Malnutrition among Malaysian Adolescents: Findings from National Health and Morbidity Survey (NHMS) 2011
Keywords:
Obesity - Thinness - Adolescents - CDC2000 - Malaysia.Abstract
Introduction
Malnutrition can be associated as one of the factors which affect health status. The term is used to describe imbalance of nutrients either over- or under-nourished, resulting in measurable adverse effects on body composition, function and clinical outcome.
Methods
The National Health And Morbidity Survey (NHMS) 2011 assessed 4304 individuals aged 10-17 years old through a household survey of Malaysian population. Thinness and obesity are the malnutrition indicators based on Centre for Disease Control (CDC) 2000 classification as recommended by WHO (2007).
Results
The findings of the survey showed that the national prevalence of thinness (BMI for age <-2SD), was 9.7% (95% Confidence Interval: 8.4-11.2). The state of Sabah/Labuan had the highest thinness of prevalence, 17.0% (11.1-25.2) and lowest in Penang at 5.3% (2.7-10.0). The prevalence of thinness was higher in urban areas than in rural areas at 10.3% (8.5-12.3). Meanwhile; national prevalence of obesity (BMI for age ≥+2SD) was only 5.7% (4.9-6.7). The state of Perak had the highest obesity prevalence 10.0% (6.2-15.8) and lowest in Sabah/Labuan at 2.4% (1.4-4.1). The obesity prevalence was higher among adolescents in urban areas at 6.3% (5.2-7.6) than in rural areas.
Conclusions
Thinness as a form of malnutrition is more prevalent than obesity. Even though the prevalence of obesity is low, the impact affects not only the adolescents, but also the family, the society and the nation in the future. The increasing prevalence of obesity will have significant public health implication related to non-communicable diseases.
Â
References
World Health Organization [WHO]. 2008 Adolescent nutrition: a neglected dimension. from www.who.int/entity/child_adolescent_health/en/
Judith MM. Meijers, Ruud JG. Halfens, Marian AE. van Bokhorst-de van der Schueren, Theo Dassen, & Jos M.G.A. Schols. Malnutrition in Dutch healthcare: Prevalence, prevention, treatment, and quality indicators, Nutrition. 2008; 25 (5): 512–519.
Popkin BM. The nutrition transition in the developing world, Development Policy Review. 2003; 21: 581–597.
Popkin BM, Du S. 2003. Dynamics of the nutrition transition toward the animal foods sector in China and its implications: a worried perspective, Journal of Nutrition. 2003; 133: 3898S–3906.
Jitnarin N, Kosulwat V, Rojroongwasinkul N, Boonpraderm A, Haddock CK, Poston WS. Prevalence of overweight and obesity in Thai population: results of the National Thai Food Consumption Survey. National Development and Research Institutes, Public Health Solutions of NYC, New York; 2011.
Institute for Public Health [IPH] 2008. Nutritional status. In: The Third National Health and Morbidity Survey 2006 (NHMS III). National Institutes of Health, Ministry of Health Malaysia; 2008. P. 5-6.
Tan AK, Dunn RA, et al. Sociodemographic and health-lifestyle determinants of obesity risks in Malaysia. Asia Pac J Public Health. 2011; 23 (2): 192-202.
Misra M, Aggarwal A, Miller KK, Almazan C, Worley M, & Soyka LA. Effects of anorexia nervosa on clinical, hematologic, biochemical, and bone density parameters in community-dwelling adolescent girls. Pediatrics. 2004; 114:1574-83.
Villa I, Yngve A, Poortvliet E, Grjibovski A, Liiv K, & Sjostrom M. 2007. Dietary intake among under-, normal- and overweight 9- and 15-year-old Estonian and Swedish schoolchildren. Public Health Nutrition. 2007; 10: 311-22.
World Health Organization [WHO]. A Global Strategy on Diet, Physical Activity and Health. WHO, Geneva; 2004.
World Health Organization [WHO]. Growth reference 5-19 years, BMI-for-age 5-19 years (z-scores); 2007.
Jonathan CK. Wells Akanksha A. Marphatia, Tim J. Cole, & David McCoy. Associations of economic and gender inequality with global obesity prevalence: Understanding the female excess. Social Science & Medicine. 2012; 75: 482-490.
GR Lekhraj Rampal, Sherina Mohd Sidik, Sanjay Rampal, & Daniel Wong Yi Jie. 2009. Prevalence of Overweight among Secondary School Students in Klang District, Selangor, Malaysian Journal Nutrition. 2009; 1(8): 362–367.
MS Zalilah, K Mirnalini, GL Khor, A Merlin, AS Bahaman & K Norimah. 2006. Estimates and Distribution of Body Mass Index in a Sample of Malaysian Adolescents. Med J Malaysia. 2006; 61(1):49-58.
