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Nutrition promotion: the role of monitoring physical growth

Zulkifli SN

Asia Pac J Public Health, 1992;6(4):210-6.
PMID: 1345448

Growth monitoring has been included as one of the basic strategies for child survival. In this paper, the rationale for this is reiterated both for individual as well as population nutritional surveillance. Methods for and approaches to growth monitoring are described. In addition, potential problems in implementing growth monitoring projects and interpreting the results are discussed. Despite its lack of sensitivity and specificity as a diagnostic tool, its advantages in terms of low cost, simplicity, reliability and social acceptability justify its use in nutritional surveillance, particularly in populations at risk of malnutrition.
Publication year: 1992-1993

Matched MeSH terms: Child Nutritional Physiological Phenomena*
Regional study of nutritional status of urban primary schoolchildren. 3. Kuala Lumpur, Malaysia

Tee ES, Khor SC, Ooi HE, Young SI, Zakiyah O, Zulkafli H

Food Nutr Bull, 2002 Mar;23(1):41-7.
PMID: 11975368

A total of 5,995 (7.8% of all 7- to 10-year-old primary schoolchildren in Kuala Lumpur), randomly selected from 166 schools (97.6% of all schools), were measured for their weight and height. The analyses of all weight and height data, including the cutoffs used for defining stunting, underweight, and wasting and for thinness and overweight, were carried out as recommended by the World Health Organization (WHO). The prevalances of stunting (height-for-age Z score < -2 SD), underweight (weight-for-age Z score < -2 SD) and wasting (weight-for-height Z score < -2 SD) among all the children studies were 6.7%, 7.1%, and 4.5%, respectively. Undernutrition among boys was more serious than among girls according to all three indicators. Because it was not possible to analyze the weight-for-height data for most of the children above 8.5 years of age, body mass index (BMI)-for-age was used to determine the prevalences of thinness and overweight for all the children. Based on the reference data, the prevalence of overweight (at or above the 95th percentile) was 9.7% and 7.1% for boys and girls, respectively, and 8.4% overall.

Matched MeSH terms: Child Nutritional Physiological Phenomena*
Fulltext A structural equation model of the determinants of malnutrition among children in rural Kelantan, Malaysia

Cheah WL, Wan Muda WAM, Zamh ZH

Rural Remote Health, 2010;10(1):1248.
PMID: 20184392

Many studies had shown that poor growth in children is associated with malnutrition. The underlying factors are diverse, multisectoral and interrelated, ranging from biological to social, cultural and economically related. Because the highest levels of under-nutrition worldwide are found in South Asia, it is essential that policymakers in the region understand the underlying determinants, in order to design effective public health intervention programs. This is especially so if public resources are limited. The purpose of this cross-sectional study was to examine causal relationships among the biological, behavioural and environmental factors related to malnutrition in children aged 5 years and under.

Matched MeSH terms: Child Nutritional Physiological Phenomena*
Fulltext Effects of unstable daily life on children's health in Baghdad City, Iraq: qualitative study

Hasanain Faisal Ghazi, Zaleha Md. Isa, Mohammed A. Abdal Qader, Tiba Nezar Hasan

Malaysian Journal of Public Health Medicine, 2014;14(1):82-89.
MyJurnal

The unstable living situation in Iraq in the last 10 years after 2003 war affected the daily life of most Iraqis, and especially the children. The objective of this study was to explore the effects of an unstable living environment on children’s health. A community-based qualitative study was done to collect data from 20 mothers of children (age 7 to 8years old) through in-depth interview (IDI). Data was recorded using tape recorders and was later transcribed and analyzed using qualitative thematic analysis techniques. The majority of mothers interviewed said the past nine years of unstable security in the capital had affected their daily life; some mothers also expressed concern about their child’s nutritional status, their eating habits during the school day, and the unhealthy food being sold at school canteens. As a conclusion, the unstable living situations in Baghdad city after the last war had affected the cognitive and nutritional development of children. More precautions should be taken by parents to ensure their children safety in the future.

