Knowledge, Beliefs, Dietary, and Lifestyle Practices Related to Bone Health among Middle-Aged and Elderly Chinese in Klang Valley, Malaysia

Chan, Chin Yi; Subramaniam, Shaanthana; Chin, Kok‐Yong; Ima‐Nirwana, Soelaiman; Muhammad, Norliza; Ahmad, Fairus; Rizal, A. M.; Ng, Pei Yuan; Jamil, Nor Aini; Aziz, Nor Azlina Abd; Mohamed, Norazlina

doi:10.3390/ijerph16101787

Cited by 21 publications

(20 citation statements)

References 38 publications

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“…Adequate dietary calcium intake through dairy sources is a well-recognized osteoprotective behavior [63]. From our previous study, most subjects were aware of the importance of sufficient calcium intake in maintaining bone health [64]. However, a positive association between dairy product intake and osteoporosis was found among men in this study.…”

Section: Discussioncontrasting

confidence: 48%

Determinants of Bone Health Status in a Multi-Ethnic Population in Klang Valley, Malaysia

Chan

Subramaniam

Mohamed

et al. 2020

IJERPH

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Background and objectives: Studies on osteoporosis risk factors are limited in Malaysia, so this study assesses the factors associated with bone health assessed using dual-energy X-ray absorptiometry (DXA) among Malaysians aged ≥40 years. Subjects and Methods: Data on demography, medical history, dietary and lifestyle practices of 786 Malaysians (51.4% women) aged ≥40 years recruited in Klang Valley were obtained. Their body composition and bone health were determined using DXA. The association between risk factors and bone health status was assessed using binary logistic regression. Results: The prevalence of suboptimal bone health and osteoporosis was higher in women (59.4% and 16.1%) than men (40.8% and 8.4%). Overall, the predictors of suboptimal bone health and osteoporosis among the subjects were increased age and higher fat mass. Lower monthly income was positively associated with osteoporosis. Being menopausal was a risk factor for both suboptimal bone health and osteoporosis in women. Women with no formal education were more likely to get osteoporosis. Being a smoker and Chinese were positively related to suboptimal bone health among men. Meanwhile, predictors of osteoporosis among men were regular alcohol and dairy product consumption, higher fat mass and having a tertiary education. Conclusions: This study calls for immediate and effective interventions for middle-aged and elderly populations with risk factors to halt the progression of bone loss.

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Section: Discussioncontrasting

confidence: 48%

Determinants of Bone Health Status in a Multi-Ethnic Population in Klang Valley, Malaysia

Chan

Subramaniam

Mohamed

et al. 2020

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“…This cross-sectional study was a part of the more comprehensive bone health study of Malaysian populations conducted from April 2018 to April 2019 [25][26][27][28][29]. Participants were residents of Klang Valley, Malaysia, aged 40 years or above, recruited through purposive sampling method.…”

Section: Methodsmentioning

confidence: 99%

Positive association between metabolic syndrome and bone mineral density among Malaysians

Chin¹,

Chan²,

Subramaniam³

et al. 2020

Int. J. Med. Sci.

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Objectives: Metabolic syndrome (MetS) is a cluster of metabolic abnormalities that elevates the individual risk of cardiovascular diseases. These abnormalities are also known to alter bone remodelling. Therefore, MetS may be associated with osteoporosis. This study aims to determine the association between MetS and its components and bone mineral density (BMD) assessed by dual-energy X-ray absorptiometry (DXA) among Malaysians. Methods: 400 Malaysians aged ≥ 40 years (52.5% women) residing in Klang Valley, Malaysia, were recruited. Subjects' demographic and lifestyle details were collected using a questionnaire, and blood pressure and body anthropometry were measured. Subjects' lumbar spine and total hip BMD were measured by DXA. Their fasting blood was collected for blood glucose level and lipid profile analysis. Regression analysis was used to analyze the relationship between MetS or its components and BMD. Results: Subjects with MetS had higher BMD compared to subjects without MetS in models unadjusted for BMI (spine p=0.008; hip p<0.001). This difference was attenuated with BMI adjustment (spine p=0.625; hip p=0.478). Waist circumference was associated positively with BMD in models unadjusted for BMI (spine p=0.012; hip p<0.001), but the association became negative with BMI adjustment (spine p=0.044; hip p=0.021). Systolic blood pressure was associated positively with total hip BMD (p=0.019) but BMI adjustment attenuated the relationship (p=0.080). Triglyceride level was associated with osteoporosis in a fully adjusted model (p=0.001). Overall, MetS was associated with osteoporosis (p=0.019) but lifestyle (p=0.188) and BMI adjustment attenuated the relationship (p=0.904). Conclusion: MetS is positively associated with BMD, and this relationship is predominantly mediated by BMI. Although MetS is not a significant risk factor for osteoporosis, the inverse relationship between waist circumference, a marker of central obesity, and BMD highlights the need to prevent adiposity to improve metabolic and skeletal health.

