BAHAGIAN HAL EHWAL PELAJAR

(STUDENT AFFAIRS DIVISION)

REFLEKSI AKTIVITI
(ACTIVITY REFLECTION)

GKI 1001
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(INDEPENDENT RESEARCH)

(A) MAKLUMAT PELAJAR

STUDENT INFORMATION

Nama Jantina
: Ahmad Haziq bin Mohd Zulasri : Male
Name Gender
No. Matrik No. Telefon
: 22003319 : 013-2588323
Matric No. Telephone No.
Alamat Email Program Microbiology and
: 22003319@siswa.um.edu.my :
E-Mail Address Program Molecular Genetics
Fakulti
: Science
Faculty
Tahap Pengajian Pelajar Baharu Tahap Pertengahan
(Sila Tandakan New Student ✔
Middle Level
(✔) Yang Mana
Berkenaan)
Level Of Study
Tahap Awal Tahap Akhir
(Please Tick (✔) Early Level Final Level
The Appropriate
Box)

Tahap Pengajian Bilangan Kredit yang

Level of Study telah disempurnakan
Number of Credit
Completed
Pelajar Baharu/New Student -
Tahap Awal/Early Level < 35 credit
Tahap Pertengahan/Middle Level 36 to 75 credit
Tahap Akhir/Final Level > 76 credit
Nota / Notes :
(B) GARIS PANDUAN AM
GENERAL GUIDELINES

1. Bahasa: Bahasa Inggeris atau Bahasa Melayu

Language: English or Bahasa Melayu

2. Panjang laporan bertulis adalah sekurang-kurangnya 5 muka surat untuk Bahagian C

The written report should be at least 5 pages in Part C

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3. Spesifikasi Teknikal
Technical Specification

● Abstrak tidak melebihi 300 patah perkataan (Abstract should be within 300
words)
● Gunakan tulisan Arial bersaiz 11(Use Arial font size 11)
● Gunakan jarak 1.5 antara ayat (Use 1.5-line spacing)
● Laporan hendaklah di antara 30-40 halaman termasuk rujukan dan lampiran.
The report should be between 30 - 40 pages including references and appendix
● Rujukan sekurang-kurangnya 30 (Minimum of 30 references)

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(C) REFLEKSI AKTIVITI

ACTIVITY REFLECTION

1. Laporan bertulis
Written report
Hasil daripada aktiviti kajian harus dijelaskan dalam refleksi ini. Pelajar diharapkan dapat berkongsi
hasil penemuan kajian pada minggu 14 dalam laporan bertulis. Pelajar juga adalah diharapkan untuk
berfikir tentang hasil, kemahiran yang diperoleh dan sumbangan/kesan/aplikasi dari program/aktiviti
penyelidikan yang telah dilaksanakan.
The outcome of the research activities should be described in this reflection. Students are expected to
share the result of the research findings in week 14 in a written report. Students are also expected to reflect
the outcome, skills acquired and the significant contribution/impact/possible application from the completed
research activities/programs.

Laporan kajian adalah termasuklah:

The research report includes:

1. Tajuk kajian (Research Title)

The prevalence of obesity between socio-economic classes in Malaysia.

2. Abstrak (Abstract)

The rate of obesity is increasing worldwide, and it is also one of the factors that could contribute
to non-communicable diseases such as coronary heart disease, diabetes, hypertension and
stroke. In Malaysia, there is a huge variation in obesity prevalence across the country. It includes
unhealthy diet, genetics, socio-economic classes and lack of physical activity. We still have an
unclear insight into how socio-economic classes have an impact on the rate of obesity in
Malaysia. Thus, this study plays a vital role in finding the relationship between the socio-
economic classes and the rate of obesity in Malaysia. This study was conducted using the
quantitative method, where the data was obtained through the technical report of the National
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Health and Morbidity Survey 2019 (NHMS) carried out by the Institute of Public Health (IPH),
Ministry of Health Malaysia. The data obtained for this study were analyzed by using RStudio, a
statistical analysis software followed by the calculation of prevalence and Pearson’s Chi-square
test. This study included 9814 respondents and found that 21.88% of Malaysian adults were
obese. Obesity was more prevalent among females, those from the B40 class and Indians.
There were no significant associations of obesity with socio-economic classes. In order to
prevent obesity in the future, drastic actions by local public health and authorities are needed in
amplified health promotion and education, especially towards the young generation.

Keywords: diet, obesity, socio-economic classes, income, Malaysia.

3. Pengenalan/ (Introduction)

3.1 Latar belakang kajian (Background of the Study)

Obesity is one of the critical health issues for the global nowadays. The rate of obesity is
increasing worldwide, and it is also one of the factors that could contribute to a variety of non-
communicable diseases such as coronary heart disease, diabetes, hypertension and stroke.
This is also worrying for our country too since the number of people being overweight and obese
is rising at an alarming rate in Malaysia.

Socioeconomic class refers to an individual or group and their position on a socioeconomic

scale. The class is divided by a combination of social and economic factors including household
income, level of education, the prestige of occupation, residency as well as ethnic origin or
religious background. Numerous studies on socioeconomic status have revealed apparent
inequalities in terms of resources, privileges, power, and control.

