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Fulltext Salt intakes and salt reduction initiatives in Southeast Asia: a review

Batcagan-Abueg AP, Lee JJ, Chan P, Rebello SA, Amarra MS

Asia Pac J Clin Nutr, 2013;22(4):490-504.
PMID: 24231008 DOI: 10.6133/apjcn.2013.22.4.04

Increased dietary sodium intake is a modifiable risk factor for cardiovascular disease. The monitoring of population sodium intake is a key part of any salt reduction intervention. However, the extent and methods used for as-sessment of sodium intake in Southeast Asia is currently unclear. This paper provides a narrative synthesis of the best available evidence regarding levels of sodium intake in six Southeast Asian countries: Indonesia, Malaysia, Philippines, Singapore, Thailand, Vietnam, and describes salt reduction measures being undertaken in these countries. Electronic databases were screened to identify relevant articles for inclusion up to 29 February 2012. Reference lists of included studies and conference proceedings were also examined. Local experts and researchers in nutrition and public health were consulted. Quality of studies was assessed using a modified version of the Downs and Black Checklist. Twenty-five studies fulfilled the inclusion criteria and were included in this review. Full texts of 19 studies including government reports were retrieved, with most studies being of good quality. In-sufficient evidence exists regarding salt intakes in Southeast Asia. Dietary data suggest that sodium intake in most SEA countries exceeded the WHO recommendation of 2 g/day. Studies are needed that estimate sodium intake using the gold standard 24-hour urinary sodium excretion. The greatest proportion of dietary sodium came from added salt and sauces. Data on children were limited. The six countries had salt reduction initiatives that differed in specificity and extent, with greater emphasis on consumer education.

Matched MeSH terms: Nutrition Policy
Fulltext Recommended dietary allowances harmonization in Southeast Asia

Barba CV, Cabrera MI

Asia Pac J Clin Nutr, 2008;17 Suppl 2:405-8.
PMID: 18460439

Issues and opportunities for RDA harmonization within the SEA region were first raised during the First Regional Forum and Workshop "RDAs: Scientific Basis and Future Directions", held in Singapore in March 1997. A regional review on RDAs in SEA showed general similarities for the different RDAs, although in some cases a country listed an exceptionally high or low RDA for a particular nutrient for a specific group. It also revealed differences in physiologic groupings and reference body weights, nutrients included and units of expression. Realizing these differences in RDA components between countries which makes technical composition different, a consensus on the need for regional collaboration and harmonization of RDAs was reached by participants from Indonesia, Malaysia, Philippines, Singapore, Thailand and Vietnam. A follow-up workshop was organized to work towards agreement throughout the region on common approaches, concepts and terminologies; application and uses, format and a research agenda. Round table discussions were held to arrive at specific recommendations for achieving harmonization. While divergence in opinions were expected, some clear-cut agreements were settled. Globalization envisions to achieve economic growth and development, with the effects expected to ripple through health, nutrition and welfare improvements. The harmonization of RDAs in SEA seeks to reach this vision by strengthening R and D capabilities (both logistic and manpower) within the region and within the countries in the region, as well as harmonizing the efforts of governments and industry within the region to reduce potential trade barriers such as those relating to food and nutrition quality assurance standards.

Matched MeSH terms: Nutrition Policy*
Development of emergency food assistance design: a nutritionally balanced, culturally tailored and cost-effective strategy for flood mitigation

Balachanthar S, Zakaria NA, Lee LK

Ecol Food Nutr, 2018 07 10;57(4):314-329.
PMID: 29989434 DOI: 10.1080/03670244.2018.1492380

Emergency food assistance forms an integral component of flood mitigation in Malaysia. A cross-sectional survey investigating emergency food assistance among 202 flood victims was conducted and alternative food assistance plan was developed using linear programming targeting post-disaster food requirement scenarios. From the study, the receipt of food aid was significantly associated with ethnicity, household income, residential area and evacuation into temporary shelters. Linear programming analysis identified nutritionally appropriate food assistance targeting mass feeding, emergency food basket, and immediate food requirement for as low as MYR 6.07 (1.55 USD), MYR 7.14 (1.82 USD), and MYR 8.00 (2.04 USD), respectively. This study provides nutritional guidelines for disaster food assistance policy.

