Food security and diet quality among urban poor adolescents in Kuala Lumpur, Malaysia

BACKGROUND/OBJECTIVES@#This study aimed to examine the food security status of urban poor adolescents and its association with diet quality. @*SUBJECTS/METHODS@#A cross-sectional survey was conducted among 188 adolescents aged 13–18 yrs living in Kuala Lumpur, Malaysia. Household food insecurity and dietary intake data were collected using the Radimer/Cornell hunger and food insecurity instrument and 2-day 24-h dietary recalls, respectively. Diet quality was determined using the Malaysian Healthy Eating Index (HEI). Weight and height were measured and body mass index-for-age, as well as height-for-age z scores were calculated. @*RESULTS@#The present study revealed that 47.9% of the adolescents experienced household food insecurity, 24.5% experienced individual food insecurity, 18.6% household food security, and 9.0% child hunger. The mean score of diet quality was 56.83 ± 10.09, with a significantly lower HEI score among food insecure adolescents (household food insecure, individual food insecure, and child hunger) than household food secure adolescents (P = 0.001). The differences between food secure and food insecure households were found to be significant for energy (P = 0.001) and nutrients including proteins (P = 0.006), carbohydrates (P = 0.005), dietary fiber (P = 0.001), folate (P < 0.001), and vitamin C (P = 0.006). The multiple linear regression showed that adolescents who experienced food insecurity (β = −0.328; P = 0.003) were found to be significantly associated with poor diet quality (F = 2.726; P < 0.01), wherein 13.3% of the variation in the diet quality was explained by the food security status. @*CONCLUSIONS@#Experiencing food insecurity contributed to poor diet quality among urban poor adolescents. Further longitudinal studies are needed to comprehensively understand this association to improve food insecurity and diet quality among urban poor communities.

Problematic Use of Internet Among Indonesia University Students: Psychometric Evaluation of Bergen Social Media Addiction Scale and Internet Gaming Disorder Scale-Short Form

Objective@#Social media addiction and internet gaming disorder may cause mental health problems among a minority of university students. The Bergen Social Media Addiction Scale (BSMAS) and the 9-item Internet Gaming Disorder Scale-Short Form (IGDS9-SF) are commonly used worldwide. However, they have not been translated or validated into Indonesian. The present study aimed to translate and validate the BSMAS and IGDS9-SF in an Indonesian context among young adults. @*Methods@#A multi-center, web-based cross-sectional study was conducted among 458 university students (74% female; mean age 22.5 years) in Indonesia from June to December 2021. The BSMAS and IGDS9-SF were translated into Indonesian. Internal consistency (using Cronbach’s α and McDonald’s ω) and factor structure (using confirmatory factor analysis) of the two instruments were examined. Concurrent validity of BSMAS and IGDS9-SF was examined using their correlations with two external concepts: nomophobia and psychological distress. @*Results@#Internal consistency of the Indonesian BSMAS and IGDS9-SF were both acceptable (Cronbach’s α=0.80 and 0.90; McDonald’s ω=0.86 and 0.92). Both instruments were unidimensional with good factor loadings (0.54–0.78 for BSMAS; 0.63–0.79 for IGDS9-SF). Moreover, BSMAS and IGDS9-SF had stronger associations with nomophobia (r=0.58 and 0.12; p<0.001) than with psychological distress (r=0.43 and 0.15; p<0.001). @*Conclusion@#The Indonesian versions of the BSMAS and IGDS9-SF had good psychometric properties in terms of linguistic validity, unidimensionality, and reliability. The findings indicate the tools are appropriate for assessing the risk of social media addiction and internet gaming disorder among university students in Indonesia.

