Search

Objective: To explore the perspectives, barriers and enablers on salt reduction in out-of-home sectors in Malaysia among street food vendors, caterers and consumers. Design: A qualitative study involving twenty-two focus group discussions and six in-depth interviews was conducted, recorded and transcribed verbatim. An inductive thematic analysis approach was employed to analyse the data. Setting: Two in-depth interviews and twenty-two focus group discussions were conducted face-to-face. Four in-depth interviews were conducted online. Participants: Focus group discussions were conducted among twenty-three street food vendors, twenty-one caterers and seventy-six consumers of various eateries. In-depth interviews were conducted among two street food vendors and four caterers, individually. Results: Consumers and food operators perceived a high-salt intake within Malaysia's out-of-home food sectors. Food operators emphasised the necessity for a comprehensive salt reduction policy in the out-of-home sector involving all stakeholders. Consumers faced limited awareness and knowledge, counterproductive practices among food operators and challenges in accessing affordable low-Na food products, whereas food operators faced the lack of standardised guidelines and effective enforcement mechanisms and uncooperative consumer practices. Both groups expressed that food quality and price of salt were also the barriers, and they advocated for awareness promotion, enhanced regulation of manufactured food products and stricter enforcement targeting vendors. Consumers also suggested promoting and recognising health-conscious food premises, whereas food operators suggested on knowledge enhancement tailored to them, strategies for gaining consumers acceptance and maintaining food quality. Conclusions: These findings provide valuable insights that serve as foundational evidence for developing and implementing salt reduction policies within Malaysia's out-of-home sectors. [ABSTRACT FROM AUTHOR]

Background: Radiation therapy is the treatment of pelvic cancers, with diarrhea often being the most frequent acute side effect. This study aimed to determine the efficacy of partially hydrolyzed guar gum (PHGG) usage in reducing radiotherapy‐induced diarrhea and improving bacterial count, nutrition status, and quality of life (QoL) among cancer patients. Methods: Adult patients undergoing pelvic radiation were recruited and randomly assigned to receive supplementation of either 10 g of PHGG or placebo (maltodextrin) twice daily, 14 days prior and 14 days during pelvic radiation. Diarrhea frequency, fecal samples, nutrition status, and QoL were assessed at baseline and days 14, 28 (2 weeks after pelvic radiation), and 45 (at the completion of pelvic radiation, 2 weeks' postsupplementation). Results: A total of 30 patients (mean age 56.5 ± 10.8 years, 75% malnourished) participated. The mean of diarrhea frequency in the intervention group (IG) was higher compared with the control group (CG) from days 14 and 28 but reduced at day 45. There was a significant intervention effect after controlling for confounders (ie, baseline diarrhea, age, nutrition status) (P <.05). Bifidobacterium count increased by double among the IG at 14 days of PHGG supplementation, whereas such trend was not observed in the CG. Conclusion: Supplementation of PHGG potentially increased the bifidobacterial count and seemed to have post‐supplementation effects by reducing the frequency of diarrhea upon the completion of pelvic radiation treatment. [ABSTRACT FROM AUTHOR]

