Mirnalini Kandiah - Academia.edu (original) (raw)

Papers by Mirnalini Kandiah

American Journal of Hospice and Palliative Medicine, Mar 1, 2010

This study aimed to evaluate the nutritional status of patients with cancer in palliative care an... more This study aimed to evaluate the nutritional status of patients with cancer in palliative care and to examine the interrelationship between objective and subjective nutritional assessment measures. Patients' nutritional status in a palliative care unit of a Malaysian government hospital and a hospice facility were assessed using anthropometric measurements, weight loss at 1/6 months, and the scored patient-generated subjective global assessment (PG-SGA). Moderate-to-severe malnutrition was observed in a range from 31% to 69% using both measurements. Common nutritional impact symptoms were pain, xerostomia, and anorexia. Patient-generated subjective global assessment scores were significantly correlated with anthropometric measurements (P < .050). The PG-SGA is equally informative as objective indicators and is recommended as a quickly applied tool for nutritional status assessment of patients with cancer in palliative care.

Asia Pacific Journal of Clinical Nutrition, 2014

in English, Chinese這個橫斷性研究評估在低收入地區的育齡婦女(625 位)，其家戶糧食不安全性 與代謝症候群的相關性。利用Radimer/Cornell 飢餓及糧食不安... more in English, Chinese這個橫斷性研究評估在低收入地區的育齡婦女(625 位)，其家戶糧食不安全性 與代謝症候群的相關性。利用Radimer/Cornell 飢餓及糧食不安全指南以評估糧 食不安全性。並取得體位測量值、飲食多樣性、血壓及禁食靜脈血脂及血糖 值。依據國際統一分類標準(Harmonized criteria)，代謝症候群的定義為至少有 3 項危險因子。糧食不安全(家戶糧食不安全26.7%；個人糧食不安全25.3%； 孩童飢餓26.4%)及代謝症候群的盛行率分別是78.4%及25.6%。雖然糧食安全 比起有糧食不安全的婦女有較高的血糖(糧食安全54.8%比上糧食不安全37.3- 46.1%)、總膽固醇(54.1%比上32.1-40.7%)及低密度脂蛋白膽固醇(63.7%比上 40.6-48.7%)，但是依糧食不安全程度來看，婦女體重過重/肥胖、腹部肥胖、 高血壓、高三酸甘油酯、低的高密度脂蛋白-膽固醇及代謝症候群的百分比， 都沒有顯著的差異。然而，在控制人口學及社經地位變項後，家戶糧食不安全 的婦女比起糧食安全的婦女有較少比率的代謝症候群(個人糧食不安全及孩童 飢餓)(p<0.05)、腹部肥胖(個人糧食不安全及孩童飢餓)(p<0.01)、高血糖(家戶 糧食不安全)、高總膽固醇(孩童飢餓)(p<0.05)及高的低密度脂蛋白膽固醇(家戶 糧食不安全及孩童飢餓)。低收入家戶處於營養轉型之際，致力於改善他們的 糧食不安全，應該著重健康食物選擇的可用性及可獲性與營養教育，以降低飲 食相關慢性疾病的風險。

The use of email and website as channels for workplace health information delivery is not fully e... more The use of email and website as channels for workplace health information delivery is not fully explored. This study aims to describe the rationale, design, and baseline findings of an email-linked website intervention to improve modifiable cancer risk factors. Employees of a Malaysian public university were recruited by systematic random sampling and randomised into an intervention (n = 174) or control group (n = 165). A website was developed for the intervention and educational modules were uploaded onto the website. The intervention group received ten consecutive weekly emails with hypertext links to the website for downloading the modules and two individual phone calls as motivational support whilst the control group received none. Diet, lifestyle, anthropometric measurements, psychosocial factors and stages of change related to dietary fat, fruit and vegetable intake, and physical activity were assessed. Participants were predominantly female and in non-academic positions. Obesity was prevalent in 15% and 37% were at risk of co-morbidities. Mean intake of fats was 31%, fruit was -1 serving/day and vegetable was &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 1 serving/day. Less than 20% smoked and drank alcohol and about 40% were physically inactive. The majority of the participants fell into the Preparation stage for decreasing fat intake, eating more fruit and vegetables, and increasing physical activity. Self-efficacy and perceived benefits were lowest among participants in the Precontemplation/Contemplation stage compared to the Preparation and Action/Maintenance stages. Baseline data show that dietary and lifestyle practices among the employees did not meet the international guidelines for cancer prevention. Hence the findings warrant the intervention planned.

Nutrition Research and Practice, Dec 1, 2010

Cardiovascular disease is a leading cause of death and disability and remains so in the future. T... more Cardiovascular disease is a leading cause of death and disability and remains so in the future. The aim of this study was to detect the impact of a 6-month diet intervention on cardiovascular risk factors in postmenopausal Iranian women. It was a randomized controlled trial that carried out in the East Health Clinic in Ahvaz-Iran. This study started on June 2007 and was completed on May 2008. A total 64 healthy postmenopausal women recruited and randomly assigned to the intervention group (35) and control (29). Over the six months follow-up, the intervention group received five educational sessions (two face to face and three lecture discussion classes with slide demonstration) at the first month. These sessions were about menopause, cardiovascular disease and healthy diet. Every participant in the intervention group received one face to face education session at the 3 rd month, and also received a telephone call at the end of each month starting with the second month to remain on the diet. Pre-intervention and post-intervention anthropometric measurements, blood pressure, blood lipids and dietary intake were assessed. Data analyzed using the SPSS version 15. Descriptive (means and SD), univariate (Paired-t test, Chi-Square and Independent T-test) and multivariate (GLM Repeated Measure) statistics were used. Participants in the diet group had significantly lower weight (-0.9 kg), body mass index (-0.4 kg/m 2 ), and fasting blood sugar (-4.5 mg/dl). The diet group significantly increased their daily intake of fiber (+2.3 g, P = 0.05), decreased their intake of sodium (-28 mg, P = 0.04), and consumption of fruit and vegetable ≥ 5 serving a day (80%, P = 0.03) compared to the control group. Post menopausal women are at a greater risk for cardiovascular disease. Healthy diet using educational intervention can be an effective means of reducing cardiovascular risk in postmenopausal women.

