Ministry of Health Malaysia, 2008 Nutrition Section Family ...iku.moh.gov.my/images/IKU/Document/REPORT/MANS2003/Volume… · sedentary, not consuming adequate energy or over consuming

First Published in Malaysia 2008 Copyright © Nutrition Section, Family Health Development Division Ministry of Health Malaysia, 2008 ISBN 978-983-42874-9-8 Published by: Nutrition Section Family Health Development Division Ministry of Health Malaysia Level 7, Block E10 Federal Government Administrative Centre 62590 Putrajaya, Malaysia Tel. : 603-88834086 Fax : 603-88884647 Website : www.nutrition.moh.gov.my All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording and/or otherwise, without the prior written permission from the publisher.

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ACKNOWLEDGEMENTS

The Malaysian Adult Nutrition Survey was funded by the Ministry of Health through the

operating budget of three Divisions, the Family Health Development Division, the Food

Safety and Quality Division and the Health Education and Communication Division. This

survey was coordinated by the Nutrition Section of the Family Health Development Division.

The completion and success of this survey was due to the hard work and dedication of the

scouting team, survey team and the Technical Committee for the Malaysian Adult Nutrition

Survey. The latter was responsible for the development of the survey design and the survey

questionnaire, monitoring the quality of the survey data, analyzing the data and preparing

this report. Throughout this period the survey team and the Technical Committee members

showed a high level of professionalism and team spirit.

The Technical Committee comprised of members from several divisions in the Ministry of

Health, the Health Departments of the states of Johor and Selangor, the Public Health

Institute, the Institute of Medical Research, the Institute for Health Systems Research, as

well as academicians from the local universities. Their commitment and contribution is

highly acknowledged. We would like to acknowledge support from the Directors of the State

Health Department, Director of the Institute for Public Health, Director of the Institute of

Medical Research, Director of the Institute for Health Systems Research, Heads of

Departments of Nutrition and Dietetic, of the Universiti Kebangsaan Malaysia and Universiti

Putra Malaysia and the Dean, School of Health Sciences, Universiti Sains Malaysia for their

support and cooperation.

Special thanks are due to the staff at the Nutrition Laboratory, Institute for Medical

Research for their help in the nutrient analysis of 41 food samples to supplement the data in

the current Malaysian Food Composition Tables, which was used in the analysis of certain

food items not in the database. This survey would not have been possible without the

understanding, commitment and participation of our respondents. We offer our deepest

gratitude to the nearly 7000 Malaysians who welcomed us into their homes and made this

Adult Nutrition Survey a success.

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The report of this survey has been written in nine volumes which are:

Volume 1: Methodology

Volume 2: General Findings

Volume 3: Nutritional Status of Adults Aged 18 to 59 Years

Volume 4: Meal Pattern of Adults Aged 18 to 59 Years

Volume 5: Dietary Intake of Adults Aged 18 to 59 Years

Volume 6: Physical Activity of Adults Aged 18 to 59 Years

Volume 7: Habitual Food Intake of Adults Aged 18 to 59 Years

Volume 8: Dietary Supplement Use among Adults Aged 18 to 59 Years

Volume 9: The Field Survey and Data Support Team

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VOLUME 1

Methodology

Malaysian Adult Nutrition Survey 2003

Authors

Safiah Mohd. Yusof Family Health Development Division Ministry of Health Malaysia

Siti Haslinda Mohd. Din Department of Statistics, Malaysia

Ahmad Mahir Razali Universiti Kebangsaan Malaysia, Bangi

Siti Fatimah Ahmad Family Health Development Division Ministry of Health Malaysia

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Technical Committee Members

Ahmad Ali Zainuddin Institute for Public Health Ministry of Health Malaysia

Ahmad Mahir Razali Universiti Kebangsaan Malaysia

Azmi Md. Yusof State Department of Health, Johor

Fatimah Salim Family Health Development Division Ministry of Health Malaysia

Fatimah Sulong State Department of Health, Negeri Sembilan

Jamal Khair Hashim State Department of Health, Selangor

Khairul Zarina Mohd Yusop Family Health Development Division Ministry of Health Malaysia

Mirnalini Kandiah Department of Nutrition and Dietetics Universiti Putra Malaysia

Nor Azliana Mohamat Nor Family Health Development Division Ministry of Health Malaysia

Norlela Mohd. Hussin State Department of Health, Selangor

Norimah A. Karim Department of Nutrition and Dietetics Universiti Kebangsaan Malaysia, Kuala Lumpur

Poh Bee Koon Department of Nutrition and Dietetics Universiti Kebangsaan Malaysia, Kuala Lumpur

Safiah Mohd. Yusof (Principal Investigator) Family Health Development Division Ministry of Health Malaysia

Siti Haslinda Mohd. Din Department of Statistics, Malaysia

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Technical Committee Members

Sabtuah Royali Health Education Division Ministry of Health Malaysia

Tahir Aris Institute for Health Systems Research (IHSR) Ministry of Health Malaysia

Wan Abdul Manan Wan Muda Universiti Sains Malaysia

Zalilah Mohd Shariff Department of Nutrition and Dietetics Universiti Putra Malaysia

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Research Officers

Aida Azna Abu Hassan (from April 2002 until October 2003) Family Health Development Division Ministry of Health Malaysia

Asnah Laile Abdul Latif (from July 2004 until January 2006) Family Health Development Division Ministry of Health Malaysia

Fasiah Wahad (from November 2006) Family Health Development Division Ministry of Health Malaysia

Fatimah Zurina Mohamad (from April 2002 until October 2003) Family Health Development Division Ministry of Health Malaysia

Mohd Hasyami Saihun (from July 2004 until November 2007) Family Health Development Division Ministry of Health Malaysia

Norhasniza Yaacob (from September 2007) Family Health Development Division Ministry of Health Malaysia

Normah Haron (from February 2006 to April 2007) Family Health Development Division Ministry of Health Malaysia

Siti Fatimah Ahmad (from October 2003 until November 2007) Family Health Development Division Ministry of Health Malaysia

Siti Norazlin Mohd Ngadikin (from April 2002 until November 2007) Family Health Development Division Ministry of Health Malaysia

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Research Assistants

Anim Zakiah Mokhter (from March 2007) Family Health Development Division Ministry of Health Malaysia

Azlina Aliyah (from August 2004 until April 2005) Family Health Development Division Ministry of Health Malaysia

Nik Fazlina Nik Mustafa (from October 2003 until July 2004) Family Health Development Division Ministry of Health Malaysia

Nor Ismawan Othman (from October 2003 until September 2004) Family Health Development Division Ministry of Health Malaysia

Siti Rohana Mohd Yunus (from October 2003 until April 2005) Family Health Development Division Ministry of Health Malaysia

Zanarita Ariffin (from January 2004 until September 2006) Family Health Development Division Ministry of Health Malaysia

viii

Volume 1: Methodology Malaysian Adult Nutrition Survey 2003

FOREWORD BY DIRECTOR GENERAL OF HEALTH MALAYSIA

This report and the results of the Malaysian Adult Nutrition Survey 2003 mark the outcome of five

years of planning, development, field work and analysis. This was brought about by a successful

collaboration between the Ministry of Health and the local universities.

This report provides definitive information on the nutritional status of Malaysian adults. For the first

time, a detailed food and nutrient intake information of the adult population in various parts of the

country, whether urban or rural, and of the various ethnic groups. Findings from this survey of a

representative sample of the population indicate the magnitude of the nutrition problems in this

country, for example, the estimated number of adults who are overweight and obese, those who are

sedentary, not consuming adequate energy or over consuming calories from fats.

This report is timely, as it coincides with our 9th Malaysia Plan mid-term review, and thus provides

useful guidance in the development of policies regarding health, nutrition, food safety, agriculture and

trade. This will place Malaysia at par with the developed countries, an important milestone in our

quest for standard setting and evidence-based planning of programmes.

The information obtained from this survey is essential in keeping up with the changing eating habits

due to globalisation and urbanisation. I, therefore, hope similar surveys will be continued on a

regular basis, and that future surveys cover other age groups such as infants, children, adolescents

and the elderly.

The Ministry of Health Malaysia would like to congratulate the Family Health Development Division,

Ministry of Health Malaysia and everyone involved in making this study a success. Special thanks to

the Technical Committee for the Malaysian Adult Nutrition Survey, all State Health Departments and

universities for their commendable effort in coming up with this extremely important document for

planning of Public Health programmes.

Thank you.

Tan Sri Dato’ Seri Dr. Hj Mohd. Ismail Merican

Director General of Health Malaysia

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FOREWORD BY DEPUTY DIRECTOR GENERAL OF HEALTH (PUBLIC HEALTH)

The increase in diet-related diseases during the last few decades in Malaysia has prompted the

government to recognize the important role that nutrition plays in the promotion of good health. To

achieve the goal of healthy population, Malaysians must have access to a nutritionally adequate diet,

safe foods and a sustainable healthy living environment.

The publication of the Malaysian Adult Nutrition Survey (MANS) 2003 would generate much interest

amongst all health and nutrition care stakeholders in the country. Data and information gathered by

these surveys are extremely valuable to all decision makers at the national, state and district level as

well as those interested in the nutritional status of the Malaysian population.

Results of the MANS 2003 can be utilised as indicators to evaluate the achievements of the targets

in the National Plan of Action for Nutrition (2006-2015). The outcome of this survey can also be used

to measure the impact of current nutrition intervention programmes as well as to plan future activities

to cater for the unique needs of the various target population. This report will serve as a useful

reference for future research and helps in improving the availability of local data sources.

I would like to take this opportunity to congratulate and thank the Director of Family Health

Development Division and the Principal Investigator MANS 2003, all those directly involved in the

conduct of the survey, the Technical Committee Members and research field survey teams for their

dedication and tenacious efforts in completing this survey and publishing this invaluable report.

Dato’ Dr. Hj. Ramlee Hj. Rahmat

Deputy Director General of Health (Public Health)

Ministry of Health Malaysia

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FOREWORD BY DIRECTOR OF FAMILY HEALTH DEVELOPMENT DIVISION

I am very happy with the successful completion of this report of the Malaysian Adult Nutrition Survey

(MANS) 2003. I appreciate the concerted effort, persistence and endurance of the officers who have

been involved in this survey. I am extra proud of the report which is the first National Adult Survey of

its kind conducted in this country.

This survey provides the data for action and policies, as well as the direction for further research

efforts towards improving the nutritional well-being of the population in line with the objectives of the

National Nutrition Policy of Malaysia.

I believe this survey report is an important document to provide guidance in the implementation and

evaluation of nutrition programmes and activities in the country under the Ninth and Tenth Malaysia

Plans.

The results of this study have given us a more comprehensive and up-to-date picture of the

nutritional status, dietary intake and physical activity of the adult population as well as their use of

food supplements. The report will also be valuable in assisting with the decision making for research,

services or training.

I would like to take this opportunity to thank the immediate past Director of Family Health

Development Division Dato‟ Dr Narimah Awin, whose support was instrumental in making this study

a success. I must congratulate Datin Dr Safiah Mohd Yusof the Principal Investigator and the

research team members whom with passion, dedication and hardwork, have successfully undertaken

and completed this study. I would also like to thank all individuals and agencies who have directly or

indirectly, contributed towards the completion of this study.

Dr. Hjh Safurah Hj. Jaafar

Director of Family Health Development Division


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FOREWORD BY PRINCIPAL INVESTIGATOR

A nutrition survey involves measuring multiple variables that are interrelated. Moreover, a person‟s

food intake or physical activity can change from time to time. However, this type of information and

others to asses the nutritional status of the Malaysian population is urgently needed to develop food

and nutrition policies, intervention and educational programmes as well as to monitor the country‟s

nutrition situation.

This is the first time that a cross-sectional nutrition survey has been conducted nationwide, covering

Peninsular Malaysia, Sabah and Sarawak. The main objective of this survey is to determine the

nutritional status, food consumption and physical activity pattern of Malaysian adults from 18 to 59

years old.

It is my sincere wish that the results of this study be maximally utilized by all stakeholders of nutrition

and health services in the country, including programme managers of the Ministry of Health

Malaysia, academicians, food manufacturers, private health institutions and individuals concerned.

The results should be used for the betterment of the nation, directly or indirectly in nutrition planning,

prioritisation, research or training.

I would like to take this opportunity to thank the Director General of Health Malaysia, Tan Sri Dato‟

Seri Dr. Hj Mohd Ismail Merican for giving valuable support in this survey.

A note of gratitude goes to the Deputy Director General of Health Malaysia (Public Health), Dato‟ Dr.

Hj. Ramlee Hj. Rahmat as an advisor to Technical Committee for this survey for his patience,

understanding and guidance to ensure the success of this survey.

