Sometimes it is hard to believe that in a culinary paradise like Malaysia where food is in abundance and variety, that a high percentage of our children still suffer from malnutrition.
According to the 2023 Malaysia Global Nutrition Report, 21.8% of our children under five years of age suffer from stunting and 9.7% from wasting.
A report in The Star Online says that at 21.8%, Malaysia’s child stunting rate is higher than in lower middle income countries like Ghana (17.5%) and even conflict-ridden areas such as Palestine (7.4%) and Iraq (12.6%). And as far as wasting is concerned, our average of 9.7% is higher than the average for the entire Asia region (8.9%).
The same Global Nutrition Report says the prevalence of overweight children under 5 years of age is 5.2% while a 2023 Bernama report states that 29.8% of children aged five to 17 are overweight or obese. In fact, The World Obesity Federation predicts that 41% of the country’s adults will be obese by 2035 if something is not done now.
What do all these Numbers Mean?
Stunting and wasting as well as obesity indicate malnutrition.
Despite having full meals every day, these children are not consuming the nutrients that their bodies need to grow and develop normally, and for children under five, nutritional deficiencies can spell long term damage to their brain, mental, psychological as well as physical health with detrimental consequences that may affect them in all areas of their lives as they grow up.
Malnutrition comes with its many signs and symptoms. The child may be too short for his or her age, too thin and not growing, or too overweight. They may be lethargic or lack energy and often fall sick because of their compromised immune system. They may have issues with their digestive system, skin, bone development, sight, taste and smell and may also always feel anxious, moody and irritable. These children don’t do well in school because they can’t stay alert or pay attention or often miss school due to being sick. Because they face increasing physical and cognitive decline as they grow up, they end up not having the education or qualifications and psychological aptitude to be selected for good paying jobs upon entering the job market when they become adults.
Why Malnutrition May Not Be Obvious Sometimes
Sometimes, however, malnutrition may not be obvious to parents especially during the early stages as it may be micronutrients that the child is lacking in his or her diet.
According to the Khazanah Research Institute (KRI) report “Addressing Malnutrition in Malaysia”, micronutrients are the vitamins, minerals and trace elements that enable the body to produce enzymes, hormones and other substances essential for normal growth and development.
These micronutrient deficiencies are often difficult to detect as their signs and symptoms don’t manifest as conspicuously as over eating when the child becomes overweight or under eating when the child becomes too thin. “A child may be suffering from mild micronutrient deficiencies without showing anatomical or clinical symptoms to the naked eye except through biochemical analysis of the blood or urine,” says the report.
Besides, malnutrition caused by micronutrient deficiencies happens gradually. A child doesn’t become obese or stunted overnight. By the time anyone notices the symptoms such as poor cognitive function or poor motor skills in relation to the child’s age, it is often after irreversible damage has been done.
Dr Tee Ee Siong, the President of the Nutrition Society of Malaysia (NSM) says that it is important to note that even healthy-looking children may also be micronutrient deficient. “The fact that your child has a full belly is meaningless if you fail to provide him with a healthy diet, as it would mean that his body is still hungry for nutrients. This is why micronutrient deficiency is often referred to as ‘hidden hunger.’”
The Most Common Micronutrient Deficiencies in Children
According to the SEANUTS report on the health status of Malaysian children, the most common micronutrient deficiencies faced by our children are a lack of: Iron, Vitamin A, Iodine, Calcium and Vitamin D, and Zinc.
The Khazanah Research Institute: Tackling Micronutrient Deficiencies: Causes and Solutions report also adds Folate as one of the micronutrients that Malaysians do not take enough of.
1: Iron
Iron is needed for various bodily functions. It is the most important component of hemoglobin, the protein in red blood cells that carries oxygen from the lungs to the rest of the body and myoglobin, a protein that provides oxygen to the muscles.
Iron reduces tiredness and fatique, supports good energy levels, improves both mental and physical performance, and helps normal cognitive function by supporting attention span, decision-making, reasoning and learning. It also assists with many vital functions in the body and supports muscle growth and development.
