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The CORFIS ("Community-Based Cardiovascular Risk Factors Intervention Strategies") program was piloted in community clinics in Malaysia to address the lack of health education in chronic disease management. The stages of change model was applied in a multicenter quasi-experimental design to evaluate adherence to advocated behaviors in CORFIS patients with hypertension. Based on submitted diet and exercise records (n = 209), adherence to sodium reduction, regular exercise, and increasing fruit and vegetable intake behaviors were quantified against weight, waist circumference (WC), systolic blood pressure (SBP), and diastolic blood pressure (DBP) changes. Patients were categorized at 6 months into nonadherent/N-A (Precontemplation, Contemplation, and Preparation), newly adherent/NA (Action) and totally adherent/TA (Maintenance) groups. Self-reported adherence records did not meet recommended targets for healthful behaviors, but clinical benefits were achieved by adherent groups as indicated by effect size (Cohen's d) comparisons. SBP reduction was associated with adherence to sodium reduction in NA (d = 0.60, p < 0.001) and TA (d = 0.45, p < 0.001) compared to N-A (d = 0.13, p > 0.05). Marginally increasing fruit and vegetable consumption (? = 0.41 servings) resulted in sizeable reductions in weight for NA (d = 0.81, p < 0.001) > TA (d = 0.54, p < 0.001) > N-A (d = 0.21, p > 0.05) and in WC for NA (d = 0.68, p < 0.00) > TA (d = 0.53, p < 0.001) > N-A (d = 0.52, p > 0.05). Exercise behavior was least successful as pedometer counting was below 10,000 steps but sizeable weight and WC reductions were largest for NA (d = 0.71 and 0.79, respectively) > TA (d = 0.60 and 0.53, respectively) > N-A (d = 0.33 and 0.35, respectively). Patients reporting a shift to positive stages of change behaviors enjoyed clinically beneficial reductions in SBP, DBP, weight, and WC.

Introduction: The internet is widely used by parents to access child feeding related information. The accuracy and reliability of information available online remain uncertain. The objective of this study was to evaluate the quality of child feeding related websites on complementary feeding for children aged 6-24 months in Malaysia. Methods: A cross-sectional study was conducted between December 2021 to April 2022 to evaluate complementary feeding-related websites in the Bahasa Malaysia (BM) language. The key terms were entered into Google Chrome and the first 30 websites were screened. Websites that could not be accessed due to broken links, duplicated websites and not freely accessible websites were excluded from the study. The quality was evaluated using Health-Related Websites Evaluation Form to appraise content, accuracy, author, currency, audience, navigation, external links, and structure of the web-based information. The website was rated as excellent (at least 90% of the total possible score), adequate (75-90%) and poor content (<75%). Results: Twenty-one websites out of 1006 websites screened were selected for evaluation. 81% of the websites were rated as excellent while 19% were with adequate quality. Websites with excellent quality ratings had higher scores for currency (p=0.039) and navigation (p=0.039) as compared to adequate quality websites. Conclusions: This study highlighted that complementary feeding practices websites in the BM language were generally of good quality. The accuracy, currency and content of these websites can be further improved by including the resources developed by dietitians to optimise child feeding practices for optimal growth and development of children between 6–24 months. [ABSTRACT FROM AUTHOR]

Introduction: Good health literacy and knowledge are associated with improved outcomes in diabetes. The purpose of this study was to determine diabetes-specific literacy and knowledge levels, and its associated socio-demographic factors, among adults with type 2 diabetes mellitus (T2DM). Methods: This cross-sectional study was conducted among 196 adults from the Indian, Chinese, and Malay ethnic groups with T2DM who attended a primary care clinic in Seremban, Malaysia. The Literacy Assessment for Diabetes and Diabetes Knowledge Test 2 were used to assess diabetes-specific literacy and knowledge, respectively. Results: The majority of participants (75.0%) had literacy scores that corresponded to Ninth Grade Level but only 3.6% of participants had a good knowledge of diabetes. Literacy scores explained up to 19.8% of the variance in knowledge scores (r=0.445, p<0.01). Indian participants had the lowest literacy and knowledge scores when compared to Chinese and Malays (p<0.05). Participants with higher education had better literacy and knowledge scores (p<0.05). Educational level was more likely than ethnicity to predict both literacy and knowledge scores (p<0.001), while gender and age did not significantly predict either score. The majority of participants could answer general questions about physical activity, diabetes-related complications and healthy eating. Knowledge of diabetes and its relation to specific foods and the effect of diet on glucose control were limited among the participants. Conclusion: Education and ethnicity were associated with literacy and knowledge on diabetes. There existed a deficit of diabetes-related nutrition knowledge among the participants. These findings may help healthcare providers tailor individualised patient educational interventions. [ABSTRACT FROM AUTHOR]

Introduction: Drastic changes in food access during the COVID-19 pandemic may impact families' feeding practices, and eating behaviour. This study aimed to determine the association between maternal feeding practices, household food security status, and children's picky eating among Malaysian mothers. Methods: A cross-sectional study was conducted virtually among 102 mothers with children aged from 5 to 12 years old (January-June 2022). Self-administered questionnaires on sociodemographic, feeding practices, household food security and child-picky eating behaviour were used. The statistical associations for key variables were analysed. Results: Most participants were Chinese mothers (87.3%) aged 30-39 years old (52.0%) with tertiary education (52.0%) and from middle to high household income (64.7%). Restriction domain had the highest median (interquartile range) score of 3.63 (1.00). A quarter of the household was experiencing food insecurity and about 34.3% of the children were classified as 'picky eaters'. A significant difference was found for restrictive feeding practices and household food security status (3.75 (0.97) versus 3.13 (1.19), p=0.022), while mothers of picky eaters were more likely to pressure their children to eat compared to non-picky eaters (3.75 (0.75) versus 3.25 (1.00), p=0.01). Conclusion: Despite food secure status during the pandemic, two food parenting approaches (restriction and pressure to eat) were significantly associated with the household food security status and children's picky eating behaviour. While the additional environmental stress from the COVID-19 pandemic could be transient, there should be consideration of the long-term impact of maternal feeding practices on the health and nutritional status of growing children [ABSTRACT FROM AUTHOR]

Background: Adequate calcium intake at an early age is crucial to achieving peak bone mass. Nevertheless, low calcium intake is common in Malaysian children. Aim: This study examined the calcium food sources and factors associated with low calcium intake among 243 children aged 9-11 years in Kuala Lumpur. Methods: Diet histories and bone density were measured. Results: The mean calcium intake was 370 ± 187 mg/day. The main contributors to calcium intake were beverages (19.2%), cereal (18.6%), milk and dairy (13.0%), meat and poultry (12.9%), and fish and seafood (10.1%). Within each food group, calcium-contributing foods tend to be from low bioavailability sources such as rice, cocoa-based and malted drinks, and chicken rather than milk. Children who practised regular meals, ate breakfast and snacks and consumed milk more than one serving daily have a higher calcium intake. Conclusion: In conclusion, public health strategies to improve the status of low calcium intake and poor choices of calcium-rich foods are needed to optimise bone health in this population., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.