Sharifah Wajihah Wafa | Universiti Sultan Zainal Abidin, Terengganu, Malaysia (original) (raw)

Papers by Sharifah Wajihah Wafa

PLOS ONE

Introduction Unhealthy weight, especially childhood obesity, is emerging as a growing epidemic an... more Introduction Unhealthy weight, especially childhood obesity, is emerging as a growing epidemic and a challenge in developed and developing countries. Partnership with parents to promote healthy lifestyle changes may have a lifelong impact on weight-related outcomes in children. This study aims to determine the efficacy of an Interactive Malaysian Childhood Healthy Lifestyle (i-MaCHeL) intervention programme to change weight-related behaviour in preschool child-parent dyads. Materials and methods The i-MaCHeL programme is a single-blind, theory-driven intervention, two-group cluster randomised controlled trial that evaluates the efficacy of a 3-month health promotion intervention in preschool child-parent dyads. In recognition of the value of multiple theoretical approaches, the strong theoretical basis consists of Social Cognitive Theory, Health Belief Model, and Trans-Theoretical Model principles underpinning the development of the intervention programme. In total, 460 child-parent...

Saudi Medical Journal

Objectives: To review relevant literature on the determinants of the nutritional status of the ch... more Objectives: To review relevant literature on the determinants of the nutritional status of the children below 5 years of age in the Eastern Mediterranean Regional (EMR) countries and investigate the updates related to risk factors associated with malnutrition. Methods: A search of pertinent literature and databases was conducted using the PubMed and Google Scholar databases by applying some keywords. Results: From the available literature reviewed, the mean prevalence of underweight, wasting, and stunting of the children below 5 years of age in the EMR were 12.8% (6.4%-22.6%), 7.5% (5.9%-9.4%), and 24.2% (15.6%-35.5%) respectively. The EMR countries like Sudan, Yemen, Libya, Afghanistan and Pakistan showed the highest rate of stunting amongst the children (>30%). Furthermore, on average, 5.7% of the children were seen to be overweight. Countries such as Lebanon, Egypt, Syria, Libya, and Tunisia reported the maximal prevalence of overweight children. The study also identified a positive and negative relationship between demographic and socioeconomic and health determinants with nutritional status of these children under 5 years old. Conclusion: In this review, the researchers have highlighted the prevalence of malnutrition in EMR countries. Thereafter, the review findings recommend for prioritization of different policies which aimed to improve the nutritional status of the people.

Malaysian Journal of Medical Sciences, 2022

Background: Early detection of high-risk people for type 2 diabetes mellitus (T2DM) using a simpl... more Background: Early detection of high-risk people for type 2 diabetes mellitus (T2DM) using a simple, non-invasive and cost-effective assessment tool helps to identify and prevent members of the community from developing this disease. Therefore, this study aims to translate the American Diabetes Association (ADA) diabetes risk test for Malaysians and then evaluate its validity. Methods: This cross-sectional study was conducted between March 2019 and April 2019. The instrument underwent forward and backward translation according to Behling and Law’s technique. Content validity was performed by two experts and face validity was conducted among 35 convenience samples from Kota Bharu, Kelantan. Both were analysed using content validity index and face validity index, respectively. Results: All respondents were Malay, and had attained tertiary education with a mean (standard deviation [SD]) age of 20.63 (2.80) years old and BMI of 30.45 (5.99). Among the respondents, 57.1%, 94.3% and 80% we...

