The nutrition transition in Malaysia; key drivers and recommendations for improved health outcomes

Malaysia is an example of a nation that is fast developing and has undergone significant socioeconomic and demographic changes since gaining independence in 1957. Rapid industrialization and a shift in employment patterns have resulted from Malaysia’s economy’s transition from primary and secondary to tertiary sectors. The fundamental way that globalization alters the current structure to bring the home economy closer to the global economy is by increasing the absorption of labor, income, and general prosperity. Transitions typically refer to the shift from traditional food and lifestyle to a more “westernized” or universal one, as well as from a mostly agrarian-based economy to an industrialized one. Famine reduction, degenerative disease, and behavioral change are three different phases that set the changes apart from one another. This transition in nutrition is preceded by demographic changes, such as populations with high fertility rates and short life expectancies becoming populations with lower fertility rates and longer life expectancies, as well as epidemiological changes, such as populations with high rates of infectious disease, poor sanitation, periodic famine, and malnutrition becoming populations with chronic disease and excessive consumption. The nutrition transition is not new to Malaysia.

The nutrition transition in Malaysia; key drivers and recommendations for improved health outcomes

Key drivers and recommendations

1) An abundance of food

The “expansion” stage of the nutrition transition has been characterized by an increase in access to and availability of more and less expensive food due to a slowing rate of population growth (Transitioning Demographic (DSM)) and a rapid increase in GDP (Rapid Economic Growth and Transition (DSM)). The availability of calories accessible during the review period suggests that Malaysia has been in the expansion stage of transition for more than 35 years. The average Malaysian woman and man had access to around 93 and 45% more calories than they required between 2010 and 2013.

2) Change in types of foods consumed

Malaysia began the “substitution phase” of the nutrition transition during the time period under consideration. While there is little to no change in the total energy supply, this phase is characterized by a change in the types of food ingested. Legumes, other vegetables, and fruits tend to be consumed less, while intake of refined carbs, added sugars, edible oils, and meals derived from animals tend to grow. Due to variations in culture, religious traditions, and beliefs, this transition may be different from one nation to the next.

In Malaysia, people choose chicken and fish over red meat for a number of reasons, including affordability, convenience, adaptability, quick availability, and acceptance by all ethnic groups. As a multicultural and multireligious country, Malaysia has a greater acceptance of fish, seafood, and poultry than of red meats like pork and beef, which are forbidden to Muslims and Hindus, respectively. Avoiding beef is also customary among Chinese who practice some forms of Buddhism. Cattle raised for meat or dairy products cannot be raised in Malaysia due to the temperature and topography (there is no grassland). Due to intensive poultry farming for the production of meat and eggs, chicken meat and eggs may be purchased at very reasonable costs.

The rise in wheat consumption is a further tendency that is widespread in nations that are transitioning. Malaysia is also consuming less rice and more wheat. It is significant to remember that rice is customarily polished and cooked or steamed before consumption, whereas wheat is typically consumed in its highly processed form of flour. A bowl of steamed rice is less processed and has fewer “value-added” ingredients than any wheat-based food offered in Malaysia, to put things in perspective. Additionally, wheat-based foods are consumed in a way that is more calorific but less nutritive. For instance, “Roti Canai,” or Malaysian flatbread, a popular breakfast food, is produced with dough made from refined wheat flour that is repeatedly kneaded, flattened, oiled, and folded before being proofed and shallow fried in additional oil.

3) Eating out

The rise in eating out and the demand for convenience foods have been fueled by changing lifestyles, primarily because of work commitments. More than 64% of Malaysians, according to the Malaysian Food Barometer, have at least one meal daily away from home; of the other 36% who eat at home, 12.5% consume at least one meal that is away from home. Foods were traditionally provided by moms as home-cooked, regional delicacies. Eating out is becoming more and more common in Malaysia as a result of the rise of “dual-income” families. It is also not shocking that a third of people, according to the review, eat a fourth large meal late at night. In fact, 24-hour dining has become so ingrained in Malaysian culture that the government was forced to abandon a plan to outlaw it in response to public outcry.

4) Trendy food culture

Outlets that provide trendy food are quickly emerging as a fundamental element of the developing urban food culture. It is impossible to ignore the long line outside these businesses. The use of “bubble tea,” a high-calorie, sweetened tea-flavored beverage containing chewy tapioca balls, is the most recent craze throughout Asia, including Malaysia. In Malaysia, there is a growing interest in coffee culture. The popular coffee shops are well-known international brands that are supported by independent local enterprises that also provide copious amounts of cakes and pastries and sweetened milk-based beverages. Juice and smoothie drinks are marketed by kiosk chains as being healthful and having a number of claimed advantages, including “immune-boosting” and “detoxing.”

The nutrition transition in Malaysia; key drivers and recommendations for improved health outcomes


Nutrition action plans and policies to improve health

The government has been working to coordinate the many agencies’ nutrition intervention programs across the nation since the early 1990s. The National Plan of Action for Nutrition in Malaysia (NPANM I) served as the initial plan (1996 to 2000). The main focus of this strategy was undernutrition. In the meantime, the issue of being overweight was acknowledged for the first time, and NPANM I provided techniques to limit unhealthful weight rise in the populace. Unfortunately, throughout the period of NPANM I implementation, the prevalence of overweight and obesity increased by 60 and 177%, respectively, in addition to the fact that the techniques had no effect at all. 

All of these initiatives ignored the potential negative effects that an oversupply of cheap, easily accessible calories can have. Policymakers anticipated that the general public would enthusiastically adopt a trickle-down strategy of commercials and giveaways urging people to eat less and exercise more. The people were simultaneously embracing the rapid development that urbanization and globalization brought forth. It is challenging to ask someone to alter or moderate their behavior while they are experiencing abundance.

Subsidies and taxes

While the MoH developed strategies to enhance health outcomes, other government agencies provided a variety of subsidies and incentives to guarantee “cheap food for all.” The government spends at least RM2 billion a year subsidizing basic needs (USD 450 million). This budget includes consumer subsidies in addition to agricultural subsidies, particularly incentives for rice production. The four consumer goods that receive government subsidies are sugar, flour, rice, and cooking oil, all of which are high in calories but low in nutrients. This subsidy may help to explain some of the rising per capita supply and surplus of these goods. The development of programs to subsidize these nutrient-poor, energy-dense food items has made the glut of surplus calories worse. It is counterintuitive to keep providing subsidies to improve access to and availability of these items.

Increase accessibility for local fruits and vegetables 

The fruit and vegetable sector in Malaysia is typically underutilized. Rice and the commodity crops of oil palm, rubber, cocoa, and most recently durian, have received the majority of attention in the growth of agriculture. Policymakers must provide at least equal research funding and financial support to regional growers of fruits and vegetables in order to boost accessibility. The best way to change behavior while also providing society with long-term financial gains is through subsidies. In order to foster healthier eating habits, fruits and vegetables should be subsidized rather than the aforementioned energy-dense items. Reduced fruit and vegetable consumption is frequently associated with ill health and a higher risk of developing NCDs. Due to their high fiber and vitamin content, fruits and vegetables may have beneficial benefits on the body by reducing blood pressure, enhancing lipoprotein profile, and boosting insulin sensitivity.

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