National Health And Morbidity Survey Research Articles

Determinants of the utilization of recognized traditional and complementary medicine service in Malaysia: a secondary analysis of a cross-sectional population-based survey.

The utilization of traditional and complementary medicine (T&CM) services has witnessed a global increase over the past decades. Currently, seven practice areas are recognized in Malaysia: traditional Malay medicine, traditional Chinese medicine, traditional Indian medicine, homeopathy, Islamic medical practice, chiropractic, and osteopathy. Many global studies have investigated the general determinants of T&CM service utilization. However, there has been no comprehensive study reporting specific determinants of recognized T&CM service utilization. This study aimed to examine the prevalence and specific determinants of recognized T&CM service utilization in Malaysia at a national level. This study is a secondary analysis of data from the National Health and Morbidity Survey (NHMS), a cross-sectional population-based survey conducted in Malaysia in 2015. A total of 6,207 respondents aged ≥18 years were included in this study. The associations of sociodemographic, health, and lifestyle factors with the utilization of the three T&CM service categories (traditional Malay medicine, traditional Chinese medicine, and other T&CM) were examined using three separate logistic regression analyses. The prevalence of recognized T&CM service utilization in the last 12 months was 19.3%, with 15.0% for traditional Malay medicine, 3.9% for traditional Chinese medicine, and 1.5% for other T&CM. The determinants of traditional Malay medicine service utilization were female sex; age range of 18-29 years; married or widowed/divorced status; Malay, Indigenous or other ethnicities; high household income; and being overweight/obese. The determinants of traditional Chinese medicine service utilization were the age range of 30-49 years, urban residential location, Chinese ethnicity, and adequate fruit and vegetable intake. No specific determinants were identified for other T&CM. This study provided novel evidence of a strong ethnocultural ownership towards traditional medicine. User profiles were distinctively different between varied T&CM services. Customized approaches to regulate, develop, and institutionalize specific T&CM services are crucial for fulfilling the unique needs of diverse communities.

Identifying obesogenic environment through spatial clustering of body mass index among adults

BackgroundThe escalating trend of obesity in Malaysia is surmounting, and the lack of evidence on the environmental influence on obesity is untenable. Obesogenic environmental factors often emerge as a result of shared environmental, demographic, or cultural effects among neighbouring regions that impact lifestyle. Employing spatial clustering can effectively elucidate the geographical distribution of obesity and pinpoint regions with potential obesogenic environments, thereby informing public health interventions and further exploration on the local environments. This study aimed to determine the spatial clustering of body mass index (BMI) among adults in Malaysia.MethodThis study utilized information of respondents aged 18 to 59 years old from the National Health and Morbidity Survey (NHMS) 2014 and 2015 at Peninsular Malaysia and East Malaysia. Fast food restaurant proximity, district population density, and district median household income were determined from other sources. The analysis was conducted for total respondents and stratified by sex. Multilevel regression was used to produce the BMI estimates on a set of variables, adjusted for data clustering at enumeration blocks. Global Moran’s I and Local Indicator of Spatial Association statistics were applied to assess the general clustering and location of spatial clusters of BMI, respectively using point locations of respondents and spatial weights of 8 km Euclidean radius or 5 nearest neighbours.ResultsSpatial clustering of BMI independent of individual sociodemographic was significant (p < 0.001) in Peninsular and East Malaysia with Global Moran’s index of 0.12 and 0.15, respectively. High-BMI clusters (hotspots) were in suburban districts, whilst the urban districts were low-BMI clusters (cold spots). Spatial clustering was greater among males with hotspots located closer to urban areas, whereas hotspots for females were in less urbanized areas.ConclusionObesogenic environment was identified in suburban districts, where spatial clusters differ between males and females in certain districts. Future studies and interventions on creating a healthier environment should be geographically targeted and consider gender differences.

Oral Health-Related Quality of Life Among Non-institutionalized Elderly in Malaysia: A Teaching Hospital-Based Survey.