A lack of iron in the body can lead to Iron Deficiency Anemia which can leave a person feeling weak, tired, short of breath which in turn, can lead to more serious health issues.
Foods rich in iron include: All meats, seafood and fish, spinach and other green leafy vegetables, beans like red kidney beans, edamame and chickpeas, nuts and wholegrain
2: Vitamin A
Vitamin A is essential for many processes in the body including maintaining healthy vision, ensuring the normal function of the organs and the immune system. It also supports bone health and development.
A lack of Vitamin A in the body can cause vision loss, cornea damage, night blindness and dry eyes. It can also lead to complications with the skin, heart, lungs, tissues and immune system including respiratory tract infections and poor wound healing. For children, a lack of Vitamin A can lead to stunting.
Foods rich in Vitamin A include: Leafy green vegetables, orange and yellow vegetables such as carrots, sweet potatoes, pumpkin, tomatoes, red and yellow bell peppers, fruits like mangoes as well as milk and eggs.
3: Iodine
Iodine is very important for a child’s brain development. In fact, children need iodine from before birth to adulthood. If the mother had an extreme iodine deficiency during pregnancy, the newborn could suffer from a disease called cretinism.
Cretinism affects the child’s brain and causes brain damage.
Children need iodine after birth. Iodine is necessary for the production of thyroid hormones in the thyroid gland, a small organ located in front of the neck below the Adam’s apple. The thyroid hormones control how the body produces energy, heart rate and body temperature.
Apart from hindering brain and cognitive development, a lack of iodine may cause a condition known as hypothyroidism which causes tiredness and weakness, dry skin, always feeling cold, learning and memory problems, weight gain and constipation. Left untreated, severe iodine deficiency can lead to intellectual development disorder.
Foods rich in iodine include: Seaweed, milk, dairy products, seafood, eggs, meat, poultry, bananas and nuts.
4: Calcium and Vitamin D
Calcium and Vitamin D are being quoted together because they work best together in growing strong bones and keeping them strong. Separately, they contribute to the health of the skin, blood ad brain but having Vitamin D in the body after consuming calcium prevents the mineral from being excreted from the body before it can work on the bones.
The Vitamin D will absorb calcium in the intestines and maintain adequate calcium and phosphate concentrations to enable bone mineralization.
Without Vitamin D, the body will absorb only 10% to 15% of dietary calcium. But with Vitamin D in sufficient amounts, intestinal calcium absorption increases to 30% to 40%.
Not only is Vitamin D essential for the absorption of calcium, it is also needed to absorb iron, magnesium, zinc and phosphate in the body. In short, Vitamin D is necessary for optimal bone growth, a robust immune system and heart health.
A Vitamin D deficiency can result in rickets – a softening of the bones in children which can cause bow legs − and disorders of the liver, kidney or small intestine.
Foods rich in Vitamin D include: Fatty fish, egg yolks, mushrooms, Vitamin D fortified milk and beef liver.
Calcium is a mineral that is essential for strong teeth and bones, heart health and nerve and muscle function. There is a window of time during childhood and adolescence to build strong, long bones for height and stature. This window of time revolves around the growth plates of bones and when they will permanently close stopping further elongation of the bones and height growth.
Typically, when puberty ends, the growth plates at the end of our bones fuse and the bones will stop growing in length. Once a growth plate hardens into solid bone, it closes for good and the child’s growth is complete. On average, girls stop growing taller at around age 13 to 15 and boys around age 15 to 17 although some children or adolescents do continue to gain some height into their late teen years. However, the vast majority of them will stop growing at the end of their puberty.
This means that a child who consumes adequate calcium during early childhood will set the stage for strong bones and teeth well into adolescence and adulthood.
Foods rich in calcium include: Milk and milk products, calcium fortified milk alternatives, dark leafy green vegetables, tofu, fish, nuts, seeds, chickpeas and fortified cereals.
5: Zinc
Zinc is an important mineral that is needed for cell proliferation, strong immunity, sex hormone development, brain and cognitive function, nerve health, metabolism regulation, healthy digestion, reduce inflammation, wound healing, blood clotting and thyroid function.
