NATIONALHEALTHANDMORBIDITY SURVEY2014 ...iku.moh.gov.my/.../NHMS2014-MANS-VOLUME-2-SurveyFindings.pdfThe National Health and Morbidity Survey 2014: Malaysian Adult Nutrition Survey,

NATIONAL HEALTH AND MORBIDITYSURVEY 2014: MALAYSIAN ADULT

(NMRR-12-815-13100)

VOLUME IISURVEY FINDINGS

CONTRIBUTORS

The following persons had contributed in the interpretation of findings, discussion on implication, conclusions and/or drawing recommendations for this report.

(In alphabetical order)Ahmad Ali Zainuddin, Ahmad Nazri Jai, Anida @ Azhana Husna Zainudeen, Azli Baharudin, Balkish Mahadir Naidu,

Chan Ying Ying, Cheong Siew Man, Chong Zhuo Lin, Faizah Paiwai, Fauziah Nordin, Foo Leng Huat, Hamid Jan B. JanMohamed, Hamizatul Akmal Abd Hamid, Hasimah Ismail, Hasmila Mat Hassan, Hatta Mutalip, Hazizi Abu Saad, HelenTee Guat Hiong, Joanita Sulaiman, Kee Chee Cheong, Khairiyah Abdul Muttalib, Khairul Zarina Yusof, Khoo Yi Yi, Leni

Tupang, Lim Kuang Hock, Lim Kuang Kuay, Mohd Azahadi Omar, Mohamad Aznuddin Abd Razak, Mohamad FuadMohamad Anuar, Mohamad Hasnan Ahmad, Mohd Hazrin Hasim, Mohd Ismail Noor, Mohd Naim Rasidi, Mohd WanAzdie Mohamad Abu Bakar, Natifah Che Salleh, Nazli Suhardi Ibrahim, Noor Safiza Mohamad Nor, Nor Azian MohdZaki, Norlida Zulkafly, Norhafizah Sahril, Norimah A Karim, Norzawati Yoep, Nurrul Ashikin Abdullah, Nur Hidayah

Jamaluddin, Nur Shahida Abdul Aziz, Poh Bee Koon, Rahama Samad, Rashidah Ambak, Riyanti Saari, RusidahSelamat, Safiah Md. Yusof, Siti Fatimah Mat Hussin, S Maria Awaluddin, Yaw Siew Lian, Yeo Pei Sien, Yussof Sabtu,

Zalilah Mohd Shariff.

Editors

Tahir Aris, Ahmad Ali Zainuddin, Noor Ani Ahmad, Jasvindar Kaur

National Health and Morbidity Survey 2014 Malaysian Adult Nutrition Surveyii

Produced and Distributed by:

The National Health and Morbidity Survey 2014: Malaysian Adult Nutrition Survey,Institut for Public Health,National Institutes of Health,Ministry of Health,Jalan Bangsar, 50590 Kuala Lumpur,Malaysia.

Tel: +603-22979400 / +603-22979595Fax: +603-22823114 / +603-22979555

Any enquiries about or comments on this report should be directed to:

Principal Investigator,The National Health and Morbidity Survey 2014: Malaysia Adult Nutrition Survey,Institute for Public Health,National Institutes of Health,Ministry of Health,Jalan Bangsar, 50590 Kuala Lumpur,Malaysia.

Tel: +603-22979540Fax: +603-22979555

VOLUME II Survey Findings iii

Published by Institute for Public Health, Ministry of Health, Malaysia

Volumes in this series

The report comprises of 3 volumes as follows :

i. Volume I : Methodology and General Findingsii. Volume II : Survey Findingsiii. Volume III : Food Consumption Statistics of Malaysia

© 2014, Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia.Kuala Lumpur.

ISBN : 978-983-2387-16-9

Suggested citation:

Institute for Public Health (IPH) 2014. National Health and Morbidity Survey 2014 : Malaysian Adult NutritionSurvey (MANS) Vol. II : Survey Findings : 343 pages.

Disclaimer:

The views expressed in this report are those of the authors alone and do not necessarily represent theopinions of the investigators participating in the survey, nor the view or policy of the Ministry of Health.

National Health and Morbidity Survey 2014 Malaysian Adult Nutrition Surveyiv

ACKNOWLEDGEMENT

The authors would like to thank the Director-General of Health Malaysia for his permission to publish thisreport. Appreciation to the Deputy Director-General of Health (Research and Technical Support) and theDirector of the Institute for Public Health, for their support and technical advice throughout the variousstages of the survey.

The National Health and Morbidity Survey 2014: Malaysian Adult Nutrition Survey, was accomplished withbudget support from the Ministry of Health Malaysia and technical advice from the Advisory Panel andSteering Committee. The authors would like to express our sincere thanks to them.

The authors thank all the State Health Directors and State Liaison Officers who have been instrumental inmobilising resources during the data collection phase. Gratitude to all concerned who have assisted in theimplementation of the survey, from the field supervisors, nutritionists, temporary staff and drivers, withoutwhom the survey would not have been a success.

Last but not least, sincere appreciation is extended to all respondents who had participated and contributedtheir time and information to the survey, without whom there would not be any findings to report.

