exudates and Obesity

Today, obesity affects over one-third of the global population and is hugely considered the Industrial Revolution's side effect. This multi-factorial disease is continuously spreading across developing countries, including the Middle East and Southeast Asia region, where Malaysia and Darussalam Brunei are the most affected. The sedentary lifestyle and availability of surplus foods have dramatically increased the number of individuals with type 2 diabetes in these countries. Thus, an adequate medical strategy must be developed urgently to address and remedy these diseases. Natural sources have been attracting attention, especially in Malaysia, where most land areas are under plant cover. Metabolomics, as a prophylactic technique, has been used extensively in Malaysia to investigate the potential use and benefits of herbs to combat obesity and diabetes.. This review aims to explain the application of the metabolomics approach in the study of anti-diabetes and anti-obesity activity of Malaysian herbs to identify the stand-up point for future advancement in using these herbs as a primary source for drug exploration.. This review provides an overview of using metabolomics technique in studying the anti-diabetes and anti-obesity activity of Malaysian herbs. Specific emphasis is given to the changed metabolites in both in vivo and in vitro treatment of Malaysia herbs that might be future drugs for treating diabetes and obesity.

Topics: Biomarkers; Diabetes Mellitus, Type 2; Humans; Malaysia; Metabolomics; Obesity

There remains a lack of information and understanding of the prevalence and incidence of Alzheimer's disease and related dementia in Indigenous populations. Little evidence available suggests that Indigenous peoples may have disproportionately high rates of Alzheimer's disease and related dementia (ADRD).. Given this information, this study systematically explores what risk factors may be associated with ADRD in Indigenous populations.. A search of all published literature was conducted in October 2016, March 2018, and July 2019 using Medline, Embase, and PsychINFO. Subject headings explored were inclusive of all terms related to Indigenous persons, dementia, and risk. All relevant words, phrases, and combinations were used. To be included in this systematic review, articles had to display an association of a risk factor and ADRD. Only studies that reported a quantifiable measure of risk, involved human subjects, and were published in English were included.. Of 237 articles originally identified through database searches, 45 were duplicates and 179 did not meet a priori inclusion criteria, resulting in 13 studies eligible for inclusion in this systematic review.. The large number of potentially modifiable risk factors reported relative to non-modifiable risk factors illustrates the importance of socioeconomic context in the pathogenesis of ADRD in Indigenous populations. The tendency to prioritize genetic over social explanations when encountering disproportionately high disease rates in Indigenous populations can distract from modifiable proximal, intermediate, and distal determinants of health.

Topics: Adverse Childhood Experiences; Age Factors; Alzheimer Disease; Australia; Canada; Cardiovascular Diseases; Cognitive Dysfunction; Craniocerebral Trauma; Dementia; Diabetes Mellitus; Educational Status; Epilepsy; Guam; Humans; Hypertension; Incidence; Indigenous Canadians; Indigenous Peoples; Inuit; Malaysia; Native Hawaiian or Other Pacific Islander; Obesity; Risk Factors; Sedentary Behavior; Sex Factors; Smoking; Social Class

Obesity is a global health burden in the non-communicable diseases and much efforts have been implemented in the past decade in response to the rise of obesity prevalence among the Malaysian population. These include the development of the national policies, health programmes and research activities. The main aim of the scoping review was to identify obesity research pattern among adults in Malaysia in terms of the scopes, topics and the research designs.. The scoping review was conducted based on the framework by Arksey and O'Malley. The Preferred Reporting Items for Systematic Reviews and Meta Analysis (PRISMA) diagram was used as a guide to record the review process. Articles from year 2008 until 2017 on overweight and obesity among adults aged 18 years and above were retrieved based on the keywords using electronic databases (Embase/Ovid, Pubmed, Cochrane library and Google Scholar). Local journals, Nutrition Research in Malaysia Biblography (2011 and 2016), online local theses databases, virtual library databases were also included in the searches. Consultations with relevant key informants from the National Institutes of Health and local universities were also conducted. Search activities were managed using Endnote software and MS Excelsheet.. The characteristics of the results were described based on the objectives of the review. A total of 2004 articles and reports were retrieved, and 188 articles related to obesity in Malaysia were included in the final review. Scopes and topics of obesity research based on the Nutrition Research Priorities in Malaysia (NRPM) for 11th Malaysia Plan were obesity prevalence, weight loss intervention, association of physical activities and dietary factors with obesity. The majority of obesity research among adults in Malaysia was cross sectional studies and only a small number of intervention studies, qualitative studies and systematic review were indentified. Research gaps were identified in order to make useful recommendations to the stakeholders.. In the past decade, there has been an emerging evidence on obesity research among adults in Malaysia. More obesity research needs to be conducted particularly on obesity intervention among specific gender, qualitative studies, economic cost and genetic factors of obesity.

Topics: Adult; Aged; Aged, 80 and over; Biomedical Research; Cross-Sectional Studies; Exercise; Female; Humans; Malaysia; Male; Middle Aged; Obesity; Overweight; Qualitative Research; Research Design; Weight Loss

Topics: Asia, Southeastern; Attitude to Health; Child; Child Behavior; Child, Preschool; Feeding Behavior; Female; Humans; Malaysia; Male; Obesity; Parents; Pediatric Obesity; Philippines; Risk Assessment; Singapore; Thailand; Vietnam

This review discussed the prevalence of diabetes mellitus (DM) in Malaysia and the associated major risk factors, namely overweight/obesity, dietary practices and physical activity in both adults and school children. Detailed analyses of such information will provide crucial information for the formulation and implementation of programmes for the control and prevention of T2DM in the country. National studies from 1996-2015, and other recent nation-wide studies were referred to. The current prevalence of DM in 2015 is 17.5%, over double since 1996. Females, older age group, Indians, and urban residents had the highest risk of DM. The combined prevalence of overweight/obesity in 2015 is 47.7% for adults. Adults did not achieve the recommended intakes for majority of the foods groups in the Malaysian Food Pyramid especially fruits and vegetables. Adults also had moderate physical activity level. Three nation-wide studies showed a prevalence ranging from 27 to 31% for combined overweight/obesity in school children. The prevalence was higher among boys, primary school age, Indian ethnicity, and even rural children are not spared. Physical activity level was also low among school children. There must be serious systematic implementation of action plans to combat the high prevalence of diabetes and associated risk factors.

Topics: Databases, Factual; Diabetes Mellitus, Type 2; Diet; Exercise; Female; Humans; Life Style; Malaysia; Male; Obesity; Overweight; Prevalence; Risk Factors; Socioeconomic Factors

Seventy-three articles related to metabolic syndrome were found in a search through databases dedicated to indexing all literature with original data involving the Malaysian population between years 2000 and 2015. Metabolic syndrome affects 25 to 40% of adult population of Malaysia with the risk increasing with age. Obese children are also at risk. Indian ethnicity has the highest rates, followed by Malay and chinese. It was found that socioeconomics determinants such as living in urban areas, unemployment, lower income, lower education level and shift workers had higher prevalence of metabolic syndrome. Metabolic syndrome is associated with other medical conditions like cardiovascular diseases, psychiatric disorders, erectile dysfunction, polycystic ovarian syndrome and colorectal cancer. Several biomarkers have been determined to be relevant to our local population but their usage in clinical setting needs further research. Literature into effectiveness of management of metabolic syndrome in Malaysia is lacking and the results were only modest. there are several diagnostic criteria available for metabolic syndrome internationally and their individual significant to our local population is not clear. It also makes it difficult to compare results between studies using different criteria. Finally, we could not identify any local study to look at the health economic burden of metabolic syndrome locally.

Topics: Ethnicity; Humans; Malaysia; Male; Metabolic Syndrome; Obesity; Prevalence; Research; Risk Factors

This systematic review aimed to examine trends in overweight, obesity, and type 2 diabetes mellitus (T2DM) among Malaysian adults, and to identify its underlying determinants. A review of studies published between 2000 and 2012 on overweight, obesity, and T2DM was conducted. The Cochrane library of systematic reviews, MEDLINE, EMBASE, Biosis, Scopus, and MyJurnal digital database were searched. According to national studies, the prevalence of overweight increased from 26.7% in 2003 to 29.4% in 2011; obesity prevalence increased from 12.2% in 2003 to 15.1% in 2011, and T2DM prevalence was reported as 11.6% in 2006 and 15.2% in 2011. Distal determinants of increased risk of overweight, obesity, and T2DM were as follows: female, Malay/Indian ethnicity, and low educational level. The limited number of studies on proximal determinants of these noncommunicable diseases (NCDs) indicated that an unhealthy diet was associated with increased risk, whereas smoking was associated with decreased risk. However, more studies on the proximal determinants of overweight, obesity, and T2DM within the Malaysian context are needed. Overall, our findings provide insights for designing both future investigative studies and strategies to control and prevent these NCDs in Malaysia.

Topics: Adult; Asian People; Diabetes Mellitus, Type 2; Ethnicity; Female; Humans; Malaysia; Obesity; Overweight; Prevalence; Risk; Socioeconomic Factors

Effective population-level solutions to the obesity pandemic have proved elusive. In low- and middle-income countries the problem may be further challenged by the perceived internal tension between economic development and sustainable solutions which create the optimal conditions for human health and well-being. This paper discusses some of the ecological obstacles to addressing the growing problem of obesity in 'aspiring' economies, using Malaysia as a case study. The authors conclude that current measures to stimulate economic growth in Malaysia may actually be exacerbating the problem of obesity in that country. Public health solutions which address the wider context in which obesity exists are needed to change the course of this burgeoning problem.

Topics: Developing Countries; Humans; Malaysia; Obesity

Recent genome-wide association studies (GWAS) have identified 38 obesity-associated loci among European populations. However, their contribution to obesity in other ethnicities is largely unknown.. We utilised five GWAS (N=10 482) from Chinese (three cohorts, including one with type 2 diabetes and another one of children), Malay and Indian ethnic groups from Singapore. Data sets were analysed individually and subsequently in combined meta-analysis for Z-score body-mass index (BMI) associations.. Variants at the FTO locus showed the strongest associations with BMI Z-score after meta-analysis (P-values 1.16 × 10(-7)-7.95 × 10(-7)). We further detected associations with nine other index obesity variants close to the MC4R, GNPDA2, TMEM18, QPCTL/GIPR, BDNF, ETV5, MAP2K5/SKOR1, SEC16B and TNKS/MSRA loci (meta-analysis P-values ranging from 3.58 × 10(-4)-1.44 × 10(-2)). Three other single-nucleotide polymorphisms (SNPs) from CADM2, PTBP2 and FAIM2 were associated with BMI (P-value ≤ 0.0418) in at least one dataset. The neurotrophin/TRK pathway (P-value=0.029) was highlighted by pathway-based analysis of loci that had statistically significant associations among Singaporean populations.. Our data confirm the role of FTO in obesity predisposition among Chinese, Malays and Indians, the three major Asian ethnic groups. We additionally detected associations for 12 obesity-associated SNPs among Singaporeans. Thus, it is likely that Europeans and Asians share some of the genetic predisposition to obesity. Furthermore, the neurotrophin/TRK signalling may have a central role for common obesity among Asians.

Topics: Alpha-Ketoglutarate-Dependent Dioxygenase FTO; Asian People; Body Mass Index; China; Cohort Studies; DNA Mutational Analysis; DNA Replication; Female; Genome-Wide Association Study; Humans; India; Malaysia; Male; Middle Aged; Nerve Growth Factors; Obesity; Polymorphism, Single Nucleotide; Proteins; Receptor, trkA; Signal Transduction; Singapore; White People

Like other nations experiencing rapid industrialization, urbanization and a nutrition transition, there is concern in Malaysia of a possible escalation in the prevalence of overweight and obesity. In 1996, the National Health and Morbidity Survey reported a 16.6% and 4.4% prevalence of overweight and obesity, respectively. In the following decade, there have been several national and community surveys on overweight and obesity in Malaysia. The objective of this systematic review is to describe the trend from 1996 to 2009 in the prevalence of overweight and obesity in adults in Malaysia nationally and by gender, age and race. Results indicate that there has been a small rise in overweight adults in the years 1996, 2003 and 2006 (20.7%, 26.7% and 29.1%) and a much more dramatic increase in obesity in 1996, 2003, 2004 and 2006 (5.5%, 12.2%, 12.3% and 14.0%). Evidence showed a greater risk for overweight and obesity among women compared with men. Based on the highest-quality studies, overweight and obesity levels were highest among adults 40-59 years old. Overweight levels were highest among Indians, followed by Malays, Chinese and Aboriginals, with less consistency across studies on the order of risk or obesity by ethnicity.

Topics: Adult; Age Factors; Female; Humans; Malaysia; Male; Obesity; Overweight; Prevalence; Risk; Sex Factors

This study was undertaken to assess the recent data on Malaysian adult body weights and associations of ethnic differences in overweight and obesity with comorbid risk factors, and to examine measures of energy intake, energy expenditure, basal metabolic rate (BMR) and physical activity changes in urban and rural populations of normal weight. Three studies were included (1) a summary of a national health morbidity survey conducted in 1996 on nearly 29 000 adults > or =20 years of age; (2) a study comparing energy intake, BMR and physical activity levels (PALs) in 409 ethnically diverse, healthy adults drawn from a population of 1165 rural and urban subjects 18-60 years of age; and (3) an examination of the prevalence of obesity and comorbid risk factors that predict coronary heart disease and type 2 diabetes in 609 rural Malaysians aged 30-65 years. Overweight and obesity were calculated using body mass index (BMI) measures and World Health Organization (WHO) criteria. Energy intake was assessed using 3-d food records, BMR and PALs were assessed with Douglas bags and activity diaries, while hypertension, hyperlipidaemia and glucose intolerance were specified using standard criteria. The National Health Morbidity Survey data revealed that in adults, 20.7% were overweight and 5.8% obese (0.3% of whom had BMI values of >40.0 kg m(-2)); the prevalence of obesity was clearly greater in women than in men. In women, obesity rates were higher in Indian and Malay women than in Chinese women, while in men the Chinese recorded the highest obesity prevalences followed by the Malay and Indians. Studies on normal healthy subjects indicated that the energy intake of Indians was significantly lower than that of other ethnic groups. In women, Malays recorded a significantly higher energy intake than the other groups. Urban male subjects consumed significantly more energy than their rural counterparts, but this was not the case in women. In both men and women, fat intakes (%) were significantly higher in Chinese and urban subjects. Men were moderately active with the exception of the Dayaks. Chinese women were considerably less active than Chinese men. Chinese and Dayak women were less active than Malay and Indian women. In both men and women, Indians recorded the highest PALs. Hence, current nutrition and health surveys reveal that Malaysians are already affected by western health problems. The escalation of obesity, once thought to be an urban phenomenon, has now spread

Topics: Adolescent; Adult; Age Distribution; Aged; Anthropometry; Asian People; Body Mass Index; Coronary Disease; Diabetes Mellitus, Type 2; Diet Records; Energy Intake; Exercise; Female; Health Surveys; Humans; Malaysia; Male; Middle Aged; Obesity; Prevalence; Rural Health; Sex Factors; Urban Health; White People

The accelerated phase of industrialisation and urbanisation in recent decades has inevitably brought about changes in the lifestyle of Malaysians. Changes in dietary habits and sedentary lifestyles are known to be associated with changes in health and increased prevalence of chronic diseases in the population. The objective of this paper is to provide a better understanding of the link between demographic variables and food consumption patterns related to the nutrition transition in Malaysia. This review uses various reports and publications from several ministries and selected local studies. The statistics compiled over the last two decades have shown that as the population achieves affluence, intakes of calories, fats and sugars increase, which may account for the substantial increase in food importation bills over the same period. Similarly, the rapid growth of the fast food industry during the last decade has added another dimension to the change in food consumption patterns of Malaysians. With the exception of a study on adolescents, the prevalences of overweight and obesity in children and adults are not strictly comparable due to the difference in body mass index (BMI) cut-off points in children and the study protocol in adults, and hence should not be misinterpreted as trends. The recent recommendation to lower the BMI cut-off points for Asians would only increase the magnitude of the existing prevalence among adults. The need to promote healthy nutrition for the population must be pursued vigorously, as the escalation of nutrition-related chronic degenerative diseases - once an urban phenomenon--has now spread to the rural population at an alarming rate. This paper indicates that the problem is real and needs urgent attention because it may be just the tip of the iceberg.

Topics: Adolescent; Adult; Body Mass Index; Child; Chronic Disease; Diet; Female; Health Transition; Humans; Industry; Malaysia; Male; Obesity; Social Change; Urbanization

Pre-conception interventions have the potential to lower non-communicable disease risk in prospective parents and reduce transmission of risk factors such as obesity to the next generation. The Jom Mama project in Malaysia investigated the effectiveness of a combined behaviour change communication and e-health intervention in young married couples prior to first pregnancy. This paper reports the evaluation of the effectiveness of this trial.. Jom Mama was a non-blinded, randomised controlled trial (RCT) conducted in Seremban, Malaysia, over a period of 33 weeks, covering six contact points between trained community health workers and newly married couples before the conception of a first child. Out of 2075 eligible nulliparous women, 549 participated and 305 completed the intervention, with 145 women in the intervention and 160 in the control group. The intervention group received a complex behavioural change intervention, combining behaviour change communication provided by community health promoters and access to a habit formation mobile application, while the control group received the standard care provided by public health clinics in Malaysia. The primary outcome was a change in the woman's waist circumference. Secondary outcomes were anthropometric and metabolic measures, dietary intake (Food Frequency Questionnaire, FFQ), physical activity (International Physical Activity Questionnaire, IPAQ) and mental health (Depression Anxiety Stress Scale, DASS 21). An extensive process evaluation was conducted alongside the trial in order to aid the interpretation of the main findings.. There were no significant differences of change in the woman's waist circumference between intervention and control groups at the start and end of the intervention. While the weight, waist circumference and Body Mass Index (BMI) of women in both groups increased, there was a significantly lower increase in the intervention vs the control group over the period of the trial among women who are obese (0.1 kg vs 1.7 kg; P = 0.023, in the intervention and control group respectively). In terms of BMI, the obese intervention subgroup showed a slight reduction (0.01) compared to the obese control subgroup whose BMI increased by 0.7 (P = 0.015). There were no changes in the other secondary outcomes.. The Jom Mama pre-conception intervention did not lead to a reduction in waist circumference or significant changes in other secondary outcomes over the eight months prior to conception. However, there was a significantly smaller weight gain in the intervention vs the control group, predominantly in women with pre-existing obesity.

Topics: Adiposity; Body Mass Index; Child; Diabetes Mellitus; Female; Humans; Malaysia; Obesity; Pregnancy; Young Adult

Computing polygenic risk scores (PRS) to predict the degree of risk for obesity may contribute to weight management programs strategically.. To investigate the combined effect of FTO rs9930501, rs9930506, and rs9932754 and ADRB2 rs1042713 and rs1042714 using PRS on (1) the odds of obesity and (2) post-intervention differences in dietary, anthropometric, and cardiometabolic parameters in response to high-protein calorie-restricted, high-vitamin E, high-fiber (Hipcref) diet intervention in Malaysian adults.. Both a cross-sectional study (n = 178) and a randomized controlled trial (RCT) (n = 128) were conducted to test the aforementioned objectives. PRS was computed as the weighted sum of the risk alleles possessed by each individual participant. Participants were stratified into first (PRS 0-0.64), second (PRS 0.65-3.59), and third (PRS 3.60-8.18) tertiles.. The third tertile of PRS was associated with significantly higher odds of obesity: 2.29 (95% CI = 1.11-4.72, adjusted p = 0.025) compared to the first tertile. Indians (3.9 ± 0.3) had significantly higher PRS compared to Chinese (2.1 ± 0.4) (p = 0.010). In the RCT, a greater reduction in high-sensitivity C-reactive protein (hsCRP) levels was found in second and third tertiles after Hipcref diet intervention compared to the control diet (p interaction = 0.048).. Higher PRS was significantly associated with increased odds of obesity. Individuals with higher PRS had a significantly greater reduction in hsCRP levels after Hipcref diet compared to the control diet.

Topics: Adolescent; Adult; Aged; Alleles; Alpha-Ketoglutarate-Dependent Dioxygenase FTO; Anthropometry; Body Weight; C-Reactive Protein; Cross-Sectional Studies; Diet; Diet, Reducing; Dietary Fiber; Energy Intake; Ethnicity; Female; Gene-Environment Interaction; Genetic Predisposition to Disease; Genetic Variation; Genotype; Humans; Malaysia; Male; Middle Aged; Obesity; Odds Ratio; Overweight; Phenotype; Polymorphism, Single Nucleotide; Receptors, Adrenergic, beta-2; Risk; Vitamin E; Young Adult

Late-night supper increases the risk of postprandial reflux from the acid pocket especially in obesity. An alginate-based, raft-forming medication may be useful for obese patients with GERD.. To compare the efficacy of Gaviscon Advance (Reckitt Benckiser, UK) and a non-alginate antacid in post-supper suppression of the acid pocket and post-prandial reflux among obese participants.. Participants underwent 48 h wireless and probe-based pH-metry recording of the acid pocket and lower oesophagus, respectively, and were randomised to single post-supper (10 pm) dose of either Gaviscon Advance or a non-alginate antacid on the second night. Primary outcomes were suppression of median pH of acid pocket and lower oesophagus, measured every 10-minutes post-supper for 1 h. Secondary outcomes were suppression of % time pH < 4 at lower oesophagus and improvement in frequency and visual analogue score (VAS) of regurgitation.. Of the 81 screened participants, 55 were excluded and 26 (mean age 33.5 years, males 77.8% and BMI 32.8 kg/m. Among obese individuals, Gaviscon Advance was superior to a non-alginate antacid in post-supper suppression of the acid pocket. (Clinical trial registration unique identifier: NCT03516188).

Topics: Adult; Alginates; Aluminum Hydroxide; Antacids; Anti-Ulcer Agents; Drug Combinations; Female; Gastric Acid; Gastroesophageal Reflux; Humans; Hydrogen-Ion Concentration; Malaysia; Male; Meals; Middle Aged; Obesity; Postprandial Period; Silicic Acid; Sodium Bicarbonate; Time Factors; Treatment Outcome; Young Adult

The aim of this study was to investigate the effectiveness of the Hipcref (high-protein, energy-restricted, high-vitamin E and high-fibre) diet in Malaysian adults on body composition and metabolic parameters after an intervention period of 6 months. Overweight/obese Malaysian adults (n 128; BMI≥23 kg/m2) were randomised to the Hipcref (n 65) or control diet (n 63). The intervention group received Hipcref diet charts based on their personal preferences. The control group followed a generalised dietary advice based on Malaysian Dietary Guidelines, 2010. All participants were responsible for preparing their own meals. There was a significant treatment group×time effect on anthropometric parameters (P<0·05) on an intention-to-treat basis. Pairwise comparisons revealed that Hipcref diet participants had significant reduction in weight, BMI, waist circumference, fat mass and percentage body fat at months 3 and 6 compared with baseline (P<0·001). The control group had significant increase in weight and BMI at months 3 and 6 compared with baseline (P<0·05). The Hipcref diet group had higher reduction in fasting insulin, insulin resistance and C-reactive protein levels compared with the control group at month 6 (P<0·05). Post-intervention, compared with the control group, the Hipcref diet group was found to consume significantly higher percentage energy from protein, and PUFA, higher energy-adjusted vitamin E (mg) and fibre (g), and lower total energy, lower percentage energy from fat and carbohydrate (P<0·05). The success of the Hipcref diet on overweight/obese Malaysian adults may be due to the combined effect of the nutrient composition of the Hipcref diet.

Topics: Adult; Anthropometry; Body Composition; Body Weight; Caloric Restriction; Diet, High-Protein; Dietary Proteins; Female; Humans; Insulin Resistance; Intention to Treat Analysis; Malaysia; Male; Middle Aged; Obesity; Overweight; Treatment Outcome; Waist Circumference; Weight Loss

Obesity is associated with numerous health problems, particularly metabolic and cardiovascular complications. This study aimed to assess the effects that, nine months of pharmacological intervention with orlistat or sibutramine, on obese Malaysians' body weight and compositions, metabolic profiles and inflammatory marker.. Seventy-six obese subjects were randomly placed into two groups. The first group received three daily 120 mg dosages of orlistat for nine months (n=39), and the second group received a once daily 10 or 15 mg dosage of sibutramine for nine months (n=37). Baseline measurements for weight, body mass index (BMI), waist circumference (WC), body fat percentage (BF), visceral fat (VF), adiponectin, fasting plasma glucose (FPG), fasting insulin, pancreatic B cell secretory capacity (HOMA%B), insulin sensitivity (HOMA%S), insulin resistance (HOMA-IR) and serum high sensitivity C-reactive protein (hs-CRP) were performed and repeated during the sixth and ninth months of treatment.. Twenty-four subjects completed the trial in both groups. For both groups, weight, BMI, WC, BF, VF, HOMA-IR and hs-CRP were significantly lower at the end of the nine month intervention. However, there were no significant differences between the two groups for these parameters with nine months treatment. There was a significant decrease in FPG in orlistat group; while fasting insulin and HOMA%B reduced in sibutramine group. For both groups, there were also significant increases in adiponectin levels and HOMA%S at the end of the nine month intervention.. Nine months of treatment with orlistat and sibutramine not only reduced weight but also significantly improved BMI, WC, BF, VF, FPG, adiponectin, fasting insulin, HOMA%B, HOMA%S, HOMA-IR and hs-CRP. These improvements could prove useful in the reduction of metabolic and cardiovascular risks in obese subjects.

Topics: Adiponectin; Adolescent; Adult; Aged; Asian People; Blood Glucose; Body Fat Distribution; Body Mass Index; C-Reactive Protein; Cardiovascular Diseases; Cyclobutanes; Fasting; Humans; Insulin; Insulin Resistance; Intra-Abdominal Fat; Lactones; Malaysia; Middle Aged; Obesity; Orlistat; Risk; Treatment Outcome; Waist Circumference; Young Adult

This study investigated changes in periodontal outcomes after nonsurgical periodontal treatment (NSPT) and evaluated associations of change in salivary resistin level with periodontal outcomes in obese Malaysians with chronic periodontitis. Sixty-two obese adults with chronic periodontitis were randomly divided into a test group (n = 31), which received NSPT, and a control group (n = 31), which received no treatment. Plaque score (PS), gingival bleeding index (GBI), probing pocket depth (PPD), and clinical attachment loss (CAL) were measured at baseline and at 6 and 12 weeks after NSPT. Salivary resistin levels were evaluated by using an enzyme-linked immunosorbent assay. PS was significantly lower in patients who received NSPT than in the control group at 6 and 12 weeks (P < 0.05). In the NSPT group the percentages of sites with shallow and moderate pockets decreased significantly, but there was no significant change in deep pockets. Resistin levels significantly decreased after NSPT (P < 0.05). Change in salivary resistin level was not significantly associated with periodontal outcomes. In obese Malaysians, NSPT significantly improved PS and GBI, and improved PPD and CAL for shallow and moderately deep pockets but not for deep pockets. Salivary resistin level was not associated with improvement in either periodontal variable.

Topics: Adult; Aged; Chronic Periodontitis; Enzyme-Linked Immunosorbent Assay; Female; Humans; Malaysia; Male; Middle Aged; Obesity; Resistin; Saliva

Nutrition and physical activity interventions is beneficial in reversing obesity. However far too little attention has been paid to the effect of these interventions on breast tissues. Thus, the aim of this study was to explore the effect of a home-based dietary and physical activity intervention (the Her Shape Program) on metabolic parameters, blood biomarkers and adiposity at the breast.. A randomized controlled study was conducted on obese women with high breast adiposity (<0.1 Sm-1), aged 40-60 years in Klang Valley, Malaysia. Subjects were assigned to intervention (n=16) and control group (n=15). Intervention group received a home based health education package with close monitoring weekly, personal diet consultation and physical training in group. Assessment was ascertained at three time points; baseline, weeks 8 and 16. Outcome measures were the energy intake, physical activity, body composition, blood tests, blood biomarkers and electrical impedance tomography (EIT) quantitative values. Analyses were done using 2-way repeated measures ANOVA.. All subjects completed the program without any drop-out. The HSI group had 100% compliance towards the intervention program; their energy intake was reduced for approximately 35% and their activity score was increased for approximately 11%. A significant interaction effect was found in body weight, body mass index (BMI), total cholesterol/HDL, vitamin C intake and matrix metallopeptidase 9 (MMP-9) (p<0.05). Interestingly, their EIT extremum values were also significantly increased indicating a reduction of breast adiposity. The intervention program was successful in improving body composition, physical activities, MMP9 and breast adipose tissue composition.

Topics: Adiposity; Adult; Biomarkers; Blood Glucose; Body Composition; Breast; Caloric Restriction; Diet; Exercise; Female; Humans; Life Style; Lipids; Malaysia; Matrix Metalloproteinase 9; Middle Aged; Obesity

Malaysia is experiencing a nutrition transition with burgeoning obesity, particularly in women, and a growing prevalence of non-communicable disease. These health burdens have severe implications not only for adult health but also across generations. Pre-conception health promotion could address the intergenerational risk of metabolic disease. This paper describes the development of the "Jom Mama" intervention using Intervention Mapping (IM). The Jom Mama intervention aims to improve the health of young adult couples in Malaysia prior to conception.. IM comprises of five steps prior to the last one, which involves the evaluation of the intervention. We used the five steps to develop the Jom Mama intervention.. Both the process and evidence is documented providing the rationale to the selection of the key objectives of the intervention: (i) increasing healthy dietary practice; (ii) increasing physical activity levels, (iii) reducing sedentary activity; and (iv) improving social support to offset stressful lifestyles. From the IM process, Jom Mama will be health-system centred approach that uniquely combines both community health promoters and an electronic-health platform to deliver the complex intervention.. IM is an iterative process that systematically gathers "best" evidence, selects appropriate theories of behaviour change, and facilitates formative research so as to develop a complex intervention. Though the IM process is time consuming, complex, and costly, it has enriched the Jom Mama intervention with a number of notable advantages: (i) intervention fashioned on formative work with stakeholders and in the target group; (ii) intervention combines research evidence with theory; (iii) intervention acknowledges multiple dynamics of influence; and (iv) intervention is embedded within health service priorities in Malaysia for greater scale-up possibility.

Topics: Adult; Community Health Services; Delivery of Health Care; Diet; Exercise; Family Characteristics; Female; Health Behavior; Health Promotion; Humans; Life Style; Malaysia; Metabolic Diseases; Obesity; Parents; Preconception Care; Pregnancy; Program Evaluation; Research Design; Risk Factors; Social Support; Young Adult

A twelve-week controlled intervention trial was carried out to evaluate the effects of combined physical activity and dietary intervention on obesity and metabolic risk factors among employees of Universiti Putra Malaysia. Participants consisted of adults aged 25-55 years with no reported chronic diseases but with abdominal obesity. They were assigned to either a combined physical activity and dietary intervention group or a control group. The final sample consisted of 56 participants, with an equal number of 28 for each study group. No significant group effect was observed for any variable except for hip circumference (HC) and fasting plasma glucose (FPG). There was a significant increase in HC (p=0.007) and reduction in FPG (p=0.02) in the intervention group compared to the control group. In the intervention group, HC (p=0.002), triglycerides (TG) (p=0.0001), total cholesterol (TC) (p=0.0001), LDL cholesterol (LDLC) (p=0.0001) and FPG (p=0.005) were significantly reduced, while waist circumference (WC) (p=0.025) and the waist-to-hip ratio (WHR) (p=0.027) were significantly reduced in the control group. No significant change in steps/day or calorie intake'was observed in either group. Taken together, these data indicate that the combined physical activity and dietary intervention was not effective at improving diet or physical activity level. However, the intervention was effective in improving FPG among participants with abdominal obesity. The significant increase in HC in the interventions group warrants further study. These findings will be useful to further improve group-based intervention for the prevention and management of obesity.

Topics: Adult; Blood Chemical Analysis; Blood Glucose; Body Weights and Measures; Diet; Exercise; Female; Humans; Lipids; Malaysia; Male; Middle Aged; Obesity; Obesity, Abdominal; Patient Compliance; Risk Factors; Socioeconomic Factors

Calorie restriction and intermittent fasting are two dietary interventions that can improve aging. Religious fasting also suggested having similar benefit; however, such studies are still scarce. Thus, this study aimed to determine the effect of fasting calorie restriction (FCR) on metabolic parameters and DNA damage among healthy older adult men.. A randomized controlled study was done on men, aged 50-70 years in Klang Valley, Malaysia. Subjects were divided into two groups; FCR (reduction of 300-500 kcal/d combined with 2 days/week of Muslim Sunnah Fasting) and control. Assessment was ascertained at three time point; baseline, weeks 6 and 12. Blood samples were analyzed for lipid profile, DNA damage and malondialdehyde (MDA).. The FCR group reduced their energy intake for approximately 18% upon completion of the study. A significant interaction effect was found in body weight, body mass index, fat percentage, fat mass, blood pressure, total cholesterol, low-density lipoprotein cholesterol and the ratio of total cholesterol/high-density lipoprotein cholesterol (p < 0.05). A significant improvement (p < 0.001) in total DNA rejoining cells and MDA (p < 0.05) was also observed in the FCR group.. FCR improved metabolic parameters and DNA damage in healthy older adult men. Therefore, there is a need to further examine the mechanism of FCR.

Topics: Aged; Aging; Blood Pressure; Body Composition; Body Mass Index; Caloric Restriction; DNA Damage; Fasting; Humans; Lipid Metabolism; Lipoproteins, HDL; Malaysia; Male; Malondialdehyde; Middle Aged; Obesity; Oxidative Stress; Treatment Outcome

The use of email and website as channels for workplace health information delivery is not fully explored. This study aims to describe the rationale, design, and baseline findings of an email-linked website intervention to improve modifiable cancer risk factors.. Employees of a Malaysian public university were recruited by systematic random sampling and randomised into an intervention (n = 174) or control group (n = 165). A website was developed for the intervention and educational modules were uploaded onto the website. The intervention group received ten consecutive weekly emails with hypertext links to the website for downloading the modules and two individual phone calls as motivational support whilst the control group received none. Diet, lifestyle, anthropometric measurements, psychosocial factors and stages of change related to dietary fat, fruit and vegetable intake, and physical activity were assessed.. Participants were predominantly female and in non-academic positions. Obesity was prevalent in 15% and 37% were at risk of co-morbidities. Mean intake of fats was 31%, fruit was -1 serving/day and vegetable was < 1 serving/day. Less than 20% smoked and drank alcohol and about 40% were physically inactive. The majority of the participants fell into the Preparation stage for decreasing fat intake, eating more fruit and vegetables, and increasing physical activity. Self-efficacy and perceived benefits were lowest among participants in the Precontemplation/Contemplation stage compared to the Preparation and Action/Maintenance stages.. Baseline data show that dietary and lifestyle practices among the employees did not meet the international guidelines for cancer prevention. Hence the findings warrant the intervention planned.

Topics: Adult; Analysis of Variance; Dietary Fats; Electronic Mail; Feeding Behavior; Female; Fruit; Health Education; Health Knowledge, Attitudes, Practice; Health Promotion; Humans; Internet; Life Style; Malaysia; Male; Motor Activity; Neoplasms; Obesity; Risk Factors; Vegetables; Workplace; Young Adult

Few randomized controlled trials (RCTs) of interventions for the treatment of childhood obesity have taken place outside the Western world.. To test whether a good practice intervention for the treatment of childhood obesity would have a greater impact on weight status and other outcomes than a control condition in Kuala Lumpur, Malaysia.. Assessor-blinded RCT of a treatment intervention in 107 obese 7- to 11-year olds. The intervention was relatively low intensity (8 hours contact over 26 weeks, group based), aiming to change child sedentary behavior, physical activity, and diet using behavior change counselling. Outcomes were measured at baseline and six months after the start of the intervention. Primary outcome was BMI z-score, other outcomes were weight change, health-related quality of life (Peds QL), objectively measured physical activity and sedentary behavior (Actigraph accelerometry over 5 days).. The intervention had no significant effect on BMI z score relative to control. Weight gain was reduced significantly in the intervention group compared to the control group (+1.5 kg vs. +3.5 kg, respectively, t-test p < 0.01). Changes in health-related quality of life and objectively measured physical activity and sedentary behavior favored the intervention group.. Treatment was associated with reduced rate of weight gain, and improvements in physical activity and quality of life. More substantial benefits may require longer term and more intensive interventions which aim for more substantive lifestyle changes.

Topics: Actigraphy; Body Mass Index; Child; Child Behavior; Counseling; Diet; Exercise; Female; Habits; Health Behavior; Health Promotion; Humans; Malaysia; Male; Obesity; Quality of Life; Risk Reduction Behavior; Surveys and Questionnaires; Time Factors; Treatment Outcome; Weight Loss

The present study describes a randomised controlled trial (RCT) based on a novel, generalisable intervention for childhood obesity, comparing the intervention with a no-treatment control group.. The Malaysian Childhood Obesity Treatment Trial (MASCOT) was a single-blind RCT of a dietetic treatment for childhood obesity in children of primary school age (7 to 11 years old) in Kuala Lumpur, Malaysia. The MASCOT comprising eight sessions, of an 8-hour family-centred group treatment programme is described, based on behavioural change techniques. The study sample was characterised by BMI z-score, health related quality of life reported by participants and their parents (PedsQL questionnaire), objectively measured habitual physical activity and sedentary behaviour (Actigraph accelerometry). The MASCOT sample of 107 children was characterised by a low quality of life, mean total score on PedsQL 67.7 (4.5) as reported by the children, and 66.0 (16.4) as reported by their parents. The children spent, on average, 89% of their waking day on sedentary activity, and 1% of the day in moderate-vigorous intensity physical activity, equivalent to only around 8 minutes/day.. Obese children in the MASCOT study had an impaired quality of life, high levels of sedentary behaviour and very low levels of physical activity.

Topics: Body Mass Index; Child; Child Welfare; Diet; Evidence-Based Medicine; Family; Female; Humans; Malaysia; Male; Motor Activity; Obesity; Quality of Life; Research Design; Sedentary Behavior; Single-Blind Method; Students; Surveys and Questionnaires; Treatment Outcome

Most studies reporting prevalence of obesity use actual weight and height measurements. Self-reported weight and height have been used in epidemiological studies as they have been shown to be reliable, convenient, and inexpensive alternatives to actual measurements. However, the accuracy of self-reported weight and height might vary in different regions because of the difference in health awareness and social influences. This study aims to determine the accuracy and reliability of self-reported weight and height compared to actual measured weight and height among adults in Malaysia. This was a cross-sectional study conducted at the community level during blood pressure screening campaigns. Participants self-reported their weight and height in a questionnaire survey. Their weight and height were validated using measurements by researchers on the same setting. Body mass index (BMI) was defined as underweight (<18.5kg/m2), normal (18.5-22.9 kg/m2), overweight (23-27.4 kg/m2) and obesity (≥27.5 kg/m2). Bland-Altman analysis, intraclass correlation coefficients and weighted Kappa statistics were used to assess the degree of agreement between self-reported and measured weight and height. A total of 2781 participants were recruited in this study. The difference between the mean self-reported and measured weight and height were 0.4 kg and 0.4 cm respectively. Weighted Kappa statistics analysis showed that there was a substantial agreement between the BMI classifications derived from self-reported and actual measurement (ҡ = 0.920, p<0.001). There was no marked difference in the sensitivity and specificity of self-reported BMI among Malaysian adults by gender. We observed substantial agreement between self-reported and measured body weight and height within a sample of Malaysian adults. While self-reported body weight showed weaker agreement with actual measurements particularly for obese and overweight individuals, BMI values derived from self-reported weight and height were accurate for 88.53% of the participants. We thus conclude that self-reported height and weight measures may be useful for tracking and estimating population trends amongst Malaysian adults.

Topics: Adult; Blood Pressure; Body Height; Body Mass Index; Body Weight; Cross-Sectional Studies; Humans; Malaysia; Obesity; Overweight; Reproducibility of Results; Self Report

Evidence for gene-diet interactions is lacking among individuals with specific dietary practices including vegetarians. This study aimed to determine the interactions of rs174547 in the fatty acid desaturase 1 (FADS1) gene with macronutrient such as carbohydrate (particularly fibre), protein and fat intakes on abdominal obesity among middle-aged Malaysian vegetarians of Chinese and Indian ethnicity.. The present cross-sectional study was conducted among 163 vegetarians in Kuala Lumpur and Selangor, Malaysia. Dietary intakes of vegetarians were assessed by using a food frequency questionnaire. Waist circumference of vegetarians was measured by using a Lufkin tape W606PM. Genotypes of the rs174547 of vegetarians were determined by using Agena® MassARRAY. A multiple logistic regression model was used to determine the interactions of the rs174547 with macronutrient on abdominal obesity.. About 1 in 2 vegetarians (51.5%) had abdominal obesity. Individuals with CT and TT genotype at T3 intake of carbohydrates, protein, fat and fibre as well as individuals with TT genotype at T2 intake of carbohydrates and protein had higher odds of abdominal obesity (pinteration <0.05). The gene-diet interaction remained significant for fibre intake (OR: 4.71, 95% CI: 1.25-17.74, pinteraction=0.022) among vegetarians with TT genotype at T2 intake of fibre after adjusting for age and sex and considering the effects of ethnicity and food groups.. The rs174547 significantly interacted with fibre intake on abdominal obesity. A specific dietary fibre recommendation based on genetics is needed among Chinese and Indian middle-aged vegetarians.

Topics: Cross-Sectional Studies; Dietary Fiber; Eating; Humans; Malaysia; Middle Aged; Obesity; Obesity, Abdominal; Vegetarians

Malaysia has the highest number of obese and overweight individuals in South-east Asia. The 2019 National Health & Morbidity survey found 50.1% of Malaysians to be overweight or obese with 30.4% being overweight and 19.7% being obese. This has led to the high rise of the bariatric surgeries demand and needs within the nation.. To assess the level of fasting blood sugar (FBS), systolic, diastolic blood pressure, stop BANG score for obstructive sleep apnoea (OSA) and BMI (Body Mass Index) for the patients before and after bariatric surgeries (sleeve/gastric bypass) for a one year follow up period.. The study was conducted among 1000 patients who underwent a single weight reduction surgery (sleeve/gastric bypass) by a single surgeon at the Cengild Medical Centre between January 2019 to January 2020. They were followed up for a one-year period through recording the parameters of fasting blood sugar (FBS), systolic, diastolic blood pressure, stop BANG score for obstructive sleep apnoea (OSA) and BMI (Body Mass Index). Study was conducted using universal sampling including all subjects visited the centre and a written consent was obtained from each participant. Descriptive statistics with mean was used and paired t-test was used for comparison and test the difference. The STOP-BANG acronym stands for: Snoring history, Tired during the day, Observed stop breathing while sleep, High blood pressure, BMI more than 35 kg/m2, Age more than 50 years, Neck circumference more than 40 cm and male Gender.. The mean age of patients was 38 years old. Mean FBS for the patients one month before the operation was 10.42 mmol/L and 5.84 three months post procedure. The systolic blood pressure one month before the operation and 3 months after was 139.81 mmHg and 123.79 mmHg, while diastolic blood pressure was 86.84 mmHg and 81.07 mmHg respectively. BMI was reduced from 39.69 to 27.99 after one year from the weight reduction operation. All the above parameters showed a significant reduction between one-month pre operation as compared to 3 months and 12 months post operation and that improved the health parameters of the patients significantly.. The weight reduction operations showed a significant reduction in the FBS, blood pressure, OSA scores and BMI at 3, 12 months after the operation These patients had better overall health after the significant reduction in these parameters.

Topics: Adult; Bariatric Surgery; Blood Glucose; Humans; Malaysia; Male; Middle Aged; Obesity; Overweight; Sleep Apnea, Obstructive

Practitioners' perceptions of patients with obesity and obesity management shape their engagement in obesity care delivery. This study aims to describe practitioners' perceptions, experiences and needs in managing patients with obesity, determine the extent of weight stigma among health practitioners, and identify the factors associated with negative judgment towards patients with obesity.. A cross-sectional online survey was conducted from May to August 2022 with health practitioners commonly involved in obesity management in Peninsular Malaysia, including doctors in primary care, internal medicine and bariatric surgery, and allied health practitioners. The survey explored practitioners' perceptions, barriers and needs in managing obesity, and evaluated weight stigma using the Universal Measures of Bias - Fat (UMB Fat) questionnaire. Multiple linear regression analysis was used to identify demographic and clinical-related factors associated with higher negative judgment towards patients with obesity.. A total of 209 participants completed the survey (completion rate of 55.4%). The majority (n = 196, 94.3%) agreed that obesity is a chronic disease, perceived a responsibility to provide care (n = 176, 84.2%) and were motivated to help patients to lose weight (n = 160, 76.6%). However, only 22% (n = 46) thought their patients were motivated to lose weight. The most frequently reported barriers to obesity discussions were short consultation time, patients' lack of motivation, and having other, more important, concerns to discuss. Practitioners needed support with access to multi-disciplinary care, advanced obesity training, financing, comprehensive obesity management guidelines and access to obesity medications. The mean (SD) of the UMB Fat summary score was 2.99 (0.87), with the mean (SD) domain scores ranging between 2.21 and 4.36 (1.06 to 1.45). No demographic and clinical-related factors were significantly associated with negative judgment from the multiple linear regression analyses.. Practitioners in this study considered obesity a chronic disease. While they had the motivation and capacity to engage in obesity management, physical and social opportunities were the reasons for not discussing obesity with their patients. Practitioners needed more support to enhance their capability and opportunity to engage with obesity management. Weight stigma in healthcare settings in Malaysia should be addressed, given the possibility of hindering weight discussions with patients.

