1.Food-based dietary guidelines in Southeast Asian countries: A comparison and update
E Siong Tee ; Maria Regina A. Pedro ; Visaratana Therakomen ; Mahenderan Appukutty ; Hardinsyah Ridwan ; Truong Tuyet Mai ; Siok Hui Voon
Malaysian Journal of Nutrition 2026;32(No. 2):171-204
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.
2.Review of recommended energy and nutrient intake values in Southeast Asian countries
E Siong Tee ; Rodolfo F Florentino ; Nalinee Chongviriyaphan ; Hardinsyah Ridwan ; Mahenderan Appukutty ; Truong Tuyet Mai
Malaysian Journal of Nutrition 2023;29(No.2):163-241
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.
4.Evaluation of Dietary Quality Using Malaysian Healthy Eating Index and Its Relationships With Cardiometabolic Risk Factors in Malaysian Adolescents
Geeta Appannah ; Nor Aishah Emi ; Nur Athira Ahmad Yusin ; Wan Ying Gan ; Zalilah Mohd Shariff ; Nurainul Hana Shamsuddin ; Azriyanti Anuar Zaini ; Mahenderan Appukutty
Malaysian Journal of Medicine and Health Sciences 2020;16(Supp 6, Aug):46-55
Introduction: This cross-sectional study aimed to investigate relationships between diet quality assessed by Malaysian Healthy Eating Index (HEI) and cardiometabolic risk factors in adolescents aged 13 years. Methods: 336 adolescents from various public secondary schools provided information on sociodemography and their anthropometric measurements including height (cm), weight (kg) and waist circumference (cm) were measured. Body mass index (BMI) was estimated thereafter. Dietary intakes assessed using a validated adolescent food frequency questionnaire (FFQ) was used to estimate Malaysian HEI. Biomarker parameters including lipid profile, fasting glucose, insulin and insulin resistance were also assessed. Associations of diet quality indicators to cardiometabolic risk factors were examined using regression models. Results: The overall diet quality of the adolescents was rather poor (49%), with a greater percentage of males were found to have low dietary quality score compared to females (56% vs. 39%; p<0.05). While males were more obese, a higher number of females (46.7%) were found to have at least one risk factors for cardiometabolic health compared to males (37.7%). After adjusting for covariates, no significant associations were observed among adolescents in the lowest quartile compared to those in the highest quartile of HEI score for obesity and abdominal obesity, as well as other cardiometabolic risk factors, in both males and females. Conclusion: Despite of poor dietary quality, no significant associations were observed between dietary quality assessed by Malaysia HEI and cardiometabolic risk factors in adolescents. Prospective studies are needed to establish a causal link between dietary patterns and cardiometabolic risk factors during adolescence.
5.Physical Activity Levels of Malaysian Vegetarians and Its Associated Factors: A Cross-Sectional Study
Yuan Kei Ching ; Mahenderan Appukutty ; Wan Ying Gan ; Yoke Mun Chan ; Yit Siew Chin
Malaysian Journal of Medicine and Health Sciences 2020;16(Supp 6, Aug):99-105
Introduction: Literatures suggest that insufficient physical activity as one of the contributors to non-communicable chronic diseases; nevertheless, data on the physical activity level is sparsely reported among individuals practising a vegetarian diet in Malaysia. The current study aims to determine the prevalence of insufficient physical activity and its association with socio-demographic factors, lifestyle factors and body weight status among 273 individuals practising a vegetarian diet in Klang Valley, Malaysia. Methods: A set of self-administered questionnaire was distributed to all vegetarians and their data on physical activity was determined using the Global Physical Activity Questionnaire (GPAQ). Results: The average years of practising vegetarianism was 14.2±9.6 years, and most of the vegetarians were practised ovo-vegetarian diet (44.0%). A majority of them were Chinese (54.9%) and female (64.8%), with an average age of 47.5 ± 13.1 years. The prevalence of overweight and obesity were 27.5% and 8.1%, respectively. According to GPAQ, about two in five vegetarians (46.2%) were having insufficient physical activity. Being females, older age, Chinese, married individuals, and those with high total household income level were found to be significantly associated with low physical activity level among Malaysian vegetarians (p<0.05). Conclusion: Since insufficient physical activity is one of the factors contributing to non-communicable chronic diseases, it is crucial to educate the importance of physical activity on overall health status, specifically for those who at risk of physically inactive. In addition, future studies can focus the causal associations based on the currently identified factors and physical activity levels, which can help to develop an effective intervention program among Malaysia vegetarians.
6.Factors associated with anemia among female adult vegetarians in Malaysia
Zi Fei CHAI ; Wan Ying GAN ; Yit Siew CHIN ; Yuan Kei CHING ; Mahenderan APPUKUTTY
Nutrition Research and Practice 2019;13(1):23-31
BACKGROUND/OBJECTIVES: A large number of studies on anemia have focused mostly on pregnant women or children. The vegetarian population, which is another potential risk group for anemia, remains largely unexplored. Therefore, this cross-sectional study examined the associations of the sociodemographic, lifestyle, nutritional, and psychological factors with the anemia status among female adult vegetarians. SUBJECTS/METHODS: A total of 177 female vegetarians were recruited from a Buddhist and Hindu organization in Selangor, Malaysia. The participants completed a self-administered questionnaire, which analyzed their sociodemographic characteristics, physical activity level, sleep quality, depression, anxiety, and stress. The body weight, height, waist circumference, and body fat percentage of the participants were also measured. A 3-day dietary recall was conducted to assess their dietary intake. Blood samples (3 ml) were withdrawn by a nurse from each participant to determine the hemoglobin (Hb) level. RESULTS: The findings revealed 28.2% of the participants to be anemic. The age group (AOR = 2.46, 95% CI = 1.19–5.05), marital status (AOR = 2.69, 95% CI = 1.27–5.71), and percentage of energy from protein (AOR = 5.52, 95% CI = 1.41–21.65) were the significant predictors of anemia. CONCLUSIONS: Anemia is a public health problem among female vegetarians in this study. Health promotion programs that target female adult vegetarians should be conducted to manage and prevent anemia, particularly among those who are married, aged 50 and below, and with an inadequate protein intake.
Adipose Tissue
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Adult
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Anemia
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Anxiety
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Body Weight
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Child
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Cross-Sectional Studies
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Depression
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Female
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Health Promotion
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Humans
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Life Style
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Malaysia
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Marital Status
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Motor Activity
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Obesity
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Pregnant Women
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Psychology
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Public Health
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Vegetarians
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Waist Circumference


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