Parental influences on self-esteem of early adolescents: a multiracial sample from Selangor, Malaysia

Background: This cross-sectional study aims to determine the association between socio-demographic characteristics, parenting style, and self-esteem among early adolescents. Materials and Methods: A total of 716 early adolescents aged 10–11 years attending primary schools in Selangor state, Malaysia were enrolled in this study. Perceived parenting style and self-esteem were assessed through the self-administered Parenting Characteristics questionnaire and Rosenberg Self-Esteem Scale, respectively. Pearson’s product-moment correlation and one-way ANOVA were employed to determine the bivariate relationships between socio-demographic characteristics and parenting style with self-esteem. Multiple linear regression analysis was utilized to determine the factors that significantly contributed to self-esteem of the respondents. Result: The results revealed that the predominant parenting style practiced by respondents’ fathers was authoritarian (44.4%), while that by respondents’ mothers was authoritative (38.2%). Ethnicity, paternal parenting style, and maternal parenting style were significantly associated with self-esteem of the respondents in the bivariate analyses. No associations were found between age, gender, paternal and maternal educational level, monthly household income, and self-esteem. Results of the multiple linear regression model demonstrated that being Chinese (β=-0.29), being Indian (β=-0.12), authoritative father (β=0.15), authoritative mother (β=0.16), and permissive mother (β=0.13) were significantly associated with self-esteem among the respondents (R2=0.14). Conclusion: These findings suggest that being Malay, authoritative, and permissive parenting positively influenced the self-esteem of early adolescents. Further research should be conducted to assess the interaction effects between ethnicity and parenting style on self-esteem in early adolescents

Eating behaviors among female adolescents in Kuantan District, Pahang, Malaysia.

This study examined eating behaviors among female adolescents. A total of 407 female students aged between 13-19 years were randomly selected from two secondary schools in Kuantan district, Pahang, Malaysia. All participants were required to complete a self-administered Eating Behaviors Questionnaire and their weight and height were measured by the researchers. A majority of the participants were Malays (65.3%), followed by Chinese (28.3%) and Indians (6.4%). There were 5.9% underweight participant, 75.4% were normal-weight and 18.7% were overweight. About one third (35.9%) never skipped any of the daily three meals, but another half (52.6%) skipped at least one meal a day and the remaining (11.5%) had even skipped all three meals in a day. The most frequently missed meals were breakfast (47.4%). Half (51.4%) snacked between meals daily and three in four (76.9%) had their meals with family members. No differences were found between the socio-demographic variables (age, household members, parent's total year of schooling, parental monthly income and living arrangement) and meal skipping behaviors. However, those who usually skipped meals were those who usually eat alone (Chi2= 16.933, p < 0.0001), overweight (Chi2= 15.943, p < 0.05) and were Malays (Chi2= 33.827, p < 0.05). In conclusion, meal skipping, snacking and practicing various weight loss behaviors were some of the unhealthy eating behavior depicted among adolescent girls. Focusing on promotion of healthy eating that stressed on the importance of regular intakes of main meals during adolescence is crucial for their current and future health and well-being

Comparison of paternal and maternal feeding practices and parenting styles between healthy weight and overweight or obese primary school children

Introduction: Parents play significant roles in developing the behaviour of their children towards food. However, mothers usually represent the parents of the children in previous studies, while fathers were left out and their contribution remained unknown. This study compared paternal and maternal feeding practices and parenting styles between overweight or obese (OW/OB) and normal weight (NW) primary school children. Methods: There were 419 children aged 10 to 11 from four randomly selected national primary schools being screened for their body weight and height. There were 105 children identified as OW/OB and matched with 105 NW children based on sex, age and ethnicity, whose both their parents were then recruited as study subjects. Parents reported their personal body weight and height, and completed a questionnaire on parenting styles and feeding practices. Results: There were 34.9% of children overweight and obese, and more than half of their fathers (66.5%) and mothers (52.5%) were over-weight and obese. Both fathers and mothers of the OW/OB children perceived their children to be slightly heavier, but a majority of them perceived their children’s body weight status less accurately and applied less pressure to eat. Fathers of the OW/OB children were more in the obese category, performed indulgent parenting style, perceived less feeding responsibility and applied less monitoring on their children, but not mothers. Conclusion: There were distinct differences in paternal and maternal feeding practices and parenting styles between OW/OB and NW children. Researchers should encourage fathers to involve in childhood obesity research instead of focusing on mothers

