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Background: Physical activity (PA), sedentary behavior (SB), and sleep are interrelated 24-hour movement behaviors that are important for the growth and well-being of children. This cross-sectional study examined the relationship between 24-hour movement behaviors and adiposity, and predicted changes in adiposity following compositional time reallocations in 7- to 12.9-year-old Malaysian children from the South East Asian Nutrition Surveys II Malaysia. Methods: A total of 381 children (mean age 9.7 [1.6] y, 57% girls) provided 24-hour wrist-worn GENEActiv accelerometry data which captured time spent for sleep, SB, light PA and moderate to vigorous PA (MVPA). Indicators of adiposity were derived from anthropometry and bioelectrical impedance analysis: body-mass-index-for-age, waist circumference, waist-to-height ratio, percent body fat, and body mass index. The composition of 4-part movement behaviors was expressed as isometric log-ratio coordinates which were entered into regression models. Isotemporal substitution analysis was used to assess changes in adiposity indicators when reallocating time between movement behaviors. Results: Relative to other movement behaviors, time spent on MVPA was significantly associated with waist circumference, waist-to-height ratio, percent body fat, and fat mass index. A 15-minute one-to-one reallocation from other movement behaviors to MVPA predicted lower body-mass-index-for-age (−0.03 to −0.11), smaller waist circumference (−0.67 to −1.28 cm), lower waist-to-height ratio (−0.004 to −0.008), percent body fat (−0.87% to −1.47%), and fat mass index (−0.23 to −0.42). Replacing SB and light PA with sleep or MVPA was associated with lower adiposity. Conclusions: The overall composition of movement behavior was significantly associated with the adiposity of Malaysian schoolchildren. Promoting MVPA and sleep and reducing SB and light PA are important for prevention of childhood obesity. [ABSTRACT FROM AUTHOR]

Increased cardiometabolic risk among children is increasingly becoming a concern, with evidence indicating that obesity, diet, and serum 25-hydroxyvitamin D (25(OH)D) are associated with cardiometabolic risk. However, such studies among Malaysian children are scarce. Thus, this study explores the associations between adiposity, dietary quality, and 25(OH)D, with cardiometabolic risk factors among Malaysian children aged 4–12 years. Data of 479 children (mean age: 8.2 ± 2.3 years old, 52% females) from the South East Asian Nutrition Surveys (SEANUTS II) Malaysia, were included in this analysis. Adiposity (percentage of body fat) was assessed with bioelectrical impedance technique. Dietary quality was assessed using 24 h dietary recall and calculated as mean adequacy ratio. Vitamin D was assessed based on serum 25-hydroxyvitamin D (25(OH)D). Measurements of cardiometabolic risk factors included waist circumference (WC), mean arterial pressure (MAP), fasting blood glucose (FBG), high-density lipoprotein (HDL), triglyceride, and high-sensitivity C-reactive protein, and cardiometabolic risk cluster score (siMS) was calculated. Overall, higher adiposity was positively associated with all cardiometabolic risk factors (WC, ß = 0.907; 95% CI = 0.865, 0.948; MAP, ß = 0.225; 95% CI = 0.158, 0.292; HDL, ß = −0.011; 95% CI = −0.014, −0.009; Triglyceride, ß = 0.012; 95% CI = 0.009, 0.016; FBG, ß = 0.006; 95% CI = 0.002, 0.011) and siMS score (ß = 0.033; 95% CI = 0.029, 0.037). Serum 25(OH)D was inversely associated with siMS score (ß = −0.002; 95% CI = −0.004, −0.000008) and positively associated with HDL (ß = 0.002; 95% CI = 0.0001, 0.003). Our findings suggest that adiposity is a key determinant of adverse cardiometabolic risk factors in children, while serum 25(OH)D may be associated with overall cardiometabolic health. Interventions to reduce obesity are needed to mitigate the deleterious consequences of cardiometabolic dysregulation in children. [ABSTRACT FROM AUTHOR]

