Association of suicidal ideation with demographic, lifestyle and health factors in Malaysians

Objective: To determine the association of suicidal ideation with demographic, lifestyle, and health factors, using data from National Health and Morbidity Survey 2011 (NHMS 2011) of Malaysia. Methods: The NHMS 2011 included 10,141 respondents. Independent variables of suicidal ideation were income, age, household size, sex, ethnicity, education, marital status, smoking, physical activity, and self-rated health. The risk factors of suicidal ideation were determined using logistic regression analysis. Results: In the pooled sample, suicidal ideation was associated with age, sex, ethnicity, and self-rated health, but not associated with income, household size, education, physical activity, or smoking. Conclusion: The likelihood of having suicidal ideation is positively associated with young adults, women, Indians, and those with poor self-rated health

Cause-specific mortality estimates for Malaysia in 2013: Results from a national sample verification study using medical record review and verbal autopsy

Mortality indicators are essential for monitoring population health. Although Malaysia has a functional death registration system, the quality of information on causes of death still needs improvement, since approximately 30% of deaths are classified to poorly defined causes. This study was conducted to verify registered causes in a sample of deaths in 2013 and utilise the findings to estimate cause-specific mortality indicators for Malaysia in 2013.This study was funded by the Ministry of Health, Malaysi

Sociodemographic, lifestyle, and health factors associated with depression and generalized anxiety disorder among Malaysian adults

Objectives: Lowering the prevalence of mental health illness is one of the main public health concerns. The objective of the present study was to examine factors associated with depression and generalized anxiety disorder (GAD) among adults in Malaysia. Methods: Data were extracted from the National Health and Morbidity Survey 2011 (NHMS 2011), which is a nationally representative sample collected using a 2-stage stratified sampling method. A bivariate probit model was utilized to examine the influences of sociodemographic, lifestyle, and health factors on the likelihood of suffering from depression and GAD. Results: Age, gender, ethnicity, education, marital status, and self-rated health were significantly associated with depression and GAD. In particular, there were positive relationships between depression and GAD, and younger adults, females, Indian ethnic group, lower level of education, being unmarried, and self-rated poor health. Conclusions: Sociodemographic and health factors were associated with determining the risks of depression and GAD in Malaysia. With this information, future policies (eg, screening and treatment) could be targeted at those at most risk to develop depression and GAD

Undiagnosed Type 2 Diabetes Mellitus and Its Risk Factors among Malaysians: Findings of a Nationwide Study

Introduction: The prevalence of Type 2 diabetes mellitus (T2DM) is increasing worldwide and many of these affected individuals remain unidentified. Undiagnosed T2DM may impose substantial public health implications because these individuals remain untreated and at risk for complications. The objective of this study was to determine the national prevalence of undiagnosed T2DM and to identify the associated risk factors. Methods: A nationwide cross-sectional study was conducted involving 17,783 respondents. Two-stage stratified sampling design was used to select a representative sample of the Malaysian adult population. Structured validated questionnaires with face to face interviews were used to obtain data. Respondents, who claimed that they were not having diabetes, were then asked to perform a fasting blood glucose finger-prick test by Accutrend GC machine. Results: The prevalence of undiagnosed T2DM was 8.9% (n=1587). The highest percentage of undiagnosed T2DM was found among males (10.2%), 55-59 years old (13.4%), highest education attainers of primary school (11.1%), Indians (10.3%), married (10.3%), working (8.9%) and living in the urban areas (9.2%). Multivariate analyses showed that factors associated with undiagnosed T2DM were gender, age group, ethnicity, marital status, obesity and hypertension. Conclusion: This study found an increasing trend of undiagnosed T2DM in Malaysia compared to 2006. This finding is alarming as risk factors associated with undiagnosed diabetes were related to most of the socio-demographic factors studied. Therefore, early diabetic screening is crucial especially among adults aged 30 and above to prevent more serious complications of this disease

Vigorous and moderate physical activity among overweight and obese adults in Malaysia: Sociodemographic correlates

Background: This study examines the effects of sociodemographic factors on participation in vigorous and moderate physical activity and how they vary across bodyweight group (underweight, normal, overweight, obese I, obese II). Methods: This study uses a nationally representative data with a sample of 10141 respondents. Bivariate and multivariate analyses are stratified by bodyweight group. The intensity of physical activity is measured using metabolic equivalent (MET). Vigorous physical activity has >6 MET, while moderate physical activity has ≤6 MET.Results Several important findings are noteworthy. First, age has a positive impact on moderate physical activity among obese I individuals but a negative impact on moderate physical activity among obese II individuals. Second, education is significant in determining participation in all intensity levels of physical activity among obese I individuals. Third, higher income obese II individuals spend less time in vigorous physical activity than their lower income counterparts. However, higher income overweight and obese I individuals spend less time in moderate physical activity compared with those who have lower income. Fourth, overweight, obese I and obese II males spend more time in vigorous and total physical activity than their female counterparts, but they allocate less time for moderate physical activity.Conclusions It appears that sociodemographic factors play an important role in determining participation in vigorous and moderate physical activity among overweight and obese adults. We conclude by discussing implications for policies directed towards promoting physically active lifestyle among overweight and obese adults who are unlikely to spend time in physical activity

The income elasticity of participation in physical activity: evidence from Malaysia