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In Malaysia, the socioeconomic classes are mainly divided into three subcategories of income
households namely B40, M40, and T20 which refers to the bottom 40%, middle 40% and top
20% of the population accordingly. Household Income & Basic Amenities Survey Report in 2019
found that the mean income in the B40 tier was RM1,849 while the mean income in the T20 tier
was RM24,293. Malaysia’s average poverty line income (PLI) was drawn at RM2,208. This
means that almost all B40 households in Malaysia live under their means and most of the time
could not meet basic needs for proper and nutritious food.

Sociologists have hypothesised that when a population is threatened with a new health risk, the
people in the higher economic class will have all the necessary resources to protect themselves
not only in material resources (good finance, safe surroundings) but also non-material resources
like educating themselves on healthy nutrition and weight control strategies (Miech, 2011).

It can be hypothesised that Malaysia’s obesity epidemic will soar faster in lower socioeconomic
classes than its counterpart. Therefore, it is crucial for us to have a better understanding of how
the rate of obesity in Malaysia was influenced by other factors such as age, gender, socio-
economic class and lifestyle choices. Apart from that, it also aids us in investigating the
association between socio-economic classes and the frequency of obesity in Malaysia.
Consequently, this may help the health authorities in forming a better strategy to tackle this
health issue.

3.2 Pernyataan masalah/hipotesis/kerangka konseptual

(Problem statement /hypothesis/conceptual framework)

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The rate of obesity in Malaysia is rising at an alarming rate. In Malaysia, there is a huge variation
in prevalence across the country. It includes unhealthy diet, genetics, socio-economic classes
and lacks of physical activity. However, we still have an unclear insight into how the socio-
economic classes have an impact on the rate of obesity in Malaysia. Thus, this study plays a
vital role in finding the relationship between the socio-economic classes and the rate of obesity
in Malaysia. It is also noteworthy to investigate the gender differences in the relationship between
socio-economic classes and obesity. It is hoped that this study would encourage the health
authorities to create awareness among the public about health and income disparities. Also, to
educate people on alternative food that is cheaper but healthier.

3.3 Persoalan kajian (Research questions)

 How does socio-economic classes relate to obesity, and does it influence the rate of obesity
in Malaysia?

 Is there any gender-specific relationships between socio-economic classes and rate of

obesity in Malaysia?

3.4 Matlamat kajian (Aim of the study)

The aim of this study is to determine the influence of socio-economic classes towards the
prevalence of obesity in Malaysia.

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3.5 Objektif kajian (Objective(s) of the study)

 To investigate the relationship between socio-economic classes and the obesity rate in
Malaysia.

 To examine whether the association between the obesity rate and socio-economic classes
varied in males and females.

3.6 Kepentingan kajian (Significance of the study)

This study is necessary in order to get a better insight into how the socio-economic classes have
affected the obesity rate in Malaysia. Besides, it is also important to investigate a few socio-
economic factors that contribute to the increasing rate of obesity in Malaysia such as income
level, poverty and employment status. Apart from that, this study was also able to distinguish the
obesity rate between different gender in Malaysia.

3.7 Skop kajian (Scope of the study)

This study is limited to citizens of both urban and rural areas in all 13 states and 3 federal
territories in Malaysia.

4. Kajian literasi (Literature review)

Obesity.

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Obesity is a chronic medical condition that impacts human health negatively (Jagriti et.al, 2017).
The trend of obesity is steadily increasing worldwide, and it is rising faster among developing
countries (Monteiro et.al., 2004). Obesity is associated with a variety of complications such as
hypertension, coronary heart disease, diabetes mellitus and others (Roland, 1997). However, it
is not just undernourishment that leads to increased human illness and death, but also
overnutrition (Ghee, 2016).

Even though the health risk of contracting obesity is similar in all populations, it is also
noteworthy that gender, race and societal conditions have directly contributed to the risk
(Paeratakul et.al., 2002). The commonness of obesity rose about twofold in 13 of the 20 most
popular nations from 1980 to 2015 (Ashkan et.al., 2017).

Body mass index (BMI) is a common method that is used to identify a person’s weight category
(WHO, 2021). Though, for any calculated BMI, there is a huge variability of inter-individual in the
body fat ratios, somewhat assigned to age, ethnicity and gender. By directly depending on BMI
to evaluate its prevalence, it may intervene in future planning for obesity control and prevention
(Chooi et.al., 2019).

In recent times, there has been a steady rise in the number of people who are obese, including
children and youths. This trend has generated widespread alarm, as it is feared that it portends
a significant public health emergency (Crosnoe, 2007). Fundamentally, it has been noted that
measuring abdominal obesity based on waist circumference (WC) instead of the more common
method of using Body Mass Index (BMI) is an even more accurate predictor of various
cardiovascular diseases and type II diabetes (Guh et al., 2009).

Obesity in Malaysia.

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The prevalence of obesity in most emergent nations, including Malaysia has risen to the
epidemic stage, particularly among citizens (Sherina et.al., 2021). For the prevalence of obesity
between gender among Malaysian adults, a higher number of women are obese in contrast to
men (Wan et.al., 2011). Apart from gender disparities, there are ethnic divergences in the
frequency of obesity among Malaysian adults. Indian and Malay races are highly prevalent
compared to others (Sherina et.al., 2021).