Matched MeSH terms: Child Nutritional Physiological Phenomena
Fulltext Food security and child nutritional status among Orang Asli (Temuan) households in Hulu Langat, Selangor

Zalilah MS, Tham BL

Med J Malaysia, 2002 Mar;57(1):36-50.
PMID: 14569716 MyJurnal

This study was conducted to determine the prevalence of household food insecurity and its potential risk factors and outcomes among the Orang Asli (Temuan) households. Socioeconomic, demographic and food security information of the households and anthropometric measurements and dietary intakes of preschoolers (n = 64) were obtained using a structured questionnaire. Food security was assessed using the Radimer/Cornell hunger and food insecurity instrument. Diet quality was based on 24 hour recall and analyzed according to the Malaysian RDA and Food Guide Pyramid. Majority of the households (82%) reported some kind of household food insecurity. The prevalence of significant underweight, stunting and wasting were 45.3%, 51.6% and 7.8%, respectively. Dietary intakes were less than 2/3 RDA levels for calories, calcium and iron. However, the intakes of protein, vitamin A, vitamin C and niacin exceeded the RDA and the sources for these nutrients were mainly rice, fish and green leafy vegetables. Among the five food groups, only the number of servings from cereals/cereal products/tubers group was achieved while that of the milk/diary products was the worst. Majority of the children (68.7%) had poor, 31.3% had fair and none with excellent diet quality. In general, diet quality and nutritional status of the children decreased as household food insecurity worsened. It is recommended that the nutritional problems of Orang Asli children be addressed through health, nutrition and economic programs and further studies should be carried out on determinants and consequences of household food insecurity.

Matched MeSH terms: Child Nutritional Physiological Phenomena*
Child nutrition. A survey in the Parit District of Perak Federation of Malaya

THOMSON FA

Bull Inst Med Res Kuala Lumpur, 1960;10:1-73.
PMID: 13776649
Matched MeSH terms: Child Nutritional Physiological Phenomena*
Nutritional and socio-economic determinants of cognitive function and educational achievement of Aboriginal schoolchildren in rural Malaysia

Al-Mekhlafi HM, Mahdy MA, Sallam AA, Ariffin WA, Al-Mekhlafi AM, Amran AA, et al.

Br J Nutr, 2011 Oct;106(7):1100-6.
PMID: 21492493 DOI: 10.1017/S0007114511001449

A community-based cross-sectional study was carried out among Aboriginal schoolchildren aged 7-12 years living in remote areas in Pos Betau, Pahang, Malaysia to investigate the potential determinants influencing the cognitive function and educational achievement of these children. Cognitive function was measured by intelligence quotient (IQ), while examination scores of selected school subjects were used in assessing educational achievement. Blood samples were collected to assess serum Fe status. All children were screened for soil-transmitted helminthes. Demographic and socio-economic data were collected using pre-tested questionnaires. Almost two-thirds (67·6 %) of the subjects had poor IQ and most of them (72·6 %) had insufficient educational achievement. Output of the stepwise multiple regression model showed that poor IQ was significantly associated with low household income which contributed the most to the regression variance (r2 0·059; P = 0·020). Low maternal education was also identified as a significant predictor of low IQ scores (r2 0·042; P = 0·043). With educational achievement, Fe-deficiency anaemia (IDA) was the only variable to show significant association (r2 0·025; P = 0·015). In conclusion, the cognitive function and educational achievement of Aboriginal schoolchildren are poor and influenced by household income, maternal education and IDA. Thus, effective and integrated measures to improve the nutritional and socio-economic status of rural children would have a pronounced positive effect on their education.

Matched MeSH terms: Child Nutritional Physiological Phenomena*
Child feeding practices, food habits, anthropometric indicators and cognitive performance among preschoolers in Peninsular Malaysia

Mohd Nasir MT, Norimah AK, Hazizi AS, Nurliyana AR, Loh SH, Suraya I

Appetite, 2012 Apr;58(2):525-30.
PMID: 22265752 DOI: 10.1016/j.appet.2012.01.007

This study aimed to determine the relationship between child feeding practices, food habits, and anthropometric indicators with cognitive performance of preschoolers aged 4-6 years in Peninsular Malaysia (n=1933). Parents were interviewed on socio-demographic background, nutrition knowledge, child feeding practices and food habits. Height and weight of the preschoolers were measured; BMI-for-age, weight-for-age and height-for-age were determined. Cognitive performance was assessed using Raven's Colored Progressive Matrices. The mean monthly household income was RM3610 and 59.6% of parents attained secondary education. Thirty-three percent of parents had good knowledge on nutrition, 39% satisfactory and 28% poor. For child feeding practices, perceived responsibility had the highest mean score (M=3.99, SD=0.72), while perceived child weight had the lowest (M=2.94, SD=0.38). The prevalence of possible risk of overweight, being overweight, and obesity were 3.9%, 7.9% and 8.1%, respectively, whereas the prevalence of underweight and stunting were 8.0% and 8.4%, respectively. Breakfast was the second most frequently skipped meal (16.8%) after dinner (18.1%). The mean cognitive score was 103.5 (SD=14.4). Height-for-age and consumption of dinner were found to contribute significantly towards cognitive performance after controlling for socio-demographic background and parent's nutrition knowledge.