Estimating the income elasticity of demand for market goods and services has received significant research attention. However, the income elasticity of participation in physical activity has never been studied thoroughly, especially in developing countries. To fill this research gap, the income elasticity of time spent in both vigorous and moderate physical activities is estimated using a two-part model. Data from the National Health and Morbidity Survey 2011 is used. After controlling for demographic variables, the present study finds that time spent in vigorous and moderate physical activities is negatively associated with income. However, the degree of sensitivity of time spent in vigorous and moderate physical activities is low, suggesting that income does not play an important role in promoting physically active lifestyle among adults. The present study concludes that acquiring a better understanding of the income elasticity of physical activity is important for policy development

Validation of verbal autopsy: determination of cause of deaths in Malaysia 2013

Background Mortality statistics by age, sex and cause are the foundation of basic health data required for health status assessment, epidemiological research and formation of health policy. Close to half the deaths in Malaysia occur outside a health facility, are not attended by medical personnel, and are given a lay opinion as to the cause of death, leading to poor quality of data from vital registration. Verbal autopsy (VA) is a very useful tool in diagnosing broad causes of deaths for events that occur outside health facilities. This article reports the development of the VA methods and our principal finding from a validation study. Methods A cross sectional study on nationally representative sample deaths that occurred in Malaysia during 2013 was used. A VA questionnaire suitable for local use was developed. Trained field interviewers visited the family members of the deceased at their homes and conducted face to face interviews with the next of kin. Completed questionnaires were reviewed by trained physicians who assigned multiple and underlying causes. Reference diagnoses for validation were obtained from review of medical records (MR) available for a sample of the overall study deaths. Results Corresponding MR diagnosis with matched sample of the VA diagnosis were available in 2172 cases for the validation study. Sensitivity scores were good (>75%) for transport accidents and certain cancers. Moderate sensitivity (50% - 75%) was obtained for ischaemic heart disease (64%) and cerebrovascular disease (72%). The validation sample for deaths due to major causes such as ischaemic heart disease, pneumonia, breast cancer and transport accidents show low cause-specific mortality fraction (CSMF) changes. The scores obtained for the top 10 leading site-specific cancers ranged from average to good. Conclusion We can conclude that VA is suitable for implementation for deaths outside the health facilities in Malaysia. This would reduce ill-defined mortality causes in vital registration data, and yield more accurate national mortality statistics.This study was funded by the Ministry of Health, Malaysia

Sociodemographic factors associated with waist circumference among male and female adults: findings of the Malaysian adult nutrition survey 2014

Introduction: This study examined how waist circumference (WC) varied across sociodemographic characteristics of Malaysian adults using a nationally representative data. Methods: Data from the Malaysian Adult Nutrition Survey 2014 (n = 2696) was used. In the sample, 46.55% were males and 53.45% were females. The outcome variable was WC. Waist circumference was categorised into four ordinal outcomes: Very low, low, high and very high. The explanatory variables were age, monthly individual income, education, gender, marital status, ethnicity, employment status and household location. Ordered probit models were utilised. Results: The majority of males had a low WC (54.66%), and only a small proportion had a very high WC (0.96%). Similarly, a high proportion of females had a low WC (55.59%), and only 1.94% had a very high WC. Younger males were more likely to have a high WC than their older counterparts. Males who had monthly income of RM2000-2999 or RM3000-3999 were more likely to have a high WC compared with those who had monthly income of ≤RM999. Chinese and Indian males were more likely to have a high WC than Bumiputera males. For females, those who were married, widowed/divorced and Bumiputera were likely to have a high WC. Conclusion: WC was associated with various sociodemographic profiles of males and females. In particular, there were positive associations between the likelihoods of having a high WC and younger age group, higher income, Chinese, Indian, and being married. Our findings provided policy makers with better information on formulating intervention measure

Prediction of body fat loss in relation to change in nutrient intake among housewives participating in the MyBFF@ home study

Background: Diet compositions are likely to be one of the influential factors for body fat deposition. The aim of this paper was to determine the nutrient changes and its association to body fat loss among the overweight and obese housewives in the MyBFF@home study. Methods: Data of participants in the MyBFF@home study (intervention and control groups) were analysed. Participants in the intervention group received personalised dietary counselling consisted of reduced calorie diet 1200–1500 kcal/day, while the control group was assigned to receive women’s health seminars. The dietary assessment was done during the intervention phase at baseline, 1 month (m), 2 m, 3 m and 6 m using a 3-day food diary. Body fat was measured using a bioelectrical impedance analyser (In-body 720) at baseline and at the end of the intervention phase. The mean differences of nutrient intake and body compositions during the intervention phase were measured with paired t-test. The changes in body fat and nutrients intake were calculated by subtracting baseline measurements from those taken at 6 months. Multiple linear regression analysis was conducted to determine the extent to which the changes in each gram of nutrients per 1000 kcal were predictive of changes in body fat mass. Results: There were significant reductions in energy, all macronutrients, dietary fibre, calcium and iron intake in both study groups after the intervention phase (p <  0.05). In the intervention group, body fat loss increased with the reduction of each gram of carbohydrate, protein and fat per 1000 kcal, (p <  0.05), and decreased with the reduction of each gram of calcium and fibre intake per 1000 kcal (p <  0.05). In the control group, body fat loss increased with the reduction of each gram fat per 1000 kcal (p <  0.05) and decreased with the reduction of each gram iron per 1000 kcal. Conclusion: Changes in the intake of various nutrients have different effects on body fat loss between the intervention and control group