Population and social indicators of food and nutrition in Peninsular Malaysia
Medical Journal of Malaysia 37(2): 134-140
Recent trends in population indicators that relate to food, nutrition, and nutritionally related health situations in Malaysia are reviewed. The overview is supplemented when possible with data obtained from recent community level nutrition assessment surveys. The death rate of children 1-4 years has for many years been accepted as a rough indicator of protein calorie malnutrition. Along ethnic lines, the Malays suffer the highest toddler mortality, being 2.91/1000 compared to 2.38 for Indians and 1.18 for the Chinese for 1978. There is also considerable variation in total mortality rate (TMR) from state to state. If one examines the annual percentage rate of decline of TMR over the 1957-1967 and 1968-1978 periods, one finds that while the average annual percentage decline in TMR was higher for the predominantly urban Chinese during the 1st decade after Merdeka, this is now reversed in favor of the predominantly rural Malay population. During 1978, the national incidence for low birth weight was 17.5% in Indians, 10.8% in Malays, and 7.9% in Chinese. Calorie availability per capita daily has increased from a mean of 2453 during 1961-1970 to 2550 during 1971-1978. Similarly, protein availability has also increased, albeit marginally, from 50 g to 52 g for the corresponding periods. Expressed as % of requirement, calorie avilability now stands at around 123%; protein availabiltiy is at 108%. The food balance sheet analysis gives no indication of the unequal distribution of food between the various socioeconomic groups. Segments of the community with extreme availabilties of calorie and protein, associated with inadequacies or excesses are bound to exist. For the purposes of national planning, the per capita daily availability of calories and protein should be aimed at levels that well exceed their estimated requirements in order to allow for unequal distribution and plate waste. The community nutritional assessments showed that although the prevalence of acute malnutrition in the form of moderate "wasting" was low (1-3%), the moderate forms of chronic malnutrition as manifested by "underweight" (12-37%) or "stunting" (5-36%) were relatively common. There was also a moderate prevalence of anemia (16-33%). In rural Malaysia and the urban squatter areas, the presence of helminthic parasites such as ascaris and trichuris is ubiquitous. Continued efforts should be directed to the improvement of the nutritional health of both rural and urban poverty communities, and public health measures should be adopted to stem the rising number of deaths associated with the country's increasing affluence, particularly those disesases that are nutritionally linked.