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Obesity and disordered eating (DE) have potential shared risk factors, including dietary practice, physical activity level and body image perception. Thus, prevention of both obesity and DE can be done simultaneously. The present study aimed to evaluate the effectiveness of the ‘Eat Right, Be Positive about Your Body and Live Actively’ (EPaL) intervention programme for preventing risk of becoming overweight and DE in Malaysian adolescents. The EPaL intervention programme promoted three main components of healthy lifestyle, namely healthy eating, positive body image and active lifestyle. The present study comprised two phases, in which Phase 1 of the study aimed to develop the EPaL intervention programme and Phase 2 of the study aimed to evaluate the effectiveness of the EPaL intervention programme. The Phase 1 of the study started with a needs assessment, and followed by the development of the EPaL Educational Package (EPaL Educational Module, EPaL Activity Book and EPaL Educational/ Activity Cards and Posters) for adolescents. The needs assessment was conducted using focus group discussions involved 72 secondary school adolescents in Form 1 and Form 2. The EPaL Educational Package, which consisted of EPaL Module: Volume 1 (Topic 1 until Topic 4) and EPaL Module: Volume 2 (Topic 5 until Topic 8), was developed. Content validity of the EPaL Educational Package by a team of expert panels was conducted. The face validity assessment of the EPaL intervention programme involved 54 adolescents aged 11-16 years who evaluated the EPaL intervention programme. The Phase 2 of the study was the evaluation of the effectiveness of the EPaL intervention programme among secondary school adolescents. This study used a quasi-experimental study design. Peer education was applied in coveying the knowledge and skills on healthy lifestyle to the adolescents. It compared the effects of the intervention on personal, eating and physical activity behaviour variables, and health outcomes, betw

Background: Obesity, eating disorders and unhealthy weight-loss practices have been associated with diminished growth in adolescents worldwide. Interventions that address relevant behavioural dimensions have been lacking in Malaysia. This paper describes the protocol of an integrated health education intervention namely 'Eat Right, Be Positive About Your Body and Live Actively' (EPaL), a primary prevention which aimed to promote healthy lifestyle in preventing overweight and disordered eating among secondary school adolescents aged 13-14 years old. Methods/design: Following quasi-experimental design, the intervention is conducted in two secondary schools located in the district of Hulu Langat, Selangor, Malaysia. Adolescents aged 13-14 years will be included in the study. A peer-education strategy is adopted to convey knowledge and teach skills relevant to achieving a healthy lifestyle. The intervention mainly promoted: healthy eating, positive body image and active lifestyle. The following parameters will be assessed: body weight, disordered eating status, stages of change (for healthy diet, breakfast, food portion size, screen viewing and physical activity), body image, health-related quality of life, self-esteem, eating and physical activity behaviours; and knowledge, attitude and practice towards a healthy lifestyle. Assessment will be conducted at three time points: baseline, post-intervention and 3-month follow-up. Discussion: It is hypothesized that EPaL intervention will contribute in preventing overweight and disordered eating by giving the positive effects on body weight status, healthy lifestyle behaviour, as well as health-related quality of life of peer educators and participants. It may serve as a model for similar future interventions designed for the Malaysian community, specifically adolescents.

The food choices in childhood have high a probability of being carried through into their adulthood life, which then contributes to the risk of many non-communicable diseases. Therefore, there is a need to gather some information about children’s views on foods which may influence their food choices for planning a related dietary intervention or programme. This paper aimed to explore the views of children on foods and the types of foods which are usually consumed by children under four food groups (snacks, fast foods, cereals and cereal products; and milk and dairy products) by using focus group discussions. A total of 33 school children aged 7-9 years old from Selangor and Kuala Lumpur participated in the focus groups. Focus groups were audio-taped, transcribed and analyzed according to the listed themes. The outcomes show that the children usually consumed snacks such as white bread with spread or as a sandwich, local cakes, fruits such as papaya, mango and watermelon, biscuits or cookies, tea, chocolate drink and instant noodles. Their choices of fast foods included pizza, burgers, French fries and fried chicken. For cereal products, they usually consumed rice, bread and ready-to-eat cereals. Finally, their choices of dairy products included milk, cheese and yogurt. The reasons for the food liking were taste, nutritional value and the characteristics of food. The outcome of this study may provide additional information on the food choices among Malaysian children, especially in urban areas with regard to the food groups which have shown to have a relationship with the risk of childhood obesity.

Snack and fast food consumption has been identified in contributing to the development of childhood obesity. To date, there is a lack of valid and reliable food frequency questionnaire (FFQ) for the assessment of these food items in Malaysia. The present study was aimed to develop a validated and reliable FFQ for the assessment of snack and fast food consumption among 7-9 years old urban children. This study was divided into two phases. Phase 1 which is the development of FFQ using focus group discussions (FGDs)aimed to identify types of snack and fast food usually consumed by children and to develop a preliminary food list for FFQ. A total of 33 children aged 7-9 years old from Selangor and Kuala Lumpur participated in the FGDs. FGDs were audio-taped, transcribed and analyzed. The outcomes showed that the children usually consumed snacks such as white bread with spread or as sandwich, local cakes, fruits such as papaya, mango and watermelon, biscuits or cookies, tea, chocolate drink and instant noodle. Their choices of fast food included pizza, burger, French fries and fried chicken. The reasons of the food liking were the taste, their knowledge on the nutritional values and the characteristics of foods. The preliminary food list was prepared which included 49 food items. Phase 2 is a validity and reliability study of the FFQ conducted in selected schools in Selangor. For face validity, 50 parents were included in the study and the suggestions of the food items to be included in the FFQ were obtained. A total of 67 food items were prepared to be included in the FFQ which consider the parents’ suggestions. To determine the internal validity, we included 424 parents (68.6% mothers) who have completed the FFQ. Out of 67 items, 37 items were retained in the final model. The factor analysis suggested 6 factors that explained 41.84% of the variance. These factors were labelled local fried and savoury snacks, fresh fruits and fruit juice, sweet snacks, sweetened beverages