Malaysian Journal of Nutrition

Fasting serum specimens from (a) 217 male and 46 female patients with coronary artery disease (CA... more Fasting serum specimens from (a) 217 male and 46 female patients with coronary artery disease (CAD), aged 35-75 years, who had undergone angioplasty (PTCA) / coronary artery bypass graft (CABG), and (b) 160 apparently healthy controls (106 males, 54 females, aged 30-75 years), were assessed for serum lipid profile. Both sex and ethnicity significantly influenced the levels of serum high density lipoprotein cholesterol (HDLC); in the controls, females had higher HDLC levels than males (46.7 mg/dl vs 38.5 mg/dl, p<0.00l), while the Indian males possessed significantly lower HDLC values than the male Malay or Chinese. HDLC, triglycerides (TG) and the atherogenic index-LDLC/HDLC ratio were significantly different between the CAD patients and the healthy controls, while total cholesterol (TC) and LDLC did not seem to be of diagnostic value. Serum HDLC was lower in the CAD patients compared to the healthy controls in both sexes (p<0.001), either expressed as HDLC per se or as % HDLC. This observation combined with the odds ratio (OR) values of 0.24 and 0.28 for HDLC and % HDLC respectively in males, firmly establishes HDL as a protective factor of CAD in Malaysians. Significance testing for the X 2 values associated with the OR values for the various lipid indices, together with the findings on the receiver-operating characteristices (ROC) curves, i.e. plots of sensitivity vs 1-specificity, indicated that HDLC, % HDLC and TQ were equally efficient as a means of risk assessment to CAD in Malaysians.

Malaysian Journal of Nutrition

The purpose of this study was to assess the dietary intake of University Putra Malaysia students ... more The purpose of this study was to assess the dietary intake of University Putra Malaysia students using the weighed record method and the 24 hourdietary recall method. The validity of the 24-hour recall method was studied by comparing it with the weighed record method. A total of 40 male and 25 female students age between 18-29 years volunteered to participate in this study. All the subjects were required to weigh and record the foods they ate for 1 day. Without prior knowledge of the purpose of the visit , the 24-hour recall was carried out the following day. The nutrients analysed were calorie, carbohydrates, protein, fat, calcium, iron, vitamin A and vitamin C. Comparisons of the nutrient intake between these two methods were determined. The paired t-test indicated no significant difference in group's mean nutrient intake between the weighed record method for all nutrients. The differences in group mean intake for all nutrients between weighed record and 24-hour recall method ranged from -3% to 3.6%. A total of 4 nutrients were underestimated, namely energy, protein, vitamin C and iron. The correlation coefficients showed a strong positive relationships between the two methods (ranged from r = 0.88-0.98, p < 0.01) for all of the nutrients analysed. In conclusion, the agreement between nutrient values from two different methods indicated that the 24 hour recall is a suitable method for the dietary assessment of university students.

World review of nutrition and dietetics

Malaysian Journal of Nutrition

Meal and snack patterns are associated with energy and nutrient intakes and consequently health a... more Meal and snack patterns are associated with energy and nutrient intakes and consequently health and nutritional status. The aim of this paper is to describe the percentage of daily energy intake from meals and afternoon snack among Malaysian adults. The study included a representative sample of adults aged 18-59 years (n=7349) from a nationwide Food Consumption Survey conducted by the Ministry of Health. Information on dietary intake was obtained using a one day 24-hour diet recall (24-HDR). Dietary data on 6886 adults were analysed using Nutritionist ProTM and statistical analysis was carried out using the SPSS 13.0. The median percentage of daily energy intake is reported only for adults consuming meals and afternoon tea and by socio-demographic characteristics as well as body mass index (BMI) status. More than 80% of Malaysian adults consumed morning meals, lunch and dinner and 54% reported having afternoon tea. The median percentage of energy intake from morning meals, lunch, dinner and afternoon tea was 29.9%, 30.5%, 32.4% and 17%, respectively. There were variations in the median percentage of energy from meals and snacks according to the socio-demographic variables and BMI status. It is important to understand the eating patterns of Malaysians as the information can assist in efforts to address obesity and diet-related chronic diseases among adults.

