Food and Nutrition in Malaysian ChildrenNorimah A. Karim and Nurliyana Abdul Razak
Rapid socioeconomic growth has led to nutrition and health transition in Malaysia. Childhood obesity has become a major concern. The findings from 2 nationwide studies, namely, SEANUTS Malaysia (the South East Asian Nutrition Survey of Malaysian Children)  and the MyBreakfast study  showed that between 13 and 17% of school children aged between 6 and 12 years were either overweight or obese, with similar prevalence in both urban and rural areas. These studies showed that overweight and obesity problems among Malaysian children should be of concern, as 3 in 10 children are either overweight or obese, irrespective of the areas where they reside.
Table 1 shows the prevalence of children not achieving the recommended nutrient intake (RNI) for selected macro- and micronutrients. The mean energy intake of the children ranged from 1,800 to 1,900 kcal/ day. The majority of the children in both studies (SEANUTS Malaysia  and MyBreakfast study ) achieved the Malaysian RNI for energy and protein; however, at least two-thirds of the children did not achieve the RNI for calcium. About 9 in 10 children did meet the RNI for vitamin D in the MyBreakfast study . These findings are worrying as both calcium and vitamin D are important nutrients for bone health. In the MyBreakfast study, breakfast was defined as the first eating occasion after an overnight sleep until 10 a.m. on weekdays and 11 a.m. on weekend days .
In the MyBreakfast study, the prevalence of breakfast skippers (ate breakfast 0–2 days/week) and irregular breakfast eaters (ate breakfast 3–4 days/week) was 9.3 and 10.8%, respectively, while 79.9% were found to be regular breakfast eaters (ate breakfast 5–7 days/ week) . In the SEANUTS Malaysia, breakfast was defined as the first eating occasion consumed by the children before 10 a.m., and irregular breakfast eaters were defined as children who skipped breakfast on a daily basis . Table 2 shows the distribution of breakfast consumption among primary school children in the SEANUTS Malaysia and the MyBreakfast study.
Table 1. Prevalence of Malaysian primary school children (6–7 to 12 years) not achieving the RNI of selected macronutrients and micronutrients
Table 2. Breakfast consumption among primary school children in Malaysia: the SEANUTS Malaysia  and MyBreakfast Study 
A total of 65.2% of children in the SEANUTS Malaysia consumed breakfast daily. Regular breakfast eaters were found to have higher intake of calcium and vitamins A, C, and D than irregular breakfast eaters . Analysis of 2-day dietary recalls from the MyBreakfast study showed that 17.7% of the children consumed ready-to-eat cereal (RTEC) at breakfast, while among non-RTEC consumers, bread (44.2%), eggs (31.8%) and nasi lemak (23.9%) were the most common foods consumed at breakfast . RTEC was found to be the major contributor of whole grain (68.6%), followed by hot cereal (18.6%), biscuits (8.7%), and bread (1.8%) . It was also shown that only 1.0% of Malaysian children achieved the 43 g/day of whole grain intake recommendation in the Malaysian Dietary Guideline (MDG) for children and adolescents.
In the SEANUTS Malaysia, among children aged 7–9 years (n=890), only 13.4 and 9.5% met the MDG for fruits and vegetables per day, respectively. The pattern was similar among the older children aged 10–12 years (n=883), although slightly higher, whereby only 19.6 and 16.1%, respectively, met the MDG for fruits and vegetables. For the milk group, only very low percentages (5.5%) of children aged 7–9 years and among those aged 10–12 years (3.7%) met the MDG for milk/dairy products . Despite the low milk drinking habits, the MyBreakfast study showed that UHT (ultraheat-treated) milk was commonly consumed at breakfast among RTEC consumers . Thus, the consumption of RTEC at breakfast can promote milk consumption among the children and, subsequently, may increase the prevalence of children meeting the MDG for milk/dairy products.
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