Alcohol is the number three contributor to the burden of disease worldwide so must remain a priority health promotion issue internationally. Malaysia is a Muslim country and alcohol-related harm was not seen as a priority until recently, because it only affects a minority of the population. Sabah has more than 30 different ethnic groups, and alcohol has a traditional role in the cultural practices of many of these groups. In 2009, the Intervention Group for Alcohol Misuse (IGAM) was formed, under the umbrella of Mercy Malaysia by a group of healthcare workers, academics, members of the Clergy and people who were previously alcohol-dependent concerned about the harmful effects of excessive alcohol consumption. IGAM in collaboration with other bodies have organized public seminars, visited villages and schools, encouraged the formation of a support group and trained healthcare professionals in health promotion intervention. The focus later changed to empowering communities to find solutions to alcohol-related harm in their community in a way which is sensitive to their culture. A standard tool-kit was developed using WHO materials as a guide. Village committees were formed and adapted the toolkit according to their needs. This strategy has been shown to be effective, in that 90% of the 20 committees formed are actively and successfully involved in health promotion to reduce alcohol-related harm in their communities.

Objectives In this study, we aimed to determine the prevalence and risk factors of alcohol use among a cohort of population in Sabah. Design This is a prospective, cohort study involving rural community residents. Setting Rural community resident at Bingkor, Keningau, Sabah. Participants 363 individuals aged 13 years old and above. Intervention Community‐based participatory research to determine the prevalence and risk factors associated with alcohol use. Main outcome measures Measurement of alcohol use using Alcohol Use Disorders Identification Test (AUDIT) and assessment of psychiatric morbidity using Mini International Neuropsychiatric Interview (MINI) questionnaires. Results Most alcohol drinkers aged between 36‐45 years old, followed by 26‐35 years old and 46‐55 years old. Interestingly, there are almost similar female to male ratio. Most were Kadazan‐Dusun ethnic, non‐Muslims, and married. Although only less than a third of the participants received tertiary education, the majority were working. Based on the findings, being a male, non‐Muslim and having an obsessive‐compulsive disorder (OCD) (current) posed a significantly higher risk of alcohol consumption. Conclusion A worryingly high prevalence of hazardous alcohol consumption among the locals is reported. There is a need for population‐wide intervention towards preventive measures based on the identified risk factors for hazardous alcohol use.

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Nutritional knowledge, attitudes and practice (KAP) may guide healthy meal choices. Here, nutritional KAP was compared across school students in Sabah based on locality and gender. A cross-sectional survey of students aged 15–19 years was conducted using multistage sampling. Nutritional KAP was measured via questionnaire. Anthropometric measures of weight and height were taken in person to calculate body mass index (BMI). Among the 994 participants, 80% were urban and 60% were female (mean age 16.5 ± 0.6 yr). Most were of Kadazan-Dusun (23%) ethnicity. Measured height for age Z score (HAZ) and BMI for age Z score (BAZ) differed between urban and rural students (−1.2 ± 0.8 versus −1.5 ± 0.7 for HAZ; p < 0.001; 0.2 ± 1.4 versus −0.1 ± 1.3; p = 0.02, respectively). No difference in nutritional knowledge was found, although urban students prioritized having a healthy/balanced diet (59.55% versus 48.50%, p = 0.03) and ate daily breakfast (57.4% versus 10.2%, p < 0.001) compared to rural. Females scored higher on nutritional knowledge than males (18.9 ± 2.8 vs. 18.1 ± 3.4, respectively, p = 0.0001), yet males selected more healthy/balanced foods (63.3% versus 53.3%, p = 0.041). The gap remains between nutritional KAP and translating this to healthy eating among adolescents, related to locality and gender.

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