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Introduction: Raised blood pressure is associated with diet high in sodium and low in potassium. According to the Malaysian Community Salt Survey (MyCoSS), Malaysian adults consume a high sodium diet, despite half claiming that they control their salt intake. The objective of this study was to investigate the association of sodium and potassium with salt-control claims among adults from the MyCoSS study based on 24-h urinary excretion. Methods: Data of 1,047 respondents aged 18 years and above who completed the knowledge, attitude, and practice (KAP) questionnaire were used in this study. Face-to-face interviews were conducted to acquire information on sociodemographic, medical reports and KAP on salt intake. Sodium and potassium level were assessed from 24-hr urine specimen, anthropometric measurements were done using WHO criteria, while blood pressure was measured using validated digital blood pressure monitor. Descriptive and analysis of variance (ANOVA) were used to determine the associations between urinary sodium and potassium with salt-control claims and practices. Results: The consumption of sodium was higher than recommended, while potassium was lower among respondents who claimed to control their salt intake. Significant associations were found between sodium intake with marital status, ethnicity, education level and employment status. Meanwhile, significant associations were found between potassium intake with ethnicity and employment status. Conclusion: Sodium intake was high, and potassium intake was low among respondents who claimed they control their salt intake. Further study with detailed intervention on specific target group is required to improve sodium and potassium intakes among Malaysian adults.

BACKGROUND/OBJECTIVES: Low early pregnancy serum 25-hydroxy vitamin D (25[OH]D) levels can increase gestational diabetes mellitus (GDM) risk, although inconsistent findings related to that association have been reported. This study examined the association of serum vitamin D with GDM and the possible influencers on this association.SUBJECTS/METHODS: This study included 259 pregnant women within the Seremban Cohort Study (SECOST). Blood samples at < 14 weeks of gestation were drawn to determine serum 25(OH)D levels. GDM diagnosis was made at 24 to 32 weeks of gestation using a standard procedure. Association between serum vitamin D and GDM was tested using binary logistic regression.RESULTS: Nearly all women (90%) had mild (68.3%) or severe (32.2%) vitamin D deficiency (VDD). Non-GDM women with mild VDD had a significantly higher mean vitamin D intake than GDM women with mild VDD (t = 2.04, p < 0.05). Women with higher early pregnancy serum vitamin D levels had a greater risk of GDM. However, this significant association was only identified among those with a family history of type 2 diabetes mellitus (T2DM) and in women with a body mass index indicating overweight or obese status.CONCLUSIONS: The high prevalence of VDD in this sample of pregnant women underscores the need for effective preventive public health strategies. Further investigation of this unexpected association between serum vitamin D level and GDM risk in predominantly VDD pregnant women and the potential effects of adiposity and family history of T2DM on that association is warranted.

Being overweight and obese during childhood increases the potential of becoming obese adults later in life. Therefore, this study aims to determine the factors associated with overweight (including obesity) among children under five years of age in Putrajaya, Malaysia. A total of 211 children with overweight cases were successfully recruited in this case-control study. The same number for control group which was normal children also being recruited by matching according to sex and age group with the case group. Data collection was performed by four approaches such as face-to-face interview, anthropometric measurements, finger prick for haemoglobin level and self-administered 3-day food diary. WHO Anthro software was used to determine the nutritional status of children. Descriptive statistic and logistic regression were performed to determine risk factors that contributed to overweight. Multiple logistic regressions showed overweight or obese father was 1.88 times more likely to have overweight children compared to normal BMI father. Mothers who had gestational diabetes mellitus (GDM) were 2.93 times more likely to have overweight children compared to those with no complication during pregnancy. Pregnant women who attended antenatal visits for less than 9 times were 3.33 times more likely to have overweight children compared to pregnant women who attended 9 to 14 times of antenatal visits. Children with fewer siblings were 2.10 times more likely to be overweight compared to children with four or more siblings. These findings indicated related risks factors contributing to childhood overweight from the early stages including maternal and paternal factors. Early life intervention especially during pregnancy stages which include antenatal care and antenatal intervention on dietary and physical activity during peri-conception period is seen to be important to prevent adverse pregnancy outcomes and further improve maternal and child’s health. Hence it would be more effective to prevent childhood overweight or obesity in later age and its long-term consequences.