Background In Malaysia, the Geriatric Oral Health Assessment Index (GOHAI) has been recognized as a vital instrument for evaluating oral health-related quality of life among the elderly population. Its integration into the National Health and Morbidity Survey (NHMS) in 2018 demonstrates the country's dedication to understandingand addressing the unique oral health challenges faced by older individuals. The NHMS, led by the Ministry of Health Malaysia, serves as a crucial platform for identifying and addressing healthcare needs, while also working towards achieving sustainable development goals. This study aimed to provide valuable information for stakeholders and researchers by investigating the relationship between quality of life related to oral health and demographic factors, with the ultimate goal of enhancing oral healthcare for older individuals. Objective The objective of this research was to identify the variables that impact the Oral Health-Related Quality of Life (OHRQoL) of non-institutionalized elderly individuals who visit the Klinik Pergigian Manipal University College Malaysia (MUCM). By utilizing the OHRQoL, dental practitioners can gain insight into the elderly's oral health-related quality of life, which is crucial information for dental healthcare providers to effectively reach out to and cater to the elderly at the institution. Methodology A cross-sectional design was employed, utilizing a non-probability sampling method to select eligible elderly individuals at the clinic. A validated questionnaire comprising 18 items covering sociodemographic details and the Geriatric Oral Health Assessment Index (GOHAI) was distributed to individuals above 60 years via printed forms. One way ANOVA, unpaired t-test and multiple linear regression analysis were performed to analyze the data. Results The overall mean GOHAI score among non-institutionalized elderly attending Klinik Pergigian MUCM was 48.38±9.33, indicating poor OHRQoL. The psychosocial impact domain had a mean score of 19.33±5.21, surpassing the pain and discomfort domain with a score of 10.73±2.82, highlighting the significant impact of psychosocial factors on poor oral health-related quality of life. Multiple linear regression analysis revealed no significantassociations between OHRQoL and factors such asethnicity, living arrangements apart from spouse and family, or tertiary education among older individuals after adjusting for confounding variables. Conclusions This study indicates that sociodemographic aspects have minimal impact on the OHRQoLof seniors. Further examination is needed to understand the economic aspects of tooth replacement options and preventive measures in this age group. To enhance the OHRQoLof older adults, especially those not living infacilities like nursing homes or assisted living centers,tailored oral healthcare plans and strategies arecrucial. Interdisciplinary collaboration among mental health professionals, geriatric experts, and oral healthcare providers is crucial for empowering both healthcare practitioners and seniors to maintain optimal oral health.

Suicide attempt among Malaysian school-going adolescents: relationship with bullying

BackgroundAccording to World Health Organization (WHO), the fourth leading cause of death among adolescents aged 15 -19 years is suicide. The National Health and Morbidity Survey (NHMS) 2017 reported that suicidal attempts among school adolescents increased from 6.8%—6.9% as compared to NHMS 2012. Suicide attempts can cause significant negative impacts on health, social and economic status. Bullying is one of the factors for adolescent suicide attempts, and its relationship to suicidality in adolescents has been shown in numerous research.ObjectivesThis study examined the relationship between suicide attempts and bullying among school adolescents in Malaysia.MethodsData from the Malaysia NHMS 2017, a nationwide study that adopted a two-stage cluster sampling design, were analysed. The survey used a self-administered questionnaire in bilingual language adapted from GSHS developed by WHO. Participants were secondary school students aged 13 -17 in all states. Descriptive and multiple logistic regression analyses were performed using IBM SPSS version 28.ResultsA total of 27,497 school adolescents participated in the study. Results showed that 6.9% of school adolescents had attempted suicide. There was 16.2% of adolescents being bullied. Multiple logistic regression revealed that students who were bullied were more likely to have suicide attempts (aOR 4.827, 95% CI: 4.143, 5.624) P < 0.001.Discussion/conclusionThis study revealed that bullying is associated with suicide attempts among school adolescents in Malaysia. The respective authority should consider and plan effective measures to curb bullying among school adolescents.

Stunting and Its Associated Factors among Children Below 5 Years Old on the East Coast of Peninsular Malaysia: Evidence from the National Health and Morbidity Survey

