Global prevalence of overweight and obesity among healthcare workers: a systematic review.

OBJECTIVE: This systematic review aims to determine the global pooled prevalence of overweight and obesity among health care workers in the 6 World Health Organization (WHO) regions. INTRODUCTION: The escalating prevalence of overweight and obesity among health care workers significantly affects both individual health and the quality of health care services. Understanding this global prevalence is crucial to be able to implement informed interventions, policies, and for the overall optimization of health care delivery. INCLUSION CRITERIA: Systematic reviews with prevalence data for overweight and obesity among health care workers in both private and public health care facilities will be considered for inclusion. Transparent documentation of anthropometric measurements and adherence to established overweight and obesity criteria by the WHO, Asia Pacific standards, or Asian criteria are required to be eligible for inclusion. The review will focus on observational study designs, including cross-sectional, survey, case-control, and cohort studies. METHODS: MEDLINE (PubMed), Scopus, and Web of Science will be searched for records with predefined keywords, including MeSH terms. Records found through hand-searching and reference lists will be added. Two researchers will independently screen studies, resolving any discrepancies with a third researcher. Standardized critical appraisal and data extraction forms will be used. If suitable, pooled prevalence for overweight and obesity based on the 6 WHO regions will be calculated using the DerSimonian-Laird random-effects model. Statistical analysis will be performed and publication bias will be assessed through funnel plot analysis and Egger's test. REVIEW REGISTRATION: PROSPERO CRD42023452330.

Development and Utility of an Interactive Online Dashboard for Monitoring Data Collection and Data Processing During a School-Based Health Survey.

We built an interactive online dashboard using Google Looker Studio to monitor data collection and data processing activities during the Adolescent Health Survey (AHS) 2022, a large-scale nationwide survey conducted among school-going adolescents in Malaysia. Through user testing and training, refinements were made to the initial dashboard, resulting in a more streamlined and concise dashboard design. The dashboard comprised 2 pages that provided key metrics on the progress of data collection and data processing, respectively. The introduction of the dashboard enhanced the quality and ease of weekly progress reporting during meetings of the survey's central coordinating team, while its drill-down and filtering functionalities helped us detect arising issues early and supported collaborative problem-solving. Research teams coordinating comparable school-based health surveys are invited to duplicate the dashboard using Looker Studio's built-in "Make a copy" function and customize it further based on their country- or survey-specific requirements.

Demographic, lifestyle, social, and psychological factors associated with worry-related sleep problems among school-going adolescents in Timor-Leste.

OBJECTIVE: Adolescent sleep problems are a worldwide public health issue. The present study examines factors associated with worry-related sleep problems among school-going adolescents. The country of interest is Timor-Leste, a low-income country, where studies pertaining to adolescent sleep problems are lacking. DESIGN AND MEASURES: Data were analysed from the Global School-Based Student Health Survey Timor-Leste (n = 3455). An ordered probit model was used to assess the effects of demographic, lifestyle, social, and psychological factors on different levels of worry-related sleep problems (i.e., no, mild and severe sleep problems). RESULTS: School-going adolescents were more likely to face mild or severe worry-related sleep problems if they were older, passive smokers, alcohol drinkers and moderately active. School-going adolescents who sometimes or always went hungry were more likely to experience worry-related sleep problems than those who did not. Involvement in physical fights, being bullied, and loneliness were positively associated with the probability of having modest or severe worry-related sleep problems. CONCLUSION: Age, exposure to second-hand smoke, alcohol consumption, physical activity, going hungry, physical fights, being bullied and loneliness are the important determining factors of adolescent worry-related sleep problems. Policymakers should pay special attention to these factors when formulating intervention measures.

Occupational Disease and Injury in Malaysia: A Thematic Review of Literature from 2016 to 2021.

