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      Characteristics associated with the consumption of malted drinks among Malaysian primary school children: findings from the MyBreakfast study


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          The consumption of beverages contributes to diet quality and overall nutrition. Studies on malted drinks, one of the widely consumed beverage choices among children in Asia, however, have received limited attention. This study aimed to examine the prevalence of malted drink consumption and explored associations of sociodemographic characteristics, nutrient intakes, weight status and physical activity levels with malted drink consumption among primary school children in Malaysia.


          Data for this analysis were from the MyBreakfast Study, a national cross-sectional study conducted from April to October 2013 throughout all regions in Malaysia. A total of 2065 primary school children aged 6 to 12 years were included in the present analysis. Data on two days 24-h dietary recall or record, anthropometry, physical activity and screen time were recorded. Associations between malted drink consumption and related factors were examined using binary logistic regression, adjusting for region, area, gender, ethnicity and household income.


          Among children aged 6 to12 years, 73.5 % reported consuming malted drinks for at least once per week. Consumption of malted drinks was significantly associated with region ( χ 2  = 45.64, p < 0.001), gender ( χ 2  = 4.41, p = 0.036) and ethnicity ( χ 2  = 13.74, p = 0.008). Malted drink consumers had similar total energy intake but higher micronutrient intakes compared to non-consumers. High physical activity level (OR = 1.77, 95 % CI = 1.06, 2.99) and lower screen time during weekends (OR = 0.93, 95 % CI = 0.86, 0.99) were independently associated with malted drink consumption among 6 to 9 year-old children, but not among 10 to 12 year-old children. No association was observed between malted drink consumption and weight status.


          Malted drink consumption is prevalent among Malaysian primary school children, particularly higher among boys, indigenous children and those who lived in the East Coast region of Malaysia. Consuming malted drinks is associated with higher micronutrient intakes and higher levels of physical activity, but not with body weight status.

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          Most cited references28

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          Parental influence on eating behavior: conception to adolescence.

          The first years of life mark a time of rapid development and dietary change, as children transition from an exclusive milk diet to a modified adult diet. During these early years, children's learning about food and eating plays a central role in shaping subsequent food choices, diet quality, and weight status. Parents play a powerful role in children's eating behavior, providing both genes and environment for children. For example, they influence children's developing preferences and eating behaviors by making some foods available rather than others, and by acting as models of eating behavior. In addition, parents use feeding practices, which have evolved over thousands of years, to promote patterns of food intake necessary for children's growth and health. However in current eating environments, characterized by too much inexpensive palatable, energy dense food, these traditional feeding practices can promote overeating and weight gain. To meet the challenge of promoting healthy weight in children in the current eating environment, parents need guidance regarding alternatives to traditional feeding practices.
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            Changes in beverage intake between 1977 and 2001.

            To examine American beverage consumption trends and causes. Nationally representative data from the 1977-1978 Nationwide Food Consumption Survey, the 1989-1991 and 1994-1996 (also for children aged 2 to 9 years in 1998) Continuing Surveys of Food Intake by Individuals (CSFII), and 1999-2001 National Health and Nutrition Examination Survey were used in this study. The sample consisted of 73,345 individuals, aged >or=2 years. For each survey year, the percentage of total energy intake from meals and snacks was calculated separately for respondents aged 2 to 18 years, 19 to 39, 40 to 59, and >or=60. The percentage of energy intake by location (at home consumption or preparation, vending, store eaten out, restaurant/fast food, and school), as well as for specific beverages was computed separately for all age groups. The proportion consumed, mean portion size, and number of servings were calculated. For all age groups, sweetened beverage consumption increased and milk consumption decreased. Overall, energy intake from sweetened beverages increased 135% and was reduced by 38% from milk, with a 278 total calorie increase. These trends were associated with increased proportions of Americans consuming larger portions, more servings per day of sweetened beverage, and reductions in these same measures for milk. There is little research that has focused on the beneficial impacts of reduced soft drink and fruit drink intake. This would seem to be one of the simpler ways to reduce obesity in the United States.
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              Nutritional status and dietary intakes of children aged 6 months to 12 years: findings of the Nutrition Survey of Malaysian Children (SEANUTS Malaysia).

              The dual burden of malnutrition reportedly coexists in Malaysia; however, existing data are scarce and do not adequately represent the nutritional status of Malaysian children. The Nutrition Survey of Malaysian Children was carried out with the aim of assessing the nutritional status in a sample of nationally representative population of children aged 6 months to 12 years. A total of 3542 children were recruited using a stratified random sampling method. Anthropometric measurements included weight, height, mid-upper arm circumference, and waist and hip circumferences. Blood biochemical assessment involved analyses of Hb, serum ferritin, and vitamins A and D. Dietary intake was assessed using semi-quantitative FFQ, and nutrient intakes were compared with the Malaysian Recommended Nutrient Intakes (RNI). The prevalence of overweight (9·8%) and obesity (11·8%) was higher than that of thinness (5·4%) and stunting (8·4%). Only a small proportion of children had low levels of Hb (6·6%), serum ferritin (4·4%) and vitamin A (4·4%), but almost half the children (47·5%) had vitamin D insufficiency. Dietary intake of the children was not compatible with the recommendations, where more than one-third did not achieve the Malaysian RNI for energy, Ca and vitamin D. The present study revealed that overnutrition was more prevalent than undernutrition. The presence of high prevalence of vitamin D insufficiency and the inadequate intake of Ca and vitamin D are of concern. Hence, strategies for improving the nutritional status of Malaysian children need to consider both sides of malnutrition and also put emphasis on approaches for the prevention of overweight and obesity as well as vitamin D insufficiency.

                Author and article information

                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                30 December 2015
                30 December 2015
                : 15
                [ ]Nutrition Programme, School of Health Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan Malaysia
                [ ]KK Research Centre, KK Women’s and Children’s Hospital, Bukit Timah Road, Singapore, 229899 Singapore
                [ ]Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor Darul Ehsan, Malaysia
                [ ]School of Healthcare Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abd Aziz, 50300 Kuala Lumpur, Malaysia
                [ ]Department of Nutrition and Dietetics, School of Health Sciences, International Medical University, No.126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Kuala Lumpur, Malaysia
                [ ]Sports Science Programme, Faculty of Sports Science and Recreation, Universiti Teknologi MARA, 40450 Shah Alam, Selangor Darul Ehsan Malaysia
                [ ]Cereal Partners Worldwide, Chemin du Viaduc 1. Prilly, Lausanne, 1008 Switzerland
                [ ]Nestlé Research Center, Vers chez les Blanc, 1000 Lausanne, Lausanne, Switzerland
                [ ]Nestlé R&D Center, 2655633, 29 Quality Road, 618802 Singapore, Singapore
                [ ]Nutrition Society of Malaysia, c/o Division of Human Nutrition, Institute for Medical Research, Kuala Lumpur, Malaysia
                © b. Jan Mohamed et al. 2015

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                Research Article
                Custom metadata
                © The Author(s) 2015

                Public health
                bmi,children,malted drinks,micronutrients,physical activity,screen time
                Public health
                bmi, children, malted drinks, micronutrients, physical activity, screen time


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