Topics: Cross-Sectional Studies; Humans; Malaysia; Obesity; Obesity Management; Weight Loss

The global obesity epidemic remains a significant threat to public health and the economy. Age-period-cohort (APC) analysis is one method to model the trajectory of obesity. However, there is scarce published evidence of such analyses among the South East Asian population. This study aims to explore the sex and ethnic variations of BMI and waist circumference trajectories over time among non-institutionalized Malaysian adults aged 18 to 80 years.. Data from four population-based National Health and Morbidity Surveys conducted in 1996, 2006, 2010, and 2015 were pooled. Hierarchical Age-Period-Cohort (HAPC) analysis explored the trajectories of BMI and waist circumference across the life course and birth cohorts by sex and ethnicity. These models assumed no period effect.. Generally, BMI and waist circumference trajectories increased across age and birth cohorts. These trajectories varied by sex and ethnicity. Females have more profound increasing BMI and waist circumference trajectories than their male counterparts as they age and as cohort recency increases. Chinese have less profound BMI and waist circumference increases across the life course and birth cohorts than other ethnic groups.. The profound increasing cohort trajectories of obesity, regardless of sex and ethnicity, are alarming. Future studies should focus on identifying factors associated with the less profound cohort effect among the Chinese to reduce the magnitude of trajectories in obesity, particularly among future generations.

Topics: Adult; Birth Cohort; Body Mass Index; Ethnicity; Female; Humans; Life Change Events; Malaysia; Male; Obesity; Risk Factors; Waist Circumference

To explore patients' experiences accessing healthcare for obesity and their perceived behaviour changes following the care.. Using a descriptive qualitative research approach informed by Levesque's framework of access to healthcare, we conducted phone interviews in the Malaysian language, which were audio-recorded and transcribed verbatim. Data were analysed inductively using a reflexive thematic analysis approach.. Primary care clinics in five states in Peninsular Malaysia.. Adult patients with obesity receiving face-to-face care for obesity from healthcare providers in Peninsular Malaysia.. We interviewed 22 participants aged 24-62, with the majority being female (77%), Malay (95%), married (73%) and with tertiary education (82%). Most participants attended obesity management services at public primary care clinics. We identified five themes: (1) moving from perceiving the need to seeking obesity care is a non-linear process for patients, (2) providers' words can inspire patients to change, (3) patients' needs and preferences are not adequately addressed in current obesity care, (4) over-focusing on weight by patients and healthcare providers can lead to self-blame and loss of hope for patients and (5) obesity healthcare can have consequences beyond weight loss.. Patients lack the self-regulatory skills to continue their lifestyle changes and struggle with self-blame and hopelessness. Over-focusing on weight by patients and obesity healthcare increase patients' self-stigmatisation. While provider-initiated weight discussions and engaging and personalised consultation provide the initial step towards weight management, obesity healthcare could be enhanced by behavioural support and patient education on the complexity of obesity. Further considerations could be given to shifting from a weight-centric to a more holistic health-centred approach in obesity healthcare.

Topics: Adult; Female; Health Personnel; Health Services Accessibility; Humans; Malaysia; Male; Obesity; Qualitative Research

THE CONTEXT AND PURPOSE OF THE STUDY: Unhealthy food consumption has raised an alarming situation of obesity among Asian nations and posing serious threats to human health. Recent studies have acknowledged that organic food consumption has been contrariwise associated with obesity. The consumption of healthy food has received research attention in social marketing and several antecedents and consequences have been identified. However, to date, there is a void in literature that how social, individual, and marketing elements together tradeoff in predicting a healthy lifestyle. Thus, the current investigation unfolds the antecedents of healthy foods' adoption in Asia by integrating the brand signaling and theory of planned behavior.. The data of 241 respondents were collected from selected social media Facebook communities through a survey using assessed 42 questions. For this purpose, participants' Facebook accounts were selected from the online healthy communities such as 'Diet Suku Suku Separuh' (469,000 followers), 'Hiking, and Camping around Malaysia' (351,200 followers), and 'Healthy Malaysia' (332 followers). The enumerator also engaged with the online community by liking posts and following health accounts.. The data was analyzed using PLS (SEM) approach, the outcomes of hypotheses revealed interesting information that health consciousness not significantly predicts the purchase intention of healthy food. All antecedents were significant contributors to the prediction of foods' purchase intentions in this study. However, the findings indicated that no positive relationship exists between brand image identifications and brand credibility identifications, and healthy foods' purchase intentions identifications. The findings also indicated that no positive relationship exists between health consciousness identifications and healthy foods' purchase intentions identifications. Owing to the perilous increase in obesity among the general public in Asia. This study reinforced the factor that can help in the adoption of a healthy lifestyle. The study validated that a healthy lifestyle is reliant on the consumers' health consciousness, environmental concern, and innovativeness through motivating the consumers' healthy foods' purchase intentions. Surprisingly, the results highlighted that respondents have not identified brand image and credibility as an antecedent of purchase intention. Given that organic food brands are somewhat new in Asian markets and therefore, brands must endure crisis marketing practices to improve their brand recognition. Therefore, policymakers must facilitate the food promotional activities that are critical to enhancing the perceived benefits of organic food to combat issues like obesity. This paper offers a foundation for future empirical investigations in Asia and various stakeholders on how to promote a healthy lifestyle in Asia. Specifically, the results will help policymakers to offer positive policies and procedures for the improvement of a healthy lifestyle through the understanding of the antecedents and consequences of health-conscious consumers' healthy foods' purchase intentions.

Topics: Consumer Behavior; Food, Organic; Humans; Intention; Malaysia; Obesity

The coronavirus disease 2019 (COVID-19) isolation has altered individuals' food purchasing behaviour and dietary intake patterns. Therefore, this study aims to investigate the changes in dietary intake patterns and their impacts on the weight status of young adults in Malaysia during the COVID-19 lockdown.. This cross-sectional study involved 1045 young adults in Malaysia. The changes in dietary intake patterns were assessed using the Dietary Diversity Questionnaire with slight modifications, while anthropometric measurements including body height, body weight before the pandemic and current body weight were self-reported.. Overall, nearly half of the respondents (48.8%) gained weight during the confinement, with an average increment of 4.06 ± 3.23 kg. Of 1045, 45.3% reported consuming more fruits and 60.2% had higher plain water intake during the pandemic. It is observed that 41.0% to 66.8% of the young adults changed their dietary intake patterns during the pandemic. Increased consumption in cereals and grains (β = 0.084,. In conclusion, the enforcement of the Movement Control Order (MCO) drove up the prevalence of overweight/obesity among young adults in Malaysia. Increased consumption of cereals and grains and oils and fats contributed to weight gain in the pandemic lockdown. Nonetheless, a noticeable proportion of young adults in Malaysia shifted to a healthier food choice by increasing the consumption of fruits and vegetables.

Topics: Age Factors; Body Weight; Communicable Disease Control; Consumer Behavior; COVID-19; Cross-Sectional Studies; Drinking; Eating; Feeding Behavior; Female; Food; Fruit; Humans; Malaysia; Male; Obesity; Overweight; Surveys and Questionnaires; Weight Gain; Young Adult

Suboptimal gestational weight gain has been associated with adverse perinatal and maternal outcomes, including increased risk of non-communicable diseases later in life. This study aimed to determine the proportion and determinants of suboptimal GWG. A cross-sectional study was conducted among 475 pregnant women in Selangor between January and March 2020. The study included all pregnant women at their second or third trimester who fulfilled the inclusion and exclusion criteria. A multistage sampling was applied. The GWG adequacy was based on recommendations from the Institute of Medicine (2009). Multinomial logistic regressions were used for data analysis. Out of the 475 respondents, 224 (47.2%) pregnant women had inadequate GWG, 142 (29.9%) had adequate GWG, and 109 (22.9%) had excessive GWG. Multinomial logistic regression showed that having diabetes in pregnancy (AdjOR 2.24, 95% CI: 1.31, 3.83, p = 0.003), middle (M40) monthly household income (AdjOR 2.33, 95% CI: 1.09, 4.96, p = 0.029), low (B40) monthly household income (AdjOR 2.22, 95% CI: 1.07, 4.72, p = 0.039), and an obese pre-pregnancy BMI (AdjOR 2.77, 95% CI: 1.43, 5.35, p = 0.002) were significantly associated with inadequate GWG. Overweight (AdjOR 5.18, 95% CI: 2.52, 10.62, p < 0.001) and obese pre-pregnancy BMIs (AdjOR 17.95, 95% CI: 8.13, 36.95, p < 0.001) were significantly associated with excessive GWG. Improving maternal and perinatal outcomes requires targeted interventions focusing on these modifiable determinants.

Topics: Body Mass Index; Cross-Sectional Studies; Female; Gestational Weight Gain; Gross Domestic Product; Humans; Malaysia; Obesity; Overweight; Pregnancy; Pregnancy Outcome; Weight Gain

Understanding the experience of people living with obesity is crucial for delivering holistic care relevant to the socio-cultural context. Although half of the Malaysian adults have excessive weight, the lived experience of people with obesity in the Malaysian context is not well studied. Using the principles of hermeneutic phenomenology, this study explores the lived experience of adults with obesity in Malaysia and their perspective on the environmental influences on obesity. Participants were adults from Peninsular Malaysia living with obesity recruited from social media, clinics and snowball sampling. Twenty-five teleconference interviews in Malay were audio-recorded and transcribed verbatim. Data were analysed inductively using a reflexive thematic analysis approach, and quotes were translated into English. We identified five themes: (1) Malaysian life is centred around food; (2) social norms shape people living with obesity's perceptions of themselves and obesity; (3) people living with obesity are physically restricted by their body; (4) people living with obesity have repeated thoughts about efforts to lose weight; and (5) stigmatization of people living with obesity leads to negative emotions. Socio-cultural influences were highly impactful on participants' lifeworld, and these influences need to be considered in clinical practice and policy for obesity management in Malaysia. Clinical management should focus on assisting patients in navigating the unsupportive food and social environment instead of overfocusing on the individual's responsibility for weight reduction.

Topics: Adult; Humans; Malaysia; Obesity; Qualitative Research; Weight Loss

The Malay version of the WHOQOL-BREF was published approximately 15 years ago. Since then, no known research has been conducted to identify the psychometric properties of the scale using confirmatory factor analysis. This study aimed to establish a model by applying a scientific approach to the translation and adaptation method. The back translation technique was used for the translation process. This cross-sectional study involved 282 employees at Universiti Kebangsaan Malaysia. The instrument received satisfactory Cronbach's alpha reliability values. The data were analysed with SEM using AMOS. Results showed that the model produced is parsimonious, with CMIN/df = 0.23, CFI = 0.93, SRMR = 0.08, RMSEA = 0.08 and PCLOSE = 0.07. Adopting the Malay version of the WHOQOL-BREF for future research is highly recommended due to its properties.

Topics: Cross-Sectional Studies; Humans; Malaysia; Obesity; Psychometrics; Quality of Life; Reproducibility of Results; Surveys and Questionnaires

Relative leptin resistance in childhood to absolute leptin resistance in maturity suggests sleep, eating behaviour, and the psychological state as probable causes. The current body of research provides inconclusive evidence linking G2548A and Q223R to obesity. Furthermore, we could find very little data that have observed the association between the environment and gene polymorphism, especially in the multiethnic population that exists in Malaysia. This study searched for a possible link between sleeping habits, eating behaviour, and stress indicators with plasma leptin and its genetic variation in young adult Malaysian healthcare students. The study involved 185 first- and second-year medical and dental students from a healthcare university. Polymerase Chain Reaction−Restriction Fragment Length Polymorphism(PCR-RFLP) determined the genotype, Enzyme Linked Immunoabsorbant Assay (ELISA) tested the serum leptin, and a self-administered questionnaire evaluated sleep, eating behaviour, and psychological condition. Gender and ethnicity are linked to fasting plasma leptin levels (p < 0.001). Plasma leptin also affects stress, anxiety, and sadness. Leptin (LEP) and Leptin Receptor (LEPR) polymorphisms were not associated with BMI, plasma leptin, sleep, eating behaviour, or psychological state. Young adult Malaysian Indians were obese and overweight, while Chinese were underweight. These findings imply overweight and obese participants were in stage I of leptin resistance and lifestyle change or leptin therapy could prevent them from becoming cripplingly obese as they age.

Topics: Body Mass Index; Fasting; Feeding Behavior; Gene Frequency; Genetic Predisposition to Disease; Genotype; Humans; Leptin; Malaysia; Obesity; Overweight; Polymorphism, Genetic; Polymorphism, Single Nucleotide; Receptors, Leptin; Sleep; Stress, Psychological; Students, Medical; Young Adult

In 2016, World Health Organization (WHO) estimated more than 650 million obese adults, resulting in a country's health burden. This study aims to determine the prevalence of obesity and its associated factors among Malaysian adults. A total of 5820 respondents, aged 18 to 59 years, from the National Health and Morbidity Survey 2019, were included for the data analysis. The prevalence of obesity was described and multivariate analyses were conducted to determine the factors associated with obesity. The prevalence of obesity among Malaysian adults was 20.1%, based on the findings from this study. Multivariate analyses showed that women, being Malays, Indians, and other Bumiputeras, were significantly associated with a higher risk of obesity. Besides, those diagnosed with diabetes mellitus and hypertension were also significantly associated with greater risk of obesity. This information is crucial for policy makers in formulating effective strategies or targeted programs in preventing obesity among Malaysian adults.

Topics: Adult; Female; Health Surveys; Humans; Malaysia; Morbidity; Obesity; Prevalence; Surveys and Questionnaires

Dietary intake may interact with gene variants and modulate inflammatory status. This study aimed to investigate the combined effect of fat mass and obesity-associated rs9930501, rs9930506, and rs9932754 and beta-2 adrenergic receptor rs1042713 on C-reactive protein (CRP) concentrations using polygenic risk scores (PRS), and modulatory effect of dietary nutrients on these associations. We hypothesized that higher protein intake is associated with lower inflammatory status in individuals genetically predisposed to obesity. PRS was computed as the weighted sum of the risk alleles possessed and stratified into first (0-0.64), second (0.65-3.59), and third (3.60-8.18) tertiles. A total of 128 overweight and obese Malaysian adults were dichotomized into groups of low and elevated inflammatory status (CRP concentrations ≤3 and >3 mg/L, respectively). One-half of the study participants (51%) were found to have elevated inflammatory status. Second- and third-tertile PRS were significantly associated with increased odds of elevated inflammatory status, 7.56 (95% confidence interval [CI], 1.98-28.80; adjusted P = .003) and 3.87 (95% CI, 1.10-13.60; adjusted P = .035), respectively. Individuals in the third-tertile PRS had significantly lower CRP concentrations (4.61 ± 1.3 mg/L vs 9.60 ± 2.6 mg/L, P = .019) when consuming ≥14% energy from protein (with an average of 18.0% ± 2.4%, 43.0% ± 7.7%, and 39.0% ± 8.0% energy from protein, carbohydrate, and fat per day). In conclusion, third-tertile PRS was significantly associated with increased odds of elevated CRP; higher protein intake may alleviate inflammatory status and reduce CRP concentrations systemically in those individuals.

Topics: Adult; C-Reactive Protein; Dietary Proteins; Humans; Malaysia; Obesity; Overweight; Risk Factors

To assess the prevalence and factors associated with multimorbidity in a community-dwelling general adult population on a large Health and Demographic Surveillance System (HDSS) scale.. Population-based cross-sectional study.. South East Asia Community Observatory HDSS site in Malaysia.. Of 45 246 participants recruited from 13 431 households, 18 101 eligible adults aged 18-97 years (mean age 47 years, 55.6% female) were included.. The main outcome was prevalence of multimorbidity. Multimorbidity was defined as the coexistence of two or more chronic conditions per individual. A total of 13 chronic diseases were selected and were further classified into 11 medical conditions to account for multimorbidity. The conditions were heart disease, stroke, diabetes mellitus, hypertension, chronic kidney disease, musculoskeletal disorder, obesity, asthma, vision problem, hearing problem and physical mobility problem. Risk factors for multimorbidity were also analysed.. Of the study cohort, 28.5% people lived with multimorbidity. The individual prevalence of the chronic conditions ranged from 1.0% to 24.7%, with musculoskeletal disorder (24.7%), obesity (20.7%) and hypertension (18.4%) as the most prevalent chronic conditions. The number of chronic conditions increased linearly with age (p<0.001). In the logistic regression model, multimorbidity is associated with female sex (adjusted OR 1.28, 95% CI 1.17 to 1.40, p<0.001), education levels (primary education compared with no education: adjusted OR 0.63, 95% CI 0.53 to 0.74; secondary education: adjusted OR 0.60, 95% CI 0.51 to 0.70; tertiary education: adjusted OR 0.65, 95% CI 0.54 to 0.80; p<0.001) and employment status (working adults compared with retirees: adjusted OR 0.70, 95% CI 0.60 to 0.82, p<0.001), in addition to age (adjusted OR 1.05, 95% CI 1.05 to 1.05, p<0.001).. The current single-disease services in primary and secondary care should be accompanied by strategies to address complexities associated with multimorbidity, taking into account the factors associated with multimorbidity identified. Future research is needed to identify the most commonly occurring clusters of chronic diseases and their risk factors to develop more efficient and effective multimorbidity prevention and treatment strategies.

Topics: Adult; Asia, Eastern; Chronic Disease; Cross-Sectional Studies; Female; Humans; Hypertension; Malaysia; Male; Middle Aged; Multimorbidity; Obesity; Prevalence

Health-related quality of life (HRQoL) is a multidimensional concept that indicated an individual's holistic health, whereby the urban-poor community are susceptible to low HRQoL due to their high vulnerability. This study aimed to determine factors that predicted the HRQoL among the urban-poor school-aged children.. This is a cross-sectional study and a total of 408 primary school-aged children (male: 72.3%; female: 27.7%), with a mean age of 9.68±1.48 years, were recruited from 10 urban-poor flats through cluster sampling at the central region of Malaysia. Their anthropometry, nutrition knowledge, attitude and practice, physical activity, dietary practices, and HRQoL were assessed.. A quarter (24.5%) of the urban-poor children were either overweight or obese in the present study. The HRQoL total score among the urban-poor children was 65.0±18.5. The result of multiple linear regression analysis shown that higher nutrition attitude (B=0.34, p=0.001) and practices (B=0.39, p=0.001), higher physical activity (B=3.73, p=0.004), higher lunch intake (B=1.35, p<0.001), lower supper intake (B=-1.35, p<0.001), and lower fast-food intake (B=-1.61, -1.17, p<0.001) are the significant predictors of better HRQoL among the urban-poor children (R2=0.32, F(8,399)=23.72, p<0.001).. Future studies should focus on these predictors to formulate interventions that could enhance the HRQoL among the Malaysian urban-poor children.

Topics: Child; Cross-Sectional Studies; Female; Humans; Malaysia; Male; Obesity; Overweight; Quality of Life

Topics: Community Pharmacy Services; Health Knowledge, Attitudes, Practice; Humans; Malaysia; Obesity; Overweight; Pharmacists; Professional Role

type 2 diabetes mellitus has become a global public health crisis. The increment in the cases has contributed significantly to the parallel increase in the prevalence of overweight and obesity. This paper aimed to analyse the relationship between lipid profile, waist circumference and body mass index (BMI) with the glycaemic control of the diabetes patients in Kedah.. a cross-sectional study was conducted, using the Kedah audit samples data extracted from the National Diabetes Registry (NDR) from the year 2014 to 2018. A total of 25,062 registered type 2 diabetes mellitus patients were selected using the inclusion and exclusion criteria from the registry. Only patients with complete data on their HbA1C, lipid profile, waist circumference and BMI were analysed using SPSS version 21.. the means for the age, BMI and waist circumference of the samples were 61.5 (±10.85) years, 27.3 (±5.05) kg/m. implementing lifestyle changes such as physical activity and dietary modifications are important in the management of BMI, waist circumference and body lipids, which in turn results in improved glycaemic control.

Topics: Aged; Blood Glucose; Body Mass Index; Cross-Sectional Studies; Diabetes Mellitus, Type 2; Female; Glycated Hemoglobin; Humans; Life Style; Lipids; Malaysia; Male; Middle Aged; Obesity; Overweight; Registries; Waist Circumference

This study examined whether the temporal patterns of energy and macronutrient intake in early and late eating windows were associated with metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO) among non-shift workers. A total of 299 overweight/obese non-shift workers (Age: 40.3 ± 6.9 years; 73.6% women; BMI: 31.7 ± 5.0 kg/m

Topics: Adult; Body Mass Index; Chronobiology Phenomena; Eating; Energy Intake; Feeding Behavior; Female; Health Status; Humans; Malaysia; Male; Metabolic Syndrome; Middle Aged; Nutritional Status; Obesity; Obesity, Metabolically Benign; Odds Ratio; Overweight; Risk Factors; Sleep

Endometrial cancer (EC) has been found to have a strong association with overweight and obesity. The aim of this study was to evaluate the link between metabolic syndrome and EC among patients. A total of 119 patients with histologically confirmed EC were recruited. About 102 cases of endometrioid carcinoma (Type I) and serous (

Topics: Carcinoma, Endometrioid; Carcinosarcoma; Correlation of Data; Endometrial Neoplasms; Female; Humans; Malaysia; Metabolic Syndrome; Middle Aged; Obesity; Overweight; Prevalence; Preventive Health Services; Risk Assessment; Risk Factors; Survival Analysis

The pervasiveness of obesity is a growing concern in the world. This study aims to determine the prevalence of obesity among a segment of the Malaysian population, as well as investigate associated factors and psychological determinants of obesity.. A cross-sectional study design was carried out in Selangor, Malaysia. A total of 1380 Malaysian adults (≥18 years old) participated in a structured and validated questionnaire survey. TANITA body scale and SECA 206 body meter were used to measure the respondents' weight and height, from which measurements of their body mass index (BMI) were calculated.. The overall prevalence of obesity (BMI ≥ 30 kg/m. There is an urgent need to integrate psychological approaches to enhance the effectiveness of obesity prevention strategies and weight-loss programs.

Topics: Adolescent; Adult; Body Mass Index; Cross-Sectional Studies; Female; Humans; Malaysia; Male; Obesity; Prevalence; Quality of Life; Risk Factors

The Mindful Eating Questionnaire is a reliable tool for the assessment of mindful eating behavior among the general population. This study aimed to determine the reliability and validity of The Malay Mindful Eating Questionnaire (MEQ-M) in a sample of overweight and obese adults. This is a cross-sectional survey which involved 144 overweight and obese adults in a selected public university. After linguistic validation of the Malay version of the MEQ, exploratory factor analysis (EFA) with varimax rotation was performed on the scale constructs. The psychometric properties of the MEQ were assessed through Cronbach's alpha and intraclass correlation coefficient (ICC) analysis. The EFA of the MEQ produced a seven-dimensional model (58.8% of overall variances). The concurrent validity analysis between total MEQ scores and total Mindfulness Attention Awareness Scale (MAAS) scores indicated a weak non-significant correlation (

Topics: Adult; Cross-Sectional Studies; Humans; Malaysia; Mindfulness; Obesity; Overweight; Psychometrics; Reproducibility of Results; Surveys and Questionnaires

Non-communicable diseases (NCDs) are an increasing problem worldwide, including in Malaysia. National surveys have been performed by the government but had poor coverage in east Malaysia, particularly in rural regions. This study aimed to describe the achievement of target therapeutic outcomes in the control of diabetes mellitus (DM), hypertension (HPT), and dyslipidemia (DLP) among diabetic patients in rural east Malaysia. A cross-sectional study was conducted among DM patients who visited the NCDs clinic in Lundu Hospital, Sarawak, Malaysia, from Jan to March 2016. In total, 214 patients (male, 37.9%; female, 62.1%) were recruited using a systemic sampling method. Multiple logistic regression models were applied to estimate the adjusted odds ratio (AOR) and confidence interval (CI) for the target therapeutic achievement in the control of DM, HPT, and DLP. Compared to the national average, therapeutic target achievement in Lundu was higher for DM (43.0% vs. 23.8%), equal for DLP (35.8% vs. 37.8%) but lower for HPT (30.9% vs. 47.9%). DM patients who had at least yearly HbA1c monitoring (AOR 2.30, 95% CI 1.04-5.06, P = 0.039), and those 58.7 years or older (AOR 2.50, 95% CI 1.32-4.74, P = 0.005) were more likely to achieve the therapeutic target for DM. Health promotion and public education regarding HPT needs to be emphasized in rural Malaysia. HbA1c monitoring at least once a year was one of the important factors associated with achieving DM control in rural east Malaysia. Accessibility to HbA1c tests and monitoring should be ensured for diabetic patients.

Topics: Adult; Aged; Aged, 80 and over; Cross-Sectional Studies; Diabetes Complications; Diabetes Mellitus; Dyslipidemias; Female; Glycated Hemoglobin; Humans; Hypertension; Logistic Models; Malaysia; Male; Middle Aged; Noncommunicable Diseases; Obesity; Policy; Risk Factors; Rural Population; Treatment Outcome

The rise in obesity has fuelled the current debate of its classification as a disease. Contrary to just being a medical condition or a risk factor for other diseases, obesity is a complex disease with multifaceted aetiology as well as its own disabling capacities, pathophysiology, and comorbidities. The problem of obesity in Malaysia is serious and calls for active intervention by all stakeholders ranging from government agencies to insurers and healthcare providers. To aid efforts to curb obesity, this consensus statement for bariatric surgery provides a basis for inclusion and exclusion criteria as well as the types of procedures accepted as the norm in Malaysia. This consensus statement was initiated by the Society of Endoscopic and Laparoscopic Surgeons of Malaysia and was collaborated with representatives from the Ministry of Health Malaysia.

Topics: Bariatric Surgery; Consensus; Humans; Laparoscopy; Malaysia; Obesity

The global epidemic of overweight and obesity presents a major challenge in the health status of the society. Their prevalence is at an alarming rate worldwide due to poor compliance with conventional treatment and high rates of relapse, thus increasing demand for an effective and safe alternative approach such as hypnotherapy. This study aimed to evaluate the feasibility and acceptability of hypnotherapy for weight loss and to compare these among selected socio-demographics.. A cross-sectional study was conducted among 30 students and staff of a public university in Terengganu, Malaysia using convenience sampling. Data analysis was carried out using SPSS 23.0.. Among the respondents (age = 26.17 ± 8.23 years; female = 66.7%; students = 63.3%), 40.0% were overweight and 60.0% were obese. Results indicated excellent feasibility as determined by participants' satisfaction towards the clarity of hypnotherapist's voice (93.3%), the suitability of content (86.7%) and time spent for the session (90.0%). Good overall acceptability (>60.0%) was also reported regarding hypnotherapist professionalism, the environment and perceived usefulness of hypnotherapy. Obese individuals were significantly more satisfied towards the hypnotherapist environment than overweight respondents (p=0.015). Additionally, no adverse effects were reported after the intervention.. This evidence signalled that hypnotherapy is a promising alternative tool in assisting overweight and obese individuals to lose weight. Extensive research is needed to substantiate its role in weight management programs for its full benefits.

Topics: Adolescent; Adult; Cross-Sectional Studies; Feasibility Studies; Female; Humans; Hypnosis; Malaysia; Obesity; Overweight; Universities; Young Adult

Obesity among health-care workers (HCWs) is an important issue as it can affect both their health condition and their professional capability. Although adult obesity is attributable to occupational factors, few reports are available on Malaysian health-care workers' obesity and whether different health-care job categories are related to workers' obesity. This study aimed to determine the prevalence of obesity among HCWs and the association between various HCW job categories and obesity. A cross-sectional study was conducted by analyzing secondary data from the 2019 annual cardiovascular health screening program, which included information regarding all government health-care workers in the east coast region of Peninsular Malaysia. The subject's body mass index (BMI) was categorized according to WHO criteria. Only 43% of the subjects had a normal BMI, while 33.1% were categorized as overweight, and 21.1% were obese. Different HCWs' job categories were shown to be significantly associated with their obesity status, with nurses apparently having a higher risk of being obese (Adj OR = 1.91, 95% CI 1.45, 2.53,

Topics: Adult; Cross-Sectional Studies; Health Personnel; Humans; Malaysia; Obesity; Occupations; Overweight

Obesity is a rising concern globally. This study investigated the prevalence and factors associated with obesity and abdominal obesity (AO) among 5613 Malaysians aged 40 years and older via computer-assisted personal interviewing and anthropometric measurements. Obesity and AO prevalence were 37.8% and 63.1%, respectively. Significant associations were observed between: obesity with higher risk in patients aged between 40 and 49 years, Indians, females, income ≥RM 2000, and health status, and AO with higher risk in patients aged between 50 and 59 years, Indians, females, never married, income ≥RM 2000, and vigorous physical activity. Hence, age, sex, income, and ethnicity are associated with both obesity and AO. Promoting healthy body mass index and waist circumference is essential for healthy ageing.

Topics: Adult; Female; Humans; Malaysia; Male; Middle Aged; Obesity; Obesity, Abdominal; Prevalence; Risk Factors; Socioeconomic Factors

To investigate the association between dietary patterns (DP) and overweight risk in the Malaysian Adult Nutrition Surveys (MANS) of 2003 and 2014.. DP were derived from the MANS FFQ using principal component analysis. The cross-sectional association of the derived DP with prevalence of overweight was analysed.. Malaysia.. Nationally representative sample of Malaysian adults from MANS (2003, n 6928; 2014, n 3000).. Three major DP were identified for both years. These were 'Traditional' (fish, eggs, local cakes), 'Western' (fast foods, meat, carbonated beverages) and 'Mixed' (ready-to-eat cereals, bread, vegetables). A fourth DP was generated in 2003, 'Flatbread & Beverages' (flatbread, creamer, malted beverages), and 2014, 'Noodles & Meat' (noodles, meat, eggs). These DP accounted for 25·6 and 26·6 % of DP variations in 2003 and 2014, respectively. For both years, Traditional DP was significantly associated with rural households, lower income, men and Malay ethnicity, while Western DP was associated with younger age and higher income. Mixed DP was positively associated with women and higher income. None of the DP showed positive association with overweight risk, except for reduced adjusted odds of overweight with adherence to Traditional DP in 2003.. Overweight could not be attributed to adherence to a single dietary pattern among Malaysian adults. This may be due to the constantly morphing dietary landscape in Malaysia, especially in urban areas, given the ease of availability and relative affordability of multi-ethnic and international foods. Timely surveys are recommended to monitor implications of these changes.

Topics: Adolescent; Adult; Body Mass Index; Carbonated Beverages; Cross-Sectional Studies; Diet; Diet, Western; Feeding Behavior; Female; Humans; Income; Malaysia; Male; Meat; Middle Aged; Nutrition Surveys; Obesity; Overweight; Risk Factors; Rural Population; Vegetables; Young Adult

The development of a second version of the Yale Food Addiction Scale (YFAS) coincides with the latest updates in the diagnosis of addiction as documented in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders. The objective of the present study was to translate the YFAS 2.0 into the Malay language and test its psychometric properties in a primary-care population.. Patients were assessed for food addiction utilizing the Malay YFAS 2.0. The participants were also assessed for eating disorder using the validated Malay Binge Eating Scale. The psychometric properties of the YFAS 2.0 were determined by analysing factor structure, overall item statistics, internal consistency and construct validity.. Between 2017 and 2018, participants were chosen from a regional primary-care clinic in the district of Seremban, Malaysia.. Patients (n 382) from a regional primary-care clinic.. The prevalence of food addiction was 5·0%. A two-factor structure of the YFAS was confirmed as the most optimal solution for the scale via confirmatory factor analysis. In both its diagnostic and symptom count version, the YFAS 2.0 had good internal consistency (Kuder-Richardson α > 0·80 and McDonald's ω > 0·9).. We validated a psychometrically sound Malay version of the YFAS 2.0 in a primary-care population. Both diagnostic and symptom count versions of the scale had robust psychometric properties. The questionnaire can be used to develop health promotion strategies to detect food addiction tendencies in a general population.

Topics: Adult; Diagnostic and Statistical Manual of Mental Disorders; Factor Analysis, Statistical; Feeding and Eating Disorders; Feeding Behavior; Female; Food Addiction; Humans; Language; Malaysia; Male; Middle Aged; Obesity; Prevalence; Psychiatric Status Rating Scales; Psychometrics; Reproducibility of Results; Surveys and Questionnaires; Translating; Translations

To examine the possible gene-environment interactions between 32 single nucleotide polymorphisms and environmental factors that could modify the probability of chronic kidney disease.. A case-control study was conducted involving 600 people with type 2 diabetes (300 chronic kidney disease cases, 300 controls) who participated in The Malaysian Cohort project. Retrospective subanalysis was performed on the chronic kidney disease cases to assess chronic kidney disease progression from the recruitment phase. We genotyped 32 single nucleotide polymorphisms using mass spectrometry. The probability of chronic kidney disease and predicted rate of newly detected chronic kidney disease progression were estimated from the significant gene-environment interaction analyses.. Four single nucleotide polymorphisms (eNOS rs2070744, PPARGC1A rs8192678, KCNQ1 rs2237895 and KCNQ1 rs2283228) and five environmental factors (age, sex, smoking, waist circumference and HDL) were significantly associated with chronic kidney disease. Gene-environment interaction analyses revealed significant probabilities of chronic kidney disease for sex (PPARGC1A rs8192678), smoking (eNOS rs2070744, PPARGC1A rs8192678 and KCNQ1 rs2237895), waist circumference (eNOS rs2070744, PPARGC1A rs8192678, KCNQ1 rs2237895 and KCNQ1 rs2283228) and HDL (eNOS rs2070744 and PPARGC1A rs8192678). Subanalysis indicated that the rate of newly detected chronic kidney disease progression was 133 cases per 1000 person-years (95% CI: 115, 153), with a mean follow-up period of 4.78 (SD 0.73) years. There was a significant predicted rate of newly detected chronic kidney disease progression in gene-environment interactions between KCNQ1 rs2283228 and two environmental factors (sex and BMI).. Our findings suggest that the gene-environment interactions of eNOS rs2070744, PPARGC1A rs8192678, KCNQ1 rs2237895 and KCNQ1 rs2283228 with specific environmental factors could modify the probability for chronic kidney disease.

Topics: Age Factors; Case-Control Studies; Diabetes Mellitus, Type 2; Diabetic Nephropathies; Female; Gene-Environment Interaction; Humans; KCNQ1 Potassium Channel; Lipoproteins, HDL; Malaysia; Male; Middle Aged; Nitric Oxide Synthase Type III; Obesity; Peroxisome Proliferator-Activated Receptor Gamma Coactivator 1-alpha; Polymorphism, Single Nucleotide; Renal Insufficiency, Chronic; Sex Factors; Smoking; Waist Circumference

In spite of the high prevalence of overweight and obesity among the Orang Asli (OA) of Malaysia being an increasing concern due to the associated adverse health implications, information regarding this issue is scarce. This cross-sectional study is aimed to investigate the predictors of overweight and obesity and its association with blood pressure and quality of life among Senoi OA women. A total of 19 villages at Batang Padang, Perak, were selected out of a total of 56 villages using a simple random sampling, in which 355 Senoi OA women were participated in the study. Face-to-face interviews were conducted to obtain information on sociodemographic characteristics, dietary intake, physical activity, and quality of life. Weight, height and blood pressure were also measured. The prevalence of overweight and obesity were 32.4% and 26.2%, respectively. In terms of multiple linear regression, monthly household income, total energy intake, and metabolic equivalents (METs) for domestic activities were found to have significantly contributed to body mass index (BMI). Furthermore, BMI contributed significantly towards levels of blood pressure and quality of life after controlling for monthly household income, total energy intake, and METs for domestic activities. In conclusion, there should be urgent attention to poverty and overweight/obesity among the OA women. The findings would aid in alerting policy makers and health professionals as underweight is no longer a sole nutritional problem among OA but it appears to be coexisting with overweight and obesity. Strategies for improving their socioeconomic status, promoting a balanced and moderate diet, and encouraging involvement of OA women in physical activities should be implemented to prevent overweight and obesity.

Topics: Adult; Blood Pressure; Body Mass Index; Child; Cross-Sectional Studies; Female; Humans; Indigenous Peoples; Malaysia; Middle Aged; Obesity; Overweight; Quality of Life; Socioeconomic Factors; Young Adult

Low vitamin D status, adiposity, and at-risk lipid profile are associated with adverse health consequences. This study aimed to assess serum 25(OH)D concentration of Indigenous (Orang Asli) adults and to determine the associations between serum 25(OH)D with adiposity and lipid profile, respectively.. This cross-sectional study was conducted among 555 (164 men, 391 women) Orang Asli adults aged 18-65 years of Jah Hut sub-tribe in Krau Wildlife Reserve (KWR), Peninsular Malaysia. Demographic and socio-economic information were obtained using interviewer-administered questionnaire. Participants were also assessed for serum 25-hydroxyvitamin D (25(OH)D) concentration, adiposity indices (BMI, WC, WHtR, WHR, %BF) and lipid parameters (TC, LDL-C, HDL-C, TG). Data were analyzed using binary logistic regression via SPSS.. While suboptimal vitamin D status was relatively low in Orang Asli adults, the prevalence of obesity and undesirable serum lipids were relatively high. The sex-specific associations between vitamin D status with adiposity indices and serum lipids warrant further investigation.

Topics: Adiposity; Adolescent; Adult; Aged; Cross-Sectional Studies; Female; Humans; Lipids; Malaysia; Male; Middle Aged; Obesity; Prevalence; Vitamin D; Vitamin D Deficiency; Young Adult

Topics: Adolescent; Adult; Child; Child, Preschool; Cross-Sectional Studies; Female; Humans; Income; Malaysia; Male; Middle Aged; Obesity; Overweight; Poverty; Thinness; Young Adult

To understand the extent to which risk factors for insulin resistance are mediated by body mass index (BMI), visceral adipose tissue (VAT), physical activity and performance, and the inflammatory markers interleukin (IL)-6, tumor necrosis factor (TNF)- α, and high-sensitivity C-reactive protein (hs-CRP).. A wide range of socio-demographic characteristics of Chinese, Malay and Indian women attending routine gynecologic care in Singapore were prospectively collected. Physical performance was objectively measured by hand grip strength and the Short Physical Performance Battery. Percent VAT was determined by dual-energy X-ray absorptiometry. Fasting serum concentrations of glucose, insulin, IL-6, TNF- α, and hs-CRP were measured.. was insulin resistance, expressed as the homeostatic model assessment of insulin resistance (HOMA-IR).. 1159 women were analyzed, mean age 56.3 (range 45-69) years, comprising women of Chinese (84.0%), Indian (10.2%), and Malay (5.7%) ethnic origins. The adjusted mean differences for obesity (0.66, 95% CI 0.32-1.00), VAT area in the highest vs lowest tertile (1.03, 95% CI 0.73-1.34), low physical performance (0.63, 95% CI 0.05-1.24), and highest vs lowest tertile of TNF- α (0.35, 95% CI 0.13-0.57) were independently associated with HOMA-IR. Women of Malay and Indian ethnicity had higher crude HOMA-IR than Chinese women. However, after adjustment for obesity, VAT, physical performance, and TNF- α, no differences in mean HOMA-IR remained, when comparing Chinese women with those of Malay ethnicity (0.27, 95% CI -0.12 to 0.66) and with those of Indian ethnicity (0.30, 95% CI -0.01 to 0.66).. Insulin resistance was independently associated with obesity, high VAT, low physical performance, and high levels of TNF- α in midlife Singaporean women. These variables entirely explained the significant differences in insulin resistance between women of Chinese, Malay and Indian ethnicity.

Topics: Aged; Biomarkers; Blood Glucose; Body Mass Index; C-Reactive Protein; China; Exercise; Female; Hand Strength; Humans; India; Insulin; Insulin Resistance; Interleukin-6; Intra-Abdominal Fat; Malaysia; Middle Aged; Obesity; Physical Functional Performance; Risk Factors; Singapore; Tumor Necrosis Factor-alpha

To examine the gestational weight gain (GWG) trajectory and its possible association with pregnancy outcomes.. GWG trajectories were identified using the latent class growth model. Binary logistic regression was performed to examine the associations between adverse pregnancy outcomes and these trajectories.. Negeri Sembilan, Malaysia.. Two thousand one hundred ninety-three pregnant women.. Three GWG trajectories were identified: 'Group 1 - slow initial GWG but followed by drastic GWG', 'Group 2 - maintaining rate of GWG at 0·58 kg/week' and 'Group 3 - maintaining rate of GWG at 0·38 kg/week'. Group 1 had higher risk of postpartum weight retention (PWR) (adjusted OR (AOR) 1·02, 95 % CI 1·01, 1·04), caesarean delivery (AOR 1·03, 95 % CI 1·01, 1·04) and having low birth weight (AOR 1·04, 95 % CI 1·02, 1·05) compared with group 3. Group 2 was at higher risk of PWR (AOR 1·18, 95 % CI 1·16, 1·21), preterm delivery (AOR 1·03, 95 % CI 1·01, 1·05) and caesarean delivery (AOR 1·02, 95 % CI 1·01, 1·03), but at lower risk of having small-for-gestational-age infants (AOR 0·97, 95 % CI 0·96, 0·99) compared with group 3. The significant associations between group 1 and PWR were observed among non-overweight/obese women; between group 1 and caesarean delivery among overweight/obese women; group 2 with preterm delivery and caesarean delivery were only found among overweight/obese women.. Higher GWG as well as increasing GWG trajectories was associated with higher risk of adverse pregnancy outcomes. Promoting GWG within the recommended range should be emphasised in antenatal care to prevent the risk of adverse pregnancy outcomes.

Topics: Adult; Body-Weight Trajectory; Cesarean Section; Female; Gestational Weight Gain; Humans; Infant, Low Birth Weight; Infant, Small for Gestational Age; Logistic Models; Malaysia; Obesity; Overweight; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Premature Birth; Prenatal Care; Retrospective Studies; Risk Factors; Weight Gain

Diabetes and obesity are established risk factors for stroke. The current study aimed to assess risk factors of ischemic stroke recurrence in diabetic patients based on their body mass index (BMI).. A total of 4005 diabetic patients who had a history of ischemic stroke were identified in a retrospective cross-sectional dataset from the Malaysian National Neurology Registry. Patients were classified based on BMI, and multivariable regression analysis was used to evaluate the association between risk factors and recurrent ischemic stroke.. Among obese patients, those with ischemic heart disease (aOR, 1.873; 95% CI, 1.131-3.103), received formal education (aOR, 2.236; 95% CI, 1.306-3.830), and received anti-diabetic medication (aOR, 1.788; 95% CI, 1.180-2.708) had a higher stroke recurrence risk, while receiving angiotensin receptors blockers (aOR, 0.261; 95% CI, 0.126-0.543) lowered the odds of recurrence. Overweight patients with hypertension (aOR, 1.011; 95% CI, 1.002-1.019) for over 10 years (aOR, 3.385; 95% CI, 1.088-10.532) and diabetes prior to the first stroke (aOR, 1.823; 95% CI, 1.020-3.259) as well as those received formal education (aOR, 2.403; 95% CI, 1.126-5.129) had higher odds of stroke recurrence, while receiving angiotensin-converting enzyme inhibitors (aOR, 0.244; 95% CI, 0.111-0.538) lowered the recurrence risk. Normal weight East Malaysians (aOR, 0.351; 95% CI, 0.164-0.750) receiving beta-blockers (aOR, 0.410; 95% CI, 0.174-0.966) had lower odds of stroke recurrence.. Ischemic heart disease, hypertension, receiving anti-hypertensive agents, and educational level were independent predictors of recurrent stroke in obese patients. Managing the modifiable risk factors can decrease the odds of stroke recurrence.