Background Sodium intake is associated with anthropometric measurement including weight, waist circumference (WC), and body mass index (BMI). Higher intake of sodium is usually linked to higher risk of obesity among adults globally, especially in developing countries. This study aims to explore the probable relationship between sodium intake by 24-h urine excretion assessment and anthropometric measurement of adults in Malaysia. Methods A cross-sectional study was conducted from October 2017 to March 2018 using a multi-stage stratified sampling method among Malaysian adults aged 18 years old and above. Sodium intake was determined by 24-h urinary sodium excretion, estimated from the respondents’ 24-h urinary sample. Height was obtained based on standard protocol. Weight and WC were measured twice using validated anthropometric equipment and BMI was calculated according to World Health Organization (WHO) 1998 classification. Descriptive analysis was done to describe socio-demographic characteristics. A simple linear regression and multiple linear regression tests were done to assess the relationship of 24-h urinary excretion and anthropometric measurement. All statistical analysis was done using SPSS version 22.0. Results Of 1047 interviewed respondents, 798 respondents had done the 24-h urine collection (76.0% response rate). Majority was between 40 and 59 years old (43.5%) and married (77.7%). Simple linear regression showed a significant positive linear association between 24-h urinary excretion and household income, WC, and obese group. In the multivariate analysis, it was indicated that, an increase of 1 unit of BMI will significantly increase the sodium intake by 129.20 mg/dl and an increase of 1 cm of WC will significantly increase the sodium intake by 376.45 mg/dl. Conclusion Our study showed a positive significant relationship between sodium intake estimated by 24-h urinary sodium excretion and BMI of Malaysian adults. More research is suggested on how sodium control can potentially contribute to obesity prevention.

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.

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.

Background Excessive intake of sodium is a major public health concern. Information on knowledge, perception, and practice (KPP) related to sodium intake in Malaysia is important for the development of an effective salt reduction strategy. This study aimed to investigate the KPP related to sodium intake among Malaysian adults and to determine associations between KPP and dietary sodium intake. Methods Data were obtained from Malaysian Community Salt Survey (MyCoSS) which is a nationally representative survey with proportionate stratified cluster sampling design. A pre-tested face-to-face questionnaire was used to collect information on socio-demographic background, and questions from the World Health Organization/Pan American Health Organization were adapted to assess the KPP related to sodium intake. Dietary sodium intake was determined using single 24-h urinary sodium excretion. Respondents were categorized into two categories: normal dietary sodium intake (< 2000 mg) and excessive dietary sodium intake (≥ 2000 mg). Out of 1440 respondents that were selected to participate, 1047 respondents completed the questionnaire and 798 of them provided valid urine samples. Factors associated with excessive dietary sodium intake were analyzed using complex sample logistic regression analysis. Results Majority of the respondents knew that excessive sodium intake could cause health problems (86.2%) and more than half of them (61.8%) perceived that they consume just the right amount of sodium. Overall, complex sample logistic regression analysis revealed that excessive dietary sodium intake was not significantly associated with KPP related to sodium intake among respondents (P > 0.05). Conclusion The absence of significant associations between KPP and excessive dietary sodium intake suggests that salt reduction strategies should focus on sodium reduction education includes measuring actual dietary sodium intake and educating the public about the source of sodium. In addition, the relationship between the authority and food industry in food reformulation needs to be strengthened for effective dietary sodium reduction in Malaysia.