Background: Child malnutrition problems still occur in Malaysia, particularly stunting. This study aimed to determine the proportion of stunting among children below 5 years old and investigate the factors associated with stunting on the East Coast of Peninsular Malaysia. Methods: This study utilised data from the 2016 National Health and Morbidity Survey (NHMS). Multiple logistic regression was used to determine the factors associated with malnutrition among non-stunted and stunted children. Results: The proportion of stunting among children below 5 years old in this East Coast region was 26.2%. When divided by state, Kelantan had the highest proportion of stunting, followed by Pahang and Terengganu, at 28.8%, 26.2% and 23.4%, respectively. In this study, the factors associated with stunting were children aged 24 months old–59 months old (adjusted odds ratio [aOR]: 1.52; 95% CI: 1.26, 1.83; P &lt; 0.001), male children (aOR: 1.47; 95% CI: 1.23, 1.76; P &lt; 0.001), Orang Asli children (aOR: 2.84; 95% CI: 1.86, 4.32; P &lt; 0.001), children with low birth weight from 1,500 g to 2,499 g (aOR: 1.86; 95% CI: 1.36, 2.55; P &lt; 0.001) and children from households that practice unsanitary waste disposal (aOR: 1.42; 95% CI: 1.16, 1.74; P = 0.001). Conclusion: Stunting among children under the age of 5 years old on the East Coast of Peninsular Malaysia remains a public health problem. To reduce the prevalence of stunting in this region, intervention programmes should be intensified. Emphasis should be placed on public health programmes that target the associated factors, such as dietary habits, Orang Asli children, low birth weight and unsanitary waste disposal.

Assessing the population’s correct knowledge of malaria in Malaysia: a vital component for malaria elimination certification

BackgroundMalaria remains a public health problem in Malaysia despite a decline in the number of cases in recent years. Public knowledge of malaria is essential to achieving and maintaining malaria elimination. Therefore, this survey assessed the prevalence of people who had ever heard of malaria, had correct knowledge of malaria transmission, symptoms, risk activities, and prevention measures in the Malaysian population, and identified the associated factors involved.MethodsThe data were obtained from the National Health and Morbidity Survey (NHMS) which was conducted from September to October 2020. A cross-sectional survey with five structured questionnaires using the method of computer-assisted telephone interviews (CATI) was used to collect data. The socio-demographic characteristics such as age, gender, ethnicity, nationality, marital status, educational level, and occupation were recorded. Data were analysed using STATA SE Version 16. Associations between variables were tested using chi-square and logistic regression, with the level of statistical significance set at p < 0.05.ResultsOut of 3085 respondents who participated in this survey, 2491 had ever heard of malaria with a prevalence of 76.1% (95% CI 70.5, 80.9). The prevalence of correct knowledge of malaria transmission was 53.9% (95% CI 50.2, 57.7), symptoms 24.1% (95% CI 21.2, 27.2), risk activities 34.0% (95% CI 29.3, 39.1) and prevention measures 59.7% (95% CI 55.5, 63.7). Multivariate analysis showed that age, ethnicity, and educational level were significantly associated with correct malaria transmission and risk activities. In addition, age and educational level were significantly associated with correct malaria symptoms. Subsequently, only the variable ethnicity showed a significant association with the correct malaria prevention measures.ConclusionIn general, the prevalence of ever heard of malaria was considered high since the survey was performed based on a non-specific malaria population. However, the prevalence of correct knowledge of malaria symptoms and risk activities were considered low. It is concluded that educational level is one of the major factors associated with correct malaria knowledge, along with age and ethnicity. Therefore, based on these findings, targeted intervention and innovation should be planned by malaria programme managers to sustain malaria elimination in Malaysia.

Smoking status and its relationship with depression among the elderly population in Malaysia: Findings from the National Health and Morbidity Survey 2018.

Literature exploring smoking status and its association with depression among the elderly population using nationwide data in Malaysia is limited. Hence, a nationwide survey to determine the prevalence of smoking and depression among the elderly (aged ≥60 years) population was undertaken. This secondary dataset analysis used data from the National Health and Morbidity Survey (NHMS) 2018. Data from 3914 participants were collected on elderly health in the Malaysian population. Sociodemographic characteristics were recorded. Smoking status was grouped as current smokers, former smokers, and non-smokers. A validated Malay language version of the Geriatric Depression Scale (M-GDS-14) was used to screen for depression among the elderly. There was a significant association between smoking status with location, gender, employment status, marital status, ethnicity, education level, income, and depression. Current smokers are significantly higher in rural than urban areas. Among depressed participants, 65.7%, 17.1% and 17.2% were non-smokers, former smokers and current smokers, respectively. Multiple logistic regression showed that single (unmarried/separated/ divorced/widowed) participants were more likely to be depressed compared to married participants (AOR=1.68; 95% CI: 1.16-2.43). Whilst unemployed participants were more likely to be depressed than those who were employed (AOR=1.72; 95% CI: 1.22-2.44). Other Bumiputras were more likely to have depression compared to Malay, Chinese and Indian participants. Participants without formal education were more likely to be depressed compared to those having tertiary education. These participants have a 2-fold increased risk of depression (AOR=2.13; 95% CI: 1.02-4.45). Participants whose monthly salaries were <2000 MYR (AOR=3.67; 95% CI: 1.84-7.31) and 1000-1999 MYR (AOR=2.71; 95% CI: 1.23-5.94) were more likely to have depression compared with those who had received ≥3000 MYR. Ever smokers were more likely to be depressed than non-smokers (AOR=1.68; 95% CI: 1.23-2.29). Elderly Malaysians are indeed at risk of developing depression particularly if they had ever smoked. Public health awareness and campaigning are pertinent to disseminate these outcomes in order to spread the awareness associated with smoking-related depression.

