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BackgroundWith the increasing prevalence of childhood obesity, the metabolic syndrome has been studied among children in many countries but not in Malaysia. Hence, this study aimed to compare metabolic risk factors between overweight/obese and normal weight children and to determine the influence of gender and ethnicity on the metabolic syndrome among school children aged 9-12 years in Kuala Lumpur and its metropolitan suburbs.MethodsA case control study was conducted among 402 children, comprising 193 normal-weight and 209 overweight/obese. Weight, height, waist circumference (WC) and body composition were measured, and WHO (2007) growth reference was used to categorise children into the two weight groups. Blood pressure (BP) was taken, and blood was drawn after an overnight fast to determine fasting blood glucose (FBG) and full lipid profile, including triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and total cholesterol (TC). International Diabetes Federation (2007) criteria for children were used to identify metabolic syndrome.ResultsParticipants comprised 60.9% (n = 245) Malay, 30.9% (n = 124) Chinese and 8.2% (n = 33) Indian. Overweight/obese children showed significantly poorer biochemical profile, higher body fat percentage and anthropometric characteristics compared to the normal-weight group. Among the metabolic risk factors, WC ≥90th percentile was found to have the highest odds (OR = 189.0; 95%CI 70.8, 504.8), followed by HDL-C≤1.03 mmol/L (OR = 5.0; 95%CI 2.4, 11.1) and high BP (OR = 4.2; 95%CI 1.3, 18.7). Metabolic syndrome was found in 5.3% of the overweight/obese children but none of the normal-weight children (p < 0.01). Overweight/obese children had higher odds (OR = 16.3; 95%CI 2.2, 461.1) of developing the metabolic syndrome compared to normal-weight children. Binary logistic regression showed no significant association between age, gender and family history of communicable diseases with the metabolic syndrome. However, for ethnicity, Indians were found to have higher odds (OR = 5.5; 95%CI 1.5, 20.5) compared to Malays, with Chinese children (OR = 0.3; 95%CI 0.0, 2.7) having the lowest odds.ConclusionsWe conclude that being overweight or obese poses a greater risk of developing the metabolic syndrome among children. Indian ethnicity is at higher risk compared to their counterparts of the same age. Hence, primary intervention strategies are required to prevent this problem from escalating.

Objective: The aim of this study was to objectively measure physical activity and its association with sociodemographic factors among Malaysian primary school-age children. Methods: A total of 111 primary school children in Kuala Lumpur were selected through random sampling. Activity pattern was determined using pedometers and differences by sex, ethnicity and body mass index categories were analysed. The relationship between pedometer-determined physical activity and sociodemographic factors were also studied. Results: Overall, boys attained significantly higher daily step counts than girls (9573 ± 4145 vs 7313 ± 2697). Significant difference in daily step counts between boys and girls were observed during weekdays (p<0.01), weekends (p<0.05) and total mean step counts (p<0.01). Malay ethnicity showed higher daily step counts during weekdays than weekends (p<0.05). Compared with boys, girls had higher odds (OR=5.58; 95% CI 1.12, 27.77) of not meeting the recommended daily step counts. Those who had low physical activity levels had higher odds (OR=15.75; 95% CI 1.78, 139.33) of not meeting recommended daily step counts than children who had moderate physical activity level. Conclusion: Boys were significantly more active than girls and physical activity was greater during weekdays than on weekends. The primary schoolchildren in Kuala Lumpur were sedentary, with minimum physical activity being observed. Differences in sexes and physical activity levels influenced pedometer step counts in children.

Background Metabolic syndrome (MetS) is defined as a cluster of risk factors for predicting type 2 diabetes mellitus and cardiovascular disease. Objectives This cross-sectional study aimed to develop a cut-off value for fat versus lean mass ratio (FLMR) in predicting MetS and to investigate the association between this indicator with MetS and its components. Methods Subjects comprised 238 Malay adolescents (79% female) aged 18–19 years old. Anthropometric assessment comprised weight, height and waist circumference (WC). Body composition was measured using bioelectrical impedance analysis techniques while blood pressure was measured using a blood pressure monitor. Fasting blood glucose, total cholesterol , triglycerides, high-density lipoprotein cholesterol (HDL-c), and low-density lipoprotein cholesterol were determined from an overnight fasting blood sample. MetS was determined based on International Diabetes Federation (2007) definition for adolescents aged 16-year-old and above. Results The prevalence of MetS was 2.1%. Receiver Operating Characteristics curve analysis revealed that the optimal cut-off value for FLMR was 0.441 with an Area Under the Curve of 0.874 (95% CI: 0.825, 0.913); with sensitivity of 80.0% and specificity of 71.0%. FLMR cut-off of 0.441 was associated with high WC ( p < .001), low HDL-c ( p < .001) and MetS ( p < .05). Binary Logistic Regression analysis revealed that adolescents with high WC, low HDL-c and MetS had higher odds of developing increased FLMR than the cut-off value with an odds ratio (OR) of 43.4 (95% CI: 9.7,193.9), 4.7 (95% CI: 2.3,9.8) and 13.3 (95% CI: 1.5,121.2), respectively. Conclusion FLMR possesses fair discriminatory ability in identifying MetS among adolescents and significant association exists between FLMR and MetS and some of its components.