I would like to acknowledge support from the Director of the Family Health Development Division,

Directors of all the State Health Departments, Director of the Institute for Public Health, Director of

the Institute of Medical Research, Director of the Institute for Health Systems Research, Heads of

Nutrition Departments of Universiti Kebangsaan Malaysia and Universiti Putra Malaysia and the

Dean, School of Health Sciences, Universiti Sains Malaysia for their support and cooperation. Their

commitment and contribution is highly appreciated.

The completion and success of this survey was due to the hard work and dedication of the scouting

team, survey team and the Technical Committee for the Malaysian Adult Nutrition Survey. The latter

was responsible for the development of the survey design and the survey questionnaire, monitoring

the quality of the survey data, analyzing the data and preparing this report. Throughout this period

the survey team and the Technical Committee members showed a high level of professionalism and

team spirit.

This survey would not have been possible without the understanding, commitment and participation

of our respondents. I offer my deepest gratitude to the nearly 7000 Malaysians who welcomed us into

their homes and made this Adult Nutrition Survey a success.

Datin Dr. Safiah Mohd Yusof

Principal Investigator


Family Health Development Division



TABLE OF CONTENTS

Contents Page

Foreword by Director General of Health Malaysia viii

Foreword by Deputy Director General of Health (Public Health) ix

Foreword by Director of Family Health Development Division x

Foreword by Principal Investigator xi

LIST OF TABLES

LIST OF APPENDICES

1.1 INTRODUCTION 1

1.2 SCOPE OF THE SURVEY 3

1.3 SURVEY OBJECTIVES 3

1.3.1 General Objective 3

1.3.2 Specific Objectives 3

1.4 METHODOLOGY 4

1.4.1 Sampling design and sample size 4

1.4.2 The pre- survey 6

1.4.3 Selection of respondents 8

1.4.3.1 Eligible respondents 8

1.4.4 Logistic support 8

1.4.5 Data collection period 9

1.4.6 The survey team 9

1.4.7 Survey instrument 9

1.4.7.1 Survey questionnaires 9

1.4.7.2 The Album on Portion Sizes of Malaysian Foods 13

1.4.7.3 The weighing scale 14

1.4.7.4 The height measuring instrument 14

1.5 IMPLEMENTATION OF THE SURVEY 14

1.5.1 Pre-test of the survey 14

1.5.2 Data collection 14

1.5.3 Data collection quality control 18

1.5.4 Questionnaire management 19


Contents Page

1.6 DATA MANAGEMENT 19

1.6.1 Data entry 19

1.6.2 Coding 21

1.6.3 Data cleaning 21

1.6.4 Data analysis 22

1.7 REFERENCES 26

OPERATIONAL DEFINITION OF TERMS 28

ETHNIC GROUP 29

APPENDIX 31


LIST OF TABLES

Tables Title of Tables Page

1.4.1 Distribution of the total selected number of EBs and LQs 6

1.4.2 Distribution of the total number EBs and LQs selected after the pre survey 7

1.4.3 Names of forms in the questionnaire 10

1.4.4 Weight of different types of rice and cooked rice in different household measurements

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LIST OF APPENDICES

Appendix Title of Appendix Page

A The questionnaire forms 32

B Sample page from the Food Photo Album 59

C List of food items analysed at the Institute for Medical Research 60

D List of physical activities carried out by subjects 62

E Type of non-mineral non-vitamin supplement 66

F List of physical activities grouped into light, moderate and vigorous-intensity categories

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1

Methodology

1.1 INTRODUCTION

Diet and nutrition are important factors in the promotion and maintenance of good health

throughout life. They play an important role in the development of chronic non-

communicable diseases (WHO, 2003). High cholesterol levels have been identified as the

primary cause of coronary heart disease. Research findings have also established that

certain cancers, for example cancer of the colon, prostate and breast are diet related and in

these cases, dietary fat can influence both the promotion stage as well as the progression

stage of the cancer (Sellers et al., 1993). Overall, epidemiological studies have revealed

that the populations consuming diets low in fat and red meat, but high in vegetables and

grains are at low risk for cardiovascular diseases, diabetes and certain cancers.

Over the past three decades, as Malaysia has prospered, the lifestyle of Malaysians has

changed in numerous ways. During this time a sharp and steady increase has occurred in

the incidence of obesity, diabetes and heart disease. The National Health and Morbidity

Survey II (NHMS II), conducted by the Ministry of Health (MOH) in 1996 and 1997, showed

that 30% of the population (above 30 years of age) have possible hypertension and 8.2% of

the population above 30 years of age have diabetes, compared to only 6.3% in first National

Health and Morbidity Survey (Maimunah, 1997). The Malaysian NHMS II, in assessing the

nutritional status of adults, used the WHO (1998) BMI cut-off points, and found that the

prevalence of overweight and obesity were 16.6%, and 4.4% respectively.

Energy balance in an individual is not determined by intake alone. It is also affected by the

caloric output, i.e. by physical activity. From NHMS II (MOH, 1996), the national prevalence

of ever exercise and adequate exercise was found to be 30.9% and 11.6% respectively.

Exercise was considered adequate if the person had performed one of the following 10

types of exercise - jogging, brisk walking, cycling, rope skipping, swimming, rowing, team

sport, racquet sport and calisthenics sport for more than 3 times a week, each lasting for at

least 15 minutes.

Assessing dietary adequacy is essential in order to formulate nutrition recommendations

with respect to nutrient intake and dietary habits of populations. In the absence of

consumption data at the national level, various studies involving relatively small sample

sizes do provide some information on food consumption among Malaysians. It has been

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reported that the dietary intakes of household members from low-income group are deficient

in calorie, iron, calcium, folate, retinol and vitamin B complex. In contrast, studies among

higher income groups showed that the major sources of calories tend to be more diverse

including meat, fish, and seafood beside cereals, cooking oil and sugars (Zanariah et al.,

1986; Khor, Hsu-Hage & Wahlqvist, 1998).

Nutrition is a complex process and difficult to characterize, unlike smoking. An individual

can give almost accurate information on whether he or she is smoking or not smoking.

They too can tell how many cigarettes, they smoke per day and since when. A nutrition

survey is complex because of the multiple exposures that need to be studied, which are

usually interrelated. For example, every individual will have fat, fibre and vitamin A in his or

her diet, but the quantity and quality of foods eaten will vary between individuals. Moreover,

a person‟s food intakes can change from time to time.

Information about the nutrition of the Malaysian population is urgently needed to develop

food and nutrition policies, intervention and educational programmes as well as monitoring

the country‟s nutrition situation. The current survey involved several thousands of subjects.

We were faced with the challenge to adopt a methodology that is precise and at the same

time at low cost. This is the first time that a cross-sectional nutrition survey was conducted

nationwide, covering Peninsular Malaysia, Sabah and Sarawak.

The objectives of the Malaysian Adult Nutrition Survey highlight the scope of the survey.

The outcome of this survey would be used for the development of baseline information for

nutrition surveillance and implementation of food-based dietary guidelines for Malaysia. It

could also be used for the development food and nutrition policies, intervention and

educational programmes, as well as a reference for planning and implementation of future

surveys.

The Malaysian Adult Nutrition Survey 2003 used a sampling frame that had included

populations in six zones of the country. Approximately 7000 statistically selected adults

were interviewed in their homes between October 2002 and December 2003. The face-to-

face interview technique was used.

This report is the first volume of nine series of the entire survey report. It outlines the

objectives of the Malaysian Adult Nutrition Survey 2003, its background, and describes the

methodologies that were used in the data collection. The process for data entry, data

coding, data cleaning and analysis is also explained in the report.


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1.2 SCOPE OF THE SURVEY

For this survey the following scopes had been included:

- Anthropometry

- Measuring the current weight and height, underweight, overweight

and obesity status.

- 24-hour diet recall

- Pattern of the three main meals, i.e breakfast, lunch and dinner

- Habitual physical activity

- 24-hour physical activity recall

- Frequency and amount of intake for various foods and drinks for the

past one year

- Pattern of intake of nutrient and food supplements for the past one

year

1.3 SURVEY OBJECTIVES

1.3.1 General objective

To determine the nutritional status, dietary pattern and physical activity pattern among

Malaysian adults aged from 18 to 59 years old.

1.3.2 Specific objectives

i. To describe the body size and weight status.

ii. To develop a database on the consumption of various food items.

iii. To assess meal pattern.

iv. To determine the energy and nutrient intake.

v. To evaluate the habitual food intake.

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vi. To determine the frequency of intake of nutrient and food

supplements.

vii. To assess physical activity pattern.

1.4 METHODOLOGY

1.4.1 Sampling design and sample size

The Malaysian Adult Nutrition Survey was a cross-sectional population survey, being

conducted nationwide for the first time between year 2002 and 2003, covering Peninsular

Malaysia, Sabah and Sarawak. Geographically, the survey covered the whole of Malaysia,

both the urban and rural areas. It covered only households living in private Living Quarters

(LQs). The institutional households of those living in hostels, hotels, hospitals, prisons etc,

which constitutes about one percent of the total households in the country, were excluded

from the coverage of the survey.

a) Sampling Frame

The sampling frame was from the Department of Statistics‟ National Household Sampling

Frame (NHSF), which is made up of Enumeration Blocks (EBs) created for the 2000

Population and Housing Census. Enumeration Blocks are land areas with identifiable

boundaries, each containing about 80-120 LQs and about 600 persons. Generally all EBs

are formed within gazette boundaries, i.e. within „mukim‟ or local authority areas.

b) Sampling technique

A stratified random sampling with proportional allocation was used for this survey which

covered six zones in Malaysia. The zones were the Southern, Central, East Coast, and

Northern zones of Peninsular Malaysia, Sabah and Sarawak.

The first stage units of sample selection were the EBs while the second stage units were

the LQs within the selected EBs. At every stage of selection the units were selected with

equal probability within each level of the secondary stratum. On average the number of

LQs selected from each EB was eight.


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c) Sample size

The sample size required was based on the estimated prevalence of a nutrition related

variable, the level of confidence and the margin of error desired. The prevalence of

overweight adult population in Malaysia was chosen because it is about the only nutrition-

related variable for which information is available at the national level. This formula was

used:

where

n = required sample size

= value of standard normal distribution at desired confidence interval

p = estimated prevalence of the variable of interest

ε = relative precision required

Findings from the NHMS II (Fatimah et al., 1997) showed that the prevalence of overweight

and obesity among adult population was 21%. At 95% confidence interval and a 5% level

of precision, the sample size required for the survey was calculated as:

n =1.962 x (1-0.21)/(0.05)

2x0.21 = 5,780

Based on the results of NHMS II, the distribution of overweight and obesity in the study

subjects appeared to be relatively uniform, with no area of particularly high prevalence and

no area of particularly low prevalence. To account for a non-response rate of 50 percent,

the required sample size was increased to 8,670.

Allocation of sample size was assisted by the Department of Statistics. The allocation of

sample between strata within each area was based on the size of the stratum. The sample

size at the National Level is 1120 EBs. Depending on the size of each EB, about eight LQs

was selected from each EB. One adult from each household was randomly selected as the

study subject. If one LQ has more than one household, thus more than one adult was

selected to be interviewed in that LQ. The distribution of EBs and LQs selected as originally

planned by the Department of Statistics for the Malaysian Adult Nutrition Survey 2003 is

shown in Table 1.4.1.

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Table 1.4.1: Distribution of the total selected number of EBs and LQs

1.4.2 The pre-survey

A pre-survey of the selected houses was conducted by Public Health Assistants and Staff

Nurses of the respective districts. The purpose of the pre-survey was primarily to scout and

locate the selected houses, and report on houses which had been demolished, destroyed,

did not exist or they were no longer considered as living quarters. During the pre-survey the

health staff made contact with a member of the household and explained to them about the

forth coming survey and requested their cooperation. The staff filled in the details of the

members of the household in a prepared form, which included the home address, telephone

number, name of each household member, ethnicity, age, gender and the language

spoken.

One form (Field-C) was used to fill in details of members in a household. In instances

where more than one household lived in the same house, separate forms were used. Every

house visited was tagged with a yellow card with the name of the survey and the EB code

number.

The distribution of the total number of Ebs and LQs selected after the pre-survey is shown

in Table 1.4.2.


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Table 1.4.2: Distribution of the total number of EBs and LQs selected after the pre survey

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1.4.3 Selection of respondents

One adult from each household was selected as the study subject using simple random

sampling. If one LQ had more than one household, thus more than one adult were

interviewed.

Details of the members from each household were entered in the computer and a master

list of all adults aged between 18 and 59 years old was made. A copy of the master list

was kept each at the central and state level. The name of the adult to be interviewed was

highlighted in both copies of the master list.

The respondents had been contacted by a survey team member (nutrition officer,

research assistant or nurse) through telephone to inform them about the team visit, and

arrange for an appointment to conduct the survey.

