Malaysian Urban Nutrition

1. Urban Nutrition

2. The accelerated phase of industrialization and urbanization in recent
decades has inevitably brought about changes in the lifestyle of
Malaysians. Changes in dietary habits and sedentary lifestyles are
known to be associated with changes in health and increased
prevalence of chronic diseases in the population.
Quoted from the discussion of:

3. Changes In Food Consumption
& Mealtime In Urban Population

4. Food Supply & Dietary Pattern
• Fundamental changes in food supply patterns emerged in recent decades.
• These changes have led to not only increasing amounts of food available but also to changes in the
composition of the diet.
• Malaysia typifies a rapid developing country, which has undergone major demographic and
socioeconomic changes since attaining independence in 1957.

6. • Families who ate out the most were the
ones who were more likely to be obese.
In Brazil, however, a national survey of
urban residents between 2002 and
2003 showed that eating out is
positively associated with
overweight/obesity (Bezerra and
Sichieri 2009)
• In Malaysia, however, obesity tends to
occur among those with lower
education levels, particularly among
women, and among those who reside
in urban areas (Rampal et al. 2007).
• Studies indicate that income is linked to
the frequency of dining out; and the
risk for obesity appears to occur
among females, Indians, and
Malays.(Ishida et al. 2003; Khambalia
and Seen 2010)

7. 1
3
2
4

10. Prevalence Of Obesity In
Urban & Rural

11. The present study revealed that
in an urban setting, obesity was more
prevalent in both males (29%) and females
(26%) as compared to Chronic Energy Deficiency
(CED), % and 0.2%,
respectively.
Similar trends were observed
in the rural areas where obesity incidence
were higher in both males (15%) and
females (20%) as compared to CED, 11%
and 14%, respectively

14. The Result

15. Factors That Influences This Unhealthy Trend

16. Nutrition Plan

17. Malaysian
Food Pyramid

19. Number of servings recommended based on calorie needed
Table 1: Distribution of Number of Servings According to Food Groups Based on Calorie Value
Food group 1500
kcal/day
1
2000
kcal/day
2
2500
kcal/day
3
Cereals and
grains
4 servings 6 servings 8 servings
Fruits 2 servings 2 servings 2 servings
Vegetables 3 servings 3 servings 3 servings
Meat/poultry
Fish
Legumes
½ serving
1 serving
½ serving
1 serving
1 serving
1 serving
2 servings
1 serving
1 serving
Milk and dairy
products
1 serving 2 servings 3 servings
1 Suitable for sedentary women and
older adult.
2 Suitable for children, teenage girls,
moderately active women and
sedentary men.
3 Suitable for teenage boys, active
men, very active women and
underweight men and women.
Reference
Ministry of Health (2010). Malaysian Dietary
Guidelines. Nutrition Division, Ministry of Health
Malaysia, Putrajaya.

20. Carbohydrates Proteins Fats
The healthiest sources of
carbohydrates—unprocessed or
minimally processed
-Unhealthier sources of
carbohydrates may contribute to
weight gain, interfere with weight
loss, and promote diabetes and
heart disease.
The Institute of Medicine
recommends that adults get a
minimum of 0.8 grams of protein for
every kilogram of body weight per
day
Contrary to past dietary advice
promoting low-fat diets, newer
research shows that healthy fats are
necessary and beneficial for health.
Whole grains offer a complete
package of health benefit.
It contains bran and fiber that may
slow down the breakdown of starch
into glucose.
Animal sources of protein may
deliver all the amino acids needed
by the body as compared to other
protein sources.
Choose foods with “good”
unsaturated fats
-Vegetable oils, nuts, fish and seeds
Limit foods high in saturated fat,
and avoid “bad” trans fat.

21. Vitamins Minerals
•Vitamin A
•Vitamin B1,2,3,5,6,7,9,12
•Vitamin C
•Vitamin D
•Vitamin E
•Vitamin K
• potassium
•Chloride
•Sodium
•Calcium
•Phosphorus
•Magnesium
•Zinc
•Iron
•Manganese
•Copper
•Iodine

22. Basal Metabolic Rate
A measure of the rate of metabolism
Rate of energy expenditure by human at rest
 Burning up to 70% of the total calories
 Is used to keep body temperature normal, power the heartbeat,
breathing and other organ functions.
Calculating BMR (Harris-Benedict equation)
For Men: (13.75 x w) + (5 x h) – (6.76 x a) + 66
For Women: (9.56 x w) + (1.85 x h) – (4.68 x a) + 655

23. Genetics
some people are
born with faster
metabolisms and
some with slower
metabolisms
Age
BMR decreases
with age,
dropping 2% per
decade after the
age of 20 years
Gender
men have greater
muscle mass and a
lower body fat
percentage, resulting in
a higher basal
metabolic rate than
women
Weight
the heavier the
weight, the
higher the BMR
Body surface
area
tall, thin people
have higher
BMR compared
to a shorter
person with the
same weight
Factors affecting BMR
Diet
restrictive low-
calorie weight loss
diets may cause
your BMR to drop as
much as 20%
Body temperature
for every increase of 0.5 ºC in
internal temperature of the
body, BMR increases by 7%)
Ext. Temperature
exposure to cold
temperature causes an
increase in the BMR, as will
prolonged exposure to heat)
Exercise
physical exercise
helps raise BMR
by building extra
lean tissue)

