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1. Factors associated with sugar-sweetened beverages consumption among Malaysian adolescents: findings from the Adolescent Nutrition Survey 2017

Author

Siew Man Cheong, Lalitha Palaniveloo, Azli Baharudin, Norazizah Ibrahim Wong, Ahmad Ali Zainuddin, Safiah Md. Yusof, Mohamad Hasnan Admad, Ruhaya Salleh, and Nur Shahida Abd Aziz

Subjects
Consumption (economics), stomatognathic diseases, Nutrition and Dietetics, business.industry, Environmental health, Medicine, Nutrition survey, business, Sugar, Food Science
Abstract

Introduction: Childhood obesity is a public health problem in Malaysia. Intake of sugar-sweetened beverages (SSB) is associated with obesity in children. There is a lack of studies on factors associated with SSB consumption in Malaysia. This study aimed to determine the sociodemographic factors associated with SSB consumption among Malaysian adolescents. Methods: Data of 2,021 students, aged 10-17 years on sociodemographic, SSB intake and anthropometrics were drawn from the school-based Adolescent Nutrition Survey 2017. A multistage stratified cluster sampling was used to obtain a nationally representative sample of primary and secondary school students. Body mass index (BMI)-for-age status was determined based on calculated z-score using the World Health Organization 2007 reference. SSB consumption was obtained from a food frequency questionnaire. Results: The prevalence of overweight and obesity among Malaysian adolescents were 16.6% and 14.7%, respectively. Malaysian adolescents consumed 1.4 cups of SSB per day. Rural children had a significantly higher SSB intake (1.5 cups) than urban (1.3 cups) children, while males (1.5 cups) had a significantly higher intake than females (1.3 cups). There were no significant differences in SSB consumption between thin, normal, overweight and obese adolescents. Conclusion: Almost all Malaysian adolescents consumed SSB during one month prior to the survey and the average amount consumed was 1.4 cups per day. Rural locality and male were associated with higher SSB consumption. There were differences in SSB consumption between Chinese and Malays, between Chinese and Indians, and between Chinese and Bumiputra Sarawak. There were no differences in consumption between the different BMI-for-age categories.

Published
2021
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2. FACTORS ASSOCIATED WITH ATTENDANCE TO EARLY CHIDHOOD EDUCATION PROGRAMS IN MALAYSIA: RESULTS FROM THE NATIONAL HEALTH AND MORBIDITY SURVEY (MATERNAL AND CHILD HEALTH) 2016

Author

Rosliza Abdul Manaf, Noor Ani Ahmad, Nik Adilah Shahein, Shubash Shander Ganapathy, Norazizah Ibrahim Wong, Norhafizah Sahril, Nor'ain Abd Wahab, Rajini Sooryanarayana, Tahir Aris, Chan Ying Ying, and Nik Mazlina Mohammad

Subjects
National health, medicine.medical_specialty, Under-five, business.industry, Public Health, Environmental and Occupational Health, Ethnic group, Attendance, Disease cluster, Logistic regression, Family medicine, Medicine, Early childhood, business, Educational program
Abstract

The National Health and Morbidity Survey (NHMS) 2016 was a nationwide cross-sectional survey focusing on maternal and child health. This study aimed to identify the prevalence of, and factors associated with early childhood educational program (ECE) attendance among children aged three to five years in Malaysia. Attendance to ECE has been shown to enhance children’s development, yet there is no national information on ECE attendance in Malaysia, where attendance is not compulsory for children below five years. Parents were interviewed face-to-face utilising a validated questionnaire from the UNICEF Multiple Indicator Cluster Survey using mobile devices. Multivariate logistic regression analysis was performed to identify factors associated with ECE attendance. Half (53.4%) of children aged three to five years in Malaysia attend ECE. Older children aged four to five were six times more likely to attend ECE than children three to four years. Malaysian children of Chinese ethnicity were thrice as likely than ethnic Malays to attend ECE. Children with access to >3 children’s books were twice more likely to attend ECE than those who had access to

Published
2021
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3. An overview of the methodology and general findings from the <scp>National Health and Morbidity Survey</scp> (NHMS) 2018: Older persons’ health in <scp>Malaysia</scp>

Author

Ying Ying Chan, Tahir Aris, Faridah Abu Bakar, Mohd Azahadi Omar, Rajini Sooryanarayana, Mohammad Aznuddin Abdul Razak, Noor Ani Ahmad, Norazizah Ibrahim Wong, Muhammad Fadhli Mohd Yusoff, and Sheleaswani Inche Zainal Abidin

Subjects
Male, Gerontology, Older population, Health problems, Quality of life (healthcare), Risk Factors, parasitic diseases, Prevalence, Humans, Medicine, Baseline (configuration management), Aged, Aged, 80 and over, National health, business.industry, Malaysia, Health Surveys, Stratified sampling, Research Design, Quality of Life, Female, Functional status, Independent Living, Morbidity, Rural area, business
Abstract

AIM This article describes the methodology of the 2018 Malaysian National Health and Morbidity Survey, and provides an overview of the sociodemographic details of the respondents and key findings on the health of older adults. METHODS The survey included 3977 community-dwelling respondents, aged ≥60 years across Malaysia. Two-stage stratified random sampling with selection of enumeration blocks from both urban and rural areas ensured the findings were representative of the Malaysian older population. RESULTS Complex sampling analyses ensured that findings on various geriatric syndromes, non-communicable diseases, nutritional status, functional status, social well-being and quality of life are representative of the Malaysian older population. Among the limitations are that the composition of older persons varied slightly from the general older population. CONCLUSIONS This article presents the methodology of the survey, and a baseline of the major health issues for older persons in Malaysia to provide clear guidance to researchers, program managers and policymakers to fully utilize the data from the Malaysian National Health and Morbidity Survey toward achieving healthy aging. The findings might stimulate more research on the health problems faced by older people to provide inputs for policymaking and program implementation. Geriatr Gerontol Int 2020; 20: 7-15.

