The Identification of the Factors Related to Household Food Insecurity among Indigenous People (Orang Asli) in Peninsular Malaysia under Traditional Food Systems

Stunting and Its Associated Factors among Children Below 5 Years Old on the East Coast of Peninsular Malaysia: Evidence from the National Health and Morbidity Survey

Background

Child malnutrition problems still occur in Malaysia, particularly stunting. This study aimed to determine the proportion of stunting among children below 5 years old and investigate the factors associated with stunting on the East Coast of Peninsular Malaysia.

Methods

This study utilised data from the 2016 National Health and Morbidity Survey (NHMS). Multiple logistic regression was used to determine the factors associated with malnutrition among non-stunted and stunted children.

Results

The proportion of stunting among children below 5 years old in this East Coast region was 26.2%. When divided by state, Kelantan had the highest proportion of stunting, followed by Pahang and Terengganu, at 28.8%, 26.2% and 23.4%, respectively. In this study, the factors associated with stunting were children aged 24 months old-59 months old (adjusted odds ratio [aOR]: 1.52; 95% CI: 1.26, 1.83; P < 0.001), male children (aOR: 1.47; 95% CI: 1.23, 1.76; P < 0.001), Orang Asli children (aOR: 2.84; 95% CI: 1.86, 4.32; P < 0.001), children with low birth weight from 1,500 g to 2,499 g (aOR: 1.86; 95% CI: 1.36, 2.55; P < 0.001) and children from households that practice unsanitary waste disposal (aOR: 1.42; 95% CI: 1.16, 1.74; P = 0.001).

Conclusion

Stunting among children under the age of 5 years old on the East Coast of Peninsular Malaysia remains a public health problem. To reduce the prevalence of stunting in this region, intervention programmes should be intensified. Emphasis should be placed on public health programmes that target the associated factors, such as dietary habits, Orang Asli children, low birth weight and unsanitary waste disposal.

Exploring the Determinants of Food Choice in Chinese Mainlanders and Chinese Immigrants: A Systematic Review

Determinants of food choice in Chinese populations have not been systematically synthesised using a cultural lens. This study reviewed qualitative studies exploring food choice determinants of both Chinese mainlanders and Chinese immigrants living in Western countries. Ovid Medline, CINAHL Plus, Web of Science, ProQuest, and China National Knowledge Infrastructure database (CNKI) were searched from database inception to 1 April 2021. Studies were included if they involved qualitative research methods, were written in English or Chinese, investigated the factors influencing food choices, and targeted Chinese mainlanders or Chinese immigrants living in Western countries. Twenty-five studies (24 in English, 1 in Chinese) were included, involving 2048 participants. Four themes were identified; (1) the principles of traditional Chinese medicine (TCM), (2) perceptions of a healthy diet in Chinese culture (e.g., regular eating, eating in moderation, and emphasis on food freshness), (3) the desire to maintain harmony in families/communities, and (4) physical/social environmental factors all significantly influenced Chinese people's food choices. It is important to acknowledge these factors when developing culturally appropriate nutrition programs for promoting health in Chinese mainlanders and Chinese immigrants.

Impact of Malaysian palm oil on sustainable development goals: co-benefits and trade-offs across mitigation strategies

Palm oil (PO) is an important source of livelihood, but unsustainable practices and widespread consumption may threaten human and planetary health. We reviewed 234 articles and summarized evidence on the impact of PO on health, social and economic aspects, environment, and biodiversity in the Malaysian context, and discuss mitigation strategies based on the sustainable development goals (SDGs). The evidence on health impact of PO is equivocal, with knowledge gaps on whether moderate consumption elevates risk for chronic diseases, but the benefits of phytonutrients (SDG2) and sensory characteristics of PO seem offset by its high proportion of saturated fat (SDG3). While PO contributes to economic growth (SDG9, 12), poverty alleviation (SDG1, 8, 10), enhanced food security (SDG2), alternative energy (SDG9), and long-term employment opportunities (SDG1), human rights issues and inequities attributed to PO production persist (SDG8). Environmental impacts arise through large-scale expansion of monoculture plantations associated with increased greenhouse gas emissions (SDG13), especially from converted carbon-rich peat lands, which can cause forest fires and annual trans-boundary haze; changes in microclimate properties and soil nutrient content (SDG6, 13); increased sedimentation and change of hydrological properties of streams near slopes (SDG6); and increased human wildlife conflicts, increase of invasive species occurrence, and reduced biodiversity (SDG14, 15). Practices such as biological pest control, circular waste management, multi-cropping and certification may mitigate negative impacts on environmental SDGs, without hampering progress of socioeconomic SDGs. While strategies focusing on improving practices within and surrounding plantations offer co-benefits for socioeconomic, environment and biodiversity-related SDGs, several challenges in achieving scalable solutions must be addressed to ensure holistic sustainability of PO in Malaysia for various stakeholders.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s11625-021-01052-4.