Analysis of Mental Health Problems Among Higher Education Students using Machine Learning

Currently, mental health concerns pose a significant issue in Odisha. Generally, mental health problems affect a person's thoughts, feelings, actions, and communication. As per the 2017 National Health and Morbidity Survey (NHMS), one in five individuals in Odisha suffer from depression, two have anxiety, and one out of ten experiences stress. Additionally, students in higher education are at an elevated risk of developing mental health problems. However, helping a person with mental health concerns can be challenging due to difficulties in identifying the root causes of their condition. The main objectives of this study are to: 1. Explore mental health issues among higher education students. 2. Investigate the factors that contribute to these issues. 3. Assess the effectiveness of machine learning techniques in analyzing and predicting mental health problems among higher education students. Using computational modeling, this paper's findings will contribute to the ongoing discussion on mental health concerns in future research.

Factors influencing the prevalence of cervical cancer screening in Malaysia: a nationwide survey

BackgroundIn 2020, cervical cancer ranked fourth in terms of both frequency of diagnosis and the leading cause of cancer-related deaths among women globally. Among Malaysian women, it was the third most prevalent form of cancer. Published data on nationally representative cervical cancer screening in Malaysia have been limited. Therefore, this study aimed to determine the prevalence of receiving a Pap smear test in the past three years, its relationship with socio-demographic factors and physical activity.MethodsUsing a subset of survey data from the National Health and Morbidity Survey (NHMS) 2019, a secondary data analysis was performed. Trained research assistants collected data through face-to-face method using a mobile tablet questionnaire system application. Logistic regression analysis was performed to examine the relationship between sociodemographic factors, physical activity, and cervical cancer screening. The analyses were conducted using STATA version 14 (Stata Corp, College Station, Texas, USA), accounting for sample weighs and complex sampling design.ResultsThe analysis included 5,650 female respondents, representing an estimated 10.3 million Malaysian female adults aged 18 and above. Overall, 35.2% (95%CI 33.2, 37.4) respondents had a Pap smear test within the past three years. Respondents who were physically active were 1.41 times more likely to have a Pap smear test. Similarly, respondents aged 35–59 (OR 1.84; 95%CI 1.46, 2.34) and those living in rural localities (OR 1.38; 95%CI 1.13, 1.70) had higher odds of receiving a Pap smear test. Compared to married respondents, single respondents (OR 0.04; 95%CI 0.02, 0.07) and widowed/divorcee respondents (OR 0.72; 95%CI 0.56, 0.82) were less likely to receive a Pap smear test. Educated respondents were more likely to have had a Pap smear test.ConclusionsThe overall prevalence of cervical cancer screening in Malaysia remains low (35.2%). Efforts should be made to strengthen health promotion programs and policies in increasing awareness on the significance of cervical cancer screening. These initiatives should specifically target younger women, single women, and widowed/divorced individuals. The higher cervical screening uptake among rural women should be studied further, and the enabling factors in the rural setup should be emulated in urban areas whenever possible.

Ever-never heard of 'Malaysian Healthy Plate': How many people know and practice this healthy eating concept?