Research Journal of Pharmacy and Technology, 2020

Cognitive recovery is a major concern to traumatic brain injury (TBI) patients and their caregive... more Cognitive recovery is a major concern to traumatic brain injury (TBI) patients and their caregivers as patients need to resume normal life after hospital discharge. A recent discovery showed that low calorie was beneficial for cognitive function with lower mortality rate and produced better clinical outcomes in critically-ill and medical intensive care unit patients. However, the effect of low calorie on cognitive function among TBI patients has not been determined yet. Hence this study was conducted to provide preliminary evidence of the relation between calorie and cognitive function and to determine calorie adequacy for optimal cognitive recovery among them. This pilot study involved ten patients recruited from Hospital Sultanah Nur Zahirah, Kuala Terengganu. The patients underwent a series of nutritional assessments including 24-hours diet recall combined with food diary; neuropsychology test [Montreal Cognitive Assessment (MoCA)], and eye-open-eye-close paradigm of electroencephalography (EEG) for two to six days. Socio-demography, nutritional and neuropsychology data were analyzed using SPSS version 22 with the percentage of calorie intake (%CI) was set as the independent variable; whilst duration to finish trail-making subtest (FT), and the total score (TS) of MoCA were the dependent variables. EEG data were analyzed using Fast-Fourier Transform (FFT) and power ratio (PR) which is the ratio of slow to fast frequency brain band was calculated. Then the comparison of %CI, FT, TS, and PR were done between day-1 and discharge-day (early or follow-up visit in EEG). Six male and four female patients with mild TBI, median age 24.0 years (IQR = 9.5) were included in the study. Scatter dot plot between %CI to FT and TS showed that the graph increased at the beginning before it became a plateau at 70%. The %CI had significant negative correlation with FT (r = -0.717; p = 0.000) but positive correlation with TS (r = 0.789; p = 0.000). Results revealed that cognitive function was improved at low %CI, approximately below CI of 70%. Improvement in neuropsychology test results was strengthened by the significant differences of median EEG power ratio between follow-up and first visit (p = 0.000). In this pilot study, it appears that cognitive function showed improvement with low calorie intake among TBI patients.

Proceedings of the Nutrition Society, 2017

Obesity among schoolchildren has been regarded as one of the most serious public health challenge... more Obesity among schoolchildren has been regarded as one of the most serious public health challenges in this decade. This problem has now become more evident in the developing countries including Malaysia. It is linked with numerous risk factors mainly unhealthy lifestyle (1). Despite many surveys that have been conducted globally, the latest data on its determinants among Malaysian schoolchildren, particularly in suburban state like Terengganu, is limited. Therefore, this study aimed to provide the current analysis on obesity determinants including demographic, socioeconomic status, dietary intake, physical activity, and physical fitness level and its relationship with childhood obesity. Using a cross-sectional study design, a total of 1,404 schoolchildren were involved in the study (46•3 % boys and 53•7 % girls; 67•7 % urban and 32•3 % rural). Data on demographic and socioeconomic were gathered using a selfadministered questionnaire. Height and body weight were measured and BMI-forage Z-score was calculated using WHO AnthroPlus software and compared with WHO BMI-forage Z-score classifications (2007) (2). Dietary intake and physical activity level were measured using FFQ and c-PAQ, respectively, whereas physical fitness level was assessed using SEGAK test, a standardised fitness norm test for Malaysian students. All data were analysed using multivariable analysis. Interestingly in the final model, obesity in both genders was found to be positively associated with parental obesity, birth weight and serving of milk and dairy products intake whilst negatively associated with household size. Schoolchildren of father or mother with one unit higher in BMI, will have 0•073 unit or 0•069 unit higher in BMI Z-score, respectively (P < 0•001). Schoolchildren who were 1 kg heavier at birth will have 0•357 unit higher in BMI Z-score (P = 0•003). Similarly, an increase in one serving size of milk and dairy products intake will increase BMI Z-score by 0•194 unit (P = 0•036). Nevertheless, schoolchildren with one extra household family member will have 0•085 unit lower in BMI Z-score (P = 0•022). Overall, 13•1 % of the variation in BMI Z-score was explained by father's BMI, mother's BMI, birth weight, household number, and serving size milk and dairy products according to the multiple linear regression (MLR) model (R 2 = 0•131).