Introduction: Working people are exposed to occupational hazards and are at risk of having occupational disease or injury in a rapidly industrializing country like Malaysia. This study aims to review and summarize the occupational disease and injury in Malaysia from 2016 to 2021. Methods: This study used PubMed and Scopus databases to conduct a systematic literature search using a set of keywords. The selected records dated from 1 January 2016 to 8 September 2021 were extracted into the Mendeley Desktop and ATLAS.ti 8 software. Systematic screening was conducted by two independent researchers and finalized by the third researcher. Data were coded and grouped according to the themes. The results were presented as the table for descriptive analysis and cross-tabulation between the themes. Results: A total of 120 records were included in this study. Under the theme of main health problems, the findings showed that mental health, infectious disease, and work-related musculoskeletal disorders are the top three problems being discussed in the literature for the working people in Malaysia. The findings also showed an increasing trend of mental health problems during pandemic COVID-19 years. In addition, hospital was the highest workplace where the occupational health problems were reported.Discussion/Conclusion. There was substantial work on the mental health problem, infectious diseases, and work-related musculoskeletal disorders as the main health problem among workers in Malaysia in the past five years. The employers must report any occupational health and injury case to the authority and prompt intervention can be initiated.

Can the association between hypertension and physical activity be moderated by age?

Objectives: Physical inactivity, hypertension and non-communicable diseases are major public concerns across the globe. To our knowledge, there is a lack of research that has investigated the moderating effect of age on the relationship between hypertension and physical activity in developing countries. This study had two objectives: (1) investigating hypertension and sociodemographic factors associated with physical activity and (2) investigating whether age moderates the relationship between hypertension and physical activity. Methods: Nationally representative data of Malaysia were used to generate cross-sectional evidence. The sample size was 2156 respondents. An ordered probit regression was utilized to assess factors associated with the practice of physical activity. Results: Respondents aged 40-49 years with hypertension were 7.3% less likely to participate in high-level physical activity when compared to those without hypertension. The probability of having a low level of physical activity was 12.3% higher among hypertensive patients aged ≥60. Males, married individuals, less-educated adults, low-income earners, and individuals who were aware of their BMI, had a higher tendency to indulge in a highly active lifestyle than others. Conclusion: The effect of hypertension on physical activity was moderated by age. Factors influencing physical activity levels among adults were income, gender, marital status, education, employment status, and BMI awareness.

Methodology of National Health and Morbidity Survey (NHMS): Adolescent Health, Malaysia 2022

Introduction@#In Malaysia, the adolescent health studies conducted in 2012 and 2017 revealed an increasing trend of adolescent health risk behaviours and protective factors. This current study aims to determine health risk behaviours and protective factors among adolescents in the country. @*Methods@#The current nationwide cross-sectional study of Malaysian secondary school students used multistage stratified sampling to select 240 nationally representative schools. This study was conducted from June to July 2022 among the students in forms 1, 2, 3, 4, and 5 in all Malaysian states by 34 data collection teams. A validated self-administered questionnaire was used, similar to those used in the NHMS 2012 and NHMS 2017. The quality control was done twice, once at the field level and once at the central level. Sample weighting and analysis were conducted using SPSS statistical software version 28.0.@*Results@#A total of 239 schools out of 240 schools took part in the study (response rate, 99.6%) and total of 33,523 students were involved in this study (response rate, 89.4%). In terms of ethnicity, the highest number of students who participated in the study were Malay (63.0%), followed by Chinese (18.1%) and Indian (6.0 %). While the distribution of sex and form among the students were almost the same. @*Conclusion@#To obtain an accurate representation of the nation's adolescent population for this study, samples from public and private schools that are governed by the Ministries of Education and Rural and Regional Development were deemed to be the most reliable.

Awareness of body mass index and its associated factors: A cross-sectional study.

