Publications by authors named "Nur Shahida Abdul Aziz"

10 Publications

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Low potassium intake and its association with blood pressure among adults in Malaysia: findings from the MyCoSS (Malaysian Community Salt Survey).

J Health Popul Nutr 2021 May 31;40(Suppl 1). Epub 2021 May 31.

Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Selangor, Malaysia.

Background: High blood pressure or hypertension is well recognized as an important modifiable risk factor for cardiovascular diseases. Several studies had indicated potassium intake has a blood pressure lowering effect. This study aimed to estimate potassium intake via 24-h urinary potassium excretion and to determine the association between potassium intake and blood pressure among adults in Malaysia.

Methods: Data for 424 respondents in this study were drawn from MyCoSS, a nationwide cross- sectional study conducted among Malaysians who were 18 years and above. Respondents were recruited using stratified cluster sampling, covering urban and rural areas in each state in Malaysia. Data collection was undertaken from October 2017 until March 2018. A single urine sample was collected over 24 h for quantification of potassium excreted. Information on socio-demography and medical history of the respondents were collected by interviewer-administered questionnaires. Anthropometric measurements were measured using validated equipment. BMI was estimated using measured body weight and height. Digital blood pressure monitor (Omron HBP-1300) was used to measure blood pressure. Descriptive statistics, analysis of variance (ANOVA), and multivariable linear regression were used to analyze the data in SPSS Version 21.

Results: Mean 24-h urinary potassium excretion for the 424 respondents was 37 mmol (95% CI 36, 38). Gender and ethnicity showed statistically significant associations with 24-h urinary potassium excretion. However, potassium excretion was not significantly associated with blood pressure in this study.

Conclusion: Potassium intake is very low among the adults in Malaysia. Therefore, further education and promotional campaigns regarding daily consumption of potassium-rich diet and its benefits to health need to be tailored for the Malaysian adult population.
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http://dx.doi.org/10.1186/s41043-021-00238-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8165986PMC
May 2021

Knowledge, attitude and behaviour on salt intake and its association with hypertension in the Malaysian population: findings from MyCoSS (Malaysian Community Salt Survey).

J Health Popul Nutr 2021 May 31;40(Suppl 1). Epub 2021 May 31.

Wolfson Institute of Preventive Medicine, London School of Medicine & Dentistry, Queen Mary University of London, London, UK.

Background: High blood pressure or hypertension has become one of the main health problems, worldwide. A number of studies have proven that an increased intake of salt was related to an increased prevalence of cardiovascular diseases. Of late, its relationship with high salt intake has received a lot of attention. Studies in Malaysia have shown both rising hypertension over time as well as high salt consumption. Actions to reduce salt intake are essential to reduce hypertension and its disease burden. As such, we carried out a study to determine associations between knowledge, attitude and behaviour towards salt intake and hypertension among the Malaysian population.

Methods: Data obtained from the Malaysian Community Salt Survey (MyCoSS) was used partially for this study. The survey used a cross-sectional two-stage sampling design to select a nationally representative sample of Malaysian adults aged 18 years and above living in non-institutional living quarters (LQ). Face-to-face interviews were done by trained research assistants (RA) to obtain information on sociodemography, medical report, as well as knowledge, attitude and behaviour of the respondents towards salt intake and blood pressure.

Results: Majority of the respondents have been diagnosed with hypertension (61.4%) as well as knowledge of the effects of high salt intake on blood pressure (58.8%). More than half of the respondents (53.3%) said they controlled their salt intake on a regular basis. Those who knew that a high salt diet could contribute to a serious health problem (OR=0.23) as well as those who controlled their salt intake (OR=0.44) were significantly less likely to have hypertension.

Conclusion: Awareness of the effects of sodium on human health, as well as the behaviour of controlling salt intake, is essential towards lowering the prevalence of hypertension among Malaysians.
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http://dx.doi.org/10.1186/s41043-021-00235-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8166009PMC
May 2021

Risk factors related with high sodium intake among Malaysian adults: findings from the Malaysian Community Salt Survey (MyCoSS) 2017-2018.

J Health Popul Nutr 2021 May 31;40(Suppl 1):14. Epub 2021 May 31.

Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Selangor, Malaysia.

Background: High sodium intake was an established risk factor for stroke and cardiovascular diseases. The objective of this study was to investigate factors associated with high sodium intake based on 24-h urinary sodium excretion from the MyCoSS study.