Topics: Antihypertensive Agents; Body Mass Index; Brain Ischemia; Diabetes Mellitus, Type 2; Educational Status; Female; Humans; Hypertension; Incidence; Malaysia; Male; Middle Aged; Myocardial Ischemia; Obesity; Recurrence; Registries; Retrospective Studies; Risk Assessment; Risk Factors; Stroke; Time Factors

Obesity is a crucial public health problem and is rising globally. This study was conducted to determine the prevalence of obesity and its associated factors among the elderly in Malaysia.. Data were obtained from the National Health and Morbidity Survey (NHMS) 2015. This was a cross sectional population-based study using a two stage stratified random sampling design. Elderly population aged 60 years and above was selected. Data were collected using pre-tested self-administered questionnaire in the form of sociodemographic profile, non-communicable diseases (NCD) comorbidities (status on hypertension, diabetes and hypercholesterolemia) and NCD risk factors (current smoker and physical activity). Obesity has been defined using the World Health Organization (WHO) Body Mass Index (BMI) guideline, 1998. A complex sampling design analysis was used for the descriptive statistics. The associated risk factors for obesity were identified using Multiple Logistic Regression analysis.. A total of 3794 respondents were included in this study. The prevalence of obesity among Malaysian elderly was 30.2%. The prevalence of obesity among the elderly was significantly higher in females, respondents from urban areas and Indians. Approximately one third of the elderly with non-communicable diseases such as hypertension (33.1%) and diabetes (38.8%), respectively, were obese. Among elderly who were obese, majority of them (89.8%) had at least one NCD. The prevalence of obesity was 16.8% among current smokers (aOR 0.59). Multiple logistic regression analysis revealed that elderly females (aOR [adjusted odds ratio] 1.52), having secondary education (aOR 1.96) with household income of RM 3000 and above (aOR 1.57) as well as being hypertensive (aOR 1.61) and diabetic (aOR 1.50) were more likely to be obese. In contrast, the Chinese elderly respondents (aOR 0.62) and current smokers (aOR 0.59) were less likely to be obese. There were no significant associations of obesity with hypercholesterolemia or with physical activity.. A substantial proportion of Malaysian elderly were obese, and factors associated with obesity among them were being female, having secondary education with a household income of RM 3000 and above and being hypertensive or diabetic. Enhanced health promotion and education should be targeted at younger people in order to prevent obesity in the later years.

Topics: Aged; Female; Health Surveys; Humans; Logistic Models; Malaysia; Male; Morbidity; Obesity; Prevalence; Risk Factors

Our study aimed to compare the ability of anthropometric obesity indices to predict MetS and to determine the sex-specific optimal cut-off values for MetS among Malaysian vegetarians. Body weight, height, waist circumference (WC), blood pressure (BP), fasting venous blood sample were collected from 273 vegetarians in Selangor and Kuala Lumpur, Malaysia. The abilities of body mass index (BMI), body fat percentage (BF%), waist to height ratio (WHtR), lipid accumulation product (LAP), visceral adiposity index (VAI), a body shape index (ABSI), and body roundness index (BRI) to identify MetS were tested using receiver operating characteristic (ROC) curve analyses. MetS was defined according to the Joint Interim Statement 2009. The ROC curve analyses show that BMI, BF%, WHtR, LAP and VAI were able to discriminate MetS in both sexes. LAP was a better predictor to predict MetS, followed by WHtR for male and female vegetarians. The suggested WHtR's optimal cut-offs and LAP's optimal cut-offs for MetS for male and female vegetarians were 0.541, 0.532, 41.435 and 21.743, respectively. In conclusion, LAP was a better predictor to predict MetS than other anthropometric obesity indices. However, WHtR could be an alternative obesity index in large epidemiology survey due to its convenient and cost-effective characteristics.

Topics: Adiposity; Adult; Aged; Anthropometry; Area Under Curve; Blood Pressure; Body Composition; Body Mass Index; Female; Humans; Lipid Accumulation Product; Malaysia; Male; Metabolic Syndrome; Middle Aged; Obesity; Risk Factors; ROC Curve; Vegetarians; Waist Circumference; Waist-Height Ratio

To address limited food frequency questionnaire (FFQ) capacity in public health monitoring in Malaysia, we aimed to develop a semi-quantitative FFQ for an adult multiethnic population for comprehensive fatty acid (FA) profiling inclusive of saturated (SFA), monounsaturated (MUFA), polyunsaturated fatty acids (PUFA), PUFA:SFA ratio, trans fatty acids, omega-3 and omega-6 FAs. A 240-food itemed FFQ used diet records (DR) of Malaysia Lipid Study (MLS) participants and fatty acid composition database from laboratory analyzed foods. The developed MLS-FFQ underwent face and content validation before relative validation in a free-living population (

Topics: Adult; Aged; Diet Surveys; Dietary Fats; Fatty Acids; Feeding Behavior; Female; Humans; Malaysia; Male; Middle Aged; Nutrients; Obesity; Reproducibility of Results; Young Adult

Cardiometabolic risk (CMR) is a cluster of risk factors that may predict the occurrence of cardiovascular diseases and diabetes mellitus. This study investigated the association between CMR with body mass index (BMI) among obese adults. The CMRs, including waist circumference, systolic and diastolic blood pressure, blood glucose, total cholesterol, low-density and high-density lipoprotein, triglyceride, and high-sensitivity C-reactive protein (hs-CRP) level, were quantified in 82 obese adults. The findings indicate the highest correlation coefficient value ( r) was .618 between BMI and waist circumference; a weak correlation between mass index and systolic ( r = .276) and diastolic ( r = .311) blood pressure and hs-CRP ( r = .384); and a very weak correlation between BMI level and fasting blood glucose ( r = .069), total cholesterol ( r = .014), low-density lipoprotein (.013), high-density lipoprotein (-.154), and triglyceride (.173). Future strategies for CMR reduction among obese adults should focus on waist circumference and hs-CRP level.

Topics: Adult; Blood Pressure; Body Mass Index; Cardiovascular Diseases; Cross-Sectional Studies; Diabetes Mellitus; Female; Humans; Malaysia; Male; Obesity; Risk Factors; Waist Circumference

Considering the double burden of malnutrition in Malaysia, data on malnourished children living in welfare homes are limited. This study aimed to determine the body weight status of children living in welfare homes and its associated factors. A total of 307 children aged 7⁻17 years old living in 15 selected welfare homes completed a standardized questionnaire, and their body weight and height were measured by trained researchers. There were 54.4% orphans, 23.8% abandoned children, and 21.8% children from problematic families. There were 51.5% boys and 48.5% girls; 52.4% were Malays, followed by 31.3% Indians, 12.7% Chinese, and 3.6% from other ethnic groups. The prevalence of overweight and obesity (23.1%) was higher than the prevalence of thinness (8.5%). In bivariate analyses, socio-demographic factors of age (

Topics: Adolescent; Body Image; Body Mass Index; Child; Cross-Sectional Studies; Ethnicity; Female; Humans; Malaysia; Male; Obesity; Overweight; Poverty; Prevalence; Socioeconomic Factors; Thinness

In obesity modelling studies, researchers have been seeking to identify the effective indicators of obesity by using appropriate statistical or mathematical techniques. The main objective of the present study is addressed in three stages. First, a new framework for modelling obesity in university students is introduced. The second stage involves data analysis based on Bayesian Structural Equation Modelling (BSEM) for estimating the Body Mass Index (BMI) (representative of the obesity level) of students at three university levels: Bachelor, Master and PhD. In the third stage, the highest significant correlation is determined between the BMI and other variables in the research model that were found significant through the second phase. The data for this study were collected from students at selected Malaysian universities. The results indicate that unhealthy food intake (fast food and soft drinks), social media use and stress exhibit the highest weightage contributing to overweight and obesity issues for Malaysian university students.

Topics: Adult; Bayes Theorem; Body Mass Index; Carbonated Beverages; Cross-Sectional Studies; Diet; Fast Foods; Female; Humans; Latent Class Analysis; Malaysia; Male; Obesity; Overweight; Social Media; Stress, Psychological; Students; Surveys and Questionnaires; Universities; Young Adult

The prevalence of overweight and obesity is increasing at an alarming rate. It is a major factor for many other metabolic disorders. This study aimed to determine the prevalence of increase body mass index (BMI) and obesity and their associated demographic characteristics among adults in an urban area.. A retrospective study was conducted where data was extracted from the Health Status Screening Form (BSSK) at health clinics in Johor Bahru. Using the World Health Organization (WHO), criteria for obesity, BMI≥30.0 kg/m2 was specified as obese and combination of both BMI ranges for overweight (25.0-30.0kg/m2) and obesity (≥30.0kg/m2) as elevated BMI.. The overall prevalence of elevated BMI and obesity was 54.6% and 20.1% respectively. Men had a higher prevalence of elevated BMI (57.4%) with odds of 1.28 higher (95%CI: 1.04-1.58). High prevalence of elevated BMI and obesity were seen among the Indians (elevated BMI - 60.2%, obesity - 19.4%) followed by Malays (elevated BMI -57.8%, obesity - 23.1%) and Chinese showed the lowest (elevated BMI - 39.0%, obesity - 8.8%). The odds of elevated BMI and obesity were lower among younger adults as compared to older adults (≥30 years old).. Using WHO criteria, about one in two adults had elevated BMI while one in five were obese. Elevated BMI and obesity disparities were evident in age and ethnicity, but sex differences were encountered in elevated BMI group.

Topics: Adult; Body Mass Index; Educational Status; Female; Humans; Malaysia; Male; Marital Status; Middle Aged; Obesity; Overweight; Prevalence; Retrospective Studies; Risk Factors; Urban Population; Young Adult

An optimal gestational weight gain is essential for maternal health and to reduce adverse birth outcomes. Current guidelines to monitor gestational weight gain are based on pre-pregnancy body mass index (BMI). However, middle-upper arm circumference (MUAC) is increasingly used as an alternative nutritional status measure for pregnant women. Hence, this study aimed to determine associations of MUAC and pre-pregnancy BMI with gestational weight gain rate among Malaysian pregnant women.. A cross-sectional study was conducted among 444 pregnant women (≥20 weeks gestation).. Women completed questionnaires on sociodemographic data, maternal characteristics and pre-pregnancy weight. Height, current weight and MUAC were measured at study visit (from 1st February 2016 to 31st January 2017).. About a third (34.24%) of pregnant women were overweight or obese prior to pregnancy. MUAC was inversely associated with an inadequate rate of gestational weight gain (OR = 0.77; 95% CI: 0.68, 0.87) as compared to normal gestational weight gain. In contrast, a higher MUAC was associated with a higher odds ratio (OR = 1.28; 95% CI: 1.11, 1.49) of having excessive rate of gestational weight. No associations were found for pre-pregnancy BMI categories for gestational weight gain rate.. Our findings revealed that women with low MUAC were more likely to have an inadequate gestational weight gain rate during pregnancy whereas higher MUAC was associated with an excessive gestational weight gain rate. MUAC may be a useful indicator of nutritional status associated with GWG. Routine measurement of MUAC in pregnant women may help health professionals, particularly in middle-income countries, to counsel women about gestational weight gain.

Topics: Adult; Arm; Body Mass Index; Cross-Sectional Studies; Female; Gestational Weight Gain; Humans; Malaysia; Nutritional Status; Obesity; Pregnancy; Surveys and Questionnaires; Young Adult

For the past decades, Malaysia has seen an increased prevalence of overweight and obesity which leads to significant health threats. Physical activity is beneficial in maintaining healthy body weight. The objective of this study was to measure physical activity of adults in Malaysia using objective measurement (accelerometer) and self-reported methods, as well as to determine their associations with (body mass index (BMI) and waist circumference (WC) measurements.. Four-hundred and ninety Malaysian adults (n = 490) aged 20 to 65 years old participated in this cross-sectional study. Their body weight, height, and WC measurements were measured according to standard procedures. Physical activity was assessed objectively with accelerometers for five to seven consecutive days. The International Physical Activity Questionnaire (IPAQ) was used to estimate the amount of time spent on various domains of physical activity. Mixed models were used to determine the associations between physical activity variables and both BMI and WC.. The mean value of objectively measured moderate-to-vigorous physical activity (MVPA) was 13.5 min per day, in which male participants recorded a significantly higher amount of time compared to females. On the other hand, the mean self-reported total physical activity was 380 min per week; male participants reported a significantly higher amount of time on physical activity in the occupation/work and leisure/recreation domains while female participants spent significantly more time in the domestic/household chores domain. We also observed that the mean values of objectively measured total MVPA, self-reported time spent on walking for leisure/recreation, and total time amount of time spent on MVPA for leisure/recreation were significantly higher among participants with BMI of less than 25 kg/m. Objectively measured MVPA was inversely associated with BMI, but not WC measurement. No significant association was observed between self-reported total physical activity and physical activity time measures across domains with both BMI and WC measurement.

Topics: Accelerometry; Adult; Aged; Body Mass Index; Body Weight; Cross-Sectional Studies; Exercise; Female; Humans; Leisure Activities; Malaysia; Male; Middle Aged; Obesity; Overweight; Prevalence; Self Report; Waist Circumference; Walking; Young Adult

Poor oral health has an impact on food choices and intake of important nutrients among older population. The use of oral health-related quality of life instruments along with the clinical dental indicators can help to assess the oral problems that lead to nutritional problems in this group. This study aims to determine the association between oral health-related quality of life (OHRQoL) and nutritional status among a group of older adults in Kuala Pilah district, Malaysia.. A cross-sectional study was carried out on 446 older adults aged 50 years and above from 20 randomly selected villages. Respondents were interviewed to collect information on their demographic characteristics and oral health perception, followed by physical examination to measure height, weight and body mass index (BMI) of respondents. The validated Malay version of General Oral Health Assessment Index (GOHAI) was used to measure OHRQoL.. About one-third (35.8%) of the respondents had normal BMI. Majority of the respondents were overweight (40.4%) and obese (19.9%), while only a small proportion was underweight (3.9%). Mean GOHAI score was 53.3 (SD = 4.7), indicating low perception of oral health. About 81.6% respondents had moderate to low perception of oral health. Logistic regression analysis showed a statistically significant association between the GOHAI and BMI scores (OR = 2.3; p < 0.01).. Oral health-related quality of life was significantly associated with nutritional condition of respondents. Older adults with poor perception of their oral health were more likely to have unsatisfactory BMI compared to those who perceived their oral health to be good.

Topics: Aged; Body Mass Index; Cross-Sectional Studies; Dental Health Surveys; Female; Geriatric Assessment; Humans; Logistic Models; Malaysia; Male; Middle Aged; Nutritional Status; Obesity; Oral Health; Quality of Life; Thinness

This study was designed to determine the influence of bariatric surgery on changes in the body mass index (BMI), and the control of diabetes, hypertension and dyslipidaemia among obese patients in Malaysia.. This was a retrospective cohort study undertaken at a public tertiary care centre in the state of Perak, Malaysia. Information of obese patients who underwent bariatric surgery was obtained from their medical records. The changes in the BMI, HbA1C, systolic and diastolic blood pressure (SBP and DBP), and lipid levels between three months before and after the surgery were assessed.. The patients (n=106) were mostly Malay (66.0%), had at least one comorbidity (61.3%), and had a mean age of 40.38±11.75 years. Following surgery, the BMI of the patients was found to reduce by 9.78±5.82kg/m2. For the patients who had diabetes (n=24) and hypertension (n=47), their mean HbA1C, SBP and DBP were also shown to reduce significantly by 2.02±2.13%, 17.19±16.97mmHg, and 11.45±12.63mmHg, respectively. Meanwhile, the mean total cholesterol, triglyceride and low-density lipoprotein levels of those who had dyslipidaemia (n=21) were, respectively, lowered by 0.91±1.18mmol/L, 0.69±1.11mmol/L and 0.47±0.52mmol/L.. The findings suggest that in addition to weight reduction, bariatric surgery is helpful in improving the diabetes, hypertension and dyslipidaemia control among obese patients. However, a large-scale trial with a control group is required to verify our findings.

Topics: Adult; Bariatric Surgery; Body Mass Index; Chronic Disease; Diabetes Mellitus; Dyslipidemias; Female; Humans; Hypertension; Malaysia; Male; Middle Aged; Obesity; Retrospective Studies; Treatment Outcome; Weight Loss

Lifestyle factors, such as diet, body weight, and physical activity, are linked to better survival after breast cancer (BC) diagnosis. A high percentage of the Malaysian population is overweight or obese. In addition, studies have shown a disparity in survival among Malaysian women compared with other higher-income countries. The Malaysian Breast Cancer Survivorship Cohort (MyBCC) study aims to study lifestyle factors that affect survival in BC survivors. These are the preliminary findings on the nutritional status of Malaysian BC survivors.. Our aim was to evaluate the nutritional status of BC survivors at 1 year after diagnosis.. This was a cross-sectional study of 194 participants from the MyBCC study, recruited within 1 year of their diagnosis. Participants completed a 3-day food diary.. Malaysian women (aged 18 years and older) who were newly diagnosed with primary BC, managed at the University Malaya Medical Center, and able to converse either in Malay, English, or Mandarin were included.. Dietary intake and prevalence of overweight or obesity among participants 1 year after diagnosis were measured.. Student's t test and analysis of variance or its equivalent nonparametric test were used for association in continuous variables.. About 66% (n=129) of participants were overweight or obese and >45% (n=86) had high body fat percentage 1 year after diagnosis. The participants' diets were low in fiber (median=8.7 g/day; interquartile range=7.2 g/day) and calcium (median=458 mg/day; interquartile range=252 mg/day). Ethnicity and educational attainment contributed to the differences in dietary intake among participants. Higher saturated fat and lower fiber intake were observed among Malay participants compared with other ethnic groups.. Overweight and obesity were highly prevalent among BC survivors and suboptimal dietary intake was observed. Provision of an individualized medical nutrition therapy by a qualified dietitian is crucial as part of comprehensive BC survivorship care.

Topics: Adolescent; Adult; Breast Neoplasms; Cancer Survivors; Cohort Studies; Cross-Sectional Studies; Diet; Diet Records; Diet Surveys; Female; Humans; Life Style; Malaysia; Middle Aged; Nutritional Status; Obesity; Overweight; Prevalence; Young Adult

There is increasing evidence to suggest that work-family conflict is implicated in poor eating patterns. Yet, the underlying mechanism remains unexplored. The objectives of the present study were to demonstrate the interplay between work-family conflict, eating style, and unhealthy eating, and to test whether body mass index (BMI) and its interactions further explicate the relationships. In this study, 586 Malaysian adults (normal weight n = 437, overweight n = 149) completed a questionnaire, which included demographic variables, work-family scales, eating style measures, namely, restrained, emotional or external eating and reported food intake. As hypothesized, results showed that family-to-work conflict (FWC), emotional eating and external eating were positively related to unhealthy food consumption. In addition, emotional eating was found to moderate the impact of FCW on eating. These findings are consistent with research that has revealed emotional eating can indeed increase the positive association between stress such as conflict and unhealthy food choices. However, we found no clear support for the interactive effects of BMI. Our research builds on the findings of existing research as it demonstrates the role of eating style in explaining the association between work-family conflict and unhealthy eating. This conclusion has potential implications for appropriate interventions and calls for the enhancement of various policies to tackle obesity and other health problems.

Topics: Adult; Body Mass Index; Choice Behavior; Cross-Sectional Studies; Diet, Healthy; Eating; Emotions; Female; Food Preferences; Health Behavior; Humans; Life Style; Malaysia; Male; Middle Aged; Obesity; Overweight; Prevalence; Surveys and Questionnaires; Work-Life Balance; Young Adult

The investigation of risk factors of cardiovascular disease (e.g., major endocrine, nutritional and metabolic diseases) across job sectors is useful for targeted public health intervention. This study examined the occurrence of type 2 diabetes mellitus (T2DM), hypercholesterolemia and obesity in 21 job sectors in the general population.. A baseline cross-sectional analysis of the Malaysian Cohort was conducted, which included 105 391 adults. Multiple logistic regression analyses were conducted for these three diseases across 20 job sectors compared with the unemployed/homemaker sector.. The prevalence of T2DM, hypercholesterolemia and obesity was 16.7%, 38.8% and 33.3%, respectively. The Accommodation & Food Service Activities and Transportation & Storage sectors had significantly higher odds for T2DM (adjusted [adj.] prevalence odds ratio [POR] 1.18, p=0.007 and adj. POR 1.15, p=0.008, respectively). No job sector had significantly higher odds for hypercholesterolemia compared with the unemployed/homemaker sector. Only the Accommodation & Food Service Activities sector had significantly higher odds for obesity (adj. POR 1.17, p≤0.001).. Many job sectors were significantly associated with lower odds of having these three diseases when compared with the unemployed/homemaker sector. These differing associations between diverse job sectors and these diseases are important for public health intervention initiatives and prioritization.

Topics: Adult; Cross-Sectional Studies; Diabetes Mellitus, Type 2; Employment; Female; Humans; Hypercholesterolemia; Malaysia; Male; Middle Aged; Obesity; Occupational Health; Occupations; Risk Factors

The understanding on the roles of obesity and lifestyle behaviors in predicting executive function of adolescents has been limited. Low executive function proficiency may have adverse effects on adolescents' school academic performance. This cross-sectional study aimed to examine the relationship between BMI-for-age and multiple lifestyle behaviors (operationalized as meal consumption, physical activity, and sleep quality) with executive function (operationalized as inhibition, working memory, and cognitive flexibility) on a sample of Malaysian adolescents aged between 12 and 16 years (N = 513). Participants were recruited from two randomly selected schools in the state of Selangor in Malaysia. Using a self-administered questionnaire, parent participants provided information concerning their sociodemographic data, whereas adolescent participants provided information regarding their meal consumptions, physical activity, and sleep quality. The modified Harvard step test was used to assess adolescents' aerobic fitness, while Stroop color-word, digit span, and trail-making tests were used to assess adolescents' inhibition, working memory, and cognitive flexibility, respectively. Three separate hierarchical regression analyses were conducted for each outcome namely, inhibition, working memory, and cognitive flexibility. After adjusted for sociodemographic factors and BMI-for-age, differential predictors of inhibition and working memory were found. Habitual sleep efficiency significantly and positively predicted inhibition. Regular dinner intakes, physical activity levels, and sleep quality significantly and positively predicted working memory. Household income emerged as a consistent predictor for all executive function domains. In conclusion, an increased trend of obesity and unhealthy lifestyles among adolescents were found to be associated with poorer executive function. Regular dinner intakes, higher physical activity levels and better sleep quality predicted better executive function despite the inverse relationship between obesity and executive function. Future studies may explore how lifestyle modifications can optimize the development of executive function in adolescents as well as relieve the burden of obesity.

Topics: Adolescent; Cognition; Cross-Sectional Studies; Executive Function; Exercise; Female; Humans; Life Style; Malaysia; Male; Memory, Short-Term; Obesity; Public Health Surveillance; Socioeconomic Factors; Surveys and Questionnaires

Bariatric surgery has become a popular treatment modality for obesity in Malaysia. However, the absence of a standardized national registry has led to paucity of information pertaining to quantity and quality of bariatric surgery in Malaysia. In the absence of a national registry, a nationwide survey was conducted with the aim of establishing a fair estimate of case volume based on type of procedure and to identify the total number of surgeons performing those procedures at their respective centers from 1st January 2010 to 31st December 2016. For this purpose, a questionnaire was designed and distributed to bariatric surgeons throughout Malaysia. The data along with a brief narrative of the history and progress of bariatric surgery in Malaysia is presented in this report.

Topics: Adolescent; Adult; Aged; Bariatric Surgery; Female; Humans; Laparoscopy; Malaysia; Male; Middle Aged; Obesity; Surgeons; Surveys and Questionnaires; Young Adult

Topics: Animals; Global Warming; Gross Domestic Product; Humans; Inventions; Malaysia; Obesity; Science

The effectiveness of lifestyle intervention for weight loss on cardiometabolic risk factors among overweight and obese individuals in the community setting remains inconclusive. This study aimed to evaluate the effect of a 6-month weight loss lifestyle intervention on cardiometabolic risk factors among overweight and obese women and the sustainability of the changes in those markers at 12-month follow-up, comparing an intervention group with a control group.. A total of 243 participants from MyBFF@home were included in this study. Fasting blood samples at baseline, 6- and 12-month were assessed for fasting plasma glucose (FPG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglycerides. The effect of the intervention on cardiometabolic risk markers were investigated within and between study groups using t-test and general linear model (GLM) repeated measure ANOVA.. Results from repeated measures ANOVA showed intervention effect only in TC where significant reduction was found in the intervention group (- 0.26 mmol/L [95% CI: - 0.47 to - 0.06], p < 0.01) compared to the control group (- 0.06 mmol/L [95% CI: - 0.28 to 0.17]) at 12 months. At 6 months, TC was reduced significantly in both groups but only intervention group retained the reduction in maintenance phase while, the level increased significantly in the control group (0.22 mmol/L [95% CI: 0.06 to 0.38]). This attributed to significant increase in TC/HDL-C ratio in the control group during maintenance phase (0.32 [95% CI: 0.15 to 0.50], p < 0.001). The intervention group also showed trend of reduction in FPG at 6 months and further decreased during maintenance phase (- 0.19 mmol/L [95% CI: - 0.32 to - 0.06], p < 0.01). At 6 months HDL-C was maintained in the intervention group but reduced significantly in the control group (- 0.05 mmol/L [95% CI: - 0.10 to - 0.01], p < 0.05). No significant difference was detected in both markers when compared between groups.. In the context of low socio-economic communities, this study supports that weight loss related lifestyle modifications over a 6-month period could improve selected cardiometabolic risk factors, particularly fasting glucose, TC and HDL-C in overweight and obese women with favourable sustainability over a 12-month period.

Topics: Adult; Cardiovascular Diseases; Female; Glucose Metabolism Disorders; Healthy Lifestyle; Humans; Malaysia; Middle Aged; Obesity; Overweight; Risk Factors; Socioeconomic Factors; Weight Loss

Obesity is a risk factor for co-morbidities such as diabetes, hypertension, osteoarthritis and cardiovascular diseases. However, it is unclear if the presence of co-morbidities has any effect on the magnitude of body composition changes following weight reduction programmes. Thus, this study aimed to determine changes in body composition among obese housewives with and without co-morbidities after they participated in a weight loss intervention.. This is a follow-up study among 84 obese housewives without co-morbidities aged 18 to 59 years old who previously participated as a control group (delayed intervention, G1) in the My Body is Fit and Fabulous at Home (MyBFF@home) Phase II. Baseline data were obtained from 12 month data collection for this group. A new group of 42 obese housewives with co-morbidities (G2) were also recruited. Both groups received a 6 month intervention (July-December 2015) consisting of dietary counselling, physical activity (PA) and self-monitoring tools (PA diary, food diary and pedometer). Study parameters included weight, height, waist circumference, blood pressure and body compositions. Body compositions were measured using a bioelectrical impedance analysis device, Inbody 720. Descriptive and repeated measures ANOVA analyses were performed using SPSS 21.. There were reductions in mean body fat, fat mass and visceral fat area, particularly among obese women without co-morbidities. There were also decreases fat and skeletal muscle from baseline to month six with mean difference - 0.12 (95% CI: -0.38, 0.14) and visceral fat area from month three to month six with mean difference - 9.22 (- 17.87, - 0.56) for G1. G2 showed a decreasing pattern of skeletal muscle from baseline to month six with mean difference - 0.01(95% CI: -0.38, 0.37). There was a significant difference for group effect of visceral fat area (p < 0.05) with mean difference of - 11.49(95% CI: -20.07, 2.91). It showed that the intervention programs was effective to reduce visceral fat area compared to other part of body composition.. Obese participants without co-morbidities showed more desirable changes in body composition. Visceral fat area was reduced regardless of morbidity status. Weight management efforts are therefore not as straightforward in those with co-morbidities compared to those without, and require thorough and tailor-made strategies for a better chance of success.

Topics: Adolescent; Adult; Body Composition; Body Weight; Comorbidity; Exercise; Female; Follow-Up Studies; Humans; Malaysia; Middle Aged; Obesity; Overweight; Waist Circumference; Weight Loss; Young Adult

Diet compositions are likely to be one of the influential factors for body fat deposition. The aim of this paper was to determine the nutrient changes and its association to body fat loss among the overweight and obese housewives in the MyBFF@home study.. Data of participants in the MyBFF@home study (intervention and control groups) were analysed. Participants in the intervention group received personalised dietary counselling consisted of reduced calorie diet 1200-1500 kcal/day, while the control group was assigned to receive women's health seminars. The dietary assessment was done during the intervention phase at baseline, 1 month (m), 2 m, 3 m and 6 m using a 3-day food diary. Body fat was measured using a bioelectrical impedance analyser (In-body 720) at baseline and at the end of the intervention phase. The mean differences of nutrient intake and body compositions during the intervention phase were measured with paired t-test. The changes in body fat and nutrients intake were calculated by subtracting baseline measurements from those taken at 6 months. Multiple linear regression analysis was conducted to determine the extent to which the changes in each gram of nutrients per 1000 kcal were predictive of changes in body fat mass.. There were significant reductions in energy, all macronutrients, dietary fibre, calcium and iron intake in both study groups after the intervention phase (p <  0.05). In the intervention group, body fat loss increased with the reduction of each gram of carbohydrate, protein and fat per 1000 kcal, (p <  0.05), and decreased with the reduction of each gram of calcium and fibre intake per 1000 kcal (p <  0.05). In the control group, body fat loss increased with the reduction of each gram fat per 1000 kcal (p <  0.05) and decreased with the reduction of each gram iron per 1000 kcal.. Changes in the intake of various nutrients have different effects on body fat loss between the intervention and control group.

Topics: Adipose Tissue; Adolescent; Adult; Body Mass Index; Energy Intake; Female; Humans; Malaysia; Middle Aged; Nutritional Status; Obesity; Weight Loss; Young Adult

The national prevalence of overweight and obesity in Malaysia has been increasing in the past 10 years and many efforts have been implemented by the Malaysian government to combat obesity problem among the Malaysian population. The aim of this paper was to describe the background of the My Body is Fit and Fabulous at home (MyBFF@home) study (Phase II).. The MyBFF@home (Phase II) was a quasi-experimental study and it was conducted among overweight and obese housewives living in the urban areas in Malaysia. In this phase, the study involved a weight loss intervention phase (6 months) and a weight loss maintenance phase (6 months). The intervention group received a standard weight loss intervention package and the control group received group seminars related to women's health. Measurements of weight, height, waist circumference, body composition, fasting blood lipids, dietary intake, physical activity, health literacy, body pain and quality of life were conducted during the study. Overweight and obese housewives from 14 People's Housing/Home Project (PHP) in Federal Territory of Kuala Lumpur (Klang Valley) were selected as control and intervention group (N = 328). Majority of the participants (76.1%) were from the low socioeconomic group. Data were analysed and presented according to the specific objectives and the needs for the particular topic in the present supplement report.. MyBFF@home is the first and the largest community-based weight loss intervention study which was conducted among overweight and obese housewives in Malaysia. Findings of the study could be used by the policy makers and the researchers to enhance the obesity intervention programme among female adults in Malaysia.

Topics: Adolescent; Adult; Body Weight; Exercise; Female; Health Promotion; Humans; Malaysia; Middle Aged; Obesity; Overweight; Quality of Life; Weight Loss; Young Adult

Several methods have been developed to determine a person's physical activity level. However, there is limited evidence in determining whether someone is physically active or not. This study aims to determine the level of physical activity and to compare the usage of short version International Physical Activity Questionnaire (IPAQ-SF) and pedometer among overweight and obese women who were involved in the My Body is Fit and Fabulous at home (MyBFF@home) study.. Baseline and sixth month data from the MyBFF@home study were used for this purpose. A total of 169 of overweight and obese respondents answered the IPAQ-SF and were asked to use a pedometer for 7 days. Data from IPAQ-SF were categorised as inactive and active while data from pedometer were categorised as insufficiently active and sufficiently active by standard classification. Data on sociodemographic and anthropometry were also obtained. Cohen's kappa was applied to measure the agreement of IPAQ-SF and pedometer in determining the physical activity level. Pre-post cross tabulation table was created to evaluate the changes in physical activity over 6 months.. From 169 available respondents, 167 (98.8%) completed the IPAQ-SF and 107 (63.3%) utilised the pedometer. A total of 102 (61.1%) respondents were categorised as active from the IPAQ-SF. Meanwhile, only 9 (8.4%) respondents were categorised as sufficiently active via pedometer. Cohen's κ found there was a poor agreement between the two methods, κ = 0.055, p > 0.05. After sixth months, there was + 9.4% increment in respondents who were active when assessed by IPAQ-SF but - 1.3% reductions for respondents being sufficiently active when assessed by pedometer. McNemar's test determined that there was no significant difference in the proportion of inactive and active respondents by IPAQ-SF or sufficiently active and insufficiently active by pedometer from the baseline and sixth month of intervention.. The IPAQ-SF and pedometer were both able to measure physical activity. However, poor agreement between these two methods were observed among overweight and obese women.

Topics: Actigraphy; Adult; Exercise; Female; Humans; Malaysia; Male; Middle Aged; Motor Activity; Obesity; Overweight; Reproducibility of Results; Self Report; Surveys and Questionnaires

Obesity is an emerging global public health concern as it is related to chronic diseases and its impact to health related quality of life. The aim of this study was to assess the effect of weight reduction on health related quality of life (HRQOL) among obese and overweight housewives.. Data on 123 obese and overweight housewives in the intervention group from the MyBFF@home study were utilised. A validated Malaysian Malay version of Obesity Weight Loss Quality of Life (OWLQOL) questionnaire was administered at baseline and 6 months after intervention. Descriptive analysis, univariate analysis, paired t-test and multiple logistic regression were performed using SPSS Version 22.. Mean body mass index (BMI) was 31.5 kg/m. Weight loss intervention programme utilizing behavioural modification has led to a significant improvement in HRQOL among overweight and obese housewives.

Topics: Adolescent; Adult; Body Mass Index; Body Weight; Female; Healthy Lifestyle; Humans; Malaysia; Middle Aged; Obesity; Overweight; Poverty; Quality of Life; Surveys and Questionnaires; Weight Loss; Weight Reduction Programs; Young Adult

The prevalence of overweight and obesity among Malaysian women remained high over the past three decades. Collaboration with existing community at-risk may be feasible for wide-scale prevention of overweight and obesity in the country. The aims of this study were to examine the impact of community-based lifestyle intervention among overweight and obese women on their anthropometric and body composition changes as compared to the usual care group.. This was a quasi-experimental study conducted in low-cost flats in Kuala Lumpur, Malaysia. A total of 255 overweight and obesity individuals aged between 18 to 59 years old were assigned to either the lifestyle intervention group (n = 169) or the usual care group (n = 146) over a period of 6 months. Individuals in the intervention group received 6 individual lifestyle counselling comprised of physical activity, diet counselling and self-monitoring components aimed to achieve at least 5% weight loss while individuals in the usual care group obtained six sessions of health care seminars from health care providers. These individuals were then followed-up for another 6 months without any intervention as part of maintenance period.. An intention-to-treat analysis of between-groups at 6-month of intervention (β, 95% CI) revealed greater changes in weight among intervention individuals' (- 1.09 kg vs. -0.99; p < 0.018) as compared to the control group. These changes were not sustained during the maintenance phase (between 6 and 12 months). Overall significant improvement at 12th month was found for visceral fat (- 0.78 vs. -0.64; p-value = 0.017), although no significant changes between groups were detected either during intervention or maintenance phase (p > 0.05). Individuals in the intervention group showed a significant increase for skeletal muscle mass (0.13 kg) than those individuals in the control group (- 0.37 kg), p = 0.033, throughout the study period.. This study provides evidence that an overweight and obesity prevention program can be implemented in a community setting, with some reduction of several anthropometric and body composition parameters.

Topics: Adolescent; Adult; Body Composition; Body Weight; Exercise; Female; Healthy Lifestyle; Humans; Malaysia; Middle Aged; Obesity; Overweight; Weight Loss; Young Adult

Obesity is related to the increased incidence of hypertension and in healthy individuals, blood pressure changes with age and body mass. The aims of this paper were to evaluate the effectiveness of the weight loss intervention on body composition and blood pressure, and to evaluate the relationship between these factors among housewives in the MyBFF@home study.. MyBFF@home intervention was a quasi-experimental study which involved 328 overweight and obese housewives aged 18-59 years old (Control group: 159, Intervention group: 169). Data of the control and intervention group (pre and post intervention who completed the body composition and blood pressure measurements were analysed. Body compositions were measured using the Body Impedance Analyser (InBody 720) and blood pressure (Systolic and Diastolic) was taken using the blood pressure monitoring device (Omron HEM 907) at baseline, 6 month and 12 month. Data analyses (Pearson's correlation test and ANOVA) were performed and analysed using SPSS Statistics for Windows, version 22.0.. Visceral fat area, fat mass and body fat percentage, were all significantly decreased in the intervention group compared to the control group after 6 month intervention (p < 0.05). Systolic blood pressure was reduced significantly by - 6.81 mmHg (95% CI: -9.72,-3.90; p < 0.01) in the intervention and by - 7.95 mmHg (95% CI: -11.69,-4.20; p < 0.01) in the control group after 6 month intervention. Diastolic blood pressure was significantly correlated with BMI (r = 0.19), waist circumference (r = 0.23), body fat mass (r = 0.22), body fat percentage (r = 0.18) visceral fat area (r = 0.22) and skeletal muscle mass (r = 0.14) with p < 0.05. At 12-month follow-up, no significant changes of blood pressure were detected in both groups.. There were significant changes in the body fat and systolic blood pressure over 6 month among the participants in the intervention group compared to the control group. However, both groups were unable to sustain the positive changes in the body fats during the maintenance phase. There was a relationship between the body composition and blood pressure during the weight loss intervention and weight loss maintenance phase. Participation among obese housewives in a community-based intervention programme led to the improvements in blood pressure and body composition.

Topics: Adolescent; Adult; Blood Pressure; Blood Pressure Determination; Body Composition; Body Mass Index; Female; Humans; Hypertension; Malaysia; Middle Aged; Obesity; Overweight; Waist Circumference; Weight Loss; Young Adult

Obesity leads to the increase of pain at different parts of the body and it is a potential marker for complications of chronic diseases. This paper aims to assess changes in the body pain among overweight and obese housewives who participated in the My Body is Fit and Fabulous at home (MyBFF@home) study.. Housewives aged 18 to 59 years old from the MyBFF@home study were selected and pain was measured using the Visual Analogue Scale (VAS) questionnaire. VAS measured the pain intensity at different parts of the body (score of 0-10). Data were collected at base line, 3 months and 6 months among the housewives in both the control and intervention group. Pain scores and other variables (age, Body Mass Index (BMI) and waist circumference) were analysed using SPSS version 22.. A total of 328 housewives completed the VAS questionnaires at baseline, while 185 (56.4%) of housewives completed the VAS at 3 months and 6 months. A decreasing trend of mean pain score in both groups after 6 months was observed. However, the intervention group showed a consistent decreasing trend of pain score mainly for back pain. In the control group, there was a slight increment of score in back pain from baseline towards the 6 months period. Older housewives in both groups (aged 50 years and above) had a higher mean score of leg pain (2.86, SD: 2.82) compared to the other age group. Higher BMI was significantly associated with pain score in both groups.. There were some changes in the level of body pain among the housewives before and after the intervention. Older obese women had a higher pain score compared to younger obese women. Pain was associated with BMI and change in BMI appears to be beneficial in reducing body pain among overweight and obese individuals.

Topics: Adolescent; Adult; Body Mass Index; Chronic Pain; Female; Humans; Malaysia; Male; Middle Aged; Musculoskeletal Pain; Obesity; Overweight; Surveys and Questionnaires; Waist Circumference; Young Adult

Health literacy (HL) consists of different components and associates with several health outcomes, including obesity. It is linked to an individual's knowledge, motivation, competencies, behavior, and application to everyday life. The present study aimed to determine the change of HL scores and to investigate the difference of intervention outcomes at the weight loss (WL) intervention and WL maintenance phase between the HL groups.. A total of 322 participants from the MyBFF@home study completed the Newest Vital Sign (NVS) test at baseline. However, only data from 209 participants who completed the NVS test from baseline to WL intervention were used to determine the HL groups. Change of the NVS scores from baseline to WL intervention phase was categorized into two groups: those with HL improvement (increased 0.1 score and above) and those without HL improvement (no change or decreased 0.1 score and more). Independent variables in this study were change of energy intake, nutrient intake, physical activity, anthropometry measurements, and body composition measurements between baseline and WL intervention as well as between WL intervention and WL maintenance. An Independent sample t-test was used in the statistical analysis.. In general, both intervention and control participants have low HL. The study revealed that the intervention group increased the NVS mean score from baseline (1.19 scores) to the end of the WL maintenance phase (1.51 scores) compared to the control group. There was no significant difference in sociodemographic characteristics between the group with HL improvement and the group without HL improvement at baseline. Most of the dietary intake measurements at WL intervention were significantly different between the two HL groups among intervention participants. Physical activity and body composition did not differ significantly between the two HL groups among both intervention and control groups.. There was an improvement of HL during the WL intervention and WL maintenance phase in intervention participants compared to control participants. HL shows positive impacts on dietary intake behavior among intervention participants. New research is suggested to explore the relationship between HL and weight loss behaviors in future obesity intervention studies.

Topics: Adult; Attitude to Health; Economic Status; Exercise; Female; Health Literacy; Humans; Malaysia; Middle Aged; Obesity; Weight Loss

Obesity in pregnancy causes both maternal and foetal complications hence adequate knowledge of obesity related pregnancy risks would ensure better outcomes. This study aims to determine the knowledge of obesity related pregnancy risks among pregnant women.. A cross-sectional study was conducted among pregnant women from four antenatal clinics in Seremban, between February and May 2015. Knowledge on pregnancy risks was assessed using questionnaire. Women were defined as having broad knowledge on obesity related pregnancy risks if they correctly identified that women who are very obese, are at higher risk of obesity related pregnancy complications and weight loss prior to pregnancy is associated with lower risk of obesity related pregnancy complications. Descriptive statistics and regression tests were used in the analysis.. A total of 315 women participated in this study. Their mean age is 29.3 (SD±4.8) years and majority were Malay (72.4%). More than half of them were overweight and obese (60.6%). About 63.2% participants had broad knowledge on obesity related pregnancy risk. Education is a significant predictor of broad knowledge as women with tertiary education had higher odds of having broad knowledge compared to those with only school education (OR 2.1; 95%CI: 1.28 to 3.59).. This study found that more than half of the participants had knowledge of obesity related pregnancy risks and that education is a significant predictor for knowledge. Pre-pregnancy care education programmes can help identify barriers, introduce simple weight management strategies to overcome obesity, to ensure better maternal and foetal outcome.

Topics: Adult; Cross-Sectional Studies; Female; Health Knowledge, Attitudes, Practice; Humans; Malaysia; Obesity; Pregnancy; Pregnancy Complications; Risk Factors

Individual variations of obesity-related traits can be a consequence of dietary influence on gene variants.. This cross-sectional study aimed to evaluate (i) the effect of FTO rs9930506 on obesity and related parameters and (ii) the influence of diet on the above association in Malaysian adults. In total, 79 obese and 99 nonobese Malaysian adults were recruited.. In comparison with Chinese and Malays, Indians had significantly higher waist circumference (P ≤ 0.001 and P = 0.016), waist-hip ratio (P = 0.001 and P < 0.001), body fat percentage (P = 0.001 and P = 0.042), fasting insulin (P = 0.001 and P = 0.001), homeostatic model assessment-insulin resistance (P = 0.001 and P = 0.001) and lower high-density lipoprotein-cholesterol levels (P < 0.001 and P < 0.001), respectively. Indians consumed significantly lower dietary cholesterol (P = 0.002), percentage energy from protein (P < 0.001) and higher fibre (P = 0.006) compared to the other two groups. Malaysian Indians expressed the highest risk allele frequency (G) of FTO rs9930506 compared to the Malays and the Chinese (P < 0.001). No significant association was found between FTO rs9930506 and obesity (dominant model). Risk allele carriers (G) consumed significantly lower vitamin E (P = 0.020) and had a higher fibre intake (P = 0.034) compared to the noncarriers (A). Gene-diet interaction analysis revealed that risk allele carriers (G) had lower high sensitivity C-reactive protein (hsCRP) levels with higher energy from protein (≥14% day. The presence of the risk allele (G) of FTO rs9930506 was not associated with an increased risk of obesity. Malaysian Indians had a significantly higher frequency of the risk allele (G). Indian participants expressed higher atherogenic phenotypes compared to Chinese and Malays. FTO rs9930506 may interact with dietary protein and vitamin E and modulate hsCRP levels.

