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Adolescents are the largest population using social media in daily life, and their use is influenced by a wide range of factors. Hence, it is applied in nutrition intervention, which improved their health. However, some intervention lacks participation and engagement. This study identifies factors influencing adolescents’ social media use for nutrition interventions. An in-depth interview was conducted virtually for 30 to 60 minutes focusing on nutrition-related matters with 15 adolescents. Almost all of them were interested to participate in nutrition interventions on social media. User characteristics, environmental factors, and social media features were identified as the factors impacting them. Keywords: Adolescents; Social media; Nutrition; Intervention eISSN: 2398-4287 © 2023. The Authors. Published for AMER & cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), and cE-Bs (Centre for Environment-Behaviour Studies), College of Built Environment, Universiti Teknologi MARA, Malaysia. DOI: https://doi.org/10.21834/ebpj.v8i24.4686

Background: Schools serve as a focal point in which to engage students and school communities, including teachers, parents and other healthcare providers (e.g. nutritionists), in implementing obesity interventions. Bringing them together is beneficial to ensuring healthy eating among schoolchildren and to creating healthy school environments. However, there are barriers and success factors related to the implementation of such an intervention. Therefore, this study aimed to explore the barriers and success factors to school-based obesity interventions to improve obesity implementation. Methods: An exploratory case study with multiple units of analysis was conducted, including interviews, document analyses and a survey. The interview sessions involved six participants, including teachers and nutritionists. The survey was conducted among 121 participants involving 30 teachers, 78 parents and 13 school canteen operators. Pattern-matching techniques were employed to formulate the results. Results: The barriers consisted of the school system, parental awareness, staff availability, and children’s compliance. The success factors included the teachers’ role, the nutritional approach used, compliance with the healthy school canteen guidelines, and strong collaboration with the Parent-Teacher Association (PTA) and other agencies. Conclusion: It is necessary to digitise an obesity intervention module with some improvements, including strengthening the broader school community’s role and integrating nutrition education with technology to improve implementation.

Background: Increasing physical activity and reducing sitting time was recommended to cancer survivors after cancer treatment for sustained health and to enhance the quality of life. This study aimed to determine the association of physical activity and sitting time with quality of life among the Malay breast and gynaecological cancer survivors. Methods: A cross-sectional study was conducted among 95 breast and gynaecology cancer survivor subjects. The Malay International Physical Activity Questionnaire (IPAQ) was used to assess physical activity and sitting time. Quality of life was assessed using the Malay EORTC QLQ-C30 questionnaire. Sociodemographic, clinical characteristics and anthropometric measurements were also obtained in this study. Results: The mean age of the subject was 51.8 ± 7.7 years old and the duration of survivorship was 4.3 ± 3.4 years. A total of 76.8% of subjects were categorized as having low physical activity level with a mean MET 403.5 ± 332.7 minutes/week and sitting time of 416.9 ± 151.0 minutes/day. Overall, subjects aged 50 years and above (p=0.006), widowed (p=0.032), retired (p=0.029) and had other non-communicable diseases (p=0.005) showed lower levels of physical activity. Increased physical activity had a positive effect on physical function (r=0.2, p=0.038), reduced insomnia (r=-0.3, p

Background: Toybox is a kindergarten-based intervention programme targeting physical activity, sedentary behaviour, snacking and drinking in improving healthy energy balance-related behaviour among children attending kindergartens in Malaysia. It was based on a quasi-experimental design involving 780 children from 22 intervention kindergartens and 26 control kindergartens. This paper aims to report the process evaluation of this intervention. Methods: We assessed five process indicators: recruitment, retention, dosage, fidelity, and satisfaction in the intervention kindergartens. Data collection included teachers’ monthly logbook, and post-intervention feedback through questionnaire and focus group discussion with teachers, parents, and children. Results: A total of 1072 children were invited and 837 children completed the programme. Retention with the programme was 88.4% (with 110 children dropping out). 91% of the 44 teachers and their assistants engaged positively with one or more of the process evaluation data collection methods. In terms of dosage and fidelity, 76% of parents had received newsletters, tip cards and posters at the appropriate times. All teachers and their assistants reported being satisfied with the intervention programme, but also that there were some barriers to implementation including suitable environments (one example, insufficient space indoors to carry out activities to reduce sedentary behaviour), and that some of the kangaroo stories were not of sufficient interest to the children or too long to hold their attention. Parents reported that the materials were easy to understand and had improved their knowledge. More than 88% of parents were satisfied with the family-based activities, and had enjoyed them. The children were reported to show a change in positive behaviour in drinking water and consumption of fruits and vegetables.Conclusions: The Toybox programme was feasible to implement and acceptable, although several factors were usefully identified which could easily be improved before this intervention is scaled up and embedded into normal practice across Malaysia.