VOLUME II Survey Findings v

TABLE OF CONTENTS III

LIST OF TABLES IIITOPIC 1 11 FOOD SECURITY STATUS 3

1.1 Findings 31.2 Implications 41.3 Conclusion 41.4 Recommendations 4

TOPIC 2 192.0 MEAL PATTERN 21

2.1 Findings 212.1.1 Breakfast 212.1.2 Lunch 222.1.3 Dinner 222.1.4 Heavy meal after dinner 23

2.2 Implications 232.3 Conclusion 242.4 Recommendations 24

TOPIC 3 1033.0 FOOD INTAKE BY FOOD GROUP 105

3.1 Findings 1053.1.1 Frequency of confectionary intake 1053.1.2 Mean serving size of confectionary intake 1053.1.3 Frequency of fruits intake 1053.1.4 Mean serving size of fruits intake 1063.1.5 Adequacy of fruits intake 1063.1.6 Frequency of vegetables intake 1063.1.7 Mean serving size of vegetables intake 1073.1.8 Adequacy of vegetables intake 1073.1.9 Frequency of water intake 1083.1.10 Mean serving size of water intake 1083.1.11 Adequacy of water intake 108

3.2 Implications 1093.2.1 Fruits and vegetables intake 1093.2.2 Water intake 109

3.3 Conclusion 1103.3.1 Fruits and vegetables 1103.3.2 Water 110

3.4 Recommendations 1103.5 References 111

National Health and Morbidity Survey 2014 Malaysian Adult Nutrition Surveyvi

TOPIC 4 1314.0 HABITS IN RELATION TO FOOD CONSUMPTION 133

4.1 Findings 1334.1.1 Consumption of plain water in relation to main meals 1334.1.2 Consumption of fruits in relation to main meals 1334.1.3 Number of times food was chewed before swallowing 1334.1.4 Use of straw when consuming carbonated drinks 1344.1.5 Mouth rinsing after consuming sugary food 1344.1.6 Brushing teeth before breakfast 1344.1.7 Brushing teeth after main meals 135

4.2 Implications 1354.3 Conclusion 1364.4 Recommendations 1364.5 References 137

TOPIC 5 1715.0 FOOD LABEL READING AND UNDERSTANDING 173

5.1 Findings 1735.1.1 Practise of Reading Food Label Every Time Buying or Receiving Food

from Others 1735.1.2 Prevalence of Reading Nutrition Information in Food Label Every Time

Buying or Receiving Food 1735.1.3 Food Label Understanding 1735.1.4 Practise of Reading Expiry Date Label Every Time Buying or Receiving Food 1755.1.5 Practise of Reading Precautionary Label Every Time Buying or Receiving

Food 1745.2 Implications 1745.3 Conclusion 1755.4 Recommendations 1755.5 References 175

TOPIC 6 1916.0 VITAMIN, MINERAL AND FOOD SUPPLEMENT INTAKE 193

6.1 Findings 1936.1.1 Overall prevalence of vitamin and mineral supplement users 1936.1.2 Prevalence of most commonly taken vitamin and mineral supplement 1936.1.3 Frequency of vitamin and mineral supplement intake 1946.1.4 Overall prevalence of Food Supplements Users 1946.1.5 Prevalence of most commonly taken food supplement 1946.1.6 Frequency of food supplement intake 195


VOLUME II Survey Findings vii

TOPIC 7 2457.0 PHYSICAL INACTIVITY 247

7.1 Findings 2477.1.1 Prevalence of Physical Inactivity by Zone and Strata 2477.1.2 Prevalence of Physical Inactivity by Gender 2477.1.3 Prevalence of Physical Inactivity by Age group 2477.1.4 Prevalence of Physical Inactivity by Ethnic group 2477.1.5 Prevalence of Physical Inactivity by Marital Status 2477.1.6 Prevalence of Physical Inactivity by Education Status 2487.1.7 Prevalence of Physical Inactivity by Occupational Status 2487.1.8 Prevalence of Physical Inactivity by Household Income 2487.1.9 Prevalence of Physical Inactivity by Domain 248


TOPIC 8 2598.0 FOOD CONSUMPTION PATTERN 261


TOPIC 9 2799.0 NUTRITIONAL STATUS 281


TOPIC 10 31910.0 NUTRIENT INTAKE 321


National Health and Morbidity Survey 2014 Malaysian Adult Nutrition Surveyviii

LIST OF TABLES

1.0 FOOD SECURITY STATUS

Table 1.1: Prevalence of food quantity insufficiency due to financial constraint in thepast 12 months

Table 1.2: Prevalence of food variety insufficiency due to financial constraint in thepast 12 months

Table 1.3: Prevalence of meal size reduction due to financial constraint in the past12 months

Table 1.4: Prevalence of main meal skip due to financial constraint in the past12 months

Table 1.5: Prevalence of children feeding with cheap and affordable foodTable 1.6: Prevalence of children feeding with less food variety due to financial constraint

