A seminar titled "Sugar Substitutes: Understanding the Basics, Global Regulatory Approvals, Safety Assessment Protocols and Benefits" organised by the Nutrition Society of Malaysia was held on 1.5th Apri12015 for nutritionists and other health care professionals, to review and discuss the latest evidence on safety and efficacy of sugar substitutes. Highlights from lectures by local and international speakers about this topical subject are presented in this report. Sugar substitutes have been extensively evaluated for decades and regulatory agencies world-wide continue to review and confirm their safety. Furthermore, the effects of sugar substitutes on human health continue to be the subject of research studies. Many studies have shown that replacement of sugar with sugar substitutes may help in weight management, glucose control for people with diabetes, and in the prevention of tooth decay. It is important for health professionals to discern whether the available evidence is based on good science and adequate protocols in order to guide consumers with the responsible use of sugar substitutes following national and international dietary guidelines. The use of sugar substitutes for certain health outcomes was discussed, specifically in regard to appetite, energy balance, body weight and other cardio-metabolic risk factors. Overall, the seminar provided an understanding of the different types of commercially available sugar substitutes, their use in a range of food and beverages, and calorie contribution to the diet. The seminar also covered the approvals of different sugar substitutes and the protocols for assessing the safety of these sugar substitutes, especially in the case of children and pregnant women.

A seminar titled "Sugar Substitutes: Understanding the Basics, Global Regulatory Approvals, Safety Assessment Protocols and Benefits" organised by the Nutrition Society of Malaysia was held on 1.5th Apri12015 for nutritionists and other health care professionals, to review and discuss the latest evidence on safety and efficacy of sugar substitutes. Highlights from lectures by local and international speakers about this topical subject are presented in this report. Sugar substitutes have been extensively evaluated for decades and regulatory agencies world-wide continue to review and confirm their safety. Furthermore, the effects of sugar substitutes on human health continue to be the subject of research studies. Many studies have shown that replacement of sugar with sugar substitutes may help in weight management, glucose control for people with diabetes, and in the prevention of tooth decay. It is important for health professionals to discern whether the available evidence is based on good science and adequate protocols in order to guide consumers with the responsible use of sugar substitutes following national and international dietary guidelines. The use of sugar substitutes for certain health outcomes was discussed, specifically in regard to appetite, energy balance, body weight and other cardio-metabolic risk factors. Overall, the seminar provided an understanding of the different types of commercially available sugar substitutes, their use in a range of food and beverages, and calorie contribution to the diet. The seminar also covered the approvals of different sugar substitutes and the protocols for assessing the safety of these sugar substitutes, especially in the case of children and pregnant women.

Over the last three decades, there has been significant changesin the lifestyles of communities, including food habits, and food purchasing and consumption patterns in the Southeast Asian region. As a result, there is a definite change in the food and nutrition issues in the region. Nutritional deficiencies in many of these countries are slowly being decreased in magnitude. On the other hand, the significant proportions of the population are now faced with the other facet of the malnutrition problem, namely diet-related chronic diseases. However, because of the different stages of socio-economic development, the extent of each of these extremes of the malnutrition problems varies considerably between the different countries in Southeast Asia. Nutrition needs in the new millennium would necessarily differ somewhat among these countries while at the same time, there would be a considerable amount of similarities. This presentation highlights several macro issues that countries in the region may focus on in the near future. Various intervention programmes have been undertaken by authorities to tackle the co-existence of twin faces of malnutrition in many developing countries. It would be desirable to have a blue print of such programmes and activities in the National Plans of Action for Nutrition (NPANs). The NPAN should be more than a framework or a descriptive document. It should be a tool for action, an operational plan that sets out priorities; identifies projects and activities, with details of implementation such as what, how and when; designates responsibilities and accountability for the activities; identifies resource requirements and their source; and sets out the plan for monitoring and evaluation. One of the main obstacles in the formulation and effective implementation of intervention programmes in developing countries is the lack of comprehensive data on the extent of the problems in many cases and the causes of such problems specificy to the communities concerned. It is thus imperative to identify appropriate research priorities and conduct relevant studies. It is also important to have basic baseline data collected at regular intervals such as nutritional status of communities and dietary intake. To conduct all these activities, it is vital to ensure adequate funding, preferably through establishing a dedicated fund for research. There should be closer collaboration between countries in the region in all nutrition activities to enable sharing of resources, experiences and learn from the mistakes of others. One existing mechanism is through the ASEAN structure. The other existing mechanisms are through WHO and FAO. One other mechanism is through the International Life Sciences Institute (ILSI) Southeast Asian Branch. Closely related to this need for networking is the need for continuing harmonization of approaches to nutrition activities in the region. Current efforts in harmonisation include RDA, nutritional status assessment methodologies and dietary guidelines. Other areas of harmonisation in the near future include nutrition labelling and claims.