This study explores the correlates of sociodemographic factors, smoking, and caloric knowledge to body mass index awareness with a focus on Malaysia. Logistic regressions were estimated to examine sociodemographic factors associated with body mass index awareness. More than half of respondents were unaware of their body mass index (54.8%). Age was negatively associated with body mass index awareness. Adults without formal education were less likely to know their body mass index than those with tertiary-level education. Adults were less likely to be aware of their body mass index if they engaged in smoking. Adults with knowledge of the definition of calories were more aware of their body mass index than others. The findings emphasize the urgent need for a forthcoming sociodemographic factors-specific policy directed toward improving body mass index awareness to lower the prevalence of obesity in Malaysia.

Physical Inactivity and Its Associated Factors among Adults in Malaysia: Findings from National Health and Morbidity Survey (NHMS) 2019

Introduction@#Physical inactivity has been identified as the fourth leading risk factor for worldwide mortality with major implications towards general health. Monitoring the level of physical inactivity may reduce the burden of non-communicable diseases (NCDs) and their risk factors. This study aims to determine the prevalence of physical inactivity and its associated factors among adults aged 18 years and above in Malaysia. @*Methodology@#Data was obtained from the National Health and Morbidity Survey (NHMS) 2019. It was a cross-sectional, population-based survey which employed two- stage stratified random sampling design. A total of 10,356 out of 10,472 respondents were interviewed using a short version of International Physical Activity Questionnaire (IPAQ). @*Results@#Overall, the prevalence of physical inactivity among adults aged 18 years and above in Malaysia was 24.6% (95% CI: 23.2, 26.1). Results from multivariable logistic model showed that Chinese ethnicity (aOR 1.32; 95% CI: 1.04, 1.67), urban dwellers (aOR 1.30; 95% CI: 1.07, 1.57), those who were single (including widow, widower and divorcee) (aOR 1.36; 95% CI: 1.14, 1.61), students (aOR 2.10; 95% CI: 1.30, 3.40), higher household income earners (aOR 1.34; 95% CI: 1.07, 1.68) and those with hypercholesterolaemia (aOR 1.25; 95% CI: 1.03, 1.51) were significantly more likely to be physically inactive.@*Conclusion@#Specific and appropriate intervention towards targeted group is in crucial need to increase the level of physical activity and to promote an active living towards an active and healthy Malaysia.

Factors Associated with Asymptomatic COVID-19 Patients in Petaling District, Selangor, Malaysia

Inntroduction@#The rapid spread of the Coronavirus disease 2019 (COVID-19) worldwide has led the World Health Organization to declare COVID-19 outbreak as a pandemic on March 11, 2020. As the local studies on factors leading to the absence or presence of clinical illness among the COVID-19 cases are sparse, the study aims to determine the factors associated with asymptomatic COVID19 patients in Petaling District, Selangor, Malaysia@*Methods@#Data on COVID-19 patients were extracted from the database of confirmed cases in Petaling District Health Office, Selangor, Malaysia from 3rd February 2020 to 30th April 2020. An asymptomatic laboratory-confirmed case is a person infected with COVID-19 who does not develop any symptoms. The study included socio-demographic variables, the detailed information on clinical manifestations and co-morbidity of the patients. Descriptive and multiple logistic regression analyses were conducted to determine the factors associated with asymptomatic patients.@*Results@#The overall COVID-19 patients in Petaling District were 434. Approximately 70% (n= 292) of the patients were symptomatic while 32.7% (n= 142) were asymptomatic. Multivple logistic regression analyses revealed that factors significantly associated with asymptomatic patients were age below 40 years old (aOR: 1.79, 95% CI 1.11, 2.86), non-Malaysians (aOR: 3.22, 95% CI 1.44, 7.19) and local cases (aOR: 2.51, 95% CI 1.42, 4.42). Gender, ethnicity, comorbidity and township were not significantly associated with asymptomatic patients.@*Conlcusion@#Approximately one-third of COVID-19 patients were asymptomatic and the risk factors identified were younger age, non-Malaysians and local cases. Rigorous epidemiological investigation is helpful in identifying COVID-19 cases among these group of people who are asymptomatic.

Prevalence and factors associated with physical inactivity among older adults in Malaysia: A cross-sectional study.

