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Vitamin D deficiency is common among women during pregnancy. This study aims to determine the prevalence of vitamin D deficiency and their shared modifiable environmental factors among pregnant women in Indonesia and Malaysia.Blood samples of 844 third-trimester pregnant women (Indonesians: 311; Malaysians: 533) were collected to determine their serum 25(OH) D levels. Information on sun exposure and sun protection behaviours were obtained through face-to-face interviews. Dietary vitamin D intake was assessed by using a semiquantitative food frequency questionnaire.The prevalence of vitamin D deficiency (30 nmol/L) among Indonesian and Malaysian pregnant women were 42.4% and 72.0%, respectively. Percentage of exposed body surface area was inversely associated with vitamin D deficiency among Indonesian pregnant women (OR = 0.21, 95% CI = 0.09-0.48). Among Malaysian pregnant women, higher intakes of dietary vitamin D were associated with lower risk of vitamin D deficiency (OR = 0.48, 95% CI = 0.29-0.81). Analysis of the combined cohorts revealed a lower risk of vitamin D deficiency among pregnant women who had a daily intake of at least 15 mcg vitamin D (OR = 0.58, 95% CI = 0.38-0.88) and exposure of more than 27% body surface area to the sunlight (OR = 0.30, 95% CI = 0.16-0.60).Despite abundant sunshine, vitamin D deficiency is prevalent among pregnant women in tropical countries. The present study suggests that nutrition education on vitamin D intake and sun exposure during pregnancy is necessary for primary prevention of vitamin D deficiency in pregnant women living in the tropical countries.

Supplemental material, sj-doc-1-nah-10.1177_02601060221134997 for A home gardening intervention to improve vegetable consumption among urban poor children: A study protocol for randomised controlled trial by Kai Ting Mok, Serene En Hui Tung, Satvinder Kaur, Yit Siew Chin, Mohammad Yusoff Martini and Vaidehi Ulaganathan in Nutrition and Health

Binge eating (BE) behaviour is associated with obesity and eating disorders. This cross-sectional study investigates BE behaviour and its relationship with nutrition-related factors among university students. A total of 170 (69% females) university students in Malaysia aged 19 to 24 years participated in this study. BE behaviour was assessed with the use of Binge Eating Scale (BES) questionnaire. Socio-demographic background and nutritional status (anthropometric measurements, body mass index (BMI) and dietary intake) were also measured. BE behaviour reported by 10% percent of the participants. BE behaviour was associated with increased energy intake, elevated BMI and sex (Adjusted R 2 = 0.116, p < 0.001). Differences in sex-specific factors in predicting the risk of BE behaviour were evident. In male participants, an increased in energy intake, elevated BMI and had a higher waist circumference associated with the risk of BE behaviour (Adjusted R 2 = 0.411, p < 0.001). In female participants, only a higher waist circumference associated with BE behaviour (Adjusted R 2 = 0.028, p < 0.05). The finding suggests that understanding sex-specific factors are necessary to prevent BE. These are the potential targets for tailored eating behaviour intervention among university students. DOI : http://dx.doi.org/10.17576/JSKM-2019-1701-08

Although diets with high energy density are associated with increased risk of overweight and obesity, it is not known whether such diets are associated with undernutrition. This study assessed the relationship between dietary energy density (ED) and nutritional status of 745 urban 1- to 10-year-old children. Dietary intakes were obtained using food recall and record for two days. Dietary energy density was based on food and caloric beverages. Higher dietary ED was associated with lower intakes of carbohydrate, sugar, vitamins C and D, and calcium but higher fat, fiber, iron, and folate intakes. While intakes of fruits and milk/dairy products decreased, meat, fish, and legume intakes increased with higher dietary ED. Stunting, but not other growth problems, was associated with higher dietary ED. Future studies should confirm the cause-and-effect relationship between higher dietary ED and stunting.

Information on the growth status of indigenous children is useful for developing intervention strategies, but the data are limited. This study determined the prevalence of undernutrition among under-five indigenous children (Orang Asli) and tracked the growth status of Orang Asli children aged 0-3 years.This study had two phases: a cross-sectional growth study of under-five Orang Asli children (N=304; Phase 1) and a 2-year prospective cohort growth study of Orang Asli children aged 0-3 years (N=214; Phase 2) in the Temerloh district of Pahang, Malaysia. Weight-for-age, length/height-for-age, weight-for-length/height, and body mass index-for-age were determined.The prevalence rates of stunting, underweight, wasting, and thinness in under-five Orang Asli children (Phase 1) were 64%, 49%, 14%, and 12%, respectively. In the cohort of 214 children (Phase 2), weight-for-age was initially documented and maintained closely at -1.50 standard deviations (SD) in the first 6 months, but it declined to approximately -2.00 SD at 15 months and remained close to -2.00 SD thereafter. Length/height-for-age declined rapidly to approximately -2.50 SD at 18 months and fluctuated between -2.30 and -2.50 SD thereafter. Weight-for-length/height increased sharply to -0.40 SD at 2-3 months, declined gradually to less than -1.00 SD at 12 months, and plateaued between -1.00 and -1.30 SD thereafter.Undernutrition is prevalent among Orang Asli children, with length rather than weight faltering being more pronounced in the first 2 years of life. Identifying the causes of early growth retardation in this population is required to inform future preventive strategies.