Background Studies have shown that having away from home meals contributes to high sodium intake among young people and those who lived in urban areas. This study aimed to determine the association between dietary sodium intake, body mass index, and away from home meal consumption behaviour among Malaysian adults. Methods MyCoSS was a cross-sectional household survey involving 1440 adults age 18 years and above. This study utilized stratified cluster sampling to obtain a nationally representative sample. Data was collected between October 2017 and March 2018. Socio-demographic information, dietary assessment using food frequency questionnaire (FFQ), and away from home meal consumption were assessed through a face-to-face interview by trained health personnel. Descriptive analysis and logistic regression were applied to identify the association of socioeconomic status and away from home meal consumption with dietary sodium intake. Results A total of 1032 participants completed the FFQ, with a mean age of 48.8 + 15.6 years. Based on the FFQ, slightly over half of the participants (52.1%) had high sodium intake. Results showed that 43.6% of participants consumed at least one to two away from home meals per day, while 20.8% of them had their three main meals away from home. Participants aged less than 30 years old were the strongest predictor to consume more sodium (adjusted OR: 3.83; 95%CI: 2.23, 6.58) while those of Indian ethnicity had significantly lower sodium intake. Surprisingly, having three away from home meals per day was not associated with high dietary sodium intake, although a significant association (crude OR; 1.67, 95% CI: 1.19, 2.35) was found in the simple logistic regression. Obese participants were less likely to have high dietary sodium intake compared with the normal BMI participants in the final model. Conclusion Over half of the participants consumed sodium more than the recommended daily intake, especially those who consumed three away from home meals. However, there was no significant association between high sodium intake and having three away from home meals per day. The promotion of healthy cooking methods among the public must continue to be emphasized to reduce the dietary sodium intake among Malaysian adults.

IntroductionVegetarian diet has been practiced in many countries in the world. There are growing evidence that vegetarian diet helps to maintain better health status compared to non-vegetarian diet. In Malaysia, there are adults practice vegetarian diet due to different reasons. This study aims to determine the overall prevalence of adults practicing vegetarian diet and to investigate the sociodemographic distribution of vegetarians among adults in Malaysia. Methods1. Secondary data from the population representative cross-sectional survey, National Health and Morbidity Survey (NHMS) 2019 was analysed. 2. A two-stage stratified cluster sampling design was used in NHMS 2019. 3. Information on socio-demographic background was obtained from a face-toface interview conducted by trained research team members. 4. Vegetarian was defined as respondent who reported practising vegetarian since one month ago during the home visit. 5. Data from 10,419 respondents who were aged 18 years and above, were selected to conduct descriptive analysis and Rao-Scott chi-square test using SPSS software. Results[Refer to Poster]. DiscussionOverall, the prevalence of adults practising vegetarian diet was 4.9%. This prevalence is comparable with the findings in the United State (5.0%) 3 . 2. There was no significant difference between location, marital status, education level, and household income among vegetarians. 3. The gender difference of practicing vegetarian diet in this study maybe be as results of different level of adherence to meat intake among males and females4 . 4. The findings of this study will help to alert the government agencies that the population prevalence of adults practicing vegetarian diet with the basic socio-demographic characteristics distribution in the country ConclusionIn conclusion, only one in twenty adults in Malaysia were vegetarians. Sex and ethnicity are the factors for vegetarian practice in Malaysia. Future study is suggested to investigate the health status and dietary quality of vegetarians in Malaysia.

IntroductionUndernutrition remains to be the underlying cause to the mortality and morbidity of children globally despite being preventable Underweight, also known as low weight for age, is one of the indicators of malnutrition. Approximately, 10.9 million children under five died in developing countries each year and 60% of the deaths directly or indirectly due to malnutrition. This study aimed to determine the risk factors for underweight among children under five years old in Putrajaya. MethodologyA case-control study with a one-to-one ratio between underweight and normal weight children. total of 364 children with underweight and 364 children with normal weight were successfully recruited in this study. The sample was recruited from all government health clinics and preschools in Putrajaya. Data collection was performed by four approaches, face to face interview, anthropometric measurements, finger prick for assessment of hemoglobin level and self-administered 3-days food diary. WHO Anthro software was used to determine the nutritional status of children in this study. Descriptive statistical analysis and logistic regression were performed to determine risk factors that contributed to underweight. Results[Refer to Poster]. Discussion and ConclusionLow birth-weight is the strongest risk factor of underweight. Children with short stature parent three times more likely to become underweight compared to the children with parents height more than 160cm. This indicated that there was a significant association between the care of babysitters and underweight children. Low household income and monthly expenditure for childcare less than RM1000 was associated with underweight children. Anaemia was one of the significant factors related to underweight among children in Putrajaya. This study suggests early pregnancy intervention among mothers to improve foetus nutrition and health status during pregnancy. &nbsp