AIM: Physical inactivity in older adults is linked to increased risk of chronic diseases, disability and various poor health outcomes. As the aging population rises, the prevalence of diseases associated with aging also increases. Regular physical activity in older adults is important to improve overall health and promote healthy aging. This study aimed to determine the prevalence and factors associated with physical inactivity among older adults in Malaysia. METHODS: This study was based on 3969 Malaysian older adults aged ≥60 years who completed the physical activity module in the National Health and Morbidity Survey 2018, a population-based cross-sectional survey. Physical activity was measured using the Global Physical Activity Questionnaire through a face-to-face interview. Participants were classified as physically active or inactive. Associations between physical inactivity, sociodemographic characteristics and a range of selected independent variables were examined using multivariable logistic regression. RESULTS: Overall, three out of 10 (29.8%) Malaysian older adults were physically inactive. Results of multivariable analysis showed that older age group (≥80 years), of Bumiputera Sarawak ethnicity, unemployed/retirees/homemakers, functional limitation, diabetes mellitus and dementia were significantly associated with a higher risk of physical inactivity. Women, with secondary education level and good social support were less likely to be physically inactive. CONCLUSIONS: The present study reported the status of physical inactivity among older adults in Malaysia. There is the need to design effective public health programs and interventions to promote active living and healthy aging among Malaysian older adults, particularly in those at-risk older population subgroups. Geriatr Gerontol Int 2020; 20: 49-56.

Smoking susceptibility among non-smoking school-going adolescents in Malaysia: findings from a national school-based survey.

OBJECTIVE: The identification of susceptible non-smoking adolescents is an essential step in reducing smoking initiation among adolescents. The aim of this study was to examine the prevalence and factors associated with smoking susceptibility among non-smoking school-going adolescents in Malaysia. DESIGN: Cross-sectional study. SETTING: Primary and secondary schools in Malaysia. PARTICIPANTS: 11 246 non-smoking school-going adolescents. OUTCOME MEASURES: The prevalence and factors associated with smoking susceptibility among non-smoking school-going adolescents in Malaysia. RESULTS: Approximately 14% of non-smokers were susceptible to smoking, and the prevalence of susceptibility was significantly higher among males, ever-smokers and e-cigarette users. The odds of susceptibility to smoking were higher among males, e-cigarette users, those aged 12 years and under and those who had ever smoked or tried cigarettes. Students from schools with educational programmes on the health effects of second-hand smoke (SHS) and who perceived smoking to be harmful were less likely to be susceptible to smoking. CONCLUSION: Smoking susceptibility is prevalent among school-going adolescents. A comprehensive approach that enhances or reinforces health education programmes on the adverse health effects of smoking and SHS among school children, that considers multiple factors and that involves all stakeholders is urgently needed to reduce the prevalence of smoking susceptibility among vulnerable subgroups, as identified from the present findings.

Prevalence and correlates of physical inactivity among older adults in Malaysia: Findings from the National Health and Morbidity Survey (NHMS) 2015.

Malaysia has an increasingly aging population. Despite the substantial benefits of physical activity for healthy aging, older adults are considered the most physically inactive segment of the Malaysian population. The purpose of this study was to determine the prevalence of physical inactivity among older adults in Malaysia and its correlates. We analysed data on adults aged ≥60 years (n = 3790) from the National Health and Morbidity Survey (NHMS) 2015, a cross-sectional, nationwide population-based survey covering information on socio-demographic characteristics, physical activity and other lifestyle-related variables, health conditions, and functional limitations. Individuals included in this study were classified as physically active or physically inactive. Logistic regression was used to determine factors associated with physical inactivity. The overall prevalence of physical inactivity among older adults aged ≥60 years old was 48.8%. Physical inactivity was significantly more prevalent among females, older age groups, Indians, those being single/widowed/divorced, those with no formal education, those who reported high sedentary time (≥7 h/day), those with diabetes, anaemia, and functional limitations (p < 0.001). In fully adjusted analyses, females, older age, high household income (≥MYR4000), inadequate fruits and vegetables consumption (<5 servings/day), high sedentary time, having diabetes, and having mobility impairment were all associated with physical inactivity. Approximately half of the Malaysian older population are physically inactive. Identifying the correlates of physical inactivity among Malaysian older adults will help to develop public health policies and interventions that encourage active living among older people and promote healthy aging in Malaysia.