There were numerous components linked with obesity which have been proven to increase the
possibility of chronic diseases among Malaysian adults ranging from 24 to 64 years old (Thin
et.al., 2022). The average sugar intake of each person in Malaysia was about 40 kg per year
and this might have lamentably contributed to the prevalence of obesity (Suthahar et.al., 2020).
As a result, obesity has become a significant clinical and public health concern in Malaysia that
poses a risk of overwhelming the existing healthcare system (Zaki et al., 2010).

Socio-economic classes.

Inequalities in socioeconomic have witnessed a jarring effect on health problems worldwide

(Robertson et.al., 2013). Socioeconomic status is conceptualized in an array of ways including
education, social class, or income (Darin-Mattsson, Fors, & Kåreholt, 2017). Previous studies
had shown a direct relationship between low socioeconomic, well-being, health, level of
education, living environment as well as access to any life-improving facilities (Shahar et.al.,
2017).

People who are economically challenged have poorer health and oftentimes die younger than
those who are well-off. This inequality could persist into old age since low economic status is
linked with poor nutritional knowledge, unattended mental health diseases, disabilities and
mortality (Huisman, Kunst, & Mackenbach, 2003). Adults who are financially secure have lower

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mortality rates by 15.3 and 10.9% in both men and women due to high accessibility to food and
treatment (Banks, Kuper, & Polack, 2017).

Socioeconomic status is a multifaceted construct, comprising various key elements such as an

individual's income, educational attainment, occupation prestige and family background (Ball et
al., 2002). Despite the fact that socioeconomic status is commonly thought of as an overarching
concept, it has been suggested that its individual components represent different aspects of
socioeconomic status, and that research on the link between socioeconomic status and obesity
should examine these individual components separately (Sobal and Stunkard, 1989).

Relationship between socio-economic classes and the rate of obesity.

The socioeconomic gradient has greatly influenced the rate of obesity, especially in high- and
middle-income countries where poor adults and children are more susceptible to becoming
obese (Tan et.al., 2022). One explanation for this issue includes the insufficient income and time
scarcity that hinder this group to have access to healthier food, which is expensive and time-
consuming in nature, compared to the less healthy option (Venn & Strazdins, 2017). Another
factor for the widening gap of obesity in income disparities is that poor households are most
likely living in an obesogenic background that encourages weight gain (Vargas, Stines, &
Granado, 2017).

Since the price of food largely determines people's food choices in the developing world, gaining
insight into how socioeconomic variables affect food choices could be useful in understanding
food behaviour (Bhurosy and Jeewon, 2014). Researchers also found out that the built
environments around people with low socioeconomic status have an ample effect on obesity
and obesity-related behaviours. It takes effect on their food choices and physical activities
(Mackenbach et.al., 2019).

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While economically-constrained individuals heavily rely on neighbourhood food that is often

lacking in fresh produce and plentiful in fast foods. The abundant access to food establishments
has been linked with eating out more instead of preparing their own food (Gamba et. al., 2015).
For example, Higher SES individuals are less bound by their residential surroundings as they
typically can travel further to opt for a healthier choice of food.

Past studies.

Obesity is a major contributor to various non-communicable diseases (NCDs), including both

fatal and non-fatal conditions; it also results in early death and impaired quality of life in
adulthood (Lemamsha et al., 2019). The significant difference in the rate of obesity among
different ethnic groups is a major concern and a puzzle in the ongoing obesity crisis (Whitaker
and Orzol, 2006).

The rise in obesity is commonly linked to economic progress and an increase in income. For
instance, it is frequently noted that the recent economic growth in developing nations has
resulted in a significant uptick in obesity (Misra and Khurana, 2008). However, the relationship
between obesity and income is not as simple as it is often portrayed (Ameye and Swinnen,
2019). In certain research, it has been found that the strength of the inverse relationship between
socio-economic class and obesity was greater for girls as compared to boys (Vazquez and
Cubbin, 2020).

Therefore, comprehending the concurrent effects of various SES indicators could provide
important information on the cause of the relationship between SES and the rate of obesity in
developing countries (Dahly et al., 2009). Regarding the connection between obesity and
gender, in the majority of countries globally, it is believed that the rate of obesity is higher among
women than men (Lemamsha et al., 2019). For the relevant organisations involved in observing

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the prevalence trends of obesity in Malaysia, the meta-analysis may offer additional
comprehensive data that they can use in managing the problem in the future (Chong and Lee,
2018).

Thus, prevention of overweight and obesity, as well as the illnesses associated with them, is
largely possible, hence it should be given high priority (Wang and Lim, 2012). More research is
required to explore the underlying mechanisms that contribute to the gender-based differences
in obesity prevalence (Garawi et al., 2014).

5. Metodologi (Methodology)

5.1 Reka bentuk eksperimen (Experimental Design)

This study was conducted using the quantitative method, where the secondary data was
obtained through the technical report of the National Health and Morbidity Survey 2019 (NHMS)
carried out by the Institute of Public Health (IPH), Ministry of Health Malaysia. This study was
categorized as descriptive research as it can illustrate the demographic data such as ethnicity,
gender, income level, occupation, and education level of the respondents. Therefore, it can be
used to relate the association between the rate of obesity in Malaysia and the interest variables.