A workshop on National Plans of Action for Nutrition:Constraints, Key Elements for Success, and Future Plans was convened and organized by the WHO Regional Office for the Western Pacific in collaboration with the Institute for Medical Research Malaysia and co-sponsored with FAO and UNICEF from 25—29 October 1999. It was attended by representatives of 25 countries in the region and resource persons, representatives from WHO and other international agencies. The objectives of the workshop were to review the progress of countries in developing, implementing and monitoring national plans of action for nutrition (NPANs) in the Western Pacific Region and to identify constraints and key elements of success in these efforts. Most of the countries have NPANs, either approved and implemented or awaiting official endorsement. The Plan formulation is usually multisectoral, involving several government ministries, non-governmental organizations, and international agencies. Often official adoption or endorsement of the Plan comes from the head of state and cabinet or the minister of health, one to six years from the start of its formulation. The NPAN has stimulated support for the development and implementation of nutrition projects and activities, with comparatively greater involvement of and more support from government ministries, UN agencies and non-governmental agencies compared to local communities, bilateral and private sectors and research and academic institutions. Monitoring and evaluation are important components of NPANs. They are, however, not given high priority and often not built into the plan. The role of an intersectoral coordinating body is considered crucial to a country's nutrition program. Most countries have an intersectoral structure or coordinating body to ensure the proper implementation, monitoring and evaluation of their NPANs.

This paper reports the nutrition knowledge of Malaysian elderly, as part of a nationwide study to evaluate the status of nutrition knowledge, attitude and practice (KAP) of food and nutrition among various communities in Malaysia. A total of 906 elderly, age ranging between 60 to 96 years old, with mean age 67.4 ± 6.7 years representing all states in Malaysia participated in the study. An interview administered questionnaire was used to assess the nutrition knowledge and to collect demographic data of the elderly. Subjects were in the 60-65 years (51%) and more than 65 years (49%) age category. There were 46% Malays, 32% Chinese, 6% Indians while the remaining 16% comprised of other minority groups in Malaysia such as Iban, Kadazan, Melanau, Orang Asli and others. More than half of the elderly (54%) had no formal education, 36% completed primary schooling and only 9% finished secondary education. Overall 73% elderly were categorized as having poor nutrition knowledge, 18% moderate and only 9% good. The minority groups had the highest percentage of poor nutrition knowledge (91%) while the Chinese had the highest percentage of good nutrition knowledge (11%). More female (78%) than male (67%) had poor nutrition knowledge, in contrast to more male (10%) than female (8%) with good nutrition knowledge. Chi square test showed that there was a significant correlation between educational status and nutrition knowledge. This was reflected in the results which showed that 81% elderly with no formal education were categorized in the poor nutrition knowledge group. Majority of the elderly did not know about foods to be consumed most (88%), or to be eaten least (87%). Only a quarter to a third of the elderly responded correctly to questions on nutrient function and content. The question on foods with high salt was well responded by the elderly (65%). It is quite discouraging to show that a majority of Malaysian elderly had poor nutrition knowledge. This study indicated that appropriate nutrition education interventions need to be implemented to improve the shortcomings of nutrition knowledge among the Malaysian elderly.

A review conducted on the regulatory status of bioactive non-nutritional food components in foods and beverages in eight Southeast Asian countries indicates these components have been recognised for their health benefits. Indonesia and Malaysia have promulgated specific regulations allowing the addition of these bioactive components in foods and beverages, provided a list of the permitted components that may be used, and clear process for the industry to apply for new components. Both countries also have separate regulations that govern the making of function claims which refer to the beneficial physiological or health effects brought about by such bioactive components. The other six countries do not have a specific regulation governing the use of these bioactive components. However, these countries also permit the making of similar function claims, provided they are scientifically substantiated, preferably human clinical trials. Each country has slightly different requirements and process in place for reviewing applications for claims. All countries, except Myanmar, also allow the sale and marketing of foods containing probiotics, another functional food component. Indonesia, Malaysia, Philippines and Thailand have promulgated specific probiotic regulations and, except for Indonesia, have published permitted list of probiotics. All seven countries have provisions for the industry to apply for the use of new probiotics. Malaysia, Philippines, Singapore and Thailand permit the use of a pre-approved generic function claims related to probiotics. The sharing of experiences in regulatory approaches would be beneficial to the advancement of scientific and regulatory development of bioactive non-nutritional food components in the region and would benefit all stakeholders.