Early childhood is a critical developmental stage where established dietary patterns can impact lifelong health outcomes. This study investigates dietary patterns and their relationships with sociodemographic factors among Malaysian preschoolers. A total of 643 preschoolers of Malay, Indian, Chinese and other ethnicities participating in South East Asian Nutrition Surveys (SEANUTS II) were included. Dietary intake was assessed using a single triple‐pass 24‐h dietary recall method. Dietary patterns were derived using principal component analysis and their association with sociodemographic factors was determined using complex sampling logistic regressions. Five dietary patterns were identified: "healthy eating," "wholegrains and starchy vegetables," "high salt and sugar," "Western food," and "sugary drinks and legumes". Having older siblings was inversely associated with a "healthy eating" pattern (adjusted OR: 0.54, 95% CI: 0.33–0.87). Malay ethnicity was associated with higher odds of adhering to the "high salt and sugar" pattern (adjusted OR: 4.12, 95% CI: 2.20–7.75). Meanwhile, children living in urban areas (adjusted OR: 1.76, 95% CI: 1.03–3.01), those from middle‐income families (adjusted OR: 3.20, 95% CI: 1.38–7.40) and whose fathers were overweight (adjusted OR: 2.79, 95% CI: 1.58–4.94) showed a higher association with "Western food" pattern. Conversely, children whose mothers had overweight were less likely to adhere to the "Western food" pattern (adjusted OR: 0.50, 95% CI: 0.30–0.83). Older age was significantly associated with a greater likelihood of the "sugary drinks and legumes" pattern (adjusted OR: 3.99, 95% CI: 1.75–9.06). There was no significant association between "wholegrains and starchy vegetables" pattern with sociodemographic characteristics (all p > 0.05). These findings suggest that ethnicity, age, residence area, having older siblings, parental weight status and household income level are associated with dietary patterns among multiethnic preschoolers in Malaysia. Thus, these sociodemographic characteristics should be considered when designing targeted dietary strategies and interventions for preschoolers. [ABSTRACT FROM AUTHOR]

Background: Adhering to 24‐h movement guidelines (24‐hMG) have health benefits for young children; yet research on Malaysian preschoolers' movement behaviors is limited. This study investigates the association between adherence to 24‐hMG and sociodemographic factors of Malaysian preschoolers. Methods: Data from 939 preschoolers aged 3–6 years (mean age = 4.83 ± 0.04 years, 53.7% boys) from the Second South East Asian Nutrition Surveys (SEANUTS II) Malaysia study was analyzed. Socio‐demography, physical activity, sedentary behaviors, and sleep were parent‐reported via questionnaire. Associations between adherence of 24‐hMG and sociodemographic factors were analyzed using complex samples logistic regression. Results: Only 12.1% of preschoolers adhered to the overall 24‐hMG, and 67.1%, 54.7%, and 42.7% of preschoolers adhered to physical activity, sleep, and sedentary behavior guidelines, respectively; while 6.8% did not meet any guidelines. Compared to 3–4‐year olds, preschoolers aged 5–6 years had higher odds of adhering to physical activity guidelines, sedentary behavior guidelines, and overall 24‐hMG, but lower odds of adhering to sleep guidelines. Chinese and Indian preschoolers were more likely to adhere to sedentary behavior guidelines than Malay preschoolers; however, Chinese preschoolers had lower odds of adhering to physical activity guidelines. Paternal tertiary education was associated with a higher likelihood of adherence to sleep guidelines. Conclusion: Our findings suggest that adherence to 24‐hMG among Malaysian preschoolers is associated with age, ethnicity, and paternal education level. This underscores the importance of targeted interventions and health awareness program to promote healthy movement behaviors, particularly among children under 5, ethnic minorities, and educationally disadvantaged families. [ABSTRACT FROM AUTHOR]

Objective: This paper aims to report South East Asian Nutrition Surveys (SEANUTS) II Malaysia data on nutritional status, dietary intake and nutritional biomarkers of children aged 6 months to 12 years. Design: Cross-sectional survey conducted in 2019–2020. Setting: Multistage cluster sampling conducted in Central, Northern, Southern and East Coast regions of Peninsular Malaysia. Participants: 2989 children aged 0·5–12·9 years. Results: Prevalences of stunting, thinness, overweight and obesity among children aged 0·5–12·9 years were 8·9 %, 6·7 %, 9·2 % and 8·8 %, respectively. Among children below 5 years old, 11·4 % were underweight, 13·8 % had stunting and 6·2 % had wasting. Data on nutritional biomarkers showed that a small proportion of children aged 4–12 years had Fe (2·9 %) and vitamin A deficiencies (3·1 %). Prevalence of anaemia was distinctly different between children below 4 years old (40·3 %) and those aged 4 years and above (3·0 %). One-fourth of children (25·1 %) had vitamin D insufficiency, which was twice as prevalent in girls (35·2 % v. boys: 15·6 %). The majority of children did not meet the recommended dietary intake for Ca (79·4 %) and vitamin D (94·8 %). Conclusions: Data from SEANUTS II Malaysia confirmed that triple burden of malnutrition coexist among children in Peninsular Malaysia, with higher prevalence of overnutrition than undernutrition. Anaemia is highly prevalent among children below 4 years old, while vitamin D insufficiency is more prevalent among girls. Low intakes of dietary Ca and vitamin D are also of concern. These findings provide policymakers with useful and evidence-based data to formulate strategies that address the nutritional issues of Malaysian children. [ABSTRACT FROM AUTHOR]

