The effect of dietary intake changes on nutritional status in acute leukaemia patients after first induction chemotherapy.

This study aimed to evaluate how changes in dietary intake among acute lymphoblastic and acute myeloid leukaemia (ALL and AML) patients affect nutritional status after the first induction chemotherapy. Dietary intake was assessed using 24-h recall and a 136-item food frequency questionnaire. Nutritional status was assessed by Patients Subjective Global Assessment questionnaire before starting induction therapy and again after 1 month. All newly diagnosed acute leukaemia patients aged 15 years old and older who attended three referral hospitals for initiation of their induction chemotherapy were included in the sample selection provided that they gave informed consent. A total of 30 AML and 33 ALL patients participated in the study. Dietary intake and nutritional status worsened after the chemotherapy treatment. Dietary intake in terms of macronutrients, micronutrients, food variety and diet diversity score changed significantly after the induction chemotherapy. No significant relationship was found between the changes in dietary indices and nutritional status. Chemotherapy-related side effects as an additional factor to cancer itself could affect dietary intake of leukaemia patients. The effectiveness of an early assessment of nutritional status and dietary intake should be further investigated in order to deter further deterioration.

Nutritional status and quality of life in patients with acute leukaemia prior to and after induction chemotherapy in three hospitals in Tehran, Iran: a prospective study.

BACKGROUND: The primary objective of the present study was to assess changes in the nutritional status and quality of life in acute leukaemia patients, aged ≥15 years, who had undergone induction chemotherapy. METHODS: A preliminary and post-induction chemotherapy assessment of patients' nutritional status, quality of life, sociodemographic status and medical characteristics was conducted using the Patient Generated Subjective Global Assessment (PG-SGA) and the European Organization for Research and Treatment of Cancer quality of life (QOL-C30, version 3) questionnaires. The PG-SGA is a clinical nutrition assessment tool used to evaluate oncology patients. Patients with newly-diagnosed acute leukaemia, aged ≥15 years, at three hospitals in Tehran (from May 2009 to March 2010), were recruited for the present study. RESULTS: Sixty-three acute leukaemia patients [65% men and 35% women with a mean (SD) age of 33 (15.4) years] participated in the present study. A total of 19.4% were found to be malnourished prior to chemotherapy. After chemotherapy, 76.1% of patients were considered moderately malnourished, whereas 6.3% were severely malnourished. After induction chemotherapy, both the nutritional status and quality of life deteriorated in the majority of patients, as demonstrated by a paired t-test. CONCLUSIONS: A deteriorated nutritional status and quality of life was the result of the side effects posed by induction chemotherapy in the patients investigated in the present study. These findings highlight the need for an appropriate nutritional support programme to improve the nutritional status and quality of life in patients with leukaemia undergoing chemotherapy.

Quality of life and functional status in patients with advanced cancer admitted to hospice home care in Malaysia: a cross-sectional study.

Cancer patients more than often experience poor quality of life after diagnosis and treatment of cancer. As the disease progresses quality of life issues become important. This cross-sectional study assessed various features of quality of life among 61 (33 women and 28 men) patients with advanced cancer cared by selected hospices in Peninsular Malaysia. The Hospice Quality of Life Index was used to assess quality of life. The mean total Hospice Quality of Life Index score for all subjects was 189.9 ± 51.7. The possible scores range from 0 to 280. The most problem areas in these patients were in the domain of functional well-being, followed by psychophysiological and social/spiritual domain. Patients with advanced cancer have a diminished quality of life. These findings suggest that there is a need for improving quality of life in terminally ill cancer patients in hospice care.

Factors associated with breast self-examination among Malaysian women teachers.