5.2 Populasi/Saiz Persampelan/Kaedah persampelan

(Population/Sample Size/ Sampling Techniques)

This study was intended to analyze the citizens of both rural and urban areas in Malaysia. Hence,
the study was centered on the population of Malaysian citizens. The sampling method that has
been used in this study was stratified random sampling and the sample size was calculated by

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using a single proportion formula as stated by NHMS 2019 technical report. Thus, the sample
size obtained for this study was (n = 9814).

5.3 Kaedah Pengumpulan data (Instrumentation for data collection)

Through the secondary data of the NHMS 2019 technical report, the data collection of this study
was obtained via a survey of structured questionnaires based on the specific scope. There were
two types of questionnaires which consist of face-to-face interviews and self-administered.

Then, the obesity status acted as the dependent variable and was determined by measuring the
respondent's weight with digital weighing machines (TANITA HD-319), and height in centimetres
using a SECA 206 Bodymeter. Body Mass Index (BMI) was then calculated and classified
according to the World Health Organization's BMI guidelines which are below 25 kg/m 2 were
declared as underweight to normal weight, whereby for range 25.0 to 29.9 kg/m 2 as overweight
and more than 30 kg/m2 recognized as obesity. Therefore, the associated factors that were taken
into consideration as independent variables were sociodemographic characteristics such as
gender, ethnicity and socio-economic class.

5.4 Teknik menganalisis data (Data analysis technique)

The variables of interest were extracted from NHMS 2019 raw data and analyzed by using
RStudio statistical analysis software and Microsoft Excel. This statistical computing software has
been used for this study since it is open-source and reliable to run for data analysis. The
prevalence of obesity was calculated based on a single proportion formula in RStudio software.
Pearson’s Chi-squared test was also involved in the data analysis that has been done by using
the RStudio software in order to determine the relationship between each variable.

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6. Penemuan & Perbincangan (Findings & Discussion)

6.1 Introduction

This study was proposed to determine the influence of socio-economic classes towards the
prevalence of obesity in Malaysia. This study also aims to investigate whether gender greatly
affects the rate of obesity and how the socio-economic classes relate to the rate of obesity in
Malaysia.

This study involved 9814 respondents consisting of Malaysian citizens from both rural and urban
areas. The data was obtained through secondary data from National Health and Morbidity
Survey (NHMS) that was conducted in 2019. The sampling method that has been used is
stratified random sampling and a single proportion formula was utilized in order to calculate the
sample size of NHMS for estimation of the prevalence.

This segment of the study will be engaging in the analysis of data based on the results obtained.
This segment will also be reviewing the findings obtained prior to analysis including a graphical
illustration of graphs and tables.

6.2 Demographics of respondents

From the secondary data obtained by NHMS, a total of 9814 responses were obtained. Through
this data, a frequency distribution was constructed in order to get a clear insight into the
background information of the study. The respondent’s demographic data based on the
secondary data obtained were illustrated in Table 1.

Variable Categories Frequency Percentage (%)

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Male 4544 46.30

Gender
Female 5270 53.70
Malay 6368 64.89
Indian 624 6.36
Ethnicity
Chinese 1204 12.27
Others 1618 16.49
B40 6412 65.34
Socio-economic
M40 2532 25.80
classes
T20 870 8.86

Table 1: Demographics data of the respondents.

6.2.1 Gender and Ethnicity

Based on Table 1, shows that out of 9814 respondents, about 4544 (46.3%) are male and 5270
(53.7%) are female. In terms of ethnicity, the majority of the respondents were Malays
(64.89%), 12.27% of Chinese and, followed up by Indians with 6.36% and for the other ethnicity
was around 16.49%. The other ethnicity was Bumiputera Sabah and Sarawak as well as other
ethnicities. This was shown in Figure 1 below.

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Ethnicity of the Respondents

16.49%

12.27%

6.36% 64.89%

Malay Indian Chinese Others

Figure 1: Ethnicity of the respondents.

6.2.2 Socio-economic classes

Based on Figure 2, which shows that the majority of the respondents are comprised of B40
class of socio-economic (65.34%). Then, for M40 socio-economic class was 25.80% followed
by the T20 class which only encompassed 8.86%.

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Socio-economic Classes of
Respondents

T20 8.86%

M40 25.80%

B40 65.34%

Figure 2: Socio-economic class of the respondents.

6.3 Prevalence of obesity in Malaysia.

Sociodemographic 95% CI
Count Prevalence (%)
Characteristics
Lower Upper
Gender
Male 759 16.70 15.63 17.82
Female 1388 26.34 25.15 27.55
Socio-economic class
B40 1427 22.26 21.24 23.29
M40 537 21.21 19.63 22.85
T20 183 21.03 18.37 23.90
Ethnicity
Malay 1519 23.85 22.81 24.92
Indian 170 27.24 23.78 30.92
Chinese 155 12.87 11.03 14.90
Others 303 18.73 16.85 20.71
Table 2: Prevalence of obesity in Malaysia.

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The prevalence of obesity in Malaysia based on sociodemographic characteristics were shown

in Table 2. The prevalence of obesity in Malaysia was significantly higher in females which is
26.34% (95% CI: 25.15 – 27.55) than in males which are 16.70% (95% CI: 15.63 – 17.82), as
determined by sociodemographic profiling.

