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The effect of being overweight on cancer incidence and all-cause mortality in Asians: a prospective study in Singapore

Lee J, Wang H, Chia KS, Koh D, Hughes K

Int J Epidemiol, 2002 Aug;31(4):875-6.
PMID: 12177037
Matched MeSH terms: Obesity/epidemiology
Fulltext Obesity in primary care patients in Kelantan, Malaysia: prevalence, and patients' knowledge and attitudes

Jackson A, Cole C, Esquiro J, Edwards M

Southeast Asian J. Trop. Med. Public Health, 1996 Dec;27(4):776-9.
PMID: 9253884

This study measured the body mass index (BMI), and assessed attitudes and knowledge about obesity, of 197 male and 217 female patients aged 20-59 years attending the primary care clinic of the university hospital in Kelantan, Malaysia. There was no significant difference between the mean BMI of males (23.7) and females (24.2). In the overweight group (BMI 25-29.9) were 60 men (30%) and 66 women (30%). In the obese group (BMI 30 and above) were 12 men (6%) and 22 women (10%). Both diabetes mellitus and hypertension were associated with significantly higher BMI's. Knowledge about obesity was lacking. Sixty-three (15%) failed to recognize that obesity is bad for health. When asked the causes of obesity, 88 (21%) failed to mention either diet or lack of exercise. "Being happy" was suggested as a cause by 32 (8%). When asked if certain foods would cause obesity if eaten in excess, 45 (11%) said "No" for fatty foods, and 164 (40%) said "No" for sweet foods. Concerning appearance, 30 (15%) men regarded an obese man as normal or even handsome, while 49 (23%) women regarded an obese woman as normal or beautiful. Obesity is common among our adult patients, and is associated with some of their common health problems. However, a substantial minority do not regard obesity as unhealthy, do not relate it to diet or lack of exercise, do not recognize important groups of fattening foods, and do not regard obesity as unattractive.

Matched MeSH terms: Obesity/epidemiology*
Comparative study of the prevalence of adult obesity in the three racial groups of Kuala Lumpur

Jones JJ

Med J Malaysia, 1976 Jun;30(4):256-60.
PMID: 979725
Matched MeSH terms: Obesity/epidemiology*
Fulltext Obesity and unhealthy lifestyle associated with poor executive function among Malaysian adolescents

Tee JYH, Gan WY, Tan KA, Chin YS

PLoS One, 2018;13(4):e0195934.
PMID: 29664932 DOI: 10.1371/journal.pone.0195934

The understanding on the roles of obesity and lifestyle behaviors in predicting executive function of adolescents has been limited. Low executive function proficiency may have adverse effects on adolescents' school academic performance. This cross-sectional study aimed to examine the relationship between BMI-for-age and multiple lifestyle behaviors (operationalized as meal consumption, physical activity, and sleep quality) with executive function (operationalized as inhibition, working memory, and cognitive flexibility) on a sample of Malaysian adolescents aged between 12 and 16 years (N = 513). Participants were recruited from two randomly selected schools in the state of Selangor in Malaysia. Using a self-administered questionnaire, parent participants provided information concerning their sociodemographic data, whereas adolescent participants provided information regarding their meal consumptions, physical activity, and sleep quality. The modified Harvard step test was used to assess adolescents' aerobic fitness, while Stroop color-word, digit span, and trail-making tests were used to assess adolescents' inhibition, working memory, and cognitive flexibility, respectively. Three separate hierarchical regression analyses were conducted for each outcome namely, inhibition, working memory, and cognitive flexibility. After adjusted for sociodemographic factors and BMI-for-age, differential predictors of inhibition and working memory were found. Habitual sleep efficiency significantly and positively predicted inhibition. Regular dinner intakes, physical activity levels, and sleep quality significantly and positively predicted working memory. Household income emerged as a consistent predictor for all executive function domains. In conclusion, an increased trend of obesity and unhealthy lifestyles among adolescents were found to be associated with poorer executive function. Regular dinner intakes, higher physical activity levels and better sleep quality predicted better executive function despite the inverse relationship between obesity and executive function. Future studies may explore how lifestyle modifications can optimize the development of executive function in adolescents as well as relieve the burden of obesity.

