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Fish crackers (keropok lekor) are known for their tastiness. Although rich in protein and iodine, it contains a high amount of salt or sodium. Therefore, this study aimed to determine the manufacturers' practice in the preparation of keropok lekor, perception and challenges concerning salt usage, and motivation to reduce salt content. This study also aimed to estimate the sodium content in keropok lekor. Seven manufacturers of keropok lekor in Terengganu were interviewed either face-to-face or online to obtain relevant information. All interviews were recorded, transcribed, and analyzed based on a thematic analysis framework. The recipes of keropok lekor were analyzed using the Nutritionist Pro software to determine the nutritional and sodium content, calculated based on the Malaysian and ASEAN Food Composition Tables. Based on the interviews, most manufacturers (90%) supported the effort to reduce salt in keropok lekor. However, the effort was met with several challenges, such as customer acceptance and negative perception of the taste, decreased sales, and increased material costs. The enabling factors include maintaining the original flavor of keropok lekor, customer requests, marketing opportunities, and the availability of salt substitutes. Support for marketing and financial technology know-how is also necessary. An estimate of 606.43 mg/100g of sodium content in keropok lekor was obtained in this study, which was mainly derived from the usage of sodium chloride and monosodium glutamate (MSG) during the preparation. This study revealed the high salt content in keropok lekor due to the addition of salt and seasonings. There is a potential to reduce salt content in keropok lekor with appropriate support provided to the manufacturers. Nevertheless, further research is needed to produce keropok lekor with reduced salt content, improved sensory, and enhanced microbial and physicochemical characteristics, which can improve customer perception. [ABSTRACT FROM AUTHOR]

Introduction: Malaysian adults consume excessive amounts of salt daily, which could lead to hypertension. Understanding knowledge, attitudes, and practices (KAP) surrounding salt intake is crucial for designing effective interventions to reduce excessive consumption and its associated health risks. Therefore, this study aimed to adapt an existing salt intake-related KAP questionnaire that was previously employed in a local population-based survey and to validate and test its reliability. Methods: This cross-sectional study comprised two phases: (1) adaptation, content validation (CV), and face validation (FV); (2) pilot testing and reliability testing. CV and FV involved a total of seven experts and ten Malaysian adults from the Klang Valley, respectively. Pilot testing involved 139 Malaysian adults to determine the questionnaire's reliability. Content validity index (CVI) and Face validity index (FVI) values were calculated to analyse CV and FV. Reliability of each domain was analysed by obtaining Cronbach's alpha (α) values. Results: A self-administered questionnaire comprising six items each for knowledge, attitude, and practice was developed. The questionnaire demonstrated acceptable item-level CVI (I-CVI) and item-level FVI (I-FVI) values of at least 0.83, indicating that the items were relevant, clear, non-ambiguous, and simple. Reliability test showed acceptable α values of at least 0.70 for each domain, suggesting that the questionnaire was reliable. Conclusion: This tool could be considered valid and reliable for assessing the level of KAP towards salt intake among adults in Malaysia. [ABSTRACT FROM AUTHOR]

Keropok lekor is a fish-based snack and traditional food originating from the East Coast of Peninsular Malaysia, especially in Terengganu. This study was conducted to identify the ingredients and packaging used in the manufacturing of keropok lekor by entrepreneurs in Selangor. This study is a qualitative study that requires in-depth interviews. The Nutritionist Pro application was used to determine the nutrients in keropok lekor. The sampling method for this study is purposive sampling and involves five keropok lekor operators around Selangor. The ingredients used in making keropok lekor are salt, fish filling (fringescale sardine), baking powder, monosodium glutamate (MSG), margarine, and sweet potato flour. Through this study, it was found that the main source of sodium in keropok lekor is salt. For keropok lekor packaging, all keropok lekor operators use the same packaging method, which is vacuum packaging. In addition, the majority of keropok lekor operators (80%) have been introduced to Modified Atmosphere Packaging (MAP). The results of the study show that the average sodium content in keropok lekor is 372.11mg/100g and is categorized as medium-level sodium. Although the majority of keropok lekor operators have been introduced to MAP packaging, further research needs to be conducted to find out whether keropok lekor operators have renewed their packaging methods or vice versa. In conclusion, based on the findings, the content of sodium in the manufacturing of keropok lekor in Selangor is still under control. The results of this study can be used to help the government monitor the sodium content found in keropok lekor around Selangor. [ABSTRACT FROM AUTHOR]

Purpose: There is a limited availability of multidomain interventions that target cognitive frailty. Thus, the aim of the present study was to develop and evaluate the content validity and acceptance of the multidomain intervention module to reverse cognitive frailty among older adults (iAGELESS). Patients and Methods: This study was conducted in two phases: Phase I included the development of the multidomain intervention module iAGELESS and evaluation of content validity, while Phase II consisted of evaluating the acceptance of the module among 18 healthcare and social care providers, 13 older adults with cognitive frailty, and 13 caregivers. Content validity index (CVI) was used to quantify the content validity. Respondents completed a questionnaire which consisted of information on sociodemographic, followed by module acceptance evaluation with respect to content, terminologies, and graphics. The data was then analyzed descriptively. Results: A multidomain intervention module, iAGELESS was developed. The module was found to have appropriate content validity (overall CVI = 0.83). All the caregivers, 92% of older adults with cognitive frailty and 83% of healthcare and social care providers were satisfied with the overall content of the module. More than 50% of those who accepted the module had satisfactory consensus on the ease of the terminologies, length of sentences, pictures, information, color, and font size included in the module. Conclusion: The iAGELESS module demonstrated good content validity and was well accepted, thus warranting its utilization in future studies to determine its effectiveness in reversing cognitive frailty among older adults. [ABSTRACT FROM AUTHOR]

Introduction: The prevalence of hypertension among Malaysian adults in 2019 was 30.0%. A study found that sodium intake among Ministry of Health staff was high, as the main source of sodium in their diet was soy sauce which included monosodium glutamate (MSG) as a food additive. This study aimed to determine the knowledge, attitude, and practice (KAP) towards MSG among the staff in Kuala Lumpur and Putrajaya Health Department. Methods: This is a cross-sectional study using convenience sampling. The validated KAP questionnaire form was disseminated online consisted of 11 questions in three main parts. There were 182 staff (18-59 years old) who participated in this study. Results: The results showed that the staff have high knowledge (91.8%), a negative attitude (42.9%), and inadequate practice (54.9%) on MSG. For the overall KAP score on MSG, the majority of the staff indicated a good score (56.0%). Those who were married were significantly associated (p<0.05) with a good score in knowledge, practice, and overall score (χ² =15.662). Female staff had significantly higher (p<0.05) practice and overall scores (χ² = 8.470), whereas subjects aged 33-39 had significantly (p<0.05) better practice (χ2 =15.182). Health staff have significantly (p<0.05) higher knowledge, practice, and overall scores compared to non-health staff. Conclusion: These results showed that the higher knowledge of the staff on MSG was associated with practice. This study can be used as an effective basic strategy for health programs to expand knowledge, build awareness, and stimulate a healthy lifestyle by reducing the intake of MSG and sodium. [ABSTRACT FROM AUTHOR]

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]