Background: The prevalence of nonalcoholic fatty liver disease (NAFLD) is increasing worldwide. Therefore, we sought to determine the most important predictors of NAFLD among middle-aged men and women in Isfahan, Iran. Methods: A total of 413 individuals (163 men and 250 women) aged 30-60 years were selected by stratified random sampling. The participants had safe alcohol consumption habits (<2 drinks/day) and no symptoms of hepatitis B and C. NAFLD was diagnosed through ultrasound. Blood pressure, anthropometric, and body composition measurements were made and liver function tests were conducted. Biochemical assessments, including the measurement of fasting blood sugar (FBS) and ferritin levels, as well as lipid profile tests were also performed. Metabolic syndrome was evaluated according to the International Diabetes Federation (IDF) criteria. Results: The overall prevalence of ultrasound-diagnosed NAFLD was 39.3%. The results indicated a significantly higher prevalence of NAFLD in men than in women (42.3% vs 30.4%; P < 0.05). Binary logistic regression analysis was performed to determine the significant variables as NAFLD predictors. Overall, male gender, high body mass index (BMI), high alanine aminotransferase (ALT), high FBS, and high ferritin were identified as the predictors of NAFLD. The only significant predictors of NAFLD among men were high BMI and high FBS. These predictors were high BMI, high FBS, and high ferritin in women (P < 0.05 for all variables). Conclusions: The metabolic profile can be used for predicting NAFLD among men and women. BMI, FBS, ALT, and ferritin are the efficient predictors of NAFLD and can be used for NAFLD screening before liver biopsy. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to investigate the prevalence of successful aging, usual aging and mild cognitive impairment among older men and women, and further determine the influence of gender in predicting cognitive decline. Method: A total of 1,993 respondents aged 60 years old and above were selected through a multi-stage random sampling method fromJohor, Kelantan, Selangor and Perak. The respondents were interviewed to obtain information on socio-demography, diet, cognitive functions, psychosocial conditions and lifestyle. Subjects were classified in either the category of successful aging, usual aging and mild cognitive impairment. Results: The predictors of cognitive decline among men were poor upper body flexibility and lower body strength, higher fasting blood sugar, hyperlipidaemia, lower education level, and poor participation in mechanical repairing activities. Meanwhile, hyperlipidaemia, not adhering to calorie restrictions, poor lower body flexibility, disabilities and lower education status were the risk factors for memory impairment among women. Conclusion: Specific gender-tailored interventions are essential for preventing or managing cognitive decline among older adults and preserving mental health. [ABSTRACT FROM AUTHOR]

Copyright of Malaysian Journal of Health Sciences / Jurnal Sains Kesihatan Malaysia is the property of Malaysian Journal of Health Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The increase in the population of aging people has increased the occurrence of cognitive decline leading to predemented stage of dementia, ie, mild cognitive impairment (MCI). The cognitive tools that are web-based have been proven to be useful in decreasing the risk of MCI. Thus, in the present study, an education tool that is web-based, called WESIHAT 2.0©, had been created to educate elderly people about precautionary strategies against MCI.Methodology: WESIHAT 2.0 was devised in a senior-friendly style, which includes touch screen, greater font size, larger icons, and employed multimedia components of text, images, and videos. The components employed in WESIHAT 2.0 were a screening tool called TUA-WELLNESS, 10 guides for memory improvement, health diary, and guide for a healthy menu. This application assessed a group of 73 candidates consisting of elderly people, health professionals, caregivers, and information technology (IT) professionals for 1 month.Results: All the elderly people, caregivers, and 75% of IT and health professionals were satisfied with the subject matter of WESIHAT 2.0. About more than half of the elderly people, caregivers, and IT and health professionals had given a consensus on the comprehensive ease of the terminologies, sentences, images, table, and advice related to diet included in the web application. Proposals for improvements of the web portal included suggestions such as using smaller sentences, using greater font size, adding more images, and avoiding the use of unfamiliar terminologies.Conclusion: WESIHAT 2.0 is a suitable tool for educating older people about the lifestyle modification strategies to slower progression to cognitive impairment, with regard to the significance of expert advice. [ABSTRACT FROM AUTHOR]

Inclination towards nutrition beliefs by parents and caregivers plays an important role in the dietary intake of children with leukemia. However, local studies examining on the nutrition practices and dietary beliefs among caregivers of leukemia patients are very limited. This study aims to assess nutrition beliefs among caregivers of children with leukemia and healthcare professionals at the Pediatric Institute of Kuala Lumpur Hospital (IPHKL), Malaysia. This qualitative study was conducted to assess the beliefs and practices towards certain foods among caregivers of pediatric leukemia patients. Thirty subjects comprising a group of 10 health care professionals and 20 caregivers were interviewed using semi-structured interview method. The interviews were transcribed and analyzed using ATLAS.ti. version 7.5.6 qualitative analysis software and subsequently several themes. were obtained. Five themes emerged from this analysis that are (1) beliefs about foods that can cure cancer, (2) beliefs related to consumption of meat and dairy products, (3) beliefs towards foods containing pesticides, (4) beliefs that certain food causes itchiness, and (5) source of nutrition information and nutrition knowledge of caregivers. This study proves that beliefs in various myths related to nutrition and dietary practices exist among caregivers and health professionals group. Information from these findings can provide perspective on the beliefs towards dietary practices among caregivers of children with leukemia and healthcare professionals. This is important for the healthcare professions, especially when planning the strategies for caregivers' nutrition education in order to improve the nutritional status of childhood leukemia patients. [ABSTRACT FROM AUTHOR]