In sociodemographic characteristics of ethnicity, Indian (27.24%; 95% CI: 23.78 – 30.92) were
having the highest prevalence of obesity compared to Malay (23.85%; 95% CI: 22.81 – 24.92),
Chinese (12.87%; 95% CI: 11.03 – 14.90) and others (18.73%; 95% CI: 16.85 – 20.71) ethnicity.
This can be summarized as the prevalence of obesity in the Indian race is 27.24% (at 95%
confidence interval with 23.78 to 30.92) cases per 100 individuals.

For socio-economic classes, the highest prevalence of obesity was among the B40 (22.26%;
95% CI: 21.24 – 23.29), followed by M40 (21.21%; 95% CI: 19.63 – 22.85) and T20 (21.03%;
95% CI: 18.37 – 23.90). This indicates that the prevalence of obesity for B40 is 22.26% of cases
per 100 individuals at 95% confidence interval.

6.4 Analysis of the relationship between the rate of obesity and socio-economic classes.

Underweight Normal Overweight Obese

B40 365 2471 2149 1427
M40 131 1056 808 537
T20 40 341 306 183

Table 3: Descriptive statistics of socio-economic classes and the BMI level.

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Chi-Square Test
df p-value
Statistic
10.521 6 0.1044

Table 4: Summary of Pearson’s Chi-squared test for socio-economic class and the rate of obesity.

From the descriptive statistics of Table 3, the frequency of obesity was significantly higher in the
B40 group (1427) compared to M40 (537) and T20 (183). Apart from that, based on the summary
of Pearson’s Chi-squared test for sociodemographic characteristics of socio-economic class and
the rate of obesity in Table 4, it shows that the p-value was not smaller than the a (a = 0.05;
degree of freedom = 6). Therefore, the null hypothesis failed to be rejected and indicated that
the socio-economic classes and rate of obesity were unrelated and independent towards each
other.

6.5 Analysis of the association between gender and the rate of obesity.

Underweight Normal Overweight Obese

Male 276 1951 1558 759
Female 260 1917 1705 1388

Table 5: Descriptive statistics of gender and the BMI level.

Chi-Square Test
df p-value
Statistic
138.73 3 2.2E-16

Table 6: Summary of Pearson’s Chi-squared test for gender and the rate of obesity.

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As shown in Table 5, the frequency of obesity was highest in females (1388) compared to males
(759). Yet, the highest BMI level for both genders was in the normal range which is range from
18.5 to 24.9. Apart from that, based on the summary of Pearson’s Chi-squared test for
sociodemographic of gender and the rate of obesity in Table 6, it shows that the p-value was
smaller than the a (a = 0.05; degree of freedom = 3). As a result, the null hypothesis was allowed
to be rejected and indicated that gender and rate of obesity were related and dependent on each
other.

7. Kesimpulan (Conclusion)

Understanding obesity as a problem of quality rather than quantity and considering socio-
economic factors in terms of access to resources leads to the conclusion that socio-economic
inequalities in obesity are caused by unequal access to healthy diets and physical activity.
Instead of asking the "poor" to make healthier choices, the solution to these inequalities is to
provide everyone with the resources they need to maintain a healthy weight. This can be
achieved through changes in fiscal, social and physical environments, such as limiting fast food
outlets and taxing unhealthy foods, or by offering subsidies for children's sports. However, the
most effective way to ensure equal access to these resources may be through stronger welfare
and employment policies, such as higher minimum wages and universal basic income.

8. Batasan dan cadangan untuk penyelidikan masa depan

(Limitations and suggestion for future research)

Limitations

Although this study was well designed and carried out, there are some limitations that need to
be acknowledged. The initial challenge encountered was difficulty in acquiring the resources

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and data. This is due to the limited study regarding the obesity rate and socio-economic class
in Malaysia that has been done. It is possible that there are many unpublished studies from
various institutions in Malaysia that were not included in this study. This study was limited based
on the raw data obtained from NHMS 2019 which might cause missed relevant grey literature.
Apart from that, the lack of time and duration in conducting the research is also one of the
challenges that have been encountered. Besides, there were also some limitations in the
process of data analysis. This is due to the raw data obtained were mostly not in values or
numerical form, which led the data analysis process to the limited statistical tests that can be
done.

Recommendations

Following the study that has been done which shows the rising prevalence of obesity in
Malaysia. It is crucial for the government, healthcare providers, non-governmental
organizations, and private health institutions to prioritize the prevention and management of
overweight and obesity. In order to have a better insight into the association between socio-
economic class and the rate of obesity, the scope of the study should include a more diverse
population, including individuals from different socio-economic backgrounds and ethnic groups.
Besides, collecting information from both published and grey literature is also helpful, in order to
have a comprehensive understanding of the issue and not miss updated past studies. It is also
can be considered to use a longitudinal study design to track changes in obesity rates over time
within different socio-economic groups. By collaboration with other researchers and institutions,
is also able to aid this study in order to gain a more complete picture of the obesity issue.