For respondents with no telephone contact, the team members made a visit prior to the

interview to arrange for a convenient time. On the other hand, some interviews were able

to be conducted during the first visit because the respondents were at home.

1.4.3.1 Eligible respondents

Those respondents who fulfilled the criteria below were eligible for the study:

i) Age between 18 and 59 years old

ii) A Malaysian citizen

iii) Not deaf, dumb or bed-ridden

iv) Staying in the living quarters for at least 2 weeks

1.4.4 Logistic support

A Senior State Nutrition Officer was appointed as the liaison officer for each state. His or

her responsibility was to promote the survey by conducting briefing sessions to all the

relevant officers at the state health department and at the district health offices. The

objective of the briefing sessions was to ensure that there was full support from all state

and district health officers. This support could be in terms of transportation and

accommodation for the survey team during the survey period. Their support had

contributed to the success of the survey.


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1.4.5 Data collection period

For Peninsular Malaysia, the survey was conducted from October 2002 until July 2003.

Sabah (including Labuan) conducted its survey from January until May 2003 and Sarawak

from July until December 2003. For Sabah and Sarawak, the survey started later than

Peninsular Malaysia due to festivals, fasting months and Hari Raya Puasa.

1.4.6 The survey team

Several survey teams were formed at each state. Each survey team comprised a nutrition

officer, one research assistant or a nurse and a number of survey scouts. The interviewers

for the survey were the selected nutrition officers, research assistants or nurses. Those

state nutrition officers themselves were appointed as the survey team leaders. While the

senior state nutrition officers were appointed as the state liaison officer as well as the state

survey supervisors. The supervisor‟s role was to prepare the state survey implementation

plan, survey schedule and work allocation for each survey team in a given area. The

supervisor also coordinated the logistics requirement for the survey teams.

They maintained a master list which contained the following information:

i) List of respondents to be interviewed

ii) Number of completed and incomplete interviews

iii) Number of refusals and non-contactable respondents

iv) Number of attempts to visit and the outcomes of the visits

The role of the survey team leader was to brief the interviewers about the tasks of the

interviewing day. At the end of each interviewing day they discussed with the interviewers

the outcome of their interviews. To ensure the quality of the interviewing session each

questionnaire was checked for completeness and, the open-ended responses were coded

correctly.

1.4.7 Survey instrument

1.4.7.1 Survey questionnaires

The survey questionnaire was designed based on the objectives of the survey and took into

consideration certain limitations and constraints. Limitations and constraints included

financial resources, capacity of MOH staff, and willingness and ability of household member

being interviewed to provide the desired information.

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The questionnaire was designed to be administered using face-to-face interviews by trained

personnel who visited respondents in their homes. They are pre-coded with few exceptions

where responses had to be written by the interviewers (Appendix A).

The questionnaire book contained five sections (Table 1.4.3).

Table 1.4.3: Names of forms in the questionnaire

Form A: Socio-demography

This form contained questions on the respondent‟s identification number (ID), socio-

demographic data i.e. sex, ethnicity, religion, marital status, date of birth, educational level,

occupation, individual income and family income. Questions on respondent‟s health status,

vegetarianism were also included in Form A. Female respondents were asked additional

questions such as pregnancy status and post-partum confinement status.

Form B: 24-Hour Diet Recall and Meal Pattern

This form was designed to assess the dietary intake of respondents 24 hours prior to

interview. This form consists of the identification number (ID) of respondent, date of

interview, name of respondent, and day of recall. All foods and beverages consumed on

the recall day were recorded in the tables according to the time taken, type of food eaten,

details of the food, quantity consumed and the amount eaten for each food. A separate

page was used to record alcohol consumption.

This format also contained information about meals taken, the place where meal was eaten,

source of the meal and the companion when meal was taken.

Questions were asked for breakfast, lunch and dinner and place where the meal was

consumed. The options for the places included home, office, canteen or cafeteria,

restaurant or hotel, hawkers or coffee shop and others.


11

The place where the meal or food was prepared was also asked and the options included

home-prepared food, food bought from shops, restaurant food, hawker foods and others.

The options for companions when meal was taken were either with family members, friends

or alone.

Form C: Habitual Physical Activity and 24-Hour Physical Activity

The questions on physical activity were divided into two parts namely, Part 1 comprising a

brief habitual physical activity questionnaire, and Part 2 comprising a 24-hour physical

activity recall form. Part 1 was designed to complement the 24-hour physical activity recall

and to provide information on transportation for going to or from work or school, climbing

stairs, and also exercises or sports activities. Transportation included those that involve

“light intensity” physical activity namely public transportation, driving and riding a

motorcycle. Transportation that involves “moderate intensity” physical activity included

cycling and walking. Information on climbing stairs included number of flights climbed at

home, at work, in school and other places (15 steps = 1 flight; 7 steps = ½ flight). The

questions on exercise was designed to obtain information on the types, frequency and

duration of the three most frequent exercises carried out during two weeks prior to the

interview.

The 24-hour physical activity recall form (Part 2) was designed in a table format in five-

minute intervals to obtain information on physical activity and body position when the

activity carried was out. Respondents were asked to recall all activities done on the day

before, starting from 12 midnight of the previous day until 12 midnight of the day before the

interview. Activities were recorded at five-minute intervals to obtain a full one-day physical

activity pattern.

Form D: Anthropometry

This form contained information about the respondents, i.e. name, weight and height. There

are spaces for three measurements of weight and height. The measurement for weight is in

kilogram and height in centimetres.

Form E: Frequency of Food Intake and Frequency of Supplement Intake

a) Frequency of Food Intake

This form is universally known as the Food Frequency Questionnaire (FFQ). The form had

listed 126 food items which were categorised into 15 food groups. There were four main

12


columns in the FFQ. The first column contained list of food items while the second column

described the frequency of intake by day, week, month, year or not eaten at all. The

frequency of intake was based on the habitual food intake during the past year. The third

column described the serving size of each food item while the fourth column described the

number of servings consumed each time the food item was eaten.

The 13 food groups included in the FFQ are listed below;

A. Cereals and cereal products (17 food items)

B. Meat and meat products (12 food items)

C. Fish and seafood (12 food items)

D. Eggs (4 food items)

E. Legumes and products (4 food items)

F. Milk and milk products (6 food items)

G. Vegetables (10 food items)

H. Fruits (20 food items)

I. Beverages (11 food items)

J. Alcoholic beverages (5 food items)

K. Confectioneries (8 food items)

L. Spreads (6 food items)

M. Condiments/Miscellaneous (11 food items)

N. There were additional questions on the use of sugar, cooking oil and salt by the

members of household in a month.


13

b) The Frequency of Supplement Intake

This form was designed to obtain information on the intake of vitamin and mineral

supplements and the intake of non-vitamin and non-mineral supplements. A total of 15

types of vitamin and mineral supplement and 11 types of non-vitamin and non-mineral

supplement were listed in this questionnaire. Reasons for taking the supplements were pre-

coded into eight options. There was a column to state the frequency of intake for each type

of supplement.

1.4.7.2 The Album on Portion Sizes of Malaysian Foods

An album describing the portion sizes of common Malaysian foods (MOH, 2004) was

specially developed for this survey. It is referred to as the Food Photo Album. A sample

page from the Food Photo Album is shown in Appendix B. It contains photographs of

several locally available foods, either cooked or raw. Its purpose was to help the

respondents to identify and relate to the interviewers the type of food and the amount they

eat. For example, in this photo album, photographs of cooked rice were shown in different

portion sizes, which include a full plate, a bowl, a „senduk‟ (scoop) and a cup. This was

thought to be important because rice is a staple food in Malaysia and they are eaten in

various serving measurements.

There are 186 types of food in the Photo Album showing 55 types of raw foods and 131

types of cooked foods. These foods are shown in various serving sizes such as cup, bowl,

spoon, plate, whole or parts of the food, piece or cut. Table 1.4.4 shows an example of the

weight of various types of rice and the weight of cooked rice in different types of household

measures.

Table 1.4.4: Weight of different types of rice and cooked rice in different household

measurements

14


1.4.7.3 The weighing scale

„Seca‟ digital platform scales (Model 880) were used to measure weight. The scales were

able to measure up to 200 kilograms. These scales were calibrated every morning before

measurements were done using standard weights of 10 kilograms. The scale was placed on

a hard and level surface when weighing the respondent.

1.4.7.4 The height measuring instrument

A portable Seca body meter (Seca 208) taped to a vertical wall and perpendicular to a level

floor was used for height measurements. The tape was graded in centimetre with one-

millimetre divisions. This portable body meter was very light (200 gm), small and was able

to measure up to 200 centimetres.

1.5 IMPLEMENTATION OF THE SURVEY

1.5.1 Pre-test of the survey

A pre-test of the survey was done concurrently with training of the supervisors and

interviewers in Pangkor district. The questionnaire was tested on a random sample of the

community to assess its comprehensiveness, clarity and duration of questioning by

conducting mock interviews. This part of the interview was under the supervision of the

facilitators who were members of the technical committee for the survey. As a result of the

pre-test, the order in which the formats were administered was rearranged.

The Food Photo Album was also pre-tested during this session. The interviewers did not

find any difficulties in using the album, therefore there were no changes made.

During this pre-test session the duration of interview was determined. This duration included

the time taken to interview and measure weight and height. As a result of this pre-test it

was found that the duration varied according to different types of respondents.

1.5.2 Data collection

All information was obtained by face-to-face structured interviews conducted in the

residence of the respondents. At the beginning of the interview each respondent was asked

to sign a consent form agreeing to take part in the survey. This was to ensure that

respondents took part in the survey voluntarily.


15

All interviews were conducted in Bahasa Malaysia. In situations where the respondent was

not able to understand Bahasa Malaysia, the interview was conducted in their respective

mother tongue in the presence of an appropriate interpreter. However, only a minimum

number of interviewing sessions were conducted in other languages.

For Form B (24-hour diet recall), it was carried out through an interactive interview

conducted in 4 stages as below (Gibson and Ferguson, 1999):

Stage 1: Recall of time and the type of food and beverages consumed

During this stage, the interviewer requested the respondent to recall the time at which he

had his food, beginning from midnight a day before the interview. The information was

recorded according to the times that the meals or foods were consumed (column „a‟). The

time was divided into four blocks:

Block 1: Morning meal or breakfast: between 12 am and 11 am

Block 2: Afternoon meal or lunch: between11 am and 3 pm

Block 3: Afternoon tea: between 3 pm and 6 pm

Block 4: Evening meal or dinner: between 6 pm and 11.59 pm

In addition, the foods eaten at each time block were also recorded in the appropriate

column (column „b‟). At this stage further probing was avoided. However, if the respondent

volunteered with the information on the amount eaten, then the information was recorded.

An example of the interview at this stage is shown below:

Stage 2: Detailed description of food and beverages consumed

The interviewer went through in detail the list of foods recalled at Stage 1 and probed

further the description of these foods with respect to ingredients, cooking methods, whether

the foods were purchased or cooked, brand names, recipes etc. This information was

recorded in column „c‟.

To enhance the accuracy of the information provided by the respondent, the interviewer

used the Food Photo Album and household measures such as glasses, plates, bowls, cups,

1. Sir/Madam, did you eat or drink anything before going to bed last night?

2. Yesterday, after you woke up, at what time did you first eat and/or drink?

3. What did you eat and or drink?

16


spoons and ladles to help the respondent to identify and estimate portion sizes and weights

of foods they recalled having eaten. In addition, information on the cost of purchased food

was also obtained. Wherever possible, the actual weight of the food was recorded if a

sample of that food was available in the household. The amount of food eaten was then

recorded into column „d‟.

Stage 3: Review of foods eaten and weights recalled

At this stage, the interviewer reviewed the detailed intake recorded together with the

respondent. It was used as a check for both the respondent and interviewer. The

interviewer reviewed what was eaten in a chronological order and asked the respondent if

anything else was eaten, besides the foods recorded. The portion sizes were once again

clarified. The respondent was given time to recall again the foods and drinks that he may

have omitted or failed to recall in Stage 2.

Stage 4: Conversion of portion sizes to weight in grams

This was the final stage in which the data on portion sizes of all foods and drinks consumed

by survey respondents were converted into grams. The data in grams were recorded in

column „e‟.

Information on alcohol consumption was obtained only for non-Muslim respondents. The

type and amount of alcohol consumed was recorded. Alcohol containing drinks include

wine, whiskey, brandy, beer, toddy, local brews, Dom, rum and tuak (rice wine). An

example of an interview on alcohol consumption is shown in the box below:

In Form C the information on physical activity, respondents were first asked on their usual

mode of transport for going to work or school and the total time for travelling. Questions on

climbing up stairs either at home, office or elsewhere were also asked. Besides that they

were asked on their participation in exercise for the purpose of recreation, sport, health or

fitness during the two weeks prior to the interview.