Journal of Fundamental and Applied Sciences, 2018

A cross-sectional study determine physical activity level among 95 undergraduate students at UniS... more A cross-sectional study determine physical activity level among 95 undergraduate students at UniSZA using pedometer. Subjects consented and completed socio-demographic details, weight and height were measured. Each subject was supplied with a pedometer and wear it for a week and record steps per day from the pedometer each night before bed. Descriptive statistic and independent T-test coefficient analyze the data using IBM SPSS version 22.0. Results showed that 66.4% of the subjects were classified as sedentary according to pedometer determined physical activity. Males recorded significantly more steps than female per day. Subjects in the age group of 18-20 years old had the highest mean average steps count than the older age group of 21-24 years old and ≥ 25 years old per day. Only 5.2% were classified as active and highly active using pedometer determined physical activity level. Keywords: physical activity; pedometer; steps; body composition

The International Journal of Academic Research in Business and Social Sciences, 2017

Rapid development in the urbanisation process is linked to a shift in dietary intake and lifestyl... more Rapid development in the urbanisation process is linked to a shift in dietary intake and lifestyle. The locality may also determine the differences in socio-demographic and environmental factors related to nutrition between the rural and urban populations. The present study aimed to determine prevalence of obesity and to compare the body weight status on body weight status among school adolescents aged 10 to 17 years within districts of Terengganu. A cross sectional survey involving school adolescents aged 10 to 17 years from all government school in seven districts in Terengganu were carried out. Anthropometrics data were obtained from National Fitness Standard (SEGAK) assessment which was uploaded into specific developed database Health Monitoring System (HEMS) and BMI were classified using WHO BMI-for-age zscore. A total of 62,567 school adolescents were involved in this study. Girls had significantly higher BMI than boys in age groups of 13 to 15 and 16 to 17 years old. There we...

International students usually experience a change in body weight and eating behaviour after migr... more International students usually experience a change in body weight and eating behaviour after migrating to a host country. The aim of this study is to determine the factors associated with body weight changes among Nigerian postgraduate students at Unversiti Sultan Zainal Abidin (UniSZA), Malaysia. A prospective study was conducted for six months to determine the association between body weight changes and socio-demographic, eating behavior, physical activity, dietary intake and quality of life. A total of 82 students (76 male and six females) completed a set of self-administered questionnaires, and their weight and height were measured. Descriptive statistic and paired t-test were carried out to analyze the data (IBM SPSS Version 20.0). Multiple linear regression analysis was conducted to determine the factors. Body weight significantly increased by 2.3 ± 0.5 kg after 6 months. Being an art student (β=1.67, p=0.006), being a female (β=-2.68, p=0.009), consuming breakfast once a week...

BMC Pediatrics, 2021

Background Childhood obesity has been associated with increased odds of adult obesity and co-morb... more Background Childhood obesity has been associated with increased odds of adult obesity and co-morbidities in later life. Finding the key determinants may help in designing the most appropriate and effective interventions to prevent obesity. This study aimed to identify the determinants of obesity among school adolescents in a sub-urban state of Malaysia. Methods This cross-sectional study involved 1,404 school adolescents aged 12 years (46% boys and 54% girls). Socio-demographic, dietary and physical activity data were collected using questionnaires whilst body weight and height were measured and body mass index was classified based on WHO BMI-for-age Z-scores cut-off. Results A multivariable linear regression model showed that BMI z-score was positively associated with parents’ BMI (P<0.001), birth weight (P=0.003), and serving size of milk and dairy products (P=0.036) whilst inversely associated with household size (P=0.022). Overall, 13.1% of the variances in BMI Z-scores were ...

Universal Journal of Educational Research, 2020

Since the announcement of the movement control order (MCO) to help curb the spread of COVID-19 vi... more Since the announcement of the movement control order (MCO) to help curb the spread of COVID-19 virus, education institutions across the nation have taken great measures to ensure that their students can continue learning through digital means. Hence, academicians and students have to start setting their mind that they have to adapt new learning processes that do not allow physical meetings. This has raised concerns on how students are to cope with this new online learning environment since they come from different socioeconomic backgrounds. Therefore, the aim of this study is to identify the challenges faced by university students when implementing online learning during pandemic COVID-19. A preliminary online study is conducted among 542 students in Universiti Sultan Zainal Abidin Malaysia (UniSZA) to investigate the challenges and problems they may face adapting with the new "norm". The findings indicated that the majority of the students are not ready for online learning as the main challenge faced is low internet access to enable them for online learning. The findings from this study have benefitted the university management in making prompt and effective decisions concerning the implementation of remote learning during the pandemic. In order to get the full benefit of online learning, a concerted effort is needed from many as to provide this structure and go beyond replicating a physical class/lecture.