Topics: Adult; Alleles; Alpha-Ketoglutarate-Dependent Dioxygenase FTO; C-Reactive Protein; China; Cholesterol, Dietary; Cross-Sectional Studies; Diet; Dietary Proteins; Female; Gene Frequency; Genetic Predisposition to Disease; Genotype; Humans; India; Insulin Resistance; Malaysia; Male; Middle Aged; Obesity; Polymorphism, Single Nucleotide; Vitamin E; Vitamins; Waist Circumference

Hidradenitis suppurativa (HS) is a chronic, recurrent, inflammatory disorder of follicular occlusion, resulting in abscesses with tunnel formation and severe scarring. Our objectives were to identify the clinical patterns and the prevalence of metabolic syndrome (MetS) among our HS patients and to determine the role of ultrasonography in the clinical assessment of HS.. This was a cross-sectional study carried out from September 2016 to August 2017 at three tertiary hospitals in Northern Peninsular Malaysia.. A total of 62 patients were recruited, 83.9% of whom were male. The mean age was 29.2 with the median age of onset at 18 years old. The median duration of delay in diagnosis was 3 years. A quarter of them had positive family history. Nearly three-quarters were overweight and obese. About 12/62 (19.4%) had MetS, and it was comparable to healthy controls (15/62, 24.2%). HS patients had a significant higher risk of low-high-density lipoprotein (HDL) and obesity. Based on Hurley staging, 15/62 (24.2%) were in stage I, 38/62 (61.3%) and 9/62 (14.5%) in stages II and III, respectively. However, sonographic scoring showed 50% had severe stage of disease, and 56.9% of the patients had subclinical lesions. There was only a fair agreement between ultrasonography and Hurley staging of disease severity (k = 0.25; P = 0.004).. There was a male preponderance among HS patients in Northern Peninsular Malaysia with early age of onset and more severe disease. Only one-fifth had MetS, but they had significantly higher risks of obesity and low HDL. Ultrasonography examination was useful to detect subclinical lesions and providing a better understanding on disease severity.

Topics: Adolescent; Adult; Age of Onset; Comorbidity; Cross-Sectional Studies; Female; Hidradenitis Suppurativa; Humans; Lipoproteins, HDL; Malaysia; Male; Metabolic Syndrome; Middle Aged; Obesity; Phenotype; Prevalence; Severity of Illness Index; Sex Factors; Ultrasonography; Young Adult

To determine the degree of food environment policies that have been implemented and supported by the Malaysian Government, in comparison to international best practice, and to establish prioritised recommendations for the government based on the identified implementation gaps.. The Healthy Food-Environment Policy Index (Food-EPI) comprises forty-seven indicators of government policy practice. Local evidence of each indicator was compiled from government institutions and verified by related government stakeholders. The extent of implementation of the policies was rated by experts against international best practices. Rating results were used to identify and propose policy actions which were subsequently prioritised by the experts based on 'importance' and 'achievability' criteria. The policy actions with relatively higher 'achievability' and 'importance' were set as priority recommendations for government action.. Malaysia.. Twenty-six local experts.. Majority (62 %) of indicators was rated 'low' implementation with no indicator rated as either 'high' or 'very little, if any' in terms of implementation. The top five recommendations were (i) restrict unhealthy food marketing in children's settings and (ii) on broadcast media; (iii) mandatory nutrition labelling for added sugars; (iv) designation of priority research areas related to obesity prevention and diet-related non-communicable diseases; and (v) introduce energy labelling on menu boards for fast-food outlets.. This first policy study conducted in Malaysia identified a number of gaps in implementation of key policies to promote healthy food environments, compared with international best practices. Study findings could strengthen civil society advocacies for government accountability to create a healthier food environment.

Topics: Environment; Fast Foods; Food Industry; Food Labeling; Food Quality; Food Services; Food Supply; Government; Health Priorities; Health Promotion; Humans; Malaysia; Marketing; Mass Media; Nutrition Policy; Obesity; Public Health

The prevalence of overweight and obesity has developed the critical global threat which leads to metabolic risks and mortality. A Leptin hormone that regulates the food intake as well as food expenditure is encoded by Leptin gene. The gene has shown a pivotal role in obesity pathogenesis. This study was sought to determine the SNPs and haplotype association of the Leptin gene that were assigned as G2548A, H1328080, and A19G with obesity among Malays in Terengganu, Malaysia.. This study comprised of 249 participants (148 overweight/ obese as a case group and 101 lean participants as controls). The PCR-RFLP technique was performed to distinguish the genotype distribution of Leptin gene polymorphisms. The allele and genotype frequencies were assessed for single and haplotype analyses.. Single association analysis of G2548A (P=0.74), A19G (P=0.38), and H1328080 (P=0.56) polymorphisms yielded no statistically significant association. However, haplotype association analysis showed a suggestive indication of AAG haplotype (G2548A, H1328080, and A19G sequence) with susceptibility effect towards obesity predisposition [P=0.002, OR=8.897 (1.59-9.78)].. This data on single and haplotype might disclose the preliminary exposure and pave the way for the obesity development with an evidence of revealed susceptibility to obesity.

Topics: Adolescent; Adult; Asian People; Case-Control Studies; Female; Gene Frequency; Genes; Haplotypes; Humans; Leptin; Malaysia; Male; Middle Aged; Obesity; Polymorphism, Single Nucleotide; Young Adult

The neonatal Apgar score at 5 min has been found to be a better predictor of outcomes than the Apgar score at 1 min. A baby, however, must pass through the first minute of life to reach the fifth. There has been no research looking at predictors of recovery (Apgar scores ≥7) by 5 min in neonates with 1 min Apgar scores <4.. An analysis of observational data was conducted using live, singleton, term births recorded in the Malaysian National Obstetrics Registry between 2010 and 2012. A total of 272,472 live, singleton, term births without congential anomalies were recorded, of which 1,580 (0.59%) had 1 min Apgar scores <4. Descriptive methods and bi- and multi-variable logistic regression were used to identify risk factors associated with recovery (5 min Apgar score ≥7) from 1 min Apgar scores <4.. Less than 1% of births have a 1 min Apgar scores <4. Only 29.4% of neonates with 1 min Apgar scores <4 recover to a 5 min Apgar score ≥7. Among uncomplicated vaginal deliveries, after controlling for other factors, deliveries by a doctor of neonates with a 1 min Apgar score <4 had odds of recovery 2.4 times greater than deliveries of neonates with a 1 min Apgar score <4 by a nurse-midwife. Among deliveries of neonates with a 1 min Apgar score <4 by doctors, after controlling for other factors, planned and unplanned CS was associated with better odds of recovery than uncomplicated vaginal deliveries. Recovery was also associated with maternal obesity, and there was some ethnic variation - in the adjusted analysis indigenous (Orang Asal) Malaysians had lower odds of recovery.. A 1 min Apgar score <4 is relatively rare, and less than a third recover by five minutes. In those newborns the qualification of the person performing the delivery and the type of delivery are independent predictors of recovery as is maternal BMI and ethnicity. These are associations only, not necessarily causes, and they point to potential areas of research into health systems factors in the labour room, as well as possible biological and cultural factors.

Topics: Apgar Score; Cesarean Section; Delivery, Obstetric; Elective Surgical Procedures; Emergencies; Female; Humans; Infant, Newborn; Malaysia; Nurse Midwives; Obesity; Obstetrics; Physicians; Pregnancy; Pregnancy Complications; Registries; Risk Factors; Term Birth

The disease burden of indigenous peoples has been augmented by the rising prevalence of obesity and hypertension in this population. This study assessed the ability of obesity indices to predict hypertension among indigenous adults of Peninsular Malaysia.. In this cross-sectional study, 482 adults (223 men, 259 women) aged ≥18 years old were measured for body mass index (BMI), waist circumference (WC), waist-height ratio (WHtR), waist-hip ratio (WHR), and blood pressure. Receiver operating characteristic (ROC) analysis was used to determine the predictive ability of obesity indices for hypertension in men and women. Gender-specific logistic regression analyses were done to examine the association between obesity, defined by BMI, WC, WHtR and WHR, and hypertension.. Prevalence of hypertension was 25.5%. Overall, WHtR was the best predictor of the presence of hypertension, in both men and women. The optimal WHtR cut-off values for hypertension were 0.45 and 0.52 in men and women, respectively. Obese adults with WHtR ≥0.5 had about two times increased odds of having hypertension compared to non-obese adults.. WHtR may serve as a simple and inexpensive screening tool to identify individuals with hypertension in this relatively difficult to reach population.

Topics: Adolescent; Adult; Aged; Asian People; Body Mass Index; Cross-Sectional Studies; Female; Health Transition; Humans; Hypertension; Malaysia; Male; Mass Screening; Middle Aged; Obesity; Predictive Value of Tests; Prevalence; Risk; ROC Curve; Rural Health; Sex Factors; Waist Circumference; Waist-Height Ratio; Waist-Hip Ratio; Young Adult

The vitamin D receptor (VDR) gene is expressed abundantly in different tissues; including adipocytes and pancreatic beta cells. The rs1544410 or BsmI single nucleotide polymorphism (SNP) in the intronic region of the VDR gene has been previously associated with vitamin D levels, obesity and insulin resistance.. This study was aimed to examine the association between BsmI polymorphism and risk of vitamin D deficiency, obesity and insulin resistance in adolescents living in a tropical country.. Thirteen-year-old adolescents were recruited via multistage sampling from twenty-three randomly selected schools across the city of Kuala Lumpur, Malaysia (n = 941). Anthropometric measurements were obtained. Obesity was defined as body mass index higher than the 95th percentile of the WHO chart. Levels of fasting serum vitamin D (25-hydroxyvitamin D (25(OH)D)), glucose and insulin were measured. HOMA-IR was calculated as an indicator for insulin resistance. Genotyping was performed using the Sequenom MassARRAY platform (n = 807). The associations between BsmI and vitamin D, anthropometric parameters and HOMA-IR were examined using analysis of covariance and logistic regression.. Those with AA genotype of BsmI had significantly lower levels of 25(OH)D (p = 0.001) compared to other genotypes. No significant differences was found across genotypes for obesity parameters. The AA genotype was associated with higher risk of vitamin D deficiency (p = 0.03) and insulin resistance (p = 0.03) compared to GG. The A allele was significantly associated with increased risk of vitamin D deficiency compared to G allele (adjusted odds ratio (OR) = 1.63 (95% Confidence Interval (CI) 1.03-2.59, p = 0.04). In those with concurrent vitamin D deficiency, having an A allele significantly increased their risk of having insulin resistance compared to G allele (adjusted OR = 2.66 (95% CI 1.36-5.19, p = 0.004).. VDR BsmI polymorphism was significantly associated with vitamin D deficiency and insulin resistance, but not with obesity in this population.

Topics: Adolescent; Anthropometry; Female; Genetic Association Studies; Genetic Predisposition to Disease; Humans; Insulin Resistance; Malaysia; Male; Obesity; Polymorphism, Single Nucleotide; Receptors, Calcitriol; Vitamin D Deficiency

This study describes the patterns of objectively measured sitting, standing and stepping in obese children using the activPALTM and highlights possible differences in sedentary levels and patterns during weekdays and weekends. Sixty-five obese children, aged 9-11 years, were recruited from primary schools in Terengganu, Malaysia. Sitting, standing and stepping were objectively measured using an activPALTM accelerometer over a period of 4-7 days. Obese children spent an average of 69.6% of their day sitting/lying, 19.1% standing and 11.3% stepping. Weekdays and weekends differed significantly in total time spent sitting/lying, standing, stepping, step count, number of sedentary bouts and length of sedentary bouts (p < 0.05, respectively). Obese children spent a large proportion of their time sedentarily, and they spent more time sedentarily during weekends compared with weekdays. This study on sedentary behaviour patterns presents valuable information for designing and implementing strategies to decrease sedentary time among obese children, particularly during weekends.

Topics: Accelerometry; Activities of Daily Living; Child; Female; Health Behavior; Humans; Malaysia; Male; Monitoring, Ambulatory; Motor Activity; Obesity; Posture; Sedentary Behavior; Walking

To determine the relationship between BMI and risk of CVD mortality and all-cause mortality among Malaysian adults.. Population-based, retrospective cohort study. Participants were followed up for 5 years from 2006 to 2010. Mortality data were obtained via record linkages with the Malaysian National Registration Department. Multiple Cox regression was applied to compare risk of CVD and all-cause mortality between BMI categories adjusting for age, gender and ethnicity. Models were generated for all participants, all participants the first 2 years of follow-up, healthy participants, healthy never smokers, never smokers, current smokers and former smokers.. All fourteen states in Malaysia.. Malaysian adults (n 32 839) aged 18 years or above from the third National Health and Morbidity Survey.. Total follow-up time was 153 814 person-years with 1035 deaths from all causes and 225 deaths from CVD. Underweight (BMI<18·5 kg/m2) was associated with a significantly increased risk of all-cause mortality, while obesity (BMI ≥30·0 kg/m2) was associated with a heightened risk of CVD mortality. Overweight (BMI=25·0-29·9 kg/m2) was inversely associated with risk of all-cause mortality. Underweight was significantly associated with all-cause mortality in all models except for current smokers. Overweight was inversely associated with all-cause mortality in all participants. Although a positive trend was observed between BMI and CVD mortality in all participants, a significant association was observed only for severe obesity (BMI≥35·0 kg/m2).. Underweight was associated with increased risk of all-cause mortality and obesity with increased risk of CVD mortality. Therefore, maintaining a normal BMI through leading an active lifestyle and healthy dietary habits should continue to be promoted.

Topics: Adolescent; Adult; Biomarkers; Blood Glucose; Body Height; Body Mass Index; Body Weight; Cardiovascular Diseases; Cholesterol; Cross-Sectional Studies; Diabetes Mellitus; Female; Follow-Up Studies; Health Surveys; Humans; Hypercholesterolemia; Life Style; Malaysia; Male; Middle Aged; Mortality; Obesity; Retrospective Studies; Socioeconomic Factors; Thinness; Young Adult

Soluble DPP4 (sDPP4) is a novel adipokine that degrades glucagon-like peptide (GLP-1). We evaluated the fasting serum levels of active GLP-1 and sDPP4 in obese, overweight and normal weight subjects to assess the association between sDPP4 levels, active GLP-1 levels and insulin resistance in obese subjects.. The study involved 235 Malaysian subjects who were randomly selected (66 normal weight subjects, 97 overweight, 59 obese subjects, and 13 subjects who were underweight). Serum sDPP4 and active GLP-1 levels were examined by enzyme-linked immunosorbent assay (ELISA). Also, body mass index kg/m. Serum sDPP4 levels were significantly higher in obese subjects compared to normal weight subjects (p=0.034), whereas serum levels of active GLP-1 were lower (p=0.021). In obese subjects, sDPP4 levels correlated negatively with active GLP-1 levels (r. Elevated serum sDPP4 levels and reduced GLP-1 levels were observed in obese subjects. In addition, sDPP4 levels correlated negatively with active GLP-1 levels but was positively associated with insulin resistance. This finding provides evidence that sDPP4 and GLP-1 may play an important role in the pathogenesis of obesity, suggesting that sDPP4 may be valuable as an early marker for the augmented risk of obesity and insulin resistance.

Topics: Adult; Aged; Biomarkers; Body Mass Index; Dipeptidyl Peptidase 4; Down-Regulation; Female; Glucagon-Like Peptide 1; Humans; Insulin Resistance; Linear Models; Malaysia; Male; Middle Aged; Obesity; Overweight; Risk; Solubility; Thinness; Up-Regulation

Researchers suggest that the rise in obesity rates may be explained by the addictive properties of certain types of food. In view of the growing obesity epidemic in South-East Asia, there is a need for a psychometric tool to assess the concept of food addiction amongst high-risk populations. The objective of this study is to translate the Yale Food Addiction Scale (YFAS) into the Malay language and subsequently validate its use in an obese population.. Between the year 2014 and 2015, a total of 250 obese adults were assessed for food addiction utilizing the Malay version of the YFAS at a primary care clinic. An assessment of the psychometric properties of the scale was performed to determine the factor structure, item statistics and internal consistency of the scale.. A one factorial structure of YFAS was confirmed in this study through factor analysis. All items except 4 (items 19, 22, 24 and 25) had factor loadings >0.42. The internal reliability (KR-20) coefficient of the one-factor solution was α = 0.76. The mean YFAS symptom count was M = 2.74 (SD = 1.57) with 10.4% (N = 26) of the participants received the diagnosis of food addiction.. The determination of construct validity and the identification of other latent variables in the Malay food addiction model is necessary prior to the formal utilization of the scale as a tool to detect addictive eating patterns in the community.

Topics: Adolescent; Adult; Aged; Body Mass Index; Cross-Sectional Studies; Factor Analysis, Statistical; Feeding and Eating Disorders; Feeding Behavior; Female; Food Addiction; Humans; Malaysia; Male; Middle Aged; Obesity; Pilot Projects; Psychiatric Status Rating Scales; Psychometrics; Reproducibility of Results; Risk Factors; Surveys and Questionnaires; Translating; Young Adult

Hypertension has become increasingly common among adolescents. This study aimed to investigate the prevalence of hypertension and its association with anthropometric indexes among pre-university students. This was a cross-sectional study carried out among pre-university students of a public university. Anthropometric measurements were conducted using mobile stadiometers, digital body fat scales and measuring tapes. Body fat percentage was measured with a body composition analyzer, and blood pressure was determined using digital blood pressure monitors. Statistical analyses were done using Statistical Package for Social Sciences (SPSS) Statistics 20. A total of 218 respondents participated in the study. The prevalence of hypertension at risk was 7.3%, which was higher among males (16.7%). About 22% of the respondents were overweight and obese. The majority of males had a normal waist circumference (WC) (75.9%), but almost half of females had a WC value in the unhealthy category (47.0%). Females had higher conicity indexes and body fat compared to males. Respondents who were found to have hypertension at risk had a higher prevalence of being overweight and having unhealthy WC and waist-to-height ratio and had high conicity indexes and a high percentage of fat. Risk factors independently associated with hypertension at risk included male gender (odds ratio=4.213, 95% CI, 1.238-14.342) and body mass index (odds ratio=7.865, 95% CI, 1.165-53.099). Regular screening of hypertension at risk among adolescents and initiation of early treatment for those affected should be conducted to avoid further complication in later life.

Topics: Adolescent; Anthropometry; Body Mass Index; Cross-Sectional Studies; Female; Humans; Hypertension; Malaysia; Male; Obesity; Prevalence; Risk Factors; Students

Parental body mass index (BMI) is strongly linked with the development of offspring overweight and obesity. However, there are a limited number of studies focusing on the association of parental body mass index before pregnancy on offspring growth and body composition in early life, particularly in developing countries.. Data from the University Sains Malaysia (USM) Pregnancy Cohort which consists of 153 mother-offspring pairs were used. Data were collected using interview-administered questionnaires and anthropometric measurements were also obtained. Multiple linear regression and generalised equation estimation (GEE) were used to examine the direction and impact of the association between parental BMI and child growth and body composition (weight for age, height for age, body mass index for age, weight for height and fat mass at age 2m, 6m, and 12m). Potential confounders, including validated measures of maternal diets and physical activity during pregnancy, were considered.. Of 153 parents, one-quarter of the mothers and 42.2% of the fathers, respectively, were overweight or obese before pregnancy. A significant association was found between maternal BMI and child's weight for height z-score (WHZ) and body mass index for age z-score (BAZ).. Having high pre-pregnancy BMI may increase BMI and WAZ of offspring in early life. Findings from this study emphasise the importance of monitoring maternal weight status, particularly before and during pregnancy and early life of offspring among Malaysians.

Topics: Adipose Tissue; Adult; Body Composition; Body Mass Index; Body Weight; Cohort Studies; Fathers; Female; Humans; Infant; Malaysia; Male; Mothers; Obesity; Overweight; Pediatric Obesity; Pregnancy; Risk Factors

The prevalence of stunting, thinness, overweight, and obesity among children differs by ethnicity. It is not known whether differences in body build across the ethnic groups influence the interpretation of nutritional parameters.. To explore the differences in body build across the 5 main ethnic groups in Malaysia and to determine whether differences in body build have an impact on the interpretation of nutrition indicators.. A total of 3227 children aged 2.0 to 12.9 years who participated in the South East Asian Nutrition Surveys (SEANUTS) in Malaysia were included in this analysis. Body weight, height, sitting height, wrist and knee breadths, and biceps and subscapular skinfolds were measured, and relative leg length, slenderness index, and sum of skinfolds were calculated. Z scores for height-for-age (HAZ) and body mass index-for-age (BAZ) were calculated using the World Health Organization (WHO) 2007 growth standards.. Differences in relative leg length and slenderness across the ethnic groups were correlated with HAZ and BAZ. Correction for differences in body build did, in some ethnic groups, have significant impact on the prevalence of stunting, thinness, overweight, and obesity, and the pattern of prevalence across ethnic groups changed.. At the population level, corrections for body build had only minor and mostly nonsignificant effects on prevalence, but at an individual level, corrections for body build placed a substantial number of children in different height or weight categories. Whether these misclassifications warrant additional assessment of body build in clinical practice will need further investigation.

Topics: Anthropometry; Body Height; Body Mass Index; Body Weight; Child; Child, Preschool; Ethnicity; Female; Growth Disorders; Humans; Infant; Malaysia; Male; Nutritional Status; Obesity; Overweight; Somatotypes; Thinness; World Health Organization

To determine the prevalence of glycaemic control and factors associated with poor glycaemic control [glycosylated haemoglobin (HbA1c) ≥6.5%] among patients with type 2 diabetes treated in public health clinics in Johor, Malaysia.. Cross-sectional study.. A review of all patients aged over 18 years and with a diagnosis of type 2 diabetes for >1 year. The National Diabetic Registry was used as the database for attendees at public health clinics in Johor Bahru between January and December 2013. A required sample of 660 was calculated, and a random sampling method was applied to acquire patient information across the 13 public health clinics in Johor Bahru. All relevant information (e.g. HbA1c, type of treatment and other parameters for glycaemic control) were abstracted from the registry.. Sixty-eight percent of 706 patients had HbA1c >6.5%, and mean HbA1c was 7.8%. Younger patients (72.3%) had poorer glycaemic control than older patients (63.0%), and most patients with poor glycaemic control were obese (79.2%). Approximately 31.7% of patients did not achieve the target blood pressure <130/80 mmHg, and 58.5% did not achieve the target lipid profile. Multiple logistic regression analysis revealed that age (<60 years), sex (male), duration of diabetes (>5 years), body mass index (obese), type of treatment (diet therapy vs combination therapy) and abnormal lipid profile were significantly associated with increased odds of HbA1C >6.5%.. More than half (68%) of the patients with diabetes had HbA1c >6.5%. This highlights the importance of providing organized care to manage patients with diabetes in the primary care setting, such as weight reduction programmes, proper prescribing treatment, and age- and gender-specific groups to ensure good glycaemic control.

Topics: Adult; Age Distribution; Aged; Blood Glucose; Cross-Sectional Studies; Diabetes Mellitus, Type 2; Female; Glycated Hemoglobin; Health Facilities; Humans; Hyperlipidemias; Hypertension; Malaysia; Male; Middle Aged; Obesity; Public Health; Risk Factors; Sex Distribution; Young Adult

The human amylase gene locus at chromosome 1p21.1 is structurally complex. This region contains two pancreatic amylase genes, AMY2B, AMY2A, and a salivary gene AMY1. The AMY1 gene harbors extensive copy number variation (CNV), and recent studies have implicated this variation in adaptation to starch-rich diets and in association to obesity for European and Asian populations. In this study, we showed that by combining quantitative PCR and digital PCR, coupled with careful experimental design and calibration, we can improve the resolution of genotyping CNV with high copy numbers (CNs). In two East Asian populations of Chinese and Malay ethnicity studied, we observed a unique non-normal distribution of AMY1 diploid CN genotypes with even:odd CNs ratio of 4.5 (3.3-4.7), and an association between the common AMY2A CN = 2 genotype and odd CNs of AMY1, that could be explained by the underlying haplotypic structure. In two further case-control cohorts (n = 932 and 145, for Chinese and Malays, respectively), we did not observe the previously reported association between AMY1 and obesity or body mass index. Improved methods for accurately genotyping multiallelic CNV loci and understanding the haplotype complexity at the AMY1 locus are necessary for population genetics and association studies.

Topics: Adolescent; Asian People; Body Mass Index; Case-Control Studies; China; DNA Copy Number Variations; Genetic Association Studies; Genetic Predisposition to Disease; Humans; Malaysia; Obesity; Pancreatic alpha-Amylases; Polymerase Chain Reaction; Salivary alpha-Amylases; Young Adult

Hypertension is the leading cardiovascular risk factor globally as well as in Malaysia. This study aimed to estimate the prevalence, awareness, treatment, control and the socio demographic determinants of hypertension among Malaysian adults.. The analytic sample consisted of 11,288 adults aged ≥ 30 years recruited at baseline in 2007-2011 from the REDISCOVER Study which is an ongoing, prospective cohort study involving 18 urban and 22 rural communities in Malaysia. Socio-demographics, anti-hypertensive treatment details and an average of at least two blood pressure measurements were obtained.. The age-adjusted prevalence was 42.0 % (CI: 40.9-43.2) and was higher in men [43.5 % (CI: 41.2-45.0)] than women [41.0 % (CI: 39.8-42.3)]. Participants from rural areas (APR: 1.12, CI: 1.04-1.20); aged at least 40-49 years (APR: 1.86, CI: 1.62-2.14); who were overweight (APR: 1.24, CI: 1.15-1.34) and obese (APR: 1.54, CI: 1.43-1.6) were more likely to have hypertension. The Indigenous ethnic group was less likely to be aware (APR: 0.81, CI: 0.69-0.92) and to be on treatment (APR: 0.66, CI: 0.55-0.79). Those in rural areas were less likely to have their hypertension controlled (APR: 0.61, CI: 0.49-0.75). On the other hand, control was more likely in females (APR: 1.25, CI: 1.01-1.54) and Indigenous group (APR: 1.64, CI: 1.19-2.25).. Hypertension is common in the Malaysian adults. The control of hypertension has increased over the years but is still quite low. Public health measures, as well as individual interventions in primary care are crucial to reduce their risk of developing complications.

Topics: Adult; Age Distribution; Antihypertensive Agents; Ethnicity; Female; Health Knowledge, Attitudes, Practice; Health Status Disparities; Humans; Hypertension; Malaysia; Male; Middle Aged; Obesity; Overweight; Population Groups; Prevalence; Prospective Studies; Risk Factors; Rural Population; Sex Distribution; Urban Population

Research suggests that physical activity plays a role to improve health related- quality of life (QoL), however studies examining the association between physical activity and HRQOL are limited in the paediatric literature. The aim of this study is to explore the relationship between physical activity and HRQoL among Malaysian children.. Participants (n = 78 normal weight; 78 obese children) aged 9-11 years completed a validated quality of life (QoL) inventory and wore an accelerometer to objectively measure physical activity for 1 week.. Psychosocial Health domain and Total QoL (all p < 0.05) were significantly lower for obese compared to normal weight children. Children who spent more time in sedentary behaviour had significantly lower QoL on Psychosocial Health domain and Total QoL except for the Physical Health domain. There was also a strong positive correlation between QoL and moderate-vigorous physical activity (MVPA) indicating that children who are physically active have a better quality of life.. Physical activity promotion should be emphasised to improve QoL in children.

Topics: Body Mass Index; Child; Cross-Sectional Studies; Exercise; Female; Humans; Malaysia; Male; Obesity; Quality of Life

The Malaysian society is experiencing and coping with a fast modernization process, which is characterized by a rapid urbanization and rural exodus, an important reduction of the size of households, and the emergence of a new middle class. The Malaysian Food Barometer launched in 2013 has provided better understanding how these macro issues have affected the lifestyles and especially the food habits of the Malaysians. The country has indeed undergone a transition period from under-nutrition to over-nutrition in a few decades, with the prevalence of overweight and obesity having markedly and rapidly increased. A quantitative survey (n = 2000), elaborated from a qualitative preliminary phase, was carried out with the aim of analyzing the transformation of food habits at the national level. The present article focuses on the BMI issue in Malaysia, and investigates its relationships with the socio-demographic variables of the population, as well as their eating patterns. The mean BMI is 23.64 kg/m

Topics: Adult; Asian People; Body Mass Index; Eating; Feeding Behavior; Female; Humans; Life Style; Malaysia; Male; Obesity; Overweight; Prevalence; Qualitative Research; Surveys and Questionnaires; Urbanization

To determine the prevalence of vitamin D deficiency (<37.5 nmol/L) among young adolescents in Malaysia and its association with demographic characteristics, anthropometric measures and physical activity.. This is a cross-sectional study among Form 1 (year 7) students from 15 schools selected using a stratified random sampling design. Information regarding sociodemographic characteristics, clinical data and environmental factors was collected and blood samples were taken for total vitamin D. Descriptive and multivariable logistic regression was performed on the data.. National secondary schools in Peninsular Malaysia.. 1361 students (mean age 12.9±0.3 years) (61.4% girls) completed the consent forms and participated in this study. Students with a chronic health condition and/or who could not understand the questionnaires due to lack of literacy were excluded.. Vitamin D status was determined through measurement of sera 25-hydroxyvitamin D (25(OH)D). Body mass index (BMI) was classified according to International Obesity Task Force (IOTF) criteria. Self-reported physical activity levels were assessed using the validated Malay version of the Physical Activity Questionnaire for Older Children (PAQ-C).. Deficiency in vitamin D was seen in 78.9% of the participants. The deficiency was significantly higher in girls (92.6%, p<0.001), Indian adolescents (88.6%, p<0.001) and urban-living adolescents (88.8%, p<0.001). Females (OR=8.98; 95% CI 6.48 to 12.45), adolescents with wider waist circumference (OR=2.64; 95% CI 1.65 to 4.25) and in urban areas had higher risks (OR=3.57; 95% CI 2.54 to 5.02) of being vitamin D deficient.. The study shows a high prevalence of vitamin D deficiency among young adolescents. Main risk factors are gender, ethnicity, place of residence and obesity.

Topics: Adolescent; Asian People; Body Mass Index; Cross-Sectional Studies; Exercise; Female; Humans; Logistic Models; Longitudinal Studies; Malaysia; Male; Obesity; Prevalence; Self Report; Sex Distribution; Sex Factors; Vitamin D; Vitamin D Deficiency

Diabetes Mellitus (DM) is notorious for its metabolic effect, acute and chronic complications and impact on Quality of Life (QoL). Successful intervention to improve QoL necessitates a valid and reliable measurement tool to identify areas of concern to patients with diabetes.. To (1) assess the factor structure of the Malay Audit of Diabetes Dependent Quality of Life-18 (ADDQoL-18) questionnaire; (2) determine the impact of DM on QoL; and (3) identify areas of concern to patients with type 2 DM from three major ethnic groups in Malaysia.. Data was obtained from a cross sectional study involving 256 patients with type 2 DM attending the diabetes clinic of the National University of Malaysia Medical Centre. The Malay version of ADDQoL-18 survey was translated from its English version according to standard guidelines and administered by a trained research assistant. Exploratory Factor Analysis (EFA) with oblimin rotation was used to determine factor structure of the data. Confirmatory Factor Analysis (CFA) was used to confirm the factor structure. Hierarchical liner regression was used to determine factors associated with QoL.. Unforced factor solution yielded two factors for the whole sample. Forced one factor solution was ascertained for the whole sample and for each ethnic group. Loadings ranged between 0.588 and 0.949. Reliability coefficients were all higher than 0.955. CFA showed that the two factor model had better fit statistics. QoL was associated with the use of insulin and desired glycaemic control, longer diabetes duration, worry about diabetes, and diabetes complications.. The Malay ADDQoL-18 is a valid tool to be used among patients with diabetes from different ethnic groups in Malaysia. The use of insulin to achieve desired glycaemic control had more negative impact on QoL than the use of tablets and/or dietary changes.

Topics: Blood Glucose; Diabetes Mellitus, Type 2; Ethnicity; Female; Humans; Insulin; Malaysia; Male; Obesity; Quality of Life; Surveys and Questionnaires

Limited information exists regarding paediatric psoriasis and its association with body mass index (bMI) in Asia.. to determine the clinico-epidemiological profile and to compare the bMI of children with and without psoriasis.. A case-control study of 92 children with psoriasis versus 59 with atopic eczema and 56 with non-inflammatory skin conditions.. Psoriasis was more common in Malay and Indian children when compared to Chinese with odds ratios (Or) of 4.30 (95% CI, 1.85-9.99) and 3.00 (95% CI, 1.02-8.81) respectively. Prevalence of psoriasis was similar between Malay and Indian children (Or 1.43, 95% CI, 0.63-3.25). Male:female ratio was 1:1.09. the mean onset age of psoriasis was 7.9 years. Median onset age was earlier in males (6.5 years versus 9.0 years in females, p=0.05). Plaque psoriasis was the most common phenotype (89.1%) and 94.5% had scalp lesions. Arthritis was seen in 4.3%. Odds of excess adiposity, defined as bMI ≤85th percentile, was higher in children with psoriasis versus noninflammatory controls (Or 2.35, 95% CI 0.99-5.56, p= 0.052). No increased risk of adiposity was noted between children with psoriasis and eczema (Or 1.14, 95% CI 0.5-2.62, p=0.753). More children with psoriasis (17.4%) and eczema (20.3%) were underweight (bMI <5th percentile) compared to non-inflammatory controls (10.7%).. Malays and Indians are three to four times more likely than Chinese to have psoriasis in multi-ethnic Malaysia. Plaque psoriasis is the most common phenotype. Odds of excess adiposity is about two times higher in children with psoriasis compared to non-inflammatory controls although this observation just missed conventional statistical significance.

Topics: Body Mass Index; Case-Control Studies; Child; China; Female; Humans; India; Malaysia; Male; Obesity; Odds Ratio; Psoriasis

Topics: Adipose Tissue; Adolescent; Cross-Sectional Studies; Fasting; Female; Glucose Tolerance Test; Humans; Hyperinsulinism; Insulin; Insulin Resistance; Malaysia; Male; Obesity; Overweight; Sex Characteristics; Waist Circumference

To develop a better understanding of perceived barriers to and ideas for weight loss and maintenance among Malay homemakers in Singapore.. Interventions for weight management were reviewed, and 5 focus groups were conducted among overweight and obese Malay homemakers (n = 24) to explore barriers to and concepts and ideas pertaining to weight loss and maintenance.. Barriers identified included the lack of time, finances, and motivation. Ideas that were most appealing included free health screening, workshops on how best to manage children and family, regular fun group activities, monetary incentives for participation in activities for healthy living, and flexible part-time jobs.. The focus groups provided useful insights pointing toward possible interventions that could appeal to Malay homemakers in Singapore. The most appealing approaches were those that were time flexible and had the least financial burden or had a financial benefit.

Topics: Adult; Body Weight Maintenance; Female; Focus Groups; Health Promotion; Humans; Malaysia; Motivation; Obesity; Overweight; Singapore; Time Factors

Understanding the factors influencing physical activity (PA) in the Asia-Pacific region is critical, given the high prevalence of inactivity in this area. The photovoice technique explores the types of PA and factors influencing PA among adolescents in Kuching, Sarawak. A total of 160 photographs were collected from participants (adolescents, n = 22, mean age = 14.27 ± 0.7 years, and parents, n = 8, mean age = 48 ± 6.8 years). Data analysis used constant comparison methods of a grounded theory. The Analysis Grid for Environments Linked to Obesity was used to categorize PA factors. Study findings were centered on the concept of safety, facilities, parental restriction, friends, cultural traits, media, community cohesiveness, and weather. The central theme was "feeling unsafe" when being outdoors. To promote PA behavior, provision of PA facilities needs to be supported by other programs that build on peer support, crime prevention, and traffic safety, together with other educational campaigns.

Topics: Adolescent; Adolescent Behavior; Adult; Asia; Emotions; Environment; Female; Humans; Malaysia; Male; Middle Aged; Motor Activity; Obesity; Parents; Photography; Poverty Areas; Prevalence; Residence Characteristics; Safety

The Malaysian Cohort study was initiated in 2005 by the Malaysian government. The top-down approach to this population-based cohort study ensured the allocation of sufficient funding for the project which aimed to recruit 100,000 individuals aged 35-70 years. Participants were recruited from rural and urban areas as well as from various socioeconomic groups. The main objectives of the study were to identify risk factors, to study gene-environment interaction and to discover biomarkers for the early detection of cancers and other diseases. At recruitment, a questionnaire-based interview was conducted, biophysical measurements were performed and biospecimens were collected, processed and stored. Baseline investigations included fasting blood sugar, fasting lipid profile, renal profile and full blood count. From April 2006 to the end of September 2012 we recruited a total of 106,527 participants. The baseline prevalence data showed 16.6% participants with diabetes, 46.5% with hypertension, 44.9% with hypercholesterolaemia and 17.7% with obesity. The follow-up phase commenced in June 2013. This is the most comprehensive and biggest cohort study in Malaysia, and has become a valuable resource for epidemiological and biological research. For information on collaboration and also data access, investigators can contact the project leader at (rahmanj@ppukm.ukm.edu.my).

Topics: Adult; Age Distribution; Aged; Cause of Death; Chronic Disease; Diabetes Mellitus; Female; Gene-Environment Interaction; Humans; Hypercholesterolemia; Hypertension; Malaysia; Male; Middle Aged; Neoplasms; Obesity; Prevalence; Prospective Studies; Residence Characteristics; Rural Health; Sex Distribution; Socioeconomic Factors; Urban Health

To determine the effect of imparting knowledge of the Malaysian Food Guideline (MFG) on a group of overweight and obese women during Ramadan.. This intervention study was conducted during the months of Ramadan 2011. A group of 84 Malay Muslim women with a body mass index (BMI) ≥25 kg/m2 were recruited. Prior to Ramadan, the respondents were educated regarding MFG, and how to monitor and record their daily food intake in a food diary. Their quantity of food intake, BMI, blood pressure (BP), blood lipid profile, and fasting blood sugar (FBS) were measured before Ramadan as a baseline. Their quantity of food intake was then measured again in the third week, whereas their BMI, BP, blood lipid profile, and FBS were determined on the fourth week of Ramadan.. At baseline, compared with the MFG recommendations, the intake of protein (107.5%), and milk and dairy products (133%) was higher, whereas the intake of carbohydrates (78.5%), and vegetables and fruits (44.4%) was lower. During Ramadan, carbohydrate intake, BMI, high density lipoprotein-cholesterol (HDL-C) and low density lipoprotein-cholesterol (LDL)-C (all p=0.000), triglyceride (p=0.005), and FBS (p=0.002) were reduced, but the TC/HDL-C ratio was increased (p=0.000).. A month-long Ramadan fast guided by the knowledge of MFG resulted in certain positive changes in this group of respondents. These changes can be a good start for health improvement, provided that they are followed-up after Ramadan.

Topics: Adult; Blood Glucose; Blood Pressure; Body Mass Index; Diet Records; Fasting; Female; Humans; Islam; Lipids; Malaysia; Middle Aged; Obesity; Overweight

South East Asia (SEA) is home to over 30 tribes of indigenous population groups who are currently facing rapid socio-economic change. Epidemiological transition and increased prevalence of non-communicable diseases (NCD) has occured. In Peninsular Malaysia, the Orang Asli (OA) indigenous people comprise 0 · 6% (150,000) of the population and live in various settlements. OA comprise three distinct large tribes with smaller sub-tribes. The three large tribes include Proto-Malay (sub-tribes: Orang Seletar and Jakun), Senoi (sub-tribes: Mahmeri and Semai), and Negrito (sub-tribes: Jehai, Mendriq and Batek).. We studied the health of 636 OA from seven sub-tribes in the Peninsular. Parameters that were assessed included height, weight, BMI and waist circumference whilst blood pressure, cholesterols, fasting blood glucose and HbA1c levels were recorded. We then analysed cardio-metabolic risk factor prevalences and performed multiple pair-wise comparisons among different sub-tribes and socio-economic clusters.. Cardio-metabolic risk factors were recorded in the seven sub-tribes.. Prevalence for general and abdominal obesity were highest in the urbanized Orang Seletar (31 · 6 ± 5 · 7%; 66 · 1 ± 5 · 9%). Notably, hunter gatherer Jehai and Batek tribes displayed the highest prevalence for hypertension (43 · 8 ± 9 · 29% and 51 · 2 ± 15 · 3%) despite being the leanest and most remote, while the Mendriq sub-tribe, living in the same jungle area with access to similar resources as the Batek were less hypertensive (16.3 ± 11.0%), but displayed higher prevalence of abdominal obesity (27.30 ± 13.16%).. We describe the cardio-metabolic risk factors of seven indigenous communities in Malaysia. We report variable prevalence of obesity, cholesterol, hypertension and diabetes in the OA in contrast to the larger ethnic majorities such as Malays, Chinese and Indians in Malaysia These differences are likely to be due to socio-economic effects and lifestyle changes. In some sub-tribes, other factors including genetic predisposition may also play a role. It is expected that the cardio-metabolic risk factors may worsen with further urbanization, increase the health burden of these communities and strain the government's resources.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Asian People; Diabetes Mellitus; Female; Humans; Hypercholesterolemia; Hypertension; Malaysia; Male; Middle Aged; Obesity; Prevalence; Risk Factors; Urbanization; Young Adult

This study aims to compare various body composition indices and their association with a predicted cardiovascular disease (CVD) risk profile in an urban population in Kuala Lumpur, Malaysia.. A cross-sectional survey was conducted in metropolitan Kuala Lumpur, Malaysia, in 2012. Households were selected using a simple random-sampling method, and adult members were invited for medical screening. The Framingham Risk Scoring algorithm was used to predict CVD risk, which was then analyzed in association with body composition measurements, including waist circumference, waist-hip ratio, waist-height ratio, body fat percentage, and body mass index.. Altogether, 882 individuals were included in our analyses. Indices that included waist-related measurements had the strongest association with CVD risk in both genders. After adjusting for demographic and socioeconomic variables, waist-related measurements retained the strongest correlations with predicted CVD risk in males. However, body mass index, waist-height ratio, and waist circumference had the strongest correlation with CVD risk in females.. The waist-related indicators of abdominal obesity are important components of CVD risk profiles. As waist-related parameters can quickly and easily be measured, they should be routinely obtained in primary care settings and population health screens in order to assess future CVD risk profiles and design appropriate interventions.

Topics: Adult; Aged; Aged, 80 and over; Body Composition; Cardiovascular Diseases; Causality; Comorbidity; Female; Humans; Malaysia; Male; Middle Aged; Obesity; Prevalence; Risk Assessment; Urban Population

Our study investigated the association of UCP1 -3826A/G and UCP3 -55C/T single nucleotide polymorphisms (SNPs) with obesity and its related traits among multi-ethnic Malaysians.. A total of 447 (225 males; 46 Malays, 339 ethnic Chinese, 62 ethnic Indians; 111 obese) participated.. Demographic and anthropometric data were collected, and genotyping was performed by polymerase chain reaction-restriction fragment length polymorphism.. The minor allele frequencies (MAFs) for UCP1 according to Malay/Chinese/Indian ethnicities were .61/.55/.52 and .32/.55/.38, respectively. UCP3 genotype and allele distribution was significantly associated with ethnicity and waist-to-hip ratio (WHR), but among non-obese and Chinese participants only, respectively, after stratified analysis. Chinese participants with T allele had significantly lesser risk to be centrally obese [odds ratio =.69 (CI =.48, 1.00; P=.04)], and also had significantly lower WHR compared to those with C allele. The UCP1 or UCP3 SNPs were not associated with obesity/BMI and total body fat (TBF), but combinatory genotype analysis revealed that those having the AA and CC genotype for the former and latter SNPs had significantly highest BMI and TBF compared to other genotype combinations.. UCP3 -55C/T SNP was associated with central obesity among Malaysian participants of Chinese descent. Combinatory genotype analysis showed that BMI and TBF were significantly different among UCPI -3826A/G and UCP3 -55C/T genotype combinations, suggesting the existence of a gene interaction between UCP1 and UCP3 in influencing obesity and adiposity.

Topics: Adult; Alleles; Anthropometry; Asian People; Demography; Female; Genotype; Humans; Ion Channels; Malaysia; Male; Mitochondrial Proteins; Obesity; Polymorphism, Single Nucleotide; Uncoupling Protein 1; Uncoupling Protein 3

We aimed to predict the ten-year cardiovascular disease (CVD) risk among low-income urban dwellers of metropolitan Malaysia. Participants were selected from a cross-sectional survey conducted in Kuala Lumpur. To assess the 10-year CVD risk, we employed the Framingham risk scoring (FRS) models. Significant determinants of the ten-year CVD risk were identified using General Linear Model (GLM). Altogether 882 adults (≥30 years old with no CVD history) were randomly selected. The classic FRS model (figures in parentheses are from the modified model) revealed that 20.5% (21.8%) and 38.46% (38.9%) of respondents were at high and moderate risk of CVD. The GLM models identified the importance of education, occupation, and marital status in predicting the future CVD risk. Our study indicated that one out of five low-income urban dwellers has high chance of having CVD within ten years. Health care expenditure, other illness related costs and loss of productivity due to CVD would worsen the current situation of low-income urban population. As such, the public health professionals and policy makers should establish substantial effort to formulate the public health policy and community-based intervention to minimize the upcoming possible high mortality and morbidity due to CVD among the low-income urban dwellers.