Matched MeSH terms: Obesity/epidemiology*
Fulltext Effect of national culture on BMI: a multilevel analysis of 53 countries

Masood M, Aggarwal A, Reidpath DD

BMC Public Health, 2019 Sep 03;19(1):1212.
PMID: 31481044 DOI: 10.1186/s12889-019-7536-0

BACKGROUND: To investigate the association between national culture and national BMI in 53 low-middle- and high-income countries.
METHODS: Data from World Health Survey conducted in 2002-2004 in low-middle- and high-income countries were used. Participants aged 18 years and over were selected using multistage, stratified cluster sampling. BMI was used as an outcome variable. Culture of the countries was measured using Hofstede's cultural dimensions: Uncertainty avoidance, individualism, Power Distance and masculinity. The potential determinants of individual-level BMI were participants' sex, age, marital status, education, occupation as well as household-wealth and location (rural/urban) at the individual-level. The country-level factors used were average national income (GNI-PPP), income inequality (Gini-index) and Hofstede's cultural dimensions. A two-level random-intercepts and fixed-slopes model structure with individuals nested within countries were fitted, treating BMI as a continuous outcome variable.
RESULTS: A sample of 156,192 people from 53 countries was included in this analysis. The design-based (weighted) mean BMI (SE) in these 53 countries was 23.95(0.08). Uncertainty avoidance (UAI) and individualism (IDV) were significantly associated with BMI, showing that people in more individualistic or high uncertainty avoidance countries had higher BMI than collectivist or low uncertainty avoidance ones. This model explained that one unit increase in UAI or IDV was associated with 0.03 unit increase in BMI. Power distance and masculinity were not associated with BMI of the people. National level Income was also significantly associated with individual-level BMI.
CONCLUSION: National culture has a substantial association with BMI of the individuals in the country. This association is important for understanding the pattern of obesity or overweight across different cultures and countries. It is also important to recognise the importance of the association of culture and BMI in developing public health interventions to reduce obesity or overweight.

Matched MeSH terms: Obesity/epidemiology*
Fulltext Socio-Demographic Factors and Body Image Perception Are Associated with BMI-For-Age among Children Living in Welfare Homes in Selangor, Malaysia

A Rahim NN, Chin YS, Sulaiman N

Nutrients, 2019 Jan 11;11(1).
PMID: 30641864 DOI: 10.3390/nu11010142

Considering the double burden of malnutrition in Malaysia, data on malnourished children living in welfare homes are limited. This study aimed to determine the body weight status of children living in welfare homes and its associated factors. A total of 307 children aged 7⁻17 years old living in 15 selected welfare homes completed a standardized questionnaire, and their body weight and height were measured by trained researchers. There were 54.4% orphans, 23.8% abandoned children, and 21.8% children from problematic families. There were 51.5% boys and 48.5% girls; 52.4% were Malays, followed by 31.3% Indians, 12.7% Chinese, and 3.6% from other ethnic groups. The prevalence of overweight and obesity (23.1%) was higher than the prevalence of thinness (8.5%). In bivariate analyses, socio-demographic factors of age (p = 0.003), sex (p = 0.0001), ethnicity (p = 0.001), and welfare home enrollment status (p = 0.003), and psychological factors of self-esteem (p = 0.003), body shape dissatisfaction (p = 0.0001), and underestimation of body weight status (p = 0.002), were significantly associated with body mass index (BMI)-for-age. In the multiple linear regression analysis, children who were either Malays (β = 0.492) or Chinese (β = 0.678), with a status of being abandoned (β = 0.409), with body shape dissatisfaction (β = 0.457), and underestimated body weight status (β = 0.628) significantly explained 39.7% of the variances in higher BMI-for-age (F = 39.550; p < 0.05). Besides socio-demographic background, the current findings emphasized the importance of incorporating body image perception in an obesity prevention intervention program in welfare homes.

Matched MeSH terms: Obesity/epidemiology*
Biliary-tract disease in Malaya

King MS

Br J Surg, 1971 Nov;58(11):829-32.
PMID: 5124853
Matched MeSH terms: Obesity/epidemiology
Fulltext Association between Availability of Neighborhood Fast Food Outlets and Overweight Among 5⁻18 Year-Old Children in Peninsular Malaysia: A Cross-Sectional Study

Chee Cheong K, Yoon Ling C, Kuang Hock L, Mohd Ghazali S, Chien Huey T, Che Ibrahim MK, et al.