PLOS ONE, 2020

With the ongoing interest in implementing school policies to address the problem of childhood obe... more With the ongoing interest in implementing school policies to address the problem of childhood obesity in Malaysia, there is urgent need for information about the association between school environment and children's weight status. This study aims to investigate the association between school environmental factors (physical, economic, political and sociocultural) with BMI of school children in Terengganu. The school environment factors were assessed using a set of validated whole-school environmental mapping questionnaires, consisting of 76 criteria with four domains; physical environment (41 criteria), economic environment (nine criteria), political environment (nine criteria) and sociocultural environment (17 criteria). This involved face-to-face interview sessions with 32 teachers from 16 schools (eight rural and eight urban). In addition, 400 school children aged between 9 and 11 years of the selected schools were assessed for BMI (WHO 2007 reference chart), dietary intake (food frequency questionnaire (FFQ)) and physical activity level (physical activity questionnaire for children (PAQ-C)). Multiple regression was used to examine the association between school environment factors and BMI of the school children. Seven school environment criteria were found to be associated with BMI of school children when it was adjusted for calorie intake and physical activity level. About 33.4% of the variation in BMI of school children was explained by health professional involvement, simple exercise before class, encouragement to walk/ride bicycle to/from school, no high-calorie food sold, healthy options of foods and drinks at tuck shop, availability of policy on physical activity and training teacher as a role model. Policy makers should make urgent actions to address the obesogenic features of school environments. It should strive towards setting up healthy school environment and improving school curricula to promote healthy behaviours among the school children.

Heliyon, 2020

Background: There is evidence suggesting that the school environment does have prominent contribu... more Background: There is evidence suggesting that the school environment does have prominent contributions to the rise of childhood obesity. Aim: The objective of this study was to assess the school environment by interviewing the teachers and compare the school environment score between rural and urban schools in Terengganu, Malaysia. Methods: Thirty-two teachers from 16 primary schools in Terengganu were interviewed using a set of validated Malay version "School Environmental Mapping" questionnaire. A total of 76 items consisting of four domains of school environment factor: physical (what is available) with 41 items; economic (what the costs are) with nine items; political (what the rules are) with nine items; and socio-cultural (what the attitudes and beliefs are) with 17 items. Every item was questioned using an initial closed question followed by an open question when the criteria were not met or need further information regarding those particular items. Results: The present study revealed that the school environment of school in state of Terengganu is still low and not satisfied. Based on the schoolteacher's information and observation, there are significant barriers to promoting healthy eating and physical activity at school e.g. limited financial and budget allocation; lack of school facilities; lack of manpower to organise and monitor the programme; lack of participation and cooperation from parents; and no enforcement and serious action from authorized personnel on street hawkers near the school. This is reflected by the score achieved for 16 schools in Terengganu was only 63.05%. The political environment indicated the highest score among the domains, which was 77.78%, whereas, the lowest score was an economic environment (50.00%). Upon comparing between the urban and rural areas, the present study reported that there was a significant difference between school settings (p < 0.001) for an overall school environment, in which the rural areas had a significantly higher score than urban counterparts (64.86% vs 59.34%, p < 0.001). For each domain of the school environment, the findings showed that only two domains (physical and political environment) were significantly different between school settings. Conclusion: This study revealed that the level of a healthy school environment among schools in both settings is still not satisfied. Addressing the obesogenic elements of school environments is one of the strategies in prevention since the school environments exert a great influence on children's behaviour.