2.0 MEAL PATTERN

Table 2.1a: Meal pattern for breakfast and lunch by socio-demographic characteristicsTable 2.1b: Meal pattern for dinner and supper by socio-demographic characteristicsTable 2.2a: Breakfast venue for home and office by socio-demographic characteristicsTable 2.2b: Breakfast venue for cafeteria and restaurant by socio-demographic characteristicsTable 2.2c: Breakfast venue for hotel and stall by socio-demographic characteristicsTable 2.2d: Breakfast venue for Fast Food outlets and others by socio-demographic characteristicsTable 2.3a: Lunch venue for home and office by socio-demographic characteristicsTable 2.3b: Lunch venue for cafeteria and restaurant by socio-demographic characteristicsTable 2.3c: Lunch venue for hotel and stall by socio-demographic characteristicsTable 2.3d: Lunch venue for Fast Food outlets and others by socio-demographic

characteristicsTable 2.4a: Dinner venue for home and office by socio-demographic characteristicsTable 2.4b: Dinner venue for cafeteria and restaurant by socio-demographic characteristicsTable 2.4c: Dinner venue for hotel and stall by socio-demographic characteristicsTable 2.4d: Dinner venue for Fast Food outlets and others by socio-demographic

characteristicsTable 2.5a: Supper venue for home and office by socio-demographic characteristicsTable 2.5b: Supper venue for cafeteria and restaurant by socio-demographic characteristicsTable 2.5c: Supper venue for hotel and stall by socio-demographic characteristicsTable 2.5d: Supper venue for Fast Food outlets and others by socio-demographic characteristicsTable 2.6a: Source of food for breakfast by socio-demographic characteristicsTable 2.6b: Source of food for breakfast by socio-demographic characteristicsTable 2.6c: Source of food for breakfast by socio-demographic characteristics

VOLUME II Survey Findings ix

Table 2.7a: Source of food for lunch by socio-demographic characteristicsTable 2.7b: Source of food for lunch by socio-demographic characteristicsTable 2.8a: Source of food for dinner by socio-demographic characteristicsTable 2.8b: Source of food for dinner by socio-demographic characteristicTable 2.8c: Source of food for dinner by socio-demographic characteristicsTable 2.9a: Source of food for supper by socio-demographic characteristicsTable 2.9b: Source of food for supper by socio-demographic characteristicsTable 2.9c: Source of food for supper by socio-demographic characteristicsTable 2.10a:Meal companion for breakfast by socio-demographic characteristicsTable 2.10b:Meal companion for breakfast by socio-demographic characteristicsTable 2.11a:Meal companion for lunch by socio-demographic characteristicsTable 2.11b:Meal companion for lunch by socio-demographic characteristicsTable 2.12a:Meal companion for dinner by socio-demographic characteristicsTable 2.12b:Meal companion for dinner by socio-demographic characteristicsTable 2.13a:Meal companion for supper by socio-demographic characteristicsTable 2.13b:Meal companion for supper by socio-demographic characteristics

3.0 FOOD INTAKE BY FOOD GROUP

Table 3.1: Confectionery intake by socio-demographic characteristicsTable 3.2 Mean serving of confectionery intake by socio-demographic characteristicsTable 3.3: Fruit intake by socio-demographic characteristicsTable 3.4: Mean serving of fruit intake by socio-demographic characteristicsTable 3.5: Vegetables intake by socio-demographic characteristicsTable 3.6: Mean serving of vegetables intake by socio-demographic characteristicsTable 3.7: Water intake by socio-demographic characteristicsTable 3.8: Mean serving of water intake by socio-demographic characteristics

4.0 HABITS IN RELATION TO FOOD CONSUMPTION

Table 4.1: Prevalence of plain water consumption in relation to main mealsTable 4.2: Prevalence of plain water drinking habit among adults consuming plain

water either before, during or after the main mealsTable 4.3: Prevalence of fruit consumption in relation to main mealsTable 4.4: Prevalence of fruit consumption habit among adults who had either ate

fruits before, during or after the main mealsTable 4.5: Prevalence of awareness of length of chewing food before swallowingTable 4.6: Prevalence of chewing habits before swallowing among adults who

were aware of the length of chewing

National Health and Morbidity Survey 2014 Malaysian Adult Nutrition Surveyx

Table 4.7: Prevalence of drinking carbonated beverages among adultsTable 4.8: Prevalence of using straw among adults who drink carbonated beveragesTable 4.9: Prevalence of mouth rinsing after taking sugary foodTable 4.10: Frequency of mouth rinsing among adults who rinse their mouth after taking sugary

foodTable 4.11: Prevalence of brushing teeth before breakfastTable 4.12: Prevalence of brushing habits among adults who brush their teeth before breakfastTable 4.13: Prevalence of brushing teeth after main mealsTable 4.14: Frequency of tooth brushing among adults who brush their teeth after main meal

5.0 FOOD LABEL READING AND UNDERSTANDING

Table 5.1: Prevalence of practice of reading nutrition label everytime buying or receiving food(where applicable)

Table 5.2a: Prevalence of reading nutrition information in food labelsTable 5.2b: Prevalence of reading nutrition information in food labels everytime buying or receiving

foodTable 5.3: Prevalence of understanding the information in nutrition labels every time when

buying or receiving foodTable 5.4: Prevalence of practise reading the expiry date label every time you buying or receiving

food (where applicable)Table 5.5: Prevalence of practice of reading the precautionary food label every time when buying

or receiving food (where applicable)

