The nutrition and health transition in Malaysia Mohd Ismail Noor Universiti Kebangsaan, Malaysia

Table 1. Selected socio-demographic statistics Malaysia (1980-2000) YEAR 1980 1985 1990 1995 2000 Population (‘000) 11442 12981 14620 20689 23263 Infant Mortality Rate/1000 23.9 16.5 13.1 10.3 7.9 Crude Birth Rate/1000 30.9 31.9 28.4 26.1 24.5 Crude Death Rate/1000 5.3 5.0 4.7 4.6 4.4 Life Expectancy Rate (yrs) Males 66.4 67.7 68.9 69.4 70.2 Females 70.5 72.4 73.5 74.2 75.0 Gross National Product (USD *‘000) 20,556 28,735 43,046 83,238 124,326 Per Capita GNP (USD) 3734 4581 6042 10058 13361 Annual GDP Growth Rate (%) +7.4 -1.4 +8.3 +9.5 +8.5 *USD 1.00 = RM 2.50 (1980-1995), RM 3.80 (2000) Source: Dept. of Statistics Malaysia (1980-2000) Noor, Public Health Nutrition, Feb 2002

Figure 1. Changes in sources of calories in Malaysia, 1961-1997 100% 90% 80% 70% 60% % of Calories 50% 40% 30% 20% 10% 0% 1961-63 1970-72 1979-81 1988-90 1997 Cereals Starchy roots Vegetables & fruits Pulses Meat, fish, egg Milk-excl butter Sweeteners Oils & fats Miscellaneous Figure 1. Changes in sources of calories in Malaysia, 1961-1997 Source: Food Balance Sheet FAO (1961-1997) Noor, Public Health Nutrition, Feb 2002

Table 2. Per capita consumption (kg/year) of major food commodities (1985-2000) ITEM YEAR 1985 1990 1995 2000 Crops Rice 102.2 89.8 86.9 85.7 Vegetables 42.4 45.5 48.5 52.0 Fruits 39.7 44.3 49.9 53.5 Live stock Beef 2.4 3.2 4.3 5.3 Mutton 0.4 0.4 0.6 0.6 Poultry 14.6 19.0 30.0 35.3 Pork 10.1 12.0 13.2 8.1 Eggs 11.4 15.7 16.4 16.8 Milk* 37.2 37.7 51.5 53.0 Food Fish 33.4 34.8 39.1 49.0 Food Import (USD Million) 909 1205 2017 NA Note: * Per capita consumption in litres/year Source: Ministry of Agriculture (1999) Noor, Public Health Nutrition, Feb 2002    

Table 3. Fast food industries in Malaysia – a selected list (2000) Brand Year No. of Market Sales (origin) (Est) Outlet Share (%) (USD million) KFC (USA) 1973 294 45 152.3 Mc Donald’s (USA) 1982 141 30 92.0 Pizza Hut’s (USA) 1984 85 8 31.6 A & W (USA) 1961 44 4 19.1 Marrybrown (Local) 1981 88 4 NA Sugar Bun (Local) 1981 45 * 9.5 (1999) Kenny Roger (USA) 1994 25 * 9.5 Domino’s Pizza (USA) 1997 17 * NA *Others 9%, USD 1.00 = RM 3.80 Source: The EDGE (2001) Noor, Public Health Nutrition, Feb 2002

Figure 2. Prevalence of obesity among (a) children and (b) adolescents 2 4 6 8 10 12 14 93-94 1998 Male Female Combine sexes (a) (b) 1990 1997 Figure 2. Prevalence of obesity among (a) children and (b) adolescents in urban area Source: Bong & Jaafar (1995), Tee et al. (1998), Ismail (1998) Noor, Public Health Nutrition, Feb 2002

Figure 3. Prevalence of obesity in adult according to sexes and area 40 93-94 96-97 5 10 15 20 25 30 35 rural urban % of obesity overweight obese Male Female Figure 3. Prevalence of obesity in adult according to sexes and area Source: Ismail et al. 1995, Lim et al. 2000 Noor, Public Health Nutrition, Feb 2002

Table 4. Basal metabolic rate (MJ/day), total daily energy expenditure (MJ/day) and physical activity level (PAL) Subjects Age Male Female (yr) BMR TDEE PAL BMR TDEE PAL Adolescent25 12-14 5.08 7.89 1.55 4.80 7.09 1.48 Adolescent26 16-18 5.76 8.64 1.50 5.02 7.64 1.52 Young Adults27 18-30 5.85 9.40 1.61 4.77 7.58 1.59 Adults27 30-60 5.66 9.53 1.68 4.79 8.17 1.70 Elderly28 >60 4.92 7.35 1.50 4.37 6.74 1.54 Armed Forces29 20-30 5.74 12.08 2.10 NA NA NA Elite Athlete30 20-30 6.84 14.91 2.18 5.39 10.67 1.98 Source: 25Yap (2001), 26Victor (1999), 27Ismail et al. (1994), 28Razali (1996), 29Ismail et al. (1996), 30Ismail et al. (1997) Noor, Public Health Nutrition, Feb 2002

Figure 4. Number of admission and mortality 20000 40000 60000 80000 100000 1985 1990 1991 1992 1993 1994 1995 1996 Number of admission 1000 2000 3000 4000 5000 6000 7000 Hypertension CVD Cancer Diabetes Admission Death Number of deaths Figure 4. Number of admission and mortality Source: Ministry of Health (1985-1997) Noor, Public Health Nutrition, Feb 2002