Introduction: Designing an effective and comprehensive weight reduction intervention requires an understanding of the motivating factors and barriers to losing weight. This study explored the motivating factors and barriers to weight reduction through the experiences, emotions and ideas shared among suburban overweight and obese Malay adults. Methods: In this qualitative study, 23 overweight or obese Malay adults aged 30-59 years old were divided into three focus group discussion (FGD). The Socio-Ecological Model (SEM), consisting of four levels (intrapersonal, interpersonal, community, and policy) was utilised in this study. Results: The motivating factors were: (1) Intrapersonal level: self-awareness, health concern, self-confidence, and desire to have good physical appearance, (2) Interpersonal level: social support from family and friends, (3) Community level: availability and accessibility of physical activity facilities and health information, and (4) Policy level: healthy lifestyle programme. The barriers were: (1) Intrapersonal level: lack of knowledge about diet, physical limitations, lack of self-control, and emotion/mood, (2) Interpersonal level: spouse and children, career or housework commitment, (3) Community level: lack of neighbourhood safety, and availability and accessibility of outside foods, and (4) Policy level: availability and accessibility of outside foods. Conclusion: Eight factors were identified as motivating factors and barriers for weight reduction practices. Support from family and friends should be considered when developing an effective and comprehensive weight loss programme as it was both a motivating factor as well as a barrier.

Objective Fear of cancer recurrent, side effects of treatment and belief in food taboos encourage cancer survivors to make changes in their dietary practices after diagnosis of cancer. The objective of this study was to determine the impact of dietary changes on quality of life (QoL) among Malay breast and gynaecological cancer survivors. Methods Questionnaire of dietary changes was modified from WHEL study and adapted to typical Malay's food intake in Malaysia. A total of 23 items were listed and categorized by types of food and cooking methods. Four categories of changes "increased", "decreased", "no changes" or "stopped" were used to determine the changes in dietary practices. Score one (+1) is given to positive changes by reference to WCRF/AICR and Malaysia Dietary Guideline healthy eating recommendations. Malay EORTC QLQ-C30 were used to determine the QoL. Sociodemographic, clinical characteristics and anthropometric measurement were also collected. Results The mean age of the subjects (n=77) was 50.7±7.8 years old with duration of survivorship 4.0±3.1 years. Subjects mean BMI was 27.8±4.9 kg/m2 which indicate subjects were 31.2% overweight and 32.5% obese. The percentage score of positive dietary changes was 34.7±16.4%. Positive dietary changes were increased intake of green leafy vegetable (49.4%), cruciferous vegetable (46.8%) and boiling cooking methods (45.5%). Subjects reduced their intake of red meat (42.9%), sugar (53.2%) and fried cooking method (44.2%). Subjects stopped consuming milk (41.6%), c 2008-5862 heese (33.8%) and sweetened condensed milk (33.8%). With increasing positive dietary changes, there was a significant improvement on emotional function (rs=0.27; p=0.016) and reduced fatigue symptoms (rs=-0.24; p=0.033). Conclusion Positive changes in dietary intake improved emotional function and reduced fatigue symptoms after cancer treatment. By knowing the trend of food changes after cancer treatment, enables the formation of healthy food intervention implemented more effective.