Obesity is gaining prominence as a serious public health challenge in the Southeast Asia(SEA)region,with an alarming rate of increase in its prevalence.Countries in the region have shown commitment to curbing the rise of obesity by establishing policies,strategies,and action plans.This paper summarises the current situation and strategies undertaken to combat obesity and related chronic diseases.Although a range of policies and strate-gies have been developed,including national nutrition action plans,community intervention programmes,fiscal measures,nutrition labelling to promote healthier choices,countries in the region are struggling to make signifi-cant progress toward halting the scourge of obesity.It is imperative to strengthen existing health systems with a paradigm shift from a focus on"sick care"to and enhancing nutrition initiatives to support obesity prevention.A comprehensive and coordinated approach is essential,one that emphasises high-level coordination across all lev-els of government and multiple sectors,and a unified plan rather than fragmented initiatives.For strategies to be effective and sustainable,they must address the fundamental environmental determinants of poor dietary choices and nutritional inequalities.A more holistic approach is clearly needed to improve the entire food environment,which in SEA countries must include the multitude of eating places where large segments of the population"eat out"everyday to meet their energy and nutrient needs.There is a recognised need for more comprehensive measures to promote healthy eating among school children and ensure a supportive environment for lifelong healthy habits.This paper calls for a whole-of-government,whole-of-society approach that combines changes to the fundamental food environment and accompanied by systematic monitoring and surveillance systems to achieve long-lasting health outcomes.

This review summarises the key components of the available probiotic regulations in six Southeast Asia countries (Indonesia, Malaysia, Philippines, Singapore, Thailand and Vietnam). Diverse approaches have been undertaken by the countries in regulating the marketing and sale of probiotics in foods and health supplements. Only Indonesia, Malaysia, Philippines and Thailand have enacted specific regulations which include their respective legal definition of probiotics. Only Malaysia, Philippines and Thailand publish a list of microorganisms permitted to be used as probiotics in foods or health supplements; the approved microorganisms are not harmonised among these countries. All six countries allow the application for new microorganisms to be used, but have adopted differing requirements and approaches. A common requirement is that all applications must be accompanied by scientific data to demonstrate clinically that the microorganisms are safe and provide health benefits. All the countries, except Indonesia and Vietnam permit the use of a small number of pre-approved generic function claims. It is noted that the countries have different specific labelling requirement for products containing probiotics. The divergent probiotic regulations in the region, either for foods or health supplements, creates inconsistencies and difficulties for all stakeholders including regulators, academia, industries and consumers, as well as impacting trade among countries. This review highlights the importance of having regulatory control to ensure consumers have access to safe, genuine and efficacious probiotic products. We propose working towards a harmonised probiotics regulation in the region to enable further development and progress of probiotics in the region.

This review describes national plans of action for nutrition (NPANs) in six Southeast Asia countries (Indonesia, Malaysia, Myanmar, Philippines, Thailand and Vietnam) in order to provide an understanding of the approach and framework undertaken by these countries in the formulation and implementation of NPANs, as well as the similarities and differences in various NPAN components. The six countries recognised the persistent undernutrition and escalating rates of obesity and other diet-related chronic diseases as the key drivers for nutrition action plan implementation. The prioritisation of nutrition interventions outlined in these NPANs are based on respective country context and needs. Although differing in strategies and targets set, these countries show similarities in several components including objectives, stakeholder involvement, nutritional issues to be addressed, implementation, monitoring and evaluation mechanism, programme/ activities identified and challenges in implementing NPANs. Countries have recognised that effective implementation, monitoring and evaluation are essential to successfully address both extremes of the challenging nutrition situation. Several important similarities in the NPANs studied suggest that closer collaboration among countries and stakeholders on NPANs would be beneficial. Opportunities should be created for periodic exchanges to enable sharing of experiences in the development and implementation of NPANs among the countries. Recommendations and conclusions drawn from this review could serve as useful reference for nutrition policy and planning in the future.

This review summarises the officially published recommended energy and nutrient intake values in five Southeast Asia (SEA) countries namely Indonesia, Malaysia, Philippines, Thailand and Vietnam. The background information, general approaches and references used for setting up recommendations and the recommended intakes levels for energy, protein, fat and carbohydrate, dietary fibre, sugars,14 vitamins and 15 minerals of these countries were tabulated and compared. The recommended intake values show remarkable similarities in terms of approaches and principles taken, as well as references used as the basis for the recommendations development and the application of the recommendations in respective country. There are nevertheless some differences in age groupings, reference height and weight used, as well as the final recommendations of the intake levels for some nutrients, after adjustment to suit local situations. All five countries had provided recommendations in terms of recommended nutrient intakes (RNI) or recommended dietary allowance (RDA) for almost all the nutrients. Due to the limited availability of local data and resources, countries in the region have referred to several references, including those from Food and Agriculture Organization/World Health Organization (FAO/WHO) consultation report and recommendations from research organisations in United States and Europe and adapted the values for local uses. Opportunities should be created to enable closer dialogue and collaboration regarding future developments in nutrient recommendations for populations in the region. These could include consideration of establishing more appropriate nutrient recommendations and the call for setting up harmonised approaches to establishing recommended nutrient intake values for the region.