Background of the Problem
The subject of this document relates to the need for mandatory support of good nutrition in all community groups and private or public facilities in Malaysia. The necessity of good nutrition for the normal development of children and adults cannot be denied. (1,2) Equally important is the influence of the composition of nutrition on the ability to learn and on proper maturation. It is no less critical for obesity or weight loss and for combating potential diseases, including cardiovascular disease and diabetes. (3) Malnutrition or improper eating behavior developed in youth can contribute to impaired growth, development, and health – anemia, nutritional deficiencies, and other health problems will not be awaited long in coming.
Society has changed and evolved a great deal these days, and globalization has led to a mixture of markets. The urbanization of people is increasing, caused by the settlement of urban agglomerations and the reduction of the rural population. Any country today, even among the most developed, can be confronted with malnutrition in children. (2,4) In case it is not a lack of necessary nutrients, it may be an overabundance of substances that the child’s body does not need in such quantities. (2) For this reason, even an undernourished and unhealthy child can experience the problem of being overweight.
In Malaysia today, three major problems are associated with malnutrition or lack of essential substances. Overall, malnutrition, although it has decreased since independence, still affects the stunting of children – 20.7% of all children under the age of 5 have this problem. (5,6) A huge deficiency of micronutrients, especially iron, is noticeable among the population – anemia affects about five million people, primarily young women. (5) The problem of the prevalence of detected and undetected diabetes and obesity likewise stands out and poses a danger to the Malaysian people.
Concern
The problems of malnutrition and their associated consequences are often part of global food insecurity. It is necessary not only to combat obesity but likewise to strengthen the fight against malnutrition, which can cause even more dire consequences for society: disease, economic loss, and death. (1,3,7) These kinds of political and societal concerns for the Malaysian population are commonly referred to as fighting a double burden – that is, malnutrition and obesity in equal measure.
Furthermore, the need for policy decisions and action to counteract malnutrition, food insecurity, and nutrition-related diseases is critical. Unfortunately, in today’s world, most political structures inadequately respond to the challenges posed to them by problematic nutrition. (8) The fight against overeating or malnutrition is often noticed, but very rarely do national policies cover the entire spectrum of nutritional deficiencies, Malaysia included. Based on the importance of many problems for the development and comfort of the country, a nationwide national nutrition strategy is needed. (5,6) The following are options for dealing with the three major problems.
Possible Solutions to the Issue
Regardless of the formation of a significant national policy, the area of food security may be included in medical areas or areas related to the production and distribution of food resources in Malaysia. The focus can be on several major topics, each of which is presented in detail: macroeconomic policy, trade, and agricultural productivity. Initially, it is as important as possible to make sure that the agricultural sector is able to provide all the necessary inputs of food products to the domestic market. If this is not enough, it is the task of the ministries of international relations and trade to fill the domestic market with available and varied products. (7,9) In one way or another, all citizens have the right to have a variety of foods available to them.
A “dual action” program has been developed by the World Health Organization and has to be modified and implemented to address all three main Malaysian malnutrition problems. It involves programs, policies, and interventions that address malnutrition and overnutrition, as well as related problems. (10,11) They address many types of malnutrition and increase government intervention in nutrition-related problems. (1,12) To counter raising child stunting and anemia rates in Malaysia certain amount of actions can be added to the list of measures, and they can be structured as ranked:
- Exceptional maternal nutritional standards rich in essential substances, vitamins, and minerals for the adequate passage of pregnancy and further maintenance of the young mother’s health should be considered.
- Prenatal care programs that include both financial and material types of assistance to families or soybeans in need in the community.
- Promotion of breastfeeding as the healthiest as long as maternal health is maintained at the required level. (5)
- Optimizing early childhood nutrition according to nutrient tables to eliminate potentially harmful or unhelpful foods and introduce the most effective and beneficial ones.
- Adjustment of school meal programs, which would denote the normalization of meals for schoolchildren and students, and the provision of such meals for those people who cannot afford paid school lunches. (5,6)
- Setting marketing rules, which would involve changing the right to advertise at the legislative level for fast food, snacks, and other products that do not belong to a healthy diet.
Other implemented changes may likewise be equally important, including complete diversification of foods with an abundance of micronutrients or additional public education (5) about the benefits of proper and healthy eating. Marketing actions could likewise include adjusting food labeling or requiring manufacturers or retailers to add specific information on products. (2,10,11) From a deeper perspective, it may be possible to consider new strategies for urban agriculture or to develop value-added adjustments for agricultural products in Malaysia.
All of the above actions to maximize effectiveness should be integrated or at least linked with other health programs and have the same priority to include the third prominent (5) malnutrition consequence – diabetes. It is possible to monitor the current situation, for example, through regular health checks of students of educational institutions to assess risk factors and derive statistics on potential malnutrition. (8,10,11) Moreover, at the level of school education, it is necessary to strengthen the understanding of Malaysian girls about the importance of good nutrition before, during, and after pregnancy.
Recommendations for the Policy Implementation
The general recommendations for introducing the above improvements at the legislative or public level may include points that may be subject to some debate. However, the main points will be highlighted that can significantly facilitate the process of political intervention in the level of malnutrition in the state and improve the overall situation. (2,4,5,6) These recommendations imply not only preventive measures but measures to eliminate problems that already exist as well.
Funding that is allocated to combat malnutrition or obesity by the Malaysian government must be clearly monitored to protect the state’s interests and be correctly counted. Keeping track of such financial flows in all sectors makes it easier to assess results and analyze the need for further intervention. (12) At the same time, all policy areas that relate to the problems of malnutrition should actively interact with each other and work toward the common goal of eliminating malnutrition in society.
It may be advisable to consider and evaluate the possibility of potentially merging the various committees involved in assessing the risks of malnutrition in different sectors. If their merger is not possible or not feasible, joint results and cooperation should be assured by the active interaction of such teams. (1,2,12) Cross-databases, given the current level of digitalization, can facilitate and unify their work. (10) An additional benefit provided by such databases is the increased transparency of political actions for both the population and for neighboring units.
There has to be a dramatic increase in the discussion of nutrition in society, including the introduction of additional topics in children’s and adults’ educational curricula. Political and social discourse should place considerable emphasis on the importance and relevance of such problems. (9,10) Simplified or visualized statistics could be added to make it easier for citizens to understand the information. Every action against malnutrition should be monitored, and its results recorded. (1,11,12) The actual collection of such data, including changes made in the agricultural and food sector, will help with the summarization of information and the strategic planning of further actions.
It is equally important to strengthen the training of medical personnel in this area. Additional efforts to implement mandatory norms for the treatment, prevention, and early detection of malnutrition in people of all ages are categorically needed. (1,5,8) Prevention and treatment of malnutrition should be part of officially approved treatment and not depend on the personal opinions or preferences of the caregiving personnel. (6,8) The policy of the Malaysian national health care system should pay close attention to the quality of care and assistance for patients of all ages, which likewise includes the rationing of a hospital or sanatorium meals. (8,12) Screening of potential victims of malnutrition should be mandatory, as should the maintenance of current standards for treatment and nutritional adjustments.
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