6.0 VITAMIN, MINERAL AND FOOD SUPPLEMENT INTAKE

Table 6.1: Prevalence of vitamins and mineral user by socio-demographic characteristicsTable 6.2: Prevalence of user by type of vitamin and mineral supplementsTable 6.3a: The top five most used vitamin and mineral supplements by socio-demographic

characteristics– i) Vitamin CTable 6.3b: The top five most used vitamin and mineral supplements by socio-demographic

characteristics – ii) Multivitamin & multimineralTable 6.3c: The top five most used vitamin and mineral supplements by socio-demographic

characteristics – iii) CalciumTable 6.3d: The top five most used vitamin and mineral supplements by socio-demographic

characteristics – iv) Vitamin B complexTable 3e: The top five most used vitamin and mineral supplements by socio-demographic

characteristics – v) Folic acidTable 6.4: Frequency of intake vitamin and mineral supplementsTable 6.5: Proportion of single user vitamins and mineral user by socio-demographic

characteristics

VOLUME II Survey Findings xi

7.0 PHYSICAL INACTIVITY

Table 7.1: Prevalence of overall physical inactivityTable 7.2: Prevalence of physical inactivity working domainTable 7.3: Prevalence of physical inactivity travel domainTable 7.4: Prevalence of physical inactivity leisure time domain

8.0 FOOD CONSUMPTION PATTERNS

Table 8.1: Mean frequency and prevalence of the top ten food items consumed daily by adults(18 - 59 years old)

Table 8.2: Mean frequency and prevalence of the top ten food items consumed daily by men.Table 8.3: Mean frequency and prevalence of the top ten food items consumed daily by women.Table 8.4: Mean frequency and prevalence of the top ten food items consumed weekly by adultsTable 8.5: Mean frequency and prevalence of the top ten food items consumed weekly by menTable 8.6: Mean frequency and prevalence of the top ten food items consumed weekly by womenTable 8.7: Mean frequency of the drinks consumed daily by adults

9 .0 NUTRITIONAL STATUS

Table 9.1: Mean weight by socio-demographic characteristicsTable 9.2: Mean height by socio-demographic characteristicsTable 9.3: Mean waist circumference (WC) by socio-demographic characteristicsTable 9.4: Mean BMI by socio-demographic characteristicsTable 9.5: Prevalence of CED Class III by socio-demographic characteristicsTable 9.6: Prevalence of CED Class II by socio-demographic characteristicsTable 9.7: Prevalence of CED Class I by socio-demographic characteristicsTable 9.8: Prevalence of normal by socio-demographic characteristicsTable 9.9: Prevalence of obesity class I by socio-demographic characteristicsTable 9.10: Prevalence of obesity class II by socio-demographic characteristicsTable 9.11: Prevalence of obesity class III by socio-demographic characteristicsTable 9.12: Prevalence of obesity by socio-demographic characteristicsTable 9.13: Prevalence of overweight by socio-demographic characteristicsTable 9.14: Prevalence of overweight and obesity by socio-demographic characteristicsTable 9.15: Prevalence of CED by socio-demographic characteristicsTable 9.16: Prevalence of abdominal obesity by socio-demographic characteristics

10 .0 NUTRIENT INTAKE

Table 10.1: Median Intake of Energy (kcal) by Socio-demographic CharacteristicsTable 10.2: Median Intake of Protein (g) by Socio-demographic CharacteristicsTable 10.3: Median Intake of Carbohydrate (g) by Socio-demographic CharacteristicsTable 10.4: Median Intake of Fat (g) by Socio-demographic CharacteristicsTable 10.5: Median Intake of Sodium (mg) by Socio-demographic CharacteristicsTable 10.6: Median Intake of Calcium (mg) by Socio-demographic CharacteristicsTable 10.7: Median Intake of Iron (mg) by Socio-demographic CharacteristicsTable 10.8: Median Intake of Vitamin C (mg) by Socio-demographic CharacteristicsTable 10.9: Median Intake of Vitamin A (ug) by Socio-demographic CharacteristicsTable 10.10: Median Intake of Thiamine (mg) by Socio-demographic CharacteristicsTable 10.11: Median Energy Intake as percentage of RNI by Socio-demographic CharacteristicsTable 10.12: Median Protein Intake as percentage of RNI by Socio-demographic CharacteristicsTable 10.13: Median Calcium Intake as percentage of RNI by Socio-demographi CharacteristicsTable 10.14: Median Iron Intake as percentage of RNI by Socio-demographic CharacteristicsTable 10.15: Median Vitamin C Intake as percentage of RNI by Socio-demographic

CharacteristicsTable 10.16: Median Vitamin A Intake as percentage of RNI by Socio-demographic

CharacteristicsTable 10.17: Median Thiamine Intake as percentage of RNI by Socio-demographic Characteristics

LIST OF FIGURE

Figure 1: Prevalence of overweight* (95% confidence interval) among Malaysian adults aged18-59 years by sex

Figu re 2: Prevalence of obesity* (95% confidence interval) among Malaysian adults aged 18-59years by sex

Figu re 3: Prevalence of abdominal obesity* (95% confidence interval) among Malaysian adultsaged 18--59 years by sex

Figu re 4: Median percentage of energy from macronutrients for total adult population

National Health and Morbidity Survey 2014 Malaysian Adult Nutrition Surveyxii

TOPIC 1

FOOD SECURITY STATUS

VOLUME II Survey Findings 3

1. FOOD SECURITY STATUS

Contributors to this section: Zalilah Mohd Shariff, Chong Zhuo Lin, Rusidah Selamat, Ahmad Ali Zainuddin, Mohd WanAzdie Mohamad Abu Bakar.