The current and simpler healthy eating concept 'Malaysian Healthy Plate', was introduced in 2016. This study aims to determine the prevalence of ever-never heard, understanding, and practice of this concept and also the associated factors to never-heard of Malaysian Health Plate after three years of the implementation. This study utilized the data from the National Health and Morbidity Survey (NHMS) 2019, a cross-sectional survey that applied two-stage stratified cluster sampling. Questionnaires pertained to ever heard, knowledge, and practised of Malaysian Healthy Plate were asked along with another questionnaire. Complex sample analysis was applied to fit with the study design. Estimated 16.9 million (79.6%) adults in Malaysia were never heard of the Malaysian Healthy Plate Concept in 2019. Never heard of this concept was significantly associated with sex (men, aOR 0.265), ethnicity (other ethnicities, aOR 1.79), an education level (no education, aOR 9.59; primary, aOR 3.50; secondary, aOR 1.70), occupation (private, aOR 2.16; self-employed, aOR 2.31; retirees, aOR 1.69; student, aOR 2.31; unpaid workers, aOA 2.35; not working, aOR 2.86), non-diabetes aOR 1.43, and low fruit and vegetable intake person aOR 1.86. Meanwhile, another 20.4% or an estimated 4.3 million adults who were ever heard of Malaysian Healthy Plate. Among those who are ever heard, 80.8% (3.5 million) correctly interpreted or understood the concept and among those who ever heard and understood the concept, only 70.5% (2.5 million) have been practising it daily or occasionally. Four-fifth of adults never heard of the 'Malaysian Healthy Plate' and among those who ever heard, the understanding and practising of the concept were probably unsatisfactory. Multisectoral collaboration is an urge to fasten the promotion to spark awareness and educate the public to practice the concept to promote healthy eating and a healthier nation.

THE DEFENCE MECHANISMS USED BY HYSTERIA MALAY STUDENTS IN KELANTAN TO PROTECT THEMSELVES FROM UNCOMFORTABLE BEHAVIOURS

Malaysians frequently use the term hysteria to describe an illness caused by a subtle disturbance or ghost behaviour. The Malay community considers hysteria to be 'phantom ghost' or 'disturbed’. Such beliefs arose because the Malay community believed that the hysteria that occurred in girls and women was a symptom of ghosts, jinn, and satanic disturbances or anything related to disturbances of subtle and unseen things. The burden of mental illness in Malaysia is high, and it is increasing. Malaysian mental health-related burden comprises up to 37% of total disability. The National Health and Morbidity Survey (NHMS) 2015 revealed a prevalence of 29.2% of Malaysians above 16 years to have mental health problems, with three in ten Malaysians struggling with some form of mental health issues. From the perspective of looking after the future generations of Malaysians, the picture of adolescent mental health is also worrying. The objective of this study was to describe how the Malay students used defence mechanism to protect themselves from unpleasant behaviours. A qualitative approach, psychological tests and triangulation method were used for this study, in which 10 specific hysteria students was selected for in-depth interview. The psychological test were DASS-21 Test and Drawing Test. Snow ball sampling was used to select young girls in high schools who experienced mass hysteria. The results show that the hysteria respondents suffered from trauma, emotional problems, verbal abuse, sexual harassment, and a lacking of their parents’ attention. There are two types of problems: internal and external. The internal problem is their personality. The findings of the study may guide students in Kelantan to get proper treatment from medical professional. If mass hysteria in the Kelantan context is better understood, teachers can be empowered through health education to enable them to identify mass hysteria outbreaks in schools early, manage victims and observers more effectively and refer victims to health workers for treatment.

Patterns of polysubstance use among adults in Malaysia-A latent class analysis.

Polysubstance use is the use of more than one non-prescribed licit or illicit substance at one time. This is a common phenomenon, but little is known about the severity and the various substances used by adults in Malaysia. To determine the pattern of polysubstance use and its associated factors among general adults in Malaysia. This was a secondary data analysis from the National Health and Morbidity Survey (NHMS) 2019), a cross-sectional population survey with a two-stage stratified random sampling design. A total of 10,472 Malaysians aged 18 years and above participated in this survey. Polysubstance use was defined as concurrent use of more than one substance, either alcohol, tobacco, or drugs (opioids, marijuana, amphetamine/ methamphetamine or kratom). A latent class analysis (LCA) was used to identify the membership of polysubstance groups. The association of class membership with demographic profiles was examined using Multinomial Logistic Regression analysis. Fit indices (AIC = 16458.9, BIC = 16443.6) from LCA supported 3 classes solution: Class 1; "moderate-drug" group primarily combination used of tobacco and alcohol (2.4%), Class 2; "high-drug" group using multiple substance including kratom (0.3%) and Class 3; "low-drug" group reporting minimal alcohol and tobacco use or non-user (97.3%). The multinomial model showed young adults (18-40 years) had a higher likelihood of being polysubstance users both for moderate-drug class (OR = 4.1) and high-drug class (OR = 3.9) compared to older age (≥60 years). Chinese (OR = 18.9), Indian (OR = 23.3), Indigenous Sabah & Sarawak (OR = 34.6) and others ethnicity (OR = 8.9) showed higher odds of being moderate-drug users than Malays. The greater odds of moderate-drug use for males (OR = 35.5), working groups (OR = 1.5) and low education level group (OR = 3.2). Our study highlights patterns and demographics related to the use of polysubstances among adults in Malaysia. These results would help formulate specific prevention programmes for these high-risk groups.