Problematic eating behaviors during childhood may lead to positive energy balance and obesity. Therefore, this study aims to investigate the association of eating behaviors with nutritional status and body composition in Malaysian children aged 7 to 12 years. A total of 1782 primary schoolchildren were randomly recruited from 6 regions in Malaysia. The multidimensional Children’s Eating Behaviour Questionnaire (CEBQ) was reported by parents to determine the 8 different dimensions of eating styles among children. Body mass index (BMI), BMI-for-age Z-score, waist circumference, and body fat percentage were assessed. Linear regression analyses revealed that both food responsiveness and desire to drink subscales were positively associated with a child’s body adiposity, whereas satiety responsiveness, slowness in eating, and emotional undereating subscales were negatively associated with adiposity (all P < .05). A multidimensional eating style approach based on the CEBQ is needed to promote healthy eating behaviors in order to prevent excessive weight gain and obesity problems among Malaysian children. [ABSTRACT FROM AUTHOR]

A large body of epidemiological data has demonstrated that diet quality follows a sociodemographic gradient. Little is known, however, about food group intake patterns among Malaysian children. This study aimed to assess consumption pattern of 7 food groups, including cereals/grains, legumes, fruits, vegetables, fish, meat/poultry, and milk/dairy products, among children 7 to 12 years of age. A total of 1773 children who participated in SEANUTS Malaysia and who completed the Food Frequency Questionnaire were included in this study. A greater proportion of children aged 10 to 12 years have an inadequate intake of cereals/grains, meat/poultry, legumes, and milk/dairy products compared with children 7 to 9 years old. With the exception of meat/poultry, food consumption of Malaysian children did not meet Malaysian Dietary Guidelines recommendations for the other 6 food groups, irrespective of sociodemographic backgrounds. Efforts are needed to promote healthy and balanced dietary habits, particularly for foods that fall short of recommended intake level. [ABSTRACT FROM AUTHOR]

Objective: To describe the economic, lifestyle and nutritional impact of the COVID-19 pandemic on parents, guardians and children in Malaysia, Indonesia, Thailand and Vietnam., Design: Data from the SEANUTS II cohort were used. Questionnaires, including a COVID-19 questionnaire, were used to study the impact of the pandemic on parents/guardians and their children with respect to work status, household expenditures and children's dietary intake and lifestyle behaviours., Setting: Data were collected in Malaysia, Indonesia, Thailand and Vietnam between May 2019 and April 2021., Participants: In total, 9203 children, aged 0·5-12·9 years, including their parents/guardians., Results: Children and their families were significantly affected by the pandemic. Although the impact of lockdown measures on children's food intake has been relatively mild in all countries, food security was negatively impacted, especially in Indonesia. Surprisingly, in Malaysia, lockdown resulted in overall healthier dietary patterns with more basic food groups and less discretionary foods. Consumption of milk/dairy products, however, decreased. In the other countries, intake of most food groups did not change much during lockdown for households based on self-reporting. Only in rural Thailand, some marginal decreases in food intakes during lockdown persisted after lockdown. Physical activity of children, monthly household income and job security of the parents/guardians were negatively affected in all countries due to the pandemic., Conclusion: The COVID-19 pandemic has significantly impacted societies in South-East Asia. To counteract negative effects, economic measures should be combined with strategies to promote physical activity and eating nutrient-adequate diets to increase resilience of the population.

