Poor nutrition puts Malaysian children's long-term health at risk

KUALA LUMPUR: Many children in Malaysia are facing "hidden hunger", a form of malnutrition in which they may not appear underweight or stunted, or show signs of inadequate food intake, but are still lacking essential nutrients.

The problem occurs when children consume enough food in terms of quantity, but their daily diets fail to provide the nutrients needed for physical growth, cognitive development, immunity and long-term health.

Experts warn that if left unaddressed, this could have lasting effects on children's physical and cognitive development, as well as their health into adulthood.

More concerning is that malnutrition can coexist with overweight and obesity, creating a more complex public health challenge.

Several studies reviewed by Berita Harian found that failure to address nutritional issues from an early age could affect not only children's growth and health, but also their quality of life and ability to reach their full potential.

The findings of the second South-East Asian Nutrition Surveys (SEANUTS II) Malaysia showed that 94.8 per cent of children had inadequate vitamin D intake, while 79.4 per cent did not meet the recommended calcium intake.

The survey, conducted every eight to 10 years, was last carried out in 2019 and 2020 under SEANUTS II.

More worryingly, 40.3 per cent of children below the age of four were found to be anaemic, indicating that nutritional deficiencies can occur even among children who do not appear underweight or underfed.

The research sampled 2,989 children aged 0.5 to 12.9 years, representing roughly 4.9 million children in that age group across Peninsular Malaysia.

It also found that Malaysian children face a "triple burden of malnutrition", where stunting, wasting, overweight and obesity occur within the same child population.

The survey recorded 8.9 per cent of children experiencing stunting, 6.7 per cent wasting, 9.2 per cent overweight, and 8.8 per cent obesity.

SEANUTS II Malaysia principal investigator and Universiti Kebangsaan Malaysia (UKM) Faculty of Health Sciences lecturer Professor Dr Poh Bee Koon said the findings showed that weight and body size alone were no longer sufficient indicators of children's nutritional status.

She said greater attention must also be given to diet quality and adequate micronutrient intake.

More concerning, she said, nutritional challenges did not end as children grew older but could persist into adolescence.

The 2022 National Health and Morbidity Survey (NHMS) found that 30.5 per cent of Malaysian adolescents aged between 13 and 17 were overweight or obese, while 8.3 per cent were underweight and 6.8 per cent stunted.

At the same time, 83.9 per cent of adolescents did not consume sufficient fruits and vegetables, while 32.4 per cent drank carbonated beverages at least once a day.

Poh said childhood nutritional challenges have grown more complex because children can look normal or carry excess weight while subsisting on low-quality diets lacking essential nutrients.

"This means the question of children's nutrition is no longer simply whether they have enough food, but also what they eat, the nutrients it contains and their daily lifestyle habits.

"Children may appear to have a normal weight or be overweight, but still have poor diet quality or insufficient intake of essential nutrients.

"Meal timings are also an important consideration, particularly among primary schoolchildren," she said.

She said SEANUTS II analysis found that 36 per cent of primary schoolchildren skipped breakfast at least once a week.

The habit was associated with lower energy and nutrient intake, including cereals, vegetables, milk and dairy products.

Poh said this showed that children's nutritional problems were not solely related to the amount of food they consumed, but also to diet quality and regular meal patterns.

"When breakfast is skipped, some of the nutrients that should be obtained early in the day may not be fully replaced during the following meals," she said.

She said children's nutrition should also be considered alongside other factors, including physical activity, sedentary lifestyles, screen time and sleep, all of which were interconnected in shaping their overall health.