Associations between home environment, behavioral factors and body-mass-index among primary school children in Selangor, Malaysia

This study aimed to determine the associations between home environment, behavioral factors, and BMI-for-age among children in Selangor. A total of 568 children aged 10.6 ± 0.6 years and their parents participated in this study. Parents self-reported their body weight and height and completed a questionnaire that assesses the home environment and their weight management knowledge. Body weight and height of the children were measured. Questions that assessed eating behaviors were answered by the children. A two-day dietary and physical activity recalls were used to assess the energy intake and energy expenditure of the children. The prevalence of overweight and obesity (28.3%) was three times higher than underweight (9.0%)among the children. More boys (37.7%) than girls (23.8%) were overweight and obese (t = 3.791, p < 0.05). Similarly, there were more overweight and obese parents (52.7% fathers; 46.1% mothers) than underweight parents (4.4% fathers; 6.2% mothers). Father's BMI (r = 0.178, p < 0.05), mother's BMI (r = 0.223, p < 0.05), availability of physical activity at home (r = −0.105, p < 0.05), availability of fat/sweet at home (r = 0.088, p < 0.05), energy intake(r = −0.618, p < 0.05), and energy expenditure (r = −0.639, p < 0.05) were associated with BMI-for-age, respectively. The multiple linear regression analysis showed that being male (β = 0.526), with low energy expenditure (β = −0.071), low energy intake (β = −0.026), high BMI of father (β = 0.019), and high BMI of mother (β = 0.047) contributed towards high BMI-for-age of the children (R2: 58.3%; F = 163.825, p < 0.05). The prevalence of overweight and obesity was high in both parents and their children. Family-based interventions that promote healthy eating and active lifestyle is recommended in preventing and managing childhood obesity

From compliance to adherence and concordance, what quantitative and qualitative studies have synthesized?

Poor adherence has long been identified as the major health challenge in the prevention and treatment of chronic diseases. The purpose of the present study is to provide a critical review on the revolution of the “compliance” concepts from compliance to adherence and concordance to both pharmacological and non-pharmacological therapies. Hence, the present study attempts to provide an update of the possible factors related to adherence by incorporating findings from both qualitative and quantitative studies with respect to various chronic conditions regardless of their causes. A comprehensive literature search was performed using online databases from Library of University Putra Malaysia, and Pub Med based on the keywords. From the present studies, the findings showed that both quantitative and qualitative studies cannot be neglected in assessing adherence and its related problems. One of major findings from the present review is that “compliance” was no more suitable for current treatments and it is important to defined concepts of the terms used (adherence or concordance) correctly and clearly. The problems of definition or concepts of the terms used further affects the measurements and the results of the studies. It should be noted that the measurements and findings of the studies reviewed reflected that researchers placed great value on medication adherence, but have little attention to the non-pharmacological aspect of adherence. Since medications is not the only way of treatments for many chronic diseases and many patients resisted to take medications due to the strong negative image of medications, non-pharmacological treatments like lifestyle modifications seems to be more natural way of treatments. This may be one of the vital factor of why little progress of patients’ adherence to treatments throughout these three decades. There were three general factors related to adherence to treatments, namely socio-economic factor, treatments-related factor and disease-related factor. The findings showed that both qualitative and quantitative studies found consistent results for most of the factors, except the experience of diseases symptoms. Factors identified in the qualitative studies provides a better understanding on patients’ adherence to treatments regardless of illnesses, but more quantitative studies with a representative sample and valid instruments are in need to clarify these factors. Both study designs contribute important values to the adherence studies. Hence, it is suggested that future studies should not only consider qualitative study but also quantitative studies