Matched MeSH terms: Child Nutritional Physiological Phenomena
Fulltext Dietary Patterns, Cardiorespiratory and Muscular Fitness in 9⁻11-Year-Old Children from Dunedin, New Zealand

Saeedi P, Black KE, Haszard JJ, Skeaff S, Stoner L, Davidson B, et al.

Nutrients, 2018 Jul 10;10(7).
PMID: 29996543 DOI: 10.3390/nu10070887

Research shows that cardiorespiratory (CRF) and muscular fitness in childhood are associated with a healthier cardiovascular profile in adulthood. Identifying factors associated with measures of fitness in childhood could allow for strategies to optimize cardiovascular health throughout the lifecourse. The aim of this study was to examine the association between dietary patterns and both CRF and muscular fitness in 9⁻11-year-olds. In this study of 398 children, CRF and muscular fitness were assessed using a 20-m shuttle run test and digital hand dynamometer, respectively. Dietary patterns were derived using principal component analysis. Mixed effects linear regression models were used to assess associations between dietary patterns and CRF and muscular fitness. Most children had healthy CRF (99%, FITNESSGRAM) and mean ± SD muscular fitness was 15.2 ± 3.3 kg. Two dietary patterns were identified; “Snacks” and “Fruit and Vegetables”. There were no significant associations between either of the dietary patterns and CRF. Statistically significant but not clinically meaningful associations were seen between dietary patterns and muscular fitness. In an almost exclusively fit cohort, food choice is not meaningfully related to measures of fitness. Further research to investigate diet-fitness relationships in children with lower fitness levels can identify key populations for potential investments in health-promoting behaviors.

Matched MeSH terms: Child Nutritional Physiological Phenomena
Fulltext Microencapsulated Tuna Oil Results in Higher Absorption of DHA in Toddlers

Ghasemi Fard S, Loh SP, Turchini GM, Wang B, Elliott G, Sinclair AJ

Nutrients, 2020 Jan 18;12(1).
PMID: 31963702 DOI: 10.3390/nu12010248

: Docosahexaenoic acid (DHA) is an essential component for brain and visual acuity development during foetal and early postnatal life. A newly released directive under the European Commission stipulates DHA as a mandatory ingredient in infant formula. This poses challenges to manufacturers in preserving the stability and bioavailability of DHA at levels akin to human breast milk. The aims of this study were (a) to investigate the bioavailability of microencapsulated omega-3 DHA formulations in healthy toddlers compared with high DHA fish oil for a one-month period and (b) to assess the effect of DHA supplementation on children's sleep and cry patterns. Sixty toddlers were randomly allocated to four groups: 1. unfortified formula, 2. unfortified formula plus high DHA tuna oil, 3. fortified formula with dairy-based microencapsulated high DHA tuna oil powder, and 4. fortified formula with allergenic-free microencapsulated high DHA tuna oil powder. Bioavailability was assessed from both blood and faecal fatty acid levels. The results showed an enhanced bioavailability with significantly greater concentrations of blood DHA levels in formulas with microencapsulated powders. There were no significant effects of treatment on sleep and cry patterns. Application and delivery of microencapsulated DHA tuna oil powder in toddlers' formula provided better bioavailability of the active DHA.

