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Malaysia scores high marks to reduce under-weight prevalence

© UNICEF Malaysia/2007/Nadchatram
The Flour Fortification Initiative’s Coordinator Mr. Glen Maberly and UNICEF’s Deputy Executive Director Mr. Kul Gautam believe that fortification of staple foods is one of the best solutions to improve public health.

By Indra Nadchatram

KUALA LUMPUR, 22 August 2007 – Malaysia has experienced the fastest rate of decline in underweight prevalence in the East Asia and Pacific region said the United Nations Children’s Fund (UNICEF) during the 10th ASEAN Food Conference held recently.

The country successfully reduced its underweight incidence from 25 per cent in 1990 to 11 per cent in 2003.

According to UNICEF’s Deputy Executive Director, Mr. Kul C Gautam, Malaysia has made very good progress for its children in the last thirty years, having dramatically reduced poverty, illiteracy, and malnutrition to rates comparable to many industrialised countries.

Shining example

”Malaysia is a shining example in action. As a result of visionary leadership, a strong commitment to the wellbeing of children and investments in health and education, it has been able to reduce its under-five mortality rates from 21 per 1,000 live births in 1990 to 8 per 1,000 live births in 2005,” said Mr. Gautam.

“Another reason for this success is the Government’s commitment to ensure children receive proper nutrition.”

Malaysia’s achievements however are shared only by a few countries in the region. UNICEF estimates that there are 22 million children in East Asia and the Pacific who are under-nourished. About one-third of children in the Philippines are stunted and underweight; while more than a quarter of children younger than five in Indonesia and Vietnam are underweight.

Quality diet with micronutrients

UNICEF warns however that addressing malnutrition is not just a question of reducing the incidence of underweight children, but to ensure that children and women receive a quality of diet that includes micronutrients to encourage physical and mental development.

Recent studies from the Universiti Putra Malaysia found that 38 per cent of women surveyed were anemic while 84.8 per cent did not have enough blood folic levels to protect their infants against congenital malformation and still births.

The body needs essential minerals such as iodine, iron and zinc as well as vitamin A and folate to manufacture enzymes, hormones and other substances required to regulate growth and the functioning of the immune and reproductive systems.

Deficiencies in these essential minerals and vitamins can lead to still births, birth defects, blindness, a weakened immune system, life-threatening anemia and severe mental or physical disability. On a larger scale it fuels an inter-generational cycle of child mortality, ill health, lack of education and loss of productivity, resulting in impoverished communities, societies and nations.

An inexpensive solution

Food fortification was highlighted by Mr. Gautam as one of the best solutions to readdress this problem since it is inexpensive and sustainable in the long run. 

“Wheat flour fortification offers a tremendous opportunity to tackle micronutrient deficiencies since more than 400 million tons of wheat is eaten each year. The cost of the premix to fortify flour with iron and folic acid can be as little as US$ 0.30 to US$ 0.50 per metric ton,” he explained. “This basically translates to approximately US$ 0.02 per person per year!”

The food industry is urged to play its role to ensure that flour fortification becomes a reality not just in Malaysia, but globally. Amongst the actions needed from the food industry are to integrate fortification within all existing large and medium mills; to share technical expertise and help transfer technology and to apply production, distribution and marketing skills to make fortified flour cereals and other products widely available.

Mandatory fortification needed

The Flour Fortification Initiative’s (FFI) Mr. Glen Maberly explained that while voluntary fortification efforts are helpful, it is inadequate. “Mandatory fortification programs are very much needed to address important issues such as ensuring national coverage, equity, a level playing field, lower promotional costs, sustainability and safety,” he said. Mr. Maberly is also Professor at the Emory University’s Rollins School of Public Health.

The FFI Leader’s Group has committed to achieving 70 per cent fortification of the world’s roller mill wheat flour with at least iron and folic acid by 2008. Currently, only 20 per cent of wheat flour is fortified. To match this level of need, national action is required with collaboration between government agencies, medical and public health groups, consumer advocates, media, disability groups and the private sector.

“We are optimistic of Malaysia's success and good example to inspire other countries to follow suit”, added Mr. Gautam.



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