Maternal Vitamin D Status and Its Associated Environmental Factors: A Cross-Sectional Study

Background: Vitamin D deficiency is common among women during pregnancy. This study aims to determine the prevalence of vitamin D&nbsp; deficiency and their shared modifiable environmental factors among pregnant women in Indonesia and Malaysia. Methods: Blood samples of 844 third-trimester pregnant women (Indonesians: 311; Malaysians: 533) were collected to determine their serum&nbsp; 25(OH) D levels. Information on sun exposure and sun protection behaviours were obtained through face-to-face interviews. Dietary vitamin D&nbsp; intake was assessed by using a semiquantitative food frequency questionnaire. Results: The prevalence of vitamin D deficiency (&lt;30 nmol/L) among Indonesian and Malaysian pregnant women were 42.4% and 72.0%,&nbsp; respectively. Percentage of exposed body surface area was inversely associated with vitamin D deficiency among Indonesian pregnant women (OR =&nbsp; 0.21, 95% CI = 0.09-0.48). Among Malaysian pregnant women, higher intakes of dietary vitamin D were associated with lower risk of vitamin D&nbsp; deficiency (OR = 0.48, 95% CI = 0.29-0.81). Analysis of the combined cohorts revealed a lower risk of vitamin D deficiency among pregnant women&nbsp; who had a daily intake of at least 15 mcg vitamin D (OR = 0.58, 95% CI = 0.38-0.88) and exposure of more than 27% body surface area to the sunlight&nbsp; (OR = 0.30, 95% CI = 0.16-0.60). Conclusion: Despite abundant sunshine, vitamin D deficiency is prevalent among pregnant women in tropical countries. The present study suggests&nbsp; that nutrition education on vitamin D intake and sun exposure during pregnancy is necessary for primary prevention of vitamin D&nbsp; deficiency in pregnant women living in the tropical countries.&nbsp

Factors associated with rates of gestational weight gain among pregnant women in Batu Pahat district of Johor state, Malaysia

Introduction: This cross-sectional study determines factors associated with the rates of gestational weight gain (GWG) among women in the second and third trimester of pregnancy. Methods: A total of 180 pregnant women (29.2 ± 4.3 years old) attending the maternal and child health clinics in Batu Pahat district were enrolled in the present study be-tween January and February, 2015. Information regarding demographic characteristics, obstetrical history, physical activity, and calorie intake was assessed through direct interview. Anthropometric data were collected from medical records. GWG rates were determined based on 2009 IOM recommendations. Results: Of the 180 pregnant women, 37.2% were at their second trimester and 62.8% were at the third trimester of pregnancy. While 53.3% of them had excessive GWG rate, 28.9% have inadequate GWG rate. More than half of the women (56.7%) were normal weight, 21.1% overweight, 14.4% underweight, and 7.8% obese before pregnant. The total mean activity and energy intake of the pregnant women were 195.9±94.2 MET-hour/week and 2365±709 kcal/day, respectively. The multinomial logistic model indicates that women who were overweight or obese at pre-pregnancy were seven times more likely to have excessive GWG rate (OR = 7.44, 95% CI = 2.07-26.66) as compared to women who were pre-pregnancy normal weight. Conclusions: About four in every five of the pregnant women had their GWG rates outside the IOM recommendations. Women who were overweight/obese at pre-pregnancy were at-risk of having excessive GWG rate, which underlines the importance of targeting these women for pre-conception counselling on GWG

Associations between socio-demographic characteristics and pubertal status with disordered eating among primary school children in Selangor, Malaysia

