Food and Food and Nutrition Nutrition Situation Situation

in Malaysiain MalaysiaAssoc. Prof. Dr Rokiah Mohd YusofAssoc. Prof. Dr Rokiah Mohd Yusof

Department of Nutrition and Department of Nutrition and DieteticsDietetics

Faculty of Medicine and Health Faculty of Medicine and Health SciencesSciences

Universiti Putra MalaysiaUniversiti Putra Malaysia

43400 UPM Serdang, 43400 UPM Serdang,

Selangor, MalaysiaSelangor, Malaysia

Topics Present Topics Present

IntroductionIntroduction Nutritional StatusNutritional Status Food supply and Food supply and

Dietary PatternDietary Pattern Diet Related Diet Related

Chronic Diseases Chronic Diseases Intervention Intervention

Activities for Activities for Promoting Healthy Promoting Healthy NutritionNutrition

IntroductionIntroduction Increasingly more developing Increasingly more developing

countries world wide are undergoing countries world wide are undergoing nutritional changes, which are nutritional changes, which are characterized by manifestation of both characterized by manifestation of both under and over nutrition.under and over nutrition.

While macronutrient and micronutrient While macronutrient and micronutrient deficiencies persist resulting in poor deficiencies persist resulting in poor nutritional status and morbidity, the nutritional status and morbidity, the prevalence of overweight and obesity prevalence of overweight and obesity has been on the rise, in urban and has been on the rise, in urban and rural areas in many countries.rural areas in many countries.

Malaysia typifies a rapid developing Malaysia typifies a rapid developing country, which has undergone major country, which has undergone major demographic and socioeconomic demographic and socioeconomic changes since attaining independence changes since attaining independence in 1957.in 1957.

Fertility rates have declined from 6.94 Fertility rates have declined from 6.94 in 1955 to 2.94 in 2005in 1955 to 2.94 in 2005

Life expectancy at birth has increased Life expectancy at birth has increased from 48.5 (1955) to 73.1 years (2005)from 48.5 (1955) to 73.1 years (2005)

Urbanization growth rate at 3% in recent years Urbanization growth rate at 3% in recent years resulted in 62% of the present population, resulted in 62% of the present population, which estimated as 25.35 millions in 2005, which estimated as 25.35 millions in 2005, living in urban areas.living in urban areas.

The country also experienced epidemiological The country also experienced epidemiological transition shifts from a situation with transition shifts from a situation with predominance of infectious disease to one predominance of infectious disease to one distinguished by growing prevalence of chronic distinguished by growing prevalence of chronic and degenerative diseaseand degenerative disease

In recent years, coronary heart disease, In recent years, coronary heart disease, cancers and stroke constitute the leading cancers and stroke constitute the leading causes of mortality, accounting to more than causes of mortality, accounting to more than 40% of total death.40% of total death.

Nutritional StatusNutritional Status

Prior to the 1960s, severe forms of protein Prior to the 1960s, severe forms of protein energy malnutrition, anemia and vitamin A energy malnutrition, anemia and vitamin A deficiency were widespread especially in deficiency were widespread especially in children and women from poor rural areas children and women from poor rural areas (Viswalingam, 1928; Reed, 1940; IMR, 1957; (Viswalingam, 1928; Reed, 1940; IMR, 1957; Thomson, 1960).Thomson, 1960).

Since the 1980s, only mild to moderate forms Since the 1980s, only mild to moderate forms of protein-energy malnutrition was found in of protein-energy malnutrition was found in children, manifested as under weight (too children, manifested as under weight (too thin for age), stunting (too short for age) and thin for age), stunting (too short for age) and wasting (too thin for height).wasting (too thin for height).

Such growth deficits are more common in poor Such growth deficits are more common in poor households and interior communities that have households and interior communities that have low access to adequate and nutritious food and low access to adequate and nutritious food and health facilities.health facilities.

The prevalence of underweight and stunting in The prevalence of underweight and stunting in poor community has been on the decline in poor community has been on the decline in recent years.recent years.

In agriculture communities, such in rice In agriculture communities, such in rice growing areas, estates, rubber and coconut growing areas, estates, rubber and coconut smallholdings, the prevalence of underweight smallholdings, the prevalence of underweight and stunting among children below 6 years old and stunting among children below 6 years old in the 1980s was 37% and 43% respectively in the 1980s was 37% and 43% respectively (Chong (Chong et alet al, 1984)., 1984).