Malaysian Journal of Nutrition

Nutrition surveys based on a representative sample of the Malaysian adult population have hithert... more Nutrition surveys based on a representative sample of the Malaysian adult population have hitherto not been reported. In 2003, the Ministry of Health, Malaysia, conducted the Malaysian Adult Nutrition Survey (MANS), the first and largest nutrition survey in the country which aimed to provide detailed quantitative information on nutritional status, food and nutrient intakes, and physical activity pattern on a nationwide representative sample of adult subjects between the ages of 18 and 59 years. The survey covered four zones in Peninsular Malaysia (Central, Southern, Northern and East Coast), Sabah and Sarawak. This paper presents the mean and selected percentiles of energy and nutrient intake of 6886 subjects by selected demographic and socioeconomic characteristics. Energy contributions by macronutrients and dietary adequacy in relation to the Recommended Nutrient Intake for Malaysians are also described. Information on dietary intake was collected by trained nutritionists using a one day 24-hour diet recall. Dietary data were analysed using Nutritionist Pro, a diet analysis software and statistical analysis was carried out using the SPSS ver. 13.0. In most of the demographic and socioeconomic groups, males had higher mean energy (1776 kcal) and nutrient intake and percent achievement of RNI than females (1447 kcal). The proportions of calories derived from macronutrients were within the recommendations for a healthy diet. Intake of micronutrients such as iron, calcium and vitamin A was about 50% of RNI particularly in women. Sodium intake of Malaysians, not reported in earlier studies, is also made available. Under-reporting using the EI/BMR ratio was found in half of the population studied. The present study provides the first national estimates of energy and nutrient intake of the Malaysian adult population. Regular nutrition surveys are needed at the national level to provide valuable information on trends in food and nutrient intake, particularly among age and ethnically diverse subgroups of the population.

Malnutrition is associated with poorer outcomes following treatment for colorectal cancer (CRC). ... more Malnutrition is associated with poorer outcomes following treatment for colorectal cancer (CRC). In addition little is known about the relationship between malnutrition and quality of life (QOL). This study aimed to determine the relationship between nutritional status and quality of life (QOL) among CRC patients at oncology outpatient clinics in Hospital Kuala Lumpur and Hospital Selayang, Malaysia. Nutritional status of the patients was determined using scored Patient Generated-Subjective Global Assessment (PG-SGA). QOL of the patients was evaluated using the validated European Organisation for Research and Treatment of Cancer questionnaire (EORTC-QLQ C30). A total of 42 CRC patients due to undergoing chemotherapy post-surgery were included in this study with informed consent. The mean age of participants was 57.1 ± 9.8 years, with a gender distribution of 64% males and 35.7% females. Well-nourished patients had statistically significantly better QOL scores on symptom scales: fati...

Malaysian Journal of Nutrition

This study was conducted on 215 working women from four private corporate companies in a suburb i... more This study was conducted on 215 working women from four private corporate companies in a suburb in Malaysia to determine the factors related to their physical activity levels. Data were collected using a questionnaire which included socio-demographic characteristics, the International Physical Activity Questionnaire (IPAQ), perceived barriers and benefits to physical activity, self-efficacy to physical activity and an 8-item questionnaire on current behavioral stage of physical activity. The majority of the respondents were Malay (81.9%) with 10.2% being Chinese and 7.9% Indian. Most of the respondents were executives (64.2%), while the rest were non-executives (24.7%) and managers (11.2%). The mean weight, height, BMI and waist circumference were 59.4 +/- 13.1 kg, 1.6 +/- 0.6 m, 23.7 +/- 4.8 kg/m2 and 77.0 +/- 12.1cm respectively. In this sample, 24.7% and 7.9% were overweight and obese respectively, while 34% were at risk of abdominal obesity. A total of 28.8% of the respondents h...

Food neophobia, unwillingness to try novel foods, is a personality trait that can influence child... more Food neophobia, unwillingness to try novel foods, is a personality trait that can influence children’s food preferences and consequently their food acceptance and consumption. The purpose of this study was to determine whether children with food neophobia have poor dietary and growth outcomes compared to non-neophobic children. Subjects were 332 primary school children from 6 randomly selected schools in the district of Hulu Selangor, Selangor. Parents and children were interviewed to obtain demographic, socio-economic, food neophobia and dietary intake information. The children were also measured for weights and heights. One-way ANOVA and Chi-square procedures were utilized for statistical data analysis. Children with food neophobia had higher intakes of energy and most nutrients than average and neophilic children. However, only the mean intakes of protein (p<0.05), fat (p<0.05), vitamin A (p<0.01) and iron (p<0.01) were significantly higher in neophobic than average o...

Malaysian Journal of Nutrition

Body image plays an important role in the management of body weight, especially among female adol... more Body image plays an important role in the management of body weight, especially among female adolescents. This study examined the differences in body image perception, weight management knowledge, eating behaviour and physical activity between overweight and normal weight Malaysian female adolescents. Body mass index screening was done on 588 secondary school students to identify overweight (OW) and normal weight (NW) subjects. A BMI-for-age of => 85th percentile and between => 5th and <85th percentile were used as cut-offs for identifying suitable subjects of overweight and normal weight, respectively. Fifty girls identified as being OW were matched for age and ethnicity with 50 NW students. Subjects completed a self-administered questionnaire on demographics, eating behaviour and physical activity, a weight management knowledge inventory (WMKI) and the Body Silhouette Chart. The study sample comprised Malays (40%), Chinese (30%) and Indians (30%) with a mean age of 14.76 ...

Objective: This cross-sectional study was conducted to determine factors associated with school p... more Objective: This cross-sectional study was conducted to determine factors associated with school performance among primary school children in Selangor, Malaysia. Methodology: The children were measured for height and weight and their parents were interviewed to assess demographic and socioeconomic information. Dietary intake data of the children was collected through 24-hour diet recall. Final examination results for four subjects (Mathematics, English and Malay Language – comprehension and composition) were obtained from the schools. Data were analyzed using SPSS version 16. Results: Most of the family (85.2%) had per capita income above the poverty line income of Malaysia. The prevalence of stunting and underweight were 22.3% and 25.1%, respectively, while 8.7% of the children were overweight and obese. Energy intake was low with several nutrients not reaching the recommended intake. Stepwise multiple regression analysis showed that mother s’ education, energy intake and expenditur...

