1
|
Tan SY, Poh BK, Sekartini R, Rojroongwasinkul N, Tran TN, Wong JE, Novita Chandra D, Pongcharoen T, Tran KV, Actis-Goretta L, Vonk MM, Ng SA, Parikh P, Khouw I. South East Asian Nutrition Surveys (SEANUTS) II - a multi-country evaluation of nutrition and lifestyle indicators in children aged 12 years and below: Rationale and Design. Public Health Nutr 2024:1-29. [PMID: 38639132 DOI: 10.1017/s1368980024000910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]
Abstract
OBJECTIVE To assess the nutritional status, growth parameters and lifestyle behaviours of children between 0.5-12 years in nationally representative samples in Malaysia, Indonesia, Thailand, and Vietnam. DESIGN A cross-sectional study was conducted in the four countries, between May 2019 and April 2021. Data collected can be categorized into four categories: (1) Growth - anthropometry, body composition, development disorder, (2) Nutrient intake and dietary habits - 24-hour dietary recall, child food habits, breast feeding and complementary feeding, (3) Socio-economic status - food insecurity and child health status/environmental, and (4) Lifestyle behaviours - physical activity patterns, fitness, sunlight exposure, sleep patterns, body image and behavioural problems. Blood samples were also collected for biochemical and metabolomic analyses. With the pandemic emerging during the study, a COVID-19 questionnaire was developed and implemented. SETTING Both rural and urban areas in Malaysia, Indonesia, Thailand, and Vietnam. PARTICIPANTS Children who were well, with no physical disability or serious infections/injuries and between the age of 0.5-12 years old were recruited. RESULTS The South East Asian Nutrition Surveys II recruited 13,933 children. Depending on the country, data collection from children were conducted in schools and commune health centres, or temples, or sub-district administrative organizations. CONCLUSIONS The results will provide up-to-date insights into nutritional status and lifestyle behaviours of children in the four countries. Subsequently, these data will facilitate exploration of potential gaps in dietary intake among Southeast Asian children and enable local authorities to plan future nutrition and lifestyle intervention strategies.
Collapse
Affiliation(s)
| | - Bee Koon Poh
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Rini Sekartini
- Universitas Indonesia, Depok, Cipto Mangunkusumo General Hospital, Indonesia
| | - Nipa Rojroongwasinkul
- Food and Nutrition Academic and Research Cluster, Institute of Nutrition, Mahidol University, Nakhon Pathom, Thailand
| | - Thuy Nga Tran
- Department of Micronutrients, National Institute of Nutrition, Hanoi, Vietnam
| | - Jyh Eiin Wong
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Dian Novita Chandra
- Universitas Indonesia, Depok, Cipto Mangunkusumo General Hospital, Indonesia
| | - Tippawan Pongcharoen
- Food and Nutrition Academic and Research Cluster, Institute of Nutrition, Mahidol University, Nakhon Pathom, Thailand
| | - Khanh Van Tran
- Department of Micronutrients, National Institute of Nutrition, Hanoi, Vietnam
| | | | | | - Swee Ai Ng
- FrieslandCampina, Amersfoort, The Netherlands
| | | | - Ilse Khouw
- FrieslandCampina, Amersfoort, The Netherlands
| |
Collapse
|
2
|
Pongcharoen T, Rojroongwasinkul N, Tuntipopipat S, Winichagoon P, Vongvimetee N, Phanyotha T, Sukboon P, Muangnoi C, Praengam K, Khouw I. South East Asian Nutrition Surveys II (SEANUTS II) Thailand: Triple burden of malnutrition among Thai children aged 6 months to 12 years. Public Health Nutr 2024:1-39. [PMID: 38250788 DOI: 10.1017/s1368980024000053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