9. Rujukan (References)

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Afshin, A., Forouzanfar, M. H., Reitsma, M. B., Sur, P., & Estep, K. (2017). Health effects of
overweight and obesity in 195 countries over 25 years. New England Journal of Medicine,
377(1), 13–27. https://doi.org/10.1056/nejmoa1614362

Ameye, H., & Swinnen, J. (2019). Obesity, income and gender: The changing global relationship.
Global Food Security, 23, 267–281. https://doi.org/10.1016/j.gfs.2019.09.003

Ariaratnam, S., Rodzlan Hasani, W. S., Krishnapillai, A. D., Abd Hamid, H. A., Jane Ling, M. Y., Ho,
B. K., Shariff Ghazali, S., Tohit, N. M., & Mohd Yusoff, M. F. (2020). Prevalence of obesity and
its associated risk factors among the elderly in Malaysia: Findings from the National Health and
Morbidity Survey (NHMS) 2015. PLOS ONE, 15(9).
https://doi.org/10.1371/journal.pone.0238566

Ball, K., Mishra, G., & Crawford, D. (2002). Which aspects of socioeconomic status are related to
obesity among men and women? International Journal of Obesity, 26(4), 559–565.
https://doi.org/10.1038/sj.ijo.0801960

Banks, L. M., Kuper, H., & Polack, S. (2017). Poverty and disability in low- and middle-income
countries: A systematic review. PLOS ONE, 12(12).
https://doi.org/10.1371/journal.pone.0189996

Bhurosy, T., & Jeewon, R. (2014). Overweight and obesity epidemic in developing countries: A
problem with diet, physical activity, or socioeconomic status? The Scientific World Journal,
2014, 1–7. https://doi.org/10.1155/2014/964236

Chong, E. T.-J., & Lee, P. C. (2018). Prevalence of overweight and obesity in Malaysia, 2010 - 2016:
a comprehensive meta-analysis. The Southeast Asian Journal of Tropical Medicine and Public
Health, 49(5), 859–869.

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Chooi, Y. C., Ding, C., & Magkos, F. (2019). The epidemiology of Obesity. Metabolism, 92, 6–10.
https://doi.org/10.1016/j.metabol.2018.09.005

Crosnoe, R. (2007). Gender, obesity, and Education. Sociology of Education, 80(3), 241–260.
https://doi.org/10.1177/003804070708000303

Dahly, D. L., Gordon-Larsen, P., Popkin, B. M., Kaufman, J. S., & Adair, L. S. (2009). Associations
between multiple indicators of socioeconomic status and obesity in young adult Filipinos vary
by gender, urbanicity, and indicator used. The Journal of Nutrition, 140(2), 366–370.
https://doi.org/10.3945/jn.109.114207

Darin-Mattsson, A., Fors, S., & Kåreholt, I. (2017). Different indicators of socioeconomic status and
their relative importance as determinants of health in old age. International Journal for Equity in
Health, 16(1). https://doi.org/10.1186/s12939-017-0670-3

Garawi, F., Devries, K., Thorogood, N., & Uauy, R. (2014). Global differences between women and
men in the prevalence of obesity: Is there an association with gender inequality? European
Journal of Clinical Nutrition, 68(10), 1101–1106. https://doi.org/10.1038/ejcn.2014.86

Ghee, L. K. (2016). A Review of Adult Obesity Research in Malaysia. International Medical University
Clinical School, 71.

Gibbs, B. G., & Forste, R. (2013). Socioeconomic status, infant feeding practices and early childhood
obesity†. Pediatric Obesity, 9(2), 135–146. https://doi.org/10.1111/j.2047-6310.2013.00155.x

Guh, D. P., Zhang, W., Bansback, N., Amarsi, Z., Birmingham, C. L., & Anis, A. H. (2009). The
incidence of co-morbidities related to obesity and overweight: A systematic review and meta-
analysis. BMC Public Health, 9(1). https://doi.org/10.1186/1471-2458-9-88

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Huisman, M., Kunst, A. E., & Mackenbach, J. P. (2003). Socioeconomic inequalities in morbidity
among the elderly; a European overview. Social Science & Medicine, 57(5), 861–873.
https://doi.org/10.1016/s0277-9536(02)00454-9

Jung, R. T. (1997). Obesity as a disease. British Medical Bulletin, 53(2), 307–321.

https://doi.org/10.1093/oxfordjournals.bmb.a011615

Kyaw, T. M., Ismail, Z., Selamat, M. I., & Nawawi, H. (2022). Obesity and its associated factors
among older adults: Myhebat ( m ala y sian he alth and well‐ b eing a SSESSMEN t ) study.
Health Science Reports, 5(4). https://doi.org/10.1002/hsr2.668

Lemamsha, H., Randhawa, G., & Papadopoulos, C. (2019). Prevalence of overweight and obesity
among Libyan men and women. BioMed Research International, 2019, 1–16.
https://doi.org/10.1155/2019/8531360

Miech, R., Pampel, F., Kim, J., & Rogers, R. G. (2011). The Enduring Association between education
and mortality. American Sociological Review, 76(6), 913–934.
https://doi.org/10.1177/0003122411411276

Misra, A., & Khurana, L. (2008). Obesity and the metabolic syndrome in developing countries. The
Journal of Clinical Endocrinology & Metabolism, 93(11_supplement_1), s9–s30.
https://doi.org/10.1210/jc.2008-1595

Mohd-Sidik, S., Lekhraj, R., & Foo, C. N. (2021). Prevalence, associated factors and psychological
determinants of obesity among adults in Selangor, Malaysia. International Journal of
Environmental Research and Public Health, 18(3), 868. https://doi.org/10.3390/ijerph18030868

Monteiro, C. A., Moura, E. C., Conde, W. L., & Popkin, B. M. (2004, December). Review of
Socioeconomic status and obesity in adult populations of developing countries. Bulletin of the

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World Health Organization, 82(12), 940–946. Retrieved November 4, 2022, from

https://pubmed.ncbi.nlm.nih.gov/15654409/.