The purpose of this study was to examine factors related to breast self-examination (BSE) among teachers in Selangor, Malaysia. A cross-sectional study was conducted among 425 female teachers in 20 randomly selected secondary schools. A self-administered questionnaire based on the health belief model was randomly selected secondary schools. A self-administered questionnaire based on the health belief model was used, including sociodemographic background and knowledge, beliefs and practices about breast cancer and BSE. Only 19% of the women performed BSE on a regular basis. Higher knowledge about breast cancer, greater confidence in performing BSE and regular visits to a physician were significant predictors for practising BSE. To promote BSE practice among Malaysian women, tailored health education and health promotion programmes should be developed based on a specific understanding of women's health beliefs.

School-administered weekly iron-folate supplements improve hemoglobin and ferritin concentrations in Malaysian adolescent girls.

BACKGROUND: Iron deficiency and its consequent anemia constitute the commonest micronutrient deficiency in the world. OBJECTIVE: We investigated whether long-term, weekly iron-folate supplements administered at school would improve hemoglobin and ferritin concentrations in adolescent girls, including those with mild-to-moderate anemia and hemoglobin concentrations indicating borderline anemia. DESIGN: Subjects were 266 girls with hemoglobin concentrations of 80-119.9 g/L (group A) and 358 girls with hemoglobin concentrations of 120-130 g/L (group B) who were otherwise healthy. Two hundred sixty-six girls in group A and 268 girls in group B were randomly assigned to receive either 60 or 120 mg Fe plus 3.5 mg folic acid weekly for 22 wk. Ninety of the girls in group B were randomly assigned to receive only 5 mg folic acid weekly. Capillary hemoglobin and plasma ferritin were measured at baseline and after 12 and 22 wk of supplementation. RESULTS: By the end of the study, 2% of the girls had dropped out and > 96% had taken > or = 20 of the 22 tablets; side effects were minimal. Mean plasma ferritin increased significantly in all iron-supplemented groups, independently of initial hemoglobin values and iron doses. Ferritin concentrations decreased in the girls supplemented with folic acid only. As expected, hemoglobin responses to iron were higher in group A than in group B and increases were positively correlated with initial plasma ferritin. Hemoglobin failed to respond to folate supplementation if initial plasma ferritin concentrations were low. Mean hemoglobin increased significantly and consistently in relation to the length of treatment. CONCLUSION: Long-term, weekly iron-folate supplementation was found to be a practical, safe, effective, and inexpensive method for improving iron nutrition in adolescent schoolgirls.

Relationship between nutritional status, physical activity and quality of life among gastrointestinal cancer survivors.

INTRODUCTION: The objective of this study was to determine the relationship between nutritional status, physical activity and quality of life among gastrointestinal cancer survivors. METHODS: A cross-sectional study was conducted among gastrointestinal cancer survivors attending the oncology outpatient clinic in Hospital Selayang, Malaysia. RESULTS: A total of 70 gastrointestinal cancer survivors with a mean age of 52.54 +/- 14.59 years (95% CI: 47.48 - 57.60) were included in this study. Results showed that 40% of the patients were classified as having low physical activity. The mean Patient Generated Subjective Global Assessment (PGSGA) score was 10.27 +/- 7.36 (95% CI: 8.23-12.31) and nearly half the patients (48.6%) were identified as severely malnourished (Stage C). Mean Gastrointestinal Quality of Life Index (GQLFI) score was 103.57 +/- 23.85 (95% CI: 92.94-114.20), and about 24.3% of the patients were classified as having a low quality of life. Pearson's correlation test showed a highly significant negative relationship between nutritional status and quality of life (r = -0.661, p<0.001) indicating the better the nutritional status (low total mean score of PGSGA), the better the quality of life of the survivors (high total mean score of GQLFI). There was a significant negative relationship between physical activity level and nutritional status score (r = -0.309, p<0.01), indicating the higher the physical activity level of the patients (high MET-min/week), the better their nutritional status (low total mean score of PGSGA). CONCLUSION: This study shows a significant relationship between nutritional status, physical activity and quality of life among gastrointestinal cancer survivors. Those low in nutritional status have a low quality of life while survivors with higher nutritional status have a better quality of life.

Colorectal cancer and its association with the metabolic syndrome: a Malaysian multi-centric case-control study.