Topics: Adult; Aged; Aged, 80 and over; Cardiovascular Diseases; Comorbidity; Cross-Sectional Studies; Employment; Female; Humans; Malaysia; Male; Marital Status; Middle Aged; Obesity; Poverty; Prevalence; Prognosis; Risk Assessment; Risk Factors; Sex Distribution; Social Class; Survival Analysis; Survival Rate; Urban Population

Obesity, in the past was perceived to be the problem of the rich, but recent studies have reported that the problem of obesity is a worldwide problem and rural population is no less affected. Self-perceived health and weight appropriateness is an important component of weight-loss and eating behaviors and may be mediated by local, social and cultural patterning. In addition to the quality of life assessment, it should therefore be an important focal point for the design and implementation of clinical and public health policies.. The present study was carried out to assess the self-perception of weight appropriateness as well as the quality of life of overweight and obese individual among the rural population particularly among housewives. A total of 421 respondents participated in the study which consisted of 36.6% in the overweight and 63.4% in the obese categories.. the analysis of the survey revealed that self-perception regarding obesity among respondents show common similarities, particularly in self reporting on health, dietary habit and also the concept of beauty and a beautiful body. Character and behavior are highly regarded in evaluating a person's self-worth in society. The results on the quality of life using the ORWELL 97 instrument show that the quality of life of respondents was moderate. Most of the respondents were aware of their body weight and indicated an intention to lose weight but also reported themselves as healthy or very healthy.. The results of the survey indicated that perception on obesity did not differed very much between respondents, in fact there existed a lot of similarities in their perception about health, quality of life, personal health and self-satisfaction with own body. However, their quality of life was within the normal or moderate level based on the ORWELL 97 assessment. Even though most of the respondents were aware of their body weight and indicated an intention to lose weight they also reported themselves as healthy or very healthy, suggesting that public health messages intended for rural housewives need to be more tailored to health-related consequences of fatness.

Topics: Adult; Aged; Aged, 80 and over; Body Image; Body Mass Index; Female; Household Work; Humans; Malaysia; Male; Middle Aged; Obesity; Overweight; Quality of Life; Rural Population; Self Concept; Self Report; Socioeconomic Factors; Young Adult

To determine the prevalence of normal weight obesity among multi-ethnic women in Peninsular Malaysia and examine its associations with cardiometabolic risks and lifestyle behaviours.. This was a cross-sectional study involving women recruited via multi-stage sampling from six states in Malaysia. Anthropometric and body composition analysis were performed. Normal weight obese (NWO) was defined as normal body mass index for Asians and the highest tertile of % body fat (BF). Biochemical measurements included fasting lipid and blood glucose levels. Metabolic syndrome was diagnosed based on the Harmonization criteria. Participants completed self-reported questionnaires that included physical activity, smoking, alcohol consumption, fruit and vegetable intake and sleep duration.. Body mass index, %BF, cardiometabolic risk factors, lifestyle behaviours.. A total of 6854 women were recruited and the prevalence of NWO was 19.8% (95% CI: 17.3-22.5). NWO was more prevalent among the Indians and older women. NWO women had higher odds for abdominal obesity (OR: 2.64, 95% CI: 1.73-4.04), hypertriglyceridemia (2.51, 1.47-4.29) and hypertension (1.63, 1.15-2.31) compared to women with lower % body fat after adjusted for age and ethnicity. The prevalence of metabolic syndrome among NWO women was 5.4% (95% CI: 3.0-9.8). None of the lifestyle behaviours were significantly associated with NWO.. Women with NWO had cardiometabolic abnormalities including abdominal obesity, dyslipidaemia and increased blood pressure. Health promotion efforts should include NWO women who may be oblivious of their deleterious health risks.

Topics: Adiposity; Adult; Aged; Body Mass Index; Body Weight; Cross-Sectional Studies; Developing Countries; Female; Health Behavior; Humans; Hypertension; Hypertriglyceridemia; Life Style; Malaysia; Metabolic Syndrome; Middle Aged; Obesity; Obesity, Abdominal; Prevalence; Risk Factors

Single nucleotide polymorphisms (SNP) in the resistin gene (RETN) are linked to obesity and resistin levels in various populations. However, results have been inconsistent. This study aimed to investigate association between polymorphisms in the resistin gene with obesity in a homogenous Malaysian Malay population. This study is also aimed to determine association between resistin levels with certain SNPs and haplotypes of RETN. A total of 631 Malaysian Malay subjects were included in this study and genotyping was carried out using Sequenom MassARRAY. There was no significant difference found in both allelic and genotype frequencies of each of the RETN SNPs between the obese and non-obese groups after Bonferroni correction. RETN rs34861192 and rs3219175 SNPs were significantly associated with log-resistin levels. The GG genotype carriers are found to have higher levels of log-resistin compared to A allele carriers. The RETN haplotypes (CAG, CGA and GA) were significantly associated with resistin levels. However, the haplotypes of the RETN gene were not associated with obesity. Resistin levels were not correlated to metabolic parameters such as body weight, waist circumference, body mass index, and lipid parameters. RETN SNPs and haplotypes are of apparent functional importance in the regulation of resistin levels but are not correlated with obesity and related markers.

Topics: Genetic Association Studies; Genotype; Humans; Lipid Metabolism; Malaysia; Middle Aged; Obesity; Polymorphism, Single Nucleotide; Resistin

To study the dietary intake and level of physical activity (PA) of patients with diabetes mellitus and the association with non-alcoholic fatty liver disease (NAFLD).. Consecutive adult patients with type 2 diabetes mellitus seen in our hospital diabetes clinic were enrolled. The Global Physical Activity Questionnaire and a semi-quantitative food-frequency questionnaire were used to assess PA and dietary intake, respectively. Diagnosis of NAFLD was ultrasound-based and following exclusion of significant alcohol intake and other causes of chronic liver disease.. Data for 299 patients were analyzed (mean age 63.3±10.5 years old, 41.1% male). Prevalence of NAFLD was 49.2%. Patients with low PA were more likely to have NAFLD (OR=1.75, 95% CI=1.03-2.99, p=0.029). There was no significant difference in energy intake, intake of macronutrients and percentage energy intake from each macronutrient, high sugar food, high cholesterol food and high SFA food between patients with and without NAFLD. Among centrally obese patients, patients with low PA and in the highest quartile of percentage energy intake from fat (OR=4.03, 95% CI=1.12-15.0, p=0.015), high cholesterol food (OR=3.61, 95% CI=1.37-9.72, p=0.004) and high SFA food (OR=2.67, 95% CI=1.08-6.67, p=0.019) were most likely to have NAFLD. Among those who were not centrally obese, PA and percentage energy intake from fat, high cholesterol food and high SFA food was not associated with NAFLD.. Low PA and high percentage energy intake from fat, high cholesterol food and high SFA food is associated with NAFLD in centrally obese but not in non-centrally obese patients with diabetes mellitus.. 目的：研究糖尿病患者的膳食摄入和体力活动水平以及与非酒精性脂肪肝病 （NAFLD）的关系。方法：连续到我院糖尿病门诊就诊的成年2 型糖尿病患 者报名参加课题。分别用国际体力活动问卷和半定量食物频率问卷评估体力活 动和膳食摄入。NAFLD 的诊断是基于超声并排除酒精摄入和其它原因引起的 严重慢性肝病。结果：299 名患者的数据被纳入分析，平均年龄为63.3±10.5 岁，其中41.1%为男性。NAFLD 的患病率为49.2%。低体力活动的患者更容 易患NAFLD（OR=1.75，95% CI =1.03-2.99，p=0.029）。2 型糖尿病患者患 NAFLD 与否在能量摄入，宏量营养素的摄入及其能量百分比，高糖食物、高 胆固醇食物和高饱和脂肪酸食物的摄入之间没有显著差异。低体力活动并处于 脂肪来源能量百分比的最高四分之一（ OR=4.03, 95% CI=1.12-15.0, p=0.015）、摄入高胆固醇食物（OR=3.61, 95% CI=1.37-9.72, p=0.004）和高饱 和脂肪酸食物（OR=2.67, 95% CI=1.08-6.67, p=0.019）的向心性肥胖患者更容 易发生NAFLD。在没有向心性肥胖的患者中，体力活动和能量百分比来自脂 肪、高胆固醇食物和高饱和脂肪酸食物均与NAFLD 无关。结论：低体力活动 和能量百分比来自高脂肪、高胆固醇食物和高饱和脂肪酸食物均与糖尿病患者 中向心性肥胖者的非酒精性脂肪肝病有关，而与非向心性肥胖者无关。.

Topics: Aged; Body Mass Index; Cholesterol, Dietary; Cross-Sectional Studies; Diabetes Mellitus, Type 2; Diet; Diet, High-Fat; Dietary Sucrose; Energy Intake; Food; Humans; Malaysia; Middle Aged; Motor Activity; Non-alcoholic Fatty Liver Disease; Obesity; Obesity, Abdominal; Surveys and Questionnaires; Waist Circumference

We previously reported ethnic disparity in adverse outcomes among Asians with type 2 diabetes (T2DM) in Singapore. Central arterial stiffness can aggravate systemic vasculopathy by propagating elevated systolic and pulse pressures forward, thereby accentuating global vascular injury. We aim to study ethnic disparity in central arterial stiffness and its determinants in a multi-ethnic T2DM Asian cohort.. Arterial stiffness was estimated by carotid-femoral pulse wave velocity (PWV) and augmentation index (AI) using applanation tonometry method in Chinese (N = 1045), Malays (N = 458) and Indians (N = 468). Linear regression model was used to evaluate predictors of PWV and AI.. PWV was higher in Malays (10.1 ± 3.0 m/s) than Chinese (9.7 ± 2.8 m/s) and Indians (9.6 ± 3.1 m/s) (P = 0.018). AI was higher in Indians (28.1 ± 10.8%) than Malays (25.9 ± 10.1%) and Chinese (26.1 ± 10.7%) (P < 0.001). Malays remain associated with higher PWV (β = 0.299, P = 0.048) post-adjustment for age, gender, duration of diabetes, hemoglobin A1c, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), soluble receptor for advanced glycation end-products, urinary albumin-to-creatinine ratio, and insulin usage, which were all independent predictors of PWV. Indians remain associated with higher AI (β = 2.776, P < 0.001) post-adjustment for age, gender, BMI, SBP, DBP, and height, which were independent predictors of AI. These variables explained 27.7% and 33.4% of the variance in PWV and AI respectively.. Malays and Indians with T2DM have higher central arterial stiffness, which may explain their higher risk for adverse outcomes. Modifying traditional major vascular risk factors may partially alleviate their excess cardiovascular risk through modulating arterial stiffness.

Topics: Aged; Arteriosclerosis; Asian People; Cardiovascular Agents; China; Comorbidity; Cross-Sectional Studies; Diabetes Mellitus, Type 2; Diabetic Angiopathies; Disease Susceptibility; Female; Glycated Hemoglobin; Glycation End Products, Advanced; Humans; Hypertension; Hypoglycemic Agents; India; Malaysia; Male; Middle Aged; Obesity; Pulse Wave Analysis; Risk Factors; Singapore; Vascular Stiffness

Double-burden of malnutrition (DBM) is an emerging public health concern among the Orang Asli (indigenous peoples) of Peninsular Malaysia. This study aimed to identify the presence of DBM at the community and household levels in Orang Asli population and its associated demographic and socio-economic factors.. This cross-sectional study was conducted in 11 Orang Asli villages surrounding the Krau Wildlife Reserve, Peninsular of Malaysia from October 2011 to January 2012. Of 438 households, a total of 981 adults and 304 children who met the study criteria agreed to participate. About 160 households were further selected with pairs of children aged 3-59 months and non-pregnant mothers aged 15-55 years. Demographic and socio-economic data were obtained using interviewer-administered questionnaire while weight and height were measured using standard procedures. Double-burden of malnutrition was defined as overweight/obese mother-underweight child (OWOBM/UWC), overweight/obese mother-stunted child (OWOBM/STC) or overweight/obese mother-underweight or/and stunted child (OWOBM/UWSTC). Binary logistic regression identified the demographic and socio-economic factors associated with double-burden households.. About 26 % of overweight and obese adults coexisting with high proportions of underweight (49%) and stunted (64%) children in these Orang Asli villages. There was a higher prevalence of households with OWOBM/UWSTC (20%) and OWOBM/STC (19.4%) than households with OWOBM/UWC (12.5%). Boys (P < 0.05), older age mothers (P < 0.05), mothers with higher education (P < 0.05) and households with income per capita less than USD 29.01 (RM 97.00) (P < 0.01) were associated with higher odds of OWOBM/STC. Jah Hut (P < 0.05) and higher number of children (P < 0.05) were significantly associated with lower odds of OWOBM/UWC.. The occurrence of double-burden of malnutrition in Orang Asli population deserves attention. Poverty reduction, access to quality diet and improved health and nutrition literacy are among strategies that could address the coexistence of DBM in this population.

Topics: Adolescent; Adult; Age Factors; Asian People; Body Weights and Measures; Child, Preschool; Cross-Sectional Studies; Diet; Humans; Malaysia; Male; Malnutrition; Middle Aged; Mothers; Nutritional Status; Obesity; Overweight; Prevalence; Risk Factors; Sex Factors; Socioeconomic Factors; Thinness

Chronic periodontitis (CP) is a global public health issue. Studies have suggested CP could be linked to obesity due to their similar pathophysiological pathway. The aim of this study is to determine the prevalence of CP and to assess the predictors for CP among the obese Malaysian population.. This is a cross-sectional study on obese participants. Obesity is defined as an individual who has Body Mass Index (BMI) ≥ 27.5 kg/m(2). A convenience sampling method was used. A total of 165 paricipants were recruited. This study involved answering questionnaires, obtaining biometric and clinical measurements of Visible plaque index (VPI), Gingival bleeding index (GBI), Probing pocket depth (PPD) and Clinical attachment loss (CAL). Data analysis was carried out using SPSS statistical software (SPSS Inc., version 20, US).. A total of 165 participants; 67 (40.6%) males and 98 (59.4%) females participated in the study. Mean age of the participants was 43.9 (± 8.9). The prevalence of CP among the obese population was found to be 73.9%. Out of this, 43 and 55% were categorised as moderate and severe CP respectively. Around 64% of participants had sites with CAL ≥ 4 mm and participants with sites with PPD ≥ 4 mm were reported to be 25%. Around 83% of the participants had sites with GBI ≥ 30 and 92% of participants had sites with VPI ≥ 20%. GBI and VPI were found to have significantly higher odds for CP.. Prevalence of CP was high among obese Malaysians. GBI and VPI were potential predictors for CP in this obese population.

Topics: Adult; Aged; Alcohol Drinking; Body Mass Index; China; Chronic Periodontitis; Cross-Sectional Studies; Dental Care; Dental Plaque Index; Educational Status; Ethnicity; Female; Humans; India; Malaysia; Male; Middle Aged; Obesity; Periodontal Attachment Loss; Periodontal Index; Periodontal Pocket; Prevalence; Smoking; Toothbrushing

We conducted a cross sectional study of cardiovascular risk factors among healthcare workers at four government hospitals in Kelantan, Malaysia. We randomly selected 330 subjects fulfilling the following study criteria: those who had been working for at least one year at that health facility, Malaysians citizens and those with some form of direct contact with patients. We conducted an interview, obtained physical measurements, a fasting blood sugar and fasting lipid profiles among 308 subjects. The mean age of the subjects was 43.5 years, 82% were female; 30.8%, 14.3%, 10.4%, 1.3% and 1.6% of the subjects had dyslipidemia, hypertension, diabetes mellitus, a history of stroke and a history of ischemic heart disease, respectively. Forty-two percent of subjects had at least one medical condition. The mean body mass index (BMI) was 27.0 kg/M2 (SD=4.8) and 24.3% had a BMI > or =30 kg/M2. The mean systolic and diastolic blood pressures were 121.5 mmHg (SD=14.0) and 76.5 mmHg (SD=9.7), respectively and the mean waist-hip ratio was 0.84 (SD=0.1). The mean fasting blood sugar, total cholesterol, triglyceride, high density lipoprotein and low density lipoprotein were 5.8 mmol/l (SD=2.4), 5.5 mmol/l (SD=1.0), 1.4 mmol/l (SD=0.9), 1.5 mmol/l (SD=0.3) and 3.5 mmol/l (SD=0.9), respectively. Our study population had a smaller proportion of hypertension than that of the general Malaysian population. They had higher fasting total cholesterol, slightly lower fasting blood sugar, with a large proportion of them, obese and had diabetes. Immediate intervention is needed to reduce the traditional cardiovascular risk factors in this population. Keywords: cardiovascular risk factors, health care workers, Malaysia

Topics: Adult; Blood Glucose; Body Mass Index; Cardiovascular Diseases; Cross-Sectional Studies; Diabetes Mellitus; Dyslipidemias; Female; Health Personnel; Humans; Hypertension; Malaysia; Male; Middle Aged; Obesity; Risk Factors; Waist-Hip Ratio

Numerous studies have shown the importance of physical activity in reducing the morbidity and mortality rates caused by cardiovascular disease (CVD). However, most of these studies emphasise little on the cumulative effect of CVD risk factors. Hence, this study investigates the association between physical exercise and cumulative CVD risk factors among adults in three different age groups.. Using a sample of 7276 respondents drawn from community centers, the REDISCOVER team gathered information on physical activity, CVD risk factors (obesity, diabetes, hypertension, hypercholesterolemia, tobacco use) and socioeconomic and demographic variables in Malaysia. Because the study required medical examination, a convenience sampling frame was preferred in which all volunteers were included in the study. Fasting blood samples and anthropometric (height, weight and more) measurements were collected by trained staffs. Socio-demographic and physical activity variables were recorded through questionnaires. A Chi-square test was performed to identify the bivariate association between the covariates (socioeconomic variables, demographic variables and physical activity) and outcome variable. The association between the main exposure, physical activity, and the outcome variable, cumulative CVD risk factors, was assessed using an ordinal logistic regression model, controlling for socioeconomic status and demographic influences in three different age groups, 35-49, 50-64 and 65 and above.. The mean age of participants is 51.8 (SD = 9.4). Respondents in the age groups of 35-49 (aORmoderate = 0.12; 95 % CI: 0.02 - 0.53 ) and 65 and above (aORhigh = 0.58; 95 % CI: 0.24, 0.78) showed a statistically significant inverse relationship between physical activity and cumulative CVD risk factors. However, this relationship was not significant among respondents in the 50-64 age group suggesting the possible influence of other variables, such as stress and environment.. The statistically significant results show a negative association between physical exercise and cumulative CVD risk factors. However, the lack of a significant relationship in the 50-64 age group suggests the need to include other considerations in future studies, such as stress and environment.

Topics: Adult; Aged; Anthropometry; Asian People; Cardiovascular Diseases; Diabetes Complications; Exercise; Female; Humans; Hypercholesterolemia; Hypertension; Logistic Models; Malaysia; Male; Middle Aged; Motor Activity; Obesity; Risk Factors; Surveys and Questionnaires

This study aimed to investigate the association of peroxisome proliferator-activated receptor (PPAR) genes PPARα L162V, PPARγ2 C161T and PPARδ T294C single nucleotide polymorphisms (SNPs) with obesity and metabolic syndrome (Met-S) in a multi-ethnic population in Kampar, Malaysia.. Socio-demographic data, anthropometric and biochemical measurements (plasma lipid profile, adiponectin and interleukin-6 [IL-6] levels) were taken from 307 participants (124 males; 180 obese; 249 Met-S; 97 Malays, 85 ethnic Chinese, 55 ethnic Indians).. The overall minor allele frequencies were .08, .22 and .30 for PPAR α L162V, γ C161T, δ T294C, respectively. All SNPs were not associated with obesity, Met-S and obesity with/without Met-S by χ(2) analysis, ethnicity-stratified and logistic regression analyses. Nevertheless, participants with V162 allele of PPARα had significantly higher IL-6, while those with T161 allele of PPARγ2 had significantly lower HOMA-IR.. All PPAR SNPs were not associated with obesity and Met-S in the suburban population of Kampar, Malaysia, where only PPARα V162 and PPARγ2 T161 alleles were associated with plasma IL-6 and HOMA-IR, respectively.

Topics: Adiponectin; Adult; Aged; Aged, 80 and over; Anthropometry; Asian People; Ethnicity; Female; Gene Frequency; Humans; Interleukin-6; Malaysia; Male; Metabolic Syndrome; Middle Aged; Obesity; Peroxisome Proliferator-Activated Receptors; Polymorphism, Single Nucleotide; Young Adult

This was a cross-sectional study that investigated the relationship between nutrient intake and psychosocial factors with the overall rate of weight loss after bariatric surgery among patients who had undergone sleeve gastrectomy in University Kebangsaan Malaysia Medical Centre (UKMMC). Forty-three subjects (15 men and 28 women) were recruited for this study. Subjects completed assessment questionnaires including the Binge Eating Scale (BES), Beck Depression Inventory (BECK), Family Support Questionnaires, and the Index of Peer Relation (IPR). Results showed that the median overall rate of weight loss was 4.3±5.5 kg/month, which was lower when compared to the rate of weight loss at three months which was 5.0±5.6 kg/month. Pre-operative weight was the predictor of overall rate of weight loss (p<0.05, R²=0.52). Binge eating disorder (BED) and depression were also closely associated with each other after bariatric surgery (p<0.001, R²=0.46). Subjects with good compliance to dietary advice had lower scores on the binge eating scale. The mean caloric and protein intake was very low, only 562±310 kcal/day and 29.6±16.1 g/day. The intake of vitamin A, B-1, B-2, B-3, B-12, C, folate, and iron met the Malaysian Recommended Nutrient Intake (RNI). However, the RNI for calcium, zinc, selenium, vitamin D, and vitamin E was not met. In conclusion, although bariatric surgery had many health benefits, several factors hindered weight loss after bariatric surgery. Health care professionals should closely monitor patients after bariatric surgery.. 该研究是一项横断面研究，旨在探讨减肥手术患者营养摄入和社会心理因素 与总失重率的关系。研究对象为来自马来西亚Kebangsaan 大学医疗中心接受 袖状胃切除术的患者（UKMMC）。共招募43 名受试者（15 名男性和28 名 女性）参加了本研究，受试者完成的问卷中有暴饮暴食规模（BES）、Beck 抑郁问卷（Beck）、家庭支持和同伴关系指标（IPR）等。结果表明，总失重 率的中位数为4.3±5.5 千克/月，低于3 个月时的5.0±5.6 千克/月。术前体重是 总失重率的预测因子（p<0.05，R²=0.52）。减肥手术患者暴饮暴食和抑郁之 间有密切相关（p<0.001，R²=0.46）。对饮食建议有良好依从性的患者暴饮暴 食得分较低。减肥手术患者平均热量和蛋白质的摄入量非常低，只有 562±310 千卡/天和29.6±16.1 克/天，维生素A、B-1、B-2、B-3、B-12、C、 叶酸和铁的摄入量达到马来西亚的推荐摄入量（RNI）。然而，钙、锌、 硒、维生素D 和维生素E 的摄入量未达到RNI。总之，虽然减肥手术对健康 有很多好处，有几个因素阻碍了减肥手术后减重，医护人员应密切监测减肥 手术后患者。.

Topics: Adult; Bariatric Surgery; Binge-Eating Disorder; Cross-Sectional Studies; Depression; Diet; Diet Records; Dietary Proteins; Energy Intake; Family; Female; Gastrectomy; Humans; Malaysia; Male; Middle Aged; Nutrition Policy; Nutritional Requirements; Obesity; Psychology; Social Support; Surveys and Questionnaires; Treatment Outcome; Weight Loss

Recent findings have shown that the rs1042714 (Gln27Glu) single-nucleotide polymorphism (SNP) on the β2-adrenoceptor gene may predispose to obesity. The findings from other studies carried on different populations, however, have been inconsistent. The authors investigated the association between the rs1042714 SNP with obesity-related parameters. DNA of 672 Malaysian Malays was analyzed using real-time polymerase chain reaction. Univariate and multivariate linear regression analyses revealed significant associations between rs1042714 and diastolic blood pressure in the pooled Malaysian Malay subjects under additive and recessive models. After gender stratification, however, a significant association was found between the rs1042714 and triglyceride and the rs1042714 and log-transformed high-density lipoprotein cholesterol levels in Malaysian Malay men. No significant association was found between the SNP and log-transformed body mass index. This polymorphism may have an important role in the development of obesity-related traits in Malaysian Malays. Gender is an effect modifier for the effect of the rs1042714 polymorphism on obesity-related traits in Malaysian Malays.

Topics: Adult; Aged; Asian People; Body Mass Index; Cholesterol, HDL; Cross-Sectional Studies; Female; Genotype; Humans; Malaysia; Male; Middle Aged; Obesity; Polymerase Chain Reaction; Polymorphism, Single Nucleotide; Receptors, Adrenergic, beta-2; Sex Factors; Triglycerides

The present study examined objectively measured physical activity in Malaysian children and compared the differences in physical levels between obese and healthy weight children. Eighty-six obese children were matched for age and sex with 86 healthy weight children with median age 9.5 years. Habitual physical activity and sedentary behaviour were measured over 5 days using Actigraph accelerometers. Time spent sedentary was significantly higher in the obese group (90% vs. 86% of daytime; p = 0.001). Moderate-to-vigorous-intensity physical activity was significantly higher in the healthy weight group (1.2 vs. 0.7% of daytime, p < 0.001). In both healthy weight and obese children, physical activity levels were exceptionally low, although moderate-to-vigorous-intensity physical activity was significantly lower in the obese group than the healthy weight group. Efforts to prevent and treat obesity in Malaysian children will need a substantial focus on the promotion of reductions in sedentary behaviour and increases in physical activity.

Topics: Accelerometry; Adolescent; Body Mass Index; Case-Control Studies; Child; Child Behavior; Exercise; Female; Habits; Humans; Malaysia; Male; Motor Activity; Obesity; Risk Factors; Sedentary Behavior; Social Class; Socioeconomic Factors; Surveys and Questionnaires

This study aimed to identify cultural-level variables that may influence the extent to which adolescents from different cultural groups are dissatisfied with their bodies.. A sample of 1730 male and 2000 female adolescents from Australia, Fiji, Malaysia, Tonga, Tongans in New Zealand, China, Chile, and Greece completed measures of body satisfaction, and the sociocultural influences on body image and body change questionnaire, and self-reported height and weight. Country gross domestic product and national obesity were recorded using global databases.. Prevalence of obesity/overweight and cultural endorsement of appearance standards explained variance in individual-level body dissatisfaction (BD) scores, even after controlling for the influence of individual differences in body mass index and internalization of appearance standards.. Cultural-level variables may account for the development of adolescent BD.

Topics: Adolescent; Body Image; Body Mass Index; Chile; China; Cross-Cultural Comparison; Cross-Sectional Studies; Cultural Characteristics; Female; Greece; Gross Domestic Product; Humans; Malaysia; Male; Models, Statistical; New Zealand; Obesity; Overweight; Personal Satisfaction; Prevalence; Self Concept; Self Report; Sex Factors; Surveys and Questionnaires; Tonga

Greater maternal adiposity is a potentially modifiable risk factor for elevated blood pressure during pregnancy; however, the association has been little studied in Asian populations, and no study has evaluated potential differences in the adiposity-blood pressure relation between ethnic groups or interaction with gestational diabetes.. We performed a cross-sectional evaluation of a Singapore mother-offspring cohort comprising 799 pregnant Chinese, Malay and Indian women. Data on body weight, height, skinfold thickness and glycaemia (oral glucose tolerance test) were collected during the 2nd trimester; peripheral SBP and DBP were measured using an oscillometric device and central pressures by noninvasive radial applanation tonometry. The associations between adiposity measures BMI and sum of skinfold thickness and blood pressure outcomes were examined by linear regression with adjustment for potential confounders.. Higher maternal BMI was associated with elevated peripheral and central pressures: the increases in pressure (mmHg) for each kg/m(2) increase in BMI were 1.19 (95% confidence interval, 1.03-1.36) for peripheral SBP, 0.76 (0.63-0.89) for peripheral DBP, 1.02 (0.87-1.17) for central systolic pressure and 0.26 (0.16-0.37) for central pulse pressure. The associations were generally stronger in Chinese women (P-interaction = 0.03 for central pulse pressure) and individuals with gestational diabetes (P-interaction = 0.03 for DBP and P-interaction = 0.046 for central systolic pressure). Similar patterns of results were found when using skinfold thickness as the measure of adiposity.. Maternal adiposity is associated with higher peripheral and central blood pressures during pregnancy. Stronger associations in Chinese women and individuals with gestational diabetes warrant further investigation.

Topics: Adiposity; Adult; Asian People; Blood Pressure; Body Mass Index; Body Weight; China; Cohort Studies; Cross-Sectional Studies; Diabetes, Gestational; Female; Glucose Tolerance Test; Humans; India; Malaysia; Mothers; Obesity; Pregnancy; Pregnancy Complications; Pregnancy Trimester, Second; Regression Analysis; Risk Factors

Studies have shown that single-nucleotide polymorphisms (SNPs) on the ADIPOQ gene have been linked with obesity and with adiponectin levels in various populations. Here, we aimed to investigate the association of ADIPOQ rs17366568 and rs3774261 SNPs with obesity and with adiponectin levels in Malaysian Malays. Obesity parameters and adiponectin levels were measured in 574 subjects. Genotyping was performed using real-time polymerase chain reaction and Sequenom MassARRAY. A significant genotypic association was observed between ADIPOQ rs17366568 and obesity. The frequencies of AG and AA genotypes were significantly higher in the obese group (11%) than in the non-obese group (5%) (P=0.024). The odds of A alleles occurring among the obese group were twice those among the non-obese group (odds ratio 2.15; 95% confidence interval 1.13-4.09). However, no significant association was found between allelic frequencies of ADIPOQ rs17366568 and obesity after Bonferroni correction (P>0.025) or between ADIPOQ rs3774261 and obesity both at allelic and genotypic levels. ADIPOQ SNPs were not significantly associated with log-adiponectin levels. GA, GG, and AG haplotypes of the ADIPOQ gene were not associated with obesity. We confirmed the previously reported association of ADIPOQ rs17366568 with the risk of obesity. ADIPOQ SNPs are not important modulators of adiponectin levels in this population.

Topics: Adiponectin; Adult; Alleles; Asian People; Female; Gene Frequency; Genetic Association Studies; Genetic Predisposition to Disease; Genotype; Haplotypes; Humans; Malaysia; Middle Aged; Obesity; Polymorphism, Single Nucleotide; Risk Factors

Recent studies revealed a possible reciprocal relationship between the skeletal system and obesity and lipid metabolism, mediated by osteocalcin, an osteoblast-specific protein. This study aimed to validate the relationship between serum osteocalcin and indices of obesity and lipid parameters in a group of Malaysian men.. A total of 373 men from the Malaysian Aging Male Study were included in the analysis. Data on subjects' demography, body mass index (BMI), body fat (BF) mass, waist circumference (WC), serum osteocalcin and fasting lipid levels were collected. Bioelectrical impendence (BIA) method was used to estimate BF. Multiple linear and binary logistic regression analyses were performed to analyze the association between serum osteocalcin and the aforementioned variables, with adjustment for age, ethnicity and BMI.. Multiple regression results indicated that weight, BMI, BF mass, BF %, WC were significantly and negatively associated with serum osteocalcin (p < 0.001). There was a significant positive association between serum osteocalcin and high density lipoprotein (HDL) cholesterol (p = 0.032). Binary logistic results indicated that subjects with low serum osteocalcin level were more likely to be associated with high BMI (obese and overweight), high BF%, high WC and low HDL cholesterol (p < 0.05). Subjects with high osteocalcin level also demonstrated high total cholesterol level (p < 0.05) but this association was probably driven by high HDL level. These variables were not associated with serum C-terminal of telopeptide crosslinks in the subjects (p > 0.05).. Serum osteocalcin is associated with indices of obesity and HDL level in men. These relationships should be validated by a longitudinal study, with comprehensive hormone profile testing.

Topics: Adipose Tissue; Adult; Asian People; Body Composition; Body Mass Index; Body Weight; Cholesterol, HDL; Humans; Lipid Metabolism; Malaysia; Male; Middle Aged; Obesity; Osteocalcin; Waist Circumference

This cross-sectional study examined the relationship between household food insecurity and the metabolic syndrome (MetS) among reproductive-aged women (n=625) in low income communities. The Radimer/Cornell Hunger and Food Insecurity instrument was utilized to assess food insecurity. Anthropometry, diet diversity, blood pressure and fasting venous blood for lipid and glucose profile were also obtained. MetS was defined as having at least 3 risk factors and is in accordance with the Harmonized criteria. The prevalence of food insecurity and MetS was 78.4% (household food insecure, 26.7%; individual food insecure, 25.3%; child hunger, 26.4%) and 25.6%, respectively. While more food secure than food insecure women had elevated glucose (food secure, 54.8% vs food insecure, 37.3-46.1%), total cholesterol (food secure, 54.1% vs food insecure, 32.1-40.7%) and LDL-cholesterol (food secure, 63.7% vs food insecure, 40.6-48.7%), the percentage of women with overweight/ obesity, abdominal obesity, hypertension, high triglyceride, low HDL-cholesterol and MetS did not vary significantly by food insecurity status. However, after controlling for demographic and socioeconomic covariates, women in food insecure households were less likely to have MetS (individual food insecure and child hunger) (p<0.05), abdominal obesity (individual food insecure and child hunger) (p<0.01), elevated glucose (household food insecure), total cholesterol (child hunger) (p<0.05) and LDL-cholesterol (household food insecure and child hunger) (p<0.05) compared to food secure women. Efforts to improve food insecurity of low income households undergoing nutrition transition should address availability and accessibility to healthy food choices and nutrition education that could reduce the risk of diet-related chronic diseases.. 這個橫斷性研究評估在低收入地區的育齡婦女(625 位)，其家戶糧食不安全性 與代謝症候群的相關性。利用Radimer/Cornell 飢餓及糧食不安全指南以評估糧 食不安全性。並取得體位測量值、飲食多樣性、血壓及禁食靜脈血脂及血糖 值。依據國際統一分類標準(Harmonized criteria)，代謝症候群的定義為至少有 3 項危險因子。糧食不安全(家戶糧食不安全26.7%；個人糧食不安全25.3%； 孩童飢餓26.4%)及代謝症候群的盛行率分別是78.4%及25.6%。雖然糧食安全 比起有糧食不安全的婦女有較高的血糖(糧食安全54.8%比上糧食不安全37.3- 46.1%)、總膽固醇(54.1%比上32.1-40.7%)及低密度脂蛋白膽固醇(63.7%比上 40.6-48.7%)，但是依糧食不安全程度來看，婦女體重過重/肥胖、腹部肥胖、 高血壓、高三酸甘油酯、低的高密度脂蛋白-膽固醇及代謝症候群的百分比， 都沒有顯著的差異。然而，在控制人口學及社經地位變項後，家戶糧食不安全 的婦女比起糧食安全的婦女有較少比率的代謝症候群(個人糧食不安全及孩童 飢餓)(p<0.05)、腹部肥胖(個人糧食不安全及孩童飢餓)(p<0.01)、高血糖(家戶 糧食不安全)、高總膽固醇(孩童飢餓)(p<0.05)及高的低密度脂蛋白膽固醇(家戶 糧食不安全及孩童飢餓)。低收入家戶處於營養轉型之際，致力於改善他們的 糧食不安全，應該著重健康食物選擇的可用性及可獲性與營養教育，以降低飲 食相關慢性疾病的風險。

Topics: Adult; Blood Glucose; Body Mass Index; Child; Cross-Sectional Studies; Female; Food Supply; Humans; Hunger; Lipids; Malaysia; Metabolic Syndrome; Middle Aged; Obesity; Obesity, Abdominal; Poverty; Rural Population; Waist Circumference; Young Adult

Obesity is a major modifiable risk factor associated with most chronic diseases. The aim of this study was to determine the prevalence of obesity, and its associated risk factors, among apparently healthy Chinese adults in a Malaysian suburban village.. This was a cross-sectional study conducted among the Chinese residents in Seri Kembangan New Village, Klang Valley, Selangor, Malaysia. Convenience sampling was used for the selection of participants. Body weight, height, waist and hip circumferences, and blood pressure were measured. Fasting venous plasma was drawn for the measurement of fasting glucose level and lipid profile. Data on sociodemographic factors, dietary habits, physical activity, perceived stress level and sleep duration were collected using interviewer-administered, pretested and validated questionnaires.. Among the 258 Chinese residents (mean age 41.4 ± 10.0 years) recruited, the prevalence of obesity was 40%. The obese participants had significantly higher mean blood pressure, and triglyceride and fasting plasma glucose levels than the non-obese participants (p < 0.05). The obese participants also had a significantly lower high-density lipoprotein cholesterol level than the non-obese participants. Logistic regression analysis showed that drinking soy milk (adjusted odds ratio [OR] 0.447; 95% confidence interval [CI] 0.253-0.787; p < 0.05) and the perception that a balanced diet consists mainly of vegetables (adjusted OR 0.440; 95% CI 0.215-0.900; p < 0.05) were associated with a reduced risk of obesity. The risk of obesity was higher in younger participants (adjusted OR 2.714; 95% CI 1.225-6.011; p < 0.05).. The prevalence of obesity was high among the apparently healthy suburban Chinese. Our findings suggest that soy milk consumption and the perception that a balanced diet consists mainly of vegetables are associated with a lower risk of developing obesity in this population.

Topics: Adult; Anthropometry; Blood Glucose; Blood Pressure; Cardiovascular Diseases; China; Cross-Sectional Studies; Diabetes Mellitus, Type 2; Female; Humans; Logistic Models; Malaysia; Male; Middle Aged; Motor Activity; Obesity; Odds Ratio; Prevalence; Risk Factors; Soy Milk; Suburban Population; Triglycerides; Young Adult

People with pre-diabetes are at high risk of developing type 2 diabetes and cardiovascular diseases. Measurements of health-related quality of life (HRQOL) among pre-diabetics enable the health care providers to understand their overall health status and planning of interventions to prevent type 2 diabetes. Therefore we aimed to determine the HRQOL and physical activity level; and its association with Body Mass Index (BMI) among pre-diabetics.. This was a cross sectional study carried out in two primary care clinics in a semi-urban locality of Ampangan, Negeri Sembilan, Malaysia. Data was collected through self-administered questionnaires assessing the demographic characteristics, medical history, lifestyle and physical activity. The Short Form 36-items health survey was used to measure HRQOL among the pre-diabetics. Data entry and analysis were performed using the SPSS version 19.. A total of 268 eligible pre-diabetics participated in this study. The prevalence of normal weight, overweight and obesity were 7.1%, 21.6% and 71.3% respectively. Their mean (SD) age was 52.5 (8.3) years and 64.2% were females. Among the obese pre-diabetics, 42.2% had both IFG and IGT, 47.0% had isolated IFG and 10.8% had isolated IGT, 36.2% had combination of hypertension, dyslipidemia and musculoskeletal diseases. More than 53.4% of the obese pre-diabetics had family history of diabetes, 15.7% were smokers and 60.8% were physically inactive with mean PA of <600 MET-minutes/week. After adjusted for co-variants, Physical Component Summary (PCS) was significantly associated with BMI categories [F (2,262)=11.73, p<0.001] where pre-diabetics with normal weight and overweight had significantly higher PCS than those obese; normal vs obese [Mdiff=9.84, p=0.006, 95% CIdiff=2.28, 17.40] and between overweight vs obese [Mdiff=8.14, p<0.001, 95% CIdiff=3.46, 12.80].. Pre-diabetics who were of normal weight reported higher HRQOL compared to those overweight and obese. These results suggest a potentially greater risk of poor HRQOL among pre-diabetics who were overweight and obese especially with regard to the physical health component. Promoting recommended amount of physical activity and weight control are particularly important interventions for pre-diabetics at the primary care level.

Topics: Analysis of Variance; Body Mass Index; Cross-Sectional Studies; Exercise; Female; Health Status; Health Surveys; Humans; Life Style; Malaysia; Male; Middle Aged; Obesity; Overweight; Prediabetic State; Prevalence; Quality of Life; Surveys and Questionnaires

To assess the impact of visual impairment (VI) on health-related quality of life and to compare the health burden of VI and other health conditions in Singapore.. Population-based cross-sectional study.. We studied the 10 009 adults (3353 Chinese, 3397 Indians, and 3259 Malays) who underwent a comprehensive eye assessment and completed the European Quality of Life-5 Dimensions (EQ-5D) questionnaire in the Singapore Epidemiology of Eye Disease Study.. We estimated the effects of VI, obesity, hypertension, diabetes, and hyperlipidemia on the EQ-5D index score using linear regression models and the association between VI and self-reported EQ-5D health problems using logistic regression models. We compared prevalence-based quality-adjusted life-year (QALY) loss associated with VI and other health conditions. For each condition, QALY loss was calculated for 100 000 persons in 1 year using associated reduction in EQ-5D index score estimated in regression analysis as disutility.. The EQ-5D index score and annual QALY loss.. The EQ-5D index score decreased with increasing VI severity in all 3 ethnicities. For example, after adjusting for sociodemographic characteristics, the difference in EQ-5D index score between adults with bilateral severe VI and those without VI was -0.044 (95% confidence interval [CI], -0.089 to 0.001) in Chinese, -0.127 (95% CI, -0.237 to -0.017) in Indians, and -0.085 (95% CI, -0.148 to -0.022) in Malays. In all 3 ethnicities, VI was associated with reporting of problems in mobility (e.g., odds ratio [OR], 3.69 for Chinese with bilateral severe VI; 95% CI, 1.21-12.13) and usual activities (e.g., OR, 6.51 for Chinese with bilateral severe VI; 95% CI, 1.59-26.58). In Indians, VI was also associated with anxiety or depression (e.g., OR, 2.68 for bilateral severe VI; 95% CI, 1.11-6.50). The annual QALY loss associated with VI was 511.8 in Chinese, 608.8 in Indians, and 706.7 in Malays, greater than that associated with other health conditions examined in this study.. Visual impairment is associated with substantial health burden among Asians in Singapore. The relatively high burden of VI highlights the importance of VI prevention. The ethnic difference exhibited in this burden warrants further study.

Topics: Adult; Aged; Aged, 80 and over; China; Cost of Illness; Cross-Sectional Studies; Diabetes Complications; Female; Health Status; Humans; Hyperlipidemias; Hypertension; India; Logistic Models; Malaysia; Male; Middle Aged; Obesity; Prevalence; Quality of Life; Singapore; Surveys and Questionnaires; Vision Disorders

The average consumption of sugar in the Malaysian population has reached an alarming rate, exceeding the benchmark recommended by experts. This article argues the need of a paradigm shift in the management of sugar consumption in the country through evidence derived from addiction research.. "Food addiction" could lead to high levels of sugar consumption. This probable link could accelerate the development of diabetes and obesity in the community. A total of 94 reports and studies that describe the importance of addiction theory-based interventions were found through a search on PubMed, Google Scholar, and Academic Search Complete.. Research in the field of addiction medicine has revealed the addictive potential of high levels of sugar intake. Preexisting health promotion strategies could benefit from the integration of the concept of sugar addiction. A targeted intervention could yield more positive results in health outcomes within the country.. Current literature seems to support food environment changes, targeted health policies, and special consultation skills as cost-effective remedies to curb the rise of sugar-related health morbidities.