Paeratakul, S., Lovejoy, J. C., Ryan, D. H., & Bray, G. A. (2002). The relation of gender, race and
socioeconomic status to obesity and obesity comorbidities in a sample of US adults.
International Journal of Obesity, 26(9), 1205–1210. https://doi.org/10.1038/sj.ijo.0802026

Robertson, T., Batty, G. D., Der, G., Fenton, C., Shiels, P. G., & Benzeval, M. (2012). Is
socioeconomic status associated with biological aging as measured by telomere length?
Epidemiologic Reviews, 35(1), 98–111. https://doi.org/10.1093/epirev/mxs001

Shahar, S., Vanoh, D., Mat Ludin, A. F., Singh, D. K., & Hamid, T. A. (2019). Factors associated with
poor socioeconomic status among Malaysian older adults: An analysis according to urban and
rural settings. BMC Public Health, 19(S4). https://doi.org/10.1186/s12889-019-6866-2

Sobal, J., & Stunkard, A. J. (1989). Socioeconomic status and obesity: A review of the literature.
Psychological Bulletin, 105(2), 260–275. https://doi.org/10.1037/0033-2909.105.2.260

Upadhyay, J., Farr, O., Perakakis, N., Ghaly, W., & Mantzoros, C. (2018). Obesity as a disease.
Medical Clinics of North America, 102(1), 13–33. https://doi.org/10.1016/j.mcna.2017.08.004

Vazquez, C. E., & Cubbin, C. (2020). Socioeconomic status and childhood obesity: A review of
literature from the past decade to inform intervention research. Current Obesity Reports, 9(4),
562–570. https://doi.org/10.1007/s13679-020-00400-2

Wang, Y., & Lim, H. (2012). The global childhood obesity epidemic and the association between
socio-economic status and childhood obesity. International Review of Psychiatry, 24(3), 176–
188. https://doi.org/10.3109/09540261.2012.688195

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Whitaker, R. C., & Orzol, S. M. (2006). Obesity among US urban preschool children. Archives of
Pediatrics & Adolescent Medicine, 160(6), 578. https://doi.org/10.1001/archpedi.160.6.578

World Health Organization. (2021, June 9). Obesity and overweight. World Health Organization.
Retrieved November 5, 2022, from https://www.who.int/en/news-room/fact-
sheets/detail/obesity-and-overweight

Zaki, M., Roobayah, Z., Chan, S. P., Vadivale, M., & Lim, T. O. (2010). Malaysia Shape of the Nation
(MySoN): a primary care based study of abdominal obesity in Malaysia. The Medical Journal of
Malaysia, 65.

10. Lampiran (jika ada) (Appendices (if any))

Raw data of needed variables from NHMS2019 -

https://docs.google.com/spreadsheets/d/1nPn28SOac7DYFX0EyyQT7XYMoK-
0QP80/edit?usp=sharing&ouid=113580692094599518349&rtpof=true&sd=true

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2. Kemahiran dan kecekapan yang diperoleh daripada aktiviti-aktiviti penyelidikan yang telah
dilaksanakan
Skills and competencies acquired from the completed research activities
Kenalpasti kemahiran dan kecekapan anda yang diperolehi selepas menjalankan aktiviti penyelidikan.
Nilaikan tahap penguasaan berdasarkan kepada skala mengikut sebelum dan selepas pelaksanaan
aktiviti-aktiviti penyelidikan. Contoh kemahiran dan kecekapan adalah seperti kemahiran membaca,
kemahiran menulis, pemikiran kritikal, kemahiran merancang, kemahiran teknikal, kecekapan
menganalisis dan lain-lain.
Identify your skills and competencies acquired after the research activity implementation. Evaluate the level
of mastery based on the scale according to before and after the execution of the research activities.
Example of skills and competencies such as reading skills, writing skills, critical thinking, planning skills,
technical skills, analysis competency and others.

Kemahiran dan Kecekapan Tahap Penguasaan

Skills and Competencies Level of Mastery
Sebelum Selepas 1 2 3 4 5 6 7 8 9 10
Before After
1) Conducting research.
5 9
None Moderate Expert

Sebelum Selepas 1 2 3 4 5 6 7 8 9 10
Before After
2) Analysing data.
4 8 None Moderate Expert

Sebelum Selepas 1 2 3 4 5 6 7 8 9 10
Before After
3) Writing report.
5 8 None Moderate Expert

3. Sumbangan (Langsung/Tidak Langsung)

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Contribution (Direct/Indirect)

Terangkan sumbangan anda terhadap komuniti/syarikat/hos dan pihak lain yang berkaitan daripada
segi sumbangan yang langsung dan tidak langsung daripada program/aktiviti yang telah dilaksanakan.
Describe your contribution towards communities/company/hosts and other relevant parties in terms of direct
and indirect from the completed programs/activities.

Sumbangan (Langsung) /Contribution (Direct)

- Initially, the direct contribution from this study is it able to observe and get a clear insight on
how the rate of obesity were affected by other sociodemographic characteristics such as
gender, socio-economic classes and ethnicity. Apart from that, this study also can contribute
directly in identification of the specific groups of income level populations that are at a higher
risk of obesity. This study might also ably aid in monitoring of trends in obesity rates among
different socio-economic classes over time to evaluate the effectiveness of interventions.