OBJECTIVE This study assessed nutritional status among Thai children using anthropometry, dietary intakes, and micronutrient status. DESIGN Cross-sectional survey with multi-stage cluster sampling. Body weight and height were measured in all children. Dietary intakes were assessed using 24-hour dietary recall. Biochemical assessment was performed in one-third of the children. SETTING The study was conducted in Thailand's four geographical regions and Bangkok. PARTICIPANTS 3478 Thai children aged 0.5-12.9 years. RESULTS Stunting showed a downward trend by age group and was most prevalent among infants and toddlers. Overweight and obesity showed a significant upward trend by age group, location, and sex, and was highest among children aged 7-12.9 years. Risks of inadequate micronutrient intakes (calcium, iron, zinc, vitamins A, C, and D) were high (53.2-93.6%). Prevalence of zinc and mild vitamin A deficiencies were low; vitamin D and B12 deficiencies were nil. Vitamin D insufficiency was significantly higher in the urban area and among girls aged 7-12.9 years. Anemia was very high in infants and toddlers (56.6 and 35.2%), but showed a significant downward trend by age group. There was an overall high prevalence of iron deficiency without anemia (25%) versus iron deficiency anemia (4.2%) among children aged 4-12.9 years old. CONCLUSIONS The high prevalence of stunting and anemia among children aged 1-3.9 years and overweight and obesity among children aged 7-12.9 years requires continued attention. While prevalence of biochemical micronutrient deficiencies was not high (except for iron), high prevalence of dietary inadequacies for several micronutrients warrants further in-depth investigations.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Pornpan Sukboon
- Institute of Nutrition, Mahidol University, Nakhon Pathom, Thailand
| | | | - Kemika Praengam
- Institute of Nutrition, Mahidol University, Nakhon Pathom, Thailand
| | - Ilse Khouw
- FrieslandCampina, Amersfoort, The Netherlands
| |
Collapse
|
3
|
Poh BK, Wong JE, Lee ST, Chia JSM, Yeo GS, Sharif R, Nik Shanita S, Jamil NA, Chan CMH, Farah NM, Sameeha MJ, Koh D, Saat NZM, Lim SM, Norimah AK, Ruzita AT, Budin SB, Wee LH, Tang SF, Khouw I. Triple burden of malnutrition among Malaysian children aged 6 months to 12 years: Current findings from SEANUTS II Malaysia. Public Health Nutr 2023:1-36. [PMID: 37932916 DOI: 10.1017/s1368980023002239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2023]
Abstract
OBJECTIVE This paper aims to report South East Asian Nutrition Surveys (SEANUTS) II Malaysia data on nutritional status, dietary intake, and nutritional biomarkers of children aged 6 months to 12 years. DESIGN Cross-sectional survey conducted in 2019-2020. SETTING Multistage cluster sampling conducted in Central, Northern, Southern, and East Coast regions of Peninsular Malaysia. PARTICIPANTS 2989 children aged 0.5-12.9 years. RESULTS Prevalences of stunting, thinness, overweight, and obesity among children aged 0.5-12.9 years were 8.9%, 6.7%, 9.2%, and 8.8%, respectively. Among children below 5 years old, 11.4% were underweight, 13.8% had stunting, and 6.2% wasting. Data on nutritional biomarkers showed a small proportion of children aged 4-12 years had iron (2.9%) and vitamin A deficiencies (3.1%). Prevalence of anaemia was distinctly different between children below 4 years old (40.3%) and those aged 4 years and above (3.0%). One-fourth of children (25.1%) had vitamin D insufficiency, which was twice as prevalent in girls (35.2% vs. boys: 15.6%). The majority of children did not meet the recommended dietary intake for calcium (79.4%) and vitamin D (94.8%). CONCLUSIONS Data from SEANUTS II Malaysia confirmed that triple burden of malnutrition co-exists among children in Peninsular Malaysia, with higher prevalence of overnutrition than undernutrition. Anaemia is highly prevalent among children below 4 years old, while vitamin D insufficiency is more prevalent among girls. Low intakes of dietary calcium and vitamin D are also of concern. These findings provide policymakers with useful and evidence-based data to formulate strategies that address the nutritional issues of Malaysian children.
