Women's participation in household decision making and implementation - a case of urban low income households in Kuala Lumpur

Kajian ini dijalankan untuk menentukan kesahihan instrumen untuk menilai pembuatan dan pelaksanaan keputusan dalam isi rumah oleh wanita. Secara khususnya, kajian ini membandingkan penglibatan ibubapa dalam pembuatan dan pelaksanaan keputusan, seterusnya menentukan faktor-faktor yang menyumbang kepada pembuatan dan pelaksanaan keputusan isi rumah oleh ibu. Subjek terdiri daripada wanita berbangsa Melayu daripada isi rumah berpendapatan rendah di Kuala Lumpur. Pengumpulan data dilakukan melalui temu bual dengan ibu dengan menggunakan borang soalselidik berstruktur yang telah diuji kesahihannya. Maklumat yang diperoleh dianalisis secara deskriptif serta menggunakan ujian-T berpasangan dan one-way ANOVA. Hasil kajian mendapati bahawa bapa lebih menglibatkan diri dalam proses pembuatan dan pelaksanaan keputusan berbanding ibu terutamanya dalam aspek pendapatan dan perbelanjaan keluarga (p < 0.001), sementara ibu lebih mendominasi aspek-aspek berkaitan makanan dan penjagaan anak, kesihatan serta pemberian makanan. Terdapat perbezaan yang signifikan antara penglibatan ibu dan bapa dalam proses pelaksanaan keputusan (p < 0.01) tetapi tiada perbezaan didapati dalam proses pembuatan keputusan. Secara keseluruhannya didapati ibu lebih menglibatkan diri dalam pelaksanaan keputusan berbanding pembuatan keputusan isi rumah. Terdapat perbezaan yang signifikan untuk penglibatan ibu dalam pembuatan dan pelaksanaan keputusan mengikut status pekerjaan dan pendapatan yang diperoleh oleh ibu. Ibu yang bekerja (p < 0.01) dan mempunyai pendapatan sendiri (p < 0.001) lebih menglibatkan diri dalam pembuatan dan pelaksanaan keputusan secara keseluruhannya. Pekerjaan ibu dan pendapatan yang diperoleh mungkin merupakan antara faktor yang menyumbang kepada autonomi di kalangan wanita dan secara tidak langsung meningkatkan imej diri dan mempengaruhi status kesihatan dan pemakanan anak mereka. Kesimpulannya, hasil kajian menunjukkan kesahihan instrumen yang digunakan dan menyokong kepentingan melihat proses pembuatan dan pelaksanaan keputusan isi rumah sebagai dua mekanisme yang berbeza

Maternal child feeding knowledge and practices and growth status of young children aged 6 to 24 months in Kuala Lumpur

This study was conducted to determine the association between maternal child feeding knowledge and practices with the growth status of young children. A total of 102 young children (62 boys and 40 girls) aged between 6 and 24 months old and their mothers participated in this study. A set of structured questionnaire; was used to obtain information on socio-economic, demographic characteristics, maternal feeding knowledge and practices, and anthropometric measurements of the young children. Maternal feeding knowledge was assessed in three different constructs i.e. general nutrition, breastfeeding and complementary feeding. Maternal feeding practice was assessed by examining whether mothers met the WHO guidelines for continued breastfeeding or feeding of milk or milk products, number of feeding times and number of food groups. Anthropometric measurements of the children such as weight and recumbent length were obtained using TANITA weighing scale and wooden measuring board, respectively. The anthropometric measurements were then compared to the National Center for Health Statistics (NCHS) reference. The results indicated that 18.6% (n=19) of the young children were significantly underweight, 16.7% (n=17) mildly underweight, and 3.9% (n=4) were overweight. The percentage of children with significant and mild wasting were 17.6% (n=18) and 32.4% (n=33) respectively, while 14.7% (n=15) and 34.3 (n=35) were significantly and mildly stunted respectively. Maternal feeding data showed that the mean of maternal feeding knowledge score in the three constructs were 6.73±0.18, 5.97±0.19 and 6.57±0.18, for general nutrition, breastfeeding and complementary feeding respectively. The total score for each construct was 10. The mean total knowledge score obtained was 19.26±4.12. Maternal feeding practice data indicated that 97.1% (n=99) of the mothers continued breastfeeding or feeding milk or milk products, 33.3% (n=34) of the children were fed the recommended minimum number of times, and 81.4% (n=83) of the children were fed the recommended minimum number of food groups. Statistical test on the association between maternal child feeding knowledge and practices with the growth status of young children will be further conducted. Maternal nutritional knowledge and child feeding practices should not be overlooked as factors that may influence growth status of young children

Household food insecurity and coping strategies in a poor rural community in Malaysia