Football Training: Prophylaxis of Hypertension and Prediabetes in Malaysia

According to the 2019 National Health and Morbidity Survey (NHMS), 3.4 million Malaysians are affected by at least two of the three major noncommunicable diseases (NCDs), i.e., diabetes, hypertension, and high cholesterol. The fundamental issue in Malaysia is that individuals are unwilling to attend the hospital for periodic examinations and to seek preventative medical care. It is necessary to adapt football training as a hobby and concurrently as a preventative measure against the NCDs as it appears to be the optimal strategy. In Germany, a prospective interventional study was conducted. Statistical analysis using IBM SPSS Statistics version 26 revealed that providing middle-aged hypertensive patients with football training can improve blood pressure control and minimize the need for antihypertensive medication. Using SPSS version 22, it has been demonstrated in a randomized control trial in the Faroe Islands that football training combined with professional nutrition counseling had a greater effect on metabolic and cardiovascular health prediabetes individuals aged 55 to 70 than expert dietary advice alone. At the state level, Selangor has greatly progressed in health sector reform. Initiatives to minimize noncommunicable diseases have received special attention. This study implies that the mission and vision of the Selangor Health and Sports Council align. After a comprehensive assessment, a viable policy for integrating football training as a preventative intervention should be considered.

THE FACTORS OF PRIMARY CHILDHOOD IMMUNIZATION UPTAKE AMONG THE URBAN POOR CHILDREN IN MALAYSIA

Reducing childhood immunization coverage has led to re-emerging of vaccine-preventable diseases among young children. This study aimed to identify the prevalence and predictors of complete childhood immunization among the low socioeconomic urban households’ children in Malaysia. A nationwide survey data from the National Health and Morbidity Survey (NHMS) 2016 was utilized to extract 2668 completed data of respondents who had a household income of less than RM 4,000 and living in urban areas were included in the analysis. The children’s home-based cards were used to verify the data on the primary childhood immunization status. Related data from the household and child health modules were extracted three levels of analysis were conducted using SPSS Version 25 that were descriptive analysis, bivariate analysis and multivariable analysis. The prevalence of complete primary childhood immunization uptake was 89.5%. Mothers of 20 to 29 years old, 30 to 39 years old, and 40 years old and above had 2.704 (aOR=2.704, 95% CI:1.255-5.827), 3.305 (aOR=3.305, 95% CI:1.526-7.160), 3.058 (aOR=3.058, 95% CI:1.165-8.029) higher odds of having children with complete childhood immunization status compared to those younger. Meanwhile, mothers who were self-employed, students and utilized private healthcare facilities had 0.2773 (aOR=0.273, 95% CI:0.138-0.540), 0.063 (aOR=0.063, 95% CI:0.014-0.288) and 0.200 (aOR=0.200, 95% CI:0.118-0.338) lower odds towards complete primary childhood immunization uptake among their children. Below global recommended coverage of complete primary immunization uptake was observed among the urban poor children. Mothers who were young, self-employed, students and utilizing private healthcare facilities should be targeted to improve immunization coverage among children or urban localities.

The Prevalence of Overweight and Obesity among Young Adults in Terengganu: A Cross-Sectional Study

