Battling With Child Health and Nutrition in Southeast Asia

Economic development and global transitions have brought about not only changes in health patterns but also nutritional changes of the population. Despite all these economic progresses, in some developing countries in the Asia Pacific region, the double burden of malnutrition and undernutrition and overweight exists, and this has serious implications on the health and nutritional status of children where millions are affected, leading to nutrition-related noncommunicable diseases. In the World Health Organization Western Pacific region, there are 187 000 preventable under-5 deaths in the Western Pacific region due to undernutrition (wasting, stunting, micronutrient deficiencies, and low birth weight). About 12 million children are stunted, and more than 6.5 million children under 5 are overweight, a number that keeps growing.1 One of the largest multicenter nutrition and health study in Southeast Asia is the Southeast Asian Nutrition Survey (SEANUTS) conducted in Indonesia (n = 7211), Malaysia (n = 3542), Thailand (n = 3119) and Vietnam (n = 2672). This study investigated anthropometry, dietary intake, food habits, bone density, nutritional status, physical activity, mental development and cognition, and blood biochemical parameters of 16 744 children ages 6 months to 12 years, using a randomized multistage cluster sampling. The children were nationally representative per age group and residence in each country. This study was commissioned by a multinational food company, Royal FrieslandCampina, to gain better insights into dietary imbalances that result in overnutrition or undernutrition of children.2 This supplement issue, sponsored by Universiti Kebangsaan Malaysia, consists mostly of SEANUTS Malaysia studies. The SEANUTS Malaysia survey was carried out in year 2011.3 The results show that overnutrition is more prevalent than undernutrition in Malaysian children. There was a higher prevalence of overweight (9.8%) and obesity (11.8%), compared to thinness (5.4%) and stunting (8.4%) among these children. Similarly, in the Malaysian National Health and Morbidity Survey 2015, the highest prevalence of obesity was found among children aged 5 to 9 years (14.8%), followed by children aged 10 to 14 years (14.4%).4 Unhealthy eating behaviors also contributed toward overweight and obesity in Malaysian children.5 The SEANUTS Malaysia also found that almost half of the children (47.5%) had vitamin D deficiency. Dietary intake of these children was not compatible with the recommendations: with more than one third not achieving the Malaysian Recommended Nutrients Intakes for energy, calcium, and vitamin D.3 Furthermore, it was found that food consumption of Malaysian children aged 7 to 12 years did not meet the Malaysian Dietary Guidelines for Children and Adolescents 2013 recommendations, except for meat/poultry.6 Physical activity among primary school children was also shown to be low, with approximately 12% of children (10% boys, 14% girls) reporting that they either did not have or