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Body image is the picture of how our body is perceived and stored in our mind. During puberty, many changes occur in the body of an adolescents. Often, a change in physical appearance has an impact on the levels of body’s satisfaction. Thus, it is crucial to assess the body image among adolescents to ensure the wellbeing of both physical and mental health is at optimal stage. Therefore, the aims of the present study is to determine the body fat percentage of female adolescents. Then, to evaluate the association between weight status and body image perception. Lastly, to assess whether the attitudes towards body image are predictive of female adolescents weight status. This cross-sectional study was conducted among 198 female adolescents in Kuala Nerus, Terengganu. Anthropometric measurements included weight and height, and BMI was determined. Body composition was assessed by using Bio-electrical Impedance Analysis through Bodystat Quadscan 4000 instrument. Body image perception was measured using the Stunkard’s Figure Rating Scale and Attitudes towards Body Image that was adapted from the Multidimensional Body Self Relation Questionnaire (MBSRQ). A total of 27.8% of female adolescents were overweight and 1.0 % were obese by body fat. Among the female adolescents, 62.5% of them were dissatisfied with their body image, although 57.5% of them were in the normal weight category. Pearson’s Chi Square test revealed there is an association between weight status and body image perception among the female adolescents (p<0.045). Based on the Multiple Linear Regression Analysis, there is a significant linear relationship between attitudes towards body image, domain of comparison of body shape and BMI (p<0.005). Thus, for every 1 unit increase in the domain of comparison of body shape there will be 0.570 decreased in BMI. Comparison of body shape is a significant predicting factor for BMI. In conclusion, further study should be carried out to investigate the factors that can possibly lead to the development of dissatisfaction with body image and the effects of getting negative body image in life of the adolescents during their adolescent’s phase.

Lack of physical activity among adolescents is one of the factors which lead to the accumulation of body fat and increase prevalence of obesity among Malaysian population. Therefore, this study was aimed to determine the association between body fat percentage and physical activity level among adolescents in Kuala Nerus, Terengganu. This cross-sectional study involved 300 participants consists of 44.7% male and 55.3% female aged between 10 to 16 years old. Anthropometric measurements included body weight, height and waist circumference. Body fat percentage (%BF) was assessed using bioelectrical impedance analysis (BIA). Physical activity was assessed by physical activity questionnaire (PAQ-C) and pedometers in a subsample (n = 50). The result shows that the mean body fat percentage and BMI of the participants were 23.02±9.41% and 20.03±4.77 kg/m2, respectively. Mean PAQ-C score and pedometer steps count for both genders were 1.9±0.42 and 6079±1878, respectively. Male has higher PA level compared to female in their daily life based on PAQ-C score and pedometer steps count. PAQ-C score and pedometer step counts were negatively associated with %BF however there is no significant association between screen time and %BF. As a conclusion, the problems of obesity can be solved by providing strategies to promote active living among adolescents in Malaysia not only focus on increasing physical activity but also emphasise reduction in sedentary behaviours.

Body composition is defined as the proportion of fat (FM) and fat-free mass (FFM) in our body. It is an important aspect of both individual’s and populations’ health. The rising prevalence of obesity among adolescents has highlighted the significance of body fat measurement and the factors that influence it. Therefore, this study aims to measure the body fat percentage (BF%) by using bioelectrical impedance analysis (BIA) and to observe its association with pubertal status among Malay adolescents in Kuala Nerus, Terengganu. Adolescents from 10 to 16 years old were the subject of this cross- sectional study. Weight, height, and waist circumference were measured anthropometrically, and body composition was determined using Bodystat Quadscan 4000 through BIA procedures. Questionnaires consist of socio-demographic characteristics and Tanner staging for the determination of pubertal status. A total of 310 students participated in this study (female, n=165, male n=145). The percentage of overweight and obese adolescents in Kuala Nerus was 12.9% and 10.6%, respectively. The difference in BF% between genders was significant (p<0.001), with pubertal girls having a greater BF% than boys (28.05±7.31% vs 17.20±8.43%). Between pubertal status and BF%, there was a significant difference (p<0.05). However, there was no significant association between BF% and pubertal status. Gender and pubertal status have an impact on the BF%. Thus, pubertal status should be considered when measuring BF% because it varies by individual and gender.