Matched MeSH terms: Nutrition Policy
Processed foods and the nutrition transition: evidence from Asia

Baker P, Friel S

Obes Rev, 2014 Jul;15(7):564-77.
PMID: 24735161 DOI: 10.1111/obr.12174

This paper elucidates the role of processed foods and beverages in the 'nutrition transition' underway in Asia. Processed foods tend to be high in nutrients associated with obesity and diet-related non-communicable diseases: refined sugar, salt, saturated and trans-fats. This paper identifies the most significant 'product vectors' for these nutrients and describes changes in their consumption in a selection of Asian countries. Sugar, salt and fat consumption from processed foods has plateaued in high-income countries, but has rapidly increased in the lower-middle and upper-middle-income countries. Relative to sugar and salt, fat consumption in the upper-middle- and lower-middle-income countries is converging most rapidly with that of high-income countries. Carbonated soft drinks, baked goods, and oils and fats are the most significant vectors for sugar, salt and fat respectively. At the regional level there appears to be convergence in consumption patterns of processed foods, but country-level divergences including high levels of consumption of oils and fats in Malaysia, and soft drinks in the Philippines and Thailand. This analysis suggests that more action is needed by policy-makers to prevent or mitigate processed food consumption. Comprehensive policy and regulatory approaches are most likely to be effective in achieving these goals.

Matched MeSH terms: Nutrition Policy
Fulltext The role of partnership in capacity building in public health nutrition - experience of Malaysia

Awin N

Malays J Nutr, 2002 Mar;8(1):99-107.
PMID: 22692442 MyJurnal

Public Health emphasizes the plurality of the determinants of health of individuals, families and communities. Nutrition, as a major determinant of health, is itself influenced by a multitude of determinants that are under the purview of several agencies. Thus, inter-sectoral collaboration among the relevant agencies is imperative for promoting optimal health and nutrition such a partnership is manifested in the development and implementation of the National Plan of Nutrition (NPAN) of Malaysia pursuant to the International Conference on Nutrition (ICN) held in 1992. While the overall coordination of NPAN is at the Family Development Division in the Ministry of Health, the body that sees to the coordination is again a multi-agency group in the form of the National Coordinating Committee for Food and Nutrition (NCCFN). The NCCFN has representation for the nine thrust areas of NPAN that cut across various sectors including health, agriculture, education, community development and economic planning. Capacity building is a central strategy in the NPAN through the creation of positions and special budgetary allocations, and the implementation of activities including research, training, development of dietary guidelines and the National Nutrition Policy. This policy will be a major driving force for strengthening and building of capacity for nutrition-related activities, and more importantly it will facilitate a coordinated and coherent approach to capacity building, including sharing of resources.

Matched MeSH terms: Nutrition Policy
Fulltext Diet quality and its associated factors among community dwelling older adults in urban district in Kuala Lumpur, Malaysia

Amin Faiz Nohan, Siti Nur ‘Asyura Adznam, Rosita Jamaluddin, Camilla Wahida Norazman

Malaysian Journal of Medicine and Health Sciences, 2020;16(106):153-162.
MyJurnal

Introduction: Diet quality is an essential factor in determining the adherence towards dietary guidelines. This study aims to assess the diet quality among community-dwelling older adults and identify the factors associated with the diet quality. Method: This is a cross-sectional study, conducted among 138 community-dwelling older adults living in PPR flats, Kuala Lumpur. Subjects were randomly recruited in this study. Diet Quality Index (DQI) was used to identify diet quality index of elderly. The Chi-square Test of Independence and Pearson’s correlation test were used to determine the association between tested covariates with DQI. Results: Majority of the respondents were report- ed with good diet quality (74.6%), whereas quarter of them (25.6%) had poor diet quality. Significant difference between the diet quality and the adherence on the food groups were observed for all food groups (p

Matched MeSH terms: Nutrition Policy
Fulltext Diet optimization using linear programming to develop low cost cancer prevention food plan for selected adults in Kuala Lumpur, Malaysia

Alaini R, Rajikan R, Elias SM

BMC Public Health, 2019 Jun 13;19(Suppl 4):546.
PMID: 31196148 DOI: 10.1186/s12889-019-6872-4

BACKGROUND: Poor dietary habits have been identified as one of the cancer risks factors in various epidemiological studies. Consumption of healthy and balance diet is crucial to reduce cancer risk. Cancer prevention food plan should consist of all the right amounts of macronutrients and micronutrients. Although dietary habits could be changed, affordability of healthy foods has been a major concern, as the price of healthy foods are more expensive the unhealthy counterparts.
METHODS: Therefore, using linear programming, this study is aimed to develop a healthy and balanced menu with minimal cost in accordance to individual needs that could in return help to prevent cancer. A cross sectional study involving 100 adults from a local university in Kuala Lumpur was conducted in 3 phases. The first phase is the data collection for the subjects, which includes their socio demographic, anthropometry and diet recall. The second phase was the creation of a balanced diet model at a minimum cost. The third and final phase was the finalization of the cancer prevention menu. Optimal and balanced menus were produced based on respective guidelines of WCRF/AICR (World Cancer Research Fund/ American Institute for Cancer Research) 2007, MDG (Malaysian Dietary Guidelines) 2010 and RNI (Recommended Nutrient Intake) 2017, with minimum cost.
RESULTS: Based on the diet recall, most of subjects did not achieve the recommended micronutrient intake for fiber, calcium, potassium, iron, B12, folate, vitamin A, vitamin E, vitamin K, and beta-carotene. While, the intake of sugar (51 ± 19.8 g), (13% ± 2%) and sodium (2585 ± 544 g) was more than recommended. From the optimization model, three menus, which met the dietary guidelines for cancer prevention by WCRF/AICR 2007, MDG 2010 and RNI 2017, with minimum cost of RM7.8, RM9.2 and RM9.7 per day were created.
CONCLUSION: Linear programming can be used to translate nutritional requirements based on selected Dietary Guidelines to achieve a healthy, well-balanced menu for cancer prevention at minimal cost. Furthermore, the models could help to shape consumer food choice decision to prevent cancer especially for those in low income group where high cost for health food has been the main deterrent for healthy eating.