This study was undertaken to assess the demand and acceptance of an Instagram-based nutrition labelling education (Info-Nutriteen®) among adolescents. In this quasi-experimental study, a series of educational messages was developed and was uploaded on Instagram for 12 weeks. Participants were recruited and randomized into the intervention group or control group. Feasibility was assessed through participants' demand and acceptance of the program. Changes in nutrition knowledge and Knowledge, Attitudes, and Practices (KAP) on nutrition labels were measured at pre- and post-intervention. A total of 125 participants completed the program. Overall, 92.7% of the participants reported positive acceptance towards Info-Nutriteen®. In terms of demand, they suggested using current and trending songs for the videos and bright colours for the info-graphics. The study showed good demand and acceptance of the Instagram based education for adolescents. The Info-Nutriteen® program also effective to improve their attitude and practice on nutrition labels. Thus, this approach is feasible. Nevertheless, Info-Nutriteen®should be improved further to enhance its impact on nutrition labels knowledge and usage among adolescents.

Introduction: The culture of eating out among Malaysians has substantially increased in recent years due to the urbanisation of the society. Frequent eating out has been linked with reduced quality of diet, reduced intake of micronutrients, and increased weight gain. This study aims to explore specific factors on the perceptions and behaviours related to eating out from the perspective of parents. Methods: A qualitative study was carried out among 27 informants from various ethnicities and locations in Peninsular Malaysia. All sessions were audio-recorded, fully transcribed and analysed using thematic content analysis. Results: The main overarching theme that surfaced from this study was the role of parents in shaping the practice of eating out. Time constraints due to parents’ work commitments, the availability of various food outlets, increase in family bonding time and food preferences were recurring themes revealed by informants as facilitating factors to eating out. Other emerging themes, such as hygiene of food premises and cost of food, posed as barriers to eating out. Conclusion: These findings offered a better understanding on the eating out practices of a family from the parents’ perspective. Information as such could be incorporated in strategies to enhance the promotion of healthy eating and nutrition interventions that aim to inculcate healthy food choices while eating out.

Introduction: Adolescent health is a priority considering they represent the future generation. Data from the Adolescent Nutrition Survey 2017 were analysed to determine the prevalence of micronutrient inadequacy, particularly calcium and iron, and the relationship with body mass index (BMI) among Malaysian secondary school students. Methods: This cross-sectional study included students aged 13 to 17 years old studying at public and private schools. Twenty-four hours dietary recall via face-to-face interview was conducted by trained nutritionists to obtain data on dietary intake. For nutritional status, BMI-for-age z-score (BAZ) was analysed using WHO Anthroplus software. Results: From 999 respondents, 449 were boys and 550 were girls. Overall findings indicated that both boys and girls had inadequate intakes of calcium and iron in their daily diet. Mean intakes of calcium (695.7±463.2 mg/day) and iron (23.4±21.0 mg/day) were higher among boys aged 16 to 17 years old. Mean intake of iron were higher among the older age groups. Majority of the respondents (boys: 94%; girls: 97%) did not meet the recommended nutrient intake (RNI) for calcium and more than half (boys: 50%; girl: 80%) did not achieve the RNI for iron. Current findings also found significant positive but weak correlations between calcium (r=0.112, p=0.001) and iron (r=0.084, p=0.008) intakes with BMI-for-age. Conclusion: BMI-for-age was related to calcium and iron intakes among secondary school students in Malaysia. Thus, intervention strategies should focus on early screening and nutrition education on food choices of high calcium and high iron contents, including iron supplementation programmes, if needed.

Introduction: Many people are seeking knowledge and skills about preparing healthy meals at home. This study aimed to determine the content of nutrients in 60 healthy dishes prepared for the recipe book Mudah, Sihat, Sedap used in the F.E.A.T nutrition intervention programme. The recipe book was developed as an educational material to guide participants in preparing healthy meals at home. Methods: A needs assessment survey was done to identify food preferences for breakfast, lunch and dinner of obese and overweight respondents. Recipes for these foods were then modified to reduce the calorie, fat, and sugar contents, while adding in fibre sources. Proximate analysis was done based on standard methods of AOAC, while total carbohydrate and calorie contents were calculated using the differentiation and Atwater methods, respectively. Mineral content was determined using atomic absorption spectrophotometer, while fatty acids content was analysed by gas chromatography using the FAME method. Results: Proximate analysis results showed that Kobis Goreng had the most calories (305 kcal/100g) (p