1.1 Findings

The Malaysian Adults Nutrition Survey measured food security at household, adult andchild levels using six items which were adapted from the USDA 18-item Household FoodSecurity Survey Module. Valid responses to each item were ʻneverʼ, ʻonly one or twomonthsʼ, ʻseveral months, but not every monthʼ, and ʻalmost every monthʼ. Respondentswho answered ʻneverʼ to an item were considered as having food security in that domainwhile those with other responses were considered as experiencing food insecurity.

In general, the proportions of respondents from East Malaysia and rural areas reportingfood insecurity at household, adult or child level were significantly higher than those fromPeninsular Malaysia and urban areas, respectively.

The prevalence of household food insecurity in terms of inadequate quantity of purchasedfoods were 39.24% (95% CI: 34.52-44.18) in East Malaysia versus 21.13% (95 % CI:18.42-24.13) in Peninsular Malaysia, and 33.50% (95% CI: 29.90-37.30) in rural areasversus 21.19% (95% CI: 18.18-24.55) in urban areas (Table 1.1). The prevalence ofrespondents reporting purchased foods lacked variety were higher in East Malaysia(40.77%; 95% CI: 35.76-45.98) and rural areas (33.59%; 95% CI: 29.99-37.38) than inPeninsular Malaysia (21.42%; 95 % CI: 18.65-24.49), and urban areas (21.97%; 95% CI:18.85-25.44) (Table 1.2).

The prevalence of adult food insecurity in relation to adults having reduced meal size were31.84% (95% CI: 27.33-36.72) in East Malaysia versus 19.18% (95 % CI: 16.68-21.95) inPeninsular Malaysia, and 28.49% (95% CI: 25.09-32.15) in rural area versus 18.93% (95%CI: 16.16-22.04) in urban area (Table 1.3).The prevalence of adults skipping main mealswere 23.29% (95% CI: 19.20-27.94) in East Malaysia versus 13.00% (95 % CI: 10.8515.51) in Peninsular Malaysia, and 21.02% (95% CI: 17.71-24.76) in rural areas versus12.61% (95% CI: 10.30-15.35) in urban areas (Table 1.4).

The prevalence of households experiencing child food insecurity in terms of reliance onlimited number of cheap food to feed children were 39.58% (95% CI: 34.45-44.96) in EastMalaysia versus 19.43% (95 % CI: 16.71-22.47) in Peninsular Malaysia, and 31.31% (95%CI: 27.61-35.27) in rural areas versus 20.11% (95% CI: 17.05-23.56) in urban areas (Table1.5). The prevalence of respondents reporting inability to feed children with variety of foodswere higher in East Malaysia (36.75%; 95% CI: 31.63-42.18) and rural areas (29.81%; 95%CI: 26.03-33.90) than in Peninsular Malaysia (16.53%; 95 % CI: 14.01-19.39) and urbanareas (16.57%; 95% CI: 13.77-19.81) (Table 1.6).

National Health and Morbidity Survey 2014 Malaysian Adult Nutrition Survey4

1.2 Implications

Food insecurity has adverse effects on health and quality of life. Food insecure individualsare at risk of having inadequate food intake and poor diet quality. These conditions couldcompromise intake of energy and nutrients, particularly vitamins and minerals. Thesubsequent low blood nutrient levels, if prolonged, could lead to micronutrient deficiency.Children living in food insecure households have increased risk of stunting andunderweight, poor cognitive development that could adversely affect academicperformance, and psychological and social problems. In adults, food insecurity isassociated with increased risk of overweight and obesity, chronic diseases and poor mentalhealth. Food insecure individuals with chronic diseases may also have difficulties to followthe prescribed diets by medical and health professionals as healthy foods may be relativelyexpensive.

1.3 Conclusion

Food insecurity occurs at household, adult and child levels in Malaysia. At each level, thedifferent dimensions of food insecurity assessed are consistently associated with similardemographic (zone, strata and ethnicity) and socioeconomic (education, work status andincome) factors Food insecurity is more prevalent in East Malaysia, rural areas, BumiputraSarawak as well as individuals with low education and income and working in nongovernment sectors. As food insecurity is interrelated with socioeconomic status, thedifferences in prevalence of food insecurity by zone, strata and ethnicity could well reflectthe socioeconomic differentials (ie income, education and work status) of individuals andhouseholds in Peninsular Malaysia – East Malaysia, urban-rural areas and of variousethnic groups.