Int J Environ Res Public Health, 2019 02 18;16(4).
PMID: 30781699 DOI: 10.3390/ijerph16040593

A growing number of fast-food outlets in close proximity to residential areas raises a question as to its impact on childhood overweight and obesity. This study aimed at determining the relationship between the availability of fast-food outlets that were in close proximity to residential areas and overweight among Malaysian children aged 5 to 18 years. Measurement data on the weight and height of 5544 children (2797 boys, 2747 girls) were obtained from the National Health and Morbidity Survey 2011. Overweight (including obesity) is defined as BMI-for-age z-score > +1 SD based on the WHO growth reference. Geographic information system geospatial analysis was performed to determine the number of fast-food outlets within 1000 m radius from the children's residential address. Multiple logistic regression was conducted to examine the association between the availability of fast-food outlets (none or more than one outlet) and overweight with adjustment for age, sex, ethnicity, monthly household income, parental educational level, residential area and supermarket density. Our results showed that the prevalence of overweight was 25.0% and there was a statistically significant association between the density of fast-food outlets and overweight (odds ratio: 1.23, 95% confidence interval: 1.03, 1.47). Our study suggested that the availability of fast-food outlets with close proximity in residential areas was significantly associated with being overweight among children. Limiting the number of fast-food outlets in residential areas could have a significant effect in reducing the prevalence of overweight among Malaysian children.

Matched MeSH terms: Pediatric Obesity/epidemiology*
Fulltext Familial and socio-environmental predictors of overweight and obesity among primary school children in Selangor and Kuala Lumpur

Serene TE, Shamarina S, Mohd NM

Malays J Nutr, 2011 Aug;17(2):151-62.
PMID: 22303570 MyJurnal

A cross-sectional study was conducted to determine the familial and socio-environmental predictors of overweight and obesity among 1430, 9-12 year-old primary school children and their parents in Selangor and Kuala Lumpur.

Matched MeSH terms: Obesity/epidemiology*
Fulltext Overweight and obesity among Malay primary school children in Kota Bharu, Kelantan: parental beliefs, attitudes and child feeding practices

Wan AM, Norazawati AK, Lee YY

Malays J Nutr, 2012 Apr;18(1):27-36.
PMID: 23713227 MyJurnal

The increasing prevalence of overweight and obesity among children has become a major public health problem in Malaysia. Parents play an important role in child feeding especially among younger children.

Matched MeSH terms: Obesity/epidemiology*
Fulltext The Gradual Shift of Overweight, Obesity, and Abdominal Obesity Towards the Poor in a Multi-ethnic Developing Country: Findings From the Malaysian National Health and Morbidity Surveys

Mariapun J, Ng CW, Hairi NN

J Epidemiol, 2018 06 05;28(6):279-286.
PMID: 29657257 DOI: 10.2188/jea.JE20170001

BACKGROUND: Economic development is known to shift the distribution of obesity from the socioeconomically more advantaged to the less advantaged. We assessed the socioeconomic trends in overweight, obesity, and abdominal obesity across a period of significant economic growth.
METHODS: We used the Malaysian National Health and Morbidity Survey data sets for the years 1996, 2006, and 2011 to analyze the trends among adults aged 30 years and above. The World Health Organization's Asian body mass index cut-off points of ≥23.0 kg/m2 and ≥27.5 kg/m2 were used to define overweight and obesity, respectively. Abdominal obesity was defined as having a waist circumference of ≥90 cm for men and ≥80 cm for women. Household per-capita income was used as a measure of socioeconomic position. As a summary measure of inequality, we computed the concentration index.
RESULTS: Women in Peninsular Malaysia demonstrated patterns that were similar to that of developed countries in which the distributions for overweight, obesity, and abdominal obesity became concentrated among the poor. For women in East Malaysia, distributions became neither concentrated among the rich nor poor, while distributions for men were still concentrated among the rich. Chinese women, particularly from the richest quintile, had the lowest rates and lowest increase in overweight and obesity. All distributions of Chinese women were concentrated among the poor. The distributions of Malay men were still concentrated among the rich, while distributions for Chinese and Indian men and Malay and Indian women were neither concentrated among the rich nor poor.
CONCLUSION: As the country continues to progress, increasing risks of overweight and obesity among the socioeconomically less advantaged is expected.
Study name: National Health and Morbidity Survey (NHMS-1996, NHMS-2006, NHMS-2011)

Matched MeSH terms: Obesity/epidemiology*
Fulltext Predisposition to insulin resistance and obesity due to staple consumption of rice: Amylose content versus germination status