Background and Study Aim. Non-sport activities like traditional games can be a practical way to promote physical activity (PA) during physical education (PE) lessons, especially among those who are less inclined towards sports. The purpose of this study is to compare the PA variables and acceptance between playing traditional games and free-play during physical education lessons among secondary school students. Material and Methods. Fifty-six (n = 56) subjects participated in this study wore accelerometers for a total of 40 minutes during each PE lesson to record PA. In the first week, a 40-min free-play PE lesson was done while in the second week, a 40-min PE lesson incorporated with traditional games (TG-PE lesson) was done. After following both lessons, subjects filled up a questionnaire on acceptance of TG-PE and free-play PE lessons. Results. The mean total activity count (p < 0.05) and time spent in moderate-to-vigorous physical activity (MVPA) (p < 0.05) were 20% and 19% greater respectively during TG-PE lesson compared to free-play PE lesson. The mean acceptance scores showed students preferred playing TG (19.29 ± 4.21; p < 0.00) over free-play PE lesson (17.59 ± 3.13). Conclusions. In conclusion, incorporating fun and meaningful activities such as TG during PE lessons can serve as an alternative strategy to promote PA during school hours. Further studies are warranted to determine other types of TG that may promote PA among secondary school students., Предпосылки и цель исследования. Неспортивные занятия, такие как традиционные игры, могут быть практическим способом стимулирования физической активности (PA) во время уроков физического воспитания (PE), особенно среди тех, кто менее склонен к спорту. Цель этого исследования - сравнить переменные PA и приемлемость между традиционными играми и произвольной игрой во время уроков физической культуры среди учащихся средней школы.Материал и методы. Пятьдесят шесть (n = 56) субъектов, участвовавших в этом исследовании, носили акселерометры в течение 40 минут в течение каждого урока физической культуры для записи PA. На первой неделе был проведен 40-минутный урок физической культуры без ограничений, а на второй неделе был проведен 40-минутный урок физической культуры , объединенный с традиционными играми (урок TG-PE). После прохождения обоих уроков испытуемые заполнили анкету о принятии уроков TG-PE и произвольной физической культуры .Результаты. Среднее значение общей активности (p, Передумови та мета дослідження. Неспортивні заняття, такі як традиційні ігри, можуть бути практичним способом стимулювання фізичної активності (PA) під час уроків фізичної культури (PE), особливо серед тих, хто менш схильний до спорту. Мета цього дослідження - порівняти змінні PA і прийнятність між традиційними іграми та довільної грою під час уроків фізичної культури серед учнів середньої школи.Матеріал і методи. П'ятдесят шість (n = 56) суб'єктів, які брали участь в цьому дослідженні, носили акселерометри протягом 40 хвилин протягом кожного уроку фізичної культури для запису PA. На першому тижні було проведено 40-хвилинний урок фізичної культури без обмежень, а на другому тижні було проведено 40-хвилинний урок фізичної культури, об'єднаний з традиційними іграми (урок TG-PE). Після проходження обох уроків випробовувані заповнили анкету про прийняття уроків TG-PE і довільної фізкультури.Результати. Середнє значення загальної активності (p

Qualitative research methods are receiving increasing recognition in healthcare-related studies. Nonetheless, the debate among scholars continues regarding validity in qualitative research; that is, whether the tools, processes, and data used are appropriate. Therefore, this study aims to describe the development and content validation of a focus group discussion (FGD) interview guide, which was utilized to explore practices and factors that influence adolescents’ usage of the Nutrition Information Panel (NIP) for food choices. A methodological study was carried out to assess the content validity of the FGD interview guide through a two-stage process (i.e., development and validation). The FGD interview guide for this study was developed by the researchers following five essential steps: identification of research objectives, selection of topics and questions, development of the guide, expert evaluations, and a pilot test. The developed FGD guide was assessed by five content experts representing a range of disciplines, including nutritionists, academicians, a qualitative researcher, and a teacher. A pilot FGD was conducted using a setting and participant criteria similar to those that will be employed in the main study. The content validity index (CVI) value for the developed FGD guide is 0.938. Seven out of 13 questions were modified based on the experts’ recommendations, such as reviewing an item, splitting it into two if necessary, retaining its original syntax if it was already suitable, or adding some new items. Subsequently, the researchers refined the questions’ wording and structure based on the analysis from the pilot FGD. Probes were also added to several questions to elicit in-depth responses from the participants. The final version of the FGD guide consisted of 13 main items and probes. The content validity of the FGD interview guide used in the pilot study was affirmed by a panel of experts; hence, it was deemed to be a valid instrument for measuring adolescents’ use of the NIP in future studies. Further investigation is needed to improve assessments of procedural knowledge and to test the interview guide in other populations.