Background and Objectives:To determine the associations between socio-demographic characteristics and pubertal status with disordered eating among primary school children. Methods and Study Design:Using a stratified multi-stage sampling, a total of 816 children (282 boys and 534 girls) aged 10 to 11 years from 12 selected primary schools in the state of Selangor, participated in this study. Data were collected on socio-demographic characteristics, pubertal status and disordered eating behaviors. The Pubertal Development Scale and the Children's Eating Attitudes Test (ChEAT) were used to assess pubertal status and disordered eating, respectively. Logistic regression analysis was conducted to determine the risk factors of disordered eating. Results:The prevalence of disordered eating was 30.8% (32.8% in boys and 29.7% in girls). However, the sex difference in the prevalence was not statistically significant. Age, ethnicity and pubertal status were significantly associated with disordered eating in univariate logistic regression analysis. Multivariate logistic regression analysis showed that among boys, being either in an advanced or post-pubertal stage (adjusted OR=8.64) and older age group (adjusted OR=2.03) were risk factors of disordered eating. However, among girls, being a Malay (adjusted OR=3.79) or Indian (adjusted OR=5.04) in an advanced or post-pubertal stage (adjusted OR=2.34) and older age group (adjusted OR=1.53) were risk factors of disordered eating. Conclusion:This study found one in three children had disordered eating. Since ethnicity and pubertal status were identified as risk factors, ethnicity-specific intervention programs on the prevention of disordered eating among children should take into consideration their pubertal status

Obesity-related behaviors of Malaysian adolescents: a sample from Kajang district of Selangor state

This study aims to determine the association between obesity-related behaviors (dietary practices, physical activity and body image) and body weight status among adolescents. A total of 382 adolescents (187 males and 195 females) aged 13 to 15 years in Kajang, Selangor participated in this study. Majority of the respondents were Malays (56.0%), followed by Chinese (30.1%) and Indians (13.9%). Dietary practices, physical activity and body image of the adolescents were assessed through the eating behaviors questionnaire, two-day dietary record, two-day physical activity record and multi-dimensional body image scale (MBIS), respectively. Body weight and height were measured by trained researchers. The prevalence of overweight and obesity (19.5%) was about twice the prevalence of underweight (10.5%). About two-thirds of the respondents (72.3%) skipped at least one meal and half of them (56.2%) snacked between meals with a mean energy intake of 1,641 ± 452 kcal/day. More than half of the respondents (56.8%) were practicing sedentary lifestyle with a mean energy expenditure of 1,631 ± 573 kcal per day. Energy intake (r = 0.153, P < 0.05), physical activity (r = 0.463, P < 0.01) and body image (r = 0.424, P < 0.01) were correlated with BMI. However, meal skipping, snacking and energy expenditure per kg body weight were not associated with body weight status. Multiple linear regression analysis showed that body image, physical activity and energy intake contributed significantly in explaining body weight status of the adolescents. In short, overweight and obesity were likely to be associated not only with energy intake and physical activity, but also body image. Hence, promoting healthy eating, active lifestyle and positive body image should be incorporated in future obesity prevention programmes in adolescents

Association between behavioural factors and BMI-for-age among early adolescents in Hulu Langat district, Selangor, Malaysia

Objective: This paper investigates the association between behavioural factors and BMI-for-age among early adolescents (10–11 years old) in Hulu Langat district, Selangor. Methods: This cross-sectional study was conducted among 333 primary school students. Body weight and height of the students were measured and their BMI-for-age was calculated. Eating behaviours, energy intake, energy expenditure, physical activity, and screen time were assessed using the Eating Behaviours Questionnaire and a 2-day dietary and physical activity recall, respectively. Data were analysed using multiple linear regression analysis. Results: The prevalence of overweight and obesity (28.2%) was about twice the prevalence of thinness (11.1%). The mean energy intake and energy expenditure of the students was 1772 ± 441 kcal/day and 1705 ± 331 kcal/day, respectively. Three in five of the students (60.1%) skipped at least one meal and 98.2% snacked between meals daily. A majority of them (55.3%) were sedentary. Low energy intake (p < 0.05) and low energy expenditure (p < 0.05) were associated with high BMI-for-age. Energy expenditure (β = −0.033) and energy intake (β = −0.090) significantly explained 65.1% of the variances in BMI-for-age (F = 119.170, p < 0.05). Conclusion: These findings suggested that promoting healthy eating and active lifestyle should be targeted in the prevention and management of obesity among early adolescents