Background: Approximately 37% of the individuals with prediabetes will have diabetes in four year... more Background: Approximately 37% of the individuals with prediabetes will have diabetes in four years if they do not change their lifestyle through any intervention. Lifestyle modification intervention has shown to be effective in reducing or delaying the onset of type 2 diabetes mellitus (T2DM) among high-risk individuals. Some intervention approaches integrate human coaching into technology using phone or email to enable wider reach, known as digital therapy. It is considered as a scalable method to reach a larger population who are at risk, convenient and accessible. This study aims to determine the feasibility and efficacy of lifestyle intervention to prevent type 2 diabetes among adults who are at risk of developing diabetes, an assessor-blinded, parallel-group, randomised controlled trial using the Malaysia Diabetes Prevention Programme (MyDiPP) app.Methods: ‘MyDiPP’ is a 12-month lifestyle intervention digital therapy with multiple approaches (weight loss, dietary modification, ...

Chinese Journal of Traumatology, 2020

This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

A major health threat for children in the 21st century is physical inactivity in conjunction with... more A major health threat for children in the 21st century is physical inactivity in conjunction with the elevated prevalence of obesity. In Malaysia, low physical activity among children is a major concern. The objective of the study was to analyze the day to day variation of step count in a sample of obese children using the activPALTM monitor. This was a cross sectional study conducted in Kuala Terengganu, Terengganu. The sample compromised 41 boys and 24 girls between the ages of 9-11 years. Number of steps was objectively measured using an activPALTM accelerometer over a period of 4-7 days and had their height and weight measured. Mean step count from this sample of obese children was 8861 ± 3157steps. Steps per day were significantly higher for boys compared to girls (p=0.034). Obese children took significantly more steps at weekdays than on weekends (p=0.001). Steps/hour were significantly higher in weekday compared to weekend between 0600 to 0700…

Advances in Intelligent Systems and Computing, 2016

Today, data mining is broadly applied in many fields, including healthcare and medical fields. Ob... more Today, data mining is broadly applied in many fields, including healthcare and medical fields. Obesity problem among children is one of the issues commonly explored using data mining techniques. In this paper, the classification of childhood obesity among year six school children from two districts in Terengganu, Malaysia is discussed. The data were collected from two main sources; a Standard Kecergasan Fizikal Kebangsaan untuk Murid Sekolah Malaysia/National Physical Fitness Standard for Malaysian School Children (SEGAK) Assessment Program and a set of distributed questionnaire. From the collected data, 4,245 complete data sets were promptly analyzed. The data preprocessing and feature selection were implemented to the data sets. The classification techniques, namely Bayesian Network, Decision Tree, Neural Networks and Support Vector Machine (SVM) were implemented and compared on the data sets. This paper presents the evaluation of several feature selection methods based on different classifiers.

BMC Public Health, 2017

Background: Body weight is highly associated with overall health status. Being severely thin or o... more Background: Body weight is highly associated with overall health status. Being severely thin or obese may impose the risk of many health problems. Early detection of body mass index (BMI) status may help to reduce the associated comorbidities. Although many studies in the literature have investigated the BMI of school adolescents in Malaysia, the data on status of body weight among school adolescents in suburban states like Terengganu is limited. This study aimed to describe the body weight status of the whole population of school adolescents in all seven districts in Terengganu, Malaysia. Methods: Using a cross-sectional study design, body weight and height were measured, and BMI was calculated and classified using WHO BMI-forage Z-score. Data was obtained using the National Fitness Standard (SEGAK) assessment, which was uploaded in a specific Health Monitoring System (HEMS). Results: From a total of 62,567 school adolescents, 50.7% were boys and 49.3% were girls. Girls had significantly higher BMI than boys in age groups of 13 to 15 and 16 to 17 years old. Among boys and girls, there were significant differences in mean BMI of school adolescents between rural and urban school locations in all age groups (p < 0.001). There were also significant differences in BMI between boys and girls in all districts in Terengganu, except Kemaman and Kuala Terengganu, for all age groups (p < 0.001). Overall, the prevalence of thinness, normal, overweight and obesity were 8.4, 64.6, 15.0 and 12.0%, respectively. There were significant differences between BMI categories and genders in total participants, and within rural and urban school locations (p < 0.05). In all districts except Marang and Dungun, significant difference was also found between BMI categories and genders. Conclusion: The prevalence of thinness, overweight and obesity in Terengganu were substantial. In this study, BMI category was associated with gender, age, school location and district. However, the actual effects of these factors on the prevalence of thinness and obesity among this population demand further investigation.