This study determines the beneficial effect of community gardening activity in obesity intervention among overweight and obese adults in semi-urban area. The study was one of the activities in Arus Perdana Research Grant for obesity intervention, The Fit, Eat, Active and Training (F.E.A.T) programme. The study employs a pre-post quasi experimental design assigned into intervention (n=31) and control (n=30) group respectively. The intervention group followed a series of activities for 12 weeks of intervention. In one of the activities, subjects received a nutrition counselling session with nutritionist on daily vegetables intake, while agriculture officers demonstrated the procedure of producing fertilizers from household waste and vegetable gardening techniques. The subjects were divided into groups which planted their own vegetables at the space around community hall and in the pot during the intervention period. There was significant difference (p

Diet composition is a key determinant of childhood obesity. While whole grains and micronutrients are known to decrease the risk of obesity, there are no interventions originating from Southeast Asia that emphasize whole grain as a strategy to improve overall quality of diet in combating childhood obesity. The GReat-Child Trial aimed to improve whole grain intake and quality of diet among overweight and obese children. It is a quasi-experimental intervention based on Social Cognitive Theory. It has a 12-week intervention and 6-month follow-up, consisting of three components that address environmental, personal, and behavioral factors. The intervention consists of: (1) six 30 min lessons on nutrition, using the Malaysian Food Pyramid to emphasize healthy eating, (2) daily deliveries of wholegrain foods to schools so that children can experience and accept wholegrain foods, and (3) diet counseling to parents to increase availability of wholegrain foods at home. Two primary schools with similar demographics in Kuala Lumpur were assigned as control (CG) and intervention (IG) groups. Inclusion criteria were: (1) children aged 9 to 11 years who were overweight/obese; (2) who did not consume whole grain foods; and (3) who had no serious co-morbidity problems. The entire trial was completed by 63 children (31 IG; 32 CG). Study outcomes were measured at baseline and at two time points post intervention (at the 3rd [T1] and 9th [T2] months). IG demonstrated significantly higher intakes of whole grain (mean difference = 9.94, 95%CI: 7.13, 12.75, p < 0.001), fiber (mean difference = 3.07, 95% CI: 1.40, 4.73, p = 0.001), calcium (mean difference = 130.27, 95%CI: 74.15, 186.39, p < 0.001), thiamin (mean difference = 58.71, 95%CI: 26.15, 91.28, p = 0.001), riboflavin (mean difference = 0.84, 95%CI: 0.37, 1.32, p = 0.001), niacin (mean difference = 0.35, 95%CI: 1.91, 5.16, p < 0.001), and vitamin C (mean difference = 58.71, 95%CI: 26.15, 91.28, p = 0.001) compared to CG in T1, after adjusting for covariates. However, T1 results were not sustained in T2 when intervention had been discontinued. The findings indicate that intervention emphasizing whole grains improved overall short-term but not long-term dietary intake among schoolchildren. We hope the present trial will lead to adoption of policies to increase whole grain consumption among Malaysian schoolchildren.

Background: It is considered that the implementation of nutrition care process (NCP) leads to more efficient and effective care, as well as enhancing the roles of dietetics and nutrition professionals in the clinical setting. However, little is known about the NCP being implemented in the sports nutrition setting to deliver nutrition care, especially in meal planning. Therefore, this study aims to identify the process that sports nutritionists (SNs) practise in meal planning to plan meals for athletes and identify the application of NCP.Methods: In-depth interviews, using semi-structured interview questions, were conducted with SNs employed at the National Sports Institute of Malaysia. Five SNs who managed different types of sports were recruited. The interviews were audio-recorded and transcribed verbatim. Data were entered into ATLAS.ti 8 and analyzed using thematic analysis.Results: The following processes were identified: (i) collecting pertinent data; (ii) analyzing the collected data; (iii) determining nutrition prescriptions; (iv) formulating goals and determining actions; (v) implementing actions and recommendations; and (vi) monitoring.Conclusions: This study identified 6 general processes practiced by sports nutritionists in meal planning that comprised of the NCP’s interrelated steps, except nutrition diagnosis statement from the Nutrition Diagnosis step of the NCP. A comprehensive process and workflow can help sports dietitians or nutritionists to develop individualized meal plans that can improve athletes’ nutritional status, adherence, health and sports performance.