OBJECTIVE: Colorectal cancer (CRC) and the metabolic syndrome (MetS) are both on the rise in Malaysia. A multi-centric case-control study was conducted from December 2009 to January 2011 to determine any relationship between the two. METHODS: Patients with confirmed CRC based on colonoscopy findings and cancer free controls from five local hospitals were assessed for MetS according to the International Diabetes Federation (IDF) definition. Each index case was matched for age, gender and ethnicity with two controls (140: 280). RESULTS: MetS among cases was highly prevalent (70.7%), especially among women (68.7%). MetS as an entity increased CRC risk by almost three fold independently (OR=2.61, 95%CI=1.53-4.47). In men MetS increased the risk of CRC by two fold (OR=2.01, 95%CI, 1.43-4.56), demonstrating an increasing trend in risk with the number of Mets components observed. CONCLUSION: This study provides evidence for a positive association between the metabolic syndrome and colorectal cancer. A prospective study on the Malaysian population is a high priority to confirm these findings.

Socio-demographic and psychosocial factors associated with physical activity of working woman in Petaling Jaya, Malaysia.

INTRODUCTION: This study was conducted on 215 working women from four private corporate companies in a suburb in Malaysia to determine the factors related to their physical activity levels. METHODS: Data were collected using a questionnaire which included socio-demographic characteristics, the International Physical Activity Questionnaire (IPAQ), perceived barriers and benefits to physical activity, self-efficacy to physical activity and an 8-item questionnaire on current behavioral stage of physical activity. RESULTS: The majority of the respondents were Malay (81.9%) with 10.2% being Chinese and 7.9% Indian. Most of the respondents were executives (64.2%), while the rest were non-executives (24.7%) and managers (11.2%). The mean weight, height, BMI and waist circumference were 59.4 +/- 13.1 kg, 1.6 +/- 0.6 m, 23.7 +/- 4.8 kg/m2 and 77.0 +/- 12.1cm respectively. In this sample, 24.7% and 7.9% were overweight and obese respectively, while 34% were at risk of abdominal obesity. A total of 28.8% of the respondents had low physical activity level, while 48.8% and 22.3% were in the moderate and high physical activity categories respectively. An association was found between monthly income (chi2 = 110.17; p < 0.05) and current behavioral stage of physical activity (chi2 = 27.527; p < 0.05) with physical activity, but no relationship was found between job category and physical activity category (chi2 = 8.940; p > 0.05). Physical activity category was also positively correlated with perceived barriers (r = 0.227, p < 0.05) and benefits to physical activity (r = 0.280, p < 0.05). However, physical activity was not associated with self-efficacy to physical activity. CONCLUSION: In this sample of working women, socio-demographic and psychosocial factors (except self-efficacy to physical activity) were found to have an association with physical activity level of the respondents. Further studies should be conducted to confirm these findings in the general working women population.

A Qualitative Study on Coping Strategies among Women from Food Insecurity Households in Selangor and Negeri Sembilan.

Understanding the experiences of household food insecurity is essential for better measurement and assessment of its nutritional, physical and psychological consequences. This qualitative study explored coping strategies and their perceived severity in relation to household food insecurity. Women (n=57; 20-50 years old) from rural and urban areas in Selangor and Negeri Sembilan participated in this study. These women were interviewed using a semi-structured questionnaire. The questionnaire was divided into two parts, that is, demographic and socio-economic information and women's experiences of coping with household food insecurity. Women were chosen since they were primarily responsible for food acquisition and preparation for the all household members. Thematic analysis was utilized in data analysis. Thematic analysis is a method for identifying, analysing and reporting patterns and themes of the qualitative data. Themes capture something important related to the study objectives and describe an integrating as well as relational idea from the data. Results showed that households displayed a variety of non-food related coping strategies and food-related coping strategies. Women's descriptions of non-food related coping strategies to food insecurity were categorised into five themes i.e. cloth purchasing behaviors, reduce school-going children's expenditure, delay the payment of bills, adjust lifestyle and increase cash and income earning. Food related coping strategies were categorised into four themes i.e. food stretching, food rationing, food seeking and food anxiety. Food stretching is a strategy of food insecurity that affects the quality of diet. Food rationing comprises coping strategies of food insecurity related to the quantity of food available for household's consumption. Food seeking is a strategy of acquiring food through socially unacceptable ways and food anxiety is a strategy that indicates households allocating money to buy staple food in order to prevent food insecurity. Each coping strategy showed a different level of perceived severity, that is, less severe, quite severe, severe and very severe. In conclusion, the qualitative data provide valuable information for understanding the experiences of food insecurity that can be used as a basis to develop direct indicators that can capture the core behaviours and their level of severity to measure household food insecurity.