Purpose: Older adults are at risk of mild cognitive impairment (MCI), and simple anthropometric measurements can be used to screen for this condition. Thus, the aim of this study was to explore the cut-off values of body mass index (BMI) and waist circumference (WC) for predicting the risk of MCI in older Malaysian adults. Methods: A total of 2,240 Malaysian older adults aged ≥60 years were recruited using multistage random sampling in a population based cross-sectional study. Receiver operating characteristic (ROC) curve was used to determine the cut-off values of BMI and WC with optimum sensitivity and specificity for the detection of MCI. Age, gender, years of education, smoking habit, alcohol consumption, depression, and medical conditions were used as confounding factors in this analysis. Results: A BMI cut-off value of 26 kg/m2 (area under the receiver operating characteristic curve [AUC] 0.725; sensitivity 90.5%; specificity 38.8%) was appropriate in identifying the risk of getting MCI in both men and women. The optimum WC cut-offs for likelihood of MCI were 90 cm (AUC 0.745; sensitivity 78.0%; specificity 59.8%) for men and 82 cm (AUC 0.714; sensitivity 84.3%; specificity 49.7%) for women. The optimum calf circumference (CC) cut-off values for identifying MCI were 29 cm (AUC 0.731; sensitivity 72.6%; specificity 61.1%) for men and 26 cm (AUC 0.598; sensitivity 79.1%; specificity 45.3%) for women. Conclusion: The cut-off values could be advocated and used as part of the screening of MCI among older Malaysian adults. There is a need to further determine the predictive values of these cut-off points on outcomes through longitudinal study design. [ABSTRACT FROM AUTHOR]

Peer-reviewed articles on the usage of mobile applications in the management of diabetes were reviewed. Studies using mobile device applications for diabetes interventions published between January 2007 and March 2013 were included in this review. Studies related to the developmental processes of the mobile applications were excluded. The characteristics of these studies and the outcomes of the methods used in the management of diabetes were gathered. We retrieved a total of 372 articles from ACM Digital library, PubMed and Proquest Medical Library. After applying the inclusion and exclusion criteria, 8 articles were eligible for further review. Most of the studies included in this review showed the effectiveness of mobile applications in diabetes management. Their major contribution comes from feedback functions of the systems that assist participants in the self-monitoring of their blood glucose and dietary intake. However, the majority of the studies showed the limited use of the mobile phone as a tool to input information into systems which would in turn convey a reminder message to the patient. In conclusion, with its features of portability and convenience, mobile application used in the management of diabetes has the potential to improve glycaemic control, resulting in significant clinical and financial benefits. [ABSTRACT FROM AUTHOR]

Obesity is a risk factor for chronic diseases which can affect work productivity and physical function of employees particularly among those in security sector. The study aimed to determine the association between obesity with total days of sick leave and health related quality of life (HRQoL) among Malay male security officers. A cross-sectional study was conducted among Malay male security officers working in a Malaysian higher learning institution. Subjects were evaluated using anthropometric measurements, quality of life and number of sick leave taken within two months prior to the study. A total of 194 subjects (mean age 40.12 ± 11.41 years) were recruited. A total of 30.4% were obese, 39.7% were pre-obese and only 29.9% had normal body weight or underweight. Central obesity was observed in 57.7% of them and 87.1% shown excessive body fat percentage. Number of sick leave days was positively correlated with Body Mass Index (BMI) (r = 0.162, p = 0.024) and waist circumference (r = 0.181, p = 0.012). Score of the general health component was negatively correlated with BMI (r = -0.161, p = 0.025), waist circumference (r = -0.194, p = 0.007) and body fat percentage (r = -0.191, p = 0.008). Physical functioning score was lowest in obese subjects than normal and pre-obese subjects (p = 0.046). Score of the bodily pain component was positively correlated with waist circumference (r = 0.156, p = 0.030). Obesity is associated with number of sick leave days and quality of life in the studied group. Hence, body weight of the security staff should be monitored and appropriate intervention should be conducted to improve their work attendance and quality of life. [ABSTRACT FROM AUTHOR]