Overweight and obesity are becoming increasingly prevalent in both industrialized and developing countries across the world [1]. Globally, over 1.9 billion adults aged 18 and above were overweight. Over 650 million of them seem to be obese in where 39% of people aged 18 and above were overweight, with 13% being obese (WHO,2019). Meanwhile, the National Health and Morbidity Survey (NHMS) revealed that the prevalence of overweight and obesity among Malaysians aged 18 and older was 50.1 % in 2019 [2]. The BMI classifications of overweight and obesity are as shown: ≥25.0 kg/ as overweight; 25.0 to 29.2 kg/ as pre-obese; 30.0 to 34.9 kg/ as obesity class I; 35.0 to 39.9 kg/ as obesity class II; and ≥40.0 kg/ as obesity class III [3].&#x0D; &#x0D; The objective of this cross-sectional study is to investigate the prevalence of overweight and obesity among adults in Terengganu. A total of 153 individuals aged 18–40 years old from Terengganu were involved in this study and the data were collected using pre-tested self-administered questionnaire from NHMS 2014. The survey was conducted online where all the answers was self-reported. The nutritional status of the participants was assessed using anthropometry measurements by self-measured height (cm) and weight (kg). The measurement was done by using their own measuring scales.&#x0D; The respondents (mean age 22.2 ± 5.4 years) were predominantly female (76.5%), Malay (51.0%) and single (94.8%). Most of the participants are from B40 category (64.7%) where their monthly household income is less than RM 4,850. Meanwhile, most of the participants were staying in their own house (57.5%) and the other participants were staying at rental house (17.0%) and hostel (25.5%). The mean body weight and height of the participants were 59.4 kg and 160.0 cm respectively. The mean BMI of the participants is 23.0 kg/ which is normal range. The participants were overweight (7.8% of male and 13.1% of female), and obesity was 3.3% among males and 4.6% among females. &#x0D; Similarly, in 2017–2018, the prevalence of severe obesity among adults in the United States (US) was 9.2 %, with women having a greater prevalence (11.5%) than men (6.9% ). Participants aged 40–59 years old (11.5%) had the highest frequency of severe obesity. Moreover, obesity is prevalent in France, according to a few studies, with figures ranging from 15 to 17.2% of adults [4].&#x0D; &#x0D; Obesity is a prominent health concern for a range of diseases and conditions, including cardiovascular disease, type 2 diabetes, some malignancies, and decreased life expectancy and death [5]. Hence, the rise in obesity in Malaysia highlights the necessity of public programs aimed at preventing obesity in adults and promoting healthy behaviours in Malaysian population.

Nutritional Strategies to Prevent Muscle Loss after Bariatric Surgery

Obesity is a chronic non-communicable disease that has increased dramatically worldwide [1]. The 2015 National Health and Morbidity Survey (NHMS) showed that the prevalence of overweight, obesity and abdominal obesity in Malaysia had increased by 0.6%, 2.6% and 2.0% respectively as compared to the previous findings of NHMS 2011[2]. Thus, many approaches have been attempted including bariatric surgery. However, it is associated with complications like lean tissue loss, augmented bone loss and a high risk of postprandial hypoglycemia due to patients being unable to achieve adequate dietary protein and accelerated nutrient emptying. Hence, this review paper provides several findings on possible causes of muscle tissue loss and nutritional strategies to prevent muscle loss.&#x0D; &#x0D; Initially, a literature search was conducted from electronic databases like PubMed, Scopus and Google Scholar Science Direct. A total of 15 articles on nutritional strategies to prevent muscle loss after bariatric surgery that was published between January 2017 and May 2022 were retrieved. In this review, several causes of muscle tissue loss, its consequences on a patient’s health and nutritional strategies to preserve muscle protein are summarized in the following figures.&#x0D; In conclusion, bariatric surgery leads to the loss of lean body mass and fat-free mass due to a significant decrease in protein intake and rapid weight loss. This will lead to several consequences that impair basal metabolism and body functions and reduce life quality [7]. Regular and sufficient protein intake together with resistance exercise are essential for muscle preservation [4]. Further research should be continued to increase the understanding of the pathophysiology and related mechanism that causes muscle loss and develop appropriate treatment and possible modifications in current bariatric procedures available.

Lifestyle Practices and Mental Health in Adolescents: Explorative Analysis from Malaysian Health and Morbidity Survey 2017

Many significant psychosocial problems may go undetected and untreated in adolescents. We aim to determine the prevalence of high-risk behaviors among Malaysian adolescents. Retrospective data analysis was performed using data from the National Health and Morbidity Survey (NHMS) 2017 report. The dataset included 27,497 responses from adolescents aged 13 to 17 years old from five established topographic zones: northern peninsular, east coast peninsular, southern peninsular, central, and east Malaysia. The strength of associations between selected high-risk behaviors and different topographical zones were performed using logistic regression analysis. Adolescents from the northern peninsular reported the highest prevalence of suicidal attempt (27.1%) and active drug user (30.1%). The same region reported the highest prevalence of those who ever had sexual intercourse (SI) (27.2%), with 32.5% who had their first SI before 14 years old, while east Malaysia reported the highest prevalence of current smokers (26.1%) and current alcohol consumers (30.6%). Overall poor lifestyle choices were evident in the northern peninsular region. Hence, specific districts breakdown may enable targeted interventional lifestyle strategies for adolescents at risk.