Zinc deficiency symptoms include appetite loss, growth retardation, slow motor development, delayed cognitive development, impaired immune function, hair loss, changes in nails and skin, diarrhoea and delayed sexual maturation.
Foods rich in zinc include: Oysters. If children refuse to eat oysters, other foods that contain zinc include red meat and poultry, beans, nuts, chickpeas, crab, lobster, whole grains and milk and other dairy products.
6: Folate (Folic Acid or Vitamin B9)
Folic Acid is Vitamin B9. In its natural form, it is known as folate and it is necessary for making red and white blood cells in the bone marrow, producing DNA and RNA and transforming carbohydrates into energy. This is why folate is such a crucial vitamin during periods of rapid growth such as pregnancy, infancy and childhood as well as adolescence.
DNA is the abbreviation of Deoxyribonucleic acid − the molecule that carries genetic information for the development and functioning of living organisms such as a human being.
RNA is the abbreviation of Ribonucleic −a nucleic acid present in all living cells that has structural similarities to DNA.
Babies, toddlers and growing children require high amounts of folate because it helps stimulate DNA replication and cellular growth. Children who are folate deficient may show shortage of breath, heart palpitations, a pale complexion, anemia, weakness, fainting, irritability and a general lack of energy.
Foods rich in folate include: Dark green leafy vegetables such as romaine lettuce, spinach, Chinese flowering cabbage (Choy Sum), kangkong, long beans, fresh fruits especially citrus fruits, legumes, beetroot, eggs and liver.
Micronutrient Deficiencies lead to Detrimental Health Consequences
The New Straits Times reported that one in three Malaysian families potentially suffer from a lack of iron, calcium, Vitamin C and D and that close to one-third of Malaysian children below the age of 12 do not achieve the recommended calcium and Vitamin D intakes. Furthermore, in the National Health and Morbidity Survey (NHMS 2022: Maternal and Child Health) it has been reported that 46.5% of children in Malaysia are anemic, caused by a lack of iron in the body.
To counter the detrimental effects of micronutrient deficiency in our children’s diets, it is important to incorporate a variety of food from all the food groups recommended in the Malaysian Food Pyramid and the Malaysian Dietary Guidelines 2020.
All the Malaysian dietary guides recommend milk as an important part of a balanced diet. The micronutrients contained in milk include calcium, zinc, magnesium, phosphorous as well as all the vitamins including Vitamin D, A and B complex. It also contains the necessary fats, carbohydrates and protein.
Morinaga Chil-kid
The goodness of milk cannot be denied. But fortified milk is even better.
As a fortified milk made specially to suit Asian children aged one to seven, Morinaga Chil-kid contains all the micronutrients found to be lacking in our Malaysian children’s diets. However, apart from iron, zinc, Vitamin A, iodine, calcium, Vitamin D and folate, Morinaga Chil-kid contains the rest of the essential nutrients needed to support and complement the dietary demands of fast-growing children.
Packed with 45 essential nutrients, Morinaga Chil-kid contains a balanced ratio of protein, fats and energy plus 27 vitamins and minerals including the entire B group of vitamins such as B1, B2, B6, and B12, plus Folic Acid, Pantothenic Acid and Biotin. Other essential vitamins in the milk include vitamins A, C, D, E and K1.
Apart from zinc, iron and iodine, Morinaga Chil-kid also contains other minerals such as magnesium, manganese, copper, selenium and phosphorus, as well as important amino acids such as taurine, L-carnitine and other nutrients.
Furthermore, it contains brain-building omega-3 fatty acids such as DHA and ARA, and other omega 3 and 6 long-chain polyunsaturated fatty acids (LCPs) plus five Nucleotides. The milk is also fortified with prebiotics Galacto-oligosaccharides (GOS).
Morinaga Chil-kid is formulated in Japan and manufactured in a state-of-the-art plant in the Netherlands using the milk of Netherlands’ cows. The formulation goes through stringent quality control at the plant with samples sent to Japan for a second inspection before the product is released into the market.
For more information on Morinaga Chil-kid, please visit the website here.