Browsing by Author "Viola Michael"
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- PublicationA Survey on Salt Content Labeling of the Processed Food Available in Malaysia(2020)
;Hasnah Haron ;Ivy Hiew ;Suzana Shahar ;Viola MichaelRashidah AmbakSalt content in processed foods is high, and it is usually used as preservatives, stabilizers, and color enhancers in the products. Increased consumption of processed foods in the modern world has contributed to a high salt intake and thus increased the prevalence of hypertension among Malaysian populations. Therefore, this study aimed to identify and compare salt content in processed food products available in supermarkets and determine the percentage of processed food products exceeding the reference value stated in International Product Criteria (2016). The percentage of processed food products without salt and sodium labeling was determined in this study, in which 76.5% of unlabeled processed food products were made in Malaysia, while 23.5% were imported products. The food group with the highest average salt content was gravy and sauce (3.97 g/100 g), followed by soup (2.95 g/100 g), cheese (2.14 g/100 g), meat (1.37 g/100 g), fish (1.25 g/100 g), chicken (1.20 g/100 g), vegetables (1.18 g/100 g), butter and margarine (1.13 g/100 g), breakfast cereal (0.94 g/100 g), savory snacks (0.90 g/100 g), flatbread (0.86 g/100 g), sweet snacks (0.30 g/100 g), and potato (0.29 g/100 g). In addition, 79.5% of butter and margarine products had an average salt content above the reference value stated in the International Product Criteria, followed by gravy and sauce (79.3%), vegetables (72%), soup (50%), fish (49.2%), breakfast cereal (41%), cheese (36.6%), potato (36%), savory and sweet snacks (29.1), meat (12.5%) and chicken products (2.3%). Most processed food products available in local supermarkets were high in salt content. - PublicationKnowledge, attitude and behaviour on salt intake and its association with hypertension in the Malaysian population: findings from MyCoSS (Malaysian Community Salt Survey)(2021)
;Azli Baharudin ;Rashidah Ambak ;Fatimah Othman ;Viola Michael ;Siew Man Cheong ;Nor Azian Mohd. Zaki ;Nur Shahida Abdul Aziz ;Syafinaz Mohd. Sallehuddin ;Shubash Shander Ganapathy ;Lalitha PalanivelooFeng J. HeBackground: High blood pressure or hypertension has become one of the main health problems, worldwide. A number of studies have proven that an increased intake of salt was related to an increased prevalence of cardiovascular diseases. Of late, its relationship with high salt intake has received a lot of attention. Studies in Malaysia have shown both rising hypertension over time as well as high salt consumption. Actions to reduce salt intake are essential to reduce hypertension and its disease burden. As such, we carried out a study to determine associations between knowledge, attitude and behaviour towards salt intake and hypertension among the Malaysian population. Methods: Data obtained from the Malaysian Community Salt Survey (MyCoSS) was used partially for this study. The survey used a cross-sectional two-stage sampling design to select a nationally representative sample of Malaysian adults aged 18 years and above living in non-institutional living quarters (LQ). Face-to-face interviews were done by trained research assistants (RA) to obtain information on sociodemography, medical report, as well as knowledge, attitude and behaviour of the respondents towards salt intake and blood pressure. Results: Majority of the respondents have been diagnosed with hypertension (61.4%) as well as knowledge of the effects of high salt intake on blood pressure (58.8%). More than half of the respondents (53.3%) said they controlled their salt intake on a regular basis. Those who knew that a high salt diet could contribute to a serious health problem (OR=0.23) as well as those who controlled their salt intake (OR=0.44) were significantly less likely to have hypertension. Conclusion: Awareness of the effects of sodium on human health, as well as the behaviour of controlling salt intake, is essential towards lowering the prevalence of hypertension among Malaysians - PublicationSalt intake was higher among males and those with high BMI and waist circumference: introduction to the Malaysian Community Salt Survey (MyCoSS), a population-based salt intake survey in Malaysia(2021)
;Rashidah Ambak ;Feng J He ;Fatimah Othman ;Viola Michael ;Muhammad Fadhli Mohd YusoffTahir ArisBackground: Recognising that excessive dietary salt intake is associated with high blood pressure and adverse cardiovascular health, the Ministry of Health Malaysia conducted the Malaysian Community Salt Survey (MyCoSS) among Malaysian adults. This paper introduced MyCoSS projects and presented findings on the salt intake of the Malaysian adult population. Methods: MyCoSS was a nationally representative survey, designed to provide valuable data on dietary salt intake, sources of salt in the diet, and knowledge, perception, and practice about salt among Malaysian adults. It was a cross-sectional household survey, covering Malaysian citizens of 18 years old and above. Multi-stage-stratified sampling was used to warrant national representativeness. Sample size was calculated on all objectives studied, and the biggest sample size was derived from the knowledge on the effect of high salt on health (1300 participants). Salt intake was estimated using a single 24-h urine collection and its sources from a food frequency questionnaire. Knowledge, attitude, and practice were determined from a pre-tested questionnaire. All questionnaires were fully administered by trained interviewers using mobile devices. Anthropometric indices (weight, height, and waist circumference) and blood pressure were measured using a standardised protocol. Ethical approvals were obtained from the Medical Research Ethics Committee, Ministry of Health Malaysia, and Queen Mary University of London prior to conducting the survey. Results: Findings showed that the average sodium intake of Malaysian adults (3167 mg/day) was higher than the WHO recommendation of 2000 mg/day. Daily intake was significantly higher among males and individuals with higher BMI and higher waist circumference. Conclusion: Salt intake in the Malaysian population was higher than the WHO recommendation. MyCoSS’s findings will be used for the development and implementation of national salt reduction policy. A successful implementation of a national salt reduction programme in Malaysia will benefit the whole population. - PublicationSodium content in sauces—a major contributor of sodium intake in Malaysia: a cross-sectional survey(BMJ Publishing Group, 2019)
;Suzana Shahar ;Yee Xing You ;NurZetty Sofia Zainuddin ;Viola Michael ;Rashidah Ambak ;Hasnah Haron ;Feng J HeGraham A MacGregorObjective: To investigate the sodium content in sauces sold in Malaysian supermarkets. Methods: A cross-sectional market survey was conducted in 2017 of 233 sauces sold in Malaysian supermarkets. Information on the sodium content was collected from the product packaging and nutrient information panels of the sauces sold in the seven top supermarkets in the capital of Malaysia. Results: Of the 233 sauces surveyed, 116 did not include sodium content information on the nutrient information panel (49.8%). Soy sauce (particularly sweet soy sauce) and ketchup (particularly chilli sauce) were found to be the highest number of products surveyed in the analysis (N=54 and N=48, respectively). The highest sodium content information was displayed by fish/prawn sauce (budu/cencalok) (5192±3228mg/100 g) which was followed by the light/thin soy sauce (5116±2084mg/100 g), and followed by salty soy sauce (4780±988mg/100 g). The sodium content information of the imported sauces was higher compared with local products produced in Malaysia. However, for sweet soy sauce, the sodium content information of the local products was higher compared with the imported products. Of the 116 sauces which displayed information regarding their sodium content, only 18.2% of the salty soy sauce and 25% of the light/thin soy sauce were found to be below the 2017 Malaysian sodium guidelines. Furthermore, only 21.7% of chilli ketchup and no tomato ketchup were below the 2017 UK salt guidelines. Conclusions Almost half of the sauces surveyed did not include sodium content information on the nutrient information panel. It is recommended that sodium content information is provided on all sauces sold in Malaysia. Also, manufacturers should be urged to reduce the sodium content level of their sauces to a minimum of 5%.