Iodine Deficiency Disorders among Pregnant Women in Sarawak, Malaysia

@#Iodine deficiency disorders (IDD) during pregnancy may impair the neurological development of the fetus. The aim of this study is to determine the iodine status among pregnant women (PW) in Sarawak after introduction of mandatory universal salt iodisation (USI) for seven years.

Physical activity and overweight/obesity among Malaysian adults: findings from the 2015 National Health and morbidity survey (NHMS).

BACKGROUND: Overweight and obesity are growing health problems both worldwide and in Malaysia due to such lifestyle changes as decreased physical activity (PA), increased sedentary behavior and unhealthy eating habits. This study examined the levels and patterns of PA among normal-weight and overweight/obese adults and to investigate the association between PA level and overweight/obesity in Malaysian adults. METHODS: This study used data from the 2015 National Health and Morbidity Survey (NHMS), a nationwide cross-sectional survey that implemented a two-stage stratified random sampling design. Respondents aged 18 years and above (n = 17,261) were included in the analysis. The short version of International Physical Activity Questionnaire (IPAQ) was administered to assess the respondents' PA levels. The respondents' height and weight were objectively measured and body mass index (BMI) was calculated. The respondents were categorized according to BMI as either normal-weight (18.5-24.9 kg/m2) or overweight/obese (≥ 25 kg/m2). Descriptive and complex sample logistic regression analyses were employed as appropriate. RESULTS: Overall, approximately 1 in 2 respondents (51.2%) were overweight/obese, even though the majority (69.0%) reporting at least a moderate level of PA (total PA ≥ 10 MET-hours/week). In both normal-weight and overweight/obese groups, a significantly higher prevalence of high PA (total PA ≥ 50 MET-hours/week) was observed among men than women (p < 0.001), but women reported a significantly higher prevalence of low and moderate PA than men (p < 0.001). Men reported significantly higher activity levels (in MET-hours/week) than women with regard to walking, vigorous-intensity PA and total PA (p < 0.001). Overweight/obese men reported a significantly lower level of vigorous-intensity PA and total PA than normal-weight men (p < 0.001). A low level of PA was associated with the risk of overweight/obesity (Adjusted OR = 1.14; 95% CI: 1.01-1.30) compared to a high level of PA among men but not among women. CONCLUSIONS: The levels of PA were inversely related to the risk of overweight/obesity in men but not in women. Programs designed to reduce overweight/obesity rates should encourage the practice of moderate- to vigorous-intensity PA. Future research should consider using longitudinal and prospective approaches that simultaneously measure dietary intake, PA and BMI among Malaysian adults to investigate the actual relationship between PA and overweight/obesity.

Iodine status among pregnant women in rural Sabah, Malaysia.

BACKGROUND AND OBJECTIVES: In 2000, legislation on mandatory universal salt iodisation was enacted in Sabah, Malaysia, to reduce the incidence of iodine deficiency disorders among its population. To evaluate the iodine levels among pregnant women from selected rural divisions in Sabah 13 years after the enactment of the universal salt iodisation programme. METHODS AND STUDY DESIGN: This cross-sectional study was conducted from 1 May to 30 June, 2013, in three rural divisions of Sabah (the Interior, the West Coast, and Kudat). Data regarding domestic iodised salt use and iodine-containing supplement consumption were obtained from respondents through face-to-face interviews; goitre enlargement was examined through palpation and graded according to the World Health Organization classification. Spot urine samples were also obtained to assess urinary iodine levels by using an in-house modified micromethod. RESULTS: In total, 534 pregnant women participated. The prevalence of goitre was 1.0% (n=5), noted only in the West Coast and Kudat divisions. Although all pregnant women consumed iodised salt, overall median urinary iodine concentration was only 106 µg/L, indicating insufficient iodine intake, with nearly two-thirds of the women (60%) having a median urinary iodine concentrations of <150 µg/L. CONCLUSIONS: Pregnant women from the rural divisions in Sabah still exhibit iodine deficiency disorder despite the mandatory universal salt iodisation programme. Iodine supplementation programmes targeting pregnant women are warranted.