Matched MeSH terms: Child Nutritional Physiological Phenomena*
Fulltext Diet Quality of Malaysians across Lifespan: A Scoping Review of Evidence in a Multi-Ethnic Population

Ramadas A, Tham SM, Lalani SA, Shyam S

Nutrients, 2021 Apr 20;13(4).
PMID: 33924050 DOI: 10.3390/nu13041380

Malaysia is a rapidly developing economy experiencing a nutrition transition. It suffers from a double burden of over- and undernutrition, making it essential to understand diet quality in the population. In this scoping review, we have collated the existing literature on Malaysian diet quality, including factors that influence it, and the association between diet quality and health outcomes across the lifespan of Malaysians. Overall, diet quality was poor in all age groups studied. The Healthy Eating Index (HEI) and its iterations were predominantly used in urban and clinical settings to evaluate diet-chronic disease relationships. These indices were significantly associated with cardio-metabolic and disease risks in adults. The Diet Diversity Score (DDS) and Food Variety Score (FVS) were used to gauge diet quality in maternal and child nutrition studies and were associated with appropriate growth and caloric intake. Deficiencies were found in fruit, vegetable, legumes, and dairy intake. Meat, salt, and sugar intake were found to be excessive in many studies. The findings can inform policies to improve diet quality in this population. The review also identified knowledge gaps that require further investigation.

Matched MeSH terms: Child Nutritional Physiological Phenomena
Fulltext The Consumption of Dairy and Its Association with Nutritional Status in the South East Asian Nutrition Surveys (SEANUTS)

Nguyen Bao KL, Sandjaja S, Poh BK, Rojroongwasinkul N, Huu CN, Sumedi E, et al.

Nutrients, 2018 Jun 13;10(6).
PMID: 29899251 DOI: 10.3390/nu10060759

Despite a major decrease in undernutrition worldwide over the last 25 years, underweight and stunting in children still persist as public health issues especially in Africa and Asia. Adequate nutrition is one of the key factors for healthy growth and development of children. In this study, the associations between dairy consumption and nutritional status in the South East Asian Nutrition Survey (SEANUTS) were investigated. National representative data of 12,376 children in Indonesia, Malaysia, Thailand, and Vietnam aged between 1 and 12 years were pooled, representing nearly 88 million children in this age category. It was found that the prevalence of stunting and underweight was lower in children who consumed dairy on a daily basis (10.0% and 12.0%, respectively) compared to children who did not use dairy (21.4% and 18.0%, respectively) (p < 0.05). The prevalence of vitamin A deficiency and vitamin D insufficiency was lower in the group of dairy users (3.9% and 39.4%, respectively) compared to non-dairy consumers (7.5% and 53.8%, respectively) (p < 0.05). This study suggests that dairy as part of a daily diet plays an important role in growth and supports a healthy vitamin A and vitamin D status.

Matched MeSH terms: Child Nutritional Physiological Phenomena*
Dietary patterns and cognitive ability among 12- to 13 year-old adolescents in Selangor, Malaysia

Nurliyana AR, Mohd Nasir MT, Zalilah MS, Rohani A

Public Health Nutr, 2015 Feb;18(2):303-12.
PMID: 24507623 DOI: 10.1017/S1368980014000068

OBJECTIVE: The present study aimed to identify dietary patterns and determine the relationship between dietary patterns and cognitive ability among 12- to 13 year-old Malay adolescents in the urban areas of Gombak district in Selangor, Malaysia.
DESIGN: Data on sociodemographic background were obtained from parents. Height and weight were measured and BMI-for-age was determined. Adolescents were interviewed on their habitual dietary intakes using a semi-quantitative FFQ. Cognitive ability was assessed using the Wechsler Nonverbal Scale of Ability in a one-to-one manner. Dietary patterns were constructed using principal component analysis based on thirty-eight food groups of the semi-quantitative FFQ.
SETTING: Urban secondary public schools in the district of Gombak in Selangor, Malaysia.
SUBJECTS: Malay adolescents aged 12 to 13 years (n 416).
RESULTS: The mean general cognitive ability score was 101·8 (sd 12·4). Four major dietary patterns were identified and labelled as 'refined-grain pattern', 'snack-food pattern', 'plant-based food pattern' and 'high-energy food pattern'. These dietary patterns explained 39·1 % of the variance in the habitual dietary intakes of the adolescents. The refined-grain pattern was negatively associated with processing speed, which is a construct of general cognitive ability. The high-energy food pattern was negatively associated with general cognitive ability, perceptual reasoning and processing speed. Monthly household income and parents' educational attainment were positively associated with all of the cognitive measures. In multivariate analysis, only the high-energy food pattern was found to contribute significantly towards general cognitive ability after controlling for socio-economic status.
CONCLUSIONS: Consumption of foods in the high-energy food pattern contributed towards general cognitive ability after controlling for socio-economic status. However, the contribution was small.