Methods: The cross-sectional survey was conducted among adults aged 18 years and above in Malaysia. A multi-stage stratified sampling was used to represent nationally. Twenty-four-hour urine was collected from a total of 900 respondents. Indirect ion-selective electrode (ISE) method was used to measure sodium intake. Descriptive and logistic regression analysis was applied to determine factors associated with high sodium intake based on 24-h urinary sodium excretion.

Results: A total of 798 respondents (76% response rate) completed the 24-h urine collection process. Logistic regression revealed that high sodium intake associated with obese [aOR 2.611 (95% CI 1.519, 4.488)], male [aOR 2.436 (95% CI 1.473, 4.030)], having a waist circumference of > 90cm for adult males [aOR 2.260 ( 95% CI 1.020, 5.009) and >80cm for adult females [aOR 1.210 (95% CI 0.556, 2.631)], being a young adult [aOR 1.977 (95% CI 1.094, 3.574)], and living in urban areas [aOR 1.701 (95% CI 1.094, 2.645)].

Conclusion: Adults who are obese, have a large waist circumference, of male gender, living in urban areas, and belonging to the young adult age group were found to have higher sodium intake than other demographic groups. Hence, reduction of salt consumption among these high-risk groups should be emphasised to reduce the risk of cardiovascular diseases.
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http://dx.doi.org/10.1186/s41043-021-00233-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8165759PMC
May 2021

Abdominal obesity and its associated factors among older adults in Malaysia.

Geriatr Gerontol Int 2020 Dec;20 Suppl 2:68-72

Nutrition Division, Ministry of Health Malaysia, Putrajaya, Malaysia.

Aim: The rise in the prevalence of abdominal obesity (AO), in particular, has become a major concern as it contributes to diabetes, hypertension, high cholesterol, heart disease and certain types of cancer. The aim of this study is to determine the prevalence and associated factors of AO among older adults aged ≥60 years in Malaysia.

Methods: This was a nationwide cross-sectional study using two-stage stratified random sampling. In total, 3977 older adults aged ≥60 years were involved in this study. Socio-demography characteristics were obtained using self-administered questionnaire. AO was measured using waist circumference and classified according to the cut-off values of ≥90 cm for men and ≥80 cm for women based on the WHO recommendation. Descriptive and multiple logistic regression analysis using a complex sample design were performed for data analysis.

Results: Our findings showed that 2371 (67.3%) older adults had AO. Older adults who were from urban areas (69.7%), of women (78.4%), married (66.7%), with tertiary education (73.6%) and unemployed (70.9%) had the highest prevalence of AO. Those from urban areas (adjusted odds ratio [aOR] = 1.29), women (aOR = 3.12), unemployed (aOR = 1.14), diagnosed with hypertension (aOR = 1.56) and diabetes mellitus (aOR = 2.08) were also significantly associated with a higher risk of AO.

Conclusions: This study identified several risk factors that are associated with AO among older adults in Malaysia. Such information is important and needed to improve the healthcare system systematically, enable nutrition screening and appropriate intervention to combat the growing AO in Malaysia. Geriatr Gerontol Int 2020; 20: 68-72.
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http://dx.doi.org/10.1111/ggi.13962DOI Listing
December 2020

Factors contributing to food insecurity among older persons in Malaysia: Findings from the National Health and Morbidity Survey (NHMS) 2018.

Geriatr Gerontol Int 2020 Dec;20 Suppl 2:73-78

Sector of Biostatistics and Data Repository, National Institutes of Health, Selangor, Malaysia.

Aim: Older persons are vulnerable to food insecurity. Therefore, this study aimed to determine the prevalence of food insecurity and associated factors among older persons in Malaysia.

Methods: This is a cross-sectional study with two-stage stratified random sampling. In total, 3977 older persons participated in this study. Face-to-face interviews were conducted using a mobile device to obtain information about socio-demographic background, food insecurity, non-communicable diseases, social support and living arrangements. Descriptive and multiple complex sample logistic regression analyses were performed for data analysis.

Results: The overall prevalence of food insecurity among older persons was 10.4%. Older persons from rural areas with no or only primary and secondary education, income less than RM 2000 (USD 477.57), at risk of malnutrition and not receiving very high social support were more likely to be food-insecure.

Conclusion: Approximately, one-tenth of Malaysian older adults were classified as food-insecure; particularly those living in rural areas from lower socio-economic status, not receiving very high social support and malnourished were more likely to be at risk. A specific nutrition program, such as meals on wheels and food vouchers, should be targeted toward older persons who are at risk to improve their malnutrition status. Geriatr Gerontol Int 2020; 20: 73-78.
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http://dx.doi.org/10.1111/ggi.14006DOI Listing
December 2020

Body Weight, Body Weight Perception, and Bullying Among Adolescents in Malaysia.