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“…Only subjects fulfilling the inclusion criteria were invited to attend the screening session. The inclusion and exclusion criteria of the subjects were similar to our pilot study [28]. Subjects previously diagnosed with osteoporosis, metabolic bone diseases (Paget’s disease, osteogenesis imperfecta, osteomalacia, and rickets), hypo/hyperparathyroidism, hypo/hypercalcemia, hypo/hyperthyroidism, and/or who were receiving pharmacological treatment for osteoporosis (bisphosphonates, teriparatide, denosumab, and strontium ranelate) or other treatments that could significantly impact bone metabolism (hormone-replacement therapy, sex hormone deprivation therapy, thiazide diuretics, anticonvulsants, antidepressants, glucocorticoids, and thyroid supplements) were excluded.…”

Section: Methodsmentioning

confidence: 99%

“…Previously, the authors had conducted a pilot study among middle-aged and elderly Malaysian Chinese to address this issue. In the study, a moderate knowledge level and positive health beliefs regarding osteoporosis were noted, but these did not translate to good osteoprotective practices [28]. The current study is an expansion of the pilot study, in which two more ethnic groups were recruited to provide a more comprehensive view of knowledge, beliefs, and practices regarding osteoporosis among Malaysians.…”

Section: Introductionmentioning

confidence: 99%

Levels of Knowledge, Beliefs, and Practices Regarding Osteoporosis and the Associations with Bone Mineral Density among Populations More Than 40 Years Old in Malaysia

Chan

Subramaniam

Chin

et al. 2019

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Osteoporosis is a skeletal disorder commonly found among the elderly, in which the bones become weak, brittle, and more susceptible to fracture. Adequate knowledge and positive attitude towards the disease and osteoprotective activities may prevent osteoporosis, but comprehensive studies to verify this hypothesis are limited in Malaysia. This study aims to bridge the research gap by determining the levels of knowledge, beliefs, and practices regarding osteoporosis and their associations with bone mineral density (BMD) among men and women ≥ 40 years in Klang Valley, Malaysia. In this cross-sectional study, 786 Malaysians (382 men, 404 women) completed a questionnaire on knowledge, beliefs, and osteoprotective practices, and underwent BMD scan using a dual-energy X-ray absorptiometry device. The current study found moderate levels of knowledge and beliefs regarding osteoporosis but poor osteoprotective practices. Osteoporosis knowledge, beliefs, and practices were significantly different based on subjects’ demographic characteristics (p < 0.05). Osteoporosis knowledge and beliefs were correlated significantly with osteoprotective practices (p < 0.05). Bone health status of the subjects was associated positively with calcium supplement intake, and negatively with exercise barriers and smoking status of the subjects (p < 0.05). However, no significant correlation was noted between osteoporosis knowledge and bone health (p > 0.05). Conclusively, despite some correlations between individual components, the detachment between bone health knowledge and beliefs, and osteoprotective practices among Malaysians is apparent. Integrating all three components into a comprehensive osteoporosis prevention program is warranted.

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Knowledge, Beliefs, Dietary, and Lifestyle Practices Related to Bone Health among Middle-Aged and Elderly Chinese in Klang Valley, Malaysia

Cited by 21 publications

References 38 publications

Determinants of Bone Health Status in a Multi-Ethnic Population in Klang Valley, Malaysia

Determinants of Bone Health Status in a Multi-Ethnic Population in Klang Valley, Malaysia

Positive association between metabolic syndrome and bone mineral density among Malaysians

Levels of Knowledge, Beliefs, and Practices Regarding Osteoporosis and the Associations with Bone Mineral Density among Populations More Than 40 Years Old in Malaysia

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