Recognising the epidemic of overweight and obesity among Malaysians, formulation of intervention programmes such as a weight management programme at workplace is essential. This study aimed to determine the effectiveness of a structured weight management programme at workplace among overweight and obese employees. In this quasi-experimental study, sixty-four of overweight and obese adults were recruited and divided into two groups (intervention group, n = 32 and control group, n = 32). Subjects in the intervention group received three months scheduled programme and the control group received a routine weight management consultation from dietitians. Significant group effect was found on waist circumference (WC) in men (p < 0.05) and Body Mass Index (BMI) in women (p < 0.05). Men from the intervention group had reduced their WC by 3.4% (-3.7 cm) as compared to controls of 0.7% (-0.8 cm). Women in the intervention group improved their BMI by 1.4% (-0.4 kg/m2) as compared to controls at 0.3% (-0.1 kg/m2). Total cholesterol and LDL-C reduced among women in both intervention and control group with significant time effect (p < 0.05). As a conclusion a structured weight management programme effectively improved WC in men and BMI in women, and appeared to be as effective as individual diet counselling by dietitians in improving lipid profiles in women. [ABSTRACT FROM AUTHOR]

Background/objectives: Monitoring food intake of patients during hospitalization using simple methods and minimal training is an ongoing problem in hospitals. Therefore, there is a need to develop and validate a simple, easy to use, and quick tool that enables staff to estimate dietary intake. Thus, this study aimed to develop and validate the Pictorial Dietary Assessment Tool (PDAT). Subjects and methods: A total of 37 health care staff members consisting of dietitians, nurses, and serving assistants estimated 130 breakfast and lunch meals consumed by 67 patients using PDAT. PDAT was developed based on the hospital menu that consists of staple food (rice or porridge), animal source protein (chicken, meat, eggs, and fish), and non-animal source protein (tau fu and tempeh), with a total of six pictorials of food at each meal time. Weighed food intake was used as a gold standard to validate PDAT. Agreement between methods was analyzed using correlations, paired t-test, Bland-Altman plots, kappa statistics, and McNemar's test. Sensitivity, specificity, and area under the curve of receiver operating characteristic were calculated to identify whether patients who had an inadequate food intake were categorized as at risk by the PDAT, based on the food weighing method. Agreement between different backgrounds of health care staff was calculated by intraclass correlation coefficient and analysis of variance test. Results: There was a significant correlation between the weighing food method and PDAT for energy (r=0.919, P<0.05), protein (r=0.843, P<0.05), carbohydrate (r=0.912, P<0.05), and fat (r=0.952; P<0.05). Nutrient intakes as assessed using PDAT and food weighing were rather similar (295±163 vs 292±158 kcal for energy; 13.9±7.8 vs 14.1±8.0 g for protein; 46.1±21.4 vs 46.7±22.3 g for carbohydrate; 7.4±3.1 vs 7.4±3.1 g for fat; P>0.05). The PDAT and food weighing method showed a satisfactory agreement beyond chance (k) (0.81 for staple food and animal source protein; 0.735 for non-animal source protein). Intraclass correlation coefficient ranged between 0.91 and 0.96 among respondents. There were no differences in energy, protein, carbohydrate, and fat intake estimated among health care staff (P=0.967; P=0.951; P=0.888; P=0.847, respectively). Conclusion: In conclusion, PDAT provides a valid estimation of macronutrient consumption among hospitalized adult patients. [ABSTRACT FROM AUTHOR]