IntroductionThe minerals are essential trace elements which are important in human metabolism and prevention of chronic diseases. Studies have highlighted the role of minerals excretion in 24-hour urine as biomarkers for dietary intake assessment in the population. This study aimed to assess 24-hour urinary minerals excretion of calcium, magnesium, phosphorus, zinc, iron, iodine, copper, manganese, selenium and molybdenum among Malaysian adults. MethodologyThis study utilised a 24-hour urine sample collected by the Malaysian Community Salt study (MyCoSS). MyCoSS was a nationwide cross-sectional study comprised of respondents ≥18 years old from urban and rural areas. A complete single 24-hour urine was collected by the respondents using two 2.5 litre screw-capped plastic containers. • The minerals’ level was measured using Inductively Coupled Plasma-Mass Spectrometer (ICPMS). • Descriptive analysis was conducted in SPSS Version 21. ResultsOf the 615 respondents in this study, 57.2% of them were females, of Malay ethnicity (61.5%), between the ages of 30-50 years old (38.9%), from rural areas (59.3%) and with overweight/obese BMI (56.6%). Median urinary excretion of calcium was 36.70 mg/day, magnesium (14.01 mg/day), phosphorus (185.33 mg/day), iron (11.14 mg/day) and iodine (32.28 µg/day), zinc (134.67 mg/day), copper (3.43 µg/day), selenium (8.29 µg/day), manganese (0.23 µg/day) and molybdenum (26.65 µg/day). DiscussionMale respondents have recorded a higher excretion of all 10 minerals in this study in comparison with females. Kesteloot et al. (1990) attributed higher dietary intake of the minerals and differences in physical activity between men and women for higher urinary minerals excretion among men compared to women in their study. Kimira et al. (2004) reported a higher excretion of calcium (166 mg/day), magnesium (80 mg/day) and phosphorus (624 mg/day) among their female respondents in comparison with female respondents in our study . Higher intake of bread and dairy foods contributed to higher excretion of calcium while a high intake of vegetables, fruits and potatoes significantly contributed to higher excretion of magnesium and phosphorus in the study. ConclusionThe findings of this study will compose the database of urinary minerals excretion of Malaysian adults for the benefits of the stakeholders in the Ministry of Health. • The data also will be useful in projecting the dietary intake of the minerals.

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.

Introduction: Vitamin D deficiency (VDD) is associated with adverse health outcomes in pregnancy and newborns. This study aims to determine the Vitamin D status among pregnant Malaysian women and its associations with specific maternal & pregnancy characteristics. Methods: This study utilised cross-sectional data from a prospective cohort study of pregnant women in Seremban district in which 259 pregnant women had available vitamin D data. Blood samples were taken 75nmol/L). Early pregnancy body mass index (AOR=2.95, 95% CI=1.03-8.47), working status (AOR=3.17, 95% CI=1.06-9.50) and gravidity (AOR=0.68, 95% CI=0.48-0.98) were significantly associated with VDD. Conclusion: The present study showed a high prevalence of VDD among pregnant women in Malaysia, especially among those who were overweight or obese, working in indoor environment and primigravida.

Introduction Both gestational diabetes mellitus (GDM) and hyperglycaemia less severe than GDM are associated with risk of adverse pregnancy outcomes. We describe the study design of a prospective cohort of pregnant women recruited in early pregnancy with follow-ups of mothers and infants up to 2 years after birth. The primary aim of the study was to identify the determinants and outcomes of maternal glycaemia. Methods and analysis Seremban Cohort Study (SECOST) is an ongoing prospective cohort study in which eligible pregnant women in first trimester (