nhms_2019.pdf

Non-Communicable Diseases: Risk Factors and other Health Problems 209 Recommendations

1. Strengthen ongoing school-based nutrition programmes, aiming at improved nutritional status of school children by creating an appropriate school’s nutrition-friendly environment through nutrition education, nutritional assessment, school meals, as well as physical activity education.
2. Consolidate and incorporate existing teaching / learning materials and curriculum on nutrition component in line with local needs and conditions.
3. Empower parents / caregivers’ and teachers’ awareness on the importance of regular growth monitoring to ensure normal growth development according to their age and identify children at risk of developing overweight and obesity.
4. Continuous engagement / partnerships with relevant ministries and other agencies to ensure the effectiveness of nutrition programmes and policies at national and local levels.
5. Formulate and support appropriate weight management services or intervention programmes for children and adolescent that already affected by overweight and obese. Table 15.2: Nutritional Status (Children 5 - 17 Years of Age) Trend in Malaysia 2011 2015 2019 Obesity 6.1 11.9 14.8 References

World Health Organization (WHO) Global Database on Child Growth and Malnutrition. Geneva: WHO, 1997. 2. WHO. 2014. Indicators for the Global Nutrition Monitoring Framework on Maternal, Infant and Young Child Nutrition (24 November 2014). 3. de Onis M, Onyango W A, Borghi E et al. (2007). Development of a WHO growth reference for school-aged children and adolescents. Bulletin of the World Health Organization 85, 660-667. 4. Institute for Public Health Malaysia. National Health & Morbidity Survey (NHMS 2015). Vol. II: Non-Communicable Diseases, Risk Factors & Other Health Table 15.3: Prevalence of Nutritional Status Among Children Below 5 Years Old in Malaysia Nutritional Status Count Estimated Population Prevalence 95% CI Lower Upper MALAYSIA Weight for age (WAZ) Underweight (WAZ < -2SD) 160 327,628 14.1 11.39 17.37 Normal (WAZ ≥ -2SD - ≤2SD) 1,007 1,907,273 82.2 78.68 85.22 Overweight (WAZ. >2SD) * growth problem 44 85,867 3.7 2.55 5.34 Height for age (HAZ) Stunting (HAZ < -2SD) 234 497,185 21.8 18.42 25.63 Normal (HAZ ≥ -2SD to + ≤2SD) 899 82,685 73.6 69.67 77.19 Tall (HAZ > +2SD to ≤ +3SD) & Very Tall (HAZ > +3SD) * endocrine problem 55 104,614 4.6 3.09 6.77 Weight for Height (WHZ) Wasting (WHZ < -2SD) 114 219,550 9.7 7.57 12.25 Normal (WHZ ≥ -2SD to ≤ +2SD) 1,009 1,934,116 85.1 82.17 87.66 Overweight (WHZ > +2SD to ≤ +3SD) 35 53,932 2.4 1.56 3.61 Obese (WHZ > +3SD) 28 64,607 2.8 1.77 4.55 BMI for age(BAZ) Wasting (BAZ < -2SD) 104 220,605 9.7 7.31 12.79 Normal (BAZ ≥ -2SD to + ≤2SD) 1,014 1,923,733 84.7 81.43 87.46 Overweight (BAZ > +2SD to ≤ +3SD) & Obese (BAZ > +3SD) 68 127,198 5.6 4.13 7.55