Physical education (PE) lesson is an important avenue for delivering physical activity (PA) opportunities during school hours. Non-sport activities like traditional games can be a practical way to promote PA during PE lesson, especially among those who are less inclined in sports. This study aims to determine whether playing traditional games during PE lesson can lead to greater PA compared to a ‘free-play’ PE lesson among secondary school students. A total of 56 subjects (Form 1: n = 27; Form 2: n = 29; mean age: 13.4 ± 0.5 years; mean BMI: 21.8 ± 4.9 kg/m2) from a school in Keramat, Kuala Lumpur were consented by their parents to participate in this study. PA was measured by using accelerometry (Actigraph GT3X+), on two separate PE lesson periods: PE lesson incorporated with traditional games and ‘free-play’ PE lesson. Subjects wore accelerometers for a total of 40 min during each PE lesson to determine total activity counts and moderate-to-vigorous physical activity (MVPA). The chosen traditional games were Galah Panjang and Baling Selipar. Mean total activity counts (p = 0.007) and time spent in MVPA (p = 0.006) were 20% and 19% greater respectively, during traditional games-based PE lesson compared to ‘free-play’ PE lesson. Time spent in sedentary activity was 45% lower during traditional games-based PE lesson (5.3 ± 4.3 min) compared ‘free-play’ PE lesson (10.7 ± 11.7 min; p = 0.006). Boys appeared to be 25% more active than girls in this study. In conclusion, incorporating fun and meaningful activities like traditional games during PE lessons can serve as an alternative strategy to promote PA during school hours. Further studies are warranted to determine other types of traditional games that may promote PA in girls.

Individualized meal planning is a nutrition counseling strategy that focuses on improving food behavior changes. In the sports setting, the number of experts who are sports dietitians or nutritionists (SD/SN) is small in number, and yet the demand for creating meal planning for a vast number of athletes often cannot be met. Although some food recommender system had been proposed to provide healthy menu planning for the general population, no similar solution focused on the athlete's needs. In this study, the iDietScoreTM architecture was proposed to give athletes and active individuals virtual individualized meal planning based on their profile, includes energy and macronutrients requirement, sports category, age group, training cycles, training time and individual food preferences. Knowledge acquisition on the expert domain (the SN) was conducted prior to the system design through a semi-structured interview to understand meal planning activities' workflow. The architecture comprises: (1) iDietScoreTM web for SN/SD, (2) mobile application for athletes and active individuals and (3) expert system. SN/SD used the iDietScoreTM web to develop a meal plan and initiate the compilation meal plan database for further use in the expert system. The user used iDietScoreTM mobile app to receive the virtual individualized meal plan. An inference-based expert system was applied in the current study to generate the meal plan recommendation and meal reconstruction for the user. Further research is necessary to evaluate the prototype's usability by the target user (athletes and active individuals).

Over the last two decades, levels of childhood overweight and obesity have increased considerably in Malaysia, such that the country now has the highest prevalence of obesity in Asia. The preschool years are a key time for establishing healthy behaviours; hence, there is a need for effective interventions aimed at early childhood. The ToyBox Study is an intervention to prevent obesity in preschoolers that has previously been conducted successfully in six different countries but to date not outside Europe. Therefore, we conducted a feasibility study to determine whether the ToyBox Study methodology could be successfully adapted and applied in Malaysia.The ToyBox Study Malaysia was conducted in 15 kindergartens in Kuala Lumpur and suburbs in Selangor and 7 kindergartens in Sarawak (Borneo), Malaysia. All participating kindergartens were funded by Jabatan Kemajuan Masyarakat (KEMAS), the Community Development Department, Ministry of Rural and Regional Development.The existing ToyBox resources and questionnaires were translated into Bahasa Malaysia and the materials were adapted to suit local culture. Theory of change workshops and focus groups were conducted with parents, caregivers, teachers, cooks and government officers in order to help develop the implementation model. Train-the-trainer and teacher training sessions were organised before the study commenced.The study was a randomised controlled trial that compared the ToyBox Study with kindergarten usual practice, over a period of one year. The ToyBox Study specifically targeted four energy balance related behaviours, namely; eating healthy snacks and meals, making water the preferred drink, increasing physical activity and reducing sedentary behaviour. Food frequency questionnaires were used to assess food intake. Accelerometry was used to measure physical activity. Weight, height and waist circumference were also measured. All measurements were made at baseline and post-intervention. Equipment such as soft mats and drinking water stations were supplied where needed. Parents, caregivers and teachers were provided with relevant materials, newsletters and tip cards and encouraged to participate and act as role models. They also completed project evaluation surveys.If successful, it is envisaged that the ToyBox Study Malaysia will be adopted by other kindergartens in Malaysia, with the intention of helping Malaysian children and their families to achieve healthy energy balance related behaviours that will benefit their health and reduce obesity risk in the long-term.