Asian Pacific journal of cancer prevention : APJCP, 2012

Colorectal cancer (CRC) and the metabolic syndrome (MetS) are both on the rise in Malaysia. A mul... more Colorectal cancer (CRC) and the metabolic syndrome (MetS) are both on the rise in Malaysia. A multi-centric case-control study was conducted from December 2009 to January 2011 to determine any relationship between the two. Patients with confirmed CRC based on colonoscopy findings and cancer free controls from five local hospitals were assessed for MetS according to the International Diabetes Federation (IDF) definition. Each index case was matched for age, gender and ethnicity with two controls (140: 280). MetS among cases was highly prevalent (70.7%), especially among women (68.7%). MetS as an entity increased CRC risk by almost three fold independently (OR=2.61, 95%CI=1.53-4.47). In men MetS increased the risk of CRC by two fold (OR=2.01, 95%CI, 1.43-4.56), demonstrating an increasing trend in risk with the number of Mets components observed. This study provides evidence for a positive association between the metabolic syndrome and colorectal cancer. A prospective study on the Mal...

Asia Pacific journal of clinical nutrition, 2009

This paper reports on the presence of dual burden households in Orang Asli (OA, indigenous people... more This paper reports on the presence of dual burden households in Orang Asli (OA, indigenous people) communities and its associated factors. A total of 182 OA households in two districts in Selangor with the required criteria (182 non-pregnant women of child bearing age and 284 children aged 2-9 years old) participated in the study. Height and weight of both women and children were measured. Energy intake and food variety score (FVS) were determined using three 24-hour diet recalls. While 58% were underweight and 64% of the children were stunted, the prevalence of overweight and obesity in women were 31% and 20% respectively. The percentage of dual burden households (overweight mother/underweight child) was 25.8% while 14.8% households had normal weight mother/normal weight child. The mean food variety score (FVS) was similar for women (7.0+/-2.1) and children (6.9+/-1.9). Dual burden households were associated with women's employment status (OR: 3.18, 95% CI: 2.65-5.66), FVS of c...

Singapore medical journal, 2006

Paediatric obesity is a public health concern worldwide as it can track into adulthood and increa... more Paediatric obesity is a public health concern worldwide as it can track into adulthood and increase the risk of adult morbidity and mortality. While the aetiology of obesity is multi-factorial, the roles of diet and physical activity are controversial. Thus, the purpose of this study was to report on the differences in energy intake, diet composition, time spent doing physical activity and energy expenditure among underweight (UW), normal weight (NW) and at-risk of overweight (OW) Malaysian adolescents (317 females and 301 males) aged 11-15 years. This was a cross-sectional study with 6,555 adolescents measured for weights and heights for body mass index (BMI) categorisation. A total of 618 subjects were randomly selected from each BMI category according to gender. The subjects' dietary intake and physical activity were assessed using self-reported three-day food and activity records, respectively. Dietary intake components included total energy and macronutrient intakes. Energy...

The Medical journal of Malaysia, 2006

The purpose of this study was to report on the estimates and distribution of body mass index in a... more The purpose of this study was to report on the estimates and distribution of body mass index in a sample of Malaysian adolescents. The study utilized a cross-sectional design and multi-stage random sampling of secondary schools to select 5 urban and 9 rural schools in Kedah and Penang. A total of 6555 male and female adolescents (11-15 years old) of Malay, Chinese and Indian ethnic groups were measured for weights and heights for body mass index calculation. Information on household demographic and socioeconomic were obtained from parents through self-administered questionnaires. Analyses of body mass index distribution by location, ethnicity, gender and age were conducted using Chi-square test of SPSS 11.5. More of the rural (12.1%) and urban (19.4%) adolescents were underweight and overweight, respectively. While in all ethnic, gender and age groups, rural adolescents were more likely to be underweight, more of the urban adolescents were overweight. The prevalence of underweight w...

The American journal of clinical nutrition, 1999

Iron deficiency and its consequent anemia constitute the commonest micronutrient deficiency in th... more Iron deficiency and its consequent anemia constitute the commonest micronutrient deficiency in the world. We investigated whether long-term, weekly iron-folate supplements administered at school would improve hemoglobin and ferritin concentrations in adolescent girls, including those with mild-to-moderate anemia and hemoglobin concentrations indicating borderline anemia. Subjects were 266 girls with hemoglobin concentrations of 80-119.9 g/L (group A) and 358 girls with hemoglobin concentrations of 120-130 g/L (group B) who were otherwise healthy. Two hundred sixty-six girls in group A and 268 girls in group B were randomly assigned to receive either 60 or 120 mg Fe plus 3.5 mg folic acid weekly for 22 wk. Ninety of the girls in group B were randomly assigned to receive only 5 mg folic acid weekly. Capillary hemoglobin and plasma ferritin were measured at baseline and after 12 and 22 wk of supplementation. By the end of the study, 2% of the girls had dropped out and > 96% had take...

Malaysian journal of nutrition, 2010

Understanding the experiences of household food insecurity is essential for better measurement an... more Understanding the experiences of household food insecurity is essential for better measurement and assessment of its nutritional, physical and psychological consequences. This qualitative study explored coping strategies and their perceived severity in relation to household food insecurity. Women (n=57; 20-50 years old) from rural and urban areas in Selangor and Negeri Sembilan participated in this study. These women were interviewed using a semi-structured questionnaire. The questionnaire was divided into two parts, that is, demographic and socio-economic information and women's experiences of coping with household food insecurity. Women were chosen since they were primarily responsible for food acquisition and preparation for the all household members. Thematic analysis was utilized in data analysis. Thematic analysis is a method for identifying, analysing and reporting patterns and themes of the qualitative data. Themes capture something important related to the study objecti...