24. Calories
• Basic unit of energy found in all foods.
• Necessary to maintain the body’s vital functions or metabolic rate.
• The amount of calories a person needs depends on factors like their age, gender,
and lean muscle mass.
Too many calories causes a person to become overweight and obese,
increasing their chances of heart disease, type II
diabetes, and cancer
Few calories causes a person to become underweight (per the
BMI) leading to muscle atrophy, weakened
immunity, and eventually, organ failure

25. Estimate Caloric Needs
Step 1 : calculate BMR
Step 2 :
Step 3 : step 1 + step 2
1. If you are sedentary : BMR x 20 percent
2. If you are lightly active: BMR x 30 percent
3. If you are moderately active (You exercise most days a week.): BMR x 40 percent
4. If you are very active (You exercise intensely on a daily basis or for prolonged periods.): BMR x
50 percent
5. If you are extra active (You do hard labor or are in athletic training.): BMR x 60 percent
The result of this formula will be the number of calories you can eat every day and maintain
your current weight. In order to lose weight, you'll need to take in fewer calories than this
result.

26. Food act and regulation to protect nutrition
in the population

27. Malaysian Food Act 1983 and Food regulation 1985
• There are 10 parts in the act include: Preliminary (I); Warranty (II); Procedure for
taking samples (III); Labelling (IV); Food Additive and nutrient supplement (V);
Packages for food (VI); Incidental constituent (VII); Standards and particular
labelling requirements (VIII); Use of water, ice and steam (IX) and Miscellaneous
(X).
• In part (VIII), it states that nutrition labelling compulsory for certain foods to
provide information about nutritional content of the product.
• The nutrients that must be declared on nutrition label are energy, protein,
carbohydrate and fat. In addition, total sugars must also be declared for ready-
to-drink beverages. In these regulations, ready-to-drink beverages include ready-
to-drink soft drink, fruit and vegetable juices, ready-to-drink malted milk and
flavoured milk.

28. Nutrition Labelling
• The nutrients that must be declared on nutrition label are energy, protein,
carbohydrate and fat. In addition, total sugars must also be declared for ready-to-
drink beverages. In these regulations, ready-to-drink beverages include ready-to-
drink soft drink, fruit and vegetable juices, ready-to-drink malted milk and flavoured
milk.

29. Claims in Food Labels

30. National Plan of Action for Nutrition (NPAN II) of Malaysia (2006-
2015)
• Promoting healthy eating and active living and ensuring that
everyone has access to nutrition information.
• Strategies and activities to overcome undernutrition and over
nutrition

31. Malaysian Dietary Guidelines 2010
• Key Message 1: Eat a variety of foods within your recommended intake
• Key Message 2: Maintain body weight in a healthy range
• Key Message 3: Be physically active everyday
• Key Message 4: Eat adequate amount of rice, other cereal products (preferably whole grain)
and tubers
• Key Message 5: Eat plenty of fruits and vegetables everyday
• Key Message 6: Consume moderate amounts of fish, meat, poultry, egg, legumes and nuts
• Key Message 7: Consume adequate amounts of milk and milk products
• Key Message 8: Limit intake of foods high in fats and minimise fats and oils in food
preparation
• Key Message 9: Choose and prepare foods with less salt and sauces
• Key Message 10: Consume foods and beverages low in sugar
• Key Message 11: Drink plenty of water daily
• Key Message 12: Practise exclusive breastfeeding from birth until six months and continue
to breastfeed until two years of age
• Key Message 13: Consume safe and clean foods and beverages
• Key Message 14: Make effective use of nutrition information on food labels

32. Nutritional problems
• Unhealthy dietary practices and lack of physical activity could be the
contributing factors for overweight and obesity in the Malaysian
population. There is an overall increasing trend of obesity among adults
in Malaysia, affecting nearly half of adult population.

33. • Another key nutritional issue is anemia, which also is high,
particularly in pregnant women.

34. Nutritional programs in Malaysia
• Ministry of Health through its Division of Family Health Development
implements several nutrition intervention programs and activities as follows:
• Supplementary Feeding Programs:
1) MOH provided full cream milk powder to undernourished children under 7
years of age, pregnant and lactating mothers.
2) Ministry of Education provides subsidized milk and free meals to primary
school children from poor families.
3) The Ministry of Rural development through its KEMAS programs provide meals
for preschool children, and food assistance to poor families.

35. • Multiple Nutrient Supplementation.
The Ministry of Health distributes iron, folic acids, vitamin C and B
complex to pregnant women during their antenatal check-ups.
• Nutrition Rehabilitation Program.
Moderately and severely malnourished childen under 7 years of age
are given food aid comprising essential items such as rice, anchovies,
biscuits, milk powder, cooking oil, sugar and green gram worth RM 60
every month.

36. • Iodine Deficiency disorder Control program.
Several approaches were used towards the effective control of
iodine deficiency disorder (IDD) in Sabah, Sarawak and Peninsula
Malaysia:
1) Legislation requiring that all salt sold in IDD gazetted areas be
iodized.
2) Free distribution of iodized slat by government clinics.
3) Use of iodinators to iodized water supplied by gravity-freed system
to villages and boarding schools in rural areas