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Background: The COVID-19 pandemic lockdowns have affected daily lives of the communities worldwide. This study aims to determine the lifestyle behaviours and their associations with body weight changes among Malaysian adults during the Movement Control Order (MCO) due to COVID-19 pandemic. Methods: A total of 1319 Malaysian adults participated in this cross-sectional online survey. Information on anthropometric data including body weight and height, and lifestyle behaviours including eating pattern, physical activity, and sleep pattern were self-reported by the respondents. A multivariable generalised linear mixed model was used to assess the associations between lifestyle behaviours and body weight changes with adjustment of confounding factors; namely, age, sex, ethnicity, and body weight status before MCO. Results: During MCO, 41.2% of the respondents perceived that their eating patterns were healthier, but 36.3% reduced their physical activities, and 25.7% had a poorer sleep quality. Further, the proportion of adults who reported having lose weight (32.2%) was almost similar to those who reported having gained weight (30.7%). Lifestyle behaviours including less frequent practice of healthy cooking methods and lunch skipping were associated with weight gain, while less frequent consumption of high fat foods, more frequent physical activity, and good sleep latency were associated with lower risk of weight gain. In contrast, practicing healthy eating concept, skipped lunch, and more frequent physical activity were significantly associated with weight loss. Conclusion Lifestyle behaviours were associated with body weight changes during MCO. While the COVID-19 pandemic lockdown is necessary to prevent further spread of the disease, promoting healthy lifestyle practices during lockdown should be implemented for a healthy weight and better health.

Background: Vitamin D deficiency is common among women during pregnancy. This study aims to determine the prevalence of vitamin D 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 25(OH) D levels. Information on sun exposure and sun protection behaviours were obtained through face-to-face interviews. Dietary vitamin D intake was assessed by using a semi-quantitative food frequency questionnaire.Results: The prevalence of vitamin D deficiency (<30 nmol/L) among Indonesian and Malaysian pregnant women were 42.4% and 72.0%, respectively. Percentage of exposed body surface area was inversely associated with vitamin D deficiency among Indonesian pregnant women (OR = 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 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 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 (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 that nutrition education on vitamin D intake and sun exposure during pregnancy is necessary for primary prevention of vitamin D deficiency in pregnant women living in the tropical countries.

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. In this prospective cohort study, 535 third-trimester pregnant women were recruited from six selected government health clinics at the state of Selangor and Federal Territory of Kuala Lumpur, Malaysia. Their blood sample was collected to determine their serum 25(OH)D concentrations. After delivery, 380 motherinfant pairs completed the 3, 6, and 12 months follow-up. At each follow-up, infant feeding practices and allergic outcomes were assessed based on parental reports. Infant’s anthropometric data were extracted from medical records. At 12 months of age, serum samples were collected from the infants to determine their sensitisation against food allergens. Vitamin D insufficiency and deficiency were observed in 48.8% and 42.8% of the pregnant women, respectively. About 46.6% of the infants were exclusively breastfed until 6 months, 97.1% had timely initiation of complementary feeding, 10.5% met minimum dietary diversity (MDD) at 6 months, and 54.5% met MDD at 12 months. About 27.6% of the infants had eczema, 20.8% had parentreported food allergy (FA), 3.8% had IgE-mediated FA, and 27.4% had food sensitisation during the first year of life. The prevalence of stunting, wasting, underweight, and overweight at 12 months was 16.3%, 7.6%, 11.6%, and 1.8%, respectively. After adjustment for confounders, study sites, and mother-infant pairs clustering effect, results from a multivariable generalised linear mixed model showed that maternal vitamin D deficiency was associated with higher odds o

Allergic diseases are the most common chronic illness in childhood. Findings from developed countries have reported associations between Vitamin D levels during pregnancy and offspring allergy risk. This prospective cohort study aimed to determine the associations between maternal Vitamin D levels during late pregnancy and allergic diseases in Malaysian infants during the first year of life. Serum 25(OH)D concentrations of 380 pregnant women in the third trimester were measured using a chemiluminescent immunoassay. Children’s allergic outcomes were assessed at 3, 6, and 12 months based on parental reports. Specific IgE antibodies against food and inhalant allergens were measured in infants at 12 months of age. A total of 43.2% pregnant women were Vitamin D deficient (<30 nmol/L) and 56.8% were nondeficient (≥30 nmol/L). A total of 27.6% of the infants had eczema, 6.1% had wheeze, 27.4% had food sensitization, 10.8% had inhalant allergen sensitization, and 3.8% had IgE-mediated food allergy during the first year of life. Compared with the nondeficient group, maternal Vitamin D deficiency in late pregnancy was not associated with any allergic outcomes after adjustment for potential confounding factors. In conclusion, the present study does not support an association between maternal Vitamin D levels in late pregnancy and allergic outcomes during the first year of life.

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.

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.

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.

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.

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.