Nutr Res Pract.  2019 Apr;13(2):159-168. 10.4162/nrp.2019.13.2.159.

Dietary intakes and obesity of Malaysian adults

• Lee YY
• Wan Muda W

• KMID: 2442373
• DOI: http://doi.org/10.4162/nrp.2019.13.2.159

Abstract

BACKGROUND/OBJECTIVES
Over the past few decades, Malaysia has been experiencing an increased prevalence of overweight and obesity that threatens the health of Malaysians. Poor dietary intake is one of the major contributors to the development of obesity and many non-communicable diseases. The dietary intakes of adults in Malaysia were assessed to determine the association between the dietary intake variables and the body mass index (BMI) and waist circumference (WC) measurements. This study examined whether the dietary intake achieved the recommended nutritional guidelines and compared the intakes between both sexes.
SUBJECTS/METHODS
The height, weight, and WC of four-hundred-and-ninety adults (n = 490) in Malaysia were measured using standard procedures. The three-day 24-hour dietary recalls were conducted on 422 out of the 490 adults and their dietary intakes were evaluated in detail. The selected dietary intake variables were used to determine the associations with the obesity indicators.
RESULTS
Among the participants, 52.8% were overweight or obese. After data analysis, the mean energy intake was 1,550 kcal/day, in which male participants had a significantly higher energy and macronutrients intake than females. Protein consumption and its percentage of energy contribution exceeded the recommended range. The consumption of fruits, vegetables, and milk and milk products were lower than the recommended number of servings for a healthy diet. The male participants consumed significantly more servings of carbohydrate-based foods, meat, and fats, oils, and sweets than females. Among the selected dietary intake variables, only the carbohydrate intake was negatively associated with the BMI (Estimate b = −0.008) and WC measurements (Estimate b = −0.019) after adjusting for covariates.
CONCLUSIONS
This study evaluated the dietary intakes of a sample of Malaysian adults and its association with the obesity indicators. The results highlight the need for improvements and modifications of the dietary intake of Malaysians to reduce the overweight and obesity rates.

Keyword

Dietary intakes; obesity; abdominal obesity; macronutrients; micronutrients

MeSH Terms

Adult*
Body Mass Index
Diet
Energy Intake
Fats
Female
Fruit
Humans
Malaysia
Male
Meat
Micronutrients
Milk
Obesity*
Obesity, Abdominal
Oils
Overweight
Prevalence
Statistics as Topic
Vegetables
Waist Circumference
Fats
Micronutrients
Oils

Reference

1. World Health Organization. Obesity and overweight [Internet]. Geneva: World Health Organization;cited 2018 February 19. Available from: http://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight.

2. Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, Mullany EC, Biryukov S, Abbafati C, Abera SF, Abraham JP, Abu-Rmeileh NM, Achoki T, AlBuhairan FS, Alemu ZA, Alfonso R, Ali MK, Ali R, Guzman NA, Ammar W, Anwari P, Banerjee A, Barquera S, Basu S, Bennett DA, Bhutta Z, Blore J, Cabral N, Nonato IC, Chang JC, Chowdhury R, Courville KJ, Criqui MH, Cundiff DK, Dabhadkar KC, Dandona L, Davis A, Dayama A, Dharmaratne SD, Ding EL, Durrani AM, Esteghamati A, Farzadfar F, Fay DF, Feigin VL, Flaxman A, Forouzanfar MH, Goto A, Green MA, Gupta R, Hafezi-Nejad N, Hankey GJ, Harewood HC, Havmoeller R, Hay S, Hernandez L, Husseini A, Idrisov BT, Ikeda N, Islami F, Jahangir E, Jassal SK, Jee SH, Jeffreys M, Jonas JB, Kabagambe EK, Khalifa SE, Kengne AP, Khader YS, Khang YH, Kim D, Kimokoti RW, Kinge JM, Kokubo Y, Kosen S, Kwan G, Lai T, Leinsalu M, Li Y, Liang X, Liu S, Logroscino G, Lotufo PA, Lu Y, Ma J, Mainoo NK, Mensah GA, Merriman TR, Mokdad AH, Moschandreas J, Naghavi M, Naheed A, Nand D, Narayan KM, Nelson EL, Neuhouser ML, Nisar MI, Ohkubo T, Oti SO, Pedroza A, Prabhakaran D, Roy N, Sampson U, Seo H, Sepanlou SG, Shibuya K, Shiri R, Shiue I, Singh GM, Singh JA, Skirbekk V, Stapelberg NJ, Sturua L, Sykes BL, Tobias M, Tran BX, Trasande L, Toyoshima H, van de Vijver S, Vasankari TJ, Veerman JL, Velasquez-Melendez G, Vlassov VV, Vollset SE, Vos T, Wang C, Wang X, Weiderpass E, Werdecker A, Wright JL, Yang YC, Yatsuya H, Yoon J, Yoon SJ, Zhao Y, Zhou M, Zhu S, Lopez AD, Murray CJ, Gakidou E. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014; 384:766–781.