Published
2020
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4. Factors contributing to food insecurity among older persons in Malaysia: Findings from the National Health and Morbidity Survey ( <scp>NHMS</scp> ) 2018

Author

Ruhaya Salleh, Cheong Siew Man, Mohamad Hasnan Ahmad, Lalitha Palaniveloo, Norlida Zulkafly, Siti Adibah Ab.Halim, Azli Baharudin@Shaharuddin, Norhasmah Sulaiman, Norsyamlina Che Abdul Rahim, Nur Shahida Abdul Aziz, Syafinaz Mohd Sallehuddin, Munawara Pardi, Ahmad Ali Zainuddin, Suhaila Abdul Ghaffar, Suzana Shahar, Rusidah Selamat, and Norazizah Ibrahim Wong

Subjects
Male, Nutritional Status, Logistic regression, 03 medical and health sciences, Social support, 0302 clinical medicine, Risk Factors, 030502 gerontology, Environmental health, Prevalence, Humans, Medicine, Poverty, Aged, Aged, 80 and over, National health, business.industry, Malnutrition, Malaysia, medicine.disease, Health Surveys, Stratified sampling, Food insecurity, Voucher, Food Insecurity, Cross-Sectional Studies, Socioeconomic Factors, Income, Female, Morbidity, Rural area, 0305 other medical science, business, 030217 neurology & neurosurgery
Abstract

Aim Older persons are vulnerable to food insecurity. Therefore, this study aimed to determine the prevalence of food insecurity and associated factors among older persons in Malaysia. Methods This is a cross-sectional study with two-stage stratified random sampling. In total, 3977 older persons participated in this study. Face-to-face interviews were conducted using a mobile device to obtain information about socio-demographic background, food insecurity, non-communicable diseases, social support and living arrangements. Descriptive and multiple complex sample logistic regression analyses were performed for data analysis. Results The overall prevalence of food insecurity among older persons was 10.4%. Older persons from rural areas with no or only primary and secondary education, income less than RM 2000 (USD 477.57), at risk of malnutrition and not receiving very high social support were more likely to be food-insecure. Conclusion Approximately, one-tenth of Malaysian older adults were classified as food-insecure; particularly those living in rural areas from lower socio-economic status, not receiving very high social support and malnourished were more likely to be at risk. A specific nutrition program, such as meals on wheels and food vouchers, should be targeted toward older persons who are at risk to improve their malnutrition status. Geriatr Gerontol Int 2020; 20: 73-78.

Published
2020
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5. Association of sociodemographic factors and self‐perception of health status on oral health‐related quality of life among the older persons in Malaysia

Author

Norazizah Ibrahim Wong, Nurulasmak Mohamed, Habibah Yacob, and Mohamad Anuar Mohamad Fuad

Subjects
Male, Gerontology, Multivariate analysis, Health Status, Oral Health, Logistic regression, Odds, Quality of life, Humans, Medicine, Association (psychology), Geriatric Assessment, Aged, Aged, 80 and over, business.industry, Malaysia, Odds ratio, Self Concept, Cross-Sectional Studies, Socioeconomic Factors, Spouse, Quality of Life, Female, Cluster sampling, Independent Living, business
Abstract

AIM This study aimed to evaluate the oral health-related quality of life (OHRQoL) among older persons in Malaysia and its associations with sociodemographic and self-perception towards general health as well as oral health. METHODS A cross-sectional survey among community dwelling older persons utilizing stratified cluster sampling was conducted in 2018. Well-trained interviewers conducted a face-to-face interview with older persons aged ≥60 years to collect information on participants' sociodemographic characteristics, self-perception on general as well as oral health using the Geriatric Oral Health Assessment Index (GOHAI). Multivariate analysis of the data collected was performed using SPSS version 23. RESULTS Overall, the GOHAI mean ± SD score for older persons in Malaysia was 51.83 ± 7.98, which was an average of fair mean (P

Published
2020
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6. Elder abuse: Nationwide findings among <scp>community‐dwelling</scp> Malaysian older persons

Author

Noran Naqiah Hairi, Shubash Shander Ganapathy, Azriman Rosman, Norazizah Ibrahim Wong, Wan Yuen Choo, and Rajini Sooryanarayana

Subjects
Male, medicine.medical_specialty, Activities of daily living, media_common.quotation_subject, Population, Elder Abuse, Neglect, 03 medical and health sciences, Social support, 0302 clinical medicine, Risk Factors, 030502 gerontology, Activities of Daily Living, Prevalence, medicine, Humans, education, Aged, media_common, Aged, 80 and over, education.field_of_study, business.industry, Public health, Malaysia, Social Support, Odds ratio, Elder abuse, Middle Aged, Sexual abuse, Female, Independent Living, 0305 other medical science, business, 030217 neurology & neurosurgery, Demography
Abstract

AIM Elder abuse is a significant public health problem. This study aims to estimate its prevalence and associated factors, using representative national Malaysian data. METHODS A nationwide population-based survey involving 3977 community-dwelling older persons aged ≥60 years was conducted via face-to-face interview, of whom 3466 older persons were eligible for screening using a locally validated tool. Elder abuse was defined as any one occurrence of neglect, financial, psychological, physical or sexual abuse perpetrated by someone in a position of trust that was experienced in the past 12 months. RESULTS About 9.0% of older persons in Malaysia have experienced elder abuse in the past 12 months, with neglect being the commonest type experienced (7.5%; 95% confidence interval [CI]: 5.54, 10.07). There is no significant difference by age group and geographical location. Males (adjusted odds ratio [aOR] 1.7; 95% CI: 1.06, 2.60), poorer social support (aOR 5.0; 95% CI: 2.25, 11.22), dependency in activities of daily living (aOR 2.1; 95% CI: 1.23, 3.44) and a previous history of abuse (aOR 10.1; 95% CI: 4.50, 22.86) show higher odds of experiencing elder abuse. Almost 5% of abused older persons reported experiencing multiple types of abuse. Reporting is low at 19.3% with none reporting to healthcare personnel. CONCLUSIONS The prevalence of elder abuse in this study is lower than global estimates, but similar to local studies. Preventive measures and programs are crucial to overcoming elder abuse and need to be carried out at multiple levels - the individual, community, healthcare and other stakeholders. Geriatr Gerontol Int 2020; 20: 85-91.