This cross-sectional study assessed household food insecurity among low-income rural communities and examined its association with demographic and socioeconomic factors as well as coping strategies to minimize food insecurity. Demographic, socioeconomic, expenditure and coping strategy data were collected from 200 women of poor households in a rural community in Malaysia. Households were categorized as either food secure (n=84) or food insecure (n=116) using the Radimer/Cornell Hunger and Food Insecurity instrument. T-test, Chi-square and logistic regression were utilized for comparison of factors between food secure and food insecure households and determination of factors associated with household food insecurity, respectively. More of the food insecure households were living below the poverty line, had a larger household size, more children and school-going children and mothers as housewives. As food insecure households had more school-going children, reducing expenditures on the children's education is an important strategy to reduce household expenditures. Borrowing money to buy foods, receiving foods from family members, relatives and neighbors and reducing the number of meals seemed to cushion the food insecure households from experiencing food insufficiency. Most of the food insecure households adopted the strategy on cooking whatever is available at home for their meals. The logistic regression model indicates that food insecure households were likely to have more children (OR=1.71; p<0.05) and non-working mothers (OR=6.15; p<0.05), did not own any land (OR=3.18; p<0.05) and adopted the strategy of food preparation based on whatever is available at their homes (OR=4.33; p<0.05). However, mothers who reported to borrow money to purchase food (OR=0.84; p<0.05) and households with higher incomes of fathers (OR=0.99; p<0.05) were more likely to be food secure. Understanding the factors that contribute to household food insecurity is imperative so that effective strategies could be developed and implemented

Nutritional status of Rohingya children in Kuala Lumpur

The Rohingya is a group of refugees from Myanmar who have been residing in Malaysia since the 1980s. At present, there is no published information on health and nutritional status of refugee children in Malaysia. This study was conducted to assess nutritional status of the Rohingya children aged 6 months to 12 years old (N=87) and to determine the associations between nutritional status with socio-demographic, dietary diversity and health (birth weight, immunization and childhood illness) variables. Children were measured for weight and height while their guardians were interviewed for socio-demographic, dietary diversity and health information. About 27.5% of the Rohingya children were underweight, 11.5% stunted, 16.1% thin and 12.6% at risk of overweight and overweight. The percentage of children with low birth weight (< 2.5 kg) and no immunization was 17.8% and 11.5%, respectively. Fever (67.8%) and flu (62.1%) were the most common childhood illnesses reported in previous month with 44-75% of the children with these illnesses did not receive any medical treatment. The mean dietary diversity score was 8.9+3.2 out of a possible 14, with a higher score indicating a more diverse diet. There were significant correlations between frequency of immunization received by the children with weight-for-age-z score (rs=0.27, p<0.05), height-for-age-z score (rs=0.25, p<0.05) and BMI-for-age-Z score (rs=0.24, p<0.05). Height-for-age-z score was also positively correlated with childhood illness score (rp=0.24, p<0.05) and dietary diversity score (rp=0.23, p<0.05) in that children with less common childhood illnesses and variety of foods in the diets had better linear growth. As refugees have limited access to health care services, they are at greater risk of health and nutritional problems

A workplace email-linked website intervention for modifying cancer-related dietary and lifestyle risk factors: rationale, design and baseline findings

INTRODUCTION: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. METHODS: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. RESULTS: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 < 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. CONCLUSION: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

Determination of factors associated with physical activity levels among adolescents attending school in Kuantan, Malaysia.

Introduction: Findings from the National Health and Morbidity Survey III (MOH, 2008) indicate a 43.7% prevalence of physical inactivity among Malaysian adults. This sedentary lifestyle can also be observed among children and adolescents. Methodology: A cross-sectional study was conducted to determine factors associated with physical activity levels of four hundred, 13 year-old adolescents in Kuantan, Pahang. Data on socio-demographic, health-related, and psychosocial factors were collected using a self-administered questionnaire while physical activity level was assessed using the Physical Activity Questionnaire for Older Children (PAQ-C). Results: About one-third of the respondents were in the low physical activity level category, 61.5% were in the moderate category and only 3.0% of the adolescents were in the high physical activity level category. Males were more physically active than females (χ 2=23.667, p=0.0001) with female adolescents (45.1%) twice as likely as male adolescents (22.1%) to be in the low physical activity level category. The associations between physical activity level with socio-demographic and health-related factors, perception of weight status and body parts satisfaction were not significant. However, physical activity was found to be positively correlated with physical activity self-efficacy (r=0.496, p=0.0001), peer influence (r=0.468, p=0.0001), family influence (r=0.298, p=0.0001) and beliefs in physical activity outcomes (r=0.207, p=0.0001). Negative relationships were found between physical activity with depression (r=-0.116, p=0.021) and body size discrepancy (r=-0.143, p<0.01). Respondents who had a better perception of their current health status were more physically active (χ 2=21.062, p=0.0001). Multivariate analyses for the prediction of physical activity showed that physical activity self-efficacy, sex and peer influence were the most significant contributors in explaining physical activity among adolescents. Conclusion: Physical activity interventions should include psychosocial components as mediator variables in interventions designed to promote regular physical activity in adolescence

Socio-demographic characteristics and nutritional status of individuals by stages of change for dietary fat reduction.