Background: Polygonum minus (PM) or locally known in Malaysia, as "kesum" is rich in micronutrients and natural antioxidants. However, its beneficial effect on outcome associates with oxidative stress including cognitive function is yet to be discovered. We assessed the efficacy of PM extract (LineMinus™) on cognitive function and psychosocial status among middle-aged women in Klang Valley of Malaysia. Methods: A randomized, double-blind, placebo-controlled trial among 35 healthy middle-aged women was performed, and subjects were randomized to receive either 250 mg PM or placebo of 100 mg maltodextrin each were taken twice daily for 6 weeks. Subjects were assessed for neuropsychological test, psychosocial status, and anthropometric at baseline, week 3, and week 6. Biomarkers were also determined at baseline and week 6. Results: The supplementation of PM showed significant intervention effect on Digit Span test (P,0.05) social functioning domain of 36-Item Short Form Health Survey (P,0.05) among subjects with mood disturbance. While, among subjects with good mood, PM supplementation improved Wechsler Abbreviated Scale of Intelligence (WASI) for IQ verbal (P=0.016) and Full Scale IQ of WASI (P=0.004). There were no adverse effects reported for the supplementation as indicated using biomarkers, including liver function and clinical symptoms. Conclusion: Supplementation of PM is safe to be consumed for 6 weeks, with potential benefits to attention, short-term memory, improved quality of life, and mood, as well as IQ. [ABSTRACT FROM AUTHOR]

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/m2) were recruited in the Klang Valley area of Malaysia. The biochemical parameters were determined from fasting blood samples, whereas information on dietary intake and timing was obtained from a 7-day diet history questionnaire. The midpoint of eating was used to determine the early and late windows. Compared to MHO non-shift workers (n = 173), MUO non-shift workers (n = 126) had lower energy intake from carbohydrates and protein during the early window. In contrast, MUO participants had greater energy intake from carbohydrates and fat during the late window. Participants with unhealthy metabolic status (regardless of their chronotypes) had similar temporal patterns of energy intake characterized by smaller energy intake during the early window and greater energy intake during the late window compared with participants with healthier metabolic status. Overall, the lowest percentile of energy intake during the early window was associated with an increased risk of MUO, after adjustment for potential confounders [odds ratio (OR) = 4.30, 95% confidence interval (CI) 1.41–13.11]. The greater the energy intake during the late window, the greater the risk of MUO (OR = 2.38, 95% CI 1.11–5.13) (OR = 2.33, 95% CI 1.03–5.32) (OR = 4.45, 95% CI 1.71–11.56). In summary, consuming less energy earlier in the day and more energy and carbohydrate later in the day was associated with a greater risk of MUO. Thus, a prospective study is needed to explore the potential role of chrono-nutrition practices in modifying risk factors to delay the transition of MHO to MUO. [ABSTRACT FROM AUTHOR]

Relatively less comprehensive web based programme has been developed for detecting risk of mild cognitive impairment (MCI) and further impart preventive strategies and lifestyle education. Thus, this study has developed a comprehensive web based programme for early screening of risk of MCI together with education package for preventing MCI known as WESIHAT 2.0. WESIHAT 2.0 is a senior friendly website which has appropriate design interface facilitating access of older people especially with the use of touch-screen technology. WESIHAT 2.0 has incorporated four major components namely TUA WELLNESS screening tool, which is a comprehensive, online based, 10-item screening tool for detecting risk of MCI, 10-guides for preventing MCI, health diary and healthy food. Evaluation of acceptance of WESIHAT 2.0 was done among 71 people which comprised of 30 older people and 30 caregivers, chosen equally based on ethnic composition and 11 health care professionals who has experience working in the field of geriatric and 2 freelance website developer. All older people and caregivers stated that the content of website was very useful for preventing MCI, however, about 36.4% of health professionals stated several improvements needed to be done before releasing the end-product to the users. Comments given were smaller font size (27.3), addition of more pictures (27.3%), using simpler terms (36.4%) and changing certain design for better view of older people (18.2%). Amendments were made based on each comment given and the finalized website were used for a 6-month intervention programme for neuroprotection among older people who failed to achieve successful aging. It is timely for an online based approach for prevention of MCI. WESIHAT 2.0 is the first website in Malaysia which has been accepted by all older people and caregiver and more than half of healthcare professionals to prevent memory decline. [ABSTRACT FROM AUTHOR]

