Dietary intake is compromised among elderly living in agricultural settlements

Purpose – This study aims to investigate dietary intake among elderly living in agricultural settlements in comparison with a recent nutritional recommendation. Design/methodology/approach – This cross-sectional study was carried out among elderly living in five agricultural settlements in Kuantan, Pahang, Malaysia. Participants were interviewed on sociodemographic information such as age, gender, marital status, smoking status, household income, education level and living status. Data on individual dietary intake were obtained through diet history method. Dietary intake data were analyzed using Nutritionist Pro software and compared to the recommended nutrient intakes (RNI) for Malaysia version 2017. Statistical analyses were performed using SPSS software version 21. Findings – A total of 413 participants (male 32.4 per cent and female 67.6 per cent) with the mean age of 69.4 ± 7.9 years participated in this study. Dietary intake results demonstrated that participants did not meet the Malaysian RNI for energy and most nutrients (p<0.05). This study also found that energy, carbohydrate, protein, fat, folate and iron intake were significantly higher in male than female (p<0.05). Meanwhile, calcium and vitamin A intake were significantly higher in female than male (p<0.05). Research limitations/implications – Integrated nutrition education and health promotion programme with a multidisciplinary approach are essential to be designed and executed to improve dietary intake of the elderly, which can further lead to appropriate dietary practices and knowledge improvement related to healthy food choices. Factors associated with inadequate dietary intake and awareness on the importance of adequate nutrients intake among the elderly warrant further investigation. Originality/value – This research is at the forefront, which indicated that the dietary intake of elderly individuals living in the agricultural settlement was inadequate in comparison to the latest recommendation. Strategies to improve their intakes need to be developed and implemented accordingly to improve nutritional status and prevent adverse effects to health

The research methodology for malnutrition risk identification and dietary practices among community living elderly

Introduction: Nutrition screening is an initial procedure to identify malnutrition, whilst subsequent nutrition intervention is warranted for at risk individuals. However, none of nutrition screening studies conducted among Malaysian elderly accompanied by individualized nutrition intervention. The objective here is to describe the methodology to determine malnutrition risk and nutritional status of elderly in community at baseline and after 3 months of nutrition intervention; and to assess perception of elderly on their dietary practices. Materials and Methods: Elderly aged ≥60 years will be recruited as participants at several FELDA in Terengganu and Pahang with the calculated sample size of 416. Nutrition screening will be performed to identify malnutrition risk using a validated nutrition screening tool for elderly in community; the Mini Nutritional Assessment-Short Form. Dietary intake will be assessed using diet history method and individualized nutrition intervention will be provided to improve nutritional status. Nutrition screening and assessment will be repeated after three months for malnourished and at risk elderly. In-depth individual interview will be conducted to assess perception on dietary practices particularly prophetic food intake. Quantitative and qualitative data will be analysed using IBM SPSS software and NVivo software, respectively. Results: Nutritional status of the elderly is anticipated to improve after 3 months of nutrition intervention and the elderly will perceive that their dietary practices are good. Conclusion: This research is at the forefront to provide individualized nutrition intervention following nutrition screening among Malaysian community elderly. It can potentially prevent further health complications associated with malnutrition through timely malnutrition identification and nutrition intervention

Prevalence and intervention of malnutrition risk of Malaysian elderly living in the community: A literature review

Introduction: Malnutrition among the elderly is a concern around the globe, including in Malaysia due to its negative effects to health. The aims of this review are to identify prevalence of malnutrition risk in Malaysian elderly living in the community; and to identify the types of nutrition intervention provided to the elderly following malnutrition risk identification. Methods: Literature searches were undertaken using online databases and a manual search. Main keywords used for literature search strategy were malnutrition, elderly and Malaysia. Inclusion criteria for the literature searches are studies performed in Malaysian community, using either nutrition screening or assessment tool and elderly aged ≥60 years old. Exclusion criteria are studied among hospitalized elderly, conducted in nursing homes, validation and development studies of nutrition screening tool. Results: Four published studies were eligible to be included in the review. The studies showed that prevalence of malnutrition in the Malaysian elderly living in the community is approximately 1.3% - 36.3%. A range of 25.3% to 48.5% elderly was reported to be at malnutrition risk. All of the identified studies were cross-sectional studies; whilst none of the studies provided nutrition intervention to the elderly. Conclusions: Alarming rates of malnutrition risk of Malaysian elderly living in the community has been identified. Appropriate nutrition intervention for malnourished and at risk elderly should be targeted to improve nutritional status and prevent health deterioration. Further evaluation of effectiveness of nutrition intervention following malnutrition risk identification is warranted in future studies

Malnutrition risk and perception on dietary practices among elderly living in agricultural settlements: A mixed-methods research