A Food Insecurity Systematic Review: Experience from Malaysia

Living free from hunger is a basic human right. However, some communities still experience household food insecurity. This systematic literature review explored different aspects of household food insecurity in Malaysia including vulnerable groups, prevalence, risk factors, coping strategies, and the consequences of food insecurity. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Thirty-three relevant articles were selected from scientific databases such as CINAHL, Pubmed and Google Scholar, scrutiny of reference lists, and personal communication with experts in the field. The prevalence of household food insecurity in Malaysia was unexpectedly reported as high, with affected groups including Orang Asli, low-income household/welfare-recipient households, university students, and the elderly. Demographic risk factors and socioeconomic characteristics included larger household, living in poverty, and low education. Coping strategies were practices to increase the accessibility of food in their households. Consequences of household food insecurity included psychological, dietary (macro- and micronutrient intakes), nutritional status, and health impacts. In conclusion, this review confirmed that household food insecurity in Malaysia continues to exist. Nevertheless, extensive and active investigations are encouraged to obtain a more holistic and comprehensive picture pertaining to household food security in Malaysia.

Predictors of Overweight and Obesity and Its Consequences among Senoi Orang Asli (Indigenous People) Women in Perak, Malaysia

In spite of the high prevalence of overweight and obesity among the Orang Asli (OA) of Malaysia being an increasing concern due to the associated adverse health implications, information regarding this issue is scarce. This cross-sectional study is aimed to investigate the predictors of overweight and obesity and its association with blood pressure and quality of life among Senoi OA women. A total of 19 villages at Batang Padang, Perak, were selected out of a total of 56 villages using a simple random sampling, in which 355 Senoi OA women were participated in the study. Face-to-face interviews were conducted to obtain information on sociodemographic characteristics, dietary intake, physical activity, and quality of life. Weight, height and blood pressure were also measured. The prevalence of overweight and obesity were 32.4% and 26.2%, respectively. In terms of multiple linear regression, monthly household income, total energy intake, and metabolic equivalents (METs) for domestic activities were found to have significantly contributed to body mass index (BMI). Furthermore, BMI contributed significantly towards levels of blood pressure and quality of life after controlling for monthly household income, total energy intake, and METs for domestic activities. In conclusion, there should be urgent attention to poverty and overweight/obesity among the OA women. The findings would aid in alerting policy makers and health professionals as underweight is no longer a sole nutritional problem among OA but it appears to be coexisting with overweight and obesity. Strategies for improving their socioeconomic status, promoting a balanced and moderate diet, and encouraging involvement of OA women in physical activities should be implemented to prevent overweight and obesity.

Exploration of Food-Seeking Behaviour, Food Preparation, and Restrictions to Sufficient Food among the Jahai Sub-Tribe (Indigenous People) in Gerik, Malaysia

Access to food has been determined to be a factor that strongly influences the dietary intake and eating habit of indigenous people (Orang Asli, OA). This study explored food acquisition and the barriers in obtaining traditional and market foods among the Jahai subtribe (within the Negrito ethnic group) via a qualitative approach. Twenty-eight OA (14 males and 14 females) from Gerik, Perak, Malaysia participated in four focus group discussions (FGDs; two male-only and two female-only groups; seven informants in each FGD). Thematic analysis was adopted to analyse the gathered data. The results found that the Jahai applied both modern (buying and receiving food assistance) and traditional (gathering, farming, fishing, and hunting) methods in obtaining food. The barriers they faced in gathering sufficient food supply included low purchasing power, high demand for food, high transport costs, depletion of food supplies in their surroundings, threats from wild animals on the farm and during food searching activities, and food sharing. Food preparation methods practiced by the OA include roasting and grilling, frying, simmering (gulai), and boiling. In conclusion, this study enhances our understanding of the dietary behaviour of the Jahai subtribe and highlights restricted food access among the OA, which demands urgent attention.

Do not neglect the indigenous peoples when reporting health and nutrition issues of the socio-economically disadvantaged populations in Malaysia

The purpose of this correspondence is to express our disappointment with the coverage of the BMC Public Health supplement: Vol 19 (4) titled “Health and Nutritional Issues Among Low Income Population in Malaysia”, which neglected to include the fundamental health and nutrition issues that are adversely affecting the lives and livelihood of the indigenous peoples. The Supplement comprised 21 papers. Two of these papers included indigenous peoples as study subjects. These two papers addressed peripheral, albeit important health issues, namely visual impairment and quality of life, and not the persistent and rising health concerns impacting this population. We will provide evidence from research and reports to justify our critique that the Supplement missed the opportunity to spotlight on the serious extent of the health and nutritional deprivations of the indigenous peoples of Malaysia. As researchers of the indigenous peoples, we ought to lend our voice to the “silenced minority” by highlighting their plight in the media including scientific journals.