For the 24-hour physical activity, the respondents were asked to recall all activities done the

day before, starting from 12 midnight the previous day until 12 midnight the day before the

interview. Activities were recorded at 5 minute-intervals to obtain a full one-day physical

activity pattern.

1. Sir/ Madam, did you take any alcohol containing drinks last night?

2. What were they?

3. How many glasses did you drink?

4. Apart from the ones, which you identified, did you take any other drink?


17

Meanwhile the weight and height of adults were taken by trained personnel working in

pairs using standard procedures (Form D). Respondents were measured in their

residence in light clothing without any footwear or heavy personal items. All female

respondents were asked if they were pregnant. If pregnant their weights and heights were

not measured. However, postnatal mothers were included as respondents. Body weight

was measured to the nearest 0.1 kg while height was measured to the nearest 0.1 cm.

Measurements were made by the one of the interviewers and recorded by the other. If a

person was not able to stand unaided, their weight and height were not measured. When

a measurement was not taken, the reason for this was recorded. Any characteristic that

may have affected the accuracy of the measurement was recorded (e.g. loss of legs, high

headgear or high hairstyle). The order of measurement was weight followed by height.

For weight measurement the respondent was asked to stand on the weighing scale with

the feet together, arms hanging loosely by the side and head facing forward. Two

measurements were made to the nearest 0.1 kg and recorded. The respondent was

asked to step down from the scale between each measurement. If the two measurements

differed by more than 0.5 kg, a third measurement was made.

For height measurement the respondent was measured with bare foot. He or she was

asked to stand with their feet flat on the floor and heels together. The respondent‟s back

was as straight as possible, the arms hanging loosely by the side. The head must be

positioned so that the line of vision was parallel to the floor. The respondent was asked to

take a deep breath without moving the head. The body meter was glided down gently onto

the respondent‟s head with enough pressure until it touched the skull. Two measurements

were made to the nearest 0.1 cm. The respondent was asked to step away from the body

meter after each measurement. If the two measurements differed by more than 0.5 cm,

then a third measurement was made.

For Form E, (Part 1), respondents were asked on the frequency of intake of each food

item. There were five options for frequency of intake categories. These options would

reflect the frequency of intake answered by the respondents as the number of times per

day, number of times per week, number of times per month, number of times per year or

never. The respondent was required to answer only one option. However for food items

which were consumed on a seasonal basis, for example during the fruit seasons or festive

seasons, the respondents would respond to the frequency of intake at that time (for

example eating rambutan three times a week for a month only) as well as the duration of

that pattern of intake.

18


Respondents were also requested to specify on the number of servings consumed each

time they ate the food. Each food item listed was given a standard serving size based on

the Food Photo Album which had pictures of various foods, their portion sizes and weights

in grams.

Meanwhile, for the foods which were not shown in the photo album, household

measurements were used. These household measurements included various sizes of

bowls, plates, cups, glasses and spoons. The weights of foods in these household

measures were listed and were used as a guide in the conversion of food serving sizes to

weights in grams. The serving size was based on the medium size.

Form E (Part 2) focussed on use of vitamin and mineral (VM) supplements and non-vitamin

and non-mineral (NVNM) dietary supplements during the last one year. Respondents were

asked to show the packaging or label of the supplement. For each category of supplement

their reasons for taking were asked.

1.5.3 Data collection quality control

Steps were taken to ensure and monitor the quality of data collection. These included:

i) Members of the survey team were trained and monitored

A five-day training session was conducted in Pulau Pangkor for the state

supervisors, survey team leaders and interviewers of Peninsular Malaysia. This

training included briefing on the questionnaires, detailed instructions on filling the

questionnaires using the manual developed for the survey. It also included

lectures and demonstrations on techniques of interviewing, standard method of

measuring weights and heights, use of the Food Photo Album developed for the

survey and use of household utensils for food measurement. A classroom practice

was carried out by using the survey questionnaire. A similar training was

conducted later for Sabah and Sarawak interviewers who consisted of nutrition

officers, research assistants and health nurses.

The team leaders in addition were given training on method of supervision,

fostering teamwork, quality control of the survey. Scouting teams were briefed by

senior state nutrition officers on the survey and locating households identified in

the EB maps provided by Department of Statistics. The training also had included

components of team building to develop team spirit among members of the survey

team.


19

ii) The survey team leader carried out field editing by checking all questions to ensure

the responses were filled into the questionnaire, before end of the interviewing

session in the selected living quarters.

iii) Survey data were monitored by the secretariat located at the head quarters in

terms of completeness of the questionnaire, actual number of received

questionnaires and the expected number of living quarters in each EB.

iv) The weighing scales and height measuring instrument used in the survey were

standardized and calibrated to ensure the validity of the measurement.

1.5.4 Questionnaire management

The questionnaire books from the same EB were tied together into a bundle. The bundles

were attached with identification sheets containing the EB number and the total number of

questionnaire books (Maimunah et al., 1998). These EB bundles were despatched to

headquarters by a survey team member weekly. The bundles from Sabah and Sarawak

were despatched by air cargo or courier services.

As soon as the bundles arrived, the research assistants checked the consistency of the EB

numbers with the master list and the total number of questionnaires received. The bundles

were stored according to state and zone.

1.6 DATA MANAGEMENT

In this survey the data management process consisted of data entry, data cleaning and data

analysis.

1.6.1. Data entry

All survey questionnaires were sent to the Family Health Development Division, MOH for

central data entry. This was to ensure quality control and close monitoring of the process.

This phase of the survey was managed by the central team headed by the Principal

Investigator assisted by two Nutrition Officers and five research assistants.

The data entry process was performed in three phases. The first phase was for data from

Forms A, B (Part 2), C (Part 1), D and E (Part 1 and Part 2). These data entries were

performed by 20 data key punchers at the Public Health Institute Computer lab from August

to December 2003, and continued at the Family Health Development Division from January

20


until September 2004. The activities continued at the Public Health Institute Computer lab

again from October to December 2004. A research assistant was appointed as manager to

the operation centre who supervised the data entry process by the data key punchers. All

data were entered twice to ensure accuracy of entry. The data entry screen was created

using the software Epi-Info 6. The central team performed quality checks on the

questionnaires.

The second phase of data entry was captured from Form B (Part 1), the 24-hour diet recall.

Before the data was captured the completeness of the information in the Form was

checked. If the foods were listed in the Food Photo Album the amount eaten were

converted into weights in gram. If not listed in the album, types of food as listed below were

weighed:

a) Those foods cited in household measures

b) For fruits and vegetables with uncommon serving sizes

c) Foods (inclusive of yong tau fu) sold in food outlets

Meanwhile, for drinks bought from food outlets, their sugar, milk and sweetened condensed

milk content were also measured.

This 24-hour diet recall data was entered using dietary analysis software, Nutritionist Pro

(First Data Bank, USA). This software was used to analyse for energy and other nutrient

intake. Food data bases utilised in the analysis included USDA Food Database, Malaysian

Food Composition Tables (both were available in the Nutritionist Pro software), Singapore

Food Composition Guide, ASEAN Food Composition Tables and The Composition of

Chinese Food.

For local mixed cooked dishes that did not have nutrient information from any of the food

data bases, local recipe books were used to identify at least two recipes for each dish.

These recipes were analysed for energy and nutrient values and the average of these

values were entered into Nutritionist Pro software to be used as a standard for dietary

analysis of the food. For example, two recipes of fish curry (gravy) were obtained and the

ingredients were analyzed for energy and nutrient values (per 100 gram). The average

values of the two recipes were then used as the standard for analysis of fish curry.

For processed and packaged foods that have energy and nutrient information on their

labels, the information was entered into the Nutritionist Pro software for dietary analysis

of these foods. Nutrient estimates were based exclusively on consumption of foods.


21

Vitamin and mineral supplements did not contribute to the nutrient intake levels of this

dataset. For foods where the recipe or nutrient contents were not obtainable from any

sources at all, samples were sent to the Institute for Medical Research Food Lab for nutrient

analysis. The foods analysed are listed in the Appendix C. Later, all processed data from

Nutritionist Pro were converted to SPSS data base format for further analysis.

In phase three of data entry, the physical activity data from Form C (Part 2) were entered

into Microsoft Excel worksheets and tabulated for each type of physical activity carried out,

and totalling 1440 minutes for all activities done in a day. The activities were also grouped

into the following categories: sleeping, resting, working, household chores, village-type

activities, child care activities, personal care activities, praying, religious activities, social

activities, transportation-related activities, activities related to moving about, watching

television, recreational activities, light-intensity sports, moderate-intensity sports, heavy-

intensity sports, eating, personal errands, and miscellaneous activities (Appendix D). In this

phase of the data entry data were entered only once. Since the responses were entered as

text and uncoded it was impossible to have a 100 percent match per response if entered

twice. Therefore to ensure the quality of the data, a 100 percent check was done on all

entered responses. This means every single data entered was being matched with the

original questionnaire. All processed data from Microsoft Excell worksheet were converted

to SPSS data base format for further analysis.

1.6.2. Coding

All the open-ended responses in this survey were coded into predefined categories. Its

main purpose was to classify the data into meaningful and useful categories (United

Nations, 1988). For example, for 24-hour physical activity recall, if the respondent stated an

activity such as singing in the sitting position, it was classified as resting (refer to Appendix

3). Another example is in Form E (Part 2), question 6 on the type of non-mineral and non-

vitamin supplement intake, the respondents were allowed to give answers other than those

listed. These responses were added to the existing listing. For example, Tongkat Ali, Kacip

Fatimah, Gamat and Habatus Sauda were not in the original list but were put as an

additional category (refer to Appendix E).

1.6.3 Data cleaning

Data cleaning is an important part of data processing to ensure that the errors were

minimised and the results were fit for use. This process consisted of two activities which

were data checking and data editing. The data editing process was usually done

immediately after data checking. The most important part of data cleaning was to detect the

22


“missing” values. These “missing” values were verified by checking the questionnaire or

re-contacting the interviewer or the respondents (Biemer & Lyberg, 2003).

The data captured from the questionnaire were then subjected to five kinds of checks.

These were range checks, checks against reference data, skip checks, consistency checks

and typography checks (Munoz, 2005).

Range checks were intended to ensure that every variable in the survey contains only data

within a limited domain of valid values. For example, sex can be coded only as “1” for men

and “2” for women. Therefore only values “1” and „2” should be entered in the data base.

By doing the range checks we were able to detect the impossible entries.

Checks against reference data were required when the data from two or more closely

related fields can be checked against external reference label. For example, height and

weight data were checked against the WHO standard reference table. Any value of the

standard indicator (weight or height) that fell more than three standard deviations from the

norm was tagged as a possible error.

Skip checks were done to verify whether the skip patterns had been followed appropriately.

In Form A of this survey, question 17 on months of pregnancy should only be responded by

those who answered “yes” to question 16 (which is status of pregnancy). Consistency

checks were done to verify that values from a question were consistent with values from

another question. For example, question 16 of Form A should only be answered by female

respondents.

A typical typographical error may occur due to the transposition of digits, for example

entering 12 rather than 21 for respondent‟s age. For this survey, typography checks were

done by having the data entered twice. Besides those checks mentioned, duplication of

records were checked by matching the identifiers. The identified records were only deleted

upon confirmation of exact duplicates.

1.6.4. Data analysis

According to Glewwe and Levin (2005), before any figures are generated to be put into

tables and graphs, the data must be prepared for analysis. This involves three tasks:

checking the data to remove observations that maybe highly inaccurate; generating

complex (derived) variables; and thoroughly documenting the preparation of the “official”

data set to be used for all analysis. In this survey, food consumption data (from Form E,

Part 1 of the questionaire), were examined for outliers as well as the extreme values. If the

extreme values were unreasonable or illogical the data were excluded from analysis.


23

In the 24-hour physical activity recall data, the activities were reclassified into three

categories of intensity of activities, namely light, moderate, or vigorous-intensity activities as

described by Ainsworth et al., (2000). Appendix E shows the list of activities that were

regrouped into these categories. This variable was used as a “new” variable for analysis.

Another example was “other types” of NVNM dietary supplements that were mentioned by

respondents and they were reclassified as Traditional Herbs. These include Akar Kayu,

Jamu, Makjun, Chinese Herbs, Herbal leaves and Indian herbs (even though these are not

considered as dietary supplements).

This survey was based on a complex, multi-stage sample design. Data analysis for this

survey took into account the complex survey design, and the sample weights. The purpose

of weighting the sample data was to allow us to produce estimates of statistics (mean,

standard error, confident interval) that would have been obtained if the entire sampling

frame had been surveyed (Levy & Lemeshow, 1999). Sample weights are used to produce

correct population estimates because each respondent does not have the same chance of

being selected. The sample weights compensate for unequal probabilities of selection and

adjustment for non-response and non-coverage.