International Journal of Software Engineering and Its Applications, 2016

The Ministry of Education Malaysia (MOE) implemented the National Physical Fitness Standard (SEGA... more The Ministry of Education Malaysia (MOE) implemented the National Physical Fitness Standard (SEGAK) for Malaysian School Children Assessment Program. Ever since, the SEGAK assessment data had been collected by the respective teachers in every school twice a year, then its summary is being submitted to the State Department of Education manually through email. This creates problems such as lack of a standardized report format, complex formula in calculating SEGAK score and different data interpretation. In this paper, an integrated and automated SEGAK submission and analysis system is proposed. The system, which is known as Health Monitoring System (HEMS), is a web based system developed with an automated pre-processing method and implemented three tier architecture. HEMS have a centralized database that collects the assessment data from seven districts in Terengganu. A total of 35,681 data was collected from 213 primary schools, and 27,201 data from 44 secondary schools, giving a big total of 67,519 data. During the pre-processing, 4,637 data or 6.9% of the collected data were excluded due to wrong and incomplete information. Using HEMS template, the submitted data have a consistent format of data types. HEMS generates an automated analysis and reporting for the use of related authorities.

Asian Pacific Journal of Cancer Prevention, 2014

Background: Dietary carbohydrate, fiber and sugar intake has been shown to play a role in the eti... more Background: Dietary carbohydrate, fiber and sugar intake has been shown to play a role in the etiology of breast cancer, but the findings have been inconsistent and limited to developed countries with higher cancer incidence. Objective: To examine the association of premenopausal and postmenopausal breast cancer risk with dietary carbohydrate, fiber and sugar intake. Materials and Methods: This population based case-control study was conducted in Malaysia with 382 breast cancer patients and 382 controls. Food intake pattern was assessed via an interviewer-administered food frequency questionnaire. Logistic regression was used to compute odds ratios (OR) with 95% confidence intervals (CI) and a broad range of potential confounders were included in analysis. Results: A significant two fold increased risk of breast cancer among premenopausal (OR Q 4 to Q 1 =1.93, 95%CI: 1.53-2.61, p-trend=0.001) and postmenopausal (OR Q 4 to Q 1 =1.87, 95%CI: 1.03-2.61, p-trend=0.045) women was observed in the highest quartile of sugar. A higher intake of dietary fiber was associated with a significantly lower breast cancer risk among both premenopausal (ORQ 4 to Q 1 =0.31, 95%CI: 0.12-0.79, p-trend=0.009) and postmenopausal (ORQ 4 to Q 1 =0.23, 95%CI: 0.07-0.76, p-trend=0.031) women. Conclusions: Sugar and dietary fiber intake were independently related to pre-and postmenopausal breast cancer risk. However, no association was observed for dietary carbohydrate intake.

Journal of Tropical Pediatrics, 2016

This study describes the patterns of objectively measured sitting, standing and stepping in obese... more This study describes the patterns of objectively measured sitting, standing and stepping in obese children using the activPAL TM and highlights possible differences in sedentary levels and patterns during weekdays and weekends. Sixty-five obese children, aged 9-11 years, were recruited from primary schools in Terengganu, Malaysia. Sitting, standing and stepping were objectively measured using an activPAL TM accelerometer over a period of 4-7 days. Obese children spent an average of 69.6% of their day sitting/lying, 19.1% standing and 11.3% stepping. Weekdays and weekends differed significantly in total time spent sitting/lying, standing, stepping, step count, number of sedentary bouts and length of sedentary bouts (p < 0.05, respectively). Obese children spent a large proportion of their time sedentarily, and they spent more time sedentarily during weekends compared with weekdays. This study on sedentary behaviour patterns presents valuable information for designing and implementing strategies to decrease sedentary time among obese children, particularly during weekends.