In the 1990s, studies found lower In the 1990s, studies found lower underweight, and stunting ranging from underweight, and stunting ranging from 31-33% and 26-27% respectively (Khor 31-33% and 26-27% respectively (Khor and Tee, 1997)and Tee, 1997)

According to the Ministry of Health According to the Ministry of Health (MOH) and UNICEF survey nationwide (MOH) and UNICEF survey nationwide in 1998-2000 among children less than 6 in 1998-2000 among children less than 6 years, 19.2% were underweight (< -2SD years, 19.2% were underweight (< -2SD weight-for-age) and 16.7% stunted (< -weight-for-age) and 16.7% stunted (< -2SD height-for-age)2SD height-for-age)

Based on surveillance data of MOH, Based on surveillance data of MOH, the overall prevalence of the overall prevalence of underweight among children aged underweight among children aged below 5 years was 17.3% in 2004 below 5 years was 17.3% in 2004 compared to 25% in 1990.compared to 25% in 1990.

The prevalence of overweight in The prevalence of overweight in children is much lower than the children is much lower than the adults.adults.

The 1998-2000 MOH/UNICEF Survey The 1998-2000 MOH/UNICEF Survey recorded 2.9% male and 2.2% female recorded 2.9% male and 2.2% female children below 6 years as overweight , children below 6 years as overweight , with higher prevalence in metropolitan with higher prevalence in metropolitan (3%) and large urban areas (2.8%) (3%) and large urban areas (2.8%) than in rural areas (1.8%).than in rural areas (1.8%).

The MOH surveillance data showed The MOH surveillance data showed that in 2004, 4.1% of children aged 5 that in 2004, 4.1% of children aged 5 years were overweight.years were overweight.

Meanwhile in adults, the problem of Meanwhile in adults, the problem of underweight has also been reported in underweight has also been reported in urban and rural areas.urban and rural areas.

NHMS II (1996) determined the NHMS II (1996) determined the overall prevalence of underweight in overall prevalence of underweight in adults as 25.2%, while other studies on adults as 25.2%, while other studies on smaller numbers of subjects reported smaller numbers of subjects reported underweight rates for men and women underweight rates for men and women at 7% and 11% in urban, and 11% and at 7% and 11% in urban, and 11% and 14% in the rural areas, respectively.14% in the rural areas, respectively.

In relation to infant feeding, the overall In relation to infant feeding, the overall prevalence of ever breastfeeding remains high prevalence of ever breastfeeding remains high at 88.6% according to the Second National at 88.6% according to the Second National Health and Morbidity Survey (NHMS II) in Health and Morbidity Survey (NHMS II) in 1996, and compared to the Malaysian Family 1996, and compared to the Malaysian Family Life Survey (MFLS) prevalence of 85% in 1988.Life Survey (MFLS) prevalence of 85% in 1988.

However the duration of breastfeeding appears However the duration of breastfeeding appears to have declined from 6 months (MFLS) to 4.5 to have declined from 6 months (MFLS) to 4.5 months (NHMS II)months (NHMS II)

NHMS II also noted that the prevalence of NHMS II also noted that the prevalence of exclusive breastfeeding through the first 4-6 exclusive breastfeeding through the first 4-6 months was low at 29% and bottle-feeding was months was low at 29% and bottle-feeding was high at 86% among children aged below 2 high at 86% among children aged below 2 years.years.

While the country is still addressing While the country is still addressing under-nutrition problems, health under-nutrition problems, health problem associated with over problem associated with over nutrition have been on the rise in nutrition have been on the rise in recent decades.recent decades.

The NHMS II (1996) covering 28,737 The NHMS II (1996) covering 28,737 adults aged 20 and older, found that adults aged 20 and older, found that 20.1% and 21.4% of the men and 20.1% and 21.4% of the men and women are overweight (Lim, 2000)women are overweight (Lim, 2000)

The same survey also reported 4% of The same survey also reported 4% of the men and 7.6% of the women were the men and 7.6% of the women were obese (BMI exceeding 30kg/mobese (BMI exceeding 30kg/m22).).

Prior to the 1990s, overweight and Prior to the 1990s, overweight and obesity were more often reported obesity were more often reported among the urban adults and children among the urban adults and children only (Ismail et al, 1995; Bong and only (Ismail et al, 1995; Bong and Safurah, 1996) but this problem has Safurah, 1996) but this problem has caught up with the rural adults too. caught up with the rural adults too.