Hence, sample weighting was used to:

1. Compensate for unequal probabilities of selection among subgroups such as age,

sex and ethnicity;

2. Reduce bias due to non-respondents because of the fact that they may be different

from those who participate;

3. Bring sample data up to the dimensions of the target population totals;

4. Compensate for the inadequacies in the sampling frame such as omissions of

some LQs that did not exist or they were no longer LQs or had been demolished or

destroyed;

5. Reduce variance in the estimation procedure by using supporting information that

is known with a high degree of accuracy.

Sampling weights are automatically computed while drawing a complex sample. The

weights are ideally corresponding to the frequency that each sampling unit represents in the

target population. Therefore, the sum of the weights over the sample should estimate the

population size. For example sample element i was selected with probability . Then the

24


sample element i represent 1/ elements in the population. Hence the weight will be

w = 1/ . For example, a sample element selected with probability represents 10

elements in the population. Table 1.4.5 shows the sampling weights used for different

zones.

Table 1.4.5: Table of sampling weights for each zone


25

Weights were also calculated to adjust for non-response. Non-response is a failure to obtain

observations such as measurements or other responses from some respondents selected

and designated for the sample. The source of this failure may be due to the respondents not

being at home; refused to be interviewed, incapacity or inability to responds or they were

not found. This non-response refers to eligible respondents only and it excludes the

ineligibles but it included vacant dwellings and household without the specified kinds of

population elements. The non-response rate was be computed for responses and non

responses among the eligible only.

Calculation for total weight that incorporated unequal selection of probabilities and non

response was:

Later, weighting for post stratification was done to make sure the weighted sample

distribution conform to a known population distribution. The calculation for post stratification

weight will be:

For example, if known population of female aged 25 to 64 and and staying in Northern zone

are 12,800,100 and total weighted samples are 11,325,553 then the post stratification

weight would be:

The final weight that adjusts for post stratification would be:

26


1.7 REFERENCES

Ainsworth BE, Haskell WL, Whitt MC, Irwin ML, Swartz Am, Strath SH, O‟Brien WL, Bassett

DR, Schmitz KH, Emplaincourt PO, Jacobs DR & Leon AS. (2000). Compendium of

physical activities: an update of activity codes and MET intensities. Med. Sci. Sports

Exerc. 32:s498-s516.

Biemer PP & Lyberg LE (2003). Introduction to Survey Quality. John Wiley & Sons

Publications, New Jersey.

Department of Statistics, Malaysia (2005). Labour Force Survey Report. Malaysia

Fatimah S, Tahir A, Siti S & Maimunah AH (1997). Nutritional Status of Adults aged 18

years and above, the Second National Health and Morbidity Survey. Public Health

Institute, Ministry of Health Malaysia, Kuala Lumpur.

Gibson RS & Ferguson EL (1999). An interactive 24-hour recall for assessing the

adequacy of iron and zinc intakes in developing countries. International Life Sciences

Institute Press, Washington DC.

Glewwe P & Levin M (2005). Presenting simple descriptive statistics from household survey

data. In Household Survey in Developing Countries and Transition Countries,

Chapter XVI. United Nations, New York.

Khor GL, BH Hsu-Hage & ML Wahlqvist (1998). Dietary Practices in nutritional transition:

the case of Malaysian urban Chinese. Ecology Food Nutrition 36: 463-489.

Levy PS & Lemeshow S, 1999. Sampling of Populations; methods and Applications.

3rd

Ed. John Wiley & Sons.

Maimunah AH (1997). General Findings of the NHMS II. Public Health Institute, Ministry of

Health Malaysia.

Maimunah Hamid, Narimah Awin, Rugayah Hj. Bakri et. al. (1998). The National Health

and Morbidity Survey, Vol. 1: The Scope and Methodology of the Survey.

Public Health Institute, Ministry of Health Malaysia.

MOH (1996). Exercise among adults aged 18 years and above. A report of The National

Health and Morbidity Survey 1996. Vol. 13. Kuala Lumpur : Public Health Institute,

Ministry of Health Malaysia.


27

MOH (2004). Album Saiz Sajian Makanan Malaysia. Kajian Pengambilan Makanan

Malaysia. MOH, Putrajaya

Muñoz,J (2005). A guide for data management of household surveys. In Household

Survey in Developing Countries and Transition Countries, Chapter XV. United

Nations, New YorkSellers

Sellers TA, Gapstur SM, Potter JD, Kushi LH, Bostic RM, & Folsom AR (1993). Association

of body fat distribution and family histories of breast and ovarian cancer with risk of

post menopausal breast cancer. Am J Epidemiol 138:799-803

United Nations, 1988. Manual on Training of Statisician. Economic and Social Commission

for Asia and the Pacific. United Nations, New York.

WHO (1998). Obesity : Preventing and Managing the Global Epidemic.Report of a WHO

Consultation on Obesity. Geneva

WHO (2003). Diet, nutrition and the prevention of chronic diseases: report of a joint WHO/

FAO expert consultation. WHO Technical Report Series: 916, Geneva.

World Health Organisation (1998). Obesity: Preventing and Managing the Global

Epidemic.Report of a WHO Consultation on Obesity. Geneva

Zanariah J, Yunos J, Noor Rehan A et al (1986). Food Intake in Selected Towns and Rural

Areas of Peninsular Malaysia Report No. 106 MARDI, Serdang.

28


Operational definition of terms

Exercise: Physical activity undertaken for the purpose of recreation, sport, health or

fitness during the two weeks prior to the interview.

VM supplements were defined as mineral, synthetic nutrients, and vitamins sold singly or

in mixtures in controlled dosages form such as sachets, capsules, liquids, lozenges,

powders or tablets.

NVNM dietary supplements were defined as products with health claim that are made

from natural food or food derivatives, for example garlic and bee-pollen.

The BMI was calculated by dividing weight in kilograms by height in meters squared

(World Health Organization, 1998)

24-Hour Diet Recall: A quantitative estimate of all foods and beverages a subject

consumes the previous day, covering 24-hour duration from midnight to midnight.

24-Hour Physical Activity Recall: A quantitative estimate of all types of physical activity

during the previous day, covering 24-hour duration from midnight to midnight.

Enumeration Blocks are geographically contiguous areas of land with identifiable

boundaries.

A household is defined as a person or group of related or unrelated persons who usually

live together and make common provision for food and other essentials of living.

Living Quarters is defined as any structurally separate and independent enclosure which

is constructed as (or converted to) quarters intended for living purpose.

Urban areas are gazetted areas with their adjoining built-up areas which has a combined

population of 10,000 or more.

Rural areas are gazetted areas with a population of less than 10,000 person and non-

gazetted areas.


29

Ethnic group

Melayu (include Jawa, Banjar and Bugis)

Chinese

Indian (include Punjabi, Telegu and Malaylee)

Orang Asli Peninsular Malaysia (PM)

Sabah Bumiputera (Include Bajau, Dumpas, Dusun, Idahan, Iranum, Kadazan, Kwijau,

Lotud, Mangkaak, Maragang, Minokok, Melayu Brunei, Murut/

Lunbawang, Paitan, Rumanau, Rungus, Sulu/Suluk, Sino-native,

Tambanuo, Tidong)

Sarawak Bumiputera (Bidayuh/Dayak Darat, Bisaya, Iban/ Dayak Laut, Kadayan,

Kajang, Kayan, Kelabit, Kenyah, Melanau, Orang Sungei, Penan,

Punan (nomad)

Other Bumiputera (Orang Bumiputera lain, Thai/ Siam)

APPENDIX 1

Methodology


KAJIAN PENGAMBILAN

MAKANAN MALAYSIA

2002 / 2003

Nama Peserta :

i

Nama Penemu Bual :

Tarikh Temu Bual :

Waktu Mula Temu Bual :

Waktu Tamat Temu Bual :

Jawatankuasa Teknikal Kajian Diet

Kementerian Kesihatan

Malaysia

APPENDIX A

MEMULAKAN TEMU BUAL

Penemu bual hanya ada sesaat atau dua sahaja bagi menyakinkan penghuni untuk bekerjasama. Gunakan masa ini dengan sebijak boleh.

Penemu bual mesti sentiasa mempunyai dan mempamerkan keyakinan diri.

Peringatan Kepada Penemu Bual

ELAKKAN dari menggunakan perkataan yang boleh menggalakkan penghuni enggan bekerjasama seperti "Adakah anda sibuk?" "Boiehkah anda meluangkan masa beberapa minit?" atau "Sudikah anda menjawab beberapa soalan?"

Layan penghuni yang keberatan menjawab atau menolak untuk ditemu bual dengan cara bijaksana.

JANGAN cepat putus asa, tekankan beberapa kali mengenai kepentingan dan kegunaan maklumat yang dikumpul. Kenalpasti punca sebenar penghuni keberatan bekerjasama. Dapatkan masa yang lebih sesuai untuk ditemu bual jika perlu.

Penemu bual hendaklah SENTIASA berkelakuan dan bertutur dengan hormat dan penuh sopan

santun.

JANGAN memaksa penghuni.

MENGAKHIRI TEMU BUAL

Contoh ucapan penutup

Berbudi bahasalah sepanjang masa

" Saya ucapkan berbanyak terima kasih atas kerjasama Encik/Puan........ menjawab soalan-soalan tadi. Maklumat yang diberi amat berguna kepada Kementertan Kesihatan Malaysia dalam usaha memperbaiki lagi perkhidmatan kesihatan. Semua maklumat ini akan dirahsiakan dan maklumat peribadi Encik/Puan........................... tidak akan diketahui oleh orang lain. Terima kasih sekali lagi. Salam/selamat tinggal".

PENUTUP

Contoh memulakan temu bual

"Selamat pagi/petang............ [Puan, Encik, Mak Cik, Pak Cik, Kakak (yang mana bersesuaian)]. Saya...…………(nama, dan tunjukkan kad Pengenalan Diri/I.D.), dari Kementerian Kesihatan Malaysia. Kami sedang menjalankan kajian mengenai pengambilan makanan dan aktiviti fizikal di Malaysia. Saya amat menghargai sekiranya Encik/Puan dapat membantu dengan menjawab beberapa soalan. Maklumat yang dikumpulkan dalam kajian ini akan dirahsiakan (SULIT) dan akan hanya digunakan untuk memperbaiki program kesihatan. Harap dapat Encik/Puan.……….. memberi sedikit masa untuk membantu Kementerian Kesihatan Malaysia.

PENGENALAN

Bahagian Pembangunan Kesihatan Keluarga

Jabatan Kesihatan Awam (Public Health Dept.)

Kementerian Kesihatan Malaysia

(Ministry of Health Malaysia)

Tingkat 1, Komplek Pejabat-Pejabat Kesihatan No.Telefon: 03-26946601

Jalan Cenderasari, No.Fax: 03-26946570

50590 Kuala Lumpur. Kawat: MINHEALTH, KUALA LUMPUR

PERSETUJUAN

KAJIAN PENGAMBILAN MAKANAN MALAYSIA 2002 / 2003

Saya telah diberi jaminan bahawa segala hasil kajian akan dirahsiakan serta

maklumat tentang peserta tidak akan didedahkan mahupun secara lisan atau bukan

lisan.

Saya telah diberi penerangan tentang kajian ini. Segala persoalan saya telah diberi

jawapan yang memuaskan.

Saya setuju untuk mengambil bahagian dalam kajian ini.

Tandatangan : .........................................................

Nama Peserta : .........................................................

No.K/P : .........................................................

Nama Penemu Bual : .........................................................

Tarikh : .........................................................

BORANG A

KAJIAN PENGAMBILAN MAKANAN

MALAYSIA 2002/2003

SOSIODEMOGRAFI

ID Peserta

Negeri Daerah Banci BP TK No. Isirumah

BAHAGIAN A KETERANGAN DIRI RUANGAN KOD

Tandakan (√ ) dalam kotak yang berkenaan.

1. Negeri:................................................

2. Daerah Pentadbiran:................................................

3. Strata:

1.

2.

1. Bandar Metropolitan

2. Bandar Besar

3. Bandar Kecil

4. Luar Bandar / Kampung

3.

4. Jantina:

1. Lelaki

2. Perempuan

5. Bangsa/Kumpulan Etnik:................................................

4.

5.

6. Agama:

1. Islam

2. Buddha

3. Hindu

4. Kristian

5. Lain-lain

6.

[A-1]

Kajian Pengambilan Makanan Malaysia 2002/2003

BORANG A

KETERANGAN DIRI RUANGAN KOD

7.

Status perkahwinan

1. Bujang

2. Berkahwin

3. Bercerai/berpisah

4. Balu/Duda

7.

(Tuliskan angka atau maklumat seperti yang dinyatakan oleh peserta)

8.

9.

10.

11.

Tarikh lahir

Taraf pendidikan:................................................

Pekerjaan:..........................................................

Pendapatan sebulan peserta:

RM: ................................