Matched MeSH terms: Child Nutritional Physiological Phenomena/ethnology
Food and Nutrition in Malaysian Children

Karim NA, Razak NA

Nestle Nutr Inst Workshop Ser, 2019;91:123-130.
PMID: 30865965 DOI: 10.1159/000493704

Two nationwide studies, namely the South East Asian Nutrition Survey (SEANUTS Malaysia) and MyBreakfast study showed that 13-17% of children aged between 6 and 12 years were either overweight or obese. From dietary assessment, the majority of children achieved the Malaysian recommended nutrient intake (RNI) for energy and protein, but more than 50% did not fulfill the RNI for calcium and vitamin D. The majority of children consumed breakfast regularly; however, 20-30% of children skipped breakfast. 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. RTEC was the major contributor of whole grain (68.6%), followed by hot cereal (18.6%), biscuits (8.7%), and bread (1.8%). In the SEANUTS Malaysia, among children aged 7-9 years, 13.4 and 9.5% met the Malaysian Dietary Guideline (MDG) for fruits and vegetables while among children aged 10-12 years, only 19.6 and 16.1%, respectively, met the MDG for fruits and vegetables. For the milk group, only 5.5% of 7- to 9-year-old children and 3.7% of those 10-12 years old met the MDG for milk/dairy products per day.

Matched MeSH terms: Child Nutritional Physiological Phenomena
Nutritional status of primary school children: a comparative rural & urban study 1976

Rampal L

Med J Malaysia, 1977 Sep;32(1):6-16.
PMID: 609347
Matched MeSH terms: Child Nutritional Physiological Phenomena*
Fulltext A short term nutrition education programme improved nutrition knowledge and increased preference for fruits, vegetables and higher intensity physical activity among kindergarteners

Stephanie Lee Lay Hua, Bonnie Teh Shou Yi, Ramlah George

Malaysian Journal of Medicine and Health Sciences, 2019;15(106):92-92.
MyJurnal

Introduction: Nutrition education is crucial to promote healthy eating behaviours and lifestyle that can prevent nutrition related non-communicable diseases. Young children are known to be amenable to nutrition education programmes and the school setting provides ideal opportunity for young children to learn. It is important to measure the impact of such programmes to determine its usefulness. Thus, the current study described the impact of a short-term nutrition education programme in kindergarteners. Methods: This pre and post-test design study involved 20 kindergarteners (aged 6 years) at Pusat Minda Lestari, Universiti Malaysia Sabah. The participants of the programme received a nutrition education module at school which comprised of nutrition lessons on key messages in the Ma-laysian Dietary Guidelines and related hands-on activities for 30min/day on 10 consecutive school days. Main outcomes were children’s nutrition knowledge and attitude, their preference for fruits and/or vegetables in a meal and types of physical activity most frequently done. These were all measured using established age-appropriate methods and tools. Results: After receiving the nutrition module; study participants’ mean score for overall nutrition knowledge significantly improved by 60%, self-reported attitude towards healthy foods were more positive and the majority of participants (85% combined) reported that they would prefer to include either vegetables, fruits or vege-tables & fruits in their meal rather than none at all (65% preferred no fruits and vegetables at baseline). The number of participants who said they preferred doing healthier types of physical activities rather than sedentary activities increased by 40% after the programme. Conclusion: This short-term nutrition programme appeared to increase kin-dergarteners’ interest in making healthy food choices and doing moderate to high intensity physical activities. Thus, the nutrition education module used in this programme may be useful in promoting healthy eating behaviours and physical activity in young children.

Matched MeSH terms: Child Nutritional Physiological Phenomena
Fulltext Validity and Reliability of a Food Frequency Questionnaire (FFQ) to Assess Dietary Intake of Preschool Children

Noor Hafizah Y, Ang LC, Yap F, Nurul Najwa W, Cheah WL, Ruzita AT, et al.