A survey of 4,595 adults from agriculture and A survey of 4,595 adults from agriculture and fishing communities found that 19.8% of the fishing communities found that 19.8% of the men and 28% of the women to be overweight, men and 28% of the women to be overweight, whilst another 4.2% and 11.1% of the men and whilst another 4.2% and 11.1% of the men and women respectively were obese (Khor women respectively were obese (Khor et al,et al, 1999).1999).

Obesity of the poor may be due to various Obesity of the poor may be due to various reasons including excess reliance on cheaper reasons including excess reliance on cheaper sources of energy, such as rice, flour, roots sources of energy, such as rice, flour, roots and tubers, increased sedentary lifestyles, and and tubers, increased sedentary lifestyles, and putting on excess weight during pregnancy.putting on excess weight during pregnancy.

Food supply and Dietary Food supply and Dietary patternpattern

Fundamental changes in food supply Fundamental changes in food supply patterns emerged in recent decades.patterns emerged in recent decades.

These changes have led to not only These changes have led to not only increasing amounts of food available increasing amounts of food available but also to changes in the but also to changes in the composition of the diet.composition of the diet.

Important changes in food consumption Important changes in food consumption between 1967 and 2000 are summarized between 1967 and 2000 are summarized below for energy and major foods:below for energy and major foods:

a) Total calories available for consumption a) Total calories available for consumption has increased by 21.3% over the past three has increased by 21.3% over the past three decades, from 2,407 calories to 2,919 decades, from 2,407 calories to 2,919 calories per person per daycalories per person per day

b) Percentage of energy from fat increased b) Percentage of energy from fat increased from 17.9% to 26.9 % with about 60% from from 17.9% to 26.9 % with about 60% from vegetables oil and 40% from animal vegetables oil and 40% from animal products.products.

c) The proportion of calories from c) The proportion of calories from cereals has declined from 57.1% of cereals has declined from 57.1% of the total calories to 43.6%.the total calories to 43.6%.

d) The proportion of calories from d) The proportion of calories from animal products increased from animal products increased from 11.2% of total calories to 19.4%11.2% of total calories to 19.4%

e) Poultry meat availability rose over e) Poultry meat availability rose over six fold from 5.7kg to 36.7kg per six fold from 5.7kg to 36.7kg per person per year.person per year.

f) Availability of eggs (hen) has almost tripled f) Availability of eggs (hen) has almost tripled from 5.0kg per person per year to 14.4 kg.from 5.0kg per person per year to 14.4 kg.

g) The amount of milk available per person g) The amount of milk available per person per year has risen from 28.9kg to 52.7kg.per year has risen from 28.9kg to 52.7kg.

h) Availability of fish and other seafood has h) Availability of fish and other seafood has doubled from 29.5kg to 57.9kg per person doubled from 29.5kg to 57.9kg per person per year.per year.

i) The amount of available sugar (raw) and i) The amount of available sugar (raw) and refined) has increased from 28 kg to 47.6kg refined) has increased from 28 kg to 47.6kg per person per year.per person per year.

Some studies found that the lower Some studies found that the lower income groups tend to depend on a income groups tend to depend on a limited range of food items for limited range of food items for calories such as rice, flour (like calories such as rice, flour (like noodles, local cakes and snacks), noodles, local cakes and snacks), cooking oil and sugar.cooking oil and sugar.

Rice and other cereals followed by Rice and other cereals followed by chicken and fish constitute their chicken and fish constitute their main source of protein.main source of protein.

In contrast, people in higher income tend to In contrast, people in higher income tend to consume a wider variety of food including more consume a wider variety of food including more dairy products, fruits and vegetables.dairy products, fruits and vegetables.

Past studies also showed that the vulnerable Past studies also showed that the vulnerable groups, comprising growing children, pregnant groups, comprising growing children, pregnant and lactating mothers and the elderly, from and lactating mothers and the elderly, from low-income communities generally consume low-income communities generally consume inadequate calories, iron, calcium and the B inadequate calories, iron, calcium and the B vitamins (Soon & Khor, 1995; Poh vitamins (Soon & Khor, 1995; Poh et alet al, 1996; , 1996; Suriah Suriah et alet al, 1996; Chee , 1996; Chee et al,et al, 1997). 1997).

Adequate consumption of vitamin A and C Adequate consumption of vitamin A and C tends to vary depending upon day to day and tends to vary depending upon day to day and seasonal fluctuations in the intake of fruits and seasonal fluctuations in the intake of fruits and vegetables.vegetables.