Background: Physical activity (PA), sedentary behavior (SB), and sleep are interrelated 24-hour movement behaviors that are important for the growth and well-being of children. This cross-sectional study examined the relationship between 24-hour movement behaviors and adiposity, and predicted changes in adiposity following compositional time reallocations in 7- to 12.9-year-old Malaysian children from the South East Asian Nutrition Surveys II Malaysia., Methods: A total of 381 children (mean age 9.7 [1.6] y, 57% girls) provided 24-hour wrist-worn GENEActiv accelerometry data which captured time spent for sleep, SB, light PA and moderate to vigorous PA (MVPA). Indicators of adiposity were derived from anthropometry and bioelectrical impedance analysis: body-mass-index-for-age, waist circumference, waist-to-height ratio, percent body fat, and body mass index. The composition of 4-part movement behaviors was expressed as isometric log-ratio coordinates which were entered into regression models. Isotemporal substitution analysis was used to assess changes in adiposity indicators when reallocating time between movement behaviors., Results: Relative to other movement behaviors, time spent on MVPA was significantly associated with waist circumference, waist-to-height ratio, percent body fat, and fat mass index. A 15-minute one-to-one reallocation from other movement behaviors to MVPA predicted lower body-mass-index-for-age (-0.03 to -0.11), smaller waist circumference (-0.67 to -1.28 cm), lower waist-to-height ratio (-0.004 to -0.008), percent body fat (-0.87% to -1.47%), and fat mass index (-0.23 to -0.42). Replacing SB and light PA with sleep or MVPA was associated with lower adiposity., Conclusions: The overall composition of movement behavior was significantly associated with the adiposity of Malaysian schoolchildren. Promoting MVPA and sleep and reducing SB and light PA are important for prevention of childhood obesity.

This study aimed to assess fruit and vegetable intake patterns and their associations with sociodemographic characteristics, anthropometric status and nutrient intake profiles among Malaysian children aged 1-6 years. Using the Malaysian dataset of South East Asian Nutrition Surveys (SEANUTS Malaysia), a total of 1307 children aged 1-6 years with complete datasets were included in this analysis. Dietary intake was assessed using age-specific, validated food frequency questionnaires. On average, Malaysian children consumed 0.91 and 1.07 servings of fruits and vegetables per day, respectively. Less than one-fifth of the children achieved the daily recommended servings of fruits (11.7%) and vegetables (15.8%). Fruit intake was associated with age, parental educational level and geographical region, and vegetable intake was associated with ethnicity and geographical region. There was little evidence of an association between fruit and vegetable intake and children's anthropometric status, but an adequate intake of fruits and vegetables contributed significantly and differently to children's micronutrient intake. Future nutrition interventions should focus on addressing the sociodemographic determinants and be tailored to the needs of the low consumers to more effectively promote and encourage the adequate intake of fruit and vegetables among young children., Competing Interests: The authors declare no conflicts of interest. FrieslandCampina sponsored SEANUTS, but was not involved in the recruitment of the participants, the assessments or the final set of the results and had no influence on the outcome of the study.

Children's physical activity has been correlated with child characteristics and social or physical environment. This study aimed to compare preschoolers' physical activity among various sociodemographic characteristics and to determine barriers, motivators, and environmental factors for active play. A total of 835 preschoolers were included in this analysis. Time spent on active play, quiet play, and screen time was reported by parents. Boys spent significantly more time on active play and screen time than girls. Time spent on quiet play was highest in East Coast Peninsular Malaysia and lowest in Sarawak. Some 40% of children achieved active play recommendation while 27% exceeded daily screen time recommendation. Most parents reported that their child played actively in the house area; and that the main barrier and motivator to active play were safety and child's enjoyment, respectively. These findings demonstrate that sociodemographic characteristics and environment should be considered in designing physical activity intervention programs., (© 2016 APJPH.)

Childhood obesity is related to low physical activity level and a sedentary lifestyle. The aim of this study was to assess the physical activity level and sedentary behaviour of Malaysian children aged 7 to 12 years and to examine their association with body mass index (BMI), BMI-for-age Z-score (BAZ), body fatness (%BF) and waist circumference (WC). A total of 1736 children, representing all ethnic groups were recruited from six regions of Malaysia. Anthropometric measurements included body weight, height and waist circumference. Body fat percentage (%BF) was assessed using bioelectrical impedance. Physical activity was assessed by a physical activity questionnaire (PAQ) in all children and by pedometers in a subsample (n = 514). PAQ score and pedometer step counts were negatively associated with BMI, BAZ, %BF and WC after adjusting for covariates. Screen time was positively associated with BAZ and WC. However, other sedentary activities were not significantly related with any anthropometric indicators. Strategies to promote active living among children in Malaysia should focus not only on increasing physical activity but also emphasise reduction in sedentary behaviours.