Purpose – This research aims to identify malnutrition risk and perception of malnourished and at-risk elderly individuals on their dietary practices. Design/methodology/approach – In Phase 1, a cross-sectional study was conducted among 413 elderly individuals aged 60 years and above in agricultural settlements in Kuantan, Pahang, Malaysia. Malnutrition risk was assessed using the Mini Nutritional Assessment Short-Form (MNA-SF). In Phase 2, in-depth semi-structured interviews were conducted among 21 elderly individuals identified in Phase 1. The interviews ceased when data saturation was achieved. Findings – 25.7 per cent (n = 106) of elderly individuals were identified as malnourished and at-risk (MNA-SF score = <12). Age, smoking, income and living status were significantly associated with malnutrition risk (p < 0.05). Thematic analysis revealed four themes that represent elderly individuals’ perception on their dietary practices: the impact of aging on dietary intake; food restriction according to health condition; poor dietary intake due to feeling of loneliness; and perceived benefits of foods for health. Research limitations/implications – Strategies from multidisciplinary healthcare professionals to eliminate improper dietary practice are required for the maintenance of health, functional independence and quality of life among the elderly. Originality/value – This research is at the forefront in reporting the elderly individuals’ perception on dietary practice in agricultural settlement. Attention to individual’s health issues and the associated factors that may influence their dietary practices is essential to provide appropriate interventions to achieve optimum nutritional status and healthy aging

Trend in dietary calcium intake among elderly in Kuantan, Pahang

Introduction: Dietary calcium intake is important in body system regulation. Inadequate intake among elderly may lead to various health issues such as osteoporosis and hip fracture. In order to counter the problem, this study was carried out to identify dietary calcium intake among elderly in Kuantan, Pahang. Methods: A face to face interviewer-administered session was done individually with seventy-nine (n=79) subjects aged ≥60 years to collect data on sociodemographic background, health status and dietary intake. Diet history method was used to obtain information related to dietary intake and analyzed using Nutritionist Pro Software. P-value was set at p<0.05 as statistically significant. Results: Almost all elderly subjects had dietary calcium intake lower than recommendation, which was 92.4%, and only 7.6% of total elderly met the recommended intake. This study found that the mean dietary calcium intake was 421.7 + 344.3 mg/day which is lower than Recommended Nutrient Intakes (RNI) for Malaysian. Mean calcium intake was significantly lower than RNI in both gender (p<0.001). The difference of calcium intake between male and female elderly was not significant; with mean dietary calcium intake for male and female were 414.2 + 344.3 mg/day and 426.0 + 347.8 mg/day, respectively. From the analysis, dietary calcium intake in elderly from non-dairy sources (228.4 + 149.3 mg) is higher than dairy sources (median (IQR)= 0.0 (326.0) 5mg). Conclusions: In conclusion, inadequate dietary calcium is an issue among elderly people in Kuantan which may lead to several health problems. Hence, appropriate strategies need to be taken in order to ensure optimum nutritional status among this at risk population

Nutritional risk according to Mini Nutritional Assessment– whort form among community dwelling elderly in Kuantan, Pahang: a pilot study

Introduction: The risk of developing malnutrition increases with advancing age. It has the potential to place significant burdens on healthcare and other support services. However, studies with regards to malnutrition among community-dwelling elderly population in Malaysia is scarce specifically in Kuantan. The objective of this study was to determine malnutrition risk using the Mini Nutritional Assessment- Short Form (MNA-SF) among community-dwelling elderly people in Kuantan and to investigate its associated factors. Methods: A pilot study was conducted among 73 community-dwelling elderly in Kuantan, Pahang, Malaysia aged 60 years and above. Malnutrition risk of the elderly was evaluated by using Mini Nutritional Assessment– Short Form (MNA-SF). A standardized questionnaire was used to record the factors associated with malnutrition: demographic characteristics, income level, percentage of food expenditure per month, body mass index, physical activity level and disease status. Chi Square test was performed for statistical analysis. Results: The subjects comprised of 39 (53.4%) males and 34 (46.6%) females. Mean age of the subjects was 65.4 ± 5.4 years old. Among 73 subjects, 36.0% were well nourished and 64.0% were at malnutrition risk. Low income (p= 0.045) and physically inactive among elderly subjects (p= 0.039) appeared to be significantly associated with malnutrition risk. Other results were not statistically significant. Conclusions: The findings provide preliminary evidence that malnutrition risk was high among elderly living in Kuantan. Therefore, nutrition screening in a full-scale study is recommended for elderly in order to further identify those at risk of malnutrition in a timely manner. Hence, intervention can be implemented to improve the health status of this population

Factors affecting commencement and cessation of betel quid chewing behaviour in Malaysian adults