National Health and Morbidity Survey 2019 Technical Report − Volume I 210 Table 15.4: Prevalence of Nutritional Status Among Children Aged 5-17 Years Old in Malaysia Nutritional Status Count Estimated Population Prevalence 95% CI Lower Upper MALAYSIA Weight for age (WAZ)* Underweight (WAZ < -2SD) 207 373,743 15.4 12.78 18.52 Normal (WAZ ≥ -2SD - ≤2SD) 1,064 1,829,685 75.6 72.01 78.79 Overweight (WAZ. >2SD)* 118 218,089 9.0 7.08 11.39 Height for age (HAZ) Stunting (HAZ < -2SD) 396 818,428 12.7 10.96 14.70 Normal (HAZ ≥ -2SD to + ≤2SD) 2,726 5,484,027 85.2 83.15 87.02 Tall (HAZ > +2SD to ≤ +3SD) 57 134,939 2.1 1.48 2.95 BMI for age (BAZ) Thinesss (BAZ < -2SD) 282 640,364 10.0 8.12 12.25 Normal (BAZ ≥ -2SD to + ≤2SD) 1,965 3,858,005 60.2 57.57 62.84 Overweight (BAZ > +2SD to ≤ +3SD) 456 959,304 15.0 13.31 16.82 Obese (BAZ > +3SD) 464 947,185 14.8 13.06 16.70 Weight-for-Age among children ( 5 to 10 years old) Table 15.5: Prevalence of Weight-for-Age Among Children Below 5 Years Old in Malaysia by Socio-Demographic Characteristics (n=1,211) Sociodemographic Characteristics Underweight (WAZ < -2SD) Normal (WAZ ≥ -2SD - ≤2SD) Count Estimated Population Prevalence (%) 95% CI Count Estimated Population Prevalence (%) 95% CI Lower Upper Lower Upper MALAYSIA 160 327,628 14.1 11.39 17.37 1,007 1,907,273 82.2 78.68 85.22 Location Urban 94 234,382 13.6 10.24 17.82 631 1,422,453 82.5 77.94 86.27 Rural 66 93,247 15.6 12.12 19.93 376 484,820 81.3 76.92 84.99 Sex Male 84 184,984 15.5 11.43 20.70 513 959,331 80.4 75.15 84.78 Female 76 142,644 12.6 9.79 16.20 494 947,942 84.1 79.90 87.49 Ethnicity Malaya 123 246,496 15.2 12.20 18.73 743 1,320,043 81.3 77.40 84.63 Chinese 4 12,699 5.8 1.51 19.65 58 204,582 93.1 80.02 97.83 Indian 2 19,972 25.7* 4.51 71.73 30 48,649 62.6 28.45 87.61 Bumiputera Sabah 12 18,464 9.9* 4.81 19.28 83 165,204 88.5 79.45 93.89 Bumiputera Sarawak 12 24,571 24.5 13.20 40.97 38 73,532 73.4 56.13 85.61 Others 7 5,426 4.8* 2.34 9.69 55 95,264 84.7 71.50 92.41 Household Income Group Less than RM 1,000 16 25,977 14.8 8.51 24.60 70 149,154 85.2 75.40 91.49 RM 1,000 - RM 1,999 30 58,553 13.8 8.95 20.62 183 346,608 81.6 74.26 87.16 RM 2,000 - RM 3,999 47 96,941 14.5 10.42 19.76 286 539,667 80.6 74.98 85.17 RM 4,000 - RM 5,999 27 47,831 12.4 6.92 21.18 166 318,223 82.4 73.24 88.87 RM 6,000 - RM 7,999 14 17,934 9.1* 4.36 18.17 111 173,365 88.4 78.06 94.24 RM 8,000 - RM 9,999 7 22,733 24.1* 6.35 59.69 34 71,753 75.9 40.31 93.65 RM 10,000 and above 8 12,416 8.5* 2.50 25.13 86 133,783 91.4 74.89 97.43 Household Income Category Bottom 40% 107 186,304 14.1 11.23 17.45 617 1,084,065 81.8 78.06 84.98 Middle 40% 32 74,268 12.3 7.63 19.31 251 505,628 83.9 76.37 89.37 Top 20% 10 21,812 13.2* 4.78 31.71 68 142,861 86.7 68.28 95.19 *Prevalence with high RSE, interpret with caution a - Malay includes Orang Asli

Non-Communicable Diseases: Risk Factors and other Health Problems 211 Sociodemographic Characteristics Overweight (WAZ >2SD) Count Estimated Population Prevalence (%) 95% CI Lower Upper MALAYSIA 44 85,867 3.7 2.55 5.34 Location Urban 30 67,476 3.9 2.50 6.07 Rural 14 18,391 3.1* 1.69 5.55 Sex Male 25 48,702 4.1 2.48 6.65 Female 19 37,165 3.3 1.88 5.70 Ethnicity Malaya 27 57,434 3.5 2.27 5.47 Chinese 4 2,533 1.2* 0.30 4.37 Indian 5 9,035 11.6* 3.21 34.30 Bumiputera Sabah 2 2,970 1.6* 0.30 7.95 Bumiputera Sarawak 1 2,083 2.1* 0.28 13.89 Others 5 11,812 10.5* 3.92 25.21 Household Income Group Less than RM 1,000 0

RM 1,000 - RM 1,999 12 19,758 4.6* 2.33 9.07 RM 2,000 - RM 3,999 15 33,116 4.9 2.79 8.62 RM 4,000 - RM 5,999 9 20,259 5.2* 2.18 12.10 RM 6,000 - RM 7,999 2 4,798 2.4* 0.35 15.07 RM 8,000 - RM 9,999 0

RM 10,000 and above 2 173 0.1* 0.03 0.51 Household Income Category Bottom 40% 30 55,323 4.2 2.72 6.36 Middle 40% 9 22,707 3.8* 1.61 8.55 Top 20% 1 73 0.0* 0.01 0.33