Prevalence and risk factors associated with suicidal ideation among adolescents in Malaysia.

BACKGROUND: Suicidal ideation, defined as thoughts, ideas and the desire to commit suicide, is becoming a major public health problem among adolescents. Indeed, suicidal ideation is known as a key predictor of future suicide risk. OBJECTIVE: This study aims to determine the prevalence and risk factors associated with suicidal ideation among adolescents in Malaysia. METHODS: This study used data from the 2013 Malaysian adolescent health risk behavior (MyAHRB) study, a cross-sectional school survey conducted in Peninsular Malaysia among school-going adolescents aged 16-17 years (n=2789). Logistic regression analysis was used to determine the risk factors associated with suicidal ideation among Malaysian adolescents. RESULTS: The overall prevalence of suicidal ideation among the adolescents was 6.2%. The prevalence was significantly higher among females than males (7.6% vs. 4.7%; p=0.002). Multivariate regression analysis revealed that adolescents who were females [odds ratio (OR)=2.02; 95% confidence interval (CI): 1.40-2.92] or of Indian ethnicity (OR=2.32; 95% CI: 1.35-3.98) were more likely to report suicidal ideation. Loneliness (OR=2.54; 95% CI: 1.57-4.11), anxiety or worry (OR=2.70; 95% CI: 1.70-4.31), no close friends (OR=2.71; 95% CI: 1.43-5.14), and lack of supportive peers (OR=1.69; 95% CI: 1.15-2.47) were identified as risk factors for adolescents' suicidal ideation. Adolescents who ever had sexual intercourse (OR=2.70; 95% CI: 1.48-4.92) and had been in a physical fight (OR=2.45; 95% CI: 1.62-3.70) were also reported to have higher risks of suicidal ideation. CONCLUSION: This study provides evidence on risk factors associated with suicidal ideation among Malaysian adolescents. Targeted mental health and health risk behavioral interventions for high-risk adolescents are recommended.

Undiagnosed Type 2 Diabetes Mellitus and Its Risk Factors among Malaysians: Findings of a Nationwide Study

​The prevalence of Type 2 diabetes mellitus (T2DM) is increasing worldwide and many of these affected individuals remain unidentified. Undiagnosed T2DM may impose substantial public health implications because these individuals remain untreated and at risk for complications. The objective of this study was to determine the national prevalence of undiagnosed T2DM and to identify the associated risk factors. A nationwide cross-sectional study was conducted involving 17,783 respondents. Two-stage stratified sampling design was used to select a representative sample of the Malaysian adult population. Structured validated questionnaires with face to face interviews were used to obtain data. Respondents, who claimed that they were not having diabetes, were then asked to perform a fasting blood glucose finger-prick test by Accutrend GC machine. The prevalence of undiagnosed T2DM was 8.9% (n=1587). The highest percentage of undiagnosed T2DM was found among males (10.2%), 55-59 years old (13.4%), highest education attainers of primary school (11.1%), Indians (10.3%), married (10.3%), working (8.9%) and living in the urban areas (9.2%). Multivariate analyses showed that factors associated with undiagnosed T2DM were gender, age group, ethnicity, marital status, obesity and hypertension. This study found an increasing trend of undiagnosed T2DM in Malaysia compared to 2006. This finding is alarming as risk factors associated with undiagnosed diabetes were related to most of the socio-demographic factors studied. Therefore, early diabetic screening is crucial especially among adults aged 30 and above to prevent more serious complications of this disease.​

Association of physical activity with blood pressure and blood glucose among Malaysian adults: a population-based study.