8.

9.

10.

11.

12.

Pendapatan sebulan isirumah:

a. Pendapatan isteri/suami

b. Pendapatan anak/ibu/bapa

(yang tinggal bersama)

c. Kiriman wang dari anak/ibu/

bapa

d. Pencen

e. Rumah sewa/kenderaan sewa

dan Iain-Iain

f. Pendapatan sebulan isirumah

(JumlahNo. 11 + No. 12)

= RM………………...

= RM………………...

= RM………………...

= RM………………...

= RM………………...

= RM………………...

12.

13. Bilangan ahli isirumah: orang

13.

1

9

[A-2]

1

9 hari bulan tahun


A

KETERANGAN DIRI RUANGAN KOD

(Sila nyatakan samaada "Ya" atau "Tidak" bagi soalan yang

berkenaan)

14. Adakah Encik/Puan mengalami masalah kesihatan berikut?

A. Kanser/barah 14a.

B. Diabetes/kencing manis 14b.

C. Darah tinggi 14c.

D. Penvakit buah pinggang 14d.

E. Penyakit jantung 14e.

F. Pekak 14f.

G. Bisu 14g.

H. Terlantar sakit teruk 14h.

I. Penyakit lain, nyatakan 14i.

15. Adakah Encik/Puan seorang vegetarian? (Tidak memakan daging atau sumber haiwan)

15.

(Soalan 16,17,18 dan 19 perlu ditanya kepada peserta wanita sahaja)

16. Adakah Puan sedang hamil? (Jika "Ya", sila ke Soalan 17. Jika "Tidak", sila ke Soalan 18)

16.

17. Sudah berapa bulankah kandungan Puan? bulan 17. bulan

18. Adakah Puan sedang berada dalam pantang lepas bersalin? 18.

Ya Tidak (Jika “Tidak”, berhenti di sini.)

19. Sudah berapa harikah Puan telah mula berpantang? hari 19. hari

[A-3]


BO

RA

NG

B

KA

JIA

N P

EN

GA

MB

ILA

N M

AK

AN

AN

M

ALA

YS

IA

2

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ING

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T 2

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es

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Da

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Isir

um

ah

1.

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ka

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ma

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rik

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ri in

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nin

2

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ela

sa

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ab

u 4

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ha

mis

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um

aa

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ab

tu 7

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ha

d (

Bu

latk

an

ha

ri in

ga

tan

)

Ko

d h

ari

in

ga

tan

:

a.

Ma

sa

P

AG

I b

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ak

an

an

/ m

inu

ma

n

c.

Pe

nje

las

an

bah

an

te

rpe

rin

ci

ma

ka

nan

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ma

n

d.

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rap

a b

an

yak

d

ima

ka

n / d

imin

um

e.

Bera

t m

akan

an

(g

ram

/m

l)

[B-1]

Kajia

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bila

n M

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ysia

2002/2

003

BO

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1.

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ka

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a.

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b. M

ak

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c.

Pe

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bah

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te

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ma

ka

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d.

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d

ima

ka

n / d

imin

um

e.

Bera

t m

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an

(g

ram

/m

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[B-2]

Kajia

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bila

n M

akanan M

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2002/2

003

BO

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B

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T 2

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1.

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ka

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a.

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sa

P

ET

AN

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b. M

ak

an

an

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c.

Pe

nje

las

an

bah

an

te

rpe

rin

ci

ma

ka

nan

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ma

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d.

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rap

a b

an

yak

d

ima

ka

n / d

imin

um

e.

Bera

t m

akan

an

(g

ram

/m

l)

[B-3]

Kajia

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bila

n M

akanan M

ala

ysia

2002/2

003

BO

RA

NG

B

BA

HA

GIA

N 1

B

OR

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G IN

GA

TA

N D

IE

T 2

4 J

AM

1.

Ma

ka

nan

/ M

inu

ma

n

a.

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sa

M

AL

AM

b. M

ak

an

an

/ m

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ma

n

c.

Pe

nje

las

an

bah

an

te

rpe

rin

ci

ma

ka

nan

/ m

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ma

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d.

Be

rap

a b

an

yak

d

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ka

n / d

imin

um

e.

Bera

t m

akan

an

(g

ram

/m

l)

[B-4]

Kajia

n P

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bila

n M

akanan M

ala

ysia

2002/2

003

BO

RA

NG

B

BA

HA

GIA

N 1

B

OR

AN

G IN

GA

TA

N D

IE

T 2

4 J

AM

1.

Ma

ka

nan

/ M

inu

ma

n

a.

Ma

sa

T

AM

BA

HA

N

b. M

ak

an

an

/ m

inu

ma

n

c.

Pe

nje

las

an

bah

an

te

rpe

rin

ci

ma

ka

nan

/ m

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ma

n

d.

Be

rap

a b

an

yak

d

ima

ka

n / d

imin

um

e.

Bera

t m

akan

an

(g

ram

/m

l)

[B-5]

Kajia

n P

engam

bila

n M

akanan M

ala

ysia

2002/2

003

BO

RA

NG

B

BA

HA

GIA

N 1

B

OR

AN

G IN

GA

TA

N D

IE

T 2

4 J

AM

2.

Min

um

an

Be

ralk

oh

ol

a.

Ma

sa

b. J

en

is m

inu

ma

n

c.

Pe

nje

las

an

bah

an

te

rpe

rin

ci

min

um

an

/ j

en

am

a

d.

Be

rap

a b

an

yak

d

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um

e.

Bera

t m

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man

(m

l)

[B-6]

Kajia

n P

engam

bila

n M

akanan M

ala

ysia

2002/2

003

BORANG B

ID Peserta


BAHAGIAN 2 BORANG PERIHAL MAKAN

1. Adakah Encik / Puan mengambil sarapan, makan tengahari dan makan malam semalam?

2. Di mana Encik / Puan makan?

3. Encik / Puan dapat makanan itu dari mana?

4. Semalam Encik / Puan makan sarapan, tengahari dan malam bersama siapa?

1. Waktu makan 2. Tempat makan 3. Daripada mana

makanan didapati

4. Makan bersama

siapa?

Sarapan

Ya

Tldak Kod B2

Kod B3

Kod B4

Kod B1

Makan Tengahari

Ya

Tldak Kod B6

Kod B7

Kod B8

Kod B5

Makan Malam

Ya

Tldak Kod B10

Kod B11

Kod B12

Kod B9

Kod Kod Kod Kod

Ya - 1 Di rumah - 1 Disediakan di rumah - 1 Sendiri - 1

Tidak - 0 Di pejabat - 2 Beli di kedai - 2 Bersama keluarga - 2

Di kantin / kafeteria - 3 Beli daripada penjaja

- 3 Bersama rakan - 3

Restoran / hotel - 4 Lain-lain, nyatakan - 4

Warung / kedai kopi - 5

Lain-lain, nyatakan - 6

[B-7]


BORANG C


MALAYSIA 2002/2003

AKTIVITI FIZIKAL

ID Peserta


BAHAGIAN 1 AKTIVITI FIZIKAL LAZIM RUANGAN KOD

1. Adakah Encik/Puan pergi ke sekolah / bekerja di luar rumah?

a) Ya (sila ke soalan 2)

b) Tidak (sila ke soalan 4)

2. Bagaimana Encik/Puan pergi dan balik ke sekolah/tempat kerja setiap hari?

3. Berapa jumlah tempoh masa untuk pergi dan balik untuk setiap pengangkutan? (silla isikan jawapan dalam kotak dibawah)

2. Aktivtti Tandakan ( √ )

3. Jumlah masa diambil pergi-balik (minit)

a. Menaiki bas/LRT/ Komuter

b. Menaiki kereta/ memandu

c. Menunggang motosikal

d. Menaiki basikal

e. Berjalan kaki

f. Lain-lain, nyatakan

4. Biasanya, berapa kali Encik/Puan naik tangga dalam sehari?

5. Berapa tingkat setiap kali?

Tempat 4. Berapa kali 5. Berapa tingkat

a. Rumah

b. Tempat belajar

c. Tempat kerja

d. Tempat-tempat lain

6. Dalam dua minggu yang tepas, adakah Encik/Puan bermain sukan

atau melakukan senaman?

a. Ya (sila ke soalan 7)

b. Tidak (sila ke Bahagian 2)

2a. 3a.

2b. 3b.

2c. 3c.

2d. 3d.

2e. 3e.

2f. 3f.

4a. 5a. .

4b. 5b. .

4c. 5c. .

4d. 5d. .

6. (sila rujuk buku kod)

1. (sila rujuk buku kod)

[C-1]


BORANG C

BAHAGIAN 1 AKTIVITI FIZIKAL LAZIM RUANGAN KOD

7. Apakah aktiviti sukan/senaman yang dilakukan itu?

(3 jenis aktiviti yang utama sahaja berdasarkan jadual di bawah)

8. Berapa kali dalam seminggu untuk setiap aktiviti?

9. Berapa lamakah setiap kali Encik/Puan bermain sukan/senaman

tersebut? (sila isikan jawapan dalam kotak di bawah)

7. Aktiviti sukan 8. Kekerapan seminggu

9. Tempoh masa setiap kali (minit)

a.

b.

c.

Jenis aktiviti fizikal / senaman

Aktiviti Kod Aktiviti Kod

Badminton 01 Joging 14

Berbasikal 02 Ping Pong 15

Berenang 03 Mendaki gunung 16

Berjalan pantas 04 Qi Gong 17

Bola jaring 05 Ragbi 18

Bola keranjang 06 Senamrobik 19

Bola lisut 07 Sepak takraw 20

Bola sepak 08 Silat 21

Bola tampar 09 Skuasy 22

Bowling 10 Taekwando 23

Gimnasium 11 Tai Chi 24

Golf 12 Tenis 25

Hoki 13 Lain-lain 26

[C-2]

7a. 8a. 9a.

7b. 8b. 9b.

7c. 8c. 9c.


BO

RA

NG

C

ID

Pe

se

rta

N

eg

eri

D

ae

rah

B

an

ci

BP

T

K

No

. Is

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ma

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BA

HA

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N 2

B

OR

AN

G IN

GA

TA

N A

KT

IV

IT

I F

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2

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AM

Ta

rik

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l:

Na

ma

pe

se

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:

Ha

ri in

ga

tan

: 1

. Is

nin

2

. S

ela

sa

3

. R

ab

u 4

. K

ha

mis

5

. J

um

aa

t 6

. S

ab

tu 7

. A

ha

d (

Bu

latk

an

ha

ri in

ga

tan

)

Ko

d h

ari

in

ga

tan

:

0

5

10

15

20

25

30

35

40

45

50

55

60

12.0

0 t

gh

mala

m

posis

i

1.0

0 p

ag

i

posis

i

2.0

0 p

ag

i

posis

i

3.0

0 p

ag

i

posis

i

4.0

0 p

ag

i

posis

i

5.0

0 p

ag

i

posis

i

6.0

0 p

ag

i

posis

i

7.0

0 p

ag

i

posis

i

8.0

0 p

ag

i

posis

i

9.0

0 p

ag

i

posis

i

10.0

0 p

agi

posis

i

11.0

0 p

agi

posis

i

P

etu

nju

k :

T =

tid

ur

D =

du

du

k / n

aik

kere

ta / p

an

du

kere

ta

J =

Jala

n

AP

= a

kti

vit

i p

eri

bad

i (m

an

di, g

oso

k g

igi, b

uan

g a

ir d

ll)

B =

bari

ng

B

D =

berd

iri

L

= b

erl

ari

T

NT

= T

uru

n n

aik

tan

gg

a

S =

Sem

ban

yan

g

BK

= M

en

un

gg

an

g b

asik

al

C =

men

ca

ng

ku

ng

K

ajia

n P

engam

bila

n M

akanan M

ala

ysia

2002/2

003

[C-3]

BO

RA

NG

C

BA

HA

GIA

N 2

B

OR

AN

G IN

GA

TA

N A

KT

IV

IT

I F

IZ

IK

AL

2

4 J

AM

0

5

10

15

20

25

30

35

40

45

50

55

60

12.0

0 t

gh

hari

posis

i

1.0

0 p

eta

ng

posis

i

2.0

0 p

eta

ng

posis

i

3.0

0 p

eta

ng

posis

i

4.0

0 p

eta

ng

posis

i

5.0

0 p

eta

ng

posis

i

6.0

0 p

eta

ng

posis

i

7.0

0 m

ala

m

posis

i

8.0

0 m

ala

m

posis

i

9.0

0 m

ala

m

posis

i

10.0

0 m

ala

m

posis

i

11.0

0 m

ala

m

posis

i

Petu

nju

k :

T =

tid

ur

D =

du

du

k / n

aik

kere

ta / p

an

du

kere

ta

J =

Jala

n

AP

= a

kti

vit

i p

eri

bad

i (m

an

di, g

oso

k g

igi, b

uan

g a

ir d

ll)

B =

bari

ng

B

D =

berd

iri

L

= b

erl

ari

T

NT

= T

uru

n n

aik

tan

gg

a

S =

Sem

ban

yan

g

BK

= M

en

un

gg

an

g b

asik

al

C =

men

ca

ng

ku

ng

Kajia

n P

engam

bila

n M

akanan M

ala

ysia

2002/2

003

[C-4]

BORANG D

ID Peserta


*Ciri- ciri khas peserta: ....................................................................................