Published
2020
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7. Cardiometabolic and Anthropometric Outcomes of Intermittent Fasting among Overweight and Obese Civil Servants in Malaysia (CAIFA): Study Protocol for A Non-Randomized Controlled Trial (Preprint)

Author

Shazana Rifham Abdullah, Nur Hayati Azizul, Ruziana Mona Wan Mohd Zin, Nur Suffia Sulaiman, Norhayati Mustafa Khalid, Roshan Jahn Mohd Salim Mullahi Jahn, Muhammad Khairul Nazri Khalil, Norhashimah Abu Seman, Nur Azlin Zainal Abidin, Azizan Ali, You Zhuan Tan, Mohd Azahadi Omar, Mohammad Zabri Johari, Nur Shahida Abdul Aziz, Azli Baharudin, Zamtira Seman, Norazizah Ibrahim Wong, Mona Lisa Md. Rasip, Hayati Mohd Yusof, and Mohd Fairulnizal Md Noh

Abstract

BACKGROUND Overweight and obesity among adults is a growing global public health threat and an essential risk factor for various non-communicable diseases. Although intermittent fasting is a generally new dietary approach to weight management that has been increasingly practised worldwide, the effectiveness of two-days per week dry fasting is still unclear. OBJECTIVE This study aimed to determine the cardiometabolic, anthropometric, dietary intake and quality of life changes among overweight and obese civil servants following combined Intermittent Fasting and Healthy Plate (IFHP) and Healthy Plate (HP), and to explore the participants’ experience. METHODS We designed a mixed-method quasi-experimental study that evaluates the effectiveness of IFHP and HP methods among overweight and obese adults. A total of 177 participants were recruited in this study, of which 91 were allocated in the IFHP group and 86 in the HP group. The intervention comprised two phases; supervised (12 weeks) and unsupervised (12 weeks). The data collection was conducted during baseline, after the supervised phase (at week 12), and after the unsupervised phase (at week 24). For each participant, serum and whole blood were collected for analysis. Data on socio-demographic, quality of life, physical activity and dietary intake were also obtained using questionnaires during data collection. RESULTS The majority of the participants were females (n=147, 83.7%) and Malays (n=141, 79.6%). The expected outcomes of this study are changes in body weight, body compositions, quality of life, physical activity, dietary intake and cardiometabolic parameters such as fasting blood glucose, 2-hour post prandial blood glucose, HbA1C, fasting insulin and lipid profile. CONCLUSIONS The CAIFA study is a mixed-method study to evaluate the effectiveness of intermittent fasting on cardiometabolic and anthropometric parameters and to explore participants’ experience throughout the study. CLINICALTRIAL ClinicalTrials.gov NCT05034653

Published
2021
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8. Calcium and iron intakes of adolescents in Malaysia and their relationships with body mass index (BMI): Findings from the Adolescent Nutrition Survey 2017

Author

Norazizah Ibrahim Wong, Rashidah Ambak, Ruzita Abd Talib, Munawara Pardi, Ruhaya Salleh, Syafinaz Mohd Sallehuddin, Mohd Azahadi Omar, and Nur Shahida Abdul Aziz

Subjects
Nutrition and Dietetics, chemistry, business.industry, Environmental health, Nutrition survey, Medicine, chemistry.chemical_element, Calcium, business, Body mass index, Food Science
Abstract

Introduction: Adolescent health is a priority considering they represent the future generation. Data from the Adolescent Nutrition Survey 2017 were analysed to determine the prevalence of micronutrient inadequacy, particularly calcium and iron, and the relationship with body mass index (BMI) among Malaysian secondary school students. Methods: This cross-sectional study included students aged 13 to 17 years old studying at public and private schools. Twenty-four hours dietary recall via face-to-face interview was conducted by trained nutritionists to obtain data on dietary intake. For nutritional status, BMI-for-age z-score (BAZ) was analysed using WHO Anthroplus software. Results: From 999 respondents, 449 were boys and 550 were girls. Overall findings indicated that both boys and girls had inadequate intakes of calcium and iron in their daily diet. Mean intakes of calcium (695.7±463.2 mg/day) and iron (23.4±21.0 mg/day) were higher among boys aged 16 to 17 years old. Mean intake of iron were higher among the older age groups. Majority of the respondents (boys: 94%; girls: 97%) did not meet the recommended nutrient intake (RNI) for calcium and more than half (boys: 50%; girl: 80%) did not achieve the RNI for iron. Current findings also found significant positive but weak correlations between calcium (r=0.112, p=0.001) and iron (r=0.084, p=0.008) intakes with BMI-for-age. Conclusion: BMI-for-age was related to calcium and iron intakes among secondary school students in Malaysia. Thus, intervention strategies should focus on early screening and nutrition education on food choices of high calcium and high iron contents, including iron supplementation programmes, if needed.

Published
2021
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9. Cardiometabolic and Anthropometric Outcomes of Intermittent Fasting Among Civil Servants With Overweight and Obesity: Study Protocol for a Nonrandomized Controlled Trial

Author

Shazana Rifham Abdullah, Nur Hayati Azizul, Ruziana Mona Wan Mohd Zin, Nur Suffia Sulaiman, Norhayati Mustafa Khalid, Roshan Jahn Mohd Salim Mullahi Jahn, Muhamad Khairul Nazrin Khalil, Norhashimah Abu Seman, Nur Azlin Zainal Abidin, Azizan Ali, You Zhuan Tan, Azahadi Omar, Mohammad Zabri Johari, Nur Shahida Abdul Aziz, Azli Baharudin, Zamtira Seman, Norazizah Ibrahim Wong, Mona Lisa Md Rasip, Hayati Mohd Yusof, and Mohd Fairulnizal Md Noh