Collapse
Affiliation(s)
- Bee Koon Poh
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300 Kuala Lumpur, Malaysia
| | - Jyh Eiin Wong
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300 Kuala Lumpur, Malaysia
| | - Shoo Thien Lee
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300 Kuala Lumpur, Malaysia
- Faculty of Health & Life Sciences, Management & Science University, 40100 Selangor, Malaysia
| | | | - Giin Shang Yeo
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300 Kuala Lumpur, Malaysia
| | - Razinah Sharif
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300 Kuala Lumpur, Malaysia
| | - Safii Nik Shanita
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300 Kuala Lumpur, Malaysia
| | - Nor Aini Jamil
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300 Kuala Lumpur, Malaysia
| | - Caryn Mei Hsien Chan
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300 Kuala Lumpur, Malaysia
| | - Nor Mf Farah
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300 Kuala Lumpur, Malaysia
| | - Mohd Jamil Sameeha
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300 Kuala Lumpur, Malaysia
| | - Denise Koh
- Faculty of Education, Universiti Kebangsaan Malaysia, 43600 Selangor, Malaysia
| | - Nur Zakiah Mohd Saat
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300 Kuala Lumpur, Malaysia
| | - See Meng Lim
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300 Kuala Lumpur, Malaysia
| | - A Karim Norimah
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300 Kuala Lumpur, Malaysia
| | - Abd Talib Ruzita
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300 Kuala Lumpur, Malaysia
| | - Siti Balkis Budin
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300 Kuala Lumpur, Malaysia
| | - Lei Hum Wee
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300 Kuala Lumpur, Malaysia
- School of Medicine, Taylor's University, 47500 Selangor, Malaysia
| | - Swee Fong Tang
- Specialist Children's Hospital, Universiti Kebangsaan Malaysia, 56000 Kuala Lumpur, Malaysia
| | - Ilse Khouw
- FrieslandCampina, Amersfoort, The Netherlands
| |
Collapse
|
4
|
Khor GL, Tan SS, Stoutjesdijk E, Ng KWT, Khouw I, Bragt M, Schaafsma A, Dijck-Brouwer DAJ, Muskiet FAJ. Temporal Changes in Breast Milk Fatty Acids Contents: A Case Study of Malay Breastfeeding Women. Nutrients 2020; 13:nu13010101. [PMID: 33396781 PMCID: PMC7824650 DOI: 10.3390/nu13010101] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 12/19/2020] [Accepted: 12/21/2020] [Indexed: 12/21/2022] Open
Abstract
The composition of human breast milk changes in the first two months of life, adapting itself to the evolving needs of the growing new-born. Lipids in milk are a source of energy, essential fatty acids (FA), fat-soluble vitamins, and vital bioactive components. Information on breast milk FA of Malaysian lactating women is scarce. Based on convenience sampling, a total of 20 Malay breastfeeding women who fulfilled the inclusion criteria were recruited. Breast milk was collected three times from each subject at consecutive intervals of 2–3 weeks apart. A total of 60 breast milk samples were collected and classified into “transitional milk” (n = 8), “early milk” (n = 26) and “mature milk” (n = 26). All milk samples were air freighted to University of Groningen, Netherlands for analysis. The dominant breast milk FA were oleic acid, constituting 33% of total fatty acids, followed by palmitic acid (26%). Both these FA and the essential FA, linoleic acid (10%) and alpha-linolenic acid (0.4%), showed no significant changes from transitional to mature milk. Breast milk ratio of n-6:n-3 polyunsaturated fatty acids (PUFA) was comparatively high, exceeding 10 throughout the lactation period, suggesting a healthier balance of PUFA intake is needed in pregnancy and at postpartum.
Collapse
Affiliation(s)
- Geok Lin Khor
- Department of Nutrition & Dietetics, School of Health Sciences, International Medical University, 57000 Kuala Lumpur, Malaysia; (S.S.T.); (K.W.T.N.)
- Correspondence:
| | - Seok Shin Tan
- Department of Nutrition & Dietetics, School of Health Sciences, International Medical University, 57000 Kuala Lumpur, Malaysia; (S.S.T.); (K.W.T.N.)
| | - Eline Stoutjesdijk
- Laboratory Medicine, University Medical Center Groningen and University of Groningen, 9713 GZ Groningen, The Netherlands; (E.S.); (D.A.J.D.-B.); (F.A.J.M.)
| | - Kock Wai Tony Ng
- Department of Nutrition & Dietetics, School of Health Sciences, International Medical University, 57000 Kuala Lumpur, Malaysia; (S.S.T.); (K.W.T.N.)
| | - Ilse Khouw
- FrieslandCampina, 3800 BN Amersfoort, The Netherlands; (I.K.); (M.B.); (A.S.)
| | - Marjolijn Bragt
- FrieslandCampina, 3800 BN Amersfoort, The Netherlands; (I.K.); (M.B.); (A.S.)
| | - Anne Schaafsma
- FrieslandCampina, 3800 BN Amersfoort, The Netherlands; (I.K.); (M.B.); (A.S.)
| | - D. A. Janneke Dijck-Brouwer
- Laboratory Medicine, University Medical Center Groningen and University of Groningen, 9713 GZ Groningen, The Netherlands; (E.S.); (D.A.J.D.-B.); (F.A.J.M.)
| | - Frits A. J. Muskiet
- Laboratory Medicine, University Medical Center Groningen and University of Groningen, 9713 GZ Groningen, The Netherlands; (E.S.); (D.A.J.D.-B.); (F.A.J.M.)