Globally, prevalence of overweight and obesity among children has increased rapidly in the recent decades. Thus, development of effective interventions to prevent childhood obesity in Malaysia is urgently needed. This paper describes the study design of a 12-week multi-component, school-based nutrition education programme aimed at managing childhood obesity. The objective of Juara Sihat™ is to determine the effectiveness of a nutrition education programme in improving anthropometric status, knowledge, attitude and practice (KAP) of nutrition, eating habits and physical activity level among overweight and obese children. This quasi-experimental study involves two primary schools in Kuala Lumpur with similar demographic characteristics. Eligibility criteria of research participants are overweight and obese children aged 9 to 11 years. The main components of the Juara Sihat™ intervention are nutrition education classes on healthy eating and active lifestyle; physical activity sessions; and active involvements of parents and teachers. The control school does not receive any interventions. The primary outcome is BMI z-score, while other outcomes include waist circumference, body fat percentage, KAP of nutrition score, dietary intake, physical activity level, sedentary behaviour and biochemical profile. Outcome measures will be assessed at three intervals: baseline, post-intervention 1 (3-month follow-up), and post-intervention 2 (6-month follow-up). The Juara Sihat™ programme represents a promising approach to examining the effectiveness of a school-based childhood obesity intervention with strong empowerment of Parents’ and Teachers’ Association (PTA). We anticipate that this study may provide insights towards the development of more effective strategies in formulating childhood obesity interventions. DOI : http://dx.doi.org./10.17576/JSKM-2018-17

Population increase in adolescence are associated with increased overweight and obesity problems. If this problem not early intervention will have an impact on increasing hypertension prevalence and risk of death. This research aimed to explain the consequences of overweight and obesity in adolescent to hypertension in adults. The study used Indonesian Family Life Survey (IFLS) data with a retrospective cohort study. Adolescent BMI measurements on 2007 and the risk of hypertension on 2014. Population are all adolescents aged 10-20 years in 2007. Sample of 1,697 adolescent who randomly IFLS 2007 with the inclusion criteria: biological children and a single birth, children living with biological parents, children remain alive until adulthood on 2014. Multivariate analysis used logistic regression. The study found 8.1% women and 5.6% men were overweight and obes. In adulthood, there was a 45.4% incidence of hypertension. Incidence of hypertension in men (67.3%) more than women (26.8%). The multivariate model showed adolescence BMI affects the blood pressure after controlled the BMI adult, adolescence blood pressure, area of residence, and gender.Gender interacts with adolescence BMI. The risk of hypertension in adulthood based on overweight and obese in adolescent boys is 3 times and girls is 2 times.

Over the past few years, Augmented Reality (AR) and Virtual Reality (VR) have become a phenomenon in this new era and nowadays smartphone device can enable these technologies quickly and seamlessly through downloadable applications. Some of them are to benefits community and others just for entertainment purposes such as movies and games. Despite their goal, researchers take the opportunity to use Mixed Reality (MR) technology as it is suitable for real-life usage by users as its low cost and it can replace the conventional way of rearranging the furniture for interior design application. MR also brings design and planning, interior design, and engineering into a digital world where people can operate the prototype without having to physically involve in real life. A user should be able to interact intuitively with the virtual content in real-time. This paper identifies the integration for both AR and VR fusion for the MR environment. It also discusses the suitable user interaction technique can be applied in interior design in the MR environment, called MR-Deco.