Evaluation of Antioxidant Properties, Knowledge, Attitude and Practice (KAP) on Selected Dietary Supplements (Barley Grass, Wheatgrass and Chlorella vulgaris powders)

@#Introduction: Three selected dietary supplements (DS), barley grass (BG), wheatgrass (WG), and Chlorella vulgaris (CV), are commercially available. However, more information is needed about the antioxidant properties of the three DS and their potential health benefits on adults’ health and well-being. Thus, this study aimed to determine the antioxidant properties and adults’ knowledge, attitudes and practices (KAP) of the three selected DS. Methods: In phase 1, an experimental study was conducted on antioxidant analysis, total phenolic content (TPC) and DPPH radical scavenging activity for the three DS. For phase 2, a cross-sectional survey (n=338) was conducted for the three DS through an online platform where convenience sampling was performed. Results: In phase 1, BG (2.83±0.50mg GAE/g DW) had the highest TPC, followed by WG (2.02±0.20mg GAE/g DW) and CV (1.74±0.65mg GAE/g DW); DPPH radical scavenging activity, BG (198.23±0.15µg/mL) and WG (177.25±0.17µg/mL) had lower IC50 compared to CV (1185.84±0.28µg/mL). Significant differences (p<0.05) were found between IC50 of the three DS and standards, butylated hydroxytoluene (24.51±0.37µg/mL) and quercetin (26.04±0.55µg/mL). While in phase 2, poor knowledge (51.5%), moderate attitude (39.6%), and poor practice (43.2%) levels were observed in most of the participants. Moreover, working adults reported higher scores in knowledge (3.70±1.51) compared to students (3.33±1.63, p=0.037). Males had higher scores (29.27±2.42) in attitude compared to females (28.49±2.68, p=0.030). Besides, participants who were single and completed tertiary education with 4-6 years of working experience showed better practice scores. The overall knowledge (r=0.134, p=0.013) and attitude (r=0.273, p<0.001) scores correlated significantly with practice scores. Conclusion: Participants’ poor knowledge, moderate attitude, and inadequate practice in phase 2 caution against over-reliance on supplements, emphasizing the importance of an active lifestyle and balanced diet for optimal health and longevity.

Socio-economic Status, Food Security Status and its Coping Strategies among ‘The Lost Food Project’ (TLFP) Recipients in Klang Valley during COVID-19 Pandemic

@#Introduction: The Lost Food Project (TLFP) is a non-profit organization who continuously working on their strategic plan in combating the food insecurity problem by distributing food surplus to low income households within Klang Valley. This cross-sectional study aims to determine the socioeconomic status, food security status and its coping strategies among TLFP recipients in Klang Valley during COVID-19 pandemic. Methods: This study was conducted from April to June 2021. There were 88 respondents recruited through convenience sampling. A set of questionnaires regarding food assistance, nutrition knowledge, food security and its coping strategies was prepared, and the respondents were interviewed either by phone, face-to-face or self-administered questionnaire. Results: The prevalence of food insecurity among households in this study was 59.1%. Most of them have moderate (37.5%) to good (27.5%) nutrition knowledge. The coping strategy that most of the respondents applied was ‘using less expensive food’ (58.3%) with at least once per week within the past one month. Food insecure households tend to adopt more coping strategies compared to those food secure households (p<0.001). Moreover, households who rent their house (p<0.01), low household income (p<0.05) and high monthly food and drinks expenditure (p<0.01) were associated with the food insecurity among TLFP recipients. Conclusion: The study concluded that lower household income, higher food and drinks expenditure and those who rent the house have negative impacts on household’s food security status. Thus, the situation forced them to apply more food-related coping strategies in their daily life. Further research should be conducted on the effectiveness of TLFP in helping them to improve Malaysian’s food security status.

Evaluation of Dietary Quality Using Malaysian Healthy Eating Index and Its Relationships With Cardiometabolic Risk Factors in Malaysian Adolescents