Diet-Related Chronic Diet-Related Chronic DiseasesDiseases

Malaysia faces the challenges arising Malaysia faces the challenges arising from increasing prevalence of the diet-from increasing prevalence of the diet-related chronic diseases including related chronic diseases including cardiovascular disease (CVD).cardiovascular disease (CVD).

Heart diseases have been the leading Heart diseases have been the leading cause of deaths in Malaysia since cause of deaths in Malaysia since 1970s, and together with the death due 1970s, and together with the death due to cerebrovascular disease, constitute to cerebrovascular disease, constitute 28% of all medically certified deaths.28% of all medically certified deaths.

Although CVD mortality rate in Although CVD mortality rate in Malaysia ranks lower than that in Malaysia ranks lower than that in other Asia Pacific region (Khor, other Asia Pacific region (Khor, 2001), the upward trend of the 2001), the upward trend of the prevalence of its risk factors is a prevalence of its risk factors is a matter of public health concern.matter of public health concern.

The major risk factors are The major risk factors are hypertension, diabetes, hypertension, diabetes, dislipidaemia and obesity. dislipidaemia and obesity.

HypertensionHypertension

Overall prevalence of hypertension Overall prevalence of hypertension among adults aged 30 years and above among adults aged 30 years and above in all states in Malaysia was 29.9% with in all states in Malaysia was 29.9% with self reported hypertension at 14% and self reported hypertension at 14% and undiagnosed hypertension at 15.9% undiagnosed hypertension at 15.9% (NHMS II) (MOH, 1997)(NHMS II) (MOH, 1997)

In comparison, the NHMS 1 in 1987 had In comparison, the NHMS 1 in 1987 had reported 14% of adults 25 years and reported 14% of adults 25 years and above had elevated blood pressure.above had elevated blood pressure.

DiabetesDiabetes

The prevalence of diabetes appears The prevalence of diabetes appears to have risen from 6.3% in 1987 to have risen from 6.3% in 1987 (NHMS1) to 8.7 % in 1997 (NHMS (NHMS1) to 8.7 % in 1997 (NHMS II).II).

Given that the population of Given that the population of Malaysia in 1996 was about 21 Malaysia in 1996 was about 21 million, the total number of diabetics million, the total number of diabetics is estimated at 1.7 million.is estimated at 1.7 million.

DyslipidaemiaDyslipidaemia

Dyslipidaemia, the most commonly Dyslipidaemia, the most commonly assessed component being total assessed component being total cholesterol or hypercholesterolemia.cholesterol or hypercholesterolemia.

In comparing some studies, Ng and In comparing some studies, Ng and co-researchers (2000) noted that the co-researchers (2000) noted that the mean total cholesterol values of the mean total cholesterol values of the rural adults in 1990s were edging rural adults in 1990s were edging closer to the levels of their urban closer to the levels of their urban counterparts.counterparts.

The prevalence of The prevalence of hypercholesterolemia (total hypercholesterolemia (total cholesterol >6.2 mmol/L) among rural cholesterol >6.2 mmol/L) among rural males (n=3153) and females (n=4033) males (n=3153) and females (n=4033) were 11.6% and 16% respectively.were 11.6% and 16% respectively.

There is an upward shift in the mean There is an upward shift in the mean total cholesterol values for the rural total cholesterol values for the rural communities of various age groups communities of various age groups during the 1980s and 1990s.during the 1980s and 1990s.

Intervention Activities for Intervention Activities for Promoting Healthy Promoting Healthy

NutritionNutrition Programs and activities aimed at the Programs and activities aimed at the

promotion of sound dietary practices promotion of sound dietary practices towards the achievement of good towards the achievement of good nutritional and health status are carried nutritional and health status are carried by Ministry of Health, while others by Ministry of Health, while others including Ministries of Agriculture, including Ministries of Agriculture, Rural Development and Education.Rural Development and Education.

Universities and research institutes Universities and research institutes contributes in research, training and contributes in research, training and providing extension and consultancy providing extension and consultancy services.services.

Professional societies like the Professional societies like the Nutrition Society of Malaysia and Nutrition Society of Malaysia and Malaysian Dieticians’ Association Malaysian Dieticians’ Association are active in advocacy and are active in advocacy and dissemination of information to the dissemination of information to the public.public.