Subjects
General Medicine
Abstract

Background Overweight and obesity among adults are a growing global public health threat and an essential risk factor for various noncommunicable diseases. Although intermittent fasting is a generally new dietary approach to weight management that has been increasingly practiced worldwide, the effectiveness of 2 days per week dry fasting remains unclear. Objective The Cardiometabolic and Anthropometric Outcomes of Intermittent Fasting study aims to determine the cardiometabolic, anthropometric, dietary intake, and quality of life changes among civil servants with overweight and obesity, following combined intermittent fasting and healthy plate (IFHP) and healthy plate (HP) and explore the participants’ experiences. Methods We designed a mixed methods quasi-experimental study to evaluate the effectiveness of the IFHP and HP methods among adults with overweight and obesity. A total of 177 participants were recruited for this study, of which 91 (51.4%) were allocated to the IFHP group and 86 (48.6%) to the HP group. The intervention comprised 2 phases: supervised (12 weeks) and unsupervised (12 weeks). Data collection was conducted at baseline, after the supervised phase (week 12), and after the unsupervised phase (week 24). Serum and whole blood samples were collected from each participant for analysis. Data on sociodemographic factors, quality of life, physical activity, and dietary intake were also obtained using questionnaires during data collection. Results Most of the participants were female (147/177, 83.1%) and Malay (141/177, 79.7%). The expected outcomes of this study are changes in body weight, body composition, quality of life, physical activity, dietary intake, and cardiometabolic parameters such as fasting blood glucose, 2-hour postprandial blood glucose, hemoglobin A1c, fasting insulin, and lipid profile. Conclusions The Cardiometabolic and Anthropometric Outcomes of Intermittent Fasting study is a mixed methods study to evaluate the effectiveness of combined IFHP and HP interventions on cardiometabolic and anthropometric parameters and explore participants’ experiences throughout the study. Trial Registration ClinicalTrials.gov NCT05034653; https://clinicaltrials.gov/ct2/show/NCT05034653 International Registered Report Identifier (IRRID) RR1-10.2196/33801

Published
2022
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10. The prevalence of hypertension among Malaysian adults and its associated risk factors: data from Malaysian Community Salt Study (MyCoSS)

Author

Nor Azian Mohd Zaki, Fatimah Othman, Azli Baharudin, Rashidah Ambak, Lalitha Palaniveloo, Norazizah Ibrahim Wong, Mohamad Faizul Azham Morad, Graham A. MacGregor, Cheong Siew Man, and Feng J. He

Subjects
Adult, medicine.medical_specialty, RC620-627, Adolescent, Health, Toxicology and Mutagenesis, Blood Pressure, Clinical nutrition, Disease, 030204 cardiovascular system & hematology, Overweight, Logistic regression, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Risk Factors, Diabetes mellitus, Epidemiology, medicine, Prevalence, Humans, 030212 general & internal medicine, Malaysian community salt study (MyCoSS), Nutritional diseases. Deficiency diseases, Child, Aged, business.industry, Public health, Research, Public Health, Environmental and Occupational Health, Middle Aged, medicine.disease, Cardiovascular disease, Blood pressure, Cross-Sectional Studies, Hypertension, medicine.symptom, Public aspects of medicine, RA1-1270, business, Food Science, Demography
Abstract

BackgroundHypertension is one of the most common risk factors for cardiovascular disease and leading cause of mortality globally. The aims of this study were to assess the prevalence of hypertension and its associated risk factors among Malaysian population using data from the Malaysian Community Salt Study (MyCoSS).MethodsThis study was a cross-sectional study using multi-stage stratified sampling method. Data collection was carried out via face-to-face interview at the respondent’s home from October 2017 until March 2018. A total of 1047 respondents aged 18 years and above completed the questionnaires and blood pressure measurement. A person who reported diagnosis of hypertension by a physician and had systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg on three readings was categorised as hypertensive. Risk factors of hypertension were analysed using multiple logistic regression.ResultsThe prevalence of hypertension in the present study was 49.39% (95% CI 44.27–54.51). There was no statistically significant difference in gender. Age, household income, BMI, and diabetes were significantly associated with hypertension. Hypertension found had inverse association with the level of education. Age was the strongest predictor of hypertension (35–44 years old; OR=2.39, 95% CI=1.39–4.09, 45–54 years old; OR=5.50, 95% CI=3.23–9.38, 55–64 years old OR=13.56, 95% CI=7.77–23.64 and 65 years old and above; OR=25.28, 95% CI=13.33–48.66). Those who had higher BMI more likely to be hypertensive as compared to respondents with normal weight (overweight, OR=1.84; 95% CI=1.18–2.86; obese, OR=4.29% CI=2.56–7.29).ConclusionThe findings showed that hypertension is prevalent among adults in Malaysia. Those with older age, higher BMI, and diabetes are more likely to have hypertension. Efforts regarding lifestyle modification and education could be important in hypertension management and prevention.