@#Introduction: This cross-sectional study aimed to investigate relationships between diet quality assessed by Malaysian Healthy Eating Index (HEI) and cardiometabolic risk factors in adolescents aged 13 years. Methods: 336 adolescents from various public secondary schools provided information on sociodemography and their anthropometric measurements including height (cm), weight (kg) and waist circumference (cm) were measured. Body mass index (BMI) was estimated thereafter. Dietary intakes assessed using a validated adolescent food frequency questionnaire (FFQ) was used to estimate Malaysian HEI. Biomarker parameters including lipid profile, fasting glucose, insulin and insulin resistance were also assessed. Associations of diet quality indicators to cardiometabolic risk factors were examined using regression models. Results: The overall diet quality of the adolescents was rather poor (49%), with a greater percentage of males were found to have low dietary quality score compared to females (56% vs. 39%; p<0.05). While males were more obese, a higher number of females (46.7%) were found to have at least one risk factors for cardiometabolic health compared to males (37.7%). After adjusting for covariates, no significant associations were observed among adolescents in the lowest quartile compared to those in the highest quartile of HEI score for obesity and abdominal obesity, as well as other cardiometabolic risk factors, in both males and females. Conclusion: Despite of poor dietary quality, no significant associations were observed between dietary quality assessed by Malaysia HEI and cardiometabolic risk factors in adolescents. Prospective studies are needed to establish a causal link between dietary patterns and cardiometabolic risk factors during adolescence.

Sociodemographic and Psychological Factors as Predictors of Body Mass Index-for-Age (BAZ) among Adolescents in Sibu, Malaysia

@#Introduction: Understanding childhood obesity becomes vital as a tremendous increase in the prevalence of overweight/obesity among children and adolescents was observed. This cross-sectional study aimed to investigate the associations between sociodemographic and psychological characteristics with body-mass-index-for-age (BAZ) among adolescents in Sibu, Sarawak. Methods: A total of 375 students (32.0% males and 68.0% females; 15-17 years old) at four randomly selected public secondary schools were recruited. A questionnaire on sociodemographic and psychological characteristics (self-efficacy for physical activity, weight management, and nutrition, body discrepancy score, and sociocultural pressure to be thin) were used to gather information. Body weight and height were also assessed. Results: Around 18.6% respondents were found to be overweight/obese while nearly 5.0% were categorized as thin. In multiple linear regression, three significant predictors, namely body discrepancy score, being Iban (Reference: Chinese) and sociocultural pressure to be thin explained 45.1% of the variance in BMI-for-age z-score. Conclusion: Future interventions on adolescent body weight management should consider incorporating sociodemographic and psychological factors such as the development of positive body image, uniqueness in cultural value, and management of perceived sociocultural pressures to increase their effectiveness

Physical Activity Levels of Malaysian Vegetarians and Its Associated Factors: A Cross-Sectional Study

@#Introduction: Literatures suggest that insufficient physical activity as one of the contributors to non-communicable chronic diseases; nevertheless, data on the physical activity level is sparsely reported among individuals practising a vegetarian diet in Malaysia. The current study aims to determine the prevalence of insufficient physical activity and its association with socio-demographic factors, lifestyle factors and body weight status among 273 individuals practising a vegetarian diet in Klang Valley, Malaysia. Methods: A set of self-administered questionnaire was distributed to all vegetarians and their data on physical activity was determined using the Global Physical Activity Questionnaire (GPAQ). Results: The average years of practising vegetarianism was 14.2±9.6 years, and most of the vegetarians were practised ovo-vegetarian diet (44.0%). A majority of them were Chinese (54.9%) and female (64.8%), with an average age of 47.5 ± 13.1 years. The prevalence of overweight and obesity were 27.5% and 8.1%, respectively. According to GPAQ, about two in five vegetarians (46.2%) were having insufficient physical activity. Being females, older age, Chinese, married individuals, and those with high total household income level were found to be significantly associated with low physical activity level among Malaysian vegetarians (p<0.05). Conclusion: Since insufficient physical activity is one of the factors contributing to non-communicable chronic diseases, it is crucial to educate the importance of physical activity on overall health status, specifically for those who at risk of physically inactive. In addition, future studies can focus the causal associations based on the currently identified factors and physical activity levels, which can help to develop an effective intervention program among Malaysia vegetarians.

