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

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

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

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

Associations between home environment, dietary practice, and physical activity among primary school children in Selangor, Malaysia

Introduction: The home environment plays an influential role in affecting dietary and physical activity practices of children. This study aimed to determine the association between the home environment, dietary practice and physical activity among primary school children in Selangor. Methods: This cross-sectional study was conducted in five primary schools selected using multistage stratified sampling. A total of 293 children (32.8% males and 67.2% females) (mean age of 11.0±0.9 years) and their parents (10.7% fathers and 89.3% mothers) completed the study. Dietary practice of the children was assessed using a two-day dietary recall. Energy expenditure and physical activity of the children were-assessed using a two-day physical activity recall. Parents of the children completed the Home Environment Survey (HES). Results: The mean energy intake of the children was 1765±416 kcal/day with 75.0% not achieving the Malaysian Recommended Nutrient Intake (RNI) for energy. Almost all children (96.5%) . . were physically inactive, with a mean energy expenditure of 1269±342 kcal/day. High availability of fruit/vegetable at home was associated with high vegetable intake (r=0.128, p<0.05) and low fat intake (r=-0.115, p<0.05). High availability of fats/sweets at home (r=0.125, p<0.05) and parental role modelling of healthy eating (r=0.117, p<0.05) were associated with high fruit intake. High availability of physical activity equipment at home was associated with high energy expenditure (r=0.123, p<0.05). Parental role modelling of physical activity was associated with high energy expenditure (r=0.123, p<0.05) and high physical activity (r=0.123, p<0.05). Conclusion: The results indicate the important roles of parents in promoting healthy eating and active lifestyles among children

Evaluation of diet quality and its associated factors among adolescents in Kuala Lumpur, Malaysia

BACKGROUND/OBJECTIVES: This study aims to determine contribution of meal frequency, self-efficacy for healthy eating, and availability of healthy foods towards diet quality of adolescents in Kuala Lumpur, Malaysia. SUBJECTS/METHODS: This study was conducted among 373 adolescents aged from 13 to 16 years old. Diet quality of the respondents was assessed using the Healthy Eating Index for Malaysians. Meal frequency, self-efficacy for healthy eating, and availability of healthy foods were assessed through the Eating Behaviours Questionnaire (EBQ), self-efficacy for healthy eating scale, and availability of healthy foods scale, respectively. RESULTS: The majority of the respondents (80.7%) were at risk of poor diet quality. Males (mean = 34.2 ± 8.2%) had poorer diet quality than females (mean = 39.9 ± 9.0%) (t = -5.941, P < 0.05). Malay respondents (mean = 36.9 ± 8.7%) had poorer diet quality than Indian respondents (mean = 41.3 ± 10.0%) (F = 2.762, P < 0.05). Age (r = 0.123, P < 0.05), self-efficacy for healthy eating (r = 0.129, P < 0.05), and availability of healthy foods (r = 0.159, P < 0.05) were positively correlated with the diet quality of the respondents. However, meal frequency was not correlated with the diet quality of the respondents. Multiple linear regression analysis showed that being a male, being a Malay, low self-efficacy for healthy eating, and low availability of healthy foods contributed significantly towards poor diet quality among respondents. CONCLUSIONS: In short, sex, ethnicity, self-efficacy for healthy eating, and availability of healthy foods were associated with diet quality among adolescents. Health practitioners should take into consideration of differences in sex and ethnicity during implementation of nutrition-related intervention programs. Self-efficacy for healthy eating and availability of healthy foods should be included as important components in improving diet quality of adolescents

Association between disordered eating and body weight status among adolescents in Kuala Lumpur, Malaysia

Overweight and disordered eating are major public health problems among adolescents due to the high prevalence and potential physical and psychological health consequences. This study aimed to determine the association between disordered eating behaviors and body weight status among adolescents in Kuala Lumpur, Malaysia. A cross-sectional multistage study was conducted in four selected schools in Kuala Lumpur. A total of 501 Malaysian adolescents (male: 42.0%; female: 58.0%) aged between 13–17 years completed the Eating Attitude Test-26 (EAT-26) which was used to screen adolescents who are at-risk of eating disorders and Three Factor Eating Questionnaire (TFEQ-R) was used to measure restrained eating, uncontrolled eating, and emotional eating. Body weight and height of the adolescents were measured. The prevalence of overweight and obesity (21.2%) was three times higher than the prevalence of thinness (7.2%) among adolescents. About one in five (24.4%) of the adolescents were at-risk of eating disorders, with the highest prevalence among obese adolescents (39.3%) followed by overweight (29.8%), normal weight (21.8%) and thin (20.0%) adolescents (X2 = 12.4, p < 0.05). Multiple linear regression analysis showed that adolescents with poor cognitive restraint on eating (R2 changed = 0.18, B = −0.154, p < 0.01) and greater tendency of emotional eating (R2 changed = 0.11, B = 0.075, p < 0.01) explained 29.0% of variances in the BMI-for-age model. In conclusion, disordered eating was prevalent in adolescents, particularly among overweight and obese adolescents. Intervening disordered eating problem should be included as one of the crucial components of overweight and obesity prevention program in adolescents

Malaysian Healthy Diet Online Survey (MHDOS): Study rationale and methodology

Introduction: Access to accurate and timely dietary information is of paramount importance in evaluating and developing well-targeted public health nutrition interventions. However, nationwide nutrition surveys are conducted infrequently because they are very costly to design, conduct and analyse. Dietary assessment tools, which are quick and cost- effective, are needed for population research and regular monitoring of Malaysians’ dietary habits. This paper describes the rationale and methodology of the Malaysian Healthy Diet Online Survey (MHDOS) project, which aims to bridge this knowledge gap on dietary intake of Malaysian adults. The main objective of the two-year project is to develop MHDOS as a valid tool to measure compliance with the Malaysian Dietary Guidelines 2020. Methods: The MHDOS project has three study phases, namely (i) adaptation of an online survey and established diet quality scoring system for Malaysia, (ii) usability, validity and reliability testing of the online survey; and (iii) online survey administration in a nationwide study. The survey will be administered to approximately 10,000 Malaysian adults aged 18-59 years. Discussion: MHDOS consists of 38 questions that measures the quantity, quality and variety of foods consumed. Individuals will receive a diet quality score that reflects their overall compliance with the Malaysian Dietary Guidelines and feedback on how to improve their scores. The findings of the online survey, which serve to complement information between larger surveys, will be useful to measure compliance of Malaysians to national dietary guidelines and inform public health interventions

Associations of Maternal Vitamin D Status and Feeding Practices with the Development of Allergic Diseases and Malnutrition among Infants in Selangor and Kuala Lumpur, Malaysia

Allergic diseases and malnutrition are two of the most common and earliest developing health issues in early childhood. The high prevalence is concerning because of the implications of allergic diseases and malnutrition on long-term health and well-being of the infants. This study aims to determine the associations of maternal vitamin D status during late pregnancy and feeding practices with the development of allergic diseases and malnutrition in infants during the first year of life