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.

Background: Quality of life (QOL) is an essential part of health outcomes for diabetes patients . Methods: This cross-sectional study aimed to evaluate the quality of life among 100 Iranian type 2 diabetes patients aged 37 to 66 years, attending the outpatient diabetes clinic at Golestan Hospital, Ahvaz, Iran, from August to October 2013. Diabetes quality of life (DQoL) questionnaire was used to determine quality of life of diabetes patients. Body weight, height, waist circumference, clinical parameters, including glycated hemoglobin A1c level (HbA1c) were also measured. Results: The mean age of men and women was 56±6.1 and 53.4± 6.7 years respectively. Sixty one present of patients were female and 39 % were male with 4.05 ± 1.4 mean years duration of diabetes. The mean total DQOL was 54.6± 2.4, a moderate quality of life and was associated with diabetes care and treatment adherence. The mean for diabetes-related worry was 77.5 ±7.05. Conclusions: Male diabetic patients in comparison with female diabetic patients, non-insulin-treated patients compared with insulin-treated patients had better quality of life. HbA1c higher than 7%, was associated with higher probabilities of worse quality of life among patients. More studies are needed to include larger study populations among Iranian type 2 diabetes patients in order to help health care providers develop proper health care programs for diabetic patients in Iran.

Type 2 diabetes is a chronic illness which can be managed by patients' commitment to self-care and self-efficacy behaviors.A randomized controlled intervention study was carried out to determine the impact of self-efficacy education based on the Health Belief Model (HBM) in 240 patients with type 2 diabetes at the Golestan Hospital, Ahvaz, Iran between October 2014 and August 2015. The education duration was three months followed by a 24-week follow-up visit to determine the progress of the subjects. In this study, reliable and validated diabetes educational booklet and questionnaires based on knowledge, health beliefs and quality of life were used. The participants were randomly allocated to either the intervention group (n=120) or to the conventional dietary counseling group as controls (n=120), and assessed at the baseline, week 12 and week 36. The study was divided into primary outcome measurements consisting of glycated hemoglobin A1c (HbA1c), fasting blood glucose, lipid profile, and anthropometric levels. Secondary outcome measures were related to nutrition knowledge, health beliefs and quality of life.The results showed that subjects in the intervention group had significantly better metabolic and glycemic profiles compared with those in the control group. It also showed that knowledge, health belief and quality of life significantly increased in the intervention group.Findings indicate that through tailored self-efficacy education, the quality of life and metabolic profile of diabetes patients can be improved.

Background: The GReat-Child Trial was a quasi-experimental intervention that has emphasized whole grain as a strategy to manage childhood obesity. Methods: Two schools in Kuala Lumpur with similar demographic characteristics were assigned as intervention (IG) and control (CG). Eligibility criteria were overweight/obese children aged 9 to 11 years who had no serious co-morbidity. Children who reported consuming wholegrain foods in their 3-day diet-recall during screening were excluded. A total of 63 children (31 IG; 32 CG) completed the entire intervention program. The IG children underwent six 30-min nutrition education lessons and had school delivery of wholegrain food on a daily basis over a 12-week period. Parents of IG children attended 1-h individual diet counseling. Anthropometric outcomes including BMI-for-age z-score (BAZ), body fat percentage and waist circumference were measured at baseline [T0], post-intervention [T1] (3rd month) and follow-up [T2] (9th month). Results: IG showed significantly lower BAZ (weighted difference: −0.12; 95% CI: −0.21, −0.03; p = 0.009), body fat percentage (weighted difference: −2.6%; 95% CI: −3.7, −1.5; p < 0.001) and waist circumference (weighted difference: −2.4 cm; 95% CI: −3.8, −1.0; p = 0.001) compared to CG. IG reported significantly lower body fat percentage (weighted difference: −3.4%; 95% CI: 1.8, 5.0; p < 0.001) and waist circumference (weighted difference: −2.1 cm; 95% CI: −3.7, −0.5; p = 0.014) at T1 compared to T0. Conclusions: The GReat-Child Trial made a positive impact in managing childhood obesity. It can be incorporated into childhood obesity intervention programs that are being implemented by the policy makers.