BACKGROUND: The health-enhancing benefits of physical activity (PA) on hypertension and diabetes have been well documented for decades. This study aimed to determine the association of PA with systolic and diastolic blood pressure as well as blood glucose in the Malaysian adult population. METHODS: Data were extracted from the 2011 National Health and Morbidity Survey (NHMS), a nationally representative, cross-sectional study. A two-stage stratified sampling method was used to select a representative sample of 18,231 Malaysian adults aged 18 years and above. The PA levels of the respondents were categorised as low, moderate or high according to the International Physical Activity Questionnaire (IPAQ)-short form. Blood pressure and fasting blood glucose levels were measured using a digital blood pressure-measuring device and finger-prick test, respectively. RESULTS: Systolic blood pressure (SBP) level was positively associated with PA level (p = 0.02) whilst no significant association was noted between PA level and diastolic blood pressure (DBP). In contrast, respondents with low (adjusted coefficient = 0.17) or moderate (adjusted coefficient = 0.03) level of PA had significantly higher blood glucose level as compared to those who were highly active (p = 0.04). CONCLUSIONS: A significant negative association was observed between PA level and blood glucose only. Future studies should employ an objective measurement in estimating PA level in order to elucidate the actual relationship between PA, hypertension and diabetes for the development of effective interventions to combat the increasing burden of premature-mortality and cardiovascular disease-related morbidity in Malaysia.

Lifestyle, chronic diseases and self-rated health among Malaysian adults: results from the 2011 National Health and Morbidity Survey (NHMS).

BACKGROUND: Self-rated health (SRH) has been demonstrated as a valid and appropriate predictor of incident mortality and chronic morbidity. Associations between lifestyle, chronic diseases, and SRH have been reported by various population studies but few have included data from developing countries. The aim of this study was to determine the prevalence of poor SRH in Malaysia and its association with lifestyle factors and chronic diseases among Malaysian adults. METHODS: This study was based on 18,184 adults aged 18 and above who participated in the 2011 National Health and Morbidity Survey (NHMS). The NHMS was a cross-sectional survey (two-stage stratified sample) designed to collect health information on a nationally representative sample of the Malaysian adult population. Data were obtained via face-to-face interviews using validated questionnaires. Two categories were used to measure SRH: "good" (very good and good) and "poor" (moderate, not good and very bad). The association of lifestyle factors and chronic diseases with poor SRH was examined using univariate and multivariate logistic regression. RESULTS: Approximately one-fifth of the Malaysian adult population (20.1 %) rated their health as poor (men: 18.4 % and women: 21.7 %). Prevalence increases with age from 16.2 % (aged 18-29) to 32.0 % (aged ≥60). In the multivariate logistic regression analysis, lifestyle factors associated with poor SRH included: underweight (OR = 1.29; 95 % CI: 1.05-1.57), physical inactivity (OR = 1.25; 95 % CI: 1.11-1.39), former smoker (OR = 1.38; 95 % CI: 1.12-1.70), former drinker (OR = 1.27; 95 % CI: 1.01-1.62), and current drinker (OR = 1.35; 95 % CI: 1.08-1.68). Chronic diseases associated with poor SRH included: asthma (OR = 1.66; 95 % CI: 1.36-2.03), arthritis (OR = 1.87; 95 % CI: 1.52-2.29), hypertension (OR = 1.39; 95 % CI: 1.18-1.64), hypercholesterolemia (OR = 1.43; 95 % CI: 1.18-1.74), and heart disease (OR = 1.85; 95 % CI: 1.43-2.39). CONCLUSIONS: This study indicates that several unhealthy lifestyle behaviours and chronic diseases are significantly associated with poor SRH among Malaysian adults. Effective public health strategies are needed to promote healthy lifestyles, and disease prevention interventions should be enhanced at the community level to improve overall health.