| |
Collapse
|
5
|
Tan SS, Khor GL, Stoutjesdijk E, Ng KWT, Khouw I, Bragt M, Schaafsma A, Dijck-Brouwer D, Muskiet FA. Case study of temporal changes in maternal dietary intake and the association with breast milk mineral contents. J Food Compost Anal 2020. [DOI: 10.1016/j.jfca.2020.103468] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
6
|
Lim SL, Teoh C, Zhao X, Umareddy I, Grillo V, Singh SS, Khouw I. Attitudes & beliefs that influence healthy eating behaviours among mothers of young children in Singapore: A cross-sectional study. Appetite 2020; 148:104555. [PMID: 31843684 DOI: 10.1016/j.appet.2019.104555] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Revised: 11/01/2019] [Accepted: 12/08/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Many countries recommend parental involvement to enhance the effectiveness of healthy lifestyle interventions focusing on behavioural modifications that encourage weight management in children. Our study investigates to what extent the different constructs of the Theory of Planned Behaviour (TPB) are influencing healthy eating behaviour among mothers of pre-school and primary school children in Singapore. METHODS A total of 716 mothers of pre-schoolers, 3-6 years old (N = 358) and primary school students, 7-12 years old (N = 358) were administered a survey to assess healthy eating behaviour using the TPB constructs. Bivariate correlations among TPB constructs were calculated and tested using Pearson's correlation. Multivariate generalized regression was performed to examine the associations between TPB constructs and healthy eating behaviour. RESULTS More than 80% of children consumed less than the daily recommended servings of at least 1 glass of dairy,2 servings of fruit and 2 servings of vegetables per day advised by the Singapore Health Board. More primary school children consumed less dairy per day compared to pre-school children (48.9% vs 26.3%; p < 0.001). Primary school children's healthy eating behaviours were correlated with mother's perceived behavioural control (PBC) such as adequate discipline (β = 0.40; p = 0.001), self-efficacy (β = 0.35; p = 0.01) and a lower barrier that healthy food does not satisfy hunger (β = -1.16; p < 0.001). Barriers that significantly reduced pre-school children's healthy food intake were lack of motivation among mothers (β = -1.13; p < 0.001) and children (β = -0.49; p = 0.02), lack of satiety (β = -1.06; p = 0.02), difficulty in changing child's eating habits (β = -0.58; p = 0.03), lack of family support (β = -0.62; p = 0.03). CONCLUSIONS Findings from this study provides a formative foundation for future research and exploration of plausible interventions around improving mother's PBC, self-efficacy and reducing barriers, which could increase mother's engagement in improving their children's healthy eating behaviours in Singapore.
Collapse
Affiliation(s)
- Su Lin Lim
- National University Hospital, 5 Lower Kent Ridge Road, Singapore, 119074.
| | - Cheryl Teoh
- Kantar Health, 50 Scotts Road, Singapore, 228242.
| | - Xiahong Zhao
- Kantar Health, 50 Scotts Road, Singapore, 228242.
| | | | - Vince Grillo
- Kantar Health, 50 Scotts Road, Singapore, 228242.
| | | | - Ilse Khouw
- FrieslandCampina, Stationsplein 4, 3818, LE Amersfoort, the Netherlands.
| |
Collapse
|
7
|
Harahap H, Sandjaja S, Soekatri M, Khouw I, Deurenberg P. Association of energy intake and physical activity with overweight among Indonesian children 6-12 years of age. Asia Pac J Clin Nutr 2019; 27:211-216. [PMID: 29222901 DOI: 10.6133/apjcn.032017.05] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND OBJECTIVES Indonesia is currently facing double burden malnutrition in children. As overweight and obesity are due to a disturbed energy balance, this study aimed to assess the association of total energy intake and physical activity with the prevalence of overweight among Indonesian children. METHODS AND STUDY DESIGN The data used for this analysis were from 1143 children, 6-12 years old, that participated in the South East Asian Nutrition Survey (SEANUTS). Physical activity (PA) was measured using pedometers for 2 consecutive days and was categorized low, moderate and high. Child nutritional status was categorized based on body mass index for age z-scores (BAZ) into normal weight (-2 SD ≤BAZ≤1 SD) or overweight (BAZ >1 SD). Energy intake was calculated from a one day 24 hour recall and compared to the Indonesian recommended dietary allowance (RDA) for energy. RESULTS Children with low PA had higher risk (ODDs 3.4, 95% CI: 2.0, 6.0) of being overweight compared to children who had high PA. Children with moderate PA and energy take >100% RDA had higher risk (ODDs 4.2, 95% CI 1.9, 9.3) of being overweight than children with high PA and energy intakes ≤100% RDA. CONCLUSIONS Low physical activity independently or moderate physical activity and high energy intake are risk factors for Indonesian children to get overweight. Program intervention such as increasing physical activity at school and home is needed to reduce overweight among children.