Published
2021

11. Author response: Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight

Author

Zahra Mohammadi, Abdul Basit, Helena I. S. Nogueira, Soile E. Puhakka, Hongsheng Bi, Ari Voutilainen, Davood Khalili, Bin Zhou, Dermot O'Reilly, Natascia Rinaldo, Paulo A. Lotufo, Bahareh Kheiri, Thein Thein Htay, Simona Giampaoli, Goodarz Danaei, M. Fernanda Lima-Costa, Simona Bo, Peter Schnohr, Jerzy Chudek, Francesco Panza, Ling Yang, Katia Vergetti Bloch, Vincenzo Capuano, Holly E. Syddall, Dong Zhao, Indah Suci Widyahening, Maria Lorenza Muiesan, Leng Huat Foo, Mohsen Azimi-Nezhad, Merete Osler, Laura Torres-Collado, Manu Raj, Adroaldo Cesar Araujo Gaya, Susi Kriemler, Ali Akbar Shayesteh, Aneta Grajda, Anette Varbo, Kazem Mohammad, Leila Beltrami Moreira, Shu Ti Chiou, Iuliia A Rusakova, Jyh Eiin Wong, Torben Jørgensen, Lela Sturua, Lubica Ticha, Hamid Hakimi, Hazzaa M. Al-Hazzaa, Yanina Zócalo, Freda Pitakaka, Savvas C. Savva, Rajeev Gupta, Jennifer Servais, Marie Kunešová, Johanna M. Geleijnse, Elysée Claude Bika Lele, Yannis Manios, Jorge Escobedo-de la Peña, Yufang Bi, Chinh Nguyen Huu, Sibel Gogen, Viviane Cunha Cardoso, Kristine H. Allin, Ana Azevedo, Line Tang Møllehave, Vincent Jr DeGennaro, Novie O. Younger-Coleman, Gretchen A Stevens, Dickman Gareta, Holger Theobald, Anja Schienkiewitz, Bekbolat Zholdin, Janice Luisa Lukrafka, Adela Chirita-Emandi, Ulla Roggenbuck, Kenisha Russell Jonsson, Robespierre Ribeiro, Gabriele Eiben, Eero Kajantie, Sounnia Mediene Benchekor, Fariborz Mansour-Ghanaei, Mary Simon, Prakash C. Gupta, Mohammad Esmaeel Motlagh, Emanuela Gualdi-Russo, María Elena Díaz-Sánchez, Pilar Guallar-Castillón, Bee Koon Poh, Cristina Padez, Azaliia M Tuliakova, Sarah P. Garnett, William R. Tebar, Yingfeng Zheng, Suhad Bahijri, Christina Mavrogianni, Mihaela Vladulescu, Jan A. Staessen, Paula Duarte de Oliveira, Rui Ornelas, Michael Sjöström, Charles Agyemang, Slawomir Koziel, Shohreh Naderimagham, Jari Jokelainen, Stephen T. McGarvey, Patrick Pasquet, Farnam Mohebi, Nader Saki, Aida Pilav, Azim Nejatizadeh, Marianna Noale, Habiba Ben Romdhane, Luís B. Sardinha, Laura Lauria, Jun Hata, Kodanda R Kanala, Gert B. M. Mensink, Nils Lehmann, Elio Riboli, Carolina Tarqui-Mamani, Rodrigo M. Carrillo-Larco, Rosangela Fernandes Lucena Batista, Victoria E Soto-Rojas, Luis Serra-Majem, Martina Müller-Nurasyid, Felipe Vogt Cureau, Lekhraj Rampal, Zhamilya Battakova, Ludmila Sevcikova, Suhaila Abdul Ghaffar, Fikru Tullu, Aung Soe Htet, Angel R. Gonzalez, Annette J. Dobson, Kavumpurathu Raman Thankappan, Hélène Delisle, Francisco J. Félix-Redondo, Ramón Suárez-Medina, Annika Rosengren, Sania Nishtar, Tanja G. M. Vrijkotte, Wolfgang Ahrens, Osvaldo Santos, Maria Cecília Formoso Assunção, Kazi M. Jamil, Stefano Marventano, Wenbin Wei, Norsyamlina Che Abdul Rahim, Shukri F. Mohamed, Bente Sparboe-Nilsen, Soon-Woo Park, Ana Isabel Rito, David Goltzman, W. M. Monique Verschuren, Catterina Ferreccio, Marta Buoncristiano, Ramón Alberto Rascón-Pacheco, Pradeep Joshi, Edward D Janus, Laetitia Huiart, Ala'a Alkerwi, Lorenza Pilotto, Mohannad Al Nsour, Daan Kromhout, Marius B. Bjertness, Oanh T. H. Trinh, Nico Dragano, Angélica Ochoa-Avilés, Ingunn Holden Bergh, Yuki Fujita, Juraci Almeida Cesar, Hajer Aounallah-Skhiri, Maria Dorobantu, Jordi Sunyer, Wolfgang Kratzer, Susanne R. de Rooij, Drude Molbo, Rebecca Goldsmith, Jean Woo, Mohammad El-khateeb, Tiffany K. Gill, Nish Chaturvedi, Benjamin Acosta-Cazares, Erik Lykke Mortensen, Nikhil D. Patel, Francesco Pistelli, Yuan He, Ivana Radic, Yi Zeng, Ilse Khouw, Reynaldo Martorell, Ching-Yu Cheng, Stine Schramm, Hana Shimizu-Furusawa, Jacek Jóźwiak, Radwan Qasrawi, Isti Ilmiati Fujiati, Charles Sossa Jérome, Ben Schöttker, Mikhail Benet, Anastasia Markaki, Christopher T. Cowell, Bharathi Viswanathan, Renata Kuciene, Jose Eugenio Lozano, Pedro J Ortiz, Delphine De Smedt, Elaine M. Murtagh, Kamel Ajlouni, Carlos A. Aguilar-Salinas, Graziella D'Arrigo, Xiangjun Wang, Lars Lind, Macia Enguerran, Marjeta Mišigoj-Duraković, Bo Werner, Jean-Michel Gaspoz, Kyungwon Oh, Seyed Rasoul Zakavi, Daniel Fernández-Bergés, Felix Kaducu, Ramon O. Jimenez, Jonathan E. Shaw, Nipa Rojroongwasinkul, Aicha Soumare, Astrid Petersmann, Tomasz Grodzicki, Parvina Mukhtorova, Eha Nurk, Bhawesh Koirala, Óscar Lopes, Ana Jelakovic, Karolina Milkowska, Magda Gasull, Regina Heidinger-Felso, Marcela González-Gross, Belong Cho, Daphne Mirkopoulou, Salvador Villalpando, Tran Quoc Bao, José Boggia, Daniela Galeone, Josep Redon, Matthias Bopp, Abbas Rezaianzadeh, Dusko Bjelica, Amir Houshang Mehrparvar, Felipe F. Casanueva, Khairil Si-Ramlee, Soheir H Ahmed, Maria Nordendahl, Luciana Zaccagni, Mahboubeh Parsaeian, Rod Jackson, Jorge Motta, Keiu Nelis, Fernando Rigo, Andrzej Pajak, Christa Meisinger, Clara Homs, Namuna Shrestha, Mar Alvarez-Pedrerol, Xun Tang, Johann Willeit, Motahareh Kheradmand, Jean Dallongeville, Jean-Bernard Ruidavets, Anne Tjønneland, Diana A. Santos, Lynne M. Boddy, Jie Hao, David Alejandro González-Chica, Elin Kolle, Jingli Gao, Małgorzata Mossakowska, Isabel O. Oliveira, Giuseppe Grosso, Seongjun Ha, Olfa Saidi, Albina A Fakhretdinova, Oye Gureje, Raluca Pop, Iulia Jurca Simina, Nuno Lunet, Maria Forsner, Peter Bjerregaard, Rachael McLean, Antonio Cabrera de León, Guy De Backer, José A. Casajús, Guang Ning, Emmanuella Magriplis, Laura Censi, Graziella Bruno, Valentina Peterkova, Angelique Chan, Yvonne T. van der Schouw, Charalambos Hadjigeorgiou, Anjani Kumar Jha, Toomas Veidebaum, Thamara Hubler Figueiró, Jana Kratenova, Michelle Cilia, Ivo Rakovac, Bill Stavreski, Ya Xing Wang, Oscar Noboa, Romana Roccaldo, Sara Magnacca, Johan Sundström, Peter Stehle, Tania Lopez, Francis Delpeuch, Julianne Williams, Ellisiv B. Mathiesen, Leanne M. Riley, Claudia M. Hormiga, Joanne Katz, Ekaterina Stoyanova, Heloisa Bettiol, Gabriele Nagel, Alireza Khosravi, Lars Bo Andersen, João Breda, Jørgen Meisfjord, Ahmad Faudzi Yusoff, Marjeta Majer, Robert Beaglehole, Caleb Ochimana, Shynar Abdrakhmanova, George S. Stergiou, Blanca Sandra Ruiz-Betancourt, Leon A. Simons, Eng Joo Tan, Victoria Farrugia Sant'Angelo, Gry Skodje, Maryam Keramati, Liv Elin Torheim, Seppo Koskinen, Assembekov Batyrbek, Jaakko Tuomilehto, Marjo-Riitta Järvelin, Ming-Hui Zhao, Krista Fischer, Tobias F. 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M. van Valkengoed, Anna Fijałkowska, Meghnath Dhimal, Murat Topbaş, George Moschonis, Robert Eggertsen, Quang Ngoc Nguyen, Janette Walton, Elnaz Faramarzi, Nasheeta Peer, Radka Taxová Braunerová, Harald Geiger, Morteza Shamshirgaran, Lela Shengelia, María Ángeles Dal Re Saavedra, Khem Bahadur Karki, Timothy J. Key, Maria G. Grammatikopoulou, Susana Vale, Bernhard O. Boehm, Songhomitra Panda-Jonas, Iveta Pudule, Elisabete Ramos, Lacramioara Aurelia Brinduse, Paul H. Lee, Terence W O'Neill, Javad Aghazadeh-Attari, Margus Punab, Bojan Jelaković, Eliza Cinteza, Ha Tp Do, and Alison J. Hayes