3. Institute for Public Health. Ministry of Health Malaysia. National Health and Morbidity Survey 2015 (NHMS 2015). Volume II-Non-communicable diseases, risk factors & other health problems [Internet]. Kuala Lumpur: Ministry of Health Malaysia;2015. cited 2018 February 16. Available from: http://iku.moh.gov.my/images/IKU/Document/REPORT/nhmsreport2015vol2.pdf.

4. Eaton SB, Konner M, Shostak M. Stone agers in the fast lane: chronic degenerative diseases in evolutionary perspective. Am J Med. 1988; 84:739–749.

5. Kirchengast S. Physical inactivity from the viewpoint of evolutionary medicine. Sports. 2014; 2:3450.

6. Swinburn BA, Caterson I, Seidell JC, James WP. Diet, nutrition and the prevention of excess weight gain and obesity. Public Health Nutr. 2004; 7:123–146. PubMed.

7. Lachat C, Otchere S, Roberfroid D, Abdulai A, Seret FM, Milesevic J, Xuereb G, Candeias V, Kolsteren P. Diet and physical activity for the prevention of noncommunicable diseases in low- and middle-income countries: a systematic policy review. PLoS Med. 2013; 10:e1001465.

8. Romieu I, Dossus L, Barquera S, Blottière HM, Franks PW, Gunter M, Hwalla N, Hursting SD, Leitzmann M, Margetts B, Nishida C, Potischman N, Seidell J, Stepien M, Wang Y, Westerterp K, Winichagoon P, Wiseman M, Willett WC. IARC working group on Energy Balance and Obesity. Energy balance and obesity: what are the main drivers? Cancer Causes Control. 2017; 28:247–258.

9. Novak NL, Brownell KD. Role of policy and government in the obesity epidemic. Circulation. 2012; 126:2345–2352.

10. Lee YY, Narimah S, Wan Abdul Manan WM. Accelerometer-measured physical activity and its relationship with body mass index (BMI) and waist circumference (WC) measurements: a cross-sectional study on Malaysian adults. Malays J Nutr. 2017; 23:397–408.

11. Ross R, Berentzen T, Bradshaw AJ, Janssen I, Kahn HS, Katzmarzyk PT, Kuk JL, Seidell JC, Snijder MB, Sørensen TI, Després JP. Does the relationship between waist circumference, morbidity and mortality depend on measurement protocol for waist circumference? Obes Rev. 2008; 9:312–325.

12. Siddiqui NS, Gaikwad AV. Metabolic syndrome: a growing threat [Internet]. Aurangabad: Knowledge Publishing, Printing and Distribution House;2018. cited 2018 February 19. Available from: http://www.ksijmr.com/1.1.4.pdf.

13. Institute for Medical Research. Nutrient Composition of Malaysian Foods. Kuala Lumpur: Institute for Medical Research (for the Malaysian Food Composition Database Programme);1997.

14. Bergman P, Grjibovski AM, Hagströmer M, Bauman A, Sjöström M. Adherence to physical activity recommendations and the influence of socio-demographic correlates - a population-based cross-sectional study. BMC Public Health. 2008; 8:367.

15. National Coordinating Committee on Food and Nutrition. Recommended Nutrient Intakes for Malaysia. Kuala Lumpur: Ministry of Health Malaysia;2005.

16. National Coordinating Committee on Food and Nutrition. Malaysian Dietary Guidelines. Kuala Lumpur: Ministry of Health Malaysia;2005.

17. Institute for Public Health. National Health and Morbidity Survey 2014: Malaysian Adult Nutrition Survey (MANS)'s Vol. II: Survey Findings. Kuala Lumpur: Ministry of Health Malaysia;2014.