Collapse
Affiliation(s)
- Heryudarini Harahap
- Provincial Research and Development Board, Riau, Indonesia. ; .,Indonesian SEANUTS Research Team, PERSAGI, Jakarta, Indonesia
| | - Sandjaja Sandjaja
- Indonesian SEANUTS Research Team, PERSAGI, Jakarta, Indonesia.,National Institute of Health Research and Development, Jakarta, Indonesia
| | - Moesijanti Soekatri
- Indonesian SEANUTS Research Team, PERSAGI, Jakarta, Indonesia.,Nutrition Department, Health Polytechnics MOH Jakarta II, Indonesia
| | - Ilse Khouw
- Friesland Campina, Development Centre AMEA, Singapore
| | | |
Collapse
|
8
|
Nguyen Bao KL, Sandjaja S, Poh BK, Rojroongwasinkul N, Huu CN, Sumedi E, Aini JN, Senaprom S, Deurenberg P, Bragt M, Khouw I. The Consumption of Dairy and Its Association with Nutritional Status in the South East Asian Nutrition Surveys (SEANUTS). Nutrients 2018; 10:nu10060759. [PMID: 29899251 PMCID: PMC6024724 DOI: 10.3390/nu10060759] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Revised: 05/30/2018] [Accepted: 06/05/2018] [Indexed: 01/20/2023] Open
Abstract
Despite a major decrease in undernutrition worldwide over the last 25 years, underweight and stunting in children still persist as public health issues especially in Africa and Asia. Adequate nutrition is one of the key factors for healthy growth and development of children. In this study, the associations between dairy consumption and nutritional status in the South East Asian Nutrition Survey (SEANUTS) were investigated. National representative data of 12,376 children in Indonesia, Malaysia, Thailand, and Vietnam aged between 1 and 12 years were pooled, representing nearly 88 million children in this age category. It was found that the prevalence of stunting and underweight was lower in children who consumed dairy on a daily basis (10.0% and 12.0%, respectively) compared to children who did not use dairy (21.4% and 18.0%, respectively) (p < 0.05). The prevalence of vitamin A deficiency and vitamin D insufficiency was lower in the group of dairy users (3.9% and 39.4%, respectively) compared to non-dairy consumers (7.5% and 53.8%, respectively) (p < 0.05). This study suggests that dairy as part of a daily diet plays an important role in growth and supports a healthy vitamin A and vitamin D status.
Collapse
Affiliation(s)
- Khanh Le Nguyen Bao
- National Institute of Nutrition, 48B Tang Bat Ho Street, Hanoi 10000, Vietnam.
| | - Sandjaja Sandjaja
- Persatuan Ahli Gizi Indonesia, Jalan Hang Jebat III/F3, Kebayoran Baru, Jakarta 12120, Indonesia.
| | - Bee Koon Poh
- Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia.
| | - Nipa Rojroongwasinkul
- Institute of Nutrition Mahidol University, Phuttamonthon 4, Nakhon Pathom 73170, Thailand.
| | - Chinh Nguyen Huu
- National Institute of Nutrition, 48B Tang Bat Ho Street, Hanoi 10000, Vietnam.
| | - Edith Sumedi
- Persatuan Ahli Gizi Indonesia, Jalan Hang Jebat III/F3, Kebayoran Baru, Jakarta 12120, Indonesia.
| | - Jamil Nor Aini
- Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia.
| | - Sayamon Senaprom
- Institute of Nutrition Mahidol University, Phuttamonthon 4, Nakhon Pathom 73170, Thailand.
| | - Paul Deurenberg
- Nutrition Consultant, 055 Laurel Street, 3319 Ramon, Isabela, The Philippines.
| | - Marjolijn Bragt
- FrieslandCampina, Stationsplein 4, 3818 LE Amersfoort, The Netherlands.
| | - Ilse Khouw
- FrieslandCampina, Stationsplein 4, 3818 LE Amersfoort, The Netherlands.