<p>Abstract</p> <p>Background</p> <p>Betel quid chewing is a common habit widely practiced in Southern Asian populations. However, variations are seen in the content of a betel quid across the different countries. Factors associated with commencement and cessation of this habit has been numerously studied. Unfortunately, data on Malaysian population is non-existent. This study aims to determine the factors associated with the inception and also cessation of betel quid chewing behaviour among Malaysian adults.</p> <p>Method</p> <p>This study is part of a nationwide survey on oral mucosal lesions carried out among 11,697 adults in all fourteen states in Malaysia. The questionnaire included sociodemographic information and details on betel quid chewing habit such as duration, type and frequency. The Kaplan-Meier estimates were calculated and plotted to compare the rates for the commencement and cessation of betel quid chewing behaviour. Cox proportional hazard regression models were used to calculate the hazard rate ratios for factors related to commencement or cessation of this habit.</p> <p>Results</p> <p>Of the total subjects, 8.2% were found to be betel quid chewers. This habit was more prevalent among females and, in terms of ethnicity, among the Indians and the Indigenous people of Sabah and Sarawak. Cessation of this habit was more commonly seen among males and the Chinese. Females were found to be significantly more likely to start (p < 0.0001) and less likely to stop the quid chewing habit. Females, those over 40 years old, Indians and a history of smoking was found to significantly increase the likelihood of developing a quid chewing habit (p < 0.0001). However, those who had stopped smoking were found to be significantly more likely to promote stopping the habit (p = 0.0064). Cessation was also more likely to be seen among those who chewed less than 5 quids per day (p < 0.05) and less likely to be seen among those who included areca nut and tobacco in their quid (p < 0.0001).</p> <p>Conclusion</p> <p>Factors that influence the development and cessation of this behaviour are gender, age, ethnicity, and also history of smoking habit while frequency and type of quid chewed are important factors for cessation of this habit.</p

Effect Of Bio-Based Lubricant Towards Emissions And Engine Breakdown Due To Spark Plug Fouling In A Two-Stroke Engine

Two-stroke also known as two-cycle gasoline engine is a spark ignition engine. Its uniqueness to the four-stroke engine is that this engine does not require lubricant sump, which makes construction lightweight and simple. Its lubricant is mixed with gasoline and burnt together during combustion. There are reports which stated that higher spark plug fouling is due to carbon deposition on the spark plug electrodes on a two-stroke engine when compared to the four-stroke. While many factors could have affected this situation, however, in this paper, the effect of mineral and bio-based lubricants towards carbon deposition and emissions are studied and reported. Idle, half and full throttle operation modes had been conducted on a two-stroke, 43 cubic centimeter engine. To keep combustion temperature below self-cleaning temperature on all three modes of operation, a zero-load test was utilized. This situation accelerates the deposition process as low temperature causes incomplete combustion. This could lead to the accumulation of char, unburned fuel, as well as condensed water and acids as the byproducts blanket the spark plug electrodes and the exhaust system. Five samples had been prepared with a commercially available mineral lubricant (T0) as reference. Trimethylolpropane Trioleate, TMPTO derived from plant origin was used as the bio-based candidate. It was then mixed with T0 which created another four lubricant samples namely T10, T15, T20 and T50 with 10%, 15%, 20% and 50% TMPTO accordingly. Results show that mineral lubricant T0 delivers the lowest hydrocarbon HC, carbon monoxide CO and smoke opacity during idle and half throttle operations. However, it exhibits a greasy deposit on the spark plug circumference and dry carbon deposits on its insulator tip. T0 also emits a liquid residue at the exhaust manifold. T10 and T50 show a wet deposit blanketing both electrodes. Severe deposition was recorded by T50 that caused the engine to fail half way with its emissions had the worst recording. T15 and T20 exhibit only dry carbon deposition on the spark plug circumference. However, T20 has outperformed T15 in terms of emissions with lower CO and CO2 emissions during idling and half-throttling. With better emissions than T15 and better carbon deposition than mineral (T0), T20 could be proposed to be used as a commercial two-stroke lubricant

Factors influencing physical activity in pregnancy : a systematic review

Lack of physical activity in pregnancy may lead to poor maternal and perinatal outcomes including gestational diabetes, hypertensive disorders and postpartum depression. Given these risks, identifying factors that influence physical activity in pregnancy is crucial to planning and implementing appropriate interventional programmes and managing this vulnerable group. Peer reviewed articles on factors influencing physical activity in pregnancy were searched using the Pub-Med and Ovid databases, from 2014 to 2019. The selected articles were reviewed by two authors and critically appraised using the Mixed Methods Assessment Tool 2018. A total of 16 articles were included. Factors that positively influenced physical activity in pregnancy were fun, higher economic status, early trimester, and higher body weight. Factors that negatively influenced physical activity in pregnancy were lack of knowledge, lack of social support, multiparity, physical pain and discomfort, ethnic minority status, and concern for the safety of the baby. Fun was one of the most reported motivators of physical activity in pregnancy, and the most reported reason for reduced physical activity was lack of knowledge. Additionally, social support from friends and family played an important role in encouraging pregnant women to be active. This systematic review highlights the need to improve current health education programmes for physical activity in pregnancy, which should ideally be extended and targeted to the whole community, beyond pregnant women themselves for better uptake and acceptance