18. Mohamud WN, Musa KI, Khir AS, Ismail AA, Ismail IS, Kadir KA, Kamaruddin NA, Yaacob NA, Mustafa N, Ali O, Isa SH, Bebakar WM. Prevalence of overweight and obesity among adult Malaysians: an update. Asia Pac J Clin Nutr. 2011; 20:35–41.

19. Suriani I, Khadijah S, Khalib AL, Hazizi AS. Food consumption among overweight and obese working Malay women in urban settings. Int J Community Med Public Health. 2016; 3:658–662.

20. Food and Agriculture Organization. The state of food and agriculture [Internet]. Rome: Food and Agriculture Organization of the United Nations;2013. cited 2018 September 14. Available from: http://www.fao.org/docrep/018/i3300e/i3300e.pdf.

21. World Resources Institute. Shifting diets for a sustainable food future: creating a sustainable food future [Internet]. Washington, D.C.: World Resources Institute;2016. cited 2018 September 14. Available from: http://www.wri.org/sites/default/files/Shifting_Diets_for_a_Sustainable_Food_Future_0.pdf.

22. The World Bank Group. Countries and economies [Internet]. Washington, D.C.: The World Bank Group;2018. cited 2018 October 1. Available from: https://data.worldbank.org/country.

23. Lipoeto NI, Geok Lin K, Angeles-Agdeppa I. Food consumption patterns and nutrition transition in South-East Asia. Public Health Nutr. 2013; 16:1637–1643.

24. Rouhani MH, Salehi-Abargouei A, Surkan PJ, Azadbakht L. Is there a relationship between red or processed meat intake and obesity? A systematic review and meta-analysis of observational studies. Obes Rev. 2014; 15:740–748.

25. Fogelholm M, Anderssen S, Gunnarsdottir I, Lahti-Koski M. Dietary macronutrients and food consumption as determinants of long-term weight change in adult populations: a systematic literature review. Food Nutr Res. 2012; 56:19103.

26. Nurul Izzah A, Aminah A, Md Pauzi A, Lee YH, Wan Rozita WM, Siti Fatimah D. Patterns of fruits and vegetable consumption among adults of different ethnics in Selangor, Malaysia. Int Food Res J. 2012; 19:1095–1107.

27. Pei CS, Appannah G, Sulaiman N. Household food insecurity, diet quality, and weight status among indigenous women (Mah Meri) in Peninsular Malaysia. Nutr Res Pract. 2018; 12:135–142.

28. Lee SJ, Ryu HK. Relationship between dietary intakes and the double burden of malnutrition in adults of Malang, Indonesia: an exploratory study. Nutr Res Pract. 2018; 12:426–435.

29. World Health Organization. Global strategy on diet, physical activity and health [Internet]. Geneva: World Health Organization;2018. cited 2019 September 14. Available from: http://www.who.int/dietphysicalactivity/fruit/en/index2.html.

30. Mozaffarian D, Hao T, Rimm EB, Willett WC, Hu FB. Changes in diet and lifestyle and long-term weight gain in women and men. N Engl J Med. 2011; 364:2392–2404.

31. Lee CL Jr, Norimah AK, Ismail MN. Association of energy intake and macronutrient composition with overweight and obesity in Malay women from Klang Valley. Malays J Nutr. 2010; 16:251–260.

32. Merchant AT, Vatanparast H, Barlas S, Dehghan M, Shah SM, De Koning L, Steck SE. Carbohydrate intake and overweight and obesity among healthy adults. J Am Diet Assoc. 2009; 109:1165–1172.

33. Roberts CK, Liu S. Carbohydrate intake and obesity: an association that needs “refining”. J Am Diet Assoc. 2009; 109:1163–1164.

34. Howard BV, Manson JE, Stefanick ML, Beresford SA, Frank G, Jones B, Rodabough RJ, Snetselaar L, Thomson C, Tinker L, Vitolins M, Prentice R. Low-fat dietary pattern and weight change over 7 years: the Women's Health Initiative Dietary Modification Trial. JAMA. 2006; 295:39–49.

35. Ma Y, Olendzki B, Chiriboga D, Hebert JR, Li Y, Li W, Campbell M, Gendreau K, Ockene IS. Association between dietary carbohydrates and body weight. Am J Epidemiol. 2005; 161:359–367.

36. Halkjaer J, Tjønneland A, Thomsen BL, Overvad K, Sørensen TI. Intake of macronutrients as predictors of 5-y changes in waist circumference. Am J Clin Nutr. 2006; 84:789–797.