Obesity and risk of colorectal adenomatous polyps: a case-control study in hospital kuala lumpur.

Colorectal adenomas are precursor lesions of colorectal cancer. Several studies have proposed that obesity is a risk factor for colorectal adenoma. This case-control study examined the relationship between body mass index (BMI), waist circumference, waistto-hip ratio (WHR), body fat percentage and colorectal adenomatous polyps (CRA) in patients who have had a colonoscopy at the Hospital Kuala Lumpur (HKL). Fifty-nine patients (42 males and 17 females) positively identified as having CRA and 59 polypfree subjects were recruited as controls (33 males and 26 females). A pre-tested questionnaire was used to collect socio-economic information, while anthropometric measurements were determined directly by established methods. The mean BMI of female case subjects was significantly higher than control females (25.63 + 4.87 kg/m2 vs. 23.86 + 3.70 kg/m2, p<0.05) but the difference in BMI was not significant in men. The mean WHR of male subjects was significantly higher in the case group (0.92 + 0.07 vs. 0.90 + 0.06, p<0.05). After adjusting for confounders, waist circumference was the only indicator that was found to significantly increase the risk for CRA in women (OR = 6.349, 95% CI = 1.063 - 37.919). Higher BMI, WHR and body fat percentage showed a non-significant risk in female subjects. In men, none of the obesity indicators were found to be significant risk factors for CRA. These findings suggest that abdominal obesity may be a contributing factor to CRA risk particularly in women. A prospective study is needed to confirm the role of obesity in the development of CRA in Malaysians.

Body Mass Index (BMI) of Adults: Findings of the Malaysian Adult Nutrition Survey (MANS).

The Malaysian Adults Nutrition Survey (MANS) was carried out between October 2002 and July 2003, involving 6,775 men and 3,441 women aged 18 - 59 years. Anthropometric assessment showed that the overall mean body weight and BMI were 62.65 kg (CI: 62.20, 63.09) and 24.37 kg/m2 (CI: 24.21, 24.53) respectively. Based on the WHO (1998) classification of BMI, 12.15% (CI: 11.26, 13.10) were obese (BMI > 30 kg/m2), and 26.71% (CI: 25.50, 27.96) overweight (BMI > 25 - 29.9 kg/m2). Significantly, more women were obese [14.66% (CI: 13.37, 16.04)] while significantly more men were overweight [28.55% (CI: 26.77, 30.40)]. Ethnicitywise, prevalence of obesity was highest among the Malays [15.28% (CI: 13.91, 16.77)] while overweight was highest for the Indians [31.01% (CI: 26.64, 35.76)]. Both obesity and overweight were highest among those aged 40 - 49 years. Obesity was highest for those whose household income was between RM1,500 - 3,500 while overweight was more prevalent for those whose household income exceeded RM3,500. The prevalence of overweight was highest for those with primary education [31.90% (CI: 29.21, 34.72)]. There was no significant urban rural differential in both obesity and overweight. The study found 9.02% (CI:8.82, 10.61) with chronic energy deficiency (CED) (BMI < 18.5 kg/m2). The prevalence of CED was relatively higher in the indigenous population (Orang Asli) [14.53% (CI: 5.14, 34.77)], subjects aged 18-19 years [26.24% (CI: 21.12, 32.09)], and with monthly household income of < RM1,500 [10.85% (CI: 9.63, 12.20)]. The prevalence of CED was not significantly different among the geographical zones and educational levels, and between urban/rural areas and sexes. The results call for priority action to address the serious problem of overweight and obesity among Malaysian adults as it poses a grave burden to the country's resources and development.