1.4 Recommendations

Several strategies are recommended to prevent food insecurity or reduce the severity offood insecurity. Lack of education, low wages, job insecurity, un- and underemploymentand poor living conditions are important underlying causes of food insecurity. These factorsshould be addressed through programs and policies that could increase economic securityand subsequently food security. In addition, life management skills are essential forindividuals to cope with the rising standard of living. Nutrition and financial managementeducation are among the life skills that should be made available and accessible toindividuals, particularly those who are at risk of food insecurity.

National food or financial assistance programs play an important role in alleviating foodinsecurity or reducing its severity. The coverage of such programs should be extended tofood insecure individuals or households who are not necessarily living in poverty but areexperiencing financial constraints. It has also been shown that promoting charity foodbased assistance programs could also benefit food insecure individuals and households.

Finally, food security should be high on the development agenda. It is important to havecomprehensive policies and multisectoral collaborative efforts to promote food security inMalaysia. For example, policies to increase agricultural production and food availabilitymust be allign with public health goals that aim to promote better health and nutrition ofpopulation. These policies should also address the multi-dimensions of food security(availability, access, utilization and stability) as increased food availability may notnecessarily improve food access and utilization.


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34.5

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.18

55.8

265

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Str

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7615

721

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18.1

824

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75.4

581

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Rur

al19

9998

533

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29.9

037

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62.7

070

.10

Sex

Mal

e27

0130

526

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23.1

530

.02

69.9

876

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Fem

ale

2174

837

23.3

220

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26.2

573

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Ag

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931

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27.2

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39.1

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28.2

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19.7

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71.5

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Eth

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22.4

619

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80.7

2C

hine

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6495

14.8

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20.0

579

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3359

25.9

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82.4

3B

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64.0

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72.1

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Oth

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240

216

168

349 74 34 188

144 51 8

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1466

6253

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1020

2505

232

1069

5957

3970

296

7514

621

7151

632

8313

7239

5856

036

3558

634

6432

127

7641

4

8191

175

3249

708

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328

3821

1793

9912

8531

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1231 889

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1144 88 497

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534

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1122 442 98 106

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122 9

75.0

5

78.8

760

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78.8

166

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73.5

676

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72.7

874

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74.9

975

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76.1

5

77.5

485

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74.0

335

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63.5

873

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--

Tab

le1.

1:P

reva

lenc

eo

fFo

od

Qua

ntit

yIn

suff

icie

ncy

Due

ToFi

nanc

ialC

ons

trai

ntIn

The

Past

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wer

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per

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rap

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Note

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ore

than

25%


Mar

ital

stat

usN

ever

mar

ried

1316

305

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ried

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22.1

627

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1455

75.2

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arat

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21.6

942

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68.8

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724

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ucat

ion

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55.7

177

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32.7

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75.6

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Tab

le1.

1:P

reva

lenc

eo

fFo

od

Qua

ntit

yIn

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nanc

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Note

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Tab

le1.

2:P

reva

lenc

eo

fFo

od

Vari

ety

Insu

ffic

ienc

yD

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Fina

ncia

lCo

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aint

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Mal

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alay

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3297

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18.6

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75.5

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ast

Mal

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a16

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435

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45.9

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Str

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Urb

an29

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618

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25.4

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Rur

al20

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929

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37.3

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Sex

Mal

e27

5782

223

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30.5

669

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Fem

ale

2222

792

20.9

027

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72.8

8

Ag

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roup

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5288

18.5

336

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63.1

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69.3

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79.0

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6029

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22.8

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227

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--

1453

8280

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2626

2445

653

1057

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7089

198

8370

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733

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3239

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8537

3609

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3180

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2108

1454 654

1215 893

961

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3 92 102

224

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74.4

8

78.5

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78.0

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72.9

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73.2

774

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76.7

273

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73.8

9

77.1

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76.9

5

81.3

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81.1

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80.4

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0

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Mar

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stat

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71.6

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men

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603 43 23 88 314

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41.6

526

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4

4186

159

9816

280

3985

4312

8106

9192

1686

1719

2655

273

9097

249

5438

664

849

2027

698

6072

796

3621

000 -

1964

161

1815

6852

9550

4943

461

4812

571

4617

717

546

1442 84 35 1 45 300

1074 671 11

328

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556 3

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694

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00

33.3

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76.1

588

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4

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474

.83

73.6

3 -61

.74

91.5

584

.69

62.2

577

.31

90.1

386

.46

92.8

8

Tab

le1.

2:P

reva

lenc

eo

fFo

od

Vari

ety

Insu

ffic

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yD

ueTo

Fina

ncia

lCo

nstr

aint

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nths

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nt.)

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ion

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unt

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op

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ion

Note

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SEm

ore

than

25%


Tab

le1.