Sumbangan (Tidak Langsung) /Contribution (Indirect)

- For indirect contribution, this study might can increase the understanding of the link between
socio-economic class and the rate of obesity, which can inform the public health policies and
interventions aimed at reducing obesity rates among specific groups of income populations.
Next, this study might also improve healthcare outcomes for low-income individuals by
addressing obesity as a key risk factor for other health issues such as diabetes, heart disease
and stroke.

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4. Pencapaian hasil kursus (Sila tandakan (✔) yang mana berkenaan)

Course outcome achievement (Please tick (✔) the appropriate box)

Nilaikan hasil pencapaian kursus.

Evaluate the course outcome achievement.
Status Pencapaian
Status of achievement
Hasil kursus Tidak Separa
Course outcome tercapai tercapai Tercapai
Not Partially Achieved
achieved achieved

1. Mencadangkan cadangan penyelidikan bagi topik yang

dipilih ✔
Propose research proposal on selected topic

2. Melaksanakan projek penyelidikan dalam jangka masa dan

sumber yang ditetapkan
✔
Perform the research project within stipulated time frame and
resources

3. Melaporkan penemuan penyelidikan kepada pihak

berkepentingan terpilih ✔
Report the research finding to selected stakeholders

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(D) PENILAIAN KENDIRI (Sila tandakan (✔) bagi setiap kategori)

SELF-EVALUATION (Please tick (✔) one from each categories)

A. Tarikh penyerahan
Submission Deadline
Penyerahan dilakukan selewat-lewatnya pada hari Jumaat minggu ke-14 (5 markah)
✔ Submission done latest by Friday in the 14th Week (5 marks)
Penyerahan dilakukan pada hari Sabtu dan Ahad minggu ke-14 (4 markah)
Submission done on Saturday and Sunday in the 14 th Week (4 marks)
Penyerahan dilakukan selewat-lewatnya pada hari Jumaat minggu ke-15 (3 markah)
Submission done latest by Friday in the 15 th Week (3 marks)
Tiada penyerahan dilakukan (0 markah)
No submission (0 marks)
B. Kesempurnaan
Completeness
Laporan bertulis mengandungi semua perkara seperti di dalam borang templat (30 markah)
✔
The report contains all items as per template (30 marks)

2 markah ditolak bagi setiap satu perkara yang tidak disenaraikan di dalam borang templat
2 marks should be deducted for every one item not listed in the proposal

Jumlah markah yang diperolehi: (30)

The total marks obtained

C. Pembangunan Kemahiran dan Kecekapan

Skills and Competencies Development
Lebih daripada 3 kemahiran dan kecekapan dibangunkan daripada program (6 markah)
✔ 3 or more skills and competencies were developed from the program (6 marks)

Hanya 2 kemahiran dan kecekapan dibangunkan daripada program (4 markah)

Only 2 skills and competencies were developed from the program (4 marks)
Hanya 1 kemahiran dan kecekapan dibangunkan daripada program (2 markah)
Only 1 skill and competency was developed from the program (2 marks)
Tiada kemahiran dan kecekapan dibangunkan daripada program (0 markah)
There were no skills and competencies developed from the program (0 marks)

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D. Sumbangan
Contribution
Terdapat 2 sumbangan langsung/tidak langsung dikenalpasti daripada program (4 markah)
✔ There were 2 direct/indirect contribution were identified from the program (4 marks)

Hanya 1 sumbangan langsung/tidak langsung dikenalpasti daripada program (2 markah)

Only 1 direct/indirect contribution was identified from the program (2 marks)

Tiada sumbangan langsung/tidak langsung dikenalpasti daripada program (0 markah)

No direct/indirect contribution were identified from the program (0 marks)

E. Pencapaian Hasil Kursus

Course Outcome Achievement

✔ Semua hasil kursus dapat dicapai (5 markah)

All of the course outcomes were achieved (5 marks)
Tiada hasil kursus yang dapat dicapai (0 markah)
No course outcomes were achieved (0 marks)

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(E) PENGESAHAN PELAJAR

STUDENT VERIFICATION

Saya dengan ini mengesahkan bahawa maklumat yang diberikan adalah benar dan markah penilaian
kendiri adalah refleksi sebenar kerja saya.

I hereby confirm that all the information provided is true and the self-evaluation marks are a reflection of my
work.

……………Haziq Zulasri…………. …………………………………..

Tandatangan pelajar
Tandatangan Penasihat
(Student’s signature)
(Advisor’s signature)

Nama Nama
: Ahmad Haziq bin Mohd Zulasri : Dr. Nurul Shamsinah binti Mohd Suhaimi
Name Name
Tarikh Tarikh
: 26/1/2023 : 26/1/2023
Date Date

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Ahmad Haziq Mohd Zulasri_RR_Group A
ORIGINALITY REPORT

25 %
SIMILARITY INDEX
25%
INTERNET SOURCES
1%
PUBLICATIONS
24%
STUDENT PAPERS

PRIMARY SOURCES

1
Submitted to University of Malaya
Student Paper 24%
2
etheses.dur.ac.uk
Internet Source 1%

Exclude quotes On Exclude matches < 1%

Exclude bibliography On