Reliability and validity of Champion's Health Belief Model Scale for breast cancer screening among Malaysian women.

INTRODUCTION: Breast cancer is the leading cause of cancer deaths in Malaysian women, and the use of breast self-examination (BSE), clinical breast examination (CBE) and mammography remain low in Malaysia. Therefore, there is a need to develop a valid and reliable tool to measure the beliefs that influence breast cancer screening practices. The Champion's Health Belief Model Scale (CHBMS) is a valid and reliable tool to measure beliefs about breast cancer and screening methods in the Western culture. The purpose of this study was to translate the use of CHBMS into the Malaysian context and validate the scale among Malaysian women. METHODS: A random sample of 425 women teachers was taken from 24 secondary schools in Selangor state, Malaysia. The CHBMS was translated into the Malay language, validated by an expert's panel, back translated, and pretested. Analyses included descriptive statistics of all the study variables, reliability estimates, and construct validity using factor analysis. RESULTS: The mean age of the respondents was 37.2 (standard deviation 7.1) years. Factor analysis yielded ten factors for BSE with eigenvalue greater than 1 (four factors more than the original): confidence 1 (ability to differentiate normal and abnormal changes in the breasts), barriers to BSE, susceptibility for breast cancer, benefits of BSE, health motivation 1 (general health), seriousness 1 (fear of breast cancer), confidence 2 (ability to detect size of lumps), seriousness 2 (fear of long-term effects of breast cancer), health motivation 2 (preventive health practice), and confidence 3 (ability to perform BSE correctly). For CBE and mammography scales, seven factors each were identified. Factors for CBE scale include susceptibility, health motivation 1, benefits of CBE, seriousness 1, barriers of CBE, seriousness 2 and health motivation 2. For mammography the scale includes benefits of mammography, susceptibility, health motivation 1, seriousness 1, barriers to mammography seriousness 2 and health motivation 2. Cronbach's alpha reliability coefficients ranged from 0.774 to 0.939 for the subscales. CONCLUSION: The translated version of the CHBMS was found to be a valid and reliable tool for use with Malaysian women. It can be used easily to evaluate the health beliefs about breast cancer, BSE, CBE and mammography and for planning interventions. For greater applicability, it is recommended that this tool be tested among ethnically diverse populations.

Food Consumption Patterns: Findings from the Malaysian Adult Nutrition Survey (MANS).

This study reports the food consumption patterns of adults aged 18 to 59 years in the Malaysian Adults Nutrition Survey (MANS) carried out between October 2002 and December 2003. A total of 6,742 subjects comprising 3,274 men and 3,468 women representing the northern, central , southern and east coast of Peninsular Malaysia as well as Sabah and Sarawak were interviewed. A semiquantitative food frequency questionnaire (FFQ) which consisted of 126 food items was used to evaluate the food consumption pattern (habitual food intake) of the respondents during the previous one- year period. The results demonstrate that nasi putih (cooked rice) was consumed by 97% of the population twice daily (average 2½ plates per day). Other food items consumed daily were marine fish, (one medium fish per day), green leafy vegetables (one cup per day) and sweetened condensed milk (three teaspoons per day. The mean frequencies for daily intake of rice, leafy vegetables, marine fish, local kuih, anchovy (ikan bilis) and biscuits were significantly higher among the rural compared to the urban adults. In contrast, more urban dwellers consumed chicken and eggs more frequently than their rural counterparts. More men than women consumed chicken and eggs more frequently. Malaysian adults showed a satisfactory habit of drinking plain water, with 99% drinking at least six glasses of plain water daily. Other beverages such as tea (47%), coffee (28%), chocolate-based drinks (23%) and cordial syrup (11%) were also consumed on daily basis, however, in a smaller proportion of the population. There were differences in the prevalence of daily consumption of foods when comparing urban and rural population, and also between men and women. The prevalence of daily consumption of marine fish among rural and urban adults was 51% and 34% respectively. For sweetened condensed milk, men and women consumed 43% and 28% respectively; however, more women drank full cream milk than men. Between the age groups, 21% of adults below 20 years old consumed chicken at least once a day, while this pattern of intake was not shown in the older age groups. Our findings show that adults, aged 50 to 59 years old, had the highest prevalence of daily consumption of full cream milk with 24% while those aged 18 to 19 years old had the lowest prevalence of daily consumption at 15%. The food consumption pattern of Malaysian adults appears to be satisfactory. However, some changes in food habits are recommended especially in substituting the less wholesome sweetened condensed milk with the more nutritious full cream or skimmed milk.