Introduction: A significant body of evidence highlights the association between maternal depression and malnutrition among young children in industrialised countries. However, studies in developing countries, including Malaysia, remain scarce. This case-control study aims to determine the association between maternal depression and malnourished children among young children in the rural community. Methods: Participants were malnourished (cases: n = 62) and well-nourished (controls: n = 62) children that was referred to all governmental health clinics in the Kuala Langat district, Selangor. Cases were matched with controls by age, gender, socioeconomic status and residential area. The existence of current maternal depression was evaluated using the validated Malay translated version of the Beck Depression Inventory Second Edition, and its association with undernourished children was expressed as odds ratios. Results: Binary logistic regression analysis shows that current maternal depression was associated with the risk of malnutrition in children (OR 2.2, 95% CI 1.03 - 4.61). Mothers who experienced depression were 2.2 times more likely to have malnourished children. Conclusion: Current maternal depression is a single risk factor for malnutrition among young children in this studied community. Upon a preliminary screening to detect symptoms of depression, preventive measures should be implemented at the early stage of pregnancy. Advice on optimising mothers' mental health should be integrated as part of prenatal and postnatal care to remove of minimize the detrimental effect in children's growth and development. [ABSTRACT FROM AUTHOR]

Introduction: This methodological research study aimed to measure content validity and reliability of a newly developed questionnaire of knowledge, attitudes, and self-reported practices towards pureed diet preparation (KAP DYS Puree) among hospital food handlers for dysphagia management. Methods: The study was conducted through face validation, content validation, content reliability and construct validation. A cross-sectional design with convenience sampling was carried out involving 4 panels for face validation, 10 raters for content validity and 161 food handlers participated for Exploratory Factor Analysis (EFA), while 30 food handlers were involved for test-retest reliability. The questionnaire which consisted of 40 items distributed into 3 domains and was assessed and analyzed using modified kappa (k*) for reliability. Results: Content Validity Index revealed the following I-CVI values: knowledge = 0.915, attitudes = 0.922 and self-reported practices = 0.900 and modified kappa values (k*) knowledge = 0.983, attitudes = 0.9214 and self-reported practices = 0.899. The EFA was employed for two dimensions which were self-reported practices and attitudes based on principal axis of factoring with varimax rotation. The factor analysis yielded two factors with a total of 10 items in the attitudes domain and two factors with a total of 9 items in the self-reported practices domain that had satisfactory factor loading (> 0.3). The Kaiser-Meyer-Olkin (KMO) values for attitudes = 0.816 and self-reported practices = 0.776. Bartlett's test of sphericity was significant at p < 0.0001 for attitudes and self-reported practices indicating the suitability of this data for factor analysis. Interclass Correlation Index (ICC) values for attitudes = 0.739 and self-reported practices = 0.789. Conclusion: This instrument can be used as a need assessment tool in the development of a comprehensive training module for pureed diet preparations in dysphagia management. [ABSTRACT FROM AUTHOR]

Introduction: Pressure ulcers (PUs) are a leading health problem among spinal cord injury(SCI) patients. Therefore, this comprehensive study was aimed at determining the association between potential factors and the occurrence of PUs among SCI adults in community settings. Methods: A cross-sectional study was conducted among adults with SCI aged 18 years and above from five selected locations in Kuala Lumpur, Malaysia. The study was carried out through interviews based on validated questionnaires such as the Dietary History Questionnaire (DHQ), Spinal Nutrition Screening Tool (SNST), Physical Activity Scale for Individuals with Physical Disabilities (PASIPD), Barthel Index for Activities of Daily Living (ADL), and Instrumental Activities of Daily Living (IADL). Estimated weight and height were obtained using recumbent formula. The stages of their PUs were assessed based on National Pressure Ulcer Advisory Panel (NPUAP) grading system. Results: A total of 40 subjects participated in the study, 25% of whom were having PUs. Their nutritional inadequacies were identified, whereby 90%, 70% and 85.5% of them were receiving below their daily requirement of energy, carbohydrate and protein, respectively. The fat and sodium intakes of 55% of them were above the Malaysian Recommended Nutrient Intakes(RNI). It was successfully found that physical activity could decrease the risk of PUs(R2=0.654, OR=0.310, p<0.05). Conclusion: Overall, 25% of the subjects had PUs that were associated with physical inactivity. The majority of the subjects did not meet their nutrient requirements. Therefore, there is a need for increased physical activity and improved nutrient intake in order to reduce the risk of pressure ulcers among SCI adults in communities. [ABSTRACT FROM AUTHOR]