Subjects
education.field_of_study, business.industry, Population, Distribution (economics), medicine.disease, Obesity, Geography, medicine, Underweight, medicine.symptom, education, business, Body mass index, Demography
Published
2020
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12. Abdominal obesity and its associated factors among older adults in Malaysia

Author

Ruhaya Salleh, Norazizah Ibrahim Wong, Azli Baharudin Shaharuddin, Jayvikramjit Singh Manjit Singh, Norlida Zulkafly, Mohamad Hasnan Ahmad, Nur Shahida Abdul Aziz, Ying Ying Chan, Chee Cheong Kee, Lalitha Palaniveloo, and Rusidah Selamat

Subjects
Male, Waist, High cholesterol, Body Mass Index, Risk Factors, Diabetes mellitus, medicine, Diabetes Mellitus, Prevalence, Humans, Multiple logistic regression analysis, Abdominal obesity, Aged, business.industry, Malaysia, Odds ratio, Middle Aged, medicine.disease, Health Surveys, Stratified sampling, Cross-Sectional Studies, Obesity, Abdominal, Hypertension, Educational Status, Female, medicine.symptom, Waist Circumference, business, Demography, Healthcare system
Abstract

Aim The rise in the prevalence of abdominal obesity (AO), in particular, has become a major concern as it contributes to diabetes, hypertension, high cholesterol, heart disease and certain types of cancer. The aim of this study is to determine the prevalence and associated factors of AO among older adults aged ≥60 years in Malaysia. Methods This was a nationwide cross-sectional study using two-stage stratified random sampling. In total, 3977 older adults aged ≥60 years were involved in this study. Socio-demography characteristics were obtained using self-administered questionnaire. AO was measured using waist circumference and classified according to the cut-off values of ≥90 cm for men and ≥80 cm for women based on the WHO recommendation. Descriptive and multiple logistic regression analysis using a complex sample design were performed for data analysis. Results Our findings showed that 2371 (67.3%) older adults had AO. Older adults who were from urban areas (69.7%), of women (78.4%), married (66.7%), with tertiary education (73.6%) and unemployed (70.9%) had the highest prevalence of AO. Those from urban areas (adjusted odds ratio [aOR] = 1.29), women (aOR = 3.12), unemployed (aOR = 1.14), diagnosed with hypertension (aOR = 1.56) and diabetes mellitus (aOR = 2.08) were also significantly associated with a higher risk of AO. Conclusions This study identified several risk factors that are associated with AO among older adults in Malaysia. Such information is important and needed to improve the healthcare system systematically, enable nutrition screening and appropriate intervention to combat the growing AO in Malaysia. Geriatr Gerontol Int 2020; 20: 68-72.