Int J Environ Res Public Health, 2019 11 27;16(23).
PMID: 31783477 DOI: 10.3390/ijerph16234722

As there are few food frequency questionnaires (FFQ) to assess the dietary intake of preschool children, this study examined the validity and reliability of an FFQ for this purpose. A total of 210 preschoolers aged 4 to 6 years participated in the validation study, while a subsample of 66 participants joined the reliability study. The FFQ is modified from the ToyBox-study and South East Asian Nutrition Surveys (SEANUTS), and comprised 108 food items from 13 food groups. A three-day estimated dietary record (3DR) was used as reference and reliability was assessed through a second administration of the FFQ (FFQ2), four weeks after the first administration (FFQ1). For the validation study, Spearman's correlation coefficients showed moderate to high correlations (p < 0.001) between FFQ and 3DR. Cross-classification of quartile analysis showed moderate agreement between the two methods. As for reliability, Spearman's correlation coefficients showed moderate to high correlations (p < 0.001) between FFQ1 and FFQ2. Cronbach's alpha values (0.708 to 0.824) and intraclass correlation coefficients (0.710 to 0.826) showed good agreement between repeated FFQs. The results suggest that the FFQ has acceptable validity and good reliability. Hence, the FFQ can be used to assess preschool children's food intake.

Matched MeSH terms: Child Nutritional Physiological Phenomena/physiology*
Fulltext Nutritional disorders encountered in children in the Department of Paediatrics, Singapore

Paul FM

Singapore Med J, 1974 Dec;15(4):231-40.
PMID: 4458066

Ninety-six cases of severe malnutrition and associated nutritional disorders were encountered in children in the department of paediatrics for the year 1971. The predominant age group was in children under the age of two years. Malay and Indian children were affected more than the Chinese children with malnutrition. Protein caloric malnutrition had already affected the growth pattern of these children as the majority were below the 50th percentile in height and weight comparing them with Hong Kong childrens’ height and weight standards. Seventy-ﬁve per cent of the children presented with infection. Fifty-four per cent of the families with malnutrition had three to six children and in two thirds of the families the income was from $100/- to $249/- per month. Forty per cent of the children lived in the kampong type of houses with no proper sanitation. Worm infestation was common in this group. The mean haemoglobin, serum iron levels, and serum folic acid levels were lower in the Indians and Malays. Protein caloric malnutrition must be treated early because of its irreversible effects on brain and bone growth. It is recommended that some form of allowance either in the form of food or money be given to these children from poor social-economic background.

Matched MeSH terms: Child Nutritional Physiological Phenomena
Fulltext Childhood Cryptosporidium infection among aboriginal communities in Peninsular Malaysia

Al-Mekhlafi HM, Mahdy MA, 'Azlin MY, Fatmah MS, Norhayati M

Ann Trop Med Parasitol, 2011 Mar;105(2):135-43.
PMID: 21396250 DOI: 10.1179/136485911X12899838683368

Cryptosporidium is a coccidian parasite that is prevalent worldwide, some species of which cause morbidity in both immunocompromised and immunocompetent individuals. The prevalence and predictors of Cryptosporidium infection, and its effect on nutritional status, have recently been explored among 276 children (141 boys and 135 girls, aged 2-15 years) in aboriginal (Orang Asli) villages in the Malaysian state of Selangor. Faecal smears were examined by the modified Ziehl-Neelsen staining technique while socio-economic data were collected using a standardized questionnaire. Nutritional status was assessed by anthropometric measurements. Cryptosporidium infection, which was detected in 7.2% of the aboriginal children, was found to be significantly associated with low birthweight (≤2.5 kg), being part of a large household (with more than seven members) and prolonged breast feeding (>2 years). The output of a binary logistic regression confirmed that large household size was a significant predictor of Cryptosporidium infection (giving an odds ratio of 2.15, with a 95% confidence interval of 1.25-5.02). Cryptosporidium infection is clearly a public-health problem among the aboriginal children of Selangor, with person-to-person the most likely mode of transmission.

Matched MeSH terms: Child Nutritional Physiological Phenomena/physiology
Fulltext Risk factors of malnutrition among preschool children in Terengganu, Malaysia: a case control study

Wong HJ, Moy FM, Nair S

BMC Public Health, 2014;14:785.
PMID: 25086853 DOI: 10.1186/1471-2458-14-785

Childhood malnutrition is a multi-dimensional problem. An increase in household income is not sufficient to reduce childhood malnutrition if children are deprived of food security, education, access to water, sanitation and health services. The aim of this study is to identify the characteristics of malnourished children below five years of age and to ascertain the risk factors of childhood malnutrition in a state in Malaysia.

Matched MeSH terms: Child Nutritional Physiological Phenomena

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