American Journal of Hospice and Palliative Medicine, Mar 1, 2010

This study aimed to evaluate the nutritional status of patients with cancer in palliative care an... more This study aimed to evaluate the nutritional status of patients with cancer in palliative care and to examine the interrelationship between objective and subjective nutritional assessment measures. Patients&amp;amp;#39; nutritional status in a palliative care unit of a Malaysian government hospital and a hospice facility were assessed using anthropometric measurements, weight loss at 1/6 months, and the scored patient-generated subjective global assessment (PG-SGA). Moderate-to-severe malnutrition was observed in a range from 31% to 69% using both measurements. Common nutritional impact symptoms were pain, xerostomia, and anorexia. Patient-generated subjective global assessment scores were significantly correlated with anthropometric measurements (P &amp;amp;lt; .050). The PG-SGA is equally informative as objective indicators and is recommended as a quickly applied tool for nutritional status assessment of patients with cancer in palliative care.

Asia Pacific Journal of Clinical Nutrition, 2014

in English, Chinese這個橫斷性研究評估在低收入地區的育齡婦女(625 位)，其家戶糧食不安全性 與代謝症候群的相關性。利用Radimer/Cornell 飢餓及糧食不安... more in English, Chinese這個橫斷性研究評估在低收入地區的育齡婦女(625 位)，其家戶糧食不安全性 與代謝症候群的相關性。利用Radimer/Cornell 飢餓及糧食不安全指南以評估糧 食不安全性。並取得體位測量值、飲食多樣性、血壓及禁食靜脈血脂及血糖 值。依據國際統一分類標準(Harmonized criteria)，代謝症候群的定義為至少有 3 項危險因子。糧食不安全(家戶糧食不安全26.7%；個人糧食不安全25.3%； 孩童飢餓26.4%)及代謝症候群的盛行率分別是78.4%及25.6%。雖然糧食安全 比起有糧食不安全的婦女有較高的血糖(糧食安全54.8%比上糧食不安全37.3- 46.1%)、總膽固醇(54.1%比上32.1-40.7%)及低密度脂蛋白膽固醇(63.7%比上 40.6-48.7%)，但是依糧食不安全程度來看，婦女體重過重/肥胖、腹部肥胖、 高血壓、高三酸甘油酯、低的高密度脂蛋白-膽固醇及代謝症候群的百分比， 都沒有顯著的差異。然而，在控制人口學及社經地位變項後，家戶糧食不安全 的婦女比起糧食安全的婦女有較少比率的代謝症候群(個人糧食不安全及孩童 飢餓)(p<0.05)、腹部肥胖(個人糧食不安全及孩童飢餓)(p<0.01)、高血糖(家戶 糧食不安全)、高總膽固醇(孩童飢餓)(p<0.05)及高的低密度脂蛋白膽固醇(家戶 糧食不安全及孩童飢餓)。低收入家戶處於營養轉型之際，致力於改善他們的 糧食不安全，應該著重健康食物選擇的可用性及可獲性與營養教育，以降低飲 食相關慢性疾病的風險。

The use of email and website as channels for workplace health information delivery is not fully e... more The use of email and website as channels for workplace health information delivery is not fully explored. This study aims to describe the rationale, design, and baseline findings of an email-linked website intervention to improve modifiable cancer risk factors. Employees of a Malaysian public university were recruited by systematic random sampling and randomised into an intervention (n = 174) or control group (n = 165). A website was developed for the intervention and educational modules were uploaded onto the website. The intervention group received ten consecutive weekly emails with hypertext links to the website for downloading the modules and two individual phone calls as motivational support whilst the control group received none. Diet, lifestyle, anthropometric measurements, psychosocial factors and stages of change related to dietary fat, fruit and vegetable intake, and physical activity were assessed. Participants were predominantly female and in non-academic positions. Obesity was prevalent in 15% and 37% were at risk of co-morbidities. Mean intake of fats was 31%, fruit was -1 serving/day and vegetable was &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 1 serving/day. Less than 20% smoked and drank alcohol and about 40% were physically inactive. The majority of the participants fell into the Preparation stage for decreasing fat intake, eating more fruit and vegetables, and increasing physical activity. Self-efficacy and perceived benefits were lowest among participants in the Precontemplation/Contemplation stage compared to the Preparation and Action/Maintenance stages. Baseline data show that dietary and lifestyle practices among the employees did not meet the international guidelines for cancer prevention. Hence the findings warrant the intervention planned.

Nutrition Research and Practice, Dec 1, 2010

Cardiovascular disease is a leading cause of death and disability and remains so in the future. T... more Cardiovascular disease is a leading cause of death and disability and remains so in the future. The aim of this study was to detect the impact of a 6-month diet intervention on cardiovascular risk factors in postmenopausal Iranian women. It was a randomized controlled trial that carried out in the East Health Clinic in Ahvaz-Iran. This study started on June 2007 and was completed on May 2008. A total 64 healthy postmenopausal women recruited and randomly assigned to the intervention group (35) and control (29). Over the six months follow-up, the intervention group received five educational sessions (two face to face and three lecture discussion classes with slide demonstration) at the first month. These sessions were about menopause, cardiovascular disease and healthy diet. Every participant in the intervention group received one face to face education session at the 3 rd month, and also received a telephone call at the end of each month starting with the second month to remain on the diet. Pre-intervention and post-intervention anthropometric measurements, blood pressure, blood lipids and dietary intake were assessed. Data analyzed using the SPSS version 15. Descriptive (means and SD), univariate (Paired-t test, Chi-Square and Independent T-test) and multivariate (GLM Repeated Measure) statistics were used. Participants in the diet group had significantly lower weight (-0.9 kg), body mass index (-0.4 kg/m 2 ), and fasting blood sugar (-4.5 mg/dl). The diet group significantly increased their daily intake of fiber (+2.3 g, P = 0.05), decreased their intake of sodium (-28 mg, P = 0.04), and consumption of fruit and vegetable ≥ 5 serving a day (80%, P = 0.03) compared to the control group. Post menopausal women are at a greater risk for cardiovascular disease. Healthy diet using educational intervention can be an effective means of reducing cardiovascular risk in postmenopausal women.