Abubakar B, Zawawi N, Omar AR, Ismail M

PLoS One, 2017;12(7):e0181309.
PMID: 28727791 DOI: 10.1371/journal.pone.0181309

Type 2 diabetes is a metabolic disorder with established, well-defined precursors. Obesity and insulin resistance are amongst most important factors in predisposition to diabetes. Rice is a staple for about half the global population and its consumption has been strongly linked with diabetogenesis. We assert that tackling the prevalence of predisposing factors by modifying certain rice cultivars could reduce the global burden of obesity and insulin resistance, and by extension type 2 diabetes. Several rice cultivars with various properties were fed to nulliparous rats (five weeks old at the start of the experiment) for 90 days. They were then returned to a diet of standard pellets and mated with males raised on a standard diet. The resulting pups and dams were investigated for obesity and insulin resistance markers. We found that germination did more to reduce predisposition to obesity and insulin resistance than high amylose content. The combined reducing effect of germination and high amylose content on predisposition to obesity and insulin resistance was greater than the sum of their independent effects. Polished (white) rice with a low amylose content predisposed dams on a high-fat diet to markers of insulin resistance and obesity and this predisposition was inherited (in biochemical terms) by their F1 offspring. Overall, the results suggest that harnessing the beneficial properties of germination and amylose in rice would reduce the burden of obesity and insulin resistance, which are known to be key risk factors for development of type 2 diabetes.

Matched MeSH terms: Obesity/epidemiology
Type 2 diabetes mellitus in Malaysia: current trends and risk factors

Tee ES, Yap RWK

Eur J Clin Nutr, 2017 07;71(7):844-849.
PMID: 28513624 DOI: 10.1038/ejcn.2017.44

This review discussed the prevalence of diabetes mellitus (DM) in Malaysia and the associated major risk factors, namely overweight/obesity, dietary practices and physical activity in both adults and school children. Detailed analyses of such information will provide crucial information for the formulation and implementation of programmes for the control and prevention of T2DM in the country. National studies from 1996-2015, and other recent nation-wide studies were referred to. The current prevalence of DM in 2015 is 17.5%, over double since 1996. Females, older age group, Indians, and urban residents had the highest risk of DM. The combined prevalence of overweight/obesity in 2015 is 47.7% for adults. Adults did not achieve the recommended intakes for majority of the foods groups in the Malaysian Food Pyramid especially fruits and vegetables. Adults also had moderate physical activity level. Three nation-wide studies showed a prevalence ranging from 27 to 31% for combined overweight/obesity in school children. The prevalence was higher among boys, primary school age, Indian ethnicity, and even rural children are not spared. Physical activity level was also low among school children. There must be serious systematic implementation of action plans to combat the high prevalence of diabetes and associated risk factors.

Matched MeSH terms: Obesity/epidemiology*
How Malaysian science can improve lives as well as the economy

Ismail A

Nature, 2018 06;558(7711):514-515.
PMID: 29950635 DOI: 10.1038/d41586-018-05509-y
Matched MeSH terms: Obesity/epidemiology
Fulltext An update on obesity research pattern among adults in Malaysia: a scoping review

Mohamad Nor NS, Ambak R, Mohd Zaki N, Abdul Aziz NS, Cheong SM, Abd Razak MA, et al.

BMC Womens Health, 2018 07 19;18(Suppl 1):114.
PMID: 30066661 DOI: 10.1186/s12905-018-0590-4

BACKGROUND: Obesity is a global health burden in the non-communicable diseases and much efforts have been implemented in the past decade in response to the rise of obesity prevalence among the Malaysian population. These include the development of the national policies, health programmes and research activities. The main aim of the scoping review was to identify obesity research pattern among adults in Malaysia in terms of the scopes, topics and the research designs.
METHODS: The scoping review was conducted based on the framework by Arksey and O'Malley. The Preferred Reporting Items for Systematic Reviews and Meta Analysis (PRISMA) diagram was used as a guide to record the review process. Articles from year 2008 until 2017 on overweight and obesity among adults aged 18 years and above were retrieved based on the keywords using electronic databases (Embase/Ovid, Pubmed, Cochrane library and Google Scholar). Local journals, Nutrition Research in Malaysia Biblography (2011 and 2016), online local theses databases, virtual library databases were also included in the searches. Consultations with relevant key informants from the National Institutes of Health and local universities were also conducted. Search activities were managed using Endnote software and MS Excelsheet.
RESULTS: The characteristics of the results were described based on the objectives of the review. A total of 2004 articles and reports were retrieved, and 188 articles related to obesity in Malaysia were included in the final review. Scopes and topics of obesity research based on the Nutrition Research Priorities in Malaysia (NRPM) for 11th Malaysia Plan were obesity prevalence, weight loss intervention, association of physical activities and dietary factors with obesity. The majority of obesity research among adults in Malaysia was cross sectional studies and only a small number of intervention studies, qualitative studies and systematic review were indentified. Research gaps were identified in order to make useful recommendations to the stakeholders.
CONCLUSIONS: In the past decade, there has been an emerging evidence on obesity research among adults in Malaysia. More obesity research needs to be conducted particularly on obesity intervention among specific gender, qualitative studies, economic cost and genetic factors of obesity.