Published
2020

13. Prevalence and Factors Associated With Oral and Hand Hygiene Practices Among Adolescents in Malaysia: Findings From the National Health and Morbidity Survey 2017

Author

Nurrul Ashikin Abdullah, Ting Teck Pei, Natifah Che Salleh, Mohamad Fuad Mohamad Anuar, Norazizah Ibrahim Wong, S Maria Awaluddin, Tahir Aris, and Siew Lian Yaw

Subjects
Male, Adolescent, media_common.quotation_subject, Oral hygiene, 03 medical and health sciences, 0302 clinical medicine, Hygiene, Risk Factors, Environmental health, Prevalence, Medicine, Humans, Hand Hygiene, 030212 general & internal medicine, Students, media_common, National health, Schools, business.industry, Public Health, Environmental and Occupational Health, Malaysia, 030206 dentistry, Oral Hygiene, Health Surveys, Cross-Sectional Studies, Adolescent Behavior, Female, business
Abstract

This cross-sectional national survey aimed to determine the prevalence of oral and hand hygiene practices as well as associations between sociodemographic characteristics and oral and hygiene practice among adolescents aged 13 to 17 years during the past 30 days. A validated self-administered bilingual questionnaire adapted from the Malaysian Global School Health Survey with computer-scanable answer sheets was distributed to 30 823 adolescents attending government secondary schools in Malaysia; and 89.2% responded to the questionnaire given. More than 80% (87.1%; 95% confidence interval [CI] = 86.24-87.96) of the adolescents reported that they had brushed their teeth at least twice daily and had always washed their hands after using the toilet (86.6%; 95% CI = 85.85-87.36). The odds of adolescents who brushed their teeth at least 2 times daily and washed their hands after using the toilet was significantly associated with sociodemographic characteristics. This study highlights the need to further improve the effectiveness of current oral health promotion programs with consideration for sociodemographic characteristics.

Published
2019

14. The Association of Internet Addiction and Perceived Parental Protective Factors Among Malaysian Adolescents

Author

Faizah Paiwai, Chan Ying Ying, Norazizah Ibrahim Wong, Nik Rubiah Nik Abd Rashid, Norzawati Yoep, Noor Aliza Lodz, Eida Nurhadzira Muhammad, S Maria Awaluddin, Noor Safiza Mohamad Nor, and Nur Azna Mahmud

Subjects
Male, Parents, Adolescent, Social connectedness, media_common.quotation_subject, Parental supervision, 03 medical and health sciences, 0302 clinical medicine, Surveys and Questionnaires, Prevalence, Medicine, Humans, 030212 general & internal medicine, Health risk, Association (psychology), media_common, Internet, business.industry, Addiction, Public Health, Environmental and Occupational Health, Malaysia, Odds ratio, Protective Factors, Confidence interval, Behavior, Addictive, Social Perception, Adolescent Behavior, The Internet, Female, business, 030217 neurology & neurosurgery, Demography
Abstract

Parental protective factors do play an important role in preventing Internet addiction. A self-administered questionnaire was used to measure health risk behaviors among Malaysian adolescents. The prevalence of Internet addiction was significantly higher among adolescents with perceived lack of parental supervision (30.1% [95% confidence interval (CI) = 28.7-31.4]) and lack of parental connectedness (30.1% [95% CI = 28.5-31.7]), compared with their counterparts. Adolescents who perceived a lack of parental supervision, respect for privacy, connectedness, and bonding were more likely to have Internet addiction: (adjusted odds ratio [aOR] = 1.39; 95% CI = 1.27-1.52), (aOR = 1.23; 95% CI = 1.16-1.31), (aOR = 1.09; 95% CI = 1.02-1.16), (aOR = 1.06; 95% CI = 1.00-1.12), respectively. Among girls, Internet addiction was associated with those who perceived lack in all 4 parental factors, while among boys, those who perceived lack of parental supervision and respect for privacy were more prone to Internet addiction.

Published
2019

15. An assessment of risk of iodine deficiency among pregnant women in Sarawak, Malaysia

Author

Lim Kuang Kuay, Tan Beng Chin, Mohd Shaiful Azlan Kassim, Nur Azna Mahmud, Ruhaya Salleh, Cheong Siew Man, Norazizah Ibrahim Wong, Chan Ying Ying, and Tahir Aris

Subjects
Pregnant women, Iodized salt, Iodine deficiency disorders, Sarawak
Abstract

Previous findings from a state-wide Iodine Deficiency Disorders (IDD) study among pregnant women (PW) in Sarawak indicated that PW are at risk of IDD and further study is needed. This paper describes the methodology used in conducting this study on assessment of risk of iodine deficiency among pregnant women in Sarawak, Malaysia. Thirty maternal child health care clinics (MCHCs) were selected using probability proportional to population size (PPS) sampling technique. The PW sample size was calculated based on 95% confidence interval (CI), relative precision of 5%, design effect of 2, anticipated IDD prevalence of 65.0% and non-response rate of 20%. Thus, the total sample size required was 750 (25 respondents per selected MCHC). The WHO Expanded Programme on Immunization (EPI) surveys approach was used to randomly select the first respondent and subsequent respondents were chosen until the required number of PW was met. The required data were obtained through: face-to-face interviews (socio-demographic and food frequency questionnaire), clinical assessments (thyroid size, and hyper/hypothyroidism) and biochemical analysis (urine and blood serum). A total of 677 PW responded in the study with a response rate of 90.2%. Majority of the PW were at second gravida, aged 25-29 years old and of Malay ethnicity. The methodology used in this study was based on international guidelines which may provide state’s estimates. All the necessary steps were taken into consideration to ensure valid and reliable findings on current iodine status among PW.

Published
2019

16. Methodology and Representativeness of the Adolescent Health Survey 2017 in Malaysia

Author

Muhammad Fadhli Mohd Yusoff, Mohd Azahadi Omar, Wan Shakira Rodzlan Hasani, Tahir Aris, Norazizah Ibrahim Wong, Nik Rubiah Nik Abd Rashid, and S Maria Awaluddin

Subjects
Male, Adolescent, Population, Adolescent Health, Representativeness heuristic, Health Risk Behaviors, 03 medical and health sciences, Health problems, Young Adult, 0302 clinical medicine, 030225 pediatrics, Environmental health, Prevalence, Cluster Analysis, Humans, 030212 general & internal medicine, Health risk, education, Child, Students, Estimation, education.field_of_study, Schools, Public Health, Environmental and Occupational Health, Malaysia, Reproducibility of Results, Mental health, Health Surveys, Cluster sampling, Female, Psychology, Adolescent health
Abstract

Health risk behaviors and mental health problems are associated with morbidity and premature mortality among adolescents. Understanding the magnitude of the problem may improve adolescent health status. The Adolescent Health Survey was conducted to collect data on health risk behaviors among Malaysian school-going adolescents using self-administered questionnaires. A 2-stage stratified cluster sampling design was used and samplings weights were calculated to ensure representativeness to the general population. A total of 27 497 out of 30 823 school-going adolescents completed the questionnaires, yielded an 89.2% overall response rate. The methodology was robust to ensure valid estimation on the prevalence of health problems among Malaysian school-going adolescents.