Topics: Behavior, Addictive; Cardiovascular Diseases; Diabetes Mellitus, Type 2; Dietary Sucrose; Health Policy; Health Promotion; Humans; Malaysia; Obesity; Primary Health Care; Public Health

To determine the influence of physical activity (PA) and sedentary behavior (SB) on obesity profiles of 454 Malaysian adolescents aged 12 to 19.. Validated PA and SB questionnaires were used and body composition assessed using anthropometry and dual-energy X-ray absorptiometry (DXA).. Gender-specific multivariate analyses showed boys with high levels of total PA and moderate-to-vigorous physical activity (MVPA) exhibited significantly lower levels of total body fat, percent body fat and android fat mass compared with low PA and MVPA groups, after adjusting for potential confounders. Girls with high SB levels showed significantly higher BMI, waist circumference and DXA-derived body fat indices than those at lower SB level. Multiple logistic analyses indicated that boys with low levels of total PA and MVPA had significantly greater obesity risk, 3.0 (OR 3.0; 95% CI, 1.1-8.1; p < 0.05) and 3.8-fold (OR 3.8; 95% CI, 1.4-10.1; p < 0.01), respectively, than more active boys. Only in girls with high SB level was there a significantly increased risk of obesity, 2.9 times higher than girls at low SP levels (OR 2.8; 95% CI, 1.0-7.5; p < 0.05).  . The present findings indicate that higher PA duration and intensity reduced body fat and obesity risk while high screen-based sedentary behaviors significantly adversely influenced body fat mass, particularly amongst girls when the PA level was low.

Topics: Adolescent; Body Composition; Child; Cross-Sectional Studies; Female; Humans; Logistic Models; Malaysia; Male; Obesity; Odds Ratio; Sedentary Behavior; Surveys and Questionnaires; Young Adult

The study on Clustering of Lifestyle risk factors and Understanding its association with Stress on health and wellbeing among school Teachers in Malaysia (CLUSTer) is a prospective cohort study which aims to extensively study teachers in Malaysia with respect to clustering of lifestyle risk factors and stress, and subsequently, to follow-up the population for important health outcomes.. This study is being conducted in six states within Peninsular Malaysia. From each state, schools from each district are randomly selected and invited to participate in the study. Once the schools agree to participate, all teachers who fulfilled the inclusion criteria are invited to participate. Data collection includes a questionnaire survey and health assessment. Information collected in the questionnaire includes socio-demographic characteristics, participants' medical history and family history of chronic diseases, teaching characteristics and burden, questions on smoking, alcohol consumption and physical activities (IPAQ); a food frequency questionnaire, the job content questionnaire (JCQ); depression, anxiety and stress scale (DASS21); health related quality of life (SF12-V2); Voice Handicap Index 10 on voice disorder, questions on chronic pain, sleep duration and obstetric history for female participants. Following blood drawn for predefined clinical tests, additional blood and urine specimens are collected and stored for future analysis. Active follow up of exposure and health outcomes will be carried out every two years via telephone or face to face contact. Data collection started in March 2013 and as of the end of March 2014 has been completed for four states: Kuala Lumpur, Selangor, Melaka and Penang. Approximately 6580 participants have been recruited. The first round of data collection and blood sampling is expected to be completed by the end of 2014 with an expected 10,000 participants recruited.. Our study will provide a good basis for exploring the clustering of lifestyle risk factors and stress and its association with major chronic medical conditions such as obesity, hypertension, impaired glucose tolerance, diabetes mellitus, coronary heart diseases, kidney failure and cancers among teachers.

Topics: Adult; Alcohol Drinking; Anxiety; Chronic Disease; Cluster Analysis; Depression; Depressive Disorder; Faculty; Female; Health Status; Humans; Life Style; Malaysia; Male; Middle Aged; Obesity; Personal Satisfaction; Prospective Studies; Quality of Life; Risk Factors; Schools; Smoking; Socioeconomic Factors; Stress, Psychological; Surveys and Questionnaires; Workplace

This study was to investigate the prevalence of single nucleotide polymorphisms (SNPs) in leptin gene LEP (A19G and G2548A) and leptin receptor gene LEPR (K109R and Q223R) and their association with fasting plasma leptin level (PLL) and obesity in a Malaysian suburban population in Kampar, Perak.. Convenience sampling was performed with informed consents, and the study sample was drawn from patients who were patrons of the Kampar Health Clinic. A total of 408 subjects (mean age, 52.4 ± 13.7 years; 169 men, 239 women; 190 obese, 218 non-obese; 148 Malays, 177 ethnic Chinese, 83 ethnic Indians) participated. Socio-demographic data and anthropometric measurements were taken, and genotyping was performed using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP).. The LEP A19G, G2548A and LEPR K109R, Q223R variant allele frequencies were 0.74, 0.67 and 0.61, 0.79, respectively. The genotype and allele distributions of these gene variants were significantly different among ethnic groups, but not among body mass index (BMI) classes. Subjects with LEPR K109 and Q223 allele had significantly higher systolic blood pressure and adiposity indices after adjustment for ethnicity (higher BMI, total body and subcutaneous fat; lower skeletal muscle percentage). Subjects with LEPR 109R allele had lower PLL than their wild-type allele counterparts. The influence of LEP A19G and G2548A SNPs on blood pressures, anthropometrics, and PLL was not evident. Interestingly, synergistic effect of the LEP and LEPR SNPs was observed as subjects homozygous for all four SNPs studied exhibited significantly higher subcutaneous fat and PLL than those with other genotype combinations.. The LEP and LEPR SNPs in this study may not be an obesity marker among Malaysians in this population, but were associated with ethnicity. Our findings suggest that each of these SNPs contributes to minor but significant variation in obesity-related traits and in combination they display synergistic effects on subcutaneous fat and PLL.

Topics: Adult; Aged; Blood Pressure; Body Weights and Measures; Female; Gene Frequency; Humans; Leptin; Malaysia; Male; Middle Aged; Obesity; Polymorphism, Single Nucleotide; Receptors, Leptin

Obesity and lack of physical activity are fast becoming a concern among Malaysian adolescents.. This study aims to assess physical activity levels among Malaysian adolescents and investigate the association between physical activity levels and body composition such as body mass index (BMI), waist circumference (WC) and percentage of body fat.. 1361 school-going 13 year old multi-ethnic adolescents from population representative samples in Malaysia were involved in our study. Self-reported physical activity levels were assessed using the validated Malay version of the Physical Activity Questionnaire for Older Children (PAQ-C). Height, weight, body fat composition and waist circumference (WC) were measured. Data collection period was from March to May 2012.. 10.8% of the males and 7.4% of the females were obese according to the International Obesity Task Force standards. A majority of the adolescents (63.9%) were physically inactive. There is a weak but significant correlation between physical activity scores and the indicators of obesity. The adjusted coefficient for body fatness was relatively more closely correlated to physical activity scores followed by waist circumference and lastly BMI.. This study demonstrates that high physical activity scores were associated with the decreased precursor risk factors of obesity.

Topics: Adolescent; Body Composition; Body Mass Index; Child; Exercise; Female; Humans; Malaysia; Male; Obesity; Risk Factors; Self Report; Waist Circumference

A genome-wide association study showed that the tagging single nucleotide polymorphism (SNP) rs7566605 in the insulin-induced gene 2 (INSIG2) was associated with obesity. Attempts to replicate this result in different populations have produced inconsistent findings. We aimed to study the association between the rs7566605 SNP with obesity and other metabolic parameters in Malaysian Malays. Anthropometric and obesity-related metabolic parameters and DNA samples were collected. We genotyped the rs7566605 polymorphism in 672 subjects using real-time polymerase chain reaction. No significant associations were found between the rs7566605 tagging SNP of INSIG2 with obesity or other metabolic parameters in the Malaysian Malay population. The INSIG2 rs7566605 SNP may not play a role in the development of obesity-related metabolic traits in Malaysian Malays.

Topics: Adult; Body Mass Index; Female; Gene Expression; Genome-Wide Association Study; Genotype; Humans; Intracellular Signaling Peptides and Proteins; Malaysia; Male; Membrane Proteins; Middle Aged; Obesity; Phenotype; Polymorphism, Single Nucleotide

Type 2 diabetes (T2DM) among the young population has become a serious concern globally, presumably due to the rising trend of obesity. Compared to other forms of diabetes, young-onset T2DM experiences more cardiovascular events and other vascular complications although the underlying mechanisms remain largely unknown. Increased arterial stiffness is a hallmark of vasculopathy. We aim to study the clinical and metabolic determinants of arterial stiffness in a cohort of multi-ethnic Asians with young-onset T2DM.. 179 subjects with T2DM onset age below 30 years old were selected in this cross sectional study. Arterial stiffness was assessed by carotid-femoral pulse wave velocity (PWV).. PWV was correlated with age, duration of diabetes, systolic blood pressure, alanine aminotransferase, urinary albumin-to-creatinine ratio (ACR) and eGFR in bivariate correlation analysis. However, PWV was only significantly correlated with body mass index (BMI), waist circumference, urinary ACR and eGFR after adjustment for age. Overweight individuals with young-onset T2DM had significantly higher PWV levels compared to their lean counterparts (7.3 ± 2.4 m/s vs 6.4 ± 2.3 m/s, p = 0.072 and p < 0.0001 without and with adjustment for age, respectively). Multivariable regression models revealed that age, BMI, eGFR and usage of insulin were independently associated with PWV. These 4 variables explained 35.5% variance in PWV levels.. Age, BMI, renal function and insulin usage are the main determinants of PWV levels in Asians with young-onset T2DM. Notably, obesity is a modifiable determinant of arterial stiffness independent of high blood pressure, dyslipidemia and hyperglycemia in this population.

Topics: Adult; Age of Onset; Alanine Transaminase; Albuminuria; Asian People; Blood Pressure; Body Mass Index; Comorbidity; Creatinine; Cross-Sectional Studies; Diabetes Mellitus, Type 2; Diabetic Angiopathies; Female; Glomerular Filtration Rate; Humans; Hypoglycemic Agents; India; Insulin; Lipids; Malaysia; Male; Obesity; Risk Factors; Singapore; Vascular Stiffness; Waist Circumference; Young Adult

A case-control study among Singapore Armed Forces' newly enlisted Servicemen was conducted to examine factors associated with male obesity. Four hundred and fifty-nine individuals from the Obese Basic Military Training program were selected as "cases" (average age: 19.5, body mass index: 30.4) and another 340 individuals were selected from the Normal Basic Military Training program as "controls" (average age: 19.3, body mass index: 21.4). Information such as family background, socioeconomic factors, and lifestyle practices were captured using facilitator-led questionnaires. Several variables were significantly associated with obesity after adjustments for possible confounders. These include childhood obesity (odds ratio [OR] = 2.06), less than an hour of exercise per day (OR = 2.97), Indian ethnicity (OR = 2.22), specific education backgrounds (especially that of Institute of Technical Education-OR = 2.75), father's employment at nonmanagerial/professional jobs (OR = 1.52), mother's employment at managerial/professional jobs (OR = 2.02), regular smoking (OR = 1.73) and alcohol consumption (OR = 2.26), 6 hours or less of sleep (OR = 3.73), obesity among family members (OR = 1.86 for mother; OR = 2.98 for siblings), parental history of diabetes mellitus (OR = 2.22 for father; OR = 2.70 for mother), and eating at inexpensive local food stalls (OR = 1.82). Our study found that a number of factors, ranging from personal and family backgrounds to lifestyle choices, were significantly associated with obesity among male youths.

Topics: Alcohol Drinking; Body Mass Index; Case-Control Studies; Diabetes Complications; Educational Status; Employment; Ethnicity; Exercise; Family; Fathers; Feeding Behavior; Humans; Income; India; Life Style; Malaysia; Male; Military Personnel; Mothers; Obesity; Occupations; Pediatric Obesity; Singapore; Sleep; Smoking; Socioeconomic Factors; Time Factors; Young Adult

The objectives are to assess the prevalence and determinants of cardiovascular disease (CVD) risk factors among the residents of Community Housing Projects in metropolitan Kuala Lumpur, Malaysia.. By using simple random sampling, we selected and surveyed 833 households which comprised of 3,722 individuals. Out of the 2,360 adults, 50.5% participated in blood sampling and anthropometric measurement sessions. Uni and bivariate data analysis and multivariate binary logistic regression were applied to identify demographic and socioeconomic determinants of the existence of having at least one CVD risk factor.. As a Result, while obesity (54.8%), hypercholesterolemia (51.5%), and hypertension (39.3%) were the most common CVD risk factors among the low-income respondents, smoking (16.3%), diabetes mellitus (7.8%) and alcohol consumption (1.4%) were the least prevalent. Finally, the results from the multivariate binary logistic model illustrated that compared to the Malays, the Indians were 41% less likely to have at least one of the CVD risk factors (OR = 0.59; 95% CI: 0.37 - 0.93).. In Conclusion, the low-income individuals were at higher risk of developing CVDs. Prospective policies addressing preventive actions and increased awareness focusing on low-income communities are highly recommended and to consider age, gender, ethnic backgrounds, and occupation classes.

Topics: Adolescent; Adult; Alcohol Drinking; Cardiovascular Diseases; Diabetes Mellitus; Female; Humans; Hypercholesterolemia; Hypertension; Logistic Models; Malaysia; Male; Middle Aged; Multivariate Analysis; Obesity; Prevalence; Public Housing; Risk Factors; Smoking; Socioeconomic Factors; Urban Health; Urban Population; Young Adult

The incidence of breast cancer in Malaysia and other Asian countries is on the increase, reflecting lifestyle changes some of which are known risk factors for the development of breast cancer. Most breast cancers are amenable to adjuvant therapies that target hormone receptors or HER2 receptors on the surface of the cancer cells and bring about significant improvement in survival. However, approximately 17% of Malaysian women with breast cancer, present with tumours that are devoid of these receptors and are consequently termed 'triple negative' breast cancers. These triple negative breast cancers typically occur in women of a younger age than receptor positive cancers, are predominantly of high grade tumours and the prognosis is usually poor. There is therefore a pressing need to understand the biological pathways that drive these tumours, in order that effective strategies are developed to treat these aggressive tumours. With the increasing affluence of developing countries, obesity and Type II Diabetes are also on the rise. These diseases are associated with an increased risk of developing a range of cancers including those of the breast. In particular, the metabolic syndrome has been shown to be associated with triple negative breast cancer. This article reviews some of the metabolic pathways and biomarkers which have been shown to be aberrantly expressed in triple negative breast cancer and highlights some of the ongoing work in this area.

Topics: Diabetes Mellitus, Type 2; Female; Humans; Malaysia; Obesity; Prognathism; Risk Factors; Triple Negative Breast Neoplasms

Childhood obesity is related to low physical activity level and a sedentary lifestyle. The aim of this study was to assess the physical activity level and sedentary behaviour of Malaysian children aged 7 to 12 years and to examine their association with body mass index (BMI), BMI-for-age Z-score (BAZ), body fatness (%BF) and waist circumference (WC). A total of 1736 children, representing all ethnic groups were recruited from six regions of Malaysia. Anthropometric measurements included body weight, height and waist circumference. Body fat percentage (%BF) was assessed using bioelectrical impedance. Physical activity was assessed by a physical activity questionnaire (PAQ) in all children and by pedometers in a subsample (n = 514). PAQ score and pedometer step counts were negatively associated with BMI, BAZ, %BF and WC after adjusting for covariates. Screen time was positively associated with BAZ and WC. However, other sedentary activities were not significantly related with any anthropometric indicators. Strategies to promote active living among children in Malaysia should focus not only on increasing physical activity but also emphasise reduction in sedentary behaviours.

Topics: Body Composition; Body Mass Index; Body Weight; Child; Computers; Cross-Sectional Studies; Female; Humans; Malaysia; Male; Monitoring, Physiologic; Motor Activity; Obesity; Sedentary Behavior; Surveys and Questionnaires; Television; Video Games; Waist Circumference

Studies on diet quality among individuals with type 2 diabetes mellitus (T2DM) are scarce. This crosssectional study aimed to assess the diet quality and to determine its associated factors among individuals with T2DM at the Medical Outpatients Department, Serdang Hospital, Selangor, Malaysia, from July 2010 to March 2011. Subjects were interviewed for sociodemographic data. Diabetes history was retrieved from the hospital's e-database. Usual dietary intake was measured using a food frequency questionnaire, from which a dietary diversity score was obtained with two measures: Food Group Score and Serving Score were constructed based on the Malaysian Dietary Guidelines. Food Group Score was computed from the number of food groups consumed from five major food groups (grains, vegetables, fruits, meat, and dairy products) whereas Serving Score was computed from the number of servings consumed from the various food groups. Anthropometric measures, including weight, height, waist- and hip-circumference were examined. For data analyses, descriptive statistics, simple and multiple linear regression were conducted using IBM SPSS Statis- tics 20.0. A total of 113 subjects (50.4% female), with mean?SD age of 54.05 +/- 10.30 years and duration of diabetes of 11.25?9.05 years were studied. The mean Food Group Score and Serving Score were 4.12 +/- 0.79 and 12.75+3.50 respectively. Slightly more than one-third of the subjects achieved five food groups a day while less than 2% consumed a desirable number of servings from all food groups. Among the five food groups, dairy, and fruits were the least-frequently consumed foods. Lower education, lower personal income, working, non-insulin, overweight and obese subjects had significantly lower Food Group Score than their counterparts [F (6,106)=4.924, p<0.0001] whereas lower education, lower waist-to-hip ratio, overweight and obese subjects had significantly lower Serving Score than their counterparts [F (4,108)=7.520, p<0.0001]. There was a high proportion of individuals with T2DM, who failed to adhere to the national dietary guidelines. The importance of taking a well-balanced diet in accordance with the guidelines should be emphasized, especially among those with lower educational level through a simple and easy-to-understand approach.

Topics: Adult; Cross-Sectional Studies; Dairy Products; Diabetes Mellitus, Type 2; Diet; Diet Records; Educational Status; Ethnicity; Female; Fruit; Humans; Income; Malaysia; Male; Middle Aged; Nutrition Policy; Obesity; Overweight; Surveys and Questionnaires; Waist-Hip Ratio

Early onset of menarche has been shown to be associated with breast cancer and ischaemic heart disease. Studies on age at menarche of the Malaysian population are poorly documented. This study aimed to determine the influence of anthropometric and socio-demographic factors on the age at menarche of university students in Malaysia. Data were obtained in 2010-11 from 961 students between the ages of 18 and 25 years from the University of Malaya using stratified sampling, and multiple regression analysis was applied. Sixty-three per cent of students reached menarche at the age of 12 or 13 years, with the mean and median of age at menarche being 12.45 ± 1.17 and 12.01 years, respectively. Menarcheal age was positively associated with height (p<0.05) and negatively associated with BMI (p<0.001). Students from urban areas attained menarche earlier than those from rural areas (p<0.05). Students from small-sized families attained menarche earlier than those from larger families (p<0.05). First-born students experienced menarche earlier than those who were seventh-born or later. Obese and overweight students reached menarche earlier than students who were underweight or of normal weight (p<0.01). The variations in age at menarche among the Malaysian ethnic groups were statistically insignificant. The results suggest that heavier and first-born students from small families are more likely to attain menarche earlier than their counterparts.

Topics: Adolescent; Adult; Age Factors; Anthropometry; Birth Order; Body Height; Body Weight; Developing Countries; Female; Health Surveys; Humans; Malaysia; Menarche; Obesity; Overweight; Socioeconomic Factors; Students; Young Adult

There is currently no published study comparing prevalence of non-alcoholic fatty liver disease (NAFLD) and associated factors among diabetics of different ethnicity in the Asia-Pacific region.. Cross-sectional study of consecutive patients in the Diabetic Clinic in University of Malaya Medical Centre. The Global Physical Activity Questionnaire and a semiquantitative food-frequency questionnaire were used to assess physical activity and dietary intake, respectively. Diagnosis of NAFLD was ultrasound-based and following exclusion of significant alcohol intake.. Data for 399 patients were analyzed (mean age 62.3 ± 10.5 years, 43.1% men). The racial distribution was Chinese 43.6%, Indian 33.1%, Malay 22.3%, and others 1.0%. The prevalence of NAFLD was 49.6%. On univariate analysis, factors associated with NAFLD were age < 65 years, race, obesity, central obesity, glycated hemoglobin ≥ 7.0%, and elevated serum alanine aminotransferase (ALT) and gamma-glutamyl transpeptidase levels. Patients with low physical activity were more likely to have NAFLD (odds ratio [OR] = 1.67, 95% confidence interval [CI] = 1.06-2.63, P = 0.020). The prevalence of NAFLD was highest among Malays (60.7%), followed by Indians (51.5%), and lowest among Chinese (42.0%) consistent with higher prevalence of central obesity and higher percentage calorie intake from fat in the former groups of patients. On multivariate analysis, independent factors associated with NAFLD were central obesity (OR = 2.20, 95% CI = 1.29-3.75, P = 0.004) and elevated serum ALT level (OR = 1.98, 95% CI = 1.21-3.25, P = 0.007).. NAFLD was seen in half of a cohort of diabetic patients and was independently associated with central obesity and elevated serum ALT level. Prevalence of NAFLD was different and paralleled the difference in prevalence of central obesity and in percentage calorie intake from fat among the different ethnic groups.

Topics: Aged; Alanine Transaminase; China; Cohort Studies; Cross-Sectional Studies; Diabetes Complications; Dietary Fats; Energy Intake; Fatty Liver; Female; Forecasting; Hospitals, University; Humans; India; Malaysia; Male; Middle Aged; Non-alcoholic Fatty Liver Disease; Obesity; Prevalence

Women of reproductive age are a group of particular concern as diabetes may affect their pregnancy outcome as well as long-term morbidity and mortality. This study aimed to compare the clinical profiles and glycemic control of reproductive and non-reproductive age women with type 2 diabetes (T2D) in primary care settings, and to determine the associated factors of poor glycemic control in the reproductive age group women.. This was a cross-sectional study using cases reported by public primary care clinics to the Adult Diabetes Control and Management registry from 1st January to 31st December 2009. All Malaysian women aged 18 years old and above and diagnosed with T2D for at least 1 year were included in the analysis. The target for glycemic control (HbA1c < 6.5%) is in accordance to the recommended national guidelines. Both univariate and multivariate approaches of logistic regression were applied to determine whether reproductive age women have an association with poor glycemic control.. Data from a total of 30,427 women were analyzed and 21.8% (6,622) were of reproductive age. There were 12.5% of reproductive age women and 18.0% of non-reproductive age women that achieved glycemic control. Reproductive age group women were associated with poorer glycemic control (OR = 1.5, 95% CI = 1.2-1.8). The risk factors associated with poor glycemic control in the reproductive age women were being of Malay and Indian race, longer duration of diabetes, patients on anti-diabetic agents, and those who had not achieved the target total cholesterol and triglycerides.. Women with T2D have poor glycemic control, but being of reproductive age was associated with even poorer control. Health care providers need to pay more attention to this group of patients especially for those with risk factors. More aggressive therapeutic strategies to improve their cardiometabolic control and pregnancy outcome are warranted.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Ambulatory Care Facilities; Antihypertensive Agents; Blood Glucose; Cross-Sectional Studies; Diabetes Mellitus, Type 2; Diet Therapy; Female; Glycated Hemoglobin; Humans; Hyperlipidemias; Hypertension; Hypoglycemic Agents; Hypolipidemic Agents; India; Logistic Models; Malaysia; Middle Aged; Multivariate Analysis; Obesity; Pregnancy; Pregnancy in Diabetics; Primary Health Care; Registries; Risk Factors; Treatment Outcome; Young Adult

To determine the optimal cut-offs of BMI for Malaysian adults.. Population-based, cross-sectional study. Receiver operating characteristic curves were used to determine the cut-off values of BMI with optimum sensitivity and specificity for the detection of three cardiovascular risk factors: diabetes mellitus, hypertension and hypercholesterolaemia. Gender-specific logistic regression analyses were used to examine the association between BMI and these cardiovascular risk factors.. All fourteen states in Malaysia.. Malaysian adults aged ≥18 years (n 32 703) who participated in the Third National Health and Morbidity Survey in 2006.. The optimal BMI cut-off value for predicting the presence of diabetes mellitus, hypertension, hypercholesterolaemia or at least one of these cardiovascular risk factors varied from 23.3 to 24.1 kg/m2 for men and from 24.0 to 25.4 kg/m2 for women. In men and women, the odds ratio for having diabetes mellitus, hypertension, hypercholesterolaemia or at least one cardiovascular risk factor increased significantly as BMI cut-off point increased.. Our findings indicate that BMI cut-offs of 23.0 kg/m2 in men and 24.0 kg/m2 in women are appropriate for classification of overweight. We suggest that these cut-offs can be used by health professionals to identify individuals for cardiovascular risk screening and weight management programmes.

Topics: Adolescent; Adult; Asian People; Body Mass Index; Cardiovascular Diseases; Diabetes Mellitus; Ethnicity; Female; Humans; Hypercholesterolemia; Hypertension; Logistic Models; Malaysia; Male; Obesity; Odds Ratio; Reference Values; Risk Factors; Sex Factors

Melanocortin-4 receptor (MC4R) is an important regulator of body weight and energy intake. Genetic polymorphisms of the MC4R gene have been found to be linked to obesity in many recent studies across the globe.. This study aimed to examine the effects of MC4R polymorphisms on obesity parameters, Linkage disequilibrium (LD) pattern and haplotypes in Malaysian Malays.. The study subjects were 652 Malaysian Malays. Genomic DNA was extracted from buccal swabs. Genotyping was performed using Sequenom MassARRAY® iPLEX platform. Anthropometric and blood lipid profiles were measured.. MC4R rs571312 SNP was associated with logBMI (p = 0.008) and systolic blood pressure (p = 0.005), while MC4R rs2229616 SNP was associated with total cholesterol (TC) levels (p = 0.016). The MC4R rs7227255 SNP did not show any association with obesity parameters.. The strength of LD of the MC4R gene region is low and the haplotypes were not associated with obesity in Malaysian Malays.

Topics: Appetite; Blood Pressure; Body Mass Index; Cholesterol; Energy Intake; Female; Genotype; Haplotypes; Humans; Linkage Disequilibrium; Lipids; Malaysia; Male; Middle Aged; Obesity; Polymorphism, Single Nucleotide; Receptor, Melanocortin, Type 4

It is known that dietary diversity improves diet quality and nutritional status of young children. This study aimed to determine the relationship between dietary diversity and nutritional status of Orang Asli children in Krau Wildlife Reserve.. A total of 216 children from three Orang Asli sub-tribes (Jah Hut, Temuan and Che Wong) aged 1 to 6 years from 162 households in 16 villages participated in this cross-sectional study. Children and mothers were measured for body weight and height. Mothers were interviewed for household socio-demographic information and diet diversity of children in the last 7 days. Diet diversity score (DDS) was calculated based on 15 food groups.. There was a high prevalence of underweight (50.9%) and stunting (61.6%) in Orang Asli children. For mothers, 11.1%, 27.8% and 7.4% were underweight, overweight and obese, respectively. Mean DDS of children was 6.38 [95% CI-6.10, 6.65] of the possible 15. Higher DDS of children was significantly related to older age (p < 0.05), the non Jahut sub-tribe (p < 0.01) and longer maternal years of schooling (p < 0.05). DDS was also positively related to weight-for-age z-scores (p < 0.001) and height-for-age z-scores (p < 0.05).. Undernutrition remains a major nutrition problem among Orang Asli children living within the forest reserve. Efforts to promote dietary diversity should emphasise traditional and nutritious foods that could improve health and nutritional status of the Orang Asli children.

Topics: Adult; Child, Preschool; Cross-Sectional Studies; Developing Countries; Diet; Educational Status; Female; Growth Disorders; Humans; Infant; Malaysia; Male; Mothers; Nutritional Requirements; Nutritional Status; Obesity; Overweight; Sex Factors; Socioeconomic Factors; Surveys and Questionnaires; Thinness

The increasing prevalence of overweight and obesity among children has become a major public health problem in Malaysia. Parents play an important role in child feeding especially among younger children.. A study was conducted to evaluate the beliefs, attitudes and practices in child feeding among parents of normal weight, as well as overweight and obese primary school children in Kelantan using the Child Feeding Questionnaire (CFQ). This cross-sectional study was carried out on 175 Malay children from three schools in Kota Bharu district in Kelantan.. This study showed that 13.1% of the children were overweight and obese. Scores for perceived parent weight (p < 0.05) and perceived child weight (p < 0.001) were significantly higher among parents of overweight and obese children compared to parents of children with normal body weight. However, the score for pressure to eat among parents of overweight and obese children was significantly lower (p < 0.05) than parents of normal weight children. The perceived child weight (r = 0.468, p < 0.01), perceived parental weight (r = 0.190, p < 0.05) and food restriction (r = 0.179, p < 0.05) factors were found to be positively correlated with children's body mass index (BMI), whereas pressure to eat factor (r = -0.355, p < 0.01) was negatively correlated with children's body mass index (BMI).. The findings showed that parental feeding practices were linked to children's weight status and childhood obesity. Therefore parents should be given education and guidance on appropriate child feeding practices to maintain their child's nutritional status on a healthy weight range.

Topics: Adult; Body Mass Index; Body Weight; Child; Diet; Health Knowledge, Attitudes, Practice; Humans; Malaysia; Nutritional Status; Obesity; Overweight; Parents; Perception; Schools; Surveys and Questionnaires

A cross-sectional study was carried out to investigate accelerometer-determined physical activity level of 233 Malay government employees (104 men, 129 women) working in the Federal Government Building Penang, Malaysia.. Body weight, height, waist and hip circumference, body fat percentage and blood pressure were measured for each respondent. All the respondents were asked to wear an accelerometer for 3 days. Body mass index (BMI) and waist-hip ratio (WHR) were calculated using a standard formulas. Fasting blood sample was obtained to determine the lipid profile and glucose levels of the respondents.. Based on the accelerometer-determined physical activity level, almost 65% of the respondents were categorised as sedentary. Approximately 50.2% of the respondents were overweight or obese. There were negative but significant relationships between body mass index (BMI) (r = -0.353, p < 0.05), body fat percentage (r = -0.394, p < 0.05), waist circumference (WC) (r = -0.198, p < 0.05) and physical activity level. Sedentary individuals had a higher risk than moderate to active individuals of having a BMI more than or equal to 25 kg/m2 (OR = 2.80, 95% CI 1.55-5.05), an-risk classified WC (OR = 1.79, 95% CI 1.01-3.20), and a body fat percentage classified as unhealthy (OR = 3.01, 95% CI 1.41-6.44).. The results of this study suggest that accelerometer-determined physical activity level is a significant factor associated with obesity in this study. The high prevalence of physical inactivity and obesity found among respondents of this study indicate a need for implementing intervention programmes among this population.

Topics: Accelerometry; Adult; Blood Glucose; Blood Pressure; Body Composition; Body Height; Body Mass Index; Body Weight; Cross-Sectional Studies; Energy Metabolism; Female; Government; Humans; Lipids; Malaysia; Male; Motor Activity; Obesity; Occupational Health; Overweight; Waist Circumference; Waist-Hip Ratio

There is a pressing need to better understand the complex biochemical pathways that lead to the pathogenesis of obesity. Increased oxidative stress and decreased antioxidant capacity have been identified to be associated with obesity. Therefore, the objectives of this study were to determine the plasma total antioxidant capacity (TAC) levels of Malaysian subjects and to evaluate its potential association with obesity and related anthropometric measurements.. Plasma TAC of 362 multi-ethnic Malaysian subjects from the Kampar Health Clinic (138 males, 224 females; 124 ethnic Malays, 152 Chinese, 86 Indians; 192 non-obese, 170 obese) was measured using Trolox equivalent antioxidant capacity (TEAC) 96-well plate assay.. Plasma TAC was significantly lower in obese subjects (M +/- SE = 292 +/- 10.4 micromol/L) compared to non-obese subjects (397 +/- 8.58 micromol/L), whereas it was significantly higher in males and those in the 21-30 age group. Those with salty food preference and practising a strict vegetarian diet also had significantly higher plasma TAC. However, no association was found for other dietary habits (coffee intake) and lifestyle factors (physical activity, smoking). Plasma TAC was also significantly negatively correlated with diastolic blood pressure, waist and hip circumferences, weight, body mass index, total body fat, % subcutaneous fat, visceral fat level, resting metabolism and % skeletal muscle.. Plasma TAC was found to be associated with obesity, strict vegetarian practice, salty food preference and all obesity anthropometric indicators, except systolic blood pressure and pulse rate. Obese people have decreased plasma TAC indicating a compromised systemic antioxidant defence and increased oxidative stress.

Topics: Adult; Age Factors; Aged; Aged, 80 and over; Antioxidants; Blood Pressure; Body Composition; Body Mass Index; Body Weight; China; Chromans; Diet, Vegetarian; Ethnicity; Feeding Behavior; Female; Humans; India; Life Style; Malaysia; Male; Middle Aged; Obesity; Oxidative Stress; Sex Factors; Sodium, Dietary

A cross-sectional study was conducted to determine bone health status and nutrient intakes among post-menopausal women residing in low cost houses in Cheras, Kuala Lumpur.. A total of 125 subjects aged 60 +/- 4 years who had attained menopause at age 50 +/- 5 years participated in this study. Subjects' weight and height were measured and calculated for body mass index (BMI). They were also assessed for bone health status using the Quantitative Ultrasound (QUS). Nutrient intake was assessed using a dietary history Questionnaire. Fasting serum lipid and blood pressure measurements were also taken.. The majority of the subjects were overweight and obese (80%) based on BMI status. Calcaneal measurements using the QUS indicated that while 57% or the subjects had normal bone mineral density, 37% were osteopenic and 6% osteoporotic. Calcium intake of the subjects was 505 +/- 263 mg /day, which is only 50% of the Malaysian Recommended Nutrient Intake for calcium (1000 mg/d). About 74% of the subjects were hypercholesterolemic and 58% were hypertriglyceridemic. Two-thirds reported that they were taking medication for hypertension, diabetes mellitus and heart disease.. The results showed low health and nutritional status among post-menopausal women living in low-cost flats in Kuala Lumpur. They have low bone mass which may be due to their predominantly non-milk based diets which places them at high risk of hip fractures. Apart from milk, other food sources of calcium, including soya bean products such as 'tempeh' and healthy ways of cooking should be recommended to older people.

Topics: Aged; Body Mass Index; Bone Density; Bone Diseases, Metabolic; Cross-Sectional Studies; Diet; Energy Intake; Female; Health Status; Humans; Lipids; Malaysia; Middle Aged; Nutritional Status; Obesity; Osteoporosis, Postmenopausal; Overweight; Postmenopause; Surveys and Questionnaires

Early childhood is a period during which many factors influence the development of lifelong eating habits. This study aimed to assess the nutritional status of young children and to determine factors related to eating habits.. A total of 992 children aged 5-6 years attending kindergartens that participated in the Bright Start Nutrition programme in the Klang Valley were included in the study. Anthropometric measurements were taken and body mass index (BMI) calculated. A questionnaire to assess the children's nutrition knowledge was administered through interviews, while their mothers self-administered another set of questionnaires regarding knowledge, attitude and practice on nutrition.. The mean BMI was 15.7 +/- 2.7 kg/m2 in boys and 15.4 +/- 2.4 kg/m2 in girls. Based on the WHO 2007 growth reference, the prevalence of overweight and obesity were 9.1% and 9.3%, respectively; while the prevalence of thinness and stunting were 5.8% and 3.9%, respectively. Most of the children consumed breakfast (86.4%), lunch (94.1%) and dinner (93.4%) daily. The majority liked fruits (95.1%), snacks (93.8%), Western fast food (93.3%) and milk (90.8%), while less than two-thirds (65.1%) liked vegetables. The mean nutrition knowledge scores for the children and mothers were 73.2 +/- 9.8% and 60.2 +/- 18.8%, respectively. Maternal nutrition knowledge was correlated positively with children's vegetable intake (r=0.111, p<0.05) and negatively with snack intake (r = -0.134, p<0.05).. These results showed a higher prevalence of overweight and obesity than underweight and thinness among the urban young children studied. As mother's nutrition knowledge was found to exert a positive influence on children's eating habits, it is important to provide nutrition education to both mothers and children when conducting intervention programmes.

Topics: Body Mass Index; Child; Child, Preschool; Diet; Feeding Behavior; Female; Health Education; Health Knowledge, Attitudes, Practice; Humans; Malaysia; Male; Malnutrition; Meals; Mothers; Nutritional Sciences; Nutritional Status; Obesity; Overweight; Snacks; Socioeconomic Factors; Surveys and Questionnaires; Vegetables

Obesity is an emerging public health threat in the elderly population in developing countries. Hence, the Third National Health and Morbidity Survey has assessed 4746 individuals aged 60 years and older recruited through a household survey to determine the prevalence of adiposity using body mass index and waist circumference. The national's prevalence of overweight and obesity in men was 29.2% (95% confidence interval [CI] = 27.2-31.3) and 7.4% (95% CI = 6.4-8.6), respectively. However, the prevalence decreased with age. The figures in women were 30.3% (95% CI = 28.5-32.1) and 13.8% (95% CI = 12.5-15.2), respectively. The prevalence of abdominal obesity was 21.4% (95%CI = 20.2-22.6), with 7.7% (95% CI = 6.7-9.0) in men and 33.4% (95% CI = 31.4-35.3) in women. Predictors of adiposity include the following: Malay and Indian ethnicity, higher education level, higher household income, from urban area, and being married. In conclusion, adiposity affects about one third of the Malaysian elderly population, especially those of the younger age group, women, and those with higher socioeconomic status.

Topics: Aged; Body Mass Index; Female; Health Surveys; Humans; Malaysia; Male; Middle Aged; Morbidity; Obesity; Obesity, Abdominal; Prevalence; Risk Factors; Waist Circumference

To investigate the roles of sociodemographic and health lifestyle factors in affecting body mass index (BMI) across ethnic groups in Malaysia.. Data are obtained from 2,436 observations from the Malaysia Non-Communicable Disease Surveillance-1. The multi-ethnic sample is segmented into Malay, Chinese, and Indian/other ethnicities. Ordered probit analysis is conducted and marginal effects of sociodemographic and health lifestyle variables on BMI calculated.. Malays between 41 and 58 years are more likely to be overweight or obese than their 31-40 years counterparts, while the opposite is true among Chinese. Retirees of Chinese and Indian/other ethnicities are less likely to be obese and more likely to have normal BMI than those between 31 and 40 years. Primary educated Chinese are more likely to be overweight or obese, while tertiary-educated Malays are less likely to suffer from similar weight issues as compared to those with only junior high school education. Affluent Malays and Chinese are more likely to be overweight than their low-middle income cohorts. Family illness history is likely to cause overweightness or obesity, irrespective of ethnicity. Malay cigarette smokers have lower overweight and obesity probabilities than non-cigarette smokers.. There exists a need for flexible policies to address cross-ethnic differences in the sociodemographic and health-lifestyle covariates of BMI.

Topics: Adult; Age Factors; Body Mass Index; China; Educational Status; Ethnicity; Female; Health Behavior; Humans; Income; India; Life Style; Malaysia; Male; Middle Aged; Obesity

Diabetes in Asia constitutes approximately half of the global burden. Although insulin resistance and incidence of type 2 diabetes differ substantially between ethnic groups within Asia, the reasons for these differences are poorly understood. We evaluated to what extent body fatness, adiponectin levels and inflammation mediate the relationship between ethnicity and insulin resistance in an Asian setting.. Cross-sectional population-based study.. In total, 4136 adult Chinese, Malays and Asian Indians residing in Singapore.. Insulin resistance was assessed using homeostasis model assessment (HOMA-IR) and systemic inflammation by C-reactive protein (CRP). Data were analyzed using path analysis.. HOMA-IR was highest in Asian Indians, intermediate in Malays and lowest in Chinese (P<0.001). The difference in HOMA-IR between Malays and Chinese disappeared after adjusting for body mass index (BMI). For the comparison of Asian Indians with Chinese, the association between ethnicity and HOMA-IR was mediated by BMI (men: 32.9%; women: 48.5%), BMI-adjusted waist circumference (men: 6.1%; women: 3.5%), and CRP (men: 5.1%; women: 5.6%), and unidentified factors (men: 47.2%; women: 26.5%). Part of the mediating effects of body fatness was indirect through effects of body fatness on CRP and adiponectin concentrations.. Mediators of ethnic differences in insulin resistance differed markedly depending on the ethnic groups compared. General adiposity explained the difference in insulin resistance between Chinese and Malays, whereas abdominal fat distribution, inflammation and unexplained factors contributed to excess insulin resistance in Asian Indians as compared with Chinese and Malays. These findings suggest that interventions targeting excess weight gain can reduce ethnic disparities in insulin resistance among Asian Indians, Chinese and Malays.

Topics: Adiponectin; Asian People; Body Composition; Body Mass Index; C-Reactive Protein; China; Cross-Sectional Studies; Female; Homeostasis; Humans; India; Inflammation; Insulin Resistance; Malaysia; Male; Middle Aged; Obesity; Prospective Studies; Risk Factors; Singapore; Waist Circumference; Weight Gain; White People

Obesity prevalence is unequally distributed across gender and ethnic group in Malaysia. In this paper, we examine the role of socioeconomic inequality in explaining these disparities.. The body mass index (BMI) distributions of Malays and Chinese, the two largest ethnic groups in Malaysia, are estimated through the use of quantile regression. The differences in the BMI distributions are then decomposed into two parts: attributable to differences in socioeconomic endowments and attributable to differences in responses to endowments.. For both males and females, the BMI distribution of Malays is shifted toward the right of the distribution of Chinese, i.e., Malays exhibit higher obesity rates. In the lower 75% of the distribution, differences in socioeconomic endowments explain none of this difference. At the 90th percentile, differences in socioeconomic endowments account for no more than 30% of the difference in BMI between ethnic groups.. Our results demonstrate that the higher levels of income and education that accrue with economic development will likely not eliminate obesity inequality. This leads us to conclude that reduction of obesity inequality, as well the overall level of obesity, requires increased efforts to alter the lifestyle behaviors of Malaysians.

Topics: Adolescent; Adult; Aged; Asian People; Body Mass Index; Educational Status; Ethnicity; Feeding Behavior; Female; Health Status Disparities; Health Surveys; Humans; Income; Malaysia; Male; Middle Aged; Obesity; Prevalence; Regression Analysis; Sex Factors; Social Class; Young Adult

OBJECTIVES. Obesity is an issue of concern among patients with schizophrenia as it is a co-morbid condition that is closely related to metabolic syndrome. The present study assessed the correlation of body mass index with antipsychotic use among multiracial schizophrenia outpatients. The study also compared the patients' body mass index with Malaysian Adult Nutrition Survey (MANS) data. METHODS. A total of 216 participants were recruited into a cross-sectional study conducted over 5 months, from December 2010 to April 2011. Body weight and height were measured using the standard methods. Demographic data and treatment variables were gathered through interview or review of the medical records. RESULTS. There were differences in mean body mass index between men and women (p = 0.02) and between Malay, Chinese and Indian races (p = 0.04). Stratified by sex, age, and race, the body mass index distributions of the patients were significantly different to those of the reference MANS population. The prevalence of obesity among patients was more than 2-fold greater than among the reference population in all variables. Although body mass index distribution was related to antipsychotic drugs (χ(2) = 33.42; p = 0.04), obesity could not be attributed to any specific drug. CONCLUSION. The prevalence of obesity among patients with schizophrenia was significantly greater than that in the healthy Malaysian population, and affects the 3 main races in Malaysia.

Topics: Adult; Antipsychotic Agents; Body Mass Index; Comorbidity; Cross-Sectional Studies; Female; Hospitals, Psychiatric; Humans; Malaysia; Male; Metabolic Syndrome; Middle Aged; Nutrition Surveys; Obesity; Outpatient Clinics, Hospital; Prevalence; Racial Groups; Risk Factors; Schizophrenia

Topics: Body Mass Index; Child; Cluster Analysis; Cross-Sectional Studies; Female; Humans; Malaysia; Male; Obesity; Prevalence; Risk Factors; Students; Surveys and Questionnaires

This study investigated the prevalence of the Melanocortin receptor 4 (MC4R) V1031 gene variant and its association with obesity among a cohort of 254 patients (101 males; 118 obese) attending the Kampar Health Clinic. Genotyping revealed the mutated I allele frequency of 0.02, no homozygous mutated (II), and similar distribution of V and I alleles across BMI groups, genders and ethnic groups. No significant difference was found for the means of anthropometric measurements between alleles. Prevalence of this gene variant among the Malaysian cohort was similar with previous populations (2-4% of mutated allele carrier), but was not associated with obesity.

Topics: Adult; Aged; Aged, 80 and over; Alleles; Female; Gene Frequency; Genetic Variation; Genotype; Humans; Malaysia; Male; Middle Aged; Mutation; Obesity; Polymorphism, Single Nucleotide; Prevalence; Receptor, Melanocortin, Type 4

The common variants in the fat mass- and obesity-associated (FTO) gene have been previously found to be associated with obesity in various adult populations. The objective of the present study was to investigate whether the single nucleotide polymorphisms (SNPs) and linkage disequilibrium (LD) blocks in various regions of the FTO gene are associated with predisposition to obesity in Malaysian Malays. Thirty-one FTO SNPs were genotyped in 587 (158 obese and 429 non-obese) Malaysian Malay subjects. Obesity traits and lipid profiles were measured and single-marker association testing, LD testing, and haplotype association analysis were performed. LD analysis of the FTO SNPs revealed the presence of 57 regions with complete LD (D' = 1.0). In addition, we detected the association of rs17817288 with low-density lipoprotein cholesterol. The FTO gene may therefore be involved in lipid metabolism in Malaysian Malays. Two haplotype blocks were present in this region of the FTO gene, but no particular haplotype was found to be significantly associated with an increased risk of obesity in Malaysian Malays.