1. Nama Peserta: ............................................................................

2. Berat(kg)

i) . kg

ii) . kg

iii) . kg

3. Tinggi (cm)

i) . cm

ii) . cm

iii) . cm

Pengukuran Indeks Jisim Tubuh (IJT) / Body Mass Index (BMI)

Berat(kg)

Tiggi x Tinggi(m2)

Klasifikasi

IJT / BMI < 18.5 IJT / BMI 18.5 - 24.9 IJT / BMI 25.0 - 29.9 IJT / BMI ≥ 30.0

= Kurang Berat Badan = Normal = Berlebihan Berat Badan = Obes


MALAYSIA 2002 / 2003

PENGUKURAN ANTROPOMETRI

IJT/BMI =

[D-1]


BORANG E


MALAYSIA 2002 / 2003

KEKERAPAN PENGAMBILAN MAKANAN DAN SUPLEMEN

ID Peserta


BAHAGIAN 1: BORANG KEKERAPAN PENGAMBILAN MAKANAN

Kod

Jenis makanan

Kekerapan pengambilan Ukuran

Sajian (Pilih satu Jenis ukuran sahaja)

Berapa banyak sajian setiap kali

makan

Berapa kali

sehari

Berapa kali

seminggu

Berapa kali

sebulan

Berapa kali

setahun

Tidak makan

A. Bijirin dan hasil bijirin

A1 *Nasi

Pinggan

Mangkuk cina

Cawan

Senduk

A2 Bubur nasi

Mangkuk Sedang

Cawan

Senduk

A3 *Pulut

Mangkuk cina

Cawan

Senduk

A4 Mee kuning/mee siput/

mee segera

Pinggan lengkung

Pinggan

Mangkuk cina

Senduk

A5 Mihun/kueh teow/laksa/

laksam

Pinggan lengkung

Pinggan

Mangkuk cina

senduk

A6 Loh shi fun Mangkuk cina

A7 *Pasta Pinggan

Senduk

A8 *Sagu

Potong

Cawan

Sudu

A9 *Roti Keping

A10 Roti bun Biji

A11 *Roti canai Keping

A12 Capati Keping

A13 Tosai Keping

A14 *Bijirin sarapan pagi Cawan

Mangkuk cina

A15 *Bijirin tersedia perlu dibancuh Mangkuk cina

Cawan

A16 Pizza Potong

A17 *Jagung Tongkol

Cawan

[E-1]


BORANG E

Kod

Jenis makanan




makan

Berapa kali

sehari

Berapa kali

seminggu

Berapa kali

sebulan

Berapa kali

setahun

Tidak makan

B. Daging dan hasil daging

B1 Ayam Ketul

B2 Lembu / kerbau Kotak mancis

B3 Kambing Kotak mancis

B4 Daging burger Keping

B5 Sosej / hotdog / frankfurter Ketul

B6 Nugget Ketul

B7 Bebola ayam/ketam/udang Ketul

B8 Itik Ketul

B9 *Ham Keping

B10 *Bacon Keping

B11 *Luncheon meat Keping

B12 *Babi (Bagi peserta bukan Islam) Kotak mancis

Kod

Jenis makanan




makan

Berapa kali

sehari

Berapa kali

seminggu

Berapa kali

sebulan

Berapa kali

setahun

Tidak makan

C. Ikan dan makanan laut

C1 *Ikan laut Keping

Ekor

C2 *Ikan air tawar Keping

Ekor

C3 Ikan bilis Sudu makan

C4 *Ikan dalam tin Ekor

C5 *Kekerang Sudu makan

C6 Udang basah Ekor sederhana

C7 Sotong basah Potong sederhana

C8 Sotong kering Keping sederhana

Potong sederhana

C9 Ketam Ekor

C10 *Ikan kering Keping

Ekor

C11 Bebola ikan/kek ikan Bebola

KetuI

C12 Keropok lekor KetuI

[E-2]


Kod

Jenis makanan




makan

Berapa kali

sehari

Berapa kali

seminggu

Berapa kali

sebulan

Berapa kali

setahun

Tidak makan

D. Telur

D1 Telur ayam Biji

D2 Telur itik Biji

D3 Telur puyuh Biji

D4 Telur masin Biji

Kod

Jenis makanan




makan

Berapa kali

sehari

Berapa kali

seminggu

Berapa kali

sebulan

Berapa kali

setahun

Tidak makan

E. Kekacang dan hasilnya

E1 *Kekacang Sudu makan

E2 Tauhu Keping

E3 Tempe Keping

Sudu makan

E4 Kacang tanah Sudu makan

Kod

Jenis makanan




makan

Berapa kali

sehari

Berapa kali

seminggu

Berapa kali

sebulan

Berapa kali

setahun

Tidak makan

F. Susu dan hasil tenusu

F1 Susu segar / UHT Cawan

Gelas

F2 Susu tepung Sudu makan

F3 Susu sejat / cair Sudu makan

F4 Susu pekat manis Sudu makan

F5 Yogurt / lassi / tairu Cawan

Sudu makan

F6 Keju Keping

[E-3]


Kod

Jenis makanan




makan

Berapa kali

sehari

Berapa kali

seminggu

Berapa kali

sebulan

Berapa kali

setahun

Tidak makan

G. Minuman

G1 *Sayuran berdaun hijau Cawan

G2 *Sayuran kacang Cawan

G3 *Sayuran berubi Cawan

G4 *Sayuran kobis Cawan

G5 *Petola / labu / timun Cawan

G6 *Sayuran asin/kering Cawan

G7 Ulam-ulam Cawan

G8 Putik jagung Sudu makan

G9 *Cendawan basah / kering Cawan

G10 Taugeh Cawan

Kod

Jenis makanan




makan

Berapa kali

sehari

Berapa kali

seminggu

Berapa kali

sebulan

Berapa kali

setahun

Tidak makan

H. Buah-buahan

H1 Betik Potong

H2 Jambu batu Keping

H3 Limau manis tempatan Biji

H4 Mangga Potong

H5 Nenas Potong

H6 *Pisang Biji

H7 Tembikai Potong

H8 Belimbing Biji

H9 Nangka Ulas

H10 Epal Biji

H11 Oren/mandarin Biji

H12 Pir/lai Biji

H13 Anggur Biji

H14 Durian Ulas

H15 Rambutan Biji

H16 Longan segar Biji

H17 Laici segar Biji

H18 Tembikai susu Potong

H19 *Buahan dalam tin Potong

H20 *Buahan kering Potong

[E-4]


Kod

Jenis makanan




makan

Berapa kali

sehari

Berapa kali

seminggu

Berapa kali

sebulan

Berapa kali

setahun

Tidak makan

I. Minuman

I1 Air kosong Gelas

I2 Teh Cawan

I3 *Kopi Cawan

I4 *Minuman bercoklat Cawan

I5 Minuman bermalt (horlick / nesto malt)

Cawan

I6 *Sirap Kordial Gelas

I7 *Jus buah-buahan Cawan

I8 Minuman bergas Gelas/Tin

I9 Air kacang soya Gelas

Kotak

I10 Minuman botani/herba Gelas

Kotak

I11 *Minuman bertenaga Gelas

Kotak

Kod

Jenis makanan

Kekerapan pengambilan

Ukuran



makan

Berapa kali

sehari

Berapa kali

seminggu

Berapa kali

sebulan

Berapa kali

setahun

Tidak makan J. Minuman beralkohol

khusus bagi peserta bukan Islam

J1 Syandi Tin

J2 Bir

Gelas

Tin

Botol

J3 Wain Gelas wain

J4 *Spirit Gelas

J5 *Likeur Gelas

[E-5]


Kod

Jenis makanan




makan

Berapa kali

sehari

Berapa kali

seminggu

Berapa kali

sebulan

Berapa kali

setahun

Tidak makan

K. Konfeksi

K1 *Kuih tempatan Ketul

K2 Kek Potong

K3 Biskut Keping

K4 Gula-gula Ketul

Potonq

K5 Aiskrim (susu) Cawan

Scoop

K6 *ABC (air batu campur) / ais / lolipop

Mangkuk

Batang

K7 Agar-agar / jeli / kastard Cawan

Potong

K9 Snek / keropok / kerepek Keping

Kod

Jenis makanan




makan

Berapa kali

sehari

Berapa kali

seminggu

Berapa kali

sebulan

Berapa kali

setahun

Tidak makan

L. Sapuan roti

L1 Jem Sudu teh

L2 Sri kaya Sudu teh

L3 Mentega Sudu teh

L4 Majerin Sudu teh

L5 Mentega kacang Sudu teh

L6 Krim keju Sudu teh

Kod

Jenis makanan




makan

Berapa kali

sehari

Berapa kali

seminggu

Berapa kali

sebulan

Berapa kali

setahun

Tidak makan

M. Perencah / perasa

M1 *Gula Sudu teh

M2 *Madu Sudu teh

M3 *Sambal belacan Sudu makan

M4 *Budu Sudu teh

M5 *Cencalok Sudu teh

M6 *Kicap pekat Sudu teh

M7 *Kicap cair Sudu makan

M8 *Sos cili / tomato Sudu makan

M9 *Sos tiram Sudu teh

M10 *Sos ikan Sudu teh

M11 *Petis / *heko / *otak udang Sudu teh

[E-6]


BORANG E

PENGGUNAAN GULA, MINYAK DAN GARAM RUANGAN KOD

N. Penggunaan gula oleh ahli isirumah

N1. Berapa banyakkah keluarga ini menggunakan gula dalam sebulan?

..................... kg

N2. Biasanya gula sebanyak itu digunakan oleh berapa orang?

................... orang

O. Penggunaan minyak oleh ahli isirumah

O1. Berapa banyakkah keluarga ini menggunakan minyak masak dalamsebulan?

...................... kg

O2. Biasanya minyak sebanyak itu digunakan oleh berapa orang?

...................... orang

P. Penggunaan garam oleh isirumah

PI. Berapa banyakkah keluarga ini menggunakan garam dalam sebulan?

....................... kg

P2. Biasanya garam sebanyak itu digunakan oleh berapa orang?

....................... orang

[E-7]


ID Peserta


BAHAGIAN 2 SUPLEMEN RUANGAN KOD

Q1. Dalam tempoh satu tahun yang lepas, adakah Encik/Puan makan

apa-apa ubat / vitamin / mineral. (Tandakan √ ) a) Ya (sila ke soalan Q2)

b) Tidak (sila ke Soalan Q5)

Q2. Apakah jenis vitamin/mineral yang diambil? (Tidak perlu bacakan senarai) Minta bekas / botol daripada

peserta untuk mengesahkan jenis vitamin / mineral, boleh terima jawapan lebih daripada satu).

Q3. Apakah sebab Encik/Puan mengambilnya?

Q4. Berapa kerapkah Encik/Puan mengambilnya?

Q1 (sila rujuk buku kod)

Q2. Jenis

(Bulatkan pada abjad

Jenis vitamin / mineral

yang diambil)

Q3. Sebab pengambilan

(rujuk kod di bawah, buiatkan angka bagi sebab

pengambilan, jawapan boleh lebih daripada

satu, maksimum empat sebab)

Q4.

Kekerapan

(rujuk kod di

bawah)

a. Multivitamin dan Multi mineral

1 2 3 4 5 6 7 8

b. Multivitamin dan zat besi

1 2 3 4 5 6 7 8

c. Vitamin A/ Karatenoid 1 2 3 4 5 6 7 8

d. Vitamin B kompieks 1 2 3 4 5 6 7 8

e. Vitamin B12 1 2 3 4 5 6 7 8

f. Vitamin C 1 2 3 4 5 6 7 8

g. Asid folik/ B6 1 2 3 4 5 6 7 8

h. Vitamin B kompieks + Vitamin C

1 2 3 4 5 6 7 8

i. Vitamin D dan Kalsium

1 2 3 4 5 6 7 8

j. Zat besi 1 2 3 4 5 6 7 8

k. Kalsium 1 2 3 4 5 6 7 8

i. Vitamin E 1 2 3 4 5 6 7 8

m. Zink 1 2 3 4 5 6 7 8

n. Zink + B kompieks 1 2 3 4 5 6 7 8

o. Selenium 1 2 3 4 5 6 7 8

* Jangkamasa pendek (berapa lama, nyatakan?)