Matched MeSH terms: Obesity/epidemiology*
Fulltext An introduction to the My Body is Fit and Fabulous at home (MyBFF@home): a community-based weight loss intervention study among Malaysian housewives

Mohamad Nor NS, Ambak R, Aris T

BMC Womens Health, 2018 07 19;18(Suppl 1):107.
PMID: 30066634 DOI: 10.1186/s12905-018-0589-x

BACKGROUND: The national prevalence of overweight and obesity in Malaysia has been increasing in the past 10 years and many efforts have been implemented by the Malaysian government to combat obesity problem among the Malaysian population. The aim of this paper was to describe the background of the My Body is Fit and Fabulous at home (MyBFF@home) study (Phase II).
DISCUSSION: The MyBFF@home (Phase II) was a quasi-experimental study and it was conducted among overweight and obese housewives living in the urban areas in Malaysia. In this phase, the study involved a weight loss intervention phase (6 months) and a weight loss maintenance phase (6 months). The intervention group received a standard weight loss intervention package and the control group received group seminars related to women's health. Measurements of weight, height, waist circumference, body composition, fasting blood lipids, dietary intake, physical activity, health literacy, body pain and quality of life were conducted during the study. Overweight and obese housewives from 14 People's Housing/Home Project (PHP) in Federal Territory of Kuala Lumpur (Klang Valley) were selected as control and intervention group (N = 328). Majority of the participants (76.1%) were from the low socioeconomic group. Data were analysed and presented according to the specific objectives and the needs for the particular topic in the present supplement report.
CONCLUSION: MyBFF@home is the first and the largest community-based weight loss intervention study which was conducted among overweight and obese housewives in Malaysia. Findings of the study could be used by the policy makers and the researchers to enhance the obesity intervention programme among female adults in Malaysia.

Matched MeSH terms: Obesity/epidemiology
MULTILEVEL LINEAR REGRESSION ANALYSIS OF FACTORS INFLUENCING BODY MASS INDEX AMONG BANGLADESHI MARRIED NON-PREGNANT WOMEN

Kamruzzaman M, Mamun ASMA, Bakar SMA, Saw A, Kamarul T, Islam MN, et al.

J Biosoc Sci, 2017 Jul;49(4):498-508.
PMID: 27866490 DOI: 10.1017/S0021932016000572

The aim of this study was to investigate the socioeconomic and demographic factors influencing the body mass index (BMI) of non-pregnant married Bangladeshi women of reproductive age. Secondary (Hierarchy) data from the 2011 Bangladesh Demographic and Health Survey, collected using two-stage stratified cluster sampling, were used. Two-level linear regression analysis was performed to remove the cluster effect of the variables. The mean BMI of married non-pregnant Bangladeshi women was 21.60±3.86 kg/m2, and the prevalence of underweight, overweight and obesity was 22.8%, 14.9% and 3.2%, respectively. After removing the cluster effect, age and age at first marriage were found to be positively (p<0.01) related with BMI. Number of children was negatively related with women's BMI. Lower BMI was especially found among women from rural areas and poor families, with an uneducated husband, with no television at home and who were currently breast-feeding. Age, total children ever born, age at first marriage, type of residence, education level, level of husband's education, wealth index, having a television at home and practising breast-feeding were found to be important predictors for the BMI of married Bangladeshi non-pregnant women of reproductive age. This information could be used to identify sections of the Bangladeshi population that require special attention, and to develop more effective strategies to resolve the problem of malnutrition.

Matched MeSH terms: Obesity/epidemiology*
Dietary Practices and Meal Patterns among Overweight and Obese School Children in Malaysia: Baseline Data from a School-Based Intervention Study

Selamat R, Raib J, Abdul Aziz NA, Zulkafly N, Ismail AN, W Mohamad WNA, et al.