BACKGROUND/OBJECTIVES Diet plays an important role in growth and development of children. However, dietary intakes of children living in either rural or urban areas can be influenced by household income. This cross-sectional study examined energy, nutrient and food group intakes of 749 urban children (1-10 years old) by household income status. SUBJECTS/METHODS Children's dietary intakes were obtained using food recall and record for two days. Diet adequacy was assessed based on recommended intakes of energy and nutrients and food group servings. RESULTS For toddlers, all nutrients except dietary fiber (5.5 g) exceeded recommended intakes. Among older children (preschoolers and school children), calcium (548 mg, 435 mg) and dietary fiber (7.4 g, 9.4 g) did not meet recommendations while percentage of energy from total fat and saturated fats exceeded 30% and 10%, respectively. The mean sodium intakes of preschoolers (1,684 mg) and school children (2,000 mg) were relatively high. Toddlers in all income groups had similar energy and nutrient intakes and percentages meeting the recommended intakes. However, low income older children had lowest intakes of energy (P < 0.05) and most nutrients (P < 0.05) and highest proportions that did not meet recommended energy and nutrient intakes. For all food groups, except milk and dairy products, all age groups had mean intakes below the recommended servings. Compared to middle and high income groups, low income preschoolers had the lowest mean intake of fruits (0.07 serving), meat/poultry (0.78 serving) and milk/dairy products (1.14 serving) while low income toddlers and school children had the least mean intake of fruits (0.09 serving) and milk/dairy products (0.54 serving), respectively. CONCLUSION Low socioeconomic status, as indicated by low household income, could limit access to adequate diets, particularly for older children. Parents and caregivers may need dietary guidance to ensure adequate quantity and quality of home food supply and foster healthy eating habits in children.

Introduction: This study aimed to determine association between behavioural factors and abdominal obesity among adolescents in Kuala Lumpur. Method: A total of 373 respondents (35.1% males, 64.9% females) aged 13—16 years participated in this study. Majority of the respondents were Malays (54.4%), followed by Chinese (34.3%) and Indians (11.3%). The 90th percentile of waist circumference was used as a cut-off to determine abdominal obesity. Eating behaviours, dietary intakes and physical activity were assessed using Eating Behaviour Questionnaire, Two-day Dietary Recall and Two-day Physical Activity Recall, respectively. Result: One in ten of respondents (13.9%) had abdominal obesity. More than half of respondents (67.0%) skipped at least one meal in the past seven days. Mean frequency of eating away from home and fast food consumption among respondents were 2.3± 1.8 days/week and 1.3± 1.3 days/week, respectively. Mean energy intake of respondents was 1699± 549 kcal/day. Mean percentage of energy intake from carbohydrate, protein and fat among respondents were 45.8± 8.4%, 14.1± 2.8% and 40.9± 8.2%, respectively. Majority of respondents engaged with sedentary lifestyle (75.9%). There was a higher proportion of Indians (23.8%) had abdominal obesity than Malays (15.3%) and Chinese (8.6%) ( 2 = 6.759, p < 0.05). Those who engaged with sedentary lifestyle (17.0%) were more likely to have abdominal obesity than their counterparts (4.4%) ( 2 = 7.904, p < 0.01). There was no significant association between meal skipping, frequency of eating away from home and fast food consumption with abdominal obesity among respondents. Energy intakes and percentage of energy from carbohydrate, protein and fat were also not associated with abdominal obesity. Based on binary logistic regression, being a Malay (OR = 2.104; 95%CI = 1.010—4.386) or Indian (OR = 3.975; 95%CI = 1.514—10.433) and engaged with sedentary lifestyle (OR = 4.964; 95%C1 = 1.721—14.318) were risk factors of abdominal obesity. Conclusion: Hence, further study should be carried out to determine other risk factors of abdominal obesity among adolescents.

Background: The study aimed to investigate the association between disordered eating and overweight and obesity among high school students in Tehran. Methods: This cross-sectional study conducted among 465 high school students (14—17 years old) from three diverse geographical zones of Tehran (227 girls and 328 boys). Weight and height was measured using standard protocol and overweight and obesity were defined using WHO (BMI Z-score) cut off. The Eating Attitude Test-26 (EAT-26) was used to assess disordered eating of adolescents. Results: The prevalence of overweight and obesity was 38.5% (35.7% in girls and 41.2% in boys; 2 = 1.48, p = 0.22). The prevalence of disordered eating was 18.9% of students with significantly higher prevalence in girls (26.4%) than boys (11.8%) ( 2 = 16.29, p < 0.05). The prevalence of disordered eating was significantly higher among overweight/obese girls compared to non-overweight/obese girls (39.5% and 19.2% respectively, 2 = 11.07, p < 0.01). Although the prevalence of disordered eating was higher in overweight/obese boys (15.3%) compared to nonoverweight/obese boys (9.3%), the difference was not statistically significant. Conclusion: More than one-third of the adolescents were overweight and obese and about one-fifth of them were having disordered eating. Disordered eating was associated with overweight and obesity in adolescent girls, but not in boys. Future overweight and obesity intervention program should consider disordered eating as an important intervening factor, especially in adolescent girls.