3:P

reva

len

ceo

fM

ealS

ize

Red

uct

ion

Du

eT

oF

inan

cial

Co

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rain

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ast

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on

ths

Mal

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a24

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2244

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ne

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lar

Mal

aysi

a21

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1496

Eas

tM

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36.7

274

8

Str

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Urb

an22

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1282

Rur

al32

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962

Sex

Mal

e27

.09

1022

Fem

ale

22.5

212

22

Ag

eG

rou

p18

–19

32.8

297

20-2

924

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528

30-3

925

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631

40-4

929

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554

50-5

925

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434

Eth

nic

ity

Mal

ay21

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1174

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21.9

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1In

dia

n34

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628

2561

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1700

589

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3678

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974

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2005

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5976

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5700

5923

9340

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2827

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374

289

428

345

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150

193

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295 74 29

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109 41 5

21.8

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24.6

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5219

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78.1

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80.8

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81.0

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76.2

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77.7

479

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78.6

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79.3

6

80.9

984

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75.7

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78.0

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72.9

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74.9

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78.0

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65.4

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80.3

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81.9

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Note

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Mar

ital

stat

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75.1

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82.8

1Te

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92.3

7O

ther

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Wo

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1P

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elf-

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tud

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3:P

reva

lenc

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le1.

4:P

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Tab

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4:P

reva

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fM

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Tab

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5:P

reva

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fC

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Tab

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5:P

reva

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6:P

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TOPIC 2

MEAL PATTERN


2. MEAL PATTERN

Contributors to this section: Yeo Pei Sien, Norhafizah Sahril, Ahmad Nazri Jai, Mohamad Aznuddin Abd Razak, NazliSuhardi Ibrahim, Hamid Jan B. Jan Mohamed

2.1 Findings

This module comprises 17 questions of interest on the usual daily food intakes of therespondents.

2.1.1 Breakfast

Overall, 93.7% (95% CI: 92.4-94.8) reported to take breakfast. Among those who reported,93.5% (95% CI: 91.9-94.8) were in Peninsular Malaysia and 92.1% (95% CI: 90.2-93.6) inEast Malaysia. The proportion of adults in the urban (94.5%, 95% CI: 92.7-95.85) whoreported to take breakfast was found to be higher than rural adults (92.1%, 95% CI: 90.293.6) (Table 2.1a).

About 54.4% (95% CI: 51.6-57.2) reported to take a breakfast at home, while 13.1% (95%CI: 11.2-15.2) at stall and 12.2% (95% CI: 10.4-14.2) at office. Of those who reported totake breakfast at home, the proportion was slightly higher in rural areas [65.1% (95% CI:62.0-68.5)] compared to urban area [49.7% (95% CI: 46.0-53.4)]. By region, significantlymore adults in East Malaysia [70.4%, 95% CI: 66.9-73.8] reported to take breakfast athome compared to those in Peninsular Malaysia [50.0%, 95% CI: 46.6-53.4] (Table 2.2a).

Results showed that 50.7% (95% CI: 47.8-53.6) of adults reported that their source ofbreakfast were home prepared ((Table 2.6a), 24.9% (95% CI: 22.4-27.6) obtained fromstall (Table 2.6b) while 11.8% (95% CI: 10.2-13.6) from cafeteria (Table 2.6a) and 10.1%(95% CI: 8.3-12.1) from restaurant (Table 2.6b). Of those who reported as home prepared,the proportion was higher in rural areas at 61.8% (95% CI: 58.4-65.1) compared to urbanarea at 46.0% (95% CI: 42.2-49.8). And by region, significantly more adults in EastMalaysia [70.3% (95% CI: 66.6-73.6)] reported that their source of breakfast were homeprepared compared to those in Peninsular Malaysia [45.4% (95% CI: 41.9-48.9)] (Table2.6a). However, for those who obtained food from stall, significantly more adults inPeninsular Malaysia (28.5%, 95% CI: 25.4-31.9) compared to East Malaysia [11.7% (95%CI: 9.6-14.0)] (Table 2.6b).

About 44.0% (95% CI: 41.4-46.7) reported to have breakfast with their family, while 28.3%(95% CI: 25.7-31.0) eat alone (Table 2.10a) and 27.5% (95% CI: 24.9-30.2) with friends(Table 2.10b). Among those who reported to take breakfast with their family, 58.3% (95%CI: 54.4-62.1) were from East Malaysia and 40.1% (95% CI: 37.0-43.3) were fromPeninsular Malaysia. There was a higher proportion of rural population (54.7%, 95% CI:51.1-58.3) taking breakfast with their family as compared to urban population (39.4%, 95%CI: 36.0 42.9) (Table 2.10a). Of those who reported taking breakfast alone and withfriends, there was a higher proportion of urban (30.5%, 95% CI: 27.1-34.2; 29.7%, 95% CI:26.2-33.5) compared to rural (23.0%, 95% CI: 19.9-26.4; 22.2%, 95% CI: 19.5-25.3)(Table 2.10a & Table 2.10b).


2.1.2 Lunch

Overall, 94.5% (95% CI: 93.3-95.4) of adults were reported to take lunch. Among those whotook lunch, the prevalence were significantly higher among adults in East Malaysia [97.1%(95% CI: 95.8-98.1)] compared to Peninsular Malaysia [93.8% (95% CI: 92.3-95.0)] (Table2.1a).