| |
Collapse
|
9
|
Chong KH, Lee ST, Ng SA, Khouw I, Poh BK. Fruit and Vegetable Intake Patterns and Their Associations with Sociodemographic Characteristics, Anthropometric Status and Nutrient Intake Profiles among Malaysian Children Aged 1-6 Years. Nutrients 2017; 9:E723. [PMID: 28758956 PMCID: PMC5579587 DOI: 10.3390/nu9080723] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 06/29/2017] [Accepted: 07/03/2017] [Indexed: 11/17/2022] Open
Abstract
This study aimed to assess fruit and vegetable intake patterns and their associations with sociodemographic characteristics, anthropometric status and nutrient intake profiles among Malaysian children aged 1-6 years. Using the Malaysian dataset of South East Asian Nutrition Surveys (SEANUTS Malaysia), a total of 1307 children aged 1-6 years with complete datasets were included in this analysis. Dietary intake was assessed using age-specific, validated food frequency questionnaires. On average, Malaysian children consumed 0.91 and 1.07 servings of fruits and vegetables per day, respectively. Less than one-fifth of the children achieved the daily recommended servings of fruits (11.7%) and vegetables (15.8%). Fruit intake was associated with age, parental educational level and geographical region, and vegetable intake was associated with ethnicity and geographical region. There was little evidence of an association between fruit and vegetable intake and children's anthropometric status, but an adequate intake of fruits and vegetables contributed significantly and differently to children's micronutrient intake. Future nutrition interventions should focus on addressing the sociodemographic determinants and be tailored to the needs of the low consumers to more effectively promote and encourage the adequate intake of fruit and vegetables among young children.
Collapse
Affiliation(s)
- Kar Hau Chong
- Nutritional Sciences Programme, School of Healthcare Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia.
| | - Shoo Thien Lee
- Nutritional Sciences Programme, School of Healthcare Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia.
| | - Swee Ai Ng
- FrieslandCampina, Stationsplein 4, 3818 LE Amersfoort, The Netherlands.
| | - Ilse Khouw
- FrieslandCampina, Stationsplein 4, 3818 LE Amersfoort, The Netherlands.
| | - Bee Koon Poh
- Nutritional Sciences Programme, School of Healthcare Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia.
- National Co-Ordinator, the SEANUTS Study Group, Nutritional Sciences Programme, School of Healthcare Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia.
| |
Collapse
|
10
|
Widodo Y, Sandjaja S, Sumedi E, Khouw I, Deurenberg P. The effect of socio-demographic variables and dairy use on the intake of essential macro- and micronutrients in 0.5-12-year-old Indonesian children. Asia Pac J Clin Nutr 2016; 25:356-67. [PMID: 27222420 DOI: 10.6133/apjcn.2016.25.2.09] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND OBJECTIVES To study the associations between nutrient intake, dairy intake and socioeconomic variables. METHODS AND STUDY DESIGN Food consumption data using 24 h recall were collected in 3600 children, aged 0.5 to 12 years old in addition to frequency of dairy use and anthropometric and sociodemographic variables. RESULTS Overall height for age Z-score (HAZ) and body mass index for age Z-score (BAZ) values (mean±SE) were -1.40±0.03 and -0.48±0.03 respectively, associated with a high prevalence of stunting and thinness in the population. The overall percentage of children not using any dairy products was 71%, and this percentage increased steadily with age. The overall energy intake from dairy was 99±3 kcal/capita/day and the overall energy intake from dairy in dairy users was 291±7 kcal/day. Dairy use did not differ between boys and girls, but was higher in urban areas, higher if the education of the mother was higher and higher if the mother had a permanent job and if the wealth status of the family was in the upper levels. Nutrient intake after the age of 3 years was inadequate for energy and all nutrients except for protein. The achievement of Recommended Dietary Allowances (RDA) for all nutrients was higher in dairy users compared to non-dairy users, also after correcting for the confounding effect of the higher energy intake (from dairy) and socio-demographic variables. The contribution increased with increasing frequency of dairy use. CONCLUSION Adequate dairy intake can substantially add to the achievement of RDA in Indonesian children.
