Countries in the Southeast Asian region have revised their national food-based dietary guidelines (FBDGs) in response to the public health and nutrition priorities. As a continuous effort to facilitate regional networking, the Southeast Asia Public Health Nutrition Network publishes this review as an update of its previous publication in 2016. This review provides an updated descriptive overview of current FBDGs for the general adult population in Brunei Darussalam, Indonesia, Malaysia, the Philippines, Thailand, and Vietnam. It summarises and compares commonalities and differences in key dietary messages and visual communication tools across countries. The findings indicate strong regional alignment on core dietary recommendations, including consuming a balanced and varied diet with foods from all food groups, prioritising vegetables and fruits, prioritising minimally processed grains or whole grains starchy staples, practising moderation in protein intake from both animal and plant sources, limiting foods high in fats/oils, sugar and salt, being physically active and maintaining a healthy body weight. Pictorial food guides, such as food pyramids and healthy plates, are widely used, with variations in design that reflect cultural contexts to enhance public understanding. While countries acknowledge the importance of FBDGs, effective dissemination and adoption remain challenging due to limited resources, weak cross-sectoral collaboration, and unsupportive food environments. This review highlights the need for stronger communication strategies, improved understanding of consumer barriers, systematic monitoring and evaluation, inclusion of guidance on away-from-home meals, strengthened multi-stakeholder collaboration across the food supply chain, and enhanced regional collaboration to support effective FBDGs implementation in Southeast Asia.

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 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.

Introduction: Access to accurate and timely dietary information is of paramount importance in evaluating and developing well-targeted public health nutrition interventions. However, nationwide nutrition surveys are conducted infrequently because they are very costly to design, conduct and analyse. Dietary assessment tools, which are quick and cost- effective, are needed for population research and regular monitoring of Malaysians’ dietary habits. This paper describes the rationale and methodology of the Malaysian Healthy Diet Online Survey (MHDOS) project, which aims to bridge this knowledge gap on dietary intake of Malaysian adults. The main objective of the two-year project is to develop MHDOS as a valid tool to measure compliance with the Malaysian Dietary Guidelines 2020. Methods: The MHDOS project has three study phases, namely (i) adaptation of an online survey and established diet quality scoring system for Malaysia, (ii) usability, validity and reliability testing of the online survey; and (iii) online survey administration in a nationwide study. The survey will be administered to approximately 10,000 Malaysian adults aged 18-59 years. Discussion: MHDOS consists of 38 questions that measures the quantity, quality and variety of foods consumed. Individuals will receive a diet quality score that reflects their overall compliance with the Malaysian Dietary Guidelines and feedback on how to improve their scores. The findings of the online survey, which serve to complement information between larger surveys, will be useful to measure compliance of Malaysians to national dietary guidelines and inform public health interventions.

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.

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.

Introduction: This paper discussed the effectiveness of “Healthy Kids Programme (HKP)”, specifically in improving the body weight status as well as knowledge, attitude and practice (KAP) of the children. Methods: In this longitudinal intervention study, a total of 12 primary schools in Klang Valley were randomly selected and divided into intervention and control groups. There were 386 standard three children participated at baseline. All children in the intervention group participated in the HKP that was conducted by nutritionists. The evaluations included the pre- and post-Immediate Impact survey (IIS) (every topic), and changes in nutrition KAP survey and anthropometric assessment of the children at the beginning and end of every year for three years. Results: School children in intervention group reported with an increased in the IIS score for each topic and achieved a significantly higher mean nutrition knowledge score than those in the control group over time. There were no significant differences in mean attitude and practice scores between two groups after the intervention. Children in the intervention group had lower rates of overweight and obesity (pre-test: 27.3%; post-test: 32.5%) than their counterpart (pre-test: 26.6%; post-test: 44.0%). Conclusions: The HKP is effective in improving nutrition knowledge of the children. A lower rate of overweight and obesity was observed in intervention group than control group. This approach will contribute towards inculcating healthy eating and active lifestyle habits among Malaysian children that bring about long-term health benefits.

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.