Infant feeding study: knowledge and attitudes of selected pregnant women.

PIP: The purpose of this study was to investigate attitudes toward infant feeding among women in their 3rd trimester of pregnancy. A total of 74 primiparous and multiparous mothers ranging in age from 18-45 who were attending antenatal clinics near Kuala Lumpur were interviewed, 78.3% of which were Malay, 12.2% Chinese, and 9.5% Indian. Most were from middle class families, and only 6.5% had never attended school. Although 91.9% considered breastmilk as being the best food for babies, only 63.5% preferred to breastfeed; 8.1% chose powdered milk and 28.4% chose mixed feeding. Most of those who chose not to breastfeed were Chinese, working women, and/or women from higher income groups. Information on the intended duration of breastfeeding showed that multiparous women and working women did not intend to breastfeed for more than 6 months. Most women did not believe that either breast milk or powdered milk alone was sufficient for infants up to 5 months of age, and intended to supplement with solid food before that age. Since 93.2% of the respondents had already decided on feeding methods by their last trimester, it is important that nutritional information be given during this time.^ieng

Confronting the health hazards of industrialization in Malaysia.

The authors outline the steps being taken in Malaysia aimed at persuading people to avoid the unhealthy lifestyles commonly associated with socioeconomic development and increased affluence, and to adopt health dietary and other habits.

Assessment of dietary intake among university students: 24-hour recall verses weighed record method.

The purpose of this study was to assess the dietary intake of University Putra Malaysia students using the weighed record method and the 24 hour-dietary recall method. The validity of the 24-hour recall method was studied by comparing it with the weighed record method. A total of 40 male and 25 female students age between 18-29 years volunteered to participate in this study. All the subjects were required to weigh and record the foods they ate for 1 day. Without prior knowledge of the purpose of the visit , the 24-hour recall was carried out the following day. The nutrients analysed were calorie, carbohydrates, protein, fat, calcium, iron, vitamin A and vitamin C. Comparisons of the nutrient intake between these two methods were determined. The paired t-test indicated no significant difference in group's mean nutrient intake between the weighed record method for all nutrients. The differences in group mean intake for all nutrients between weighed record and 24-hour recall method ranged from -3% to 3.6%. A total of 4 nutrients were underestimated, namely energy, protein, vitamin C and iron. The correlation coefficients showed a strong positive relationships between the two methods (ranged from r = 0.88-0.98, p < 0.01) for all of the nutrients analysed. In conclusion, the agreement between nutrient values from two different methods indicated that the 24 hour recall is a suitable method for the dietary assessment of university students.

A critical evaluation of high density lipoprotein cholesterol as an index of coronary artery disease risk in Malaysians.