Changes in lifestyle and food habits have been implicated in the increasing rate of nutrition related chronic diseases in Malaysia. A cross-sectional study was conducted to identify socio-demographic characteristic and nutritional status of individuals by their readiness to reduce dietary fat intake. A total of 202 non-academic staff aged 18-56 years at Universiti Putra Malaysia participated in the study. Information on demographic, socio-economic and stages of change related to dietary fat reduction were collected using a pre-tested interview-administered questionnaire. Subjects were measured for weight, height and waist circumference. Fasting blood through venipuncture was obtained for triglycerides, LDL-, HDL- and total cholesterol. Energy and dietary fat intake were estimated based on two days 24 h diet recall. Chi-square test and Analysis of Covariance (ANCOVA) were used for data analysis. Of the respondents, about 12% reported reduced fat intake, 20% were not committed to change and more than half (68%) were in preparation stage. There was no significant association between stages of change and socio-demographic factors. Body mass index was highest in preparation group (Mean±SE = 24.93±0.35 kg/m2) [F = 5.686; p<0.01]. Men in action/maintenance group (Mean±SE = 76.22±4.17 cm) had significantly lower adjusted mean waist circumference than those in preparation group (Mean±SE = 89.77±1.85 cm) [F = 5.324, p<0.01]. No significant difference across stages was observed in waist circumference for women, lipid profile, caloric and fat intake. It is important to identify characteristics of individuals by their readiness to change dietary behaviors so that effective nutrition strategies can be developed and implemented to meet their dietary needs and goals

Association between CD36 gene variants, PROP taster status and oral fatty taste intensity perception among Malaysian obese and non-obese subjects

Genetic variation in taste is one of the factors that influence taste perception. This study is carried out to ascertain whether CD36 gene variants and PROP taster status are associated with fatty taste sensitivity and perception among lean and obese individuals. A total of 103 obese and 77 lean subjects with mean age of 25.78 ± 5.65 years who took part in the study were classified into PROP nontasters, medium tasters, or supertasters by using the PROP filter paper screening procedure. The suprathreshold sensitivity for linoleic acid solutions and intensity towards two food products (‘Bubur Chacha’ and mango pudding) with different fat content was assessed using the general Labeled Magnitude Scales. The subjects were genotyped for CD36 gene variants (Single Nucleotide Polymorphism (SNPs): rs1761667, rs152748 and rs1049673). It was observed that obese subjects were less sensitive toward fatty taste and gave a lower creaminess rating for the studied food products. Only one CD36 gene polymorphism i.e. rs1761677 and PROP taster status were associated with fat suprathreshold rating. Subjects with AA homozygous for rs1761667 and the supertaster perceived higher oiliness in linoleic acid solution. PROP supertaster significantly perceived higher creaminess in both the food products, but no association was observed between the creaminess rating and CD36 gene variant (rs1761667). All the CD36 gene variants and PROP taster status were not associated with obesity status. These findings indicated that even though the CD36 gene variant influences individuals’ oral fat sensitivity, PROP taster status plays a more dominant role in fat taste perception among obese and non-obese individuals

Correlates of children's eating attitude test scores among primary school children

A total of 107 Malay primary school girls (8–9 yr. old) completed a set of measurements on eating behavior (ChEAT, food neophobia scales, and dieting experience), the Rosenberg Self-Esteem Scale, body shape satisfaction, dietary intake, weight, and height. About 38% of the girls scored 20 and more on the ChEAT, and 46% of them reported dieting by reducing sugar and sweets (73%), skipping meals (67%), reducing fat foods (60%) and snacks (53%) as the most frequent methods practiced. In general, those girls with higher ChEAT scores tended to have lower self-esteem (r = .39), indicating they were more unwilling to try new foods (food neophobic) (r = .29), chose a smaller figure for desired body size (r = -.25), and were more dissatisfied with their body size (r = .31)

Obesity indices predict hypertension among indigenous adults in Krau Wildlife Reserve, Peninsular Malaysia

Background: The disease burden of indigenous peoples has been augmented by the rising prevalence of obesity and hypertension in this population. This study assessed the ability of obesity indices to predict hypertension among indigenous adults of Peninsular Malaysia. Methods: In this cross-sectional study, 482 adults (223 men, 259 women) aged ≥18 years old were measured for body mass index (BMI), waist circumference (WC), waist-height ratio (WHtR), waist-hip ratio (WHR), and blood pressure. Receiver operating characteristic (ROC) analysis was used to determine the predictive ability of obesity indices for hypertension in men and women. Gender-specific logistic regression analyses were done to examine the association between obesity, defined by BMI, WC, WHtR and WHR, and hypertension. Results: Prevalence of hypertension was 25.5%. Overall, WHtR was the best predictor of the presence of hypertension, in both men and women. The optimal WHtR cut-off values for hypertension were 0.45 and 0.52 in men and women, respectively. Obese adults with WHtR ≥0.5 had about two times increased odds of having hypertension compared to non-obese adults. Conclusions: WHtR may serve as a simple and inexpensive screening tool to identify individuals with hypertension in this relatively difficult to reach population