Institute for Public Health (IPH) 2011a National Health And Morbidity Survey 2011, Volume I: Methodology and General Findings, Institut Kesihatan Umum, Kementerian Kesihatan Malaysia; 2011.
Institute for Public Health (IPH) 2011b National Health and Morbidity Survey 2011, Volume II: Non-Communicable Diseases, Institut Kesihatan Umum, Kementerian Kesihatan Malaysia; 2011.
Rancangan Malaysia Kesepuluh (2011-2015), Unit Perancangan Ekonomi, Jabatan Perdana Menteri, Putrajaya; 2010.
Foong Ming Moy, Chong Ying Gan, & Siti Zaleha Mohd Kassim. Body mass status of school children and adolescents in Kuala Lumpur, Malaysia. Asia Pacific Journal of Clinical Nutrition. 2004; 13(4): 324-329.
Al-Mekhlafi MH, Surin J, Atiya AS, Ariffin WA, Mahdy AK & Abdullah HC. Anaemia and iron deficiency anaemia among aboriginal schoolchildren in rural Peninsular Malaysia: an update on a continuing problem. Trans Royal Soc Trop Med Hyg. 2008; 102: 1046–1052.
Anuar Zaini MZ, Lim CT, Low WY, Harun F. Factors affecting Nutritional Status of Malaysian Primary School Children. Asia Pac J Public Health. 2005; 17(2): 71-80.
Zalilah MS, Bond JT & Johnson NE 2000. Nutritional status of primary school children from low income households in Kuala Lumpur. Malaysia J Nutri. 2000; 6:17-32.
Khor GL, Zalilah MS, Phan YY, Maznah B & Norimah AK. Perception of body image among Malaysian male and female adolescents. Singapore Med J. 2009; 50 (3): 303.
Abdallah A, Magne T, Yehia A, Gerd HO. Overweight, stunting and anemia are public health problems among low socio economic groups in school adolescents (12-15 years) in the North Gaza Strip. Nutrition Research. 2007; 27:762-771.
Marie T. Ruel & James L. Garret. 2004. Features of urban food and nutrition security and considerations for successful urban programming. Electronic Journal of Agricultural and Development Economics. 2004; 1(2): 242-271.
SP Reddy, K Resnicow, S James, N Kambaran, R Omardien and AD MBewu. Underweight, overweight and obesity among South African adolescents: results of the 2002 National Youth Risk Behaviour Survey. Public Health Nutrition. 2008; 12(2): 203–207.
Charles Daboné, Hélène F Delisle and Olivier Receveur. Poor nutritional status of schoolchildren in urban and peri-urban areas of Ouagadougou (Burkina Faso). Nutrition Journal. 2011; 10:34.
Idowu O. Senbanjo, Kazeem A. Oshikoya, Olumuyiwa O. Odusanya and Olisamedua F. Njokanma. Prevalence of and risk factors for stunting among school children and adolescents in Abeokuta, Southwest Nigeria. J Health Popul Nutr. 2011; 29(4): 364-370.
Maibam Samson Singh and R. K. Neeta Devi. Nutritional Status among the Urban Meitei Children and Adolescents of Manipur, Northeast India. Journal of Anthropology. 2013; Article ID 983845, 1-5.
Zalilah MS, Khor GL, Mirnalini K, Norimah AK and Ang M. Dietary intake, physical activity and energy expenditure of Malaysian adolescents. Singapore Med J. 2006; 47(6): 491.
Işıl Özgüven, Betül Ersoy, Ali Aykan Özgüven and Pınar Dündar Erbay. Evaluation of nutritional status in Turkish adolescents as related to gender and socioeconomic status. J Clin Res Ped Endo. 2010; 2(3): 111-116.
Anuradha Dutta, Kiran Pant, Rekha Puthia and Archana Sah. Prevalence of undernutrition among children in the Garhwal Himalayas. Food and Nutrition Bulletin. 2009; 30(1): 77-81.
GR Lekhraj Rampal, Sherina Mohd Sidik, Sanjay Rampal, Daniel Wong Yi Jie, Chow Poh Lee, Liew Jer Shya & Shum Yong Shun. Prevalence of Overweight among Secondary School Students in Klang District, Selangor. Mal J Nutr. 2007; 13(1): 1-8.
Mohd Nasir MT and Dan SP. Prevalence of overweight and obesity among male adolescents in Kuantan, Pahang. Malaysian Journal of Nutrition. 2005; 11 (1): S27-S27.
Mohd Nasir MT and Chin YS. Prevalence of overweight and obesity among female adolescents in Kuantan, Pahang. Malaysian Journal of Nutrition. 2005; 11 (1):S27-S27.
D Samani-Radia and HD McCarthy. Comparison of children’s body fatness between two contrasting income groups: contribution of height difference. International Journal of Obesity. 2011; 35:128–133.