Malaysian Journal of Nutrition

Fasting serum specimens from (a) 217 male and 46 female patients with coronary artery disease (CA... more Fasting serum specimens from (a) 217 male and 46 female patients with coronary artery disease (CAD), aged 35-75 years, who had undergone angioplasty (PTCA) / coronary artery bypass graft (CABG), and (b) 160 apparently healthy controls (106 males, 54 females, aged 30-75 years), were assessed for serum lipid profile. Both sex and ethnicity significantly influenced the levels of serum high density lipoprotein cholesterol (HDLC); in the controls, females had higher HDLC levels than males (46.7 mg/dl vs 38.5 mg/dl, p<0.00l), while the Indian males possessed significantly lower HDLC values than the male Malay or Chinese. HDLC, triglycerides (TG) and the atherogenic index-LDLC/HDLC ratio were significantly different between the CAD patients and the healthy controls, while total cholesterol (TC) and LDLC did not seem to be of diagnostic value. Serum HDLC was lower in the CAD patients compared to the healthy controls in both sexes (p<0.001), either expressed as HDLC per se or as % HDLC. This observation combined with the odds ratio (OR) values of 0.24 and 0.28 for HDLC and % HDLC respectively in males, firmly establishes HDL as a protective factor of CAD in Malaysians. Significance testing for the X 2 values associated with the OR values for the various lipid indices, together with the findings on the receiver-operating characteristices (ROC) curves, i.e. plots of sensitivity vs 1-specificity, indicated that HDLC, % HDLC and TQ were equally efficient as a means of risk assessment to CAD in Malaysians.

Malaysian Journal of Nutrition

The purpose of this study was to assess the dietary intake of University Putra Malaysia students ... more The purpose of this study was to assess the dietary intake of University Putra Malaysia students using the weighed record method and the 24 hourdietary recall method. The validity of the 24-hour recall method was studied by comparing it with the weighed record method. A total of 40 male and 25 female students age between 18-29 years volunteered to participate in this study. All the subjects were required to weigh and record the foods they ate for 1 day. Without prior knowledge of the purpose of the visit , the 24-hour recall was carried out the following day. The nutrients analysed were calorie, carbohydrates, protein, fat, calcium, iron, vitamin A and vitamin C. Comparisons of the nutrient intake between these two methods were determined. The paired t-test indicated no significant difference in group's mean nutrient intake between the weighed record method for all nutrients. The differences in group mean intake for all nutrients between weighed record and 24-hour recall method ranged from -3% to 3.6%. A total of 4 nutrients were underestimated, namely energy, protein, vitamin C and iron. The correlation coefficients showed a strong positive relationships between the two methods (ranged from r = 0.88-0.98, p < 0.01) for all of the nutrients analysed. In conclusion, the agreement between nutrient values from two different methods indicated that the 24 hour recall is a suitable method for the dietary assessment of university students.

World review of nutrition and dietetics

Malaysian Journal of Nutrition

Meal and snack patterns are associated with energy and nutrient intakes and consequently health a... more Meal and snack patterns are associated with energy and nutrient intakes and consequently health and nutritional status. The aim of this paper is to describe the percentage of daily energy intake from meals and afternoon snack among Malaysian adults. The study included a representative sample of adults aged 18-59 years (n=7349) from a nationwide Food Consumption Survey conducted by the Ministry of Health. Information on dietary intake was obtained using a one day 24-hour diet recall (24-HDR). Dietary data on 6886 adults were analysed using Nutritionist ProTM and statistical analysis was carried out using the SPSS 13.0. The median percentage of daily energy intake is reported only for adults consuming meals and afternoon tea and by socio-demographic characteristics as well as body mass index (BMI) status. More than 80% of Malaysian adults consumed morning meals, lunch and dinner and 54% reported having afternoon tea. The median percentage of energy intake from morning meals, lunch, dinner and afternoon tea was 29.9%, 30.5%, 32.4% and 17%, respectively. There were variations in the median percentage of energy from meals and snacks according to the socio-demographic variables and BMI status. It is important to understand the eating patterns of Malaysians as the information can assist in efforts to address obesity and diet-related chronic diseases among adults.