National Plan of Action for National Plan of Action for NutritionNutrition

The formation of the National The formation of the National Coordinating Committee on Food and Coordinating Committee on Food and Nutrition of Malaysia (NCCFN) in 1995 Nutrition of Malaysia (NCCFN) in 1995 has stimulated active collaboration has stimulated active collaboration among the various agencies and groups among the various agencies and groups which carry out nutrition and related which carry out nutrition and related activities, towards achieving the activities, towards achieving the general objectives of improving general objectives of improving nutritional status and health of nutritional status and health of Malaysians.Malaysians.

The NCCFN was formed following the The NCCFN was formed following the FAO/WHO International Conference on FAO/WHO International Conference on Nutrition in Rome in 1992, whereby members Nutrition in Rome in 1992, whereby members countries were committed to developing their countries were committed to developing their own National Plan of Action for Nutrition own National Plan of Action for Nutrition (NPAN) (Ministry of Health, 1996).(NPAN) (Ministry of Health, 1996).

The NPAN of Malaysia was completed in The NPAN of Malaysia was completed in 1996 and one of its major recommendations 1996 and one of its major recommendations was the formation of the four Technical was the formation of the four Technical Working Groups:Working Groups:

Research, Training, Dietary Guidelines and Research, Training, Dietary Guidelines and Nutrition Policy Nutrition Policy

Each Technical Working Groups (TWG) comprises Each Technical Working Groups (TWG) comprises members from agencies wth nutrition activities members from agencies wth nutrition activities including universities, the private sector, including universities, the private sector, government and non-government organizations.government and non-government organizations.

Some of the activities of TWG are:Some of the activities of TWG are:1) The research TWG coordinated a workshop in 1) The research TWG coordinated a workshop in

identifying the priority research areas in nutrition identifying the priority research areas in nutrition under the 8under the 8thth Malaysian Plan (2001-2005). Malaysian Plan (2001-2005).

2) The Training TWG developed five nutrition modules 2) The Training TWG developed five nutrition modules and has been conducting training courses for and has been conducting training courses for trainers and community workers from various trainers and community workers from various agencies.agencies.

3) The Dietary Guidelines TWG published the Malaysia 3) The Dietary Guidelines TWG published the Malaysia Dietary Guidelines in 1999, and is coordinating Dietary Guidelines in 1999, and is coordinating efforts in revising the Malaysian recommended efforts in revising the Malaysian recommended dietary allowance (RDAs)dietary allowance (RDAs)

4) The Policy TWG has the task of preparing an 4) The Policy TWG has the task of preparing an important milestone namely, “The National Nutrition important milestone namely, “The National Nutrition Policy of Malaysia”, launched in 2003.Policy of Malaysia”, launched in 2003.

Malaysian Dietary Malaysian Dietary GuidelinesGuidelines

Dietary guidelines are useful Dietary guidelines are useful principles to guide consumers in principles to guide consumers in making informed choices in food making informed choices in food selection and feeding practices.selection and feeding practices.

There are 8 principles in the There are 8 principles in the Malaysian Dietary Guidelines:Malaysian Dietary Guidelines:

1)1) Enjoy a variety of foods.Enjoy a variety of foods.2)2) Maintain healthy body weight by balancing food Maintain healthy body weight by balancing food

intake with regular physical activity.intake with regular physical activity.3)3) Eat more rice and other cereals products, Eat more rice and other cereals products,

legumes, fruits and vegetables.legumes, fruits and vegetables.4)4) Minimize fat in food preparation and choose Minimize fat in food preparation and choose

foods that are low in fat and cholesterol.foods that are low in fat and cholesterol.5)5) Use small amounts of salts and choose foods low Use small amounts of salts and choose foods low

in salt.in salt.6)6) Reduce sugar intake and choose foods low in Reduce sugar intake and choose foods low in

sugarsugar7)7) Drink plenty of water dailyDrink plenty of water daily8)8) Practice and promote breastfeeding.Practice and promote breastfeeding.

Ministry of Health through its Division o Family Ministry of Health through its Division o Family Health Development implements several nutrition Health Development implements several nutrition intervention programs and activities as follows:intervention programs and activities as follows:

Supplementary Feeding Programs:Supplementary Feeding Programs:1)1) MOH provided full cream milk powder to MOH provided full cream milk powder to

undernourished children under 7 years of age, undernourished children under 7 years of age, pregnant and lactating mothers.pregnant and lactating mothers.

2)2) Ministry of Education provides subsidized milk Ministry of Education provides subsidized milk and free meals to primary school children from and free meals to primary school children from poor families.poor families.

3)3) The Ministry of Rural development through its The Ministry of Rural development through its KEMAS programs provide meals for preschool KEMAS programs provide meals for preschool children, and food assistance to poor families. children, and food assistance to poor families.