More than half of the Malaysian adults [52.7% (95% CI: 49.8-55.5)] had their lunch at homeand the prevalence were significantly higher among those who resided in East Malaysia[61.2% (95% CI: 57.5-64.8)] and rural areas [70.1% (95% CI: 66.7-73.2) (Table 2.3a). Theother venues where lunch were consumed most, were at restaurant [14.4% (95% CI: 12.516.5) and office [12.1% (95% CI: 10.5-14.0)]. Adults who resided in Peninsular Malaysia[16.1% (95% CI: 13.8-18.8)] and urban areas [18.7% (95% CI: 16.1-21.6)] were reportedto have higher prevalence of taking lunch at the restaurant (Table 2.3b). Meanwhile, adultswho resided in East Malaysia 14.0% (95% CI: 11.2- 17.4) and urban areas [14.0% (95%CI: 11.9-16.5)] were found had higher prevalence of taking lunch at the office (Table 2.3a).

The results showed that 59.8% (95% CI: 52.1-57.5) of adults reported that their source oflunch were home prepared (Table 2.7a), 17.5% (95% CI: 15.4-19.9) obtained fromrestaurant (Table 2.7b), 14.2% (95% CI: 12.2-16.5) from stall (Table 2.7b), while 11.3%(95% CI: 9.8-13.0) from the cafeteria (Table 2.7a). There were significantly higherprevalence of adults in East Malaysia [71.7% (95% CI: 68.0-75.1)] and in rural areas[74.3% (95% CI: 70.8-77.5) had home prepared lunch (Table 2.7a). Of those whoconsumed food from restaurant, the higher prevalence were among adults in PeninsularMalaysia [19.5% (95% CI: 16.8-22.4)] and urban areas [22.6% (95% CI: 19.6-25.8)] (Table2.7b). Significantly more adults in Peninsular Malaysia [16.4% (95% CI: 13.9-19.3)]consumed lunch at stall (Table 2.7b).

The majority of Malaysian adults had their lunch with their family [44.7% (95% CI: 42.047.5)] (Table 2.11a), followed by eating with friends [34.3% (95% CI: 31.8-36.9)] (Table2.11b) and eating alone [20.8% (95 CI: 18.7-23.0)] (Table 2.11a). Among those who hadlunch with family, the higher prevalence were significantly reported among adults thatresided in East Malaysia [51.9% (95% CI: 47.8 56.0)] and rural areas [58.2% (95% CI: 54.461.9)] (Table 2.11a). Meanwhile, significant higher proportion of adults in PeninsularMalaysia [35.5% (95% CI: 32.5-38.6) and urban [39.8% (95% CI: 36.5-43.1)] had lunchwith friends (Table 2.11b). There were no significant differences by zone and strata forthose who ate their lunch alone.

2.1.3 Dinner

Dinner consumption indicated that 96.4% (95% CI: 95.4-97.1) of respondents consumeddinner (Table 2.1b). The percentage of those who took dinner at home was significantlyhigher among the respondents in East Malaysia [93.7% (95% CI: 91.8-95.2)] and ruralareas [92.1% (95% CI: 90.1-93.8)] (Table 2.4a). Meanwhile, significantly more adults inPeninsular Malaysia [6.9% (95% CI: 5.5 – 8.5)] and urban areas [7.3% (95% CI: 5.8 – 9.1)]had dinner at a restaurant (Table 2.4b). In general, 83.2% (95% CI: 81.0-85.2) of adultsreported that their dinner was home prepared with significantly more in East Malaysia[93.0% (95% CI: 91.1-94.5)] and rural areas [89.8% (95% CI: 87.4-91.7)] (Table 2.8a).While, 9.3% (95% CI: 7.6-11.2) and 7.5% (95% CI: 6.0-9.3)] of adults in PeninsularMalaysia reported that their sources of dinner were obtained from restaurant and stall,respectively (Table 2.8b). About 79.7% (95% CI: 77.2-82.1) Malaysian adults had theirdinner with the family (Table 2.12a). The results showed that higher proportion of adults in


East Malaysia [83.9 (95% CI: 80.8-86.7)] and rural areas [82.0% (95% CI: 78.7-84.9)] hadtheir dinner with their family (Table 2.12a). As for other meal companion for dinner, therewere no significant differences among Malaysian adults.

2.1.4 Heavy meal after dinner

A total of 31.9% (95% CI: 29.4-34.5) of adults had the habit of having heavy meal afterdinner. Among those who reported, 34.0% (95% CI: 30.9-37.2) were in PeninsularMalaysia and 24.2% (95% CI: 21.2-27.5) were in East Malaysia. Meanwhile, the proportionof adults in the urban [33.8% (95% CI: 30.4-37.3)] who had heavy meal after dinner wasalso found to be higher than rural adults [(27.7% (95% CI: 24.7-30.9)] (Table 2.1b).

About 56.6% (95% CI: 52.1-61.0) reported that they had heavy meal after dinner at home(Table 2.5a), while 21.7% (95% CI: 17.9-26.1) at restaurant (Table 2.5b) and 16.5% (95%CI: 13.4-20.2) at stall (Table 2.5c). Of those who had their heavy meal

Documents

NATIONALHEALTHANDMORBIDITY SURVEY2014 ...iku.moh.gov.my/.../NHMS2014-MANS-VOLUME-2-SurveyFindings.pdfThe National Health and Morbidity Survey 2014: Malaysian Adult Nutrition Survey,