Malaysian Journal of Nutrition

Nutrition surveys based on a representative sample of the Malaysian adult population have hithert... more Nutrition surveys based on a representative sample of the Malaysian adult population have hitherto not been reported. In 2003, the Ministry of Health, Malaysia, conducted the Malaysian Adult Nutrition Survey (MANS), the first and largest nutrition survey in the country which aimed to provide detailed quantitative information on nutritional status, food and nutrient intakes, and physical activity pattern on a nationwide representative sample of adult subjects between the ages of 18 and 59 years. The survey covered four zones in Peninsular Malaysia (Central, Southern, Northern and East Coast), Sabah and Sarawak. This paper presents the mean and selected percentiles of energy and nutrient intake of 6886 subjects by selected demographic and socioeconomic characteristics. Energy contributions by macronutrients and dietary adequacy in relation to the Recommended Nutrient Intake for Malaysians are also described. Information on dietary intake was collected by trained nutritionists using a one day 24-hour diet recall. Dietary data were analysed using Nutritionist Pro, a diet analysis software and statistical analysis was carried out using the SPSS ver. 13.0. In most of the demographic and socioeconomic groups, males had higher mean energy (1776 kcal) and nutrient intake and percent achievement of RNI than females (1447 kcal). The proportions of calories derived from macronutrients were within the recommendations for a healthy diet. Intake of micronutrients such as iron, calcium and vitamin A was about 50% of RNI particularly in women. Sodium intake of Malaysians, not reported in earlier studies, is also made available. Under-reporting using the EI/BMR ratio was found in half of the population studied. The present study provides the first national estimates of energy and nutrient intake of the Malaysian adult population. Regular nutrition surveys are needed at the national level to provide valuable information on trends in food and nutrient intake, particularly among age and ethnically diverse subgroups of the population.

Malnutrition is associated with poorer outcomes following treatment for colorectal cancer (CRC). ... more Malnutrition is associated with poorer outcomes following treatment for colorectal cancer (CRC). In addition little is known about the relationship between malnutrition and quality of life (QOL). This study aimed to determine the relationship between nutritional status and quality of life (QOL) among CRC patients at oncology outpatient clinics in Hospital Kuala Lumpur and Hospital Selayang, Malaysia. Nutritional status of the patients was determined using scored Patient Generated-Subjective Global Assessment (PG-SGA). QOL of the patients was evaluated using the validated European Organisation for Research and Treatment of Cancer questionnaire (EORTC-QLQ C30). A total of 42 CRC patients due to undergoing chemotherapy post-surgery were included in this study with informed consent. The mean age of participants was 57.1 ± 9.8 years, with a gender distribution of 64% males and 35.7% females. Well-nourished patients had statistically significantly better QOL scores on symptom scales: fati...

Malaysian Journal of Nutrition

This study was conducted on 215 working women from four private corporate companies in a suburb i... more This study was conducted on 215 working women from four private corporate companies in a suburb in Malaysia to determine the factors related to their physical activity levels. Data were collected using a questionnaire which included socio-demographic characteristics, the International Physical Activity Questionnaire (IPAQ), perceived barriers and benefits to physical activity, self-efficacy to physical activity and an 8-item questionnaire on current behavioral stage of physical activity. The majority of the respondents were Malay (81.9%) with 10.2% being Chinese and 7.9% Indian. Most of the respondents were executives (64.2%), while the rest were non-executives (24.7%) and managers (11.2%). The mean weight, height, BMI and waist circumference were 59.4 +/- 13.1 kg, 1.6 +/- 0.6 m, 23.7 +/- 4.8 kg/m2 and 77.0 +/- 12.1cm respectively. In this sample, 24.7% and 7.9% were overweight and obese respectively, while 34% were at risk of abdominal obesity. A total of 28.8% of the respondents h...

Food neophobia, unwillingness to try novel foods, is a personality trait that can influence child... more Food neophobia, unwillingness to try novel foods, is a personality trait that can influence children’s food preferences and consequently their food acceptance and consumption. The purpose of this study was to determine whether children with food neophobia have poor dietary and growth outcomes compared to non-neophobic children. Subjects were 332 primary school children from 6 randomly selected schools in the district of Hulu Selangor, Selangor. Parents and children were interviewed to obtain demographic, socio-economic, food neophobia and dietary intake information. The children were also measured for weights and heights. One-way ANOVA and Chi-square procedures were utilized for statistical data analysis. Children with food neophobia had higher intakes of energy and most nutrients than average and neophilic children. However, only the mean intakes of protein (p<0.05), fat (p<0.05), vitamin A (p<0.01) and iron (p<0.01) were significantly higher in neophobic than average o...

Malaysian Journal of Nutrition

Body image plays an important role in the management of body weight, especially among female adol... more Body image plays an important role in the management of body weight, especially among female adolescents. This study examined the differences in body image perception, weight management knowledge, eating behaviour and physical activity between overweight and normal weight Malaysian female adolescents. Body mass index screening was done on 588 secondary school students to identify overweight (OW) and normal weight (NW) subjects. A BMI-for-age of => 85th percentile and between => 5th and <85th percentile were used as cut-offs for identifying suitable subjects of overweight and normal weight, respectively. Fifty girls identified as being OW were matched for age and ethnicity with 50 NW students. Subjects completed a self-administered questionnaire on demographics, eating behaviour and physical activity, a weight management knowledge inventory (WMKI) and the Body Silhouette Chart. The study sample comprised Malays (40%), Chinese (30%) and Indians (30%) with a mean age of 14.76 ...

Objective: This cross-sectional study was conducted to determine factors associated with school p... more Objective: This cross-sectional study was conducted to determine factors associated with school performance among primary school children in Selangor, Malaysia. Methodology: The children were measured for height and weight and their parents were interviewed to assess demographic and socioeconomic information. Dietary intake data of the children was collected through 24-hour diet recall. Final examination results for four subjects (Mathematics, English and Malay Language – comprehension and composition) were obtained from the schools. Data were analyzed using SPSS version 16. Results: Most of the family (85.2%) had per capita income above the poverty line income of Malaysia. The prevalence of stunting and underweight were 22.3% and 25.1%, respectively, while 8.7% of the children were overweight and obese. Energy intake was low with several nutrients not reaching the recommended intake. Stepwise multiple regression analysis showed that mother s’ education, energy intake and expenditur...

