Double-burden of malnutrition among the indigenous peoples (Orang Asli) of Peninsular Malaysia

Abstract

BackgroundDouble-burden of malnutrition (DBM) is an emerging public health concern among the Orang Asli (indigenous peoples) of Peninsular Malaysia. This study aimed to identify the presence of DBM at the community and household levels in Orang Asli population and its associated demographic and socio-economic factors.MethodsThis cross-sectional study was conducted in 11 Orang Asli villages surrounding the Krau Wildlife Reserve, Peninsular of Malaysia from October 2011 to January 2012. Of 438 households, a total of 981 adults and 304 children who met the study criteria agreed to participate. About 160 households were further selected with pairs of children aged 3–59 months and non-pregnant mothers aged 15–55 years. Demographic and socio-economic data were obtained using interviewer-administered questionnaire while weight and height were measured using standard procedures. Double-burden of malnutrition was defined as overweight/obese mother-underweight child (OWOBM/UWC), overweight/obese mother-stunted child (OWOBM/STC) or overweight/obese mother-underweight or/and stunted child (OWOBM/UWSTC). Binary logistic regression identified the demographic and socio-economic factors associated with double-burden households.ResultsAbout 26 % of overweight and obese adults coexisting with high proportions of underweight (49 %) and stunted (64 %) children in these Orang Asli villages. There was a higher prevalence of households with OWOBM/UWSTC (20 %) and OWOBM/STC (19.4 %) than households with OWOBM/UWC (12.5 %). Boys (P < 0.05), older age mothers (P < 0.05), mothers with higher education (P < 0.05) and households with income per capita less than USD 29.01 (RM 97.00) (P < 0.01) were associated with higher odds of OWOBM/STC. Jah Hut (P < 0.05) and higher number of children (P < 0.05) were significantly associated with lower odds of OWOBM/UWC.ConclusionsThe occurrence of double-burden of malnutrition in Orang Asli population deserves attention. Poverty reduction, access to quality diet and improved health and nutrition literacy are among strategies that could address the coexistence of DBM in this population.

Prevalence and factors associated with double and triple burden of malnutrition among mothers and children in Nepal: evidence from 2016 Nepal Demographic and Health Survey

“…Our results revealed that mothers who were above 35 years were found to be at higher risk of double burden of malnutrition. This result is consistent with Emdadul et al, and Wong et al, who suggested that the prevalence of overweight/obesity was higher in older age groups compared to younger groups [3,35].…”

“…Malnourished mothesr are more likely to have a low birth weight baby which signifies the importance of exploring the double burden of malnutrition among mother-child pairs. [19,34].…”

“…The explanation for this conflicting finding could be that mothers having a higher level of education may not necessarily be sufficient to adopt behavior change in a healthy lifestyle. In the case of the mothers having with poor health and nutritional knowledge contribute to women being less sensitive to child and her nutritional status or less responsive to health and nutrition issues in terms of food choices and barriers such as food cost, accessibility, availability, lack of cooking skills [19,38]. As we found that DBM was more prevalent in mothers who had a lower level of education, therefore, providing nutrition education during pregnancy could bridge this nutritional knowledge gap in Nepal [39].…”

“…Association of socioeconomic status (SES) and the double burden of malnutrition has been explored in several studies [16,18]. Maternal overweight/obesity and child undernutrition among mother-child pairs is thought to be the result of an interaction of changes related to socio-demographic and economic status, dietary habit and intensity of physical activity [19]. Popkin et al (2012) has highlighted that most low-and middle-income countries are undergoing economic and nutrition transition [20].…”

Do not neglect the indigenous peoples when reporting health and nutrition issues of the socio-economically disadvantaged populations in Malaysia

“…Childhood undernutrition is a persistent health problem in the Orang Asli population that has been documented over the decades at levels that are much higher than those reported in other rural or poor communities in Malaysia. Studies reported that child undernutrition remains relatively high (43-86%) with stunting being more prevalent than underweight [31][32][33][34][35][36][37][38]. Anaemia indicative of iron deficiency and helminthic infestation is also an age-old nutritional problem affecting the Orang Asli [5].…”