Asia Pac J Public Health 2019 11 16;31(8_suppl):38S-47S. Epub 2019 Oct 16.

Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Jalan Bangsar, Kuala Lumpur, Malaysia.

Body weight is a factor, with body weight perception a mediator, toward being a victim of bullying. This study aimed to explore the association between body weight, body weight perception, and bullying among students 13 to 17 years of age in Malaysia. Data were collected using a self-administered questionnaire. A 2-stage stratified cluster sampling design was used, and 212 schools across Malaysia were selected for this survey. Body weight was measured and body weight perception was the student's reflection of their body weight. The prevalence of being bullied among adolescents in Malaysia was 16.2%. Being too thin or being obese increased the probability of being bullied. Students with a normal body mass index, but with a misperception of their body weight, also had increased odds of being bullied. Obesity prevention, together with instilling positive body weight perception, should be part of all programs directed toward tackling the problem of bullying.
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http://dx.doi.org/10.1177/1010539519879339DOI Listing
November 2019

Factors Associated with High Sodium Intake Assessed from 24-hour Urinary Excretion and the Potential Effect of Energy Intake.

J Nutr Metab 2019 2;2019:6781597. Epub 2019 May 2.

Centre for Nutrition Epidemiology Research, Institute for Public Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia.

Dietary consumption and other environmental factors are known factors associated with sodium intake. However, little is known about the influence of energy intake on this relationship. The aim of this study was to determine the risk factors associated with high sodium intake assessed from urine sodium excretion and the influence of energy intake. A nationwide, cross-sectional study was conducted from 2015 to 2016 among Malaysian health staff (MySalt 2015). A total of 1027 participants from 1568 targeted participants aged 18 years and older that were randomly selected were included in this study. Sodium intake was determined by measuring sodium excretion in the 24 hr urine test. Dietary, sociodemography, and anthropometry variables as associated risk factors were assessed. Multiple logistic regression models were used to determine the association between high sodium intake (≥2000 mg/day urinary sodium) and potential risk factors. The prevalence of high sodium intake in this study was 70.1% (=733). High sodium intake was associated with male (OR 1.93, 95% confidence interval (CI) 1.41, 2.64), Bumiputera Sarawak ethnicity (OR 0.24, 95% CI 0.09, 0.62), and energy-adjusted sodium intake (mg/d) (OR 1.19, 95% CI 1.03-1.39). Our results suggested that sex, ethnicity, and energy-adjusted sodium consumption were strong risk factors associated with high sodium intake independent from energy and other potential confounding factors.
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http://dx.doi.org/10.1155/2019/6781597DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6525945PMC
May 2019

An update on obesity research pattern among adults in Malaysia: a scoping review.

BMC Womens Health 2018 07 19;18(Suppl 1):114. Epub 2018 Jul 19.

Institute for Public Health, National Institutes for Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia.

Background: Obesity is a global health burden in the non-communicable diseases and much efforts have been implemented in the past decade in response to the rise of obesity prevalence among the Malaysian population. These include the development of the national policies, health programmes and research activities. The main aim of the scoping review was to identify obesity research pattern among adults in Malaysia in terms of the scopes, topics and the research designs.

Methods: The scoping review was conducted based on the framework by Arksey and O'Malley. The Preferred Reporting Items for Systematic Reviews and Meta Analysis (PRISMA) diagram was used as a guide to record the review process. Articles from year 2008 until 2017 on overweight and obesity among adults aged 18 years and above were retrieved based on the keywords using electronic databases (Embase/Ovid, Pubmed, Cochrane library and Google Scholar). Local journals, Nutrition Research in Malaysia Biblography (2011 and 2016), online local theses databases, virtual library databases were also included in the searches. Consultations with relevant key informants from the National Institutes of Health and local universities were also conducted. Search activities were managed using Endnote software and MS Excelsheet.

Results: The characteristics of the results were described based on the objectives of the review. A total of 2004 articles and reports were retrieved, and 188 articles related to obesity in Malaysia were included in the final review. Scopes and topics of obesity research based on the Nutrition Research Priorities in Malaysia (NRPM) for 11th Malaysia Plan were obesity prevalence, weight loss intervention, association of physical activities and dietary factors with obesity. The majority of obesity research among adults in Malaysia was cross sectional studies and only a small number of intervention studies, qualitative studies and systematic review were indentified. Research gaps were identified in order to make useful recommendations to the stakeholders.

