Ismail M N, Chee S S, Nawawi H, Yusoff K, Lim T O, James W P T
Department of Nutrition and Dietetics, University Kebangsaan Malaysia, Kuala, Lumpur.
Obes Rev. 2002 Aug;3(3):203-8. doi: 10.1046/j.1467-789x.2002.00074.x.
This study was undertaken to assess the recent data on Malaysian adult body weights and associations of ethnic differences in overweight and obesity with comorbid risk factors, and to examine measures of energy intake, energy expenditure, basal metabolic rate (BMR) and physical activity changes in urban and rural populations of normal weight. Three studies were included (1) a summary of a national health morbidity survey conducted in 1996 on nearly 29 000 adults > or =20 years of age; (2) a study comparing energy intake, BMR and physical activity levels (PALs) in 409 ethnically diverse, healthy adults drawn from a population of 1165 rural and urban subjects 18-60 years of age; and (3) an examination of the prevalence of obesity and comorbid risk factors that predict coronary heart disease and type 2 diabetes in 609 rural Malaysians aged 30-65 years. Overweight and obesity were calculated using body mass index (BMI) measures and World Health Organization (WHO) criteria. Energy intake was assessed using 3-d food records, BMR and PALs were assessed with Douglas bags and activity diaries, while hypertension, hyperlipidaemia and glucose intolerance were specified using standard criteria. The National Health Morbidity Survey data revealed that in adults, 20.7% were overweight and 5.8% obese (0.3% of whom had BMI values of >40.0 kg m(-2)); the prevalence of obesity was clearly greater in women than in men. In women, obesity rates were higher in Indian and Malay women than in Chinese women, while in men the Chinese recorded the highest obesity prevalences followed by the Malay and Indians. Studies on normal healthy subjects indicated that the energy intake of Indians was significantly lower than that of other ethnic groups. In women, Malays recorded a significantly higher energy intake than the other groups. Urban male subjects consumed significantly more energy than their rural counterparts, but this was not the case in women. In both men and women, fat intakes (%) were significantly higher in Chinese and urban subjects. Men were moderately active with the exception of the Dayaks. Chinese women were considerably less active than Chinese men. Chinese and Dayak women were less active than Malay and Indian women. In both men and women, Indians recorded the highest PALs. Hence, current nutrition and health surveys reveal that Malaysians are already affected by western health problems. The escalation of obesity, once thought to be an urban phenomenon, has now spread to the rural population at an alarming rate. As Malaysia proceeds rapidly towards a developed economy status, the health of its population will probably continue to deteriorate. Therefore, a national strategy needs to be developed to tackle both dietary and activity contributors to the excess weight gain of the Malaysian population.
本研究旨在评估有关马来西亚成年人体重的最新数据，以及超重和肥胖方面的种族差异与合并症风险因素之间的关联，并研究正常体重的城乡人口的能量摄入、能量消耗、基础代谢率（BMR）和身体活动变化情况。纳入了三项研究：（1）1996年对近29000名年龄≥20岁成年人进行的全国健康发病率调查的总结；（2）一项对从1165名18 - 60岁城乡受试者中抽取的409名不同种族、健康成年人的能量摄入、基础代谢率和身体活动水平（PALs）进行比较的研究；（3）对609名年龄在30 - 65岁的马来西亚农村居民中肥胖及预测冠心病和2型糖尿病的合并症风险因素患病率的调查。超重和肥胖采用体重指数（BMI）测量方法及世界卫生组织（WHO）标准进行计算。能量摄入通过3天食物记录进行评估，基础代谢率和身体活动水平通过道格拉斯袋和活动日记进行评估，而高血压、高脂血症和葡萄糖耐量异常则采用标准标准进行判定。全国健康发病率调查数据显示，在成年人中，20.7%超重，5.8%肥胖（其中0.3%的BMI值>40.0 kg·m⁻²）；女性肥胖患病率明显高于男性。在女性中，印度和马来女性的肥胖率高于华裔女性，而在男性中，华裔的肥胖患病率最高，其次是马来人和印度人。对正常健康受试者的研究表明，印度人的能量摄入明显低于其他种族群体。在女性中，马来人的能量摄入明显高于其他群体。城市男性受试者的能量消耗明显高于农村男性，但女性并非如此。在男性和女性中，华裔和城市受试者的脂肪摄入量（%）明显更高。除达雅克人外，男性活动水平中等。华裔女性的活动水平明显低于华裔男性。华裔和达雅克女性的活动水平低于马来和印度女性。在男性和女性中，印度人的身体活动水平最高。因此，当前的营养与健康调查显示马来西亚人已经受到西方健康问题的影响。肥胖率的上升，曾被认为是城市现象，现在已以惊人的速度蔓延到农村人口。随着马来西亚迅速迈向发达经济体地位，其人口健康状况可能会继续恶化。因此，需要制定一项国家战略来应对导致马来西亚人口体重过度增加的饮食和活动因素。