Collapse
Affiliation(s)
- Yekti Widodo
- SEANUTS Indonesian Team, PERSAGI, Kebayoran Baru, Jakarta, Indonesia.,Center of Public Health Intervention Technology, NIHRD, MoH, Indonesia
| | - Sandjaja Sandjaja
- SEANUTS Indonesian Team, PERSAGI, Kebayoran Baru, Jakarta, Indonesia. ; .,Center of Applied Health Technology and Clinical Epidemiology, NIHRD, MoH, Indonesia
| | - Edith Sumedi
- SEANUTS Indonesian Team, PERSAGI, Kebayoran Baru, Jakarta, Indonesia.,Division of Nutrition, Polytechnic of Health Jakarta II, MoH, Indonesia
| | - Ilse Khouw
- FrieslandCampina, Amersfoort, the Netherlands
| | | |
Collapse
|
11
|
Tay CW, Chin YS, Lee ST, Khouw I, Poh BK. Association of Eating Behavior With Nutritional Status and Body Composition in Primary School–Aged Children. Asia Pac J Public Health 2016; 28:47S-58S. [DOI: 10.1177/1010539516651475] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Problematic eating behaviors during childhood may lead to positive energy balance and obesity. Therefore, this study aims to investigate the association of eating behaviors with nutritional status and body composition in Malaysian children aged 7 to 12 years. A total of 1782 primary schoolchildren were randomly recruited from 6 regions in Malaysia. The multidimensional Children’s Eating Behaviour Questionnaire (CEBQ) was reported by parents to determine the 8 different dimensions of eating styles among children. Body mass index (BMI), BMI-for-age Z-score, waist circumference, and body fat percentage were assessed. Linear regression analyses revealed that both food responsiveness and desire to drink subscales were positively associated with a child’s body adiposity, whereas satiety responsiveness, slowness in eating, and emotional undereating subscales were negatively associated with adiposity (all P < .05). A multidimensional eating style approach based on the CEBQ is needed to promote healthy eating behaviors in order to prevent excessive weight gain and obesity problems among Malaysian children.
Collapse
Affiliation(s)
- Chee Wee Tay
- Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | | | | | - Ilse Khouw
- FrieslandCampina Development Centre, Singapore
| | - Bee Koon Poh
- Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | | |
Collapse
|
12
|
Purttiponthanee S, Rojroongwasinkul N, Wimonpeerapattana W, Thasanasuwan W, Senaprom S, Khouw I, Deurenberg P. The Effect of Breakfast Type on Total Daily Energy Intake and Body Mass Index Among Thai School Children. Asia Pac J Public Health 2016; 28:85S-93S. [PMID: 27183975 DOI: 10.1177/1010539516647774] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The study investigated the association between breakfast types consumed, daily energy intake, and body mass index for age Z-score (BAZ). Cross-sectional data from 1258 children aged 7 to 12.9 years were analyzed for breakfast type, nutrient intakes, BAZ, and proportion of overweight or obesity. Analysis of covariance was used to compare energy and nutrient intakes, BAZ, and proportion of overweight/obese children between breakfast groups. Only 19% of children had adequate energy intake from breakfast. Those consuming snacks had a significantly lower BAZ (Z = -0.73), with 5% of them being overweight/obese. Those consuming beverages and desserts had the lowest total daily energy intake (1314 kcal) and lowest protein intake (8.4 g). The results suggest that breakfast type is associated with daily energy intake and BAZ. Most breakfasts are not adequate. School-based nutrition education programs involving families, teachers, and health professionals can contribute to improve this situation.
Collapse
Affiliation(s)
| | | | | | | | | | - Ilse Khouw
- FrieslandCampina Development Centre AMEA, Singapore
| | - Paul Deurenberg
- Nutrition Consultant, Telaga Harbour Marina, Langkawi, Malaysia
| |
Collapse
|
13
|
Le Nguyen Bao K, Tran Thuy N, Nguyen Huu C, Khouw I, Deurenberg P. Anemia and Iron Deficiency in Vietnamese Children, 6 to 11 Years Old. Asia Pac J Public Health 2016; 28:94S-102S. [PMID: 27052301 DOI: 10.1177/1010539516641506] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In a population sample of 385 children, 6 to 11 years old, venous blood parameters-hemoglobin (Hb), ferritin, red blood cell count (RBC), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), C-reactive protein (CRP), and α1-acid glycoprotein (AGP)-were determined to get insight into the iron status. The prevalence of anemia was 11.4%; 5.6% had iron deficiency (ID), whereas 0.4% had ID anemia. Correction for inflammation based on CRP and AGP did not markedly change the overall prevalence of ID and ID anemia. Stunted children had lower Hb and ferritin values compared with nonstunted children, and thin children had lower values compared with normal-weight or overweight and obese children. Many nonanemic children had alert values for RBC, MCV, MCH, and MCHC. It is concluded that although the prevalence of anemia is of the magnitude of a mild public health problem, the iron status of many nonanemic children is borderline, as indicated by a high number of children with low values for red blood cytology.