Conclusions: In the past decade, there has been an emerging evidence on obesity research among adults in Malaysia. More obesity research needs to be conducted particularly on obesity intervention among specific gender, qualitative studies, economic cost and genetic factors of obesity.
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http://dx.doi.org/10.1186/s12905-018-0590-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6069511PMC
July 2018

Changes in body pain among overweight and obese housewives living in Klang Valley, Malaysia: findings from the [email protected] study.

BMC Womens Health 2018 07 19;18(Suppl 1):101. Epub 2018 Jul 19.

Kuala Lumpur General Hospital, Ministry of Health Malaysia, Jalan Pahang, Kuala Lumpur, Malaysia.

Background: Obesity leads to the increase of pain at different parts of the body and it is a potential marker for complications of chronic diseases. This paper aims to assess changes in the body pain among overweight and obese housewives who participated in the My Body is Fit and Fabulous at home ([email protected]) study.

Methods: Housewives aged 18 to 59 years old from the [email protected] study were selected and pain was measured using the Visual Analogue Scale (VAS) questionnaire. VAS measured the pain intensity at different parts of the body (score of 0-10). Data were collected at base line, 3 months and 6 months among the housewives in both the control and intervention group. Pain scores and other variables (age, Body Mass Index (BMI) and waist circumference) were analysed using SPSS version 22.

Results: A total of 328 housewives completed the VAS questionnaires at baseline, while 185 (56.4%) of housewives completed the VAS at 3 months and 6 months. A decreasing trend of mean pain score in both groups after 6 months was observed. However, the intervention group showed a consistent decreasing trend of pain score mainly for back pain. In the control group, there was a slight increment of score in back pain from baseline towards the 6 months period. Older housewives in both groups (aged 50 years and above) had a higher mean score of leg pain (2.86, SD: 2.82) compared to the other age group. Higher BMI was significantly associated with pain score in both groups.

Conclusion: There were some changes in the level of body pain among the housewives before and after the intervention. Older obese women had a higher pain score compared to younger obese women. Pain was associated with BMI and change in BMI appears to be beneficial in reducing body pain among overweight and obese individuals.
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http://dx.doi.org/10.1186/s12905-018-0597-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6069687PMC
July 2018

Influence of co-morbidity on body composition changes after weight loss intervention among overweight housewives: a follow-up study of the [email protected]

BMC Womens Health 2018 07 19;18(Suppl 1):115. Epub 2018 Jul 19.

Institute for Public Health, National Institute of Health, Ministry of Health Malaysia, 50590, Kuala Lumpur, Malaysia.

Background: Obesity is a risk factor for co-morbidities such as diabetes, hypertension, osteoarthritis and cardiovascular diseases. However, it is unclear if the presence of co-morbidities has any effect on the magnitude of body composition changes following weight reduction programmes. Thus, this study aimed to determine changes in body composition among obese housewives with and without co-morbidities after they participated in a weight loss intervention.

Methods: This is a follow-up study among 84 obese housewives without co-morbidities aged 18 to 59 years old who previously participated as a control group (delayed intervention, G1) in the My Body is Fit and Fabulous at Home ([email protected]) Phase II. Baseline data were obtained from 12 month data collection for this group. A new group of 42 obese housewives with co-morbidities (G2) were also recruited. Both groups received a 6 month intervention (July-December 2015) consisting of dietary counselling, physical activity (PA) and self-monitoring tools (PA diary, food diary and pedometer). Study parameters included weight, height, waist circumference, blood pressure and body compositions. Body compositions were measured using a bioelectrical impedance analysis device, Inbody 720. Descriptive and repeated measures ANOVA analyses were performed using SPSS 21.

Results: There were reductions in mean body fat, fat mass and visceral fat area, particularly among obese women without co-morbidities. There were also decreases fat and skeletal muscle from baseline to month six with mean difference - 0.12 (95% CI: -0.38, 0.14) and visceral fat area from month three to month six with mean difference - 9.22 (- 17.87, - 0.56) for G1. G2 showed a decreasing pattern of skeletal muscle from baseline to month six with mean difference - 0.01(95% CI: -0.38, 0.37). There was a significant difference for group effect of visceral fat area (p < 0.05) with mean difference of - 11.49(95% CI: -20.07, 2.91). It showed that the intervention programs was effective to reduce visceral fat area compared to other part of body composition.

Conclusion: Obese participants without co-morbidities showed more desirable changes in body composition. Visceral fat area was reduced regardless of morbidity status. Weight management efforts are therefore not as straightforward in those with co-morbidities compared to those without, and require thorough and tailor-made strategies for a better chance of success.
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http://dx.doi.org/10.1186/s12905-018-0600-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6069513PMC
July 2018