Ecol Food Nutr, 2019 11 22;59(3):263-278.
PMID: 31755310 DOI: 10.1080/03670244.2019.1694922

This study aimed to determine dietary practices and meal patterns among Malaysian overweight and obese school children at baseline. This study was part of a school-based obesity intervention study, My Body is Fit and Fabulous at School (MyBFF@school). It involved 1045 primary and 1041 secondary overweight and obese school children from a randomly selected 23 out of 1196 primary and 15 out of 416 secondary government schools in central Peninsular Malaysia. The results showed a significantly higher of adequate intake (4-8 servings/day) of cereals and grains among primary (54.7%) than secondary school children (48.2%). About 28.2% of primary and 32.6% of secondary school children had consumed adequate fruit (2 servings/day), while a very low percentage of both primary (5.0%) and secondary (3.6%) school children consumed adequate vegetables (3 servings/day). As for the meal patterns, school children in both primary and secondary were not taking breakfast regularly (mean±SD for primary: 3.16 ± 2.61 days/week vs secondary: 2.97 ± 2.52 days/week). There was also a significantly higher mean frequency of primary school children brought plain water to school than the secondary school children. In conclusion, urgent actions to address improper dietary practices and meal patterns of overweight and obese school children in Malaysia are warranted.

Matched MeSH terms: Pediatric Obesity/epidemiology*
Prevalence of elevated body mass index condition and its associated demographic variables among adults in urban areas in Johor, Malaysia

Rozita Z, Lim MT, Lee HS

Med J Malaysia, 2019 04;74(2):145-150.
PMID: 31079126

INTRODUCTION: The prevalence of overweight and obesity is increasing at an alarming rate. It is a major factor for many other metabolic disorders. This study aimed to determine the prevalence of increase body mass index (BMI) and obesity and their associated demographic characteristics among adults in an urban area.
METHODS: A retrospective study was conducted where data was extracted from the Health Status Screening Form (BSSK) at health clinics in Johor Bahru. Using the World Health Organization (WHO), criteria for obesity, BMI≥30.0 kg/m2 was specified as obese and combination of both BMI ranges for overweight (25.0-30.0kg/m2) and obesity (≥30.0kg/m2) as elevated BMI.
RESULTS: The overall prevalence of elevated BMI and obesity was 54.6% and 20.1% respectively. Men had a higher prevalence of elevated BMI (57.4%) with odds of 1.28 higher (95%CI: 1.04-1.58). High prevalence of elevated BMI and obesity were seen among the Indians (elevated BMI - 60.2%, obesity - 19.4%) followed by Malays (elevated BMI -57.8%, obesity - 23.1%) and Chinese showed the lowest (elevated BMI - 39.0%, obesity - 8.8%). The odds of elevated BMI and obesity were lower among younger adults as compared to older adults (≥30 years old).
CONCLUSION: Using WHO criteria, about one in two adults had elevated BMI while one in five were obese. Elevated BMI and obesity disparities were evident in age and ethnicity, but sex differences were encountered in elevated BMI group.

Matched MeSH terms: Obesity/epidemiology*
Fulltext Food-based approaches to combat the double burden among the poor: challenges in the Asian context

Khor GL

Asia Pac J Clin Nutr, 2008;17 Suppl 1:111-5.
PMID: 18296315

Estimates of FAO indicate that 14% of the population worldwide or 864 million in 2002-2004 were undernourished in not having enough food to meet basic daily energy needs. Asia has the highest number of undernourished people, with 163 million in East Asia and 300 million in South Asia. Meanwhile obesity and diet-related non-communicable diseases continue to escalate in the region. The double burden of malnutrition also affects the poor, which is a serious problem in Asia, as it has the largest number of poor subsisting on less than $1/day. As poverty in the region is predominantly rural, agriculture-based strategies are important for improving household food security and nutritional status. These measures include shifting toward production of high-value products for boosting income, enhancing agricultural biodiversity, increasing consumption of indigenous food plants and biofortified crops. Urban poor faces additional nutritional problems being more sensitive to rising costs of living, lack of space for home and school gardening, and trade-offs between convenience and affordability versus poor diet quality and risk of contamination. Time constraints faced by working couples in food preparation and child care are also important considerations. Combating the double burden among the poor requires a comprehensive approach including adequate public health services, and access to education and employment skills, besides nutrition interventions.

Matched MeSH terms: Obesity/epidemiology

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