Topics: Alpha-Ketoglutarate-Dependent Dioxygenase FTO; Body Mass Index; Case-Control Studies; Female; Genetic Predisposition to Disease; Genotype; Humans; Linkage Disequilibrium; Malaysia; Male; Middle Aged; Obesity; Polymorphism, Single Nucleotide; Proteins

Overweight and obesity are defined as abnormal or excessive fat accumulation that may impair health. Body mass index is a simple index of weight-for-height that is commonly used in classifying overweight and obesity in adult populations and individuals.. A study was conducted to screen the medical students of AIMST University for overweight/obesity using Body Mass Index(BMI) and to determine the prevalence among them.. This is an institution based cross sectional study was conducted among 290 medical students using a pre-tested questionnaire and measured their Body Mass Index (BMI). Data obtained was analyzed statistically by calculating proportions.. Out of 290 students who participated in the study, 45.2% were males. In the study, 14.8% were found to be overweight (BMI 23-24.9 kg/m2); 13.7% of males and 15.7% of females. Pre-obese students (BMI 25-29kg/m2) accounted for 15.9% of the total (males 18.3% and females 13.8%). 5.2% were found to be obese (BMI > 30 kg/m2): males 9.2% and females 1.9%. Also 14.8% were found to be underweight (males 12.2% and females 17.0%). The study group consisted of 63.8% Indian, 32.4% Chinese and 3.8% Malay students.. The study reveals that the prevalence of overweight and obesity among the medical students of AIMST University is on the high, which is comparable to the findings of earlier studies conducted in Malaysia, reinforcing the need to encourage healthy lifestyle, healthy food habits and a physically active daily routine, among the adolescents and youth of this country.

Topics: Adult; Body Mass Index; Female; Humans; Malaysia; Male; Obesity; Overweight; Prevalence; Students, Medical; Young Adult

The purpose of this study was to examine the sociodemographic and health-lifestyle factors that affect the likelihood of obesity among Malaysians. Data were obtained from the Malaysian Non-Communicable Disease Surveillance-1. The cross-sectional population-based survey consisted of 2447 observations, with an obesity prevalence rate of 17.2%. Based on logit regression analysis, the results suggest that obesity risks in Malaysia are affected by gender, education level, family history, health conditions, smoking status, and ethnic backgrounds. Specifically, Malaysians more likely to be obese are females (5.3%), lower educated (0.9%), those with history of family illnesses (4.8%), and nonsmokers (6.4%). However, Chinese (9.3%) and other (5.5%) ethnic groups are less likely to be obese when compared with Malays. Based on these results, several policy implications are discussed vis-à-vis obesity risks in Malaysia.

Topics: Adult; Cross-Sectional Studies; Educational Status; Ethnicity; Family Health; Female; Health Policy; Humans; Life Style; Malaysia; Male; Middle Aged; Obesity; Population Surveillance; Risk Factors; Sex Distribution; Smoking

Deficiencies of micronutrients can affect the growth and development of children. There is increasing evidence of vitamin D deficiency world-wide resulting in nutritional rickets in children and osteoporosis in adulthood. Data on the micronutrient status of children in Malaysia is limited. The aim of this study was to determine the anthropometric and micronutrient status of primary school children in the capital city of Kuala Lumpur.. A cross sectional study of primary aged school children was undertaken in 2008. A total of 402 boys and girls aged 7-12 years, attending primary schools in Kuala Lumpur participated in the study. Fasting blood samples were taken to assess vitamin D [as 25(OH)D], vitamin B12, folate, zinc, iron, and ferritin and haemoglobin concentrations. Height-for-age and body mass index for age (BMI-for-age) of the children were computed.. Most of the children had normal height-for-age (96.5%) while slightly over half (58.0%) had normal BMI-for-age. A total of 17.9% were overweight and 16.4% obese. Prevalence of obesity was significantly higher among the boys (25%) than in the girls (9.5%) (χ2 = 22.949; P < .001). Most children had adequate concentrations of haemoglobin, serum ferritin, zinc, folate and vitamin B12. In contrast, 35.3% of the children had serum 25(OH)D concentrations indicative of vitamin D deficiency(≤ 37.5 nmol/L) and a further 37.1% had insufficiency concentrations (> 37.5-≤ 50 nmol/L). Among the boys, a significant inverse association was found between serum vitamin D status and BMI-for-age (χ2 = 5.958; P = .016).. This study highlights the presence of a high prevalence of sub-optimal vitamin D status among urban primary school children in a tropical country. In light of the growing problem of obesity in Malaysian children, these findings emphasize the important need for appropriate interventions to address both problems of obesity and poor vitamin D status in children.

Topics: Adult; Anthropometry; Body Mass Index; Child; Cross-Sectional Studies; Female; Humans; Malaysia; Male; Nutritional Status; Obesity; Prevalence; Social Class; Vitamin D Deficiency

A total of 4428 adults (>18 years old) from 5 different selected regions in Peninsular and East Malaysia participated in this health survey. Using World Health Organization recommendations for body mass index (BMI), the prevalence of overweight and obesity were found to be 33.6% (95% CI= 32.2, 35.0) and 19.5% (95% CI= 18.3, 20.7) respectively. There were more females who were obese (22.5%, 95% CI=20.9, 24.0) compared to males (14.1%, 95% CI=12.3, 15.9). Highest prevalence of obesity were among the Indians (24.6%, 95% CI=20.3, 29.3), followed closely by the Malays (23.2%, 95% CI=21.6, 24.8%) and lowest prevalence was among the Chinese subjects (8.2%, 95% CI=6.2, 10.6). More than 43% of the 531 younger subjects (<30 years old) were either overweight (20%, 95% CI=16.6, 23.6) or obese (13.9%, 95% CI=11.1, 17.2%). All subjects who claimed to be non-diabetes were required to undergo 75 g glucose tolerance test. Compared to subjects with normal BMI (18.5-24.9 kg/m2), there was a 3- and 2-folds increase in the prevalence of newly diagnosed diabetes and impaired glucose tolerance respectively, among obese subjects (BMI>30 kg/m2) who initially claimed to have no diabetes. This study highlights a need for more active, inter-sectoral participation advocating a health-promoting environment in order to combat obesity in this country.

Topics: Adult; Aged; Body Mass Index; Cross-Sectional Studies; Diabetes Mellitus; Ethnicity; Female; Glucose Intolerance; Humans; Malaysia; Male; Middle Aged; Obesity; Odds Ratio; Overweight; Sex Factors

With the increasing prevalence of childhood obesity, the metabolic syndrome has been studied among children in many countries but not in Malaysia. Hence, this study aimed to compare metabolic risk factors between overweight/obese and normal weight children and to determine the influence of gender and ethnicity on the metabolic syndrome among school children aged 9-12 years in Kuala Lumpur and its metropolitan suburbs.. A case control study was conducted among 402 children, comprising 193 normal-weight and 209 overweight/obese. Weight, height, waist circumference (WC) and body composition were measured, and WHO (2007) growth reference was used to categorise children into the two weight groups. Blood pressure (BP) was taken, and blood was drawn after an overnight fast to determine fasting blood glucose (FBG) and full lipid profile, including triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and total cholesterol (TC). International Diabetes Federation (2007) criteria for children were used to identify metabolic syndrome.. Participants comprised 60.9% (n = 245) Malay, 30.9% (n = 124) Chinese and 8.2% (n = 33) Indian. Overweight/obese children showed significantly poorer biochemical profile, higher body fat percentage and anthropometric characteristics compared to the normal-weight group. Among the metabolic risk factors, WC ≥90th percentile was found to have the highest odds (OR = 189.0; 95%CI 70.8, 504.8), followed by HDL-C≤1.03 mmol/L (OR = 5.0; 95%CI 2.4, 11.1) and high BP (OR = 4.2; 95%CI 1.3, 18.7). Metabolic syndrome was found in 5.3% of the overweight/obese children but none of the normal-weight children (p < 0.01). Overweight/obese children had higher odds (OR = 16.3; 95%CI 2.2, 461.1) of developing the metabolic syndrome compared to normal-weight children. Binary logistic regression showed no significant association between age, gender and family history of communicable diseases with the metabolic syndrome. However, for ethnicity, Indians were found to have higher odds (OR = 5.5; 95%CI 1.5, 20.5) compared to Malays, with Chinese children (OR = 0.3; 95%CI 0.0, 2.7) having the lowest odds.. We conclude that being overweight or obese poses a greater risk of developing the metabolic syndrome among children. Indian ethnicity is at higher risk compared to their counterparts of the same age. Hence, primary intervention strategies are required to prevent this problem from escalating.

Topics: Case-Control Studies; Child; Female; Humans; Malaysia; Male; Metabolic Syndrome; Obesity; Overweight; Risk Assessment; Thinness; Urban Population

Vitamin D status is influenced by sun exposure, geographic latitude, daily outdoor activities, body surface exposed to sunlight and dietary intakes. Malaysia, is sunny all year round. However, the vitamin D status of this population especially among the healthy and free living adults is not known. Therefore a study of vitamin D status and associated factors was initiated among an existing Malay cohort in Kuala Lumpur. A total of 380 subjects were sampled to have their vitamin D status assessed using 25-hydroxyvitamin D (25(OH)D). A short questionnaire enquiring socio-demographic characteristics, exposure to sunlight and clothing style was administered. Their mean age was 48.5±5.2years and the mean 25(OH)D for males and females were 56.2±18.9nmol/L and 36.2±13.4nmol/L respectively. There were significant positive correlation for sun exposure score (r=0.27, p<0.001) and negative correlation for sun protection score (r=-0.41, p<0.001) with 25(OH)D levels. In the logistic regression model, females (OR=2.93; 95% CI: 1.17, 7.31), BMI (1.1; 1.03, 1.20) and sun exposure score (0.998; 0.996, 0.999) were significantly associated with vitamin D status as represented by 25(OH)D levels. Our findings show that obesity, lifestyle behaviours and clothing style are directly associated with our participants especially females' low vitamin D status.

Topics: Adult; Body Mass Index; Clothing; Cohort Studies; Demography; Female; Health Behavior; Humans; Logistic Models; Malaysia; Male; Middle Aged; Obesity; Sunlight; Surveys and Questionnaires; Vitamin D

The aim of this study was to determine the prevalence of metabolic syndrome and the most common combination of cardiometabolic disorders among different ethnic groups of obese adolescents in Malaysia.. A cross-sectional study among 335 obese adolescent boys and girls aged 12-18 years from 10 randomly selected schools was conducted. After recording blood pressure and waist circumference (WC), a fasting blood sample was obtained and analyzed for glucose and lipids. Metabolic syndrome was diagnosed on the basis of adolescent metabolic syndrome criteria specified by National Cholesterol Education Program Adult Treatment Panel III if three of the five risk factors--hypertriglyceridemia, hyperglycemia, hypertension, low high-density lipoprotein C, and increased WC--were present. The prevalence among different ethnic groups was analyzed.. The obesity rate among adolescents was 8.4%, and nearly one-third of the obese adolescents had metabolic syndrome. More than 90% of obese adolescents had at least one metabolic abnormality. Metabolic syndrome was more prevalent among obese boys (40.2%) compared to obese girls (17%). Boys had significantly higher mean WC and triglycerides and lower HDL-C (P value 0.0001). Increased WC and triglycerides and high blood pressure comprised the most prevalent (34.3%) risk factor combination followed by WC, low HDL, and high blood pressure (22.5%). Over all, Indians had the highest prevalence of metabolic syndrome (36.4%), followed by Chinese (33.8%) and Malays (27.4%). Elevated triglyceride levels were more prevalent among Chinese, hypertension among Malays, and the other three abnormalities among Indians.. Indians had the highest prevalence of metabolic syndrome. Increased WC and triglycerides and high blood pressure comprised the most prevalent risk factor combination.

Topics: Adolescent; Blood Pressure; Body Mass Index; Child; Cross-Sectional Studies; Ethnicity; Female; Humans; Malaysia; Male; Metabolic Syndrome; Obesity; Prevalence; Risk Factors; Waist Circumference

Quality of life (QoL) is impaired in childhood obesity, but the literature on this is all from Western countries. Aim. To test for impairment of QoL in obese children in Malaysia, using parent-reported and child-reported QoL.. Health-related Quality of Life was measured using the Paediatric Quality of Life Inventory version 4.0. Comparison of QoL between a community sample of 90 obese children (as defined by US CDC and Cole-IOTF definitions), median age 9.5 y (interquartile range [IQR] 8.6, 10.5 y) and 90 control children of healthy weight (BMI less than the 85th centile of US reference data), median age 10.0 y (IQR 9.6, 10.5 y). Children were matched pair-wise for age, gender, and ethnic group, and controls were recruited from schools in the same area as obese participants.. For child self-report, the healthy weight group had significantly higher QoL for the physical (median 82.9, IQR 65.7, 90.6), and psychosocial domains (median, 73.3, IQR 64.4, 83.3), and total QoL (median 76.1, IQR 64.1, 84.8) compared to the obese group (median 67.2, IQR 59.4, 81.3; median 62.5, IQR 53.3, 75.4; median 60.9, IQR 50.8, 73.9; all p < 0.001). There were no significant differences between the obese and healthy weight group for parent-reported physical health, psychosocial health, or total QoL.. Obese children in Malaysia have markedly poorer QoL than their peers, but this is not evident when parent reports of QoL are used.

Topics: Child; Female; Humans; Malaysia; Male; Obesity; Quality of Life

This study investigates ethnic disparities in metabolic syndrome in Malaysia.. Data were obtained from the Malaysia Non-Communicable Disease Surveillance-1 (2005/2006). Logistic regressions of metabolic syndrome health risks on sociodemographic and health-lifestyle factors were conducted using a multiracial (Malay, Chinese, and Indian and other ethnic groups) sample of 2,366 individuals.. Among both males and females, the prevalence of metabolic syndrome amongst Indians was larger compared to both Malays and Chinese because Indians are more likely to exhibit central obesity, elevated fasting blood glucose, and low high-density lipoprotein cholesterol. We also found that Indians tend to engage in less physical activity and consume fewer fruits and vegetables than Malays and Chinese. Although education and family history of chronic disease are associated with metabolic syndrome status, differences in socioeconomic attributes do not explain ethnic disparities in metabolic syndrome incidence. The difference in metabolic syndrome prevalence between Chinese and Malays was not statistically significant. Whereas both groups exhibited similar obesity rates, ethnic Chinese were less likely to suffer from high fasting blood glucose.. Metabolic syndrome disproportionately affects Indians in Malaysia. Additionally, fasting blood glucose rates differ dramatically amongst ethnic groups. Attempts to decrease health disparities among ethnic groups in Malaysia will require greater attention to improving the metabolic health of Malays, especially Indians, by encouraging healthful lifestyle changes.

Topics: Adult; Asian People; Blood Glucose; Blood Pressure; Cholesterol, HDL; Female; Health Status Disparities; Healthcare Disparities; Humans; India; Malaysia; Male; Metabolic Syndrome; Middle Aged; Obesity; Prevalence; Risk Factors; Triglycerides

Vitamin D status, as indicated by 25-hydroxyvitamin D is inversely associated with adiposity, glucose homeostasis, lipid profiles, and blood pressure along with its classic role in calcium homeostasis and bone metabolism. It is also shown to be inversely associated with metabolic syndrome and cardiovascular diseases in western populations. However, evidence from the Asian population is limited. Therefore, we aim to study the prevalence of vitamin D insufficiency (< 50 nmol/L) and the association of 25-hydroxyvitamin D with metabolic risk factors among an existing Malay cohort in Kuala Lumpur.. This is an analytical cross sectional study. A total of 380 subjects were sampled and their vitamins D status (25-hydroxyvitamin D), fasting blood glucose, full lipid profile were assessed using venous blood. Systolic and diastolic blood pressure, weight, height and waist circumference were measured following standard protocols. Socio-demographic data such as sex, age, smoking status etc were also collected. Data was analysed using t-test, chi-square test, General Linear Model and multiple logistic regression.. Females made up 58% of the sample. The mean age of respondents was 48.5 (SD 5.2) years. Females had significantly lower mean Vitamin D levels (36.2; 95% CI: 34.5, 38.0 nmol/L) compared to males (56.2; 95% CI: 53.2, 59.2 nmol/L). Approximately 41% and 87% of males and females respectively had insufficient (< 50 nmol/L) levels of 25-hydroxyvitamin D (p < 0.001). The prevalence of Metabolic Syndrome for the whole sample was 38.4 (95% CI: 33.5, 43.3)%. In the multivariate model (adjusted for age, sex, abdominal obesity, HDL-cholesterol, diastolic blood pressure), insufficient Vitamin D status was significantly associated with 1-year age increments (OR: 0.93; 95% CI: 0.88, 0.98), being female (OR: 8.68; 95% CI: 5.08, 14.83) and abdominal obesity (OR: 2.57; 95% CI: 1.51, 4.39). Respondents with insufficient vitamin D were found to have higher odds of having Metabolic Syndrome (OR: 1.73; 95% CI: 1.02, 2.92) after adjusting for age and sex.. Our results highlight the high prevalence of vitamin D insufficiency among Malay adults in Kuala Lumpur. Vitamin D insufficiency is independently associated with younger age, female sex and greater abdominal obesity. Vitamin D insufficiency is also associated with Metabolic Syndrome.

Topics: Adult; Body Mass Index; Cohort Studies; Cross-Sectional Studies; Female; Humans; Luminescent Measurements; Malaysia; Male; Metabolic Syndrome; Middle Aged; Obesity; Prevalence; Risk Factors; Vitamin D; Vitamin D Deficiency

This study was carried out among undergraduate students in Universiti Malaysia Sarawak with the objective of examining gender differences in body mass index (BMI), body weight perception, eating attitudes and weightloss strategies.. Subjects consisted of 600 undergraduates (300 males and 300 females) recruited from the various faculties between September 2008 until mid-November 2008. The Original Figure Rating Scale: Body Weight Perception, Body Shape Questionnaire (BSQ) and Eating Attitudes Test-26 (EAT-26) were used as assessment tools.. Overall, 52.8% of students had normal BMI, with approximately an equal number of both sexes. More males than females were overweight (33.7%), while more females were underweight (25.3%). Males were more likely to perceive themselves as overweight, and fail to see themselves as underweight. More than half of the females preferred their ideal figure to be underweight, whereas about 30% males chose an overweight figure as their ideal model. Females were generally more concerned about body weight, body shape and eating than males. They diet more frequently, had self-induced vomiting, and used laxatives and exercise as their weight-loss strategies.. Issues pertaining to body weight perception, eating attitudes and weight-loss strategies exist with differences among male and female undergraduates. Thus, in order to correct misperceptions among young adults, a more tailored intervention programme and more in-depth studies into the various factors involved are required.

Topics: Adolescent; Body Image; Body Mass Index; Cross-Sectional Studies; Female; Health Behavior; Humans; Malaysia; Male; Obesity; Sex Factors; Students; Surveys and Questionnaires; Weight Loss; Young Adult

INTRDUCTION: Obesity and chronic diseases have been increasing since the last few decades alongside rapid economic development in developed and developing countries. The alarming increase in the prevalence of childhood obesity had been shown by many epidemiological studies worldwide. The aims of this study were to determine the prevalence of overweight and obesity among Chinese school children in Kota Bharu, Kelantan, and to map the association between dietary practices and their nutritional status.. A cross-sectional study was conducted on 278 school children aged 10 to 12 years old (144 boys and 134 girls) studying in a Chinese primary school in Kota Bharu.. The survey revealed that while only 1.4% (n=4) were overweight, 23.4% (n=65) of the children were obese. A total of 67.7% (n=44) of the obese children were boys. The overweight and obese children (n=70) were compared with a randomly selected group of normal weight children (n=70). Dietary assessment showed that protein, fat and total calorie intake were significantly higher among the overweight group (p<0.05). A significantly higher proportion of the normal weight children (85.7%) took breakfast daily or at least 4 days per week compared to the overweight groups (59.4%) (p<0.05).. The prevalence of obesity among school children in the study is a matter of concern. These findings may be useful in targeting programmes and strategies for prevention and intervention of childhood obesity.

Topics: Child; Child Health Services; China; Cross-Sectional Studies; Feeding Behavior; Female; Health Behavior; Humans; Malaysia; Male; Obesity; Schools

A cross-sectional study was conducted to determine the familial and socio-environmental predictors of overweight and obesity among 1430, 9-12 year-old primary school children and their parents in Selangor and Kuala Lumpur.. Body weight and height were measured and body mass index was calculated. Modified Child Feeding (CFQ) and Determinants of Adolescent Social Well-being and Health (DASH) questionnaires were used to measure familial and socio-environmental factors.. A total of 17.9% of the children were overweight while 16.0% were obese. Positive relationships were found between child's BMI and parent's BMI (r = 0.129, p < or = 0.01), concern about child's weight (r = 0.125, p < or = 0.01) and restriction (r = 0.057, p < or = 0.05) to unhealthy foods. However, negative relationships were found between child's BMI with pressure to eat (r = -0.135, p < or = 0.01) and neighbourhood safety perception (r = -0.053, p < or = 0.05). The logistic regression analysis showed that being male (Exp (beta) = 0.538; 95% CI = 0.421-0.687), higher parent's BMI (Exp (beta) = 1.055; 95% CI = 1.028-1.082), higher concern about child's weight (Exp (beta) = 1.082; 95% CI = 1.030-1.127), low pressure to eat (Exp (beta) = 0.857; 95% CI = 0.801-0.916) and low perception of neighbourhood safety (Exp (beta) = 0.951; 95% CI = 0.913-0.990) were significantly associated with increased risk of overweight.. Parents should be the main target for education to modify children's weight status. Further research should be carried out to understand the mechanism of influence of parents and the socio-environment on child's health.

Topics: Adult; Body Mass Index; Child; Child Welfare; Cross-Sectional Studies; Family; Female; Humans; Malaysia; Male; Obesity; Risk Factors; Sex Factors; Socioeconomic Factors; Surveys and Questionnaires

Peptide Tyrosine-Tyrosine (PYY) is a 36-amino acid peptide hormone released post-prandially from the endocrine cells in the intestinal tract to suppress pancreatic secretions and eventually reduce appetite. The R72T variant in the PYY gene (rs1058046) has been associated with increased susceptibility to obesity. Therefore, the objective of this study was to investigate the association of this variant with obesity and its related anthropometric measurements among the Kampar Health Clinic cohort, Malaysia.. A total of 197 (78 males, 119 females; 98 non-obese, 99 obese) subjects were recruited by convenience sampling and anthropometric measurements were taken. Genotyping was performed using StuI Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP), revealing 61 RR, 94 RT and 42 TT subjects.. Most of the obese subjects had the RT genotype (50.5%), while only 18.2% were TT. PYY R72T genotypes and alleles had no association with obesity (p = 0.535; 0.074, respectively), gender (p = 0.767; p = 0.100, respectively) but were associated with ethnicity (p = 0.003; p = 0.002, respectively). Among the 13 anthropometric measurements taken, significant difference was only found in Waist Circumference (WC) and Visceral Fat Level (VFL) among the alleles, suggesting that subjects with T allele will have an increment of 1.82 cm in WC and 1.32% in VFL.. The R72T variant in PYY gene was not associated with obesity and most of its related anthropometric measurements. This suggests that other genes and/or environmental factors like dietary habits and lifestyle factors may be the contributors of obesity.

Topics: Adult; Aged; Aged, 80 and over; Body Mass Index; Cohort Studies; DNA; DNA Primers; Female; Genotype; Humans; Malaysia; Male; Middle Aged; Obesity; Peptide YY; Polymerase Chain Reaction; Polymorphism, Restriction Fragment Length; Surveys and Questionnaires; Young Adult

Generalised obesity and central obesity are risk factors for Type II diabetes mellitus and cardiovascular diseases. Waist circumference (WC) has been suggested as a single screening tool for identification of overweight or obese subjects in lieu of the body mass index (BMI) for weight management in public health program. Currently, the recommended waist circumference cut-off points of > or = 94cm for men and > or =80cm for women (waist action level 1) and > or = 102cm for men and > or = 88cm for women (waist action level 2) used for identification of overweight and obesity are based on studies in Caucasian populations. The objective of this study was to assess the sensitivity and specificity of the recommended waist action levels, and to determine optimal WC cut-off points for identification of overweight or obesity with central fat distribution based on BMI for Malaysian adults. Data from 32,773 subjects (14,982 men and 17,791 women) aged 18 and above who participated in the Third National Health Morbidity Survey in 2006 were analysed. Sensitivity and specificity of WC at waist action level 1 were 48.3% and 97.5% for men; and 84.2% and 80.6% for women when compared to the cut-off points based on BMI > or = 25kg/m2. At waist action level 2, sensitivity and specificity were 52.4% and 98.0% for men, and 79.2% and 85.4% for women when compared with the cut-off points based on BMI (> or = 30 kg/m2). Receiver operating characteristic analyses showed that the appropriatescreening cut-off points for WC to identify subjects with overweight (> or = 25kg/m2) was 86.0cm (sensitivity=83.6%, specificity=82.5%) for men, and 79.1cm (sensitivity=85.0%, specificity=79.5%) for women. Waist circumference cut-off points to identify obese subjects (BMI > or = 30 kg/m2) was 93.2cm (sensitivity=86.5%, specificity=85.7%) for men and 85.2cm (sensitivity=77.9%, specificity=78.0%) for women. Our findings demonstrated that the current recommended waist circumference cut-off points have low sensitivity for identification of overweight and obesity in men. We suggest that these newly identified cut-off points be considered.

Topics: Adolescent; Adult; Aged; Body Mass Index; Female; Health Surveys; Humans; Malaysia; Male; Middle Aged; Obesity; Overweight; Reference Values; ROC Curve; Sensitivity and Specificity; Waist Circumference

Compliance with medical nutrition therapy is important to improve patient outcomes. The purpose of this study was to determine dietary compliance and its association with glycemic control among outpatients with poorly controlled type 2 diabetes mellitus (T2DM) in Hospital Universiti Sains Malaysia (HUSM).. In this cross-sectional study, patients who had a glycosylated hemoglobin (HbA1c) level of at least 6.5%, after attending a diet counseling session at the Outpatient Dietetic Clinic, HUSM, were enrolled. Out of 150 diabetic patients reviewed between 2006 and 2008, 61 adults (32 men and 29 women) agreed to participate in this study. A questionnaire-based interview was used to collect socio-demographic, clinical and diabetes self-care data. The patient's dietary compliance rate was determined by the Summary of Diabetes Self-Care Activities (SDSCA) measure. Anthropometric and biological measurements were also taken.. Only 16.4% of the respondents adhered to the dietary regimen provided by dietitians. Among the 7 dietary self-care behaviours, item number 6 (eat lots of food high in dietary fibre such as vegetable or oats) had the highest compliant rate (54.1%); whereas item number 3 (eat five or more servings of fruits and vegetables per day) had the lowest compliant rate (23.0%). There was a significant association between gender (p = 0.037) and fasting blood sugar (FBS) (p = 0.007) with the compliance status.. Dietary non-compliance is still common among T2DM patients. Dietitians need to improve their skills and use more effective intervention approaches in providing dietary counseling to patients.

Topics: Adult; Blood Glucose; Body Mass Index; Counseling; Cross-Sectional Studies; Diabetes Mellitus, Type 2; Dietary Fiber; Female; Glycated Hemoglobin; Health Knowledge, Attitudes, Practice; Humans; Malaysia; Male; Middle Aged; Obesity; Overweight; Patient Compliance; Surveys and Questionnaires

To test the null hypothesis that there is no difference in facial profile shape, malocclusion class, or palatal morphology in Malay adults with and without obstructive sleep apnea (OSA).. Subjects were 120 adult Malays aged 18 to 65 years (mean +/- standard deviation [SD], 33.2 +/- 13.31) divided into two groups of 60. Both groups underwent clinical examination and limited channel polysomnography (PSG). The mean OSA and control values were subjected to t-test and the chi square test.. Physical examination showed that 61.7% of the OSA patients were obese, and 41.7% of those obese patients had severe OSA. The mean body mass index (BMI) was significantly greater for the OSA group (33.2 kg/m2 +/- 6.5) than for the control group (22.7 kg/m2 +/- 3.5; P < .001). The mean neck size and systolic blood pressure were greater for the OSA group (43.6 cm +/- 6.02; 129.1 mm Hg +/- 17.55) than for the control group (35.6 cm +/- 3.52; 114.1 mm Hg +/- 13.67; P < .001). Clinical examination showed that the most frequent findings among OSA groups when compared with the control group were convex profiles (71.7%), Class II malocclusion (51.7%), and V palatal shape (53.3%), respectively; the chi square test revealed a significant difference in terms of facial profile and malocclusion class (P < .05), but no significant difference in palatal shape was found.. The null hypothesis is rejected. A convex facial profile and Class II malocclusion were significantly more common in the OSA group. The V palatal shape was a frequent finding in the OSA group.

Topics: Adolescent; Adult; Aged; Blood Pressure; Body Height; Body Mass Index; Body Weight; Cephalometry; Face; Female; Humans; Malaysia; Male; Malocclusion; Malocclusion, Angle Class II; Middle Aged; Neck; Obesity; Overweight; Oxygen; Palate; Polysomnography; Sleep Apnea, Obstructive; Young Adult

This study aimed to determine the prevalence of obesity among medical students and its relationship with their dietary intake and physical activities.. This observational study was carried out on 240 medical students during the clinical phase of their medical course in a private medical school. Their body weight and height were measured, and a standardised questionnaire was used to collect information on their physical activities and dietary intake.. The median body weight of the participants was 59.0 kg (interquartile range: 51.3-66.8), the mean body height was 166.1 cm (standard deviation [SD] 8.5 cm), and the mean body mass index (BMI) was 21.8 kg/m2 (SD 3.4 kg/m2). Based on the World Health Organization BMI cut-offs for the Asian population, 30.1 percent (n is equal to 72) of the students were overweight or obese, with a BMI that was equal to or greater than 23.0 kg/m2. Logistic regression analysis showed that, after controlling for various potential confounders, the only significant risk factors associated with overweight/obesity among these students were: male gender (adjusted odds ratio [OR] 2.1; 95 percent confidence intervals [CI] of 1.1 and 4.1; p is equal to 0.03), Malay ethnic group (adjusted OR 2.4; 95 percent CI 1.0 and 5.7; p is equal to 0.04), Indian ethnic group (adjusted OR 3.6; 95 percent CI 1.5 and 8.9; p is equal to 0.005), and the number of soft drinks consumed per week (adjusted OR 1.3; 95 percent CI 1.0 and 1.5; p is equal to 0.02). Skipping breakfast, the frequency of physical exercise per week, the number of hours of sleep per day, and eating noodles or roti canai (a type of Malaysian pancake) for breakfast were not significant risk factors.. Obesity remains a common problem among medical students in their clinical years.

Topics: Body Mass Index; Clinical Clerkship; Feeding Behavior; Female; Humans; Malaysia; Male; Obesity; Odds Ratio; Prevalence; Sex Factors; Students, Medical

Socio-economic status, lifestyle behaviors, and psychosocial factors have been implicated in the development of overweight and obesity. This study aims to observe the prevalence of overweight and obesity in an academic worksite and to examine the possible association between variables such as socio-economic characteristics, work factors, psychosocial factors, and weight control behaviors and obesity. In this study, the target population were full-time academic and non-academic staff. Body mass index (BMI) and waist circumference (WC) were computed to determine obesity. A pretested self-administered questionnaire was used to obtain information on socio-demographic factors, work related factors, psychosocial factors, and weight control behaviors. Data were obtained on 367 adults of whom 39.2% were males and 60.8% females. Overweight was seen in 31.9% of males and 26.5% of females while 16.1% of them were obese, irrespective of gender. Central obesity was noted in about 37% of males and 39% of females. The results showed that socio-demographic factors (age, gender, and education) and psychosocial factors (perceived health status, body weight perception, and weight-control goals) were significantly associated with BMI. Working hours were also significantly associated with BMI. However, weight control practices (diet-control practices and physical activity practices) were not significantly associated with BMI. In conclusion, this study found a higher prevalence of overweight and obesity among employees of a selected public university in comparison to the general population. Socio-demographic, psychosocial factors, and working hours were found to contribute to obesity in this sample of adults.

Topics: Adult; Age Distribution; Body Mass Index; Cross-Sectional Studies; Employment; Faculty; Female; Humans; Malaysia; Male; Middle Aged; Obesity; Overweight; Prevalence; Public Sector; Risk Factors; Sex Distribution; Surveys and Questionnaires; Universities; Waist Circumference; Workplace; Young Adult

The increased prevalence of metabolic syndrome worldwide is closely related to the rising obesity epidemic. The objectives of the study were to determine the prevalence and identify the associated and prognostic factors that influence the risk of metabolic syndrome among obese patients attending the Obesity Clinic at Hospital Universiti Sains Malaysia.. A study was conducted involving 102 obese persons who attended the Obesity Clinic from January 1 to December 31, 2005. Metabolic syndrome was defined according to the International Diabetes Federation criteria.. The overall prevalence of metabolic syndrome among obese patients was 40.2 percent. The prevalence was higher in females (43.7 percent) than in males (32.3 percent). The prevalence of metabolic syndrome was noted to increase with increasing body mass index class, from class 1 to class 2. However, the prevalence was lower in obesity class 3. The prevalence of metabolic comorbidities of raised blood pressure, reduced high density lipoprotein, high triglyceride and raised fasting blood glucose was 42, 40, 36 and 17 percent, respectively. A quarter of obese patients in this study had no other comorbidity. Based on logistic regression multivariable analysis, age was the only significant associated factor that influenced the risk of having metabolic syndrome.. The prevalence of metabolic syndrome was high and the highest comorbidity was high blood pressure. Age was the only significant risk factor of having this syndrome.

Topics: Adolescent; Adult; Aged; Body Mass Index; Comorbidity; Cross-Sectional Studies; Disease Outbreaks; Female; Health Surveys; Humans; Incidence; Malaysia; Male; Metabolic Syndrome; Middle Aged; Obesity; Registries; Waist-Hip Ratio; Young Adult

Many studies in Asia have demonstrated that Asian populations may require lower cut-off levels for body mass index (BMI) and waist circumference to define obesity and abdominal obesity respectively, compared to western populations. Optimal cut-off levels for body mass index and waist circumference were determined to assess the relationship between the two anthropometric- and cardiovascular indices. Receiver operating characteristics analysis was used to determine the optimal cut-off levels. The study sample included 1833 subjects (mean age of 44+/-14 years) from 93 primary care clinics in Malaysia. Eight hundred and seventy two of the subjects were men and 960 were women. The optimal body mass index cut-off values predicting dyslipidaemia, hypertension, diabetes mellitus, or at least one cardiovascular risk factor varied from 23.5 to 25.5 kg/m2 in men and 24.9 to 27.4 kg/m2 in women. As for waist circumference, the optimal cut-off values varied from 83 to 92 cm in men and from 83 to 88 cm in women. The optimal cut-off values from our study showed that body mass index of 23.5 kg/m2 in men and 24.9 kg/m2 in women and waist circumference of 83 cm in men and women may be more suitable for defining the criteria for overweight or obesity among adults in Malaysia. Waist circumference may be a better indicator for the prediction of obesity-related cardiovascular risk factors in men and women compared to BMI. Further investigation using a bigger sample size in Asia needs to be done to confirm our findings.

Topics: Adult; Body Mass Index; Cardiovascular Diseases; Cross-Sectional Studies; Diabetes Mellitus; Female; Humans; Hyperlipidemias; Hypertension; Malaysia; Male; Middle Aged; Obesity; Reference Values; Risk Factors; ROC Curve; Waist Circumference

The objective of this study was to explore the perception of, feelings and attitudes toward overweight or obesity, and the perceived barriers to weight loss among native adults from lower socio-economic background. A total of six gender- and ethnic-specific focus groups consisted of 38 overweight and obese purposefully and criterion selected adults (21 women and 17 men), participated in this study. An unstructured discussion guide based on the study objectives were used for the focus groups. The results showed that some participants perceived themselves as ugly, felt ashamed of their body size and were frustrated because they did not desire to be overweight. Due to their excess weight, most also expressed they were less effective in their work performances. Although some participants had negative attitudes toward themselves because of excess weight, this appeared to link to self-stigmatization rather than anti-obesity discrimination. The participants remained in the Pre-contemplation stage of losing weight probably because of perceived barriers such as difficulty to resist eating, lack of know how and previous failed attempts to lose weight. Importantly, this study provided some evidence that individuals in the Pre-contemplation stage are unable to take action to lose weight, even if effective strategies are suggested.

Topics: Adult; Body Mass Index; Female; Focus Groups; Humans; Hyperphagia; Malaysia; Male; Middle Aged; Obesity; Overweight; Rural Population; Self Concept; Sex Characteristics; Weight Loss

This paper reports on the presence of dual burden households in Orang Asli (OA, indigenous people) communities and its associated factors. A total of 182 OA households in two districts in Selangor with the required criteria (182 non-pregnant women of child bearing age and 284 children aged 2-9 years old) participated in the study. Height and weight of both women and children were measured. Energy intake and food variety score (FVS) were determined using three 24-hour diet recalls. While 58% were underweight and 64% of the children were stunted, the prevalence of overweight and obesity in women were 31% and 20% respectively. The percentage of dual burden households (overweight mother/underweight child) was 25.8% while 14.8% households had normal weight mother/normal weight child. The mean food variety score (FVS) was similar for women (7.0+/-2.1) and children (6.9+/-1.9). Dual burden households were associated with women's employment status (OR: 3.18, 95% CI: 2.65-5.66), FVS of children (OR: 0.71, 95% CI: 0.51-0.95) and FVS of women (OR: 1.39, 95% CI: 1.02- 1.89). The FVS of children (OR: 0.49, 95% CI: 0.25-0.89) and women (OR: 1.92, 95% CI: 1.64-2.77) remained significant even when dual burden households were compared to only households with normal weight mother/normal weight child. In these OA communities, food variety may predict a healthier diet in children, but may increase the risk of overweight and obesity in adults. Efforts to address households with dual burden malnutrition should consider promotion of healthy diets and lifestyle for all members.

Topics: Adolescent; Adult; Child; Child, Preschool; Diet; Ethnicity; Family Characteristics; Female; Food; Health Promotion; Humans; Malaysia; Male; Malnutrition; Nutritional Status; Obesity; Overweight; Rural Population; Thinness; Young Adult

This cross-sectional study was undertaken with 489 secondary school girls, ages 15-17 years, to examine disordered eating behaviours of adolescent girls in Malaysia and to estimate associations with body weight, body-size discrepancy, and self-esteem. Dietary restraint, binge eating, body image, and self-esteem were assessed using the Restrained Eating scale of the Dutch Eating Behaviour Questionnaire, the Binge Scale Questionnaire, the Contour Drawing Rating Scale, and the Rosenberg Self-Esteem Scale, respectively. Pearson correlations estimated associations between variables. There were 3.1% underweight, 9.8% at risk of being overweight, and 8.6% overweight girls. A total of 87.3% were dissatisfied with their own body size. Dietary restraint and binge eating were reported by 36.0% and 35.4%, respectively. Body Mass Index (r = .34, p < .01) and body-size dissatisfaction (r = .24, p < .01) were significantly associated with dietary restraint and binge eating, but self-esteem (r = -.20, p < .001) was significantly associated only with binge eating.

Topics: Adolescent; Adolescent Behavior; Body Height; Body Image; Body Mass Index; Body Size; Cross-Sectional Studies; Feeding and Eating Disorders; Feeding Behavior; Female; Humans; Malaysia; Obesity; Overweight; Personal Satisfaction; Personality Inventory; Psychiatric Status Rating Scales; Psychology, Adolescent; Self Concept; Surveys and Questionnaires

Worldwide the prevalence of overweight and obesity in children is escalating. Parents' recognition of overweight or obesity in their own children is very important for a successful intervention in these children. This study examined parental perception of their children's weight status, and its association with their knowledge on nutrition and obesity.. This was a cross sectional study of parents with children aged 9 to 12 years, in a primary school of Kuala Lumpur. Parents responded to a self-administered questionnaire which contains parental perception of their child weight status as well as knowledge on nutrition and obesity. The parents' perception of the children's weight status was then compared with the actual measured weight status.. There were 204 parents who participated in the study. Parents were found to underestimate their child weight status and 38.2% were inaccurate in their perception. The mean score of knowledge on nutrition and obesity was 78.5+/-14.4; and this did not associate with the accuracy of their perception on the child weight status. Parents showed inadequate knowledge in food pyramid and preparation of low fat meals.. The Malaysian Health Campaigns had resulted in overall good knowledge on nutrition and obesity in the parents except in few domains. However, this was insufficient to make the parents recognize the growing overweight and obesity problem in their children.

Topics: Adult; Awareness; Body Mass Index; Child; Child Nutrition Sciences; Cross-Sectional Studies; Female; Health Knowledge, Attitudes, Practice; Health Surveys; Humans; Malaysia; Male; Nutrition Policy; Obesity; Parents; Social Perception; Surveys and Questionnaires

A nutritional status survey of Orang Asli (Aboriginal) adults in Lembah Belum, Grik, has been conducted involving a total of 138 subjects. Jahai (58.7%) was the main ethnic group as compared to that of Temiar (41.3%). Based on the Body Mass Index (BMI) characteristics, the majority (63.2%) of the respondents were normal, 26.7% underweight and 10.1% were either overweight or obese. However, by using two different indices of waist circumference and waist-to-hip ratio, 1.6% and 10.8% of the total respondents revealed abdominal obesity, respectively. Measurement of mid upper arm muscle circumference (MUAMC) indicated that about 40% showed nutritional insufficiency whereas 0.8% showed over-nutrition. Body fat classification revealed that 53.4% of the respondents were thin, 45.8% at normal level and only 0.8% were obese. Student's t-test revealed a significant difference in anthropometric indices of body weight, height, MUAMC, triceps, sub-scapular, supra-iliac and body fat according to gender. Meanwhile, analysis of variance (ANOVA) showed significant differences in body weight, waist circumference, WHR and body fat according to different age categories. It was also found that those who smoked had lower BMI compared with non-smokers. Alcohol consumption was associated with higher BMI and WHR among the respondents. Pearson's correlation test between anthropometric measurements and socio-economic and demographic factors showed that ethnic group was the strongest variable.

Topics: Adolescent; Adult; Age Factors; Aged; Anthropometry; Body Mass Index; Cross-Sectional Studies; Female; Health Surveys; Humans; Life Style; Malaysia; Male; Middle Aged; Native Hawaiian or Other Pacific Islander; Nutritional Status; Obesity; Sex Factors; Smoking; Waist-Hip Ratio

A multidimensional assessment of nutritional and health status comprised of subjective global assessment (SGA), anthropometry function, biochemistry, dietary intake, social and health aspects was carried out on 820 older people (52.8% men and 47.2% women) from four rural areas of Peninsular Malaysia. A proportion of the subjects had been classified as either overweight (25.7%) or chronic energy deficient (20.3%). Although 49% of subjects had normal body weight, 68.4% have been classified as having mild to moderate malnutrition according to the SGA. Only 1.1% and 2.3% had low serum albumin and ferritin, respectively. Almost 80% of subjects, especially men, were at high risk of cardiovascular diseases on the basis of the assessment of total cholesterol and LDL-cholesterol. The majority of the subjects (87.2%) were fully independent in performing daily tasks, with men having a significantly higher score compared to women (p<0.001). However, men were less likely to be able to perform a flexibility test (50.7%) than were women (27.0%) (p<0.05). The mean energy intake for men (1412 +/- 461 kcal/d) and women (1201 +/- 392 kcal/d) were below the Recommended Nutrient Intake (RNI) for Malaysia, although this is a difficult assertion to make in an age-group which generally experiences declining energy expenditure. Moreover, 52.5% of men and 47.5% of women might have underreported their food intake. Dietary micronutrients most likely to be deficient were thiamin, riboflavin and calcium. It is concluded that a substantial proportion of rural elderly Malays had problems related to both undernutrition and overnutrition. An appropriate nutrition intervention program is needed to improve the nutritional status of rural elderly Malays.