Fasting serum specimens from (a) 217 male and 46 female patients with coronary artery disease (CAD), aged 35-75 years, who had undergone angioplasty (PTCA) / coronary artery bypass graft (CABG), and (b) 160 apparently healthy controls (106 males, 54 females, aged 30-75 years), were assessed for serum lipid profile. Both sex and ethnicity significantly influenced the levels of serum high density lipoprotein cholesterol (HDLC); in the controls, females had higher HDLC levels than males (46.7 mg/dl vs 38.5 mg/dl, p<0.00l), while the Indian males possessed significantly lower HDLC values than the male Malay or Chinese. HDLC, triglycerides (TG) and the atherogenic index- LDLC/HDLC ratio were significantly different between the CAD patients and the healthy controls, while total cholesterol (TC) and LDLC did not seem to be of diagnostic value. Serum HDLC was lower in the CAD patients compared to the healthy controls in both sexes (p<0.001), either expressed as HDLC per se or as % HDLC. This observation combined with the odds ratio (OR) values of 0.24 and 0.28 for HDLC and % HDLC respectively in males, firmly establishes HDL as a protective factor of CAD in Malaysians. Significance testing for the X2 values associated with the OR values for the various lipid indices, together with the findings on the receiver-operating characteristices (ROC) curves, i.e. plots of sensitivity vs 1-specificity, indicated that HDLC, % HDLC and TQ were equally efficient as a means of risk assessment to CAD in Malaysians.

Nutritional anemia in pregnancy: a study at the maternity hospital, Kuala Lumpur.

PIP: The study presents recent data on the prevalence and pattern of nutritional anemia in the Maternity Hospital, Kuala Lumpur. A total of 309 pregnant women in their 3rd trimester, of Malay, Chinese and Indian origin from the lower socio-economic strata were randomly selected for the study. Hematological indices (including Hb, PCV, MCHC, and TRBC), serum iron, transferrin saturation and ferritin, serum folate as well as protein and albumin were determined. Based on Hb and PCV values, 30-40% of the women could be considered anemic; approximately 50% of them presented with unsatisfactory serum iron, transferrin saturation and ferritin values; 60.9% had low serum folate levels; and about 30% may be considered to be of poor protein nutriture. Anemia in the study population was seen to be related mostly to iron and to a lesser extent, folate deficiency. Hematological, iron, folate and protein status was observed to be the poorest amongst the Indian women, better in the Malay group and generally the best amongst the Chinese women. Birth records of 169 of these women revealed that all of them had live births. Nearly all the infants were delivered by normal vaginal delivery (NVD). The mean gestational age was 38.6 weeks. One of the infants had a birth weight of 2.0 kg; incidence of low birth weight, 2.5 kg, was 8.3%. Although there was a trend of deteriorating hematological, iron and protein status of women from the 0, 1-3 and 4 parity groups, these differences were not statistically significant.^ieng

Prevalence of overweight among Malaysian adults from rural communities.

Assessment of the nutritional status of 4054 households from rural communities in Peninsular Malaysia was undertaken from 1992 to 1995. Body mass index (BMI) and waist-to-hip ratio (WHR) were obtained from a self-selected sample of 1854 men and 2741 women aged >= 18 years. The BMI and WHR results are presented according to gender, age groups and type of community as defined by the main occupation, namely, fishing, rice farming, estate work, rubber and coconut small-holding. The mean BMI for men and women of all age groups are 22.5 kg/m2 and 23.8 kg/m2, respectively. The mean BMI for both genders increases with age between 18.0 and 49.9 years, after which the value declines. The prevalence of pre-obese (BMI >= 25.0-29.9 kg/m2) is 19.8% for men and 28.0% for women. The prevalence of obese men and women (>= 30.0 kg/m2) is 4.2% and 11.1%, respectively. The highest prevalence of pre-obese and obese men is found in the age groups of 30.0-49.9 years, while that for women is in the 40.0-49.9 years age group. The prevalence of pre-obesity and obesity is higher in women than in men for every age group. A similar result was indicated by WHR whereby a higher proportion of women (22.5%) than men (5%) for all ages was found to show central obesity. The prevalence of overweight adults is higher when compared with previous studies on subjects from almost similar rural communities. This study indicated that overweight is on the increase in rural communities, especially among female subjects.