Published
2019

17. Associated Factors to Prevalence of Childhood under Nutrition in Malaysia: Findings from the National Health and Morbidity Survey (NHMS 2016)

Author

Azli Baharudin, Cheong Siew Man, Mohamad Hasnan Ahmad, Norazizah Ibrahim Wong, Megat Rusydi Megat Radzi, Ruhaya Salleh, Noor Ani Ahmad, and Tahir Aris

Subjects
business.industry, medicine.disease, Stratified sampling, Malnutrition, Environmental health, medicine, Childbirth, Household income, Rural area, Underweight, medicine.symptom, business, Socioeconomic status, Wasting, General Nursing
Abstract

Objectives: This study aimed to assess the prevalence of underweight, wasting and stunting in children less than five years and to determine its associations with socioeconomic factors using nationally representative data. Study Design: Stratified random sampling was used in the study. Structured questionnaire with face-to-face interview was used for data collection. Method: A total of 11,845 living quarters were selected with eligibility of the mothers aged 15-49 years with last childbirth less than two years prior and their children aged below five years. The WHO growth standards were applied to classify malnutrition (World Health Organization, 2006), as follows: Underweight (weight-forage

Published
2019
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18. Prevalence and determinants of disability among adults in Malaysia: results from the National Health and Morbidity Survey (NHMS) 2015

Author

Yusniza Mohd Yusof, Muslimah Yusof, Ying Ying Chan, Noraida Mohamad Kasim, Nur Azna Mahmud, Norazizah Ibrahim Wong, Mohamad Aznuddin Abd Razak, Noor Ani Ahmad, Maisarah Omar, Salimah Othman, Tahir Aris, Fazly Azry Abdul Aziz, and Rasidah Jamaluddin

Subjects
Adult, Male, medicine.medical_specialty, Adolescent, Population, Ethnic group, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Environmental health, Health care, Prevalence, Humans, Medicine, Disabled Persons, 030212 general & internal medicine, education, Socioeconomic status, Aged, education.field_of_study, Disability, 030505 public health, business.industry, lcsh:Public aspects of medicine, Public health, Malaysia, Public Health, Environmental and Occupational Health, lcsh:RA1-1270, Population-based survey, Middle Aged, Health Surveys, Mental health, Stratified sampling, Female, Biostatistics, Washington group, 0305 other medical science, business, Research Article
Abstract

Background Reliable national data on disability which is internationally comparable is needed in Malaysia. This study aims to examine the prevalence of disability among adults in Malaysia and its determinants, particularly the socioeconomic factors and comorbidities. Methods This study was based on the disability module, which is part of the National Health and Morbidity Survey 2015. This survey was implemented using a multi-stage stratified sampling design. A locally validated Washington Group questionnaire was used to collect data on disability. Results Based on the definition of having at least one domain scored "a lot of difficulty or unable to do at all" or at least “some difficulty” scored in two domains, the prevalence of disability among adults in Malaysia was 11.8% (95% CI: 11.15, 12.53). Logistic regression analysis performed showed that population at risk of having disability in Malaysia were those of older people, ethnic minority, low level of education, single, obese, physically inactive and having mental health problems. Among older people, disability was significantly higher among those with no formal education, having mental health problems and physically inactive. Conclusions The prevalence of disability among adults in Malaysia is comparable to WHO estimates and most developing countries. Planning for healthcare services should consider at-risk population, particularly older people and those from disadvantaged background to ensure equity healthcare.

Published
2017
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19. An assessment of risk of iodine deficiency among pregnant women in Sarawak, Malaysia2018

Author

Lim Kuang Kuay, Chan Ying Ying, Cheong Siew Man, Tan Beng Chin, Norazizah Ibrahim Wong, Tahir Aris, Mohd Shaiful Azlan Kassim, Ruhaya Salle, and Nur Azna Mahmud

Subjects
Response rate (survey), Nutrition and Dietetics, Health (social science), business.industry, Health Policy, Public Health, Environmental and Occupational Health, Medicine (miscellaneous), medicine.disease, Iodine deficiency, language.human_language, Confidence interval, Design effect, Blood serum, Sample size determination, Environmental health, Respondent, language, medicine, business, Malay
Abstract

Previous findings from a state-wide Iodine Deficiency Disorders (IDD) study among pregnant women (PW) in Sarawak indicated that PW are at risk of IDD and further assessment is needed. This paper describes the methodology used in conducting this study for an assessment of risk of iodine deficiency among pregnant women in Sarawak, Malaysia. A total of 30 maternal child health care clinics (MCHCs) were selected using probability proportional to population size (PPS) sampling technique. The PW sample size was calculated based on 95% confidence interval (CI), relative precision of 5%, design effect of 2, anticipated IDD prevalence of 65.0% and non-response rate of 20%. Thus, the total sample size required was 750 (25 respondents per selected MCHC). The WHO Expanded Programme on Immunization (EPI) surveys approach was used to randomly select the first respondent and subsequent respondents were chosen until the required number of PW was met. The required data were obtained through: face-to-face interviews (socio-demographic and food frequency questionnaire), clinical assessments (thyroid size, and hyper/hypothyroidism) and biochemical analysis (urine and blood serum). A total of 677 PW responded in the study with a response rate of 90.2%. Majority of the PW were at second gravida, aged 25-29 years old and of Malay ethnicity. The methodology used in this study was based on international guidelines which may provide state’s estimates. All the necessary steps were taken into consideration to ensure valid and reliable findings on current iodine status among PW.

Published
2019
Full Text
View/download PDF

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