The Effects of Socio-demographic Characteristics, Nutritional Status, Physical Activity and Physical Function on Cognitive Function of Community-dwelling Older Adults in the Klang Valley, Malaysia

@#Introduction: Cognitive decline and cognitive impairment among older adults is a rising public health concern because of its association with increased risk of dementia, disability and mortality. In Malaysia, early identification of cognitive impairment is uncommon due to lack of understanding of risk profile of the elderly population. The objective of this study was to determine factors associated with cognitive impairment among community-dwelling older adults. Methods: This cross-sectional study was conducted among 698 community-dwelling older adults aged 60 years old and above in Klang Valley, Malaysia by using multi-stage sampling to determine the risk factors and predictors of cognitive impairment from a multidimensional approach. Multivariate logistic regression analysis was performed to determine the relationship between socio-demographic characteristics, physical activity, physical functional status and cognitive impairment. Results: Increased of age (OR = 1.056), being female (OR = 2.219) and Indian (OR = 2.722) were the risk factors for cognitive impairment, while years of education (OR = 0.765), physically active (OR = 0.823) and better physical function (OR = 0.843) were significantly associated with decreased risk of cognitive impairment. Marital and nutritional status failed to predict the risk of cognitive impairment. Conclusion: Given the protective effects of physical activity and physical function on the cognitive decline at later age, relevant policymakers should formulate appropriate health education programmes to promote regular physical activity to improve physical and cognitive function among Malaysians across all ages.

Factors associated with anemia among female adult vegetarians in Malaysia

BACKGROUND/OBJECTIVES: A large number of studies on anemia have focused mostly on pregnant women or children. The vegetarian population, which is another potential risk group for anemia, remains largely unexplored. Therefore, this cross-sectional study examined the associations of the sociodemographic, lifestyle, nutritional, and psychological factors with the anemia status among female adult vegetarians. SUBJECTS/METHODS: A total of 177 female vegetarians were recruited from a Buddhist and Hindu organization in Selangor, Malaysia. The participants completed a self-administered questionnaire, which analyzed their sociodemographic characteristics, physical activity level, sleep quality, depression, anxiety, and stress. The body weight, height, waist circumference, and body fat percentage of the participants were also measured. A 3-day dietary recall was conducted to assess their dietary intake. Blood samples (3 ml) were withdrawn by a nurse from each participant to determine the hemoglobin (Hb) level. RESULTS: The findings revealed 28.2% of the participants to be anemic. The age group (AOR = 2.46, 95% CI = 1.19–5.05), marital status (AOR = 2.69, 95% CI = 1.27–5.71), and percentage of energy from protein (AOR = 5.52, 95% CI = 1.41–21.65) were the significant predictors of anemia. CONCLUSIONS: Anemia is a public health problem among female vegetarians in this study. Health promotion programs that target female adult vegetarians should be conducted to manage and prevent anemia, particularly among those who are married, aged 50 and below, and with an inadequate protein intake.

Comparing the nutritional status of vegetarians and non-vegetarians from a Buddhist Organisation in Kuala Lumpur, Malaysia

Introduction: A vegetarian diet is generally considered as healthy for preventing metabolic-related diseases. There is lack of studies in Malaysia comparing the nutritional status of vegetarians and non-vegetarians. This cross-sectional study aims to compare body weight status, dietary intake and blood pressure level between these two groups. Methods: A total of 131 vegetarians and 135 non-vegetarians were recruited using convenience sampling from a Buddhist organisation in Kuala Lumpur. Body weight, height, waist circumference, percentage of body fat, and blood pressure measurements were taken, while dietary intake was assessed using a 2-day 24-hour dietary recall. Results: More vegetarians were underweight than non-vegetarians (31.3% vs 15.6%), while prevalence of overweight and obesity was higher among the non-vegetarians (23.7% vs 9.9%). A higher proportion of nonvegetarians (34.1%) had an unhealthy range of body fat percentage and significantly higher risk of abdominal obesity (24.4%) than the vegetarians (19.1% body fat; 13.7% abdominal obesity). Mean intakes for protein and fat were significantly lower among the vegetarians, while no significant differences were observed in the mean intake for energy and carbohydrate. Vegetarians had significantly higher intakes of vitamins C, D and E, calcium, potassium and folate, while vitamin B12 intake was significantly higher in the non-vegetarians. More non-vegetarians presented with unhealthy blood pressure status. Conclusion: Vegetarians in this study generally showed healthier dietary intake and lower body fatness than the non-vegetarians. Studies are suggested to be undertaken on a bigger sample size of vegetarians to confirm these findings.