Background: Digital health has been widely used in delivering healthcare, presenting emerging opportunities to overcome barriers to effective obesity care. One strategy suggested for addressing obesity involves a hybrid weight management intervention that incorporates digital health. This scoping review aimed to map existing evidence regarding hybrid weight management intervention., Methods: PubMed, Scopus, Cochrane Library, and the Web of Science electronic databases were searched for studies published between January 1, 2012 and May 16, 2023, with language restricted to English. The focus was on controlled trials in which a hybrid weight management intervention was used in the intervention among overweight or obese adults. The scoping review framework followed Arksey and O'Malley's guidelines and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISM-P)., Results: Full-text article review in the screening stage resulted in a total of 10 articles being included for narrative synthesis. Almost two-third of the articles originated from the United States (60%), followed by Europe and Australia, each accounting for 20%. The most common hybrid weight management intervention type was the combination of face-to-face and telehealth (i.e. phone call/text messaging) (40%), closely followed by a combination email intervention (30%) and mHealth apps intervention (30%). Most of the face-to-face dietary interventions were delivered as a group counseling (80%), while some were conducted as individual counseling (20%). Most studies observed a positive effect of the hybrid weight management intervention on body weight (weight lost 3.9-8.2 kg), body mass index (decreased 0.58 kg/m 2 ), waist circumference (decreased 2.25 cm), and physical activity level compared to standard care. Findings suggest a direct association between hybrid weight management interventions and weight loss. The weight loss ranged from 3.9 to 8.2 kg, with some evidence indicating a significant weight loss of 5% from baseline. There is a need to explore stakeholders' telehealth perspective to optimize the delivery of hybrid weight management interventions, thereby maximizing greatest benefits for weight management., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

Objective: To explore the perspectives, barriers and enablers on salt reduction in out-of-home sectors in Malaysia among street food vendors, caterers and consumers., Design: A qualitative study involving twenty-two focus group discussions and six in-depth interviews was conducted, recorded and transcribed verbatim. An inductive thematic analysis approach was employed to analyse the data., Setting: Two in-depth interviews and twenty-two focus group discussions were conducted face-to-face. Four in-depth interviews were conducted online., Participants: Focus group discussions were conducted among twenty-three street food vendors, twenty-one caterers and seventy-six consumers of various eateries. In-depth interviews were conducted among two street food vendors and four caterers, individually., Results: Consumers and food operators perceived a high-salt intake within Malaysia's out-of-home food sectors. Food operators emphasised the necessity for a comprehensive salt reduction policy in the out-of-home sector involving all stakeholders. Consumers faced limited awareness and knowledge, counterproductive practices among food operators and challenges in accessing affordable low-Na food products, whereas food operators faced the lack of standardised guidelines and effective enforcement mechanisms and uncooperative consumer practices. Both groups expressed that food quality and price of salt were also the barriers, and they advocated for awareness promotion, enhanced regulation of manufactured food products and stricter enforcement targeting vendors. Consumers also suggested promoting and recognising health-conscious food premises, whereas food operators suggested on knowledge enhancement tailored to them, strategies for gaining consumers acceptance and maintaining food quality., Conclusions: These findings provide valuable insights that serve as foundational evidence for developing and implementing salt reduction policies within Malaysia's out-of-home sectors.