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Study: Children In Southeast Asia Suffer From Malnutrition

The nutritional status of Malaysian children appears to be worsening, with increases in underweight prevalence, stunting, and obesity, says Dr Poh Bee Koon.

Photo by Andrzej Rembowski from Pixabay .

KUALA LUMPUR, August 9 – The results of the second South East Asian Nutrition Surveys (SEANUTS II), which was released in June, highlighted the triple burden of malnutrition: the coexistence of undernutrition, micronutrient deficiencies, and overweight/obesity.

The study, involving nearly 14,000 children aged 6 months to 12 years, was commissioned by dairy company, FrieslandCampina. The study was conducted between 2019 and 2021 by leading universities and research institutes in Indonesia, Malaysia, Thailand, and Vietnam.

This new study follows the South East Asian Nutrition Surveys (SEANUTS I), which were presented in 2012. Overall, this second study (SEANUTS II) shows that stunting and anaemia still exist, especially in younger children.

However, for older children, there is a higher overweight prevalence and rate of obesity. Additionally, most of the children do not meet the average needs of calcium and vitamin D intake, and show vitamin D deficiencies.

According to the study, this ‘triple burden’ makes it a matter of great importance to fill nutritional gaps with proper nutrition interventions and educational programmes.

“Healthy nutrition is about balance, moderation and variety. If children don’t get the nutrition they need, they won’t grow and develop properly,” said Dr Poh Bee Koon, principal investigator for SEANUTS II in Malaysia and Professor of Nutrition at Universiti Kebangsaan Malaysia’s Faculty of Health Sciences.

“Our new study revealed that more than 70 per cent of the children in all four countries did not meet the average needs for calcium and more than 84 per cent did not meet the average vitamin D requirements.

“These numbers emphasise an urgent need to improve food security, as well as the availability of food products that meet the children’s needs, thus increasing access to healthy nutrition.”

Worsening Nutritional Status Of Malaysian Children

In Malaysia, the nutritional status of children appears to be worsening, she told Ova. “Based on the National Health and Morbidity Survey data from 2011, 2015 and 2019, we can see an increasing prevalence of underweight at 11.6 per cent, 12.4 per cent and 14.1 per cent respectively,” she said.

“For stunting, the increase in prevalence is from 16.6 per cent to 17.7 per cent and 21.8 per cent respectively, in children aged below 5 years.

“In older children (5 to 17 years old), prevalence of obesity has gone up from 6.1 per cent to 11.9 per cent to 14.8 per cent in those same years.”

Dr Poh said SEANUTS II data also shows some increase of prevalence in thinness, underweight and wasting, in comparison to a decade ago.

SEANUTS II was conducted during the height of the pandemic, which also allowed for the opportunity to evaluate the impact of Covid-19 on lifestyles behaviours of the children and families involved in the survey.

Almost 10,000 children between six months to 12.9 years were involved in the Covid-19 sub-study. Data collection for Malaysia was done via an online survey, which was carried out during the lockdown period.

During the Covid-19 lockdown, a shift was seen as fewer parents or guardians worked from the office and more of them worked from home. This trend was most prominent in Malaysia for both female and male parents or guardians.  

Across all countries, there was also an increase in the proportion of parents not working either due to loss of job or retirement. As a result, 44 per cent of households reported a reduction in household income, which in turn led to a decrease in food expenditure.

Malaysia Increased Food Expenditure By 54% During Lockdown

However, Malaysia was the exception as the study indicated that the country had a 54 per cent increase in food expenditure.

“During the movement control order in Malaysia, only one family member was allowed to go grocery shopping. So, Malaysian families were more likely to stock up their groceries, eventually, increasing their food expenditure,” Dr Poh told Ova.

“Besides, being alert to the Covid-19 situation in Malaysia, parents might choose healthier foods such as fruits and vegetables, and food with longer shelf-life like instant noodles,” she said, adding that the increase could also be attributed to larger household sizes due to family members returning home to observe the lockdown and because educational institutions that provide boarding had to remain close.

Dr Poh said that comparison of food habits before and during the Covid-19 pandemic showed a significant improvement in the diet quality of Malaysian children during lockdown with increased consumption of vegetables, fruits and bread, and less intake of sweetened beverages and confectionery.

This change in food habits is likely to be influenced by the physical presence of parents working from home.

Decrease In Dairy Intake During Lockdown

However, according to the study, a couple of concerning patterns emerged. One is the increase (from 22 per cent to 35 per cent) of children eating instant noodles at least once a week, although fewer children ate fast or outside food during the lockdown.

Another was the reduced intake of milk and other dairy products by the children during the lockdown.

“The price of milk and dairy products might be a top concern of Malaysian families. Especially during the Covid lockdown when many families have financial constraints, milk and dairy products consumption might be reduced, particularly among those with lower household income,” Dr Poh told Ova

“Due to school closure during lockdown, children enrolled in the school milk programme were not able to get their regular milk supply from school,” she said, citing another reason for the reduced intake of dairy products.

“Milk and dairy products are good sources of animal protein, amino acids, and provide bone-fortifying nutrients (e.g. calcium, vitamin D, phosphorus). Hence, it is an important component of a child’s diet to ensure children attain their growth and developmental potential.”

She said that she hoped that the findings from SEANUTS II will help inform the planning and implementation of policies, programmes and strategies to improve the nutritional status and dietary intake of Malaysian children.

“Besides, SEANUTS II results might also alert our local nutritionists and dietitians on the malnutrition issues in Malaysian children,” Dr Poh told Ova.

“The food industry might also benefit from the SEANUTS findings, and work on improving the nutrient profile of their product formulation to cater to the needs of our children.”

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