National Health and Morbidity Survey 2019 Technical Report − Volume I 212 Table 15.6: Prevalence of Height-for-Age Among Children Below 5 Years Old in Malaysia by Socio-Demographic Characteristics (n=1,188) Sociodemographic Characteristics Stunting (HAZ < -2SD) Normal (HAZ ≥ -2SD to + ≤2SD) Count Estimated Population Prevalence (%) 95% CI Count Estimated Population Prevalence (%) 95% CI Lower Upper Lower Upper MALAYSIA 234 497,185 21.8 18.42 25.63 899 82,685 73.6 69.67 77.19 Location Urban 142 366,237 21.7 17.35 26.72 554 1,234,810 73.1 67.90 77.67 Rural 92 130,948 22.2 18.72 26.12 345 443,247 75.1 71.10 78.79 Sex Male 113 235,807 20.2 15.52 25.89 462 870,891 74.7 68.88 79.67 Female 121 261,377 23.5 18.90 28.77 437 807,166 72.5 67.09 77.33 Ethnicity Malaya 170 338,684 21.3 17.63 25.51 665 1,183,191 74.4 70.04 78.38 Chinese 9 33,541 15.3* 5.63 35.42 50 179,497 82.0 62.70 92.46 Indian 3 20,911 26.9* 5.14 71.47 31 41,045 52.9* 24.27 79.68 Bumiputera Sabah 23 49,378 26.5 15.58 41.25 73 137,160 73.5 58.75 84.42 Bumiputera Sarawak 18 40,025 41.5 26.09 58.71 32 56,490 58.5 41.29 73.91 Others 11 14,646 13.2* 6.96 23.76 48 80,674 72.9 58.26 83.89 Household Income Group Less than RM 1,000 21 40,321 23.0 14.68 34.22 60 124,888 71.3 58.63 81.37 RM 1,000 - RM 1,999 51 101,419 24.5 18.88 31.14 161 291,904 70.5 63.36 76.78 RM 2,000 - RM 3,999 63 144,104 21.8 15.83 29.26 262 486,573 73.6 66.12 79.99 RM 4,000 - RM 5,999 40 77,979 20.9 13.03 31.70 149 282,658 75.6 65.18 83.73 RM 6,000 - RM 7,999 17 29,180 15.1 8.46 25.43 100 147,487 76.2 61.87 86.33 RM 8,000 - RM 9,999 7 15,851 16.8* 4.90 44.12 32 76,704 81.2 53.35 94.21 RM 10,000 and above 16 13,018 9.1* 4.00 19.30 72 126,779 88.4 77.32 94.48 Household Income Category Bottom 40% 153 290,806 22.4 18.47 26.84 551 946,352 72.8 68.17 77.02 Middle 40% 48 103,829 17.5 11.41 25.86 227 461,416 77.7 68.71 84.72 Top 20% 14 27,236 16.8 9.09 29.08 58 129,223 79.9 67.52 88.36 *Prevalence with high RSE, interpret with caution a - Malay includes Orang Asli

Non-Communicable Diseases: Risk Factors and other Health Problems 213 Sociodemographic Characteristics Tall (HAZ > +2SD to ≤ +3SD) & Very Tall (HAZ > +3SD) Count Estimated Population Prevalence (%) 95% CI Lower Upper MALAYSIA 55 104,614 4.6 3.09 6.77 Location Urban 40 88,936 5.3 3.33 8.21 Rural 15 15,678 2.7 1.50 4.66 Sex Male 32 59,905 5.1 3.32 7.85 Female 23 44,709 4.0* 2.14 7.42 Ethnicity Malaya 39 67,649 4.3 2.66 6.74 Chinese 6 5,983 2.7* 0.76 9.30 Indian 3 15,700 20.2* 5.48 52.56 Bumiputera Sabah 0

Bumiputera Sarawak 0

Others 7 15,281 13.8* 6.16 28.13 Household Income Group Less than RM 1,000 5 9,880 5.6* 2.06 14.50 RM 1,000 - RM 1,999 9 20,666 5.0* 2.36 10.23 RM 2,000 - RM 3,999 16 30,131 4.6* 2.49 8.19 RM 4,000 - RM 5,999 8 13,082 3.5* 1.25 9.38 RM 6,000 - RM 7,999 6 16,906 8.7* 2.33 27.75 RM 8,000 - RM 9,999 2 1,931 2.0* 0.26 14.16 RM 10,000 and above 6 3,577 2.5* 0.41 13.59 Household Income Category Bottom 40% 35 62,456 4.8 3.13 7.31 Middle 40% 12 28,429 4.8* 1.88 11.65 Top 20% 5 5,289 3.3* 0.81 12.32