Findings from a Nationwide Study on Alcohol Consumption Patterns in an Upper Middle-Income Country.

Alcohol consumption is a risk factor for various diseases, especially non-communicable diseases (NCDs) and injuries. The reduction of the harmful use of alcohol is mentioned in Target 3.5 of the Sustainable Developmental Goals (SDG). This study aimed to determine factors associated with current alcohol drinking among Malaysians aged 15 years and above. Data from the National Health and Morbidity Survey (NHMS) 2019, a cross-sectional nationwide survey using a two-stage stratified random sampling design, was used. Current alcohol drinking was defined as having consumed any alcoholic beverage in the past 12 months. Descriptive statistics and multiple logistic regression analysis were employed. The prevalence of current drinkers was 11.5%; 95% CI: 9.8, 13.5. The majority (65%) consumed alcoholic beverages in Category 2, which is mainly beer. Current drinkers consumed alcohol mostly once a month (59.0%), one or two drinks (71.1%), on a typical day. Most respondents had six or more drinks less than once a month (27.6%). Sex, age, ethnicity, education, employment, and smoking were found to be significantly associated with current alcohol drinking. Marital status, locality of residence, and household income were not significantly associated. Alcohol drinking is a problem among certain vulnerable groups and should be tackled appropriately.

Overweight and Obesity Among Rural Community in Northern Borneo: Prevalence, Body Weight Perception and Its Associated Factors

The World Health Organization (WHO) reported that Malaysia has the highest rate of obesity and overweight among Asian countries. There is an increasing trend in obesity from 11.9% (2015) to 14.8% (2019), according to the National Health and Morbidity Survey (NHMS). This study aimed to investigate the prevalence, bodyweight perception, and associated factors of overweight and obesity among rural communities in Northern Borneo. This cross-sectional study was conducted in one village in Northern Borneo. Adults from 18 to 69 years of age (n = 165) were included in the survey, and data were collected by interview or self-administered questionnaires. Measurements of weight and height were done for body-mass-index (BMI) calculation. The prevalence of overweight and obesity in the village was 71.5%. Kappa statistic indicated only a slight agreement between perceived and actual body weight status (k = 0.163, 95% CI = −0.156 to 0.482, p &lt; 0.000). There were higher odds of being overweight and obese among the middle-aged group (35 – 55 years old) than the younger group (&lt;35 years old) (OR = 3.575; 95% CI: 1.667, 7.667; p &lt; 0.05) and among the married adults than the unmarried adults (OR = 2.196; 95% CI: 1.057, 4.565; p &lt; 0.05). Although age and marital status are non-modifiable factors of overweight and obesity, this research indicated poor consistency between perceived and actual body weight with kappa statistics. The large magnitude of body weight misperception might contribute to overweight and obesity in the rural community.

Intergenerational Transmission of Obesity from Mothers to Their Offspring: Trends and Associated Factors Derived from the Malaysian National Health and Morbidity Survey (NHMS).

Along with the increasing overweight and obesity trends among adults and children globally, numerous studies have suggested a strong association between maternal overweight and obesity among their offspring. We sought to report the prevalence and associated factors of intergenerational overweight and obesity among mother–child pairs in Malaysia from 2006 to 2015. Data were analysed from three waves of the Malaysian National Health and Morbidity Survey, a population-based cross-sectional study conducted in 2006, 2011 and 2015. A mother and the youngest child from each household formed ‘mother–child pairs’ and were grouped according to their body mass index categories. A multivariable logistic regression model was performed to determine the factors associated with overweight mother/overweight child pairs (OWM/OWC), with normal weight mother/normal weight child pairs (NWM/NWC) as the reference group. The prevalence of OWM/OWC increased from 15.3% to 21.7%, while the prevalence of NWM/NWC decreased from 28.4% to 23.8% between 2006 and 2015. Older maternal age and having primary and secondary education levels were positively associated with OWM/OWC. Conversely, older child age, Chinese ethnicity, large household size and low-income households were inversely associated with OWM/OWC. In conclusion, intergenerational weight gain is a worrisome trend in Malaysia. These findings may help in guiding priority setting for obesity prevention strategies in Malaysia.