Q2a Q3a Q4a

Q2b Q3b Q4b

Q2c Q3c Q4c

Q2d Q3d Q4d

Q2e Q3e Q4e

Q2f Q3f Q4f

Q2g Q3g Q4g

Q2h Q3h Q4h

Q2i Q3i Q4i

Q2j Q3j Q4j

Q2k Q3k Q4k

Q2l Q3l Q4l

Q2m Q3m Q4m

Q2n Q3n Q4n

Q2o Q3o Q4o

Kod sebab pengambilan: 1- Atas arahan doktor 2- Kesihatan (bukan arahan

doktor) secara am 3- Tambah tenaga 4- Kecantikan 5- Penurunan berat badan 6- Tambah ingatan 7- Penurunan kotesterol

8- Tidak pasti/ tiada jawapan Kod kekerapan: 1- Setiap hari 2- Lebih dari sekali seminggu 3- Seminggu sekali 4- 1 hingga 3 kali sebulan 5- Sekali sekala (jangkamasa

pendek)

[E-8]


BAHAGIAN 2 SUPLEMEN RUANGAN KOD

Q5. Dalam tempoh satu tahun yang lepas, adakah Encik/Puan

mengambil apa-apa suplemen makanan? (Seperti minyak ikan,

lesitin, evening primrose oil, jus buah noni dan Iain-Iain) a) Ya (sila ke soalan Q6)

b) Tidak (sila berhenti sini, temubual tamat)

Q6. Adakah Encik /Puan mengambil bahan berikut (bacakan senarai

suplemen makanan di bawah. Minta bekas/botol daripada peserta

untuk mengesahkan jenis suplemen)

Q7. Apakah sebab Encik/Puan mengambilnya?

Q8. Berapa kerapkah Encik/Puan mengambilnya?

Q5 (sila rujuk buku kod)

Q6. Jenis

(Bulatkan pada abjad

Jenis vitamin / mineral

yang diambil)

Q7. Sebab pengambilan

(rujuk kod di bawah, buiatkan angka bagi sebab

pengambilan, jawapan boleh lebih daripada

satu, maksimum empat sebab)

Q8.

Kekerapan

(rujuk kod di

bawah)

a. Minyak Ikan 1 2 3 4 5 6 7 8

b. Pati Ayam 1 2 3 4 5 6 7 8

c. Pati Ikan Haruan 1 2 3 4 5 6 7 8

d. Pil Bawang Putih 1 2 3 4 5 6 7 8

e. Jus Buah Noni 1 2 3 4 5 6 7 8

f. Hasil Madu Lebah / Royal Jelly

1 2 3 4 5 6 7 8

g. Evening Primrose oil 1 2 3 4 5 6 7 8

h. Lesitin 1 2 3 4 5 6 7 8

i. Spirulina 1 2 3 4 5 6 7 8

j. Gingko Biloba 1 2 3 4 5 6 7 8

k. Lain-lain, nyatakan

1 1 2 3 4 5 6 7 8

2 1 2 3 4 5 6 7 8

3 1 2 3 4 5 6 7 8

4 1 2 3 4 5 6 7 8

* Jangkamasa pendek (berapa lama, nyatakan?)

Q6a Q7a Q8a

Q6b Q7b Q8b

Q6c Q7c Q8c

Q6d Q7d Q8d

Q6e Q7e Q8e

Q6f Q7f Q8f

Q6g Q7g Q8g

Q6h Q7h Q8h

Q6i Q7i Q8i

Q6j Q7j Q8j

Q6k Q7k Q8k

Q6l Q7l Q8l

Q6m Q7m Q8m

Q6n Q7n Q8n

Q6o Q7o Q8o

Kod sebab pengambilan: 1- Atas arahan doktor 2- Kesihatan (bukan arahan

doktor) secara am 3- Tambah tenaga 4- Kecantikan 5- Penurunan berat badan 6- Tambah ingatan 7- Penurunan kotesterol 8- Tidak pasti/ tiada jawapan

Kod kekerapan: 1- Setiap hari 2- Lebih dari sekali seminggu 3- Seminggu sekali 4- 1 hingga 3 kali sebulan 5- Sekali sekala (jangkamasa

pendek)

[E-9]



59

APPENDIX B

Sample page from the Food Photo Album

Nasi Putih = 4 senduk = 1 pinggan

Nasi putih dalam pelbagai ukuran

60


APPENDIX C

List of food items analysed at the Institute for Medical Research

No. Malay name English translation

1. Roti sardin, kuah kari, kuah dhall,

sambal bilis

Sardine bread, curry gravy, dhall gravy, dried anchovy cooked in chili sambal

2. Roti tisu, sambal bilis Tissue Bread, dried anchovy cooked in chili sambal

3. Keropok sayur tanpa sos Vegetable cracker without sauce

4. Nangka muda Unripen jackfruit

5. Pucuk mengkudu Mengkudu shoot

6. Ikan seludu mentah Seludu fish, fresh

7. Pekasam ikan mentah Fermented fish, uncooked

8. Kuih cakar ayam Kuih cakar ayam

9. Jeruk kelubi Preserved kelubi

10. Jeruk cermai Preserved cermai

11 Asam kulit limau Preserved lime rind

12. Buntut ayam mentah Bishop’s nose (chicken) , fresh

13. Bakso Meat ball soup

14. Keropok lekor goreng (tanpa sos) Fried fish keropok (without sauce)

15. Keropok lekor mentah Fish keropok , uncooked

16. Pau inti kacang merah Red bean dumpling

17. Keropok beras Rice cracker

18. Cucur tepung kosong Wheat fritter plain

19. Pekasam ikan goreng Fermented fish, fried

20. Umbut kelapa Coconut shoot

21. Pucuk daun meranti Meranti shoot

22. Acar buah Pickled mixed fruits

23. Tapai ubi kayu Fermented tapioca,

24. Mini popia (inti ikan) Mini spring roll (fish)

25. Aiskrim Cornetto Cornetto brand ice cream

26. Sup mee kolok Mee kolok soup

27. Mee kolok goreng Fried mee kolok

28. Kuih celorot Kuih celorot


61

No. Malay name English translation

29. Sabong Sabong

30. Umbut lalis Lalis shoot

31. Umbut apong Apong shoot

32. Umbut nanas Pineapple shoot

33. Terung masam Sour eggplant/brinjal

34. Tabaloi Tabaloi

35. Kuih cincin Kuih cincin

36. Sagu goreng Fried sago

62


APPENDIX D

List of physical activities carried out by subjects

No.

Responses

Grouping of activities Activity Body position

1. Sleeping Sleeping Lying down

Sleeping

2. Resting, reading, listening radio, patting a child to sleep

Lying down supine or on the front

Resting

Singing (karaoke), resting at work, playing PC games at home, patting a child to sleep, caring for a child

Sitting

3. Mechanic working under a car

Lying down Working

Tailoring, sewing, typing, teaching extra class, giving tuition, cleaning boat engine, attending lecture, writing

Sitting

Cooking, farming, fishing, assembly, queuieng, packing tools, watering plants

Standing

Walking on the beat (policeman)

Walking

Gardening

Squat

Lifting boxes and other things

Lifting

Climbing trees to pick coconuts, or other fruits

Climbing

Diving

Diving

Rowing a boat

Rowing

Yoga, taichi, qi-gong Light-intensity sports

Working (athletes, sports trainers)

Golfer, bowling, walking competition

Moderate-intensity sports

Playing football, tennis, squash, weight lifting

Heavy sports


63

No.

Responses

Grouping of activities Activity Body Position

4. Personal activity Showering, brushing teeth, defecating, dressing, cleaning up

Personal activity

Washing clothes, ironing clothes, baking cookies, cleaning store room, cleaning prayer room, sewing, cutting cloth, knitting, caring for older or sick relative

Sitting 5. Household chores

Cooking, washing car, making bed, helping out in the kitchen, cleaning up backyard, showering disabled relative, burning rubbish

Standing

Sweeping, tidying up the house, carrying water

Walking

Shopping, marketing, lifting flower pots, carrying basket

Lifting objects

Scrubbing the floor, painting

Squat

Solat Muslim / Friday prayer

6. Praying

Praying while sitting

Sitting

Praying while standing

Standing

Praying while kneeling

Kneeling

7. Reciting Al-Quran, chanting, listening to religious talks, giving religious talks, helping out in the mosque, bathing corpse

Sitting Religous activities

Getting ready to pray, visiting grave

Standing

Walking

64


No.

Responses

Grouping of activities Activity Position

8. Chatting, dating, attending to guests, listening to talks, visiting, playing draughts/chess/poker cards, gambling, attending meeting, playing monopoly, preparing a feast

Sitting Social activities

Chatting with neighbour, chatting on the phone, watching movies/concerts/play, barbequing, dancing, dragon/lion dancing, playing with younger siblings at home

Standing

Attending to guests at kenduri, attending to husband, gotong-royong, walking on the beat (rukun tetangga)

Walking

9. Breastfeeding, playing with baby, massaging baby’s feet, caring for children, accompanying child on first day of school, feeding child, teaching a child

Sitting Child care

Waiting for school bus with child, preparing child’s milk, waking up child, waiting for child to come home

Standing

Carrying child

Walking

Playing with child

Running

10. Chopping coconuts, sharpening the cleaver, molding cleaver handles, carving wood, plucking vegetables

Sitting Village work

Plucking coconuts, sawing trees, chopping trees, stacking wood, hoeing, feeding livestock, building fences, gardening, mending nets, shooting squirrels, fixing house, cleaning aquarium, mixing cement

Standing


65

No.

Responses

Grouping of activities Activity Body Position

Herding cows, plucking vegetables, chopping rattan/wood, lifting rattan/wood, stacking rattan/wood, shoveling, picking fruits

Walking

Climbing tree

Climbing

Looking for snails at the river

Stooping

11. Waiting for public transport, sitting inside vehicles

Sitting Transportation

Standing in bus/commuter, waiting for public transport

Standing

Cycling

Rowing

12. Standing

Moving about Getting from one place to another : around the house, from the kitchen to living room, from office desk to toilet, etc.

Walking

Running

TNT-climbing up and down stairs

13. Watching TV while lying down or sitting

Lying down Sitting

Watching television

14. Lying down at the park

Lying down Recreation/hobby (leisure activity- out door)

Playing computer games, chess, refereeing a competition, watching people play football or badminton

Sitting

Relaxing by the beach or at the park, fishing, picnicking at the waterfall, sunbathing, sight-seeing with motorcycle, making a kite

Sitting

Taking photographs, playing snooker, photo copying

Standing

66


APPENDIX E


67

APPENDIX F

List of physical activities grouped into light, moderate and vigorous-intensity categories

No. Old variables (Physical activity and body position) New variable (Intensity of

physical activity category)

1 Sleeping

2 Resting - lying down

3 Resting - sitting

4 Working - lying down

5 Working - sitting

6 Working - standing

7 Working - light intensity sports

8 Working - squatting

9 Household chores - sitting

10 Household chores - standing

11 Household chores - squatting

12 Village-type activities - sitting

13 Village-type activities - standing

14 Pray - solat

15 Pray - sitting

16 Pray - standing

17 Pray - kneeling

18 Child care activities - sitting

19 Child care activities - standing Light

20 Personal activities

21 Religious activities - sitting

22 Religious activities - standing

23 Social activities - sitting

24 Social activities- standing

25 Transportation - sitting

26 Transportation - standing

27 Watching television/video

28 Recreational activities - lying down

29 Recreational activities - sitting playing games

30 Recreational activities - sitting recreation

31 Recreational activities - squatting

32 Recreational activities - standing

33 Light intensity sports

34 Meal time - sitting

35 Meal time - standing

36 Personal errand - sitting

37 personal errand - standing

38 miscellaneous - sitting

39 miscellaneous - walking

68


No. Old variables (Physical activity and body position) New variable (Intensity of

physical activity category)

40 Working - walking

41 Working - lifting objects

42 Working - rowing a boat

43 Working - moderate intensity sports

44 Household chores - walking

45 Household chores - lifting objects

46 Household chores - walking

47 Household chores - stooping

48 Child care activities - walking Moderate

49 Religious activities - walking

50 Social activities - walking

51 Transportation - cycling bicycle

52 Activities related to moving about - walking

53 Moderate-intensity sports

54 Recreational activities - walking

55 Meal time - walking

56 miscellaneous - walking

57 Village-type activities - sitting

58 Working - climbing

59 Working - diving

60 Working – heavy-intensity sports

61 Child care activities - running Heavy

62 Activities related to moving about - running

63 Activities related to moving about – climbing up and down stairs

64 Recreational activities - running

65 Heavy intensity sports

Documents

Ministry of Health Malaysia, 2008 Nutrition Section Family ...iku.moh.gov.my/images/IKU/Document/REPORT/MANS2003/Volume… · sedentary, not consuming adequate energy or over consuming