Multiple Nutrient Supplementation.Multiple Nutrient Supplementation. The Ministry of Health distributes iron, folic The Ministry of Health distributes iron, folic

acids, vitamin C and B complex to pregnant acids, vitamin C and B complex to pregnant women during their antenatal check-ups.women during their antenatal check-ups.

Nutrition Rehabilitation Program.Nutrition Rehabilitation Program. Moderately and severely malnourished Moderately and severely malnourished

childen under 7 years of age are given food childen under 7 years of age are given food aid comprising essential items such as rice, aid comprising essential items such as rice, anchovies, biscuits, milk powder, cooking anchovies, biscuits, milk powder, cooking oil, sugar and green gram worth RM 60 oil, sugar and green gram worth RM 60 every month.every month.

Iodine Deficiency disorder Control Iodine Deficiency disorder Control program. program.

Several approaches were used towards Several approaches were used towards the effective control of iodine deficiency the effective control of iodine deficiency disorder (IDD) in Sabah, Sarawak and disorder (IDD) in Sabah, Sarawak and Peninsula Malaysia:Peninsula Malaysia:

1)1) Legislation requiring that all salt sold in Legislation requiring that all salt sold in IDD gazetted areas be iodized.IDD gazetted areas be iodized.

2)2) Free distribution of iodized slat by Free distribution of iodized slat by government clinics.government clinics.

3)3) Use of iodinators to iodized water supplied Use of iodinators to iodized water supplied by gravity-freed system to villages and by gravity-freed system to villages and boarding schools in rural areasboarding schools in rural areas

Nutrition Education and Nutrition Education and Health PromotionHealth Promotion

1) The Ministry of Health through its network 1) The Ministry of Health through its network of hospitals, health centers and family health of hospitals, health centers and family health clinics as well as at the community level clinics as well as at the community level routinely conducts nutrition education and routinely conducts nutrition education and food preparation classes.food preparation classes.

2) The Ministry of Health coordinating an 2) The Ministry of Health coordinating an annual Healthy Lifestyles Campaign since annual Healthy Lifestyles Campaign since 1990 with nutrition either directly or 1990 with nutrition either directly or indirectly as the central theme in the “Healthy indirectly as the central theme in the “Healthy Eating Campaign” (1998), “Cardiovascular Eating Campaign” (1998), “Cardiovascular Diseases” (1991), “Food Safety” (1993), Diseases” (1991), “Food Safety” (1993), “Cancer” (1995) and “Diabetes mellitus” “Cancer” (1995) and “Diabetes mellitus” (1996), and “Healthy Family” (2001)(1996), and “Healthy Family” (2001)

3) The Ministry of Education includes aspects of 3) The Ministry of Education includes aspects of nutrition in the primary and secondary curriculum nutrition in the primary and secondary curriculum e.g. in Physical and Health education and Home e.g. in Physical and Health education and Home Economics subjects.Economics subjects.

4) The Ministry of Rural Development through 4) The Ministry of Rural Development through KEMAS carries out classes and home visits KEMAS carries out classes and home visits involving food and nutrition components.involving food and nutrition components.

5) Professional societies such as the Nutrition 5) Professional societies such as the Nutrition Society of Malaysia, Malaysian Dieticians’ Society of Malaysia, Malaysian Dieticians’ Association, Malaysia Association for the Study of Association, Malaysia Association for the Study of Obesity and the Heart foundation of Malaysia are Obesity and the Heart foundation of Malaysia are involved in disseminating information on food and involved in disseminating information on food and nutrition and health to members and general nutrition and health to members and general public through talks, seminars, and exhibitions.public through talks, seminars, and exhibitions.

ConclusionConclusion

From the above overview, it can be seen that From the above overview, it can be seen that Malaysia has a multitude of nutrition and public Malaysia has a multitude of nutrition and public health intervention programs and activities, health intervention programs and activities, aimed at the promoting healthy eating and aimed at the promoting healthy eating and nutrition of the general population as well as nutrition of the general population as well as specific vulnerable groups (e.g. the poor, the specific vulnerable groups (e.g. the poor, the malnourished, and the children below 7 years malnourished, and the children below 7 years of age).of age).

Whatever future programs plan for promoting Whatever future programs plan for promoting healthy eating could be incorporated into the healthy eating could be incorporated into the existing programs carried out in the various existing programs carried out in the various ministries and agencies.ministries and agencies.

Thank you Thank you

for your for your attention.attention.