Matched MeSH terms: Nutrition Policy*
Fulltext Dietary Fat and Fibre Intakes of Malaysian Adults: Issues and Implications when â€˜Western Targetsâ€™ Are Set as Dietary Goals

Malays J Nutr, 1997;3(2):-.
MyJurnal

This article examines the fat and fibre intakes of Malaysian adults and highlights discrepancies and practical limitations if these intakes are to match the levels for these nutrients advocated in the World Health Organisation (WHO) and American Heart Association (AHA) â€˜diet modelsâ€™. Local data on food consumption showed that the total fat intakes amongst Malaysian adults, contrary to common perception, were not high and the mean values obtained fell within the range of 40-66g or 22-26% kcal. As such, the dietary target of 30% kcal total fat or its intermediate target of 30-35% kcal, advocated by WHO and AHA mainly to address the problem of a high consumption of dietary fats in western populations, should not be adopted indiscriminately by Malaysians. Dietary fatty acid (FA) analysis by high performance liquid chromatography (HPLC) coupled with the use of food composition tables, showed that the typical Malaysian diet prepared with palm olein or palm olein-groundnut oil blends as cooking oil contained 3.2-4.0% kcal polyunsaturated fatty acids (PUFA), mainly as the w-6 linoleic acid, which is also the predominant essential fatty acid (EFA) in humans. This level of linoleic acid, with an Ï‰-6/ Ï‰--3 FA ratio approximating 10, is adequate for basal PUPA and EFA needs but fell short of the 4-10% kcal linoleic acid recommended by WHO (1993) to counter the effects of the cholesterol-raising saturated fatty acids (SFA). This raised upper limit of 10% kcal linoleic acid (previously 7% kcal), which equals the level of PUFA implied in the AHA diet model, appears unnecessarily high considering that the cholesterol-lowering potential of linoleic acid is maximum at about 6% kcal, while the health hazards associated with long-term high intakes of PUPA have never been completely dismissed. The new WHO lower limit for dietary linoleic acid (4% kcal) would have a controversial impact of raising the previous minimal 3% kcal EFA to above 4% kcal (linoleic + alpha-linolenic acids). Similarly, the WHO recommendation for total dietary fibre of 27-40g (equivalent to a daily combined intake of 400g of vegetables and fruits, 30g of which should come from pulses) appears at present, too high a dietary target for the average Malaysian adult whose habitual daily diet was estimated to contain about 180g of vegetables plus fruits, providing only about 13-16g total dietary fibre. Appropriately, an expert panel on Malaysian Dietary Guidelines has recommended instead, 20-30% kcal total fat containing 3-7% kcal PUFA, and 20-30g total dietary fibre for the local population.

Matched MeSH terms: Nutrition Policy
Fulltext Review article : Malaysia’s strategic food security approach

International Food Research Journal, 2010;17(3):501-507.
MyJurnal

This paper is interested in exploring the interrelatedness of some accompanying policy changes and
initiatives in the selected Asian countries as well as reviewing the Malaysian National Food Security Policy. Actions taken in response to the food crisis in the selected Asian countries have worked out well and produced promising outcomes from a combination of availability, accessibility, utilization, and stability aspects in food security. Malaysia weighted more on availability aspect in food security by introducing more short- and longterm policy measures for boosting paddy and rice production, particularly in Sabah and Sarawak under the National Food Security Policy. However, much of the unhappiness and disequilibrium in the local paddy and rice market were created due to irrational extensive intervention of the Miller Subsidy and Beras Nasional programmes in the nation. Many of the policy measures targeted at area expansion and productivity but it was suggested that the dominant path to achieve the targeted self-sufficiency level is through research and development at specialized and committed paddy and rice research centre. Trade oriented self-reliance approach that strategized with multiple and diversified sources of rice import was tipped to be superior of current selfsufficiency approach.

Matched MeSH terms: Nutrition Policy