Asian Pacific journal of cancer prevention : APJCP, 2012

Colorectal cancer (CRC) and the metabolic syndrome (MetS) are both on the rise in Malaysia. A mul... more Colorectal cancer (CRC) and the metabolic syndrome (MetS) are both on the rise in Malaysia. A multi-centric case-control study was conducted from December 2009 to January 2011 to determine any relationship between the two. Patients with confirmed CRC based on colonoscopy findings and cancer free controls from five local hospitals were assessed for MetS according to the International Diabetes Federation (IDF) definition. Each index case was matched for age, gender and ethnicity with two controls (140: 280). MetS among cases was highly prevalent (70.7%), especially among women (68.7%). MetS as an entity increased CRC risk by almost three fold independently (OR=2.61, 95%CI=1.53-4.47). In men MetS increased the risk of CRC by two fold (OR=2.01, 95%CI, 1.43-4.56), demonstrating an increasing trend in risk with the number of Mets components observed. This study provides evidence for a positive association between the metabolic syndrome and colorectal cancer. A prospective study on the Mal...

Asia Pacific journal of clinical nutrition, 2009

This paper reports on the presence of dual burden households in Orang Asli (OA, indigenous people... more This paper reports on the presence of dual burden households in Orang Asli (OA, indigenous people) communities and its associated factors. A total of 182 OA households in two districts in Selangor with the required criteria (182 non-pregnant women of child bearing age and 284 children aged 2-9 years old) participated in the study. Height and weight of both women and children were measured. Energy intake and food variety score (FVS) were determined using three 24-hour diet recalls. While 58% were underweight and 64% of the children were stunted, the prevalence of overweight and obesity in women were 31% and 20% respectively. The percentage of dual burden households (overweight mother/underweight child) was 25.8% while 14.8% households had normal weight mother/normal weight child. The mean food variety score (FVS) was similar for women (7.0+/-2.1) and children (6.9+/-1.9). Dual burden households were associated with women's employment status (OR: 3.18, 95% CI: 2.65-5.66), FVS of c...

Singapore medical journal, 2006

Paediatric obesity is a public health concern worldwide as it can track into adulthood and increa... more Paediatric obesity is a public health concern worldwide as it can track into adulthood and increase the risk of adult morbidity and mortality. While the aetiology of obesity is multi-factorial, the roles of diet and physical activity are controversial. Thus, the purpose of this study was to report on the differences in energy intake, diet composition, time spent doing physical activity and energy expenditure among underweight (UW), normal weight (NW) and at-risk of overweight (OW) Malaysian adolescents (317 females and 301 males) aged 11-15 years. This was a cross-sectional study with 6,555 adolescents measured for weights and heights for body mass index (BMI) categorisation. A total of 618 subjects were randomly selected from each BMI category according to gender. The subjects' dietary intake and physical activity were assessed using self-reported three-day food and activity records, respectively. Dietary intake components included total energy and macronutrient intakes. Energy...

The Medical journal of Malaysia, 2006

The purpose of this study was to report on the estimates and distribution of body mass index in a... more The purpose of this study was to report on the estimates and distribution of body mass index in a sample of Malaysian adolescents. The study utilized a cross-sectional design and multi-stage random sampling of secondary schools to select 5 urban and 9 rural schools in Kedah and Penang. A total of 6555 male and female adolescents (11-15 years old) of Malay, Chinese and Indian ethnic groups were measured for weights and heights for body mass index calculation. Information on household demographic and socioeconomic were obtained from parents through self-administered questionnaires. Analyses of body mass index distribution by location, ethnicity, gender and age were conducted using Chi-square test of SPSS 11.5. More of the rural (12.1%) and urban (19.4%) adolescents were underweight and overweight, respectively. While in all ethnic, gender and age groups, rural adolescents were more likely to be underweight, more of the urban adolescents were overweight. The prevalence of underweight w...

The American journal of clinical nutrition, 1999

Iron deficiency and its consequent anemia constitute the commonest micronutrient deficiency in th... more Iron deficiency and its consequent anemia constitute the commonest micronutrient deficiency in the world. We investigated whether long-term, weekly iron-folate supplements administered at school would improve hemoglobin and ferritin concentrations in adolescent girls, including those with mild-to-moderate anemia and hemoglobin concentrations indicating borderline anemia. Subjects were 266 girls with hemoglobin concentrations of 80-119.9 g/L (group A) and 358 girls with hemoglobin concentrations of 120-130 g/L (group B) who were otherwise healthy. Two hundred sixty-six girls in group A and 268 girls in group B were randomly assigned to receive either 60 or 120 mg Fe plus 3.5 mg folic acid weekly for 22 wk. Ninety of the girls in group B were randomly assigned to receive only 5 mg folic acid weekly. Capillary hemoglobin and plasma ferritin were measured at baseline and after 12 and 22 wk of supplementation. By the end of the study, 2% of the girls had dropped out and > 96% had take...

Malaysian journal of nutrition, 2010

Understanding the experiences of household food insecurity is essential for better measurement an... more Understanding the experiences of household food insecurity is essential for better measurement and assessment of its nutritional, physical and psychological consequences. This qualitative study explored coping strategies and their perceived severity in relation to household food insecurity. Women (n=57; 20-50 years old) from rural and urban areas in Selangor and Negeri Sembilan participated in this study. These women were interviewed using a semi-structured questionnaire. The questionnaire was divided into two parts, that is, demographic and socio-economic information and women's experiences of coping with household food insecurity. Women were chosen since they were primarily responsible for food acquisition and preparation for the all household members. Thematic analysis was utilized in data analysis. Thematic analysis is a method for identifying, analysing and reporting patterns and themes of the qualitative data. Themes capture something important related to the study objecti...