Topics: Age Factors; Aged; Aged, 80 and over; Energy Intake; Female; Geriatric Assessment; Health Status; Humans; Malaysia; Male; Malnutrition; Middle Aged; Nutrition Assessment; Nutritional Status; Obesity; Rural Health; Sex Factors; Thinness

A population-based cross-sectional study was conducted in all states of Malaysia with the aim to determine the prevalence of obesity among Malaysians aged fifteen years and above and factors associated. A stratified two-stage cluster sampling design with proportional allocation was used. Trained interviewers using a standardized protocol obtained the weight and height measurements and other relevant information. Subjects with a body mass index >= 30 kg/m2 were labelled as obese. The results show that the overall national prevalence of obesity among Malaysians aged 15 years old and above was 11.7% (95% CI = 11.1 - 12.4%). The prevalence of obesity was significantly higher in females (13.8%) as compared to 9.6% in males (p< 0.0001). Prevalence of obesity was highest amongst the Malays (13.6%) and Indians (13.5%) followed by the indigenous group of "Sarawak Bumiputra" (10.8%) and the Chinese (8.5%). The indigenous group of "Sabah Bumiputra" had the lowest prevalence of 7.3%. These differences are statistically significant (p< 0.0001). Logistic regression analysis results show that there was a significant association between obesity and age, gender, ethnicity urban/rural status and smoking status. The prevalence of obesity amongst those aged >= 18 years old has markedly increased by 280% since the last National Health and Morbidity Survey in 1996.. The overall prevalence of obesity in Malaysia is very high as compared to 1996. There is an urgent need for a comprehensive integrated population-based intervention program to ameliorate the growing problem of obesity in Malaysians.

Topics: Adolescent; Adult; Age Factors; Body Mass Index; Cluster Analysis; Cross-Sectional Studies; Ethnicity; Female; Health Surveys; Humans; Logistic Models; Malaysia; Male; Middle Aged; Obesity; Prevalence; Rural Population; Sex Factors; Smoking; Social Class; Socioeconomic Factors; Urban Population

Comparisons of body attitudes and associated behaviours were undertaken using Malay, Samoan, and Australian female students. The general goal of the research was to determine the degree to which the observed pattern of attitudes and behaviours was attributable to culture. The specific analyses comprised an examination of group differences using standard measures that included the Body Attitudes Questionnaire, the Three-Factor Eating Questionnaire and detailed questions concerning the use of diet and exercise as weight control strategies. The main findings concerned a number of cultural differences, particularly in relation to diet and exercise, that were evident even with the effect of body mass index held constant. These results are interpreted in terms of the efficacy of entrenched cultural beliefs in protecting against introduced, more dominant, cultural values. The Australian sample exhibited the most negative body image, although there was some evidence that Malays and Samoans were influenced by Western ideals of weight and shape. It is proposed that to fully understand the differential meaning of negative body image across cultures and the potential impact of westernisation, both within-group and between-group differences in body size need to be acknowledged.

Topics: Adult; Attitude to Health; Australia; Body Image; Body Mass Index; Body Weight; Cross-Cultural Comparison; Diet; Exercise; Female; Health Knowledge, Attitudes, Practice; Humans; Malaysia; Obesity; Samoa

To examine clinical outcomes in Asian patients with schizophrenia receiving monotherapy with olanzapine, risperidone or typical antipsychotics in naturalistic settings.. In this report, data from the first 12 months of the prospective, observational, 3-year Intercontinental Schizophrenia Outpatient Health Outcomes study are presented for patients from participating Asian countries (Korea, Taiwan and Malaysia) who were started on, or switched to, monotherapy with olanzapine (n = 484), risperidone (n = 287) or a typical antipsychotic drug (n = 127) at baseline.. At 12 months, overall reduction in the score of Clinical Global Impressions-Severity of Illness rating scale was greatest with olanzapine (p < 0.001 vs typical agents), followed by risperidone (p = 0.007 vs typical agents) treatment. Olanzapine treatment was found to have significantly better effects than typical agents on negative and depressive symptom scores, and significantly greater improvements than risperidone on negative and cognitive symptoms. The occurrence of extrapyramidal symptoms was least likely with olanzapine (p < 0.001 vs typical agents, and p = 0.012 vs risperidone), while the estimated odds of tardive dyskinesia were greatest in the typical treatment group (p = 0.046 vs olanzapine, and p = 0.082 vs risperidone). Mean weight increase was greater for olanzapine-treated patients compared with the other agents (p = 0.030 vs typical agents and p < 0.001 vs risperidone). The risk of menstrual disturbance was relatively high with risperidone when compared with olanzapine treatment (p < 0.001).. The results of this observational study indicate that, in Asian patients with schizophrenia, olanzapine may offer benefits when compared with typical agents or risperidone. However, the significantly greater odds of weight gain should be considered in the clinical management of olanzapine-treated patients.

Topics: Adult; Antipsychotic Agents; Asian People; Basal Ganglia Diseases; Benzodiazepines; Diagnostic and Statistical Manual of Mental Disorders; Female; Humans; Korea; Malaysia; Male; Obesity; Olanzapine; Risperidone; Schizophrenia; Severity of Illness Index; Taiwan

The purpose of this study was to report on the estimates and distribution of body mass index in a sample of Malaysian adolescents. The study utilized a cross-sectional design and multi-stage random sampling of secondary schools to select 5 urban and 9 rural schools in Kedah and Penang. A total of 6555 male and female adolescents (11-15 years old) of Malay, Chinese and Indian ethnic groups were measured for weights and heights for body mass index calculation. Information on household demographic and socioeconomic were obtained from parents through self-administered questionnaires. Analyses of body mass index distribution by location, ethnicity, gender and age were conducted using Chi-square test of SPSS 11.5. More of the rural (12.1%) and urban (19.4%) adolescents were underweight and overweight, respectively. While in all ethnic, gender and age groups, rural adolescents were more likely to be underweight, more of the urban adolescents were overweight. The prevalence of underweight was highest among the Indians (19.2%) and lowest in Chinese (7.2%). The prevalence of overweight in the three ethnic groups was in the range of 18-19%. More male than female adolescents were underweight (15% vs 7.8%) and overweight (19.5% vs 16.7%). Consistent patterns were also observed across location, ethnic and age groups. As age increased, the prevalence of overweight decreased across the ethnic and gender groups. The reported findings can serve as current reference on body mass index distribution of Malaysian adolescents and a basis for future efforts in health and nutrition interventions for Malaysian children and adolescents.

Topics: Adolescent; Age Distribution; Body Mass Index; Child; Cross-Sectional Studies; Female; Humans; Malaysia; Male; Obesity; Overweight; Rural Health; Schools; Sex Distribution; Surveys and Questionnaires; Urban Health

Paediatric obesity is a public health concern worldwide as it can track into adulthood and increase the risk of adult morbidity and mortality. While the aetiology of obesity is multi-factorial, the roles of diet and physical activity are controversial. Thus, the purpose of this study was to report on the differences in energy intake, diet composition, time spent doing physical activity and energy expenditure among underweight (UW), normal weight (NW) and at-risk of overweight (OW) Malaysian adolescents (317 females and 301 males) aged 11-15 years.. This was a cross-sectional study with 6,555 adolescents measured for weights and heights for body mass index (BMI) categorisation. A total of 618 subjects were randomly selected from each BMI category according to gender. The subjects' dietary intake and physical activity were assessed using self-reported three-day food and activity records, respectively. Dietary intake components included total energy and macronutrient intakes. Energy expenditure was calculated as a sum of energy expended for basal metabolic rate and physical activity. Time spent (in minutes) in low, medium and high intensity activities was also calculated.. The OW adolescents had the highest crude energy intake and energy expenditure. However, after adjusting for body weight, the OW subjects had the lowest energy intake and energy expenditure (p-value is less than 0.001). The study groups did not differ significantly in time spent for low, medium and high intensity activities. Macronutrient intakes differed significantly only among the girls where the OW group had the highest intakes compared to UW and NW groups (p-value is less than 0.05). All study groups had greater than 30 percent and less than 55 percent of energy intake from fat and carbohydrate, respectively.. The data suggested that a combination of low energy expenditure adjusted for body weight and high dietary fat intake may be associated with overweight and obesity among adolescents. To prevent overweight and obesity among children and adolescents, strategies that address eating behaviours and physical activity are required. Various segments of the society must be involved in efforts to promote healthful dietary intakes and active lifestyle in children and adolescents.

Topics: Adolescent; Adolescent Behavior; Adolescent Nutritional Physiological Phenomena; Body Mass Index; Cross-Sectional Studies; Energy Intake; Energy Metabolism; Female; Humans; Malaysia; Male; Motor Activity; Nutritional Status; Obesity; Overweight; Risk Assessment; Risk Factors; Self Disclosure

The worksite is one of the key channels for the delivery of interventions to reduce chronic diseases among adult populations. It provides easy and regular access to a relatively stable population and it encourages sustained peer support. This paper reports a 2-year follow-up of the impact of a worksite health promotion programme on serum cholesterol and dietary changes among employees in a city in Malaysia. A quasi-experimental study was conducted among Malay-Muslim male security guards, with those working in a public university in Kuala Lumpur comprising the intervention group, and those working in the teaching hospital of the same university as the comparison group. They were comparable in socio-demographic characteristics. The intervention group received intensive individual and group counselling on diet, physical activity and quitting smoking. The comparison group was given minimal education on the same lifestyle changes through mail and group counselling. The intervention group showed a statistically significant reduction in their mean total cholesterol levels as compared with the comparison group, with an intervention effect of -0.38 (95% CI = -0.63, -0.14) mmol/l. The intervention group also reported a reduction in the amount of cigarettes smoked. The worksite was shown to be an effective channel for health promotion. The adoption of the new lifestyle behaviours should be supported and sustained through modification of work policies.

Topics: Adult; Cholesterol; Counseling; Diabetes Mellitus; Health Behavior; Health Promotion; Health Services Research; Humans; Hypertension; Life Style; Malaysia; Male; Middle Aged; Obesity; Occupational Health Services; Outcome Assessment, Health Care; Patient Education as Topic; Program Evaluation; Universities; Workplace

To revisit cut-off values of BMI, waist circumference (WC), and waist-to-stature ratio (WSR) based on their association with cardiorespiratory fitness (CRF). The derived cut-off points were compared with current values (BMI, 25.0 kg/m(2); WC, 80 cm) as recommended by the World Health Organization.. Anthropometric indices were measured in a cross sectional study of 358 Singaporean female employees of a large tertiary hospital (63% Singaporean Chinese, 28% Malays, and 9% Indians). CRF was determined by the 1-mile walk test. Receiver operating characteristic curves were constructed to determine cut-off points.. The cut-off points for BMI, WC, and WSR were 23.6 kg/m(2), 75.3 cm, and 0.48, respectively. The areas under the curve of BMI, WC, and WSR were 0.68, 0.74, and 0.74, respectively. For a given BMI, women with low CRF had higher WSR compared with women with high CRF.. These findings provide convergent evidence that the cut-off points for Singaporean women were lower than the World Health Organization's criteria but were in good agreement with those reported for Asians.

Topics: Adult; Area Under Curve; Body Mass Index; China; Cross-Sectional Studies; Female; Humans; India; Likelihood Functions; Malaysia; Middle Aged; Obesity; Oxygen Consumption; Physical Fitness; Reference Values; Sensitivity and Specificity; Singapore; Waist-Hip Ratio

Topics: Diabetes Mellitus; Humans; Malaysia; Obesity

Childhood obesity is an established problem in many countries and emerging in others. Epidemiological data on obesity in children is essential in order to plan public health policy and services. A study was conducted to determine the prevalence of obesity in schoolchildren in the fifth grade of elementary school (10-12 years old) in the district of Kuala Selangor. Ten schools of which five are in urban and five in rural areas were selected consisting of 699 eleven year old schoolchildren from the three major ethnic groups. Using international cut-off points for obesity, we report an overall prevalence of obesity of 7.2%. Prevalence of obesity in urban children is 7.2% whereas in rural children it is 7.0 %. Analysed by gender, there were 8.9% obese boys and 5.3% obese girls. Among the 3 major ethnic groups, the Malays had the highest prevalence of obesity at 9.3% followed by the Chinese with 6.6% while among Indians 3.0%. The data obtained from this study suggests that obesity in Kuala Selangor children is a cause for concern in urban and rural areas.

Topics: Child; Cross-Sectional Studies; Ethnicity; Female; Humans; Malaysia; Male; Obesity; Prevalence; Rural Population; Urban Population

Perilipin is a lipid droplet surface protein present in adipocytes and steroidogenic cells. We examined five common single nucleotide polymorphisms (SNPs) at the perilipin (PLIN) locus (PLIN 6209C>T, 10171A>T, 11482G>A, 13041A>G, and 14995A>T) to investigate their association with obesity risk. The study population included 4,131 subjects of three ethnic groups (Chinese, Malay, and Indian) from Singapore. The prevalence of obesity in Malays and Indians was much higher than in Chinese. Moreover, in these groups the prevalence of obesity was three times higher in women than in men. Crude analysis indicated that haplotype 11212 (CAAAT) is shared by Malays and Indians and is significantly associated with increased obesity risk as compared to the most common haplotype 21111 (TAGAA): OR 1.65 (95% CI 1.11-2.46) in Malays and 1.94 (95% CI 1.06-3.53) in Indians. No associations between PLIN haplotypes and obesity risk were found in Chinese. To simplify the haplotype analyses we used a subgroup of three SNPs (11482G>A, 13041A>G, and 14995A>T) in positive linkage disequilibrium. These analyses revealed similar associations, showing that haplotypes XX212 (XXAAT) and XX222 (XXAGT) are associated with increased obesity risk in Malays OR 2.04 (95% CI 1.28-3.25) and 2.05 (95% CI 1.35-3.12) respectively, and that haplotype XXX212 (XXAAT) is significantly associated with increased obesity risk in Indians OR 2.16 (95% CI 1.10-4.26) after adjusting for covariates including age, sex, smoking, alcohol consumption, exercise, and diabetes status. Moreover, individual SNP analyses demonstrated that the PLIN 14995A>T SNP is the most informative single genetic marker for the observed haplotype association, being significantly associated with increased obesity risk in both Malays OR 2.28 (95% CI 1.45-3.57) and Indians OR 2.04 (95% CI 1.08-3.64). These results support the role of the PLIN locus as an ethnically dependent modulator of obesity risk in humans.

Topics: Adolescent; Adult; Asian People; Carrier Proteins; China; Female; Genetic Linkage; Genetic Variation; Haplotypes; Humans; India; Linkage Disequilibrium; Malaysia; Male; Middle Aged; Obesity; Odds Ratio; Perilipin-1; Phosphoproteins; Polymorphism, Single Nucleotide; Risk Factors; Singapore

The study examined nutritional outcomes related to body fat accumulation of food insecurity among women from selected rural communities in Malaysia.. Cross-sectional study.. Rural communities (seven villages and two palm plantations) in a district with high percentage of welfare recipients.. Malay (n = 140) and Indian (n = 60) women were interviewed and measured for demographic, socioeconomic, anthropometric, dietary and physical activity information. The women were measured for their body mass index and waist circumference (WC). Energy and nutrient intakes, food group intake and food variety score were analyzed from 24 h dietary recalls and food-frequency questionnaire. Daily physical activity of the women was examined as the number of hours spent in economic, domestic, leisure and sport activities.. Using the Radimer/Cornell Hunger and Food Insecurity Instrument, 58% of the women reported some degree of food insecurity (household insecure 14%, adult insecure 9.5% and child hunger 34.5%). In general, food-insecure women had lower years of education, household income and income per capita, more children and mothers as housewives. More than 50% of food-insecure women were overweight and obese than women from food-secure households (38%). Similarly, more food-insecure women (32-47%) had at-risk WC (> or = 88 cm) than food-secure women (29%). Food-insecure women spent significantly more time in domestic and leisure activities than food-secure women. Overweight and abdominal adiposity among the women were associated with a number of independent variables, such as women as housewives, women with more children, larger household size, food insecurity, shorter time spent in economic activities, longer time spent in leisure activities and lower food variety score. After adjusting for factors that are related to both adiposity and food insecurity, women from food-insecure households were significantly more likely to have at-risk WC, but not obese.. Among this sample of rural women, the relationship between food insecurity and obesity is a complex one, which involves the interaction with other factors. Nevertheless, given that obesity and food insecurity are of public health concerns in the developing nations, the association between the two should be further investigated.

Topics: Adipose Tissue; Adult; Body Composition; Body Constitution; Body Fat Distribution; Cross-Sectional Studies; Exercise; Family Characteristics; Feeding Behavior; Female; Food Supply; Humans; Income; Leisure Activities; Malaysia; Middle Aged; Obesity; Poverty; Rural Population; Socioeconomic Factors; Surveys and Questionnaires; Waist-Hip Ratio

Factors related to overweight were examined in a cross-sectional survey that included 1612 women workers from 10 large electronics assembly factories in Peninsular Malaysia. Respondents were Malaysian citizens, direct production workers below the supervisory level, and had worked at least a year in the factory where they were presently employed. Heights and weights were taken to calculate the body mass index (BMI). Weights and BMI increased with increasing age. After adjusting for age, odds ratios for overweight were significantly raised for married women in relation to not married women (OR 1.5, 95% CI=1.15-2.02), lower secondary education in relation to higher than upper secondary education (OR 1.8, 95% CI=1.06-3.14), monthly income RM800-999 (OR 1.7, 95% CI=1.21-2.45) and >/=RM1,000 (OR 1.8, 95% CI=1.23-2.72) in relation to

Topics: Adolescent; Adult; Age Factors; Body Mass Index; Confidence Intervals; Cross-Sectional Studies; Educational Status; Female; Humans; Income; Logistic Models; Malaysia; Marital Status; Middle Aged; Obesity; Odds Ratio; Work Schedule Tolerance

A case-control study was carried out in Alor Gajah to determine the socio-economic, dietary and lifestyle factors and the occurrence of pregnancy-induced hypertension. There were a total of 30 cases who were selected from antenatal mothers attending 3 selected health centers in 1998. The control group consisted of 30 antenatal mothers who were matched according to health centre, race and age. The results showed that pregnancy-induced hypertension was significantly associated with obesity (P < 0.05) and being a housewife (P < 0.05).

Topics: Adult; Case-Control Studies; Female; Humans; Hypertension; Incidence; Life Style; Malaysia; Obesity; Pregnancy; Pregnancy Complications, Cardiovascular; Risk Factors; Surveys and Questionnaires

The study was conducted to determine whether the clinical targets for the control of diabetes recommended by American Diabetes Association can be met in the context of routine diabetes practice. This cross-sectional study was undertaken on 211 type 2 diabetic patients at the Outpatients Diabetes Clinic, Hospital Universisti Sains Malaysia (HUSM) Kubang Kerian, Kelantan between the year 2001-2002. Patients' physical examination and their medical history as well as their family history were obtained by administering a structured questionnaire. Samples of patients' venous blood during fasting were taken and analysed for plasma glucose, glycated haemoglobin and lipid profile. Analysis showed that many patients had comorbidities or complications. A large number of them had poor glycaemic control (73%). Systolic and diastolic blood pressures of 75% and 85% subjects were > or = 130 and > or = 80 mmHg, respectively. Body Mass Index (BMI) values of 66% of the patients were outside the clinical target (BMI > or = 25 in male and > or = 24 kg/m2 in female). The lipid profile showed that 96% of the patients had at least one lipid value outside the clinical target level. In this study, 70% of the patients had total cholesterol > or = 5.2 mmol/L, 87% had LDL cholesterol > or = 2.6 mmol/L, 57% had HDL cholesterol less than the normal range, < or = 1.15 mmol/L in men and < or = 1.4 mmol/L in women, while 46% had triglycerides > or = 1.71 mmol/L. Complications of diabetes were observed in 48% of the total number of patients. As for the patients' systolic blood pressure, age and duration of diabetes were found to have significant effects. Older subjects with a longer duration of diabetes were more hypertensive. Variables that had significant effects on BMI were age, duration of diabetes, glycaemic control and gender. Younger females and newly diagnosed subjects with better glycaemic control (A1C < 7%) were found to have higher BMI values. The overall clinical targets were suboptimal. The prevalence of hyperlipidaemia and hypertension was high. It is imperative that better treatment strategies and methods be adopted to enhance diabetes control and reduce long-term complications of the disease.

Topics: Adult; Analysis of Variance; Blood Glucose; Chi-Square Distribution; Comorbidity; Cross-Sectional Studies; Diabetes Complications; Diabetes Mellitus, Type 2; Female; Guideline Adherence; Humans; Hyperlipidemias; Hypertension; Linear Models; Malaysia; Male; Obesity

Topics: Asia; Body Weight; Health Promotion; Humans; Life Style; Malaysia; Obesity; Oceania; Overweight; Program Evaluation; School Health Services; Weight Loss

Two thousand five hundred and eight subjects from the state of Kelantan in North-East Peninsular Malaysia were included in this study to determine the prevalence of hypertension and their association with cardiovascular risk factors. The overall prevalence of hypertension was 13.9%. There was no difference in the prevalence of hypertension between the males and females. The prevalence increased with age--the highest being in those above 70-years old. Subjects with hypertension also had a higher prevalence of diabetes mellitus (19.0%), obesity (39.4%) and hypercholesterolaemia (70.7%) than non-hypertensive subjects. Of the hypertensive subjects, 83.3% had 1 other risk factor for cardiovascular disease, 66.7% had 2 other risk factors and 16.7% had more than 2 risk factors. Other than age, body mass index, plasma glucose, total cholesterol and LDL-cholesterol, hypertensive subjects also had a higher mean serum urea, creatinine, uric acid and triglyceride than non-hypertensive subjects. In conclusion, hypertension is a common disease in this area and is associated with multiple risk factors for cardiovascular disease. The prevalence is likely to increase in the near future with increasing affluence and becoming a major health problem.

Topics: Adult; Aged; Cardiovascular Diseases; Chi-Square Distribution; Diabetes Complications; Diabetes Mellitus; Female; Glucose Tolerance Test; Humans; Hypercholesterolemia; Hypertension; Malaysia; Male; Middle Aged; Obesity; Prevalence; Risk Assessment; Risk Factors; Sampling Studies

Topics: Body Mass Index; Cause of Death; China; Ethnicity; Female; Humans; Incidence; Malaysia; Male; Neoplasms; Obesity; Proportional Hazards Models; Prospective Studies; Risk Factors; Singapore

Bimodality in blood glucose (BG) distribution has been demonstrated in several populations with a high prevalence of diabetes and obesity. However, other population studies had not found bimodality, thus casting doubt on its universality. We address this question in four ethnic populations-namely Malay, Chinese, Indian, and the indigenous people of Borneo.. A national health survey was conducted in Malaysia in 1996. A total of 18,397 subjects aged > or =30 years had post-challenge BG measurements taken. To test whether BG was consistent with a bimodal distribution, we fitted unimodal normal and skewed distribution as well a mixture of two normal distributions to the data by age and ethnic groups.. Age-specific prevalence of diabetes varied from 1.3 to 26.3%. In all ethnic/age groups, the bimodal model fitted the log BG data better (likelihood ratio tests, all P values <0.001).. Bimodality in BG distribution is demonstrable even in populations with a very low prevalence of diabetes and obesity. Previous studies that found unimodality had failed to detect the second mode because of inadequate sample size, bias due to treatment of subjects with known diabetes, and inclusion of subjects with type 1 diabetes in the sample. Bimodality implies that diabetes is a distinct entity rather than an arbitrarily defined extreme end of a continuously distributed measurement.

Topics: Adult; Blood Glucose; Body Mass Index; Diabetes Mellitus; Ethnicity; Female; Glucose Intolerance; Health Surveys; Humans; Incidence; Malaysia; Male; Middle Aged; Obesity; Reference Values; Sex Characteristics

The practice of losing weight is gaining popularity globally with an increase in health consciousness among the general public. A survey was conducted in seven shopping centres in Kuala Lumpur and its neighbouring towns to assess the weight-loss practices of the general public. Out of the 1032 people approached by the researcher, 389 (37.7%) admitted that they had tried to lose weight before. Of these respondents, 50.4% had the wrong perceptions about their weight with 39.1% of the respondents having BMI lower than what they had perceived. The most common weight-loss method used was dieting (89.5%), followed by exercise (81%) and the use of slimming teas (24.9%). Exercise (79.0%) was perceived as the most effective method for losing weight, followed by dieting (71.6%). Most respondents (60.6%) obtained their weight-loss products from the pharmacies but only 34.9% of these respondents had consulted the pharmacists on these products. Therefore, pharmacists should play a more active role in assisting the general public to lose weight successfully and safely.

Topics: Adolescent; Adult; Anti-Obesity Agents; Counseling; Diet, Reducing; Exercise; Female; Health Behavior; Humans; Malaysia; Male; Obesity; Risk Reduction Behavior; Weight Loss

A total of 5,995 (7.8% of all 7- to 10-year-old primary schoolchildren in Kuala Lumpur), randomly selected from 166 schools (97.6% of all schools), were measured for their weight and height. The analyses of all weight and height data, including the cutoffs used for defining stunting, underweight, and wasting and for thinness and overweight, were carried out as recommended by the World Health Organization (WHO). The prevalances of stunting (height-for-age Z score < -2 SD), underweight (weight-for-age Z score < -2 SD) and wasting (weight-for-height Z score < -2 SD) among all the children studies were 6.7%, 7.1%, and 4.5%, respectively. Undernutrition among boys was more serious than among girls according to all three indicators. Because it was not possible to analyze the weight-for-height data for most of the children above 8.5 years of age, body mass index (BMI)-for-age was used to determine the prevalences of thinness and overweight for all the children. Based on the reference data, the prevalence of overweight (at or above the 95th percentile) was 9.7% and 7.1% for boys and girls, respectively, and 8.4% overall.

Topics: Body Height; Body Mass Index; Body Weight; Child; Child Nutrition Disorders; Child Nutritional Physiological Phenomena; Female; Humans; Malaysia; Male; Nutritional Status; Obesity; Random Allocation; Schools; Thinness; Urban Population; Wasting Syndrome

To investigate the effect of body mass index (BMI) and body fat distribution as measured by waist-to-hip ratio (WHR) on the cardiovascular risk factor profile of the three major ethnic groups in Singapore (Chinese, Malay and Indian people) and to determine if WHO recommended cut-off values for BMI and WHR are appropriate for the different sub-populations in Singapore.. Cross-sectional population study.. A total of 4723 adult subjects (64% Chinese individuals, 21% Malay individuals and 15% Indian individuals) were selected through a multi-staged sampling technique to take part in the National Health Survey in 1998.. Data on socio-economic status (education level, occupation, housing type) and lifestyle habits (smoking and physical activity), body weight, body height, waist and hip circumferences and blood pressure measured using standardised protocols. Fasting venous blood samples were obtained for determination of serum total cholesterol (TC), high density lipoprotein cholesterol (HDL), low density lipoprotein cholesterol (LDL), triglycerides (TG). Venous blood samples were taken for 2 h oral glucose tolerance test (2 h glu).. Absolute and relative risks for at least one cardiovascular risk factor (elevated TC, elevated TC/HDL ratio, elevated TG, hypertension and diabetes mellitus) were determined for various categories of BMI and WHR. At low categories of BMI (BMI between 22 and 24 kg/m(2)) and WHR (WHR between 0.80 and 0.85 for women, and between 0.90 and 0.95 for men), the absolute risks are high, ranging from 41 to 81%. At these same categories the relative risks are significantly higher compared to the reference category, ranging from odds ratio of 1.97 to 4.38. These categories of BMI and WHR are all below the cut-off values of BMI and WHR recommended by WHO.. The results show that, at relatively low BMI and WHR, Singaporean adults experience elevated levels of risks (absolute and relative) for cardiovascular risk factors. These findings, in addition to earlier reported high percentage body fat among Singaporeans at low levels of BMI, confirm the need to revise the WHO cut-off values for the various indices of obesity and fat distribution, viz BMI and WHR, in Singapore.

Topics: Adolescent; Adult; Aged; Body Constitution; Body Mass Index; Cardiovascular Diseases; China; Comorbidity; Cross-Sectional Studies; Female; Health Surveys; Humans; India; Life Style; Malaysia; Male; Middle Aged; Obesity; Odds Ratio; Reference Values; Risk; Sex Characteristics; Singapore; Social Class

We determine the prevalence and determinants of clustering of hypertension, abnormal glucose tolerance, hypercholesterolaemia and overweight in Malaysia. A national probability sample of 17,392 individuals aged 30 years or older had usable data. 61% of adults had at least one risk factor, 27% had 2 or more risk factors. The observed frequency of 4 factors cluster was 6 times greater than that expected by chance. Indian and Malay women were at particular high risk of risk factors clustering. Individuals with a risk factor had 1.5 to 3 times higher prevalence of other risk factors. Ordinal regression analyses show that higher income, urban residence and physical inactivity were independently associated with risk factors clustering, lending support to the hypotheses that risk factors clustering is related to lifestyle changes brought about by modernisation and urbanisation. In conclusion, risk factor clustering is highly prevalent among Malaysian adults. Treatment and prevention programme must emphasise the multiple risk factor approach.

Topics: Adult; Aged; Blood Glucose; Cluster Analysis; Cross-Sectional Studies; Diabetes Mellitus; Female; Glucose Tolerance Test; Humans; Hypercholesterolemia; Hypertension; Malaysia; Male; Middle Aged; Obesity

To study the relationship between body fat percentage and body mass index (BMI) in three different ethnic groups in Singapore (Chinese, Malays and Indians) in order to evaluate the validity of the BMI cut-off points for obesity.. Cross-sectional study.. Two-hundred and ninety-one subjects, purposively selected to ensure adequate representation of range of age and BMI of the general adult population, with almost equal numbers from each ethnic and gender group.. Body weight, body height, sitting height, wrist and femoral widths, skinfold thicknesses, total body water by deuterium oxide dilution, densitometry with Bodpod(R) and bone mineral content with Hologic(R) QDR-4500. Body fat percentage was calculated using a four-compartment model.. Compared with body fat percentage (BF%) obtained using the reference method, BF% for the Singaporean Chinese, Malays and Indians were under-predicted by BMI, sex and age when an equation developed in a Caucasian population was used. The mean prediction error ranged from 2.7% to 5.6% body fat. The BMI/BF% relationship was also different among the three Singaporean groups, with Indians having the highest BF% and Chinese the lowest for the same BMI. These differences could be ascribed to differences in body build. It was also found that for the same amount of body fat as Caucasians who have a body mass index (BMI) of 30 kg/m2 (cut-off for obesity as defined by WHO), the BMI cut-off points for obesity would have to be about 27 kg/m2 for Chinese and Malays and 26 kg/m2 for Indians.. The results show that the relationship between BF% and BMI is different between Singaporeans and Caucasians and also among the three ethnic groups in Singapore. If obesity is regarded as an excess of body fat and not as an excess of weight (increased BMI), the cut-off points for obesity in Singapore based on the BMI would need to be lowered. This would have immense public health implications in terms of policy related to obesity prevention and management.

Topics: Absorptiometry, Photon; Adipose Tissue; Adolescent; Adult; Aged; Asian People; Body Composition; Body Mass Index; China; Cross-Sectional Studies; Deuterium Oxide; Female; Humans; India; Malaysia; Male; Middle Aged; Obesity; Singapore; White People

To evaluate the anthropometric measurements and dietary intake of the free-living elderly in a Chinese community.. A survey was carried out on 48 male and female subjects aged 60 to 96 years using anthropometric, dietary intake and questionnaire techniques.. The study indicated female subjects to have more health problems, like pain at the joints (33%), hypertension (17%) and diabetes (27%) as compared to the male subjects. Dietary intake analysis showed the Chinese male subjects to have a higher energy intake (1,623 kcal) compared to the females (1,197 kcal) even though they did not fulfill the recommended dietary intake. The intake for energy, fats and carbohydrates, was found to be significantly different (p < 0.05) between both sexes. Anthropometric measurements indicated male elderly subjects to be significantly heavier (p < 0.05, 55.4 kg) and taller (161.8 cm) than female elderly subjects (49.5 kg; 146.2 cm respectively). About half of the elderly were normal in their BMI (male 55.6%; female 50%) and only 6.6% of the female subjects were obese. More male subjects were found to be underweight (33%) compared to female subjects (17%). Waist hip ratio was 0.92 for male and 0.87 for female.. Our study showed that female elderly subjects had more health problems compared to male elderly subjects. On the whole, the elderly did not fulfill the recommended amount for energy intake while the percentage for carbohydrates, fats and protein from the total calorie intake were not in accordance with the healthy diet guidelines. Anthropometrically, male subjects were heavier and taller than female subjects. Looking at body mass index, most of the male elderly subjects were in the normal to underweight range. With these results, more research is warranted to give a clearer picture of the Chinese elderly in the country.

Topics: Aged; Aged, 80 and over; Arthritis; Body Constitution; Body Height; Body Mass Index; Body Weight; China; Diabetes Complications; Diet; Dietary Carbohydrates; Dietary Fats; Energy Intake; Ethnicity; Female; Health Status; Humans; Hypertension; Malaysia; Male; Middle Aged; Nutrition Policy; Nutritional Physiological Phenomena; Obesity; Sex Factors; Surveys and Questionnaires

To examine the hypothesis that the higher rates of coronary heart disease (CHD) in Indians (South Asians) compared with Malays and Chinese is at least partly explained by central obesity, insulin resistance, and syndrome X (including possible components).. Cross sectional study of the general population.. Singapore.. Random sample of 961 men and women (Indians, Malays, and Chinese) aged 30 to 69 years.. Fasting serum insulin concentration was correlated directly and strongly with body mass index (BMI), waist-hip ratio (WHR), and abdominal diameter. The fasting insulin concentration was correlated inversely with HDL cholesterol and directly with the fasting triglyceride concentration, blood pressures, plasminogen activator inhibitor 1 (PAI-1), and tissue plasminogen activator (tPA), but it was not correlated with LDL cholesterol, apolipoproteins B and A1, lipoprotein(a), (Lp(a)), fibrinogen, factor VIIc, or prothrombin fragment (F)1 + 2. This indicates that the former but not the latter are part of syndrome X. While Malays had the highest BMI, Indians had a higher WHR (men 0.93 and women 0.84) than Malays (men 0.91 and women 0.82) and Chinese (men 0.91 and women 0.82). In addition, Indians had higher fasting insulin values and more glucose intolerance than Malays and Chinese. Indians had lower HDL cholesterol, and higher PAI-1, tPA, and Lp(a), but not higher LDL cholesterol, fasting triglyceride, blood pressures, fibrinogen, factor VIIc, or prothrombin F1 + 2.. Indians are more prone than Malays or Chinese to central obesity with insulin resistance and glucose intolerance and there are no apparent environmental reasons for this in Singapore. As a consequence, Indians develop some but not all of the features of syndrome X. They also have higher Lp(a) values. All this puts Indians at increased risk of atherosclerosis and thrombosis and must be at least part of the explanation for their higher rates of CHD.

Topics: Adult; Body Mass Index; China; Cholesterol, HDL; Coronary Disease; Cross-Sectional Studies; Female; Humans; India; Insulin; Insulin Resistance; Lipoprotein(a); Malaysia; Male; Middle Aged; Obesity; Risk Factors; Singapore

This study measured the body mass index (BMI), and assessed attitudes and knowledge about obesity, of 197 male and 217 female patients aged 20-59 years attending the primary care clinic of the university hospital in Kelantan, Malaysia. There was no significant difference between the mean BMI of males (23.7) and females (24.2). In the overweight group (BMI 25-29.9) were 60 men (30%) and 66 women (30%). In the obese group (BMI 30 and above) were 12 men (6%) and 22 women (10%). Both diabetes mellitus and hypertension were associated with significantly higher BMI's. Knowledge about obesity was lacking. Sixty-three (15%) failed to recognize that obesity is bad for health. When asked the causes of obesity, 88 (21%) failed to mention either diet or lack of exercise. "Being happy" was suggested as a cause by 32 (8%). When asked if certain foods would cause obesity if eaten in excess, 45 (11%) said "No" for fatty foods, and 164 (40%) said "No" for sweet foods. Concerning appearance, 30 (15%) men regarded an obese man as normal or even handsome, while 49 (23%) women regarded an obese woman as normal or beautiful. Obesity is common among our adult patients, and is associated with some of their common health problems. However, a substantial minority do not regard obesity as unhealthy, do not relate it to diet or lack of exercise, do not recognize important groups of fattening foods, and do not regard obesity as unattractive.

Topics: Adult; Female; Health Knowledge, Attitudes, Practice; Humans; Malaysia; Male; Obesity; Prevalence

Height and body weight were measured in 2,284 subjects over 20 years old. The subjects were chosen by cluster sampling in 9 districts of Kelantan. Blood was drawn after an overnight fast for measurement of cholesterol (chol), triglyceride (TG), VLDL and HDL-Chol. Oral glucose tolerance test was performed with 75 g glucose. The overall prevalence of overweight [BMI (kg/m2) > or = 25-< or = 30] and obesity (BMI > 30) was 21.3% and 4.5% respectively. The overweight and obese were significantly younger than the lean subjects. The prevalence of hypercholesterolemia (chol > 5.2 mmol/l) in lean, overweight and obese subjects was 65.3%, 70.2% and 74.7%, respectively. Impaired glucose tolerance was found in 16.6% of the lean, 21.6% of the overweight and 32.0% of the obese subjects. Diabetes mellitus was found in 7.9% of the lean, 10.5% of the overweight and 6.7 of the obese subjects. 10.1% of lean, 13.2% of overweight and 23.3% of obese individuals were hypertensive. In conclusion, the high prevalence of overweight and obesity in Malaysia was associated with adverse lipid and glucose metabolism as well as poor blood pressure control.

Topics: Adult; Aged; Aged, 80 and over; Body Mass Index; Cardiovascular Diseases; Cluster Analysis; Diabetes Mellitus; Female; Humans; Hypercholesterolemia; Hypertension; Malaysia; Male; Middle Aged; Obesity; Population Surveillance; Prevalence; Risk Factors; Rural Health

The Programme on Prevention and Management of Obesity in Preschool Children, aged three to six years, was implemented in 17 Primary Health Clinics in November 1991. The study sample comprised 1128 preschool children who qualified to enter the obesity register, using the defined criteria for obesity of 2 standard deviations above the normal weight for height and age. This group was divided into three categories, namely, mildly overweight (120% to below 140%), moderately overweight (140% to below 160%), and severely overweight (above 160%). The severely overweight category was referred to dietitians for follow-up management, while the other two categories were managed by the clinic staff through pre-planned nurse-conducted counselling sessions. In this paper, we analysed the first 1128 preschool children aged three to six years on the Programme with respect to their demographic characteristics; medical conditions; family history of obesity, diabetes, hypertension and ischaemic heart disease; number of siblings and parents' educational and occupational status. The Malay children showed significantly more severe grades of obesity compared to the Chinese and Indian children. A family history of obesity and hypertension among the three groups were significant (P < 0.001). After one year of follow-up with the intervention programme, the following were found: 40.4% (456) of the children improved in their obesity status and 20.2% (228) reached normal status. The severe, moderate and mild categories reduced from 6.3% to 5.9%, 29.3% to 23.2% and 64.4% to 50.7% respectively and was found to be statistically significant (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Child; Child Nutritional Physiological Phenomena; Child, Preschool; China; Counseling; Dietetics; Ethnicity; Female; Follow-Up Studies; Health Education; Humans; Malaysia; Male; Obesity; Population Surveillance; Primary Health Care; Referral and Consultation; Sex Factors; Singapore

Kuala Lumpur is the capital city of Malaysia with an estimated population of 1.55 million. Approximately 12% of the population live in squatter settlements occupying about 7% of the city total area. The squatter settlements generally are provided with basic amenities such as piped water, toilet facilities and electricity. Health indicators for the overall population of Kuala Lumpur are better off than for the rest of the country; however, intra-city differentials prevail along ethnic and socio-economic lines. Malays and Indians have higher rates for stillbirths, and neonatal, infant and toddler mortality than the Chinese. The wide disparity in the socio-economic status between the advantaged and the poor groups in the city is reflected in the dietary practices and nutritional status of young children from these communities. The percentage of preschool children from urban poor households with inadequate intakes of calories and nutrients is two to three times higher than those from the advantaged group. Compared to rural infants, a lower percentage of urban infants are breastfed. A lower percentage of Malays from the urban advantaged group breastfed, compared with the urban poor group. The reversed trend is found for the Chinese community. Growth attainment of young children from the urban poor is worse than the urban advantaged, though better than the rural poor. Health and nutritional practices implications related to both undernutrition and overnutrition are discussed, to illustrate the twin challenges of malnutrition in the city.

Topics: Adolescent; Adult; Breast Feeding; Child; Child, Preschool; Cross-Sectional Studies; Deficiency Diseases; Developing Countries; Female; Humans; Hypercholesterolemia; Ill-Housed Persons; Incidence; Infant, Newborn; Malaysia; Male; Maternal-Child Health Centers; Nutrition Disorders; Nutritional Requirements; Nutritional Sciences; Obesity; Population Growth; Poverty; Pregnancy; Protein-Energy Malnutrition; Socioeconomic Factors; Transients and Migrants; Urban Population

A population based cross-sectional survey has measured body mass indices (BMIs) in Singapore and compared their means and the proportions who are overweight and obese amongst Chinese, Malays and Indians. For males there was little ethnic differences; for the 18-69 age group, the age-adjusted mean BMIs being Chinese 22.3, Malays 23.1 and Indians 22.5. However for females, Malays and Indians were considerably more obese than Chinese; for the 18-69 age group the age-adjusted mean BMIs in Malays (25.1) and Indians (24.6) were significantly greater (p less than 0.001) than in Chinese (22.2). The proportions categorised as overweight or obese (BMI equal to or more than 26 in males and 25 in females) were males (Chinese 16.7%, Malays 22.4%, and Indians 14.0%) and females (Chinese 21.2%, Malays 51.5%, and Indians 42.0%). Health education on the harmful effects of obesity should be targeted especially on Malay and Indian females.

Topics: Adolescent; Adult; Aged; Body Mass Index; China; Cross-Sectional Studies; Female; Humans; India; Malaysia; Male; Middle Aged; Obesity; Singapore

Heat stroke is hardly seen in Malaysia. However, it occurs commonly in Saudi Arabia during the Haj season. Many Malaysian pilgrims are affected every year and some die. Having faced this environmental hazard for eight years, the Malaysian Medical Mission, sent each year to look after our pilgrims, modified its treatment strategy in 1988 and successfully decreased the overall morbidity and mortality of affected patients without the use of sophisticated equipment. A brief account of the management of 17 cases seen in 1988 is given. Only one died following treatment. The rest recovered fully without any residual neurological deficit or other complications.

Topics: Female; Heat Exhaustion; Humans; Malaysia; Male; Middle Aged; Obesity; Religious Missions; Saudi Arabia

One hundred and thirty-two newly diagnosed Asian diabetic patients (39 Malay, 30 Chinese and 63 Indians) have been studied in Kuala Lumpur. The highest proportion of diabetic patients were Indian and the lowest were Chinese. Vascular complications were equally common in Asian diabetic patients as in Europeans; coronary heart disease was relatively more common in Indians and cerebral vascular disease in Chinese. Twenty percent of all Asian diabetic patients requiring admission to hospital also had coronary heart disease, 9% had cerebral vascular disease and 8% had gangrene or ulceration of the feet. In Kuala Lumpur, diabetes is a very important risk factor for coronary heart disease: 17% of all patients admitted to the General Hospital with coronary heart disease were already diabetic.

Topics: Adult; Aged; Blood Glucose; Cerebrovascular Disorders; Cholesterol; Coronary Disease; Diabetes Mellitus; Diabetic Angiopathies; Diabetic Retinopathy; Feeding Behavior; Female; Humans; Hypertension; Insulin; London; Malaysia; Male; Middle Aged; Obesity; Triglycerides; Uric Acid

Topics: Adult; Asian People; China; Ethnicity; Female; Humans; India; Malaysia; Male; Middle Aged; Obesity; White People

Topics: Adult; Age Factors; Blood Pressure; Cholesterol; Coronary Disease; Diet; Dietary Carbohydrates; Erythrocytes; Ethnicity; gamma-Globulins; Hematocrit; Humans; Lipids; Malaysia; Male; Middle Aged; Obesity; Physical Exertion; Serum Albumin; Transketolase; Triglycerides

Topics: Age Factors; Biliary Tract Diseases; China; Cholangitis; Cholecystitis; Cholelithiasis; Ethnicity; India; Malaysia; Obesity; Sex Factors

Topics: Adult; Age Factors; Aged; Blood Glucose; Central America; Diabetes Mellitus; Diet; Environment; Environmental Exposure; Female; Glucose Tolerance Test; Humans; Hyperglycemia; Malaysia; Male; Mass Screening; Middle Aged; Nutrition Surveys; Obesity; Pakistan; Parity; Racial Groups; Sex Factors; Time Factors; United States