Collapse
Affiliation(s)
| | | | | | - Ilse Khouw
- FrieslandCampina, Amersfoort, Netherlands
| | | |
Collapse
|
14
|
Senaprom S, Yamborisut U, Rojroongwasinkul N, Wimonpeerapattana W, Purttiponthanee S, Khouw I, Deurenberg P. FACTORS ASSOCIATED WITH VITAMIN D STATUS AMONG THAI CHILDREN AGED 3-13 YEARS. Southeast Asian J Trop Med Public Health 2016; 47:277-286. [PMID: 27244966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The impact of vitamin D status on bone health and other health conditions is receiving increasingly attention. We aimed to determine the association between environmental factors and vitamin D intake by examining serum 25-hydroxy vitamin D [25(OH)D] levels in Thai children. We conducted a cross sectional study among 477 Thai children from 4 regions in Thailand. Vitamin D intake was assessed using a self-administered questionnaire completed by the older children or by the parents for younger children. Dietary vitamin D intake was assessed using a semi-quantitative food frequency questionnaire. A serum 25(OH)D level was examined for each subject using a chemiluminescence immunoassay. We used structural equation modeling (SEM) to assess the association between studied factors and the serum 25(OH)D level. The final model showed a significant association between sunlight exposure and the serum 25(OH)D level (β = 0.65, p < 0.01), but not between dietary vitamin D intake and the serum 25(OH)D level (p = 0.01, p = 0.77), suggesting sunlight exposure is more important for the vitamin D status than dietary vitamin D intake.
Collapse
|
15
|
Srichan W, Thasanasuwan W, Kijboonchoo K, Rojroongwasinkul N, Wimonpeerapattana W, Khouw I, Deurenberg P. Bone status measured by quantitative ultrasound: a comparison with DXA in Thai children. Eur J Clin Nutr 2015; 70:894-7. [PMID: 26508460 DOI: 10.1038/ejcn.2015.180] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 09/24/2015] [Accepted: 09/29/2015] [Indexed: 02/04/2023]
Abstract
BACKGROUND/OBJECTIVES Quantitative ultrasound (QUS) is used to measure bone quality and is known to be safe, radiation free and relatively inexpensive compared with dual-energy X-ray absorptiometry (DXA) that is considered the gold standard for bone status assessments. However, there is no consensus regarding the validity of QUS for measuring bone status. The aim of this study was to compare QUS and DXA in assessing bone status in Thai children. SUBJECTS/METHODS A total of 181 Thai children (90 boys and 91 girls) aged 6 to 12 years were recruited. Bone status was measured by two different techniques in terms of the speed of sound (SOS) using QUS and bone mineral density (BMD) using DXA. Calcium intake was assessed by 24 h diet recall. Pearson's correlation, κ-statistic and Bland and Altman analysis were used to assess the agreement between the methods. RESULTS There was no correlation between the two different techniques. Mean difference (s.d.) of the Z-scores of BMD and SOS was -0.61 (1.27) that was different from zero (P<0.05). Tertiles of Z-scores of BMD and QUS showed low agreement (κ 0.022, P=0.677) and the limits of agreement in Bland and Altman statistics were wide. CONCLUSIONS Although QUS is easy and convenient to use, the SOS measurements at the radius seem not appropriate for assessing bone quality status.
Collapse
Affiliation(s)
- W Srichan
- Institute of Nutrition, Mahidol University, Salaya Campus, Nakhon Pathom, Thailand
| | - W Thasanasuwan
- Institute of Nutrition, Mahidol University, Salaya Campus, Nakhon Pathom, Thailand
| | - K Kijboonchoo
- Institute of Nutrition, Mahidol University, Salaya Campus, Nakhon Pathom, Thailand
| | - N Rojroongwasinkul
- Institute of Nutrition, Mahidol University, Salaya Campus, Nakhon Pathom, Thailand
| | - W Wimonpeerapattana
- Institute of Nutrition, Mahidol University, Salaya Campus, Nakhon Pathom, Thailand
| | - I Khouw
- FrieslandCampina, Amersfoort, The Netherlands
| | - P Deurenberg
- Nutrition Consultant, Lighthouse Training & Consultancies, Langkawi, Malaysia
| |
Collapse
|
16
|
Magdorf K, Khouw I, Ertel M, Wahn U. Positiver Tuberkulintest bei nicht BCG-geimpften Kindern - immer ein Hinweis auf eine spezifische Infektion? Monatsschr Kinderheilkd 1996. [DOI: 10.1007/s001120050073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|