level and OIDP for both groups. Feedback received from the IG participants included convenience, practical, preferred approach during the pandemic, increased awareness and knowledge, and favourable lifestyle changes. This study demonstrates that an online diabetes wellness programme with healthcare professionals is feasible and can facilitate knowledge and lifestyle improvements that can be adapted during the crisis situation.
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This paper describes a study to evaluate the readability scores of Malaysian newspaper articles meant to create awareness of diabetes among the public. In contrast to patient-specific sources of information, mass media may potentially reach healthy people, thus preventing them from becoming part of the diabetes statistics. Articles published within a selected corpus from the years 2013 to 2018 and related to awareness regarding diabetes were sampled, and their readability was scored using Flesch Kinkaid Reading Ease (FKRE). Features of three articles ranked as the best and worst for readability were qualitatively analyzed. The average readability for the materials is low at 49.6 FKRE, which may impede the uptake of information contained in the articles. Feature analysis of articles with the best and worst readability indicates that medical practitioners may not be the best spokesperson to reach the public. It also indicates that simple sentence structures could help improve readability. There is still much room for improvement in attaining good public health literacy through mass media communication. Public health and media practitioners should be vigilant of the language aspects of their writing when reaching out to the public.
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Diabetes Mellitus , Letramento em Saúde , Compreensão , Humanos , Internet , Idioma , LeituraRESUMO
Sports nutrition and food knowledge can influence athletes' dietary intake, potentially affecting athletic performance. Limited studies have been conducted to identify sports nutrition and food knowledge among Malaysian university athletes. This study aimed to determine Malaysian university athletes' knowledge of sports nutrition and food, and their reference sources and preferred sports nutrition education programme. Seventy athletes (52.9% females, mean weight = 61.8 kg; height = 1.66 m) aged 18.5-22.4 years responded to an online survey administered using a Google Form. A score of ≥60% was considered as adequate knowledge. The average overall knowledge score was 58.6%. The highest knowledge score was for sports nutrition, specifically food intake periodicity (84.8%), while the lowest was for general food knowledge on fat (44.6%). An analysis of specific questions revealed a lack of understanding about the recommended daily intake of fruits and vegetables (only 14.3% answered correctly), the roles of vitamins and minerals in energy production (21.4%), and good sources of unsaturated fat (37.2%). The academician was the primary reference source (81%), while magazines were the least referred to sources (36%). The university athletes preferred sports camps (33%) over the other nutrition education programme options. More initiatives are needed to improve Malaysian university athletes' understanding and knowledge of sports nutrition and general food.
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Desempenho Atlético , Ciências da Nutrição e do Esporte , Adolescente , Adulto , Atletas , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Universidades , Adulto JovemRESUMO
INTRODUCTION: The diabetes mellitus-periodontitis relationship has advocated several strategic management approaches on effective glycaemic control and oral health improvement for diabetic patients and periodontitis patients with diabetes. We aimed to identify the challenges of providing health education to patients with diabetes and/or periodontitis among healthcare professionals and needs for an integrated nutrition-oral health education module. METHODS: This study involved semi-structure in-depth interview with fifteen healthcare professionals from a training hospital focused on: (i) the existing issues and challenges encountered while managing patients for their nutrition and care and (ii) issues related to the current practice among healthcare professionals. Details pertaining to the participants' verbal and non-verbal responses were recorded, transcribed ad verbatim and analysed using themes codes. RESULTS: Patients' attitude and behaviour, language barriers and prioritising time were found as the common problems with patients, while limited knowledge on the relationship between diabetes-periodontitis, limited availability of appropriate and cultural-based health educational tools, lack of inter-professional multidisciplinary collaboration in managing patients, and constrains in time as well as costly therapy were common issues in the current practice. CONCLUSIONS: Cost-effective efforts must be focused on overcoming these issues besides emphasizing the needs on developing an integrated module to achieve better management outcomes.