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BMC Public Health
Published in: BMC Public Health 1/2015

Open Access 01-12-2015 | Research article

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

Authors: C. Y. Wong, M. S. Zalilah, E. Y. Chua, S. Norhasmah, Y. S. Chin, A. Siti Nur’Asyura

Published in: BMC Public Health | Issue 1/2015

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Abstract

Background

Double-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.

Methods

This 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.

Results

About 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.

Conclusions

The 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.
Literature
1.
2.
Garrett J, Ruel M. Stunted child-overweight mother pairs: prevalence and association with economic development and urbanization. FNB. 2005;26:209–21.
3.
Jehn M, Brewis A. Paradoxical malnutrition in mother-child pairs: untangling the phenomenon of over- and under-nutrition in underdeveloped economies. Econ Hum Biol. 2009;7:28–35.CrossRefPubMed
4.
Lee J, Houser RF, Must A, de Fulladolsa PP, Bermudez OI. Disentangling nutritional factors and household characteristics related to child stunting and maternal overweight in Guatemala. Econ Hum Biol. 2010;8:188–96.CrossRefPubMed
5.
Barnett I. Is the dual burden of over- and under-nutrition a concern for poor household in Ethiopia, India, Peru, and Vietnam? Working Paper No.67. Young Lives: UK; 2011.
6.
Gluckman PD, Hanson M. The fetal matrix: evolution, development, and disease. Cambridge: Cambridge University Press; 2004.CrossRef
7.
8.
Victora CG, Adair L, Fall C, Hallal PC, Martorell R, Richter L, et al. Maternal and child undernutrition: consequences for adult health and human capital. Lancet. 2008;371:340–57.CrossRefPubMedPubMedCentral
9.
10.
Popkin BM. The nutrition transition in low income countries: an emerging crisis. Nutr Rev. 1994;52:285–98.CrossRefPubMed
11.
12.
Saibul N, Shariff ZM, Lin KG, Kandiah M, Ghani NA, Rahman HA. Food variety score is associated with dual burden of malnutrition in Orang Asli (Malaysian indigenous peoples) households: implications for health promotion. Asia Pac J Clinl Nutr. 2009;18:412–22.
13.
Ihab AN, Rohana AJ, Wan Manan WM, Wan Suriati WN, Zalilah MS, Rusli AM. The coexistence of dual burden of malnutrition in a sample of rural Malaysia. Int J Prev Med. 2013;4(6):690–9.PubMedPubMedCentral
14.
15.
16.
Horta BL, Santos RV, Welch JR, Cardosa AM, dos Santos JV, Assis AMO, et al. Nutritional status of indigenous children: findings from the First National Survey of Indigenous People’s Health and Nutrition in Brazil. Int J Equity Health. 2013;12:23.CrossRefPubMedPubMedCentral
17.
Coimbra CEA, Santos RV, Welch JR, Cardosa AM, Souza MC, Garnelo L, et al. The First National Survey of Indigenous People’s Health and Nutrition in Brazil: rationale, methodology, and overview of results. BMC Public Health. 2013;13.
18.
19.
20.
National Collaborating Centre for Aboriginal Health [NCCAH]. The state of knowledge of Aboriginal health: a review of aboriginal public health in Canada. Prince George, BC: Author; 2012.
21.
22.
Shashikala S, Kandiah M, Zalilah MS, Khor GL. Nutritional status of 1-3 year old child and maternal care behaviours in the Orang Asli Malaysia. S Afr J Clin Nutr. 2005;18:173–80.CrossRef
23.
Hayati MY, Ting SC, Roshita I, Safiih L. Anthropometric indices and lifestyle practices of the indigenous Orang Asli adults in Lembah Belum, Grik of Peninsular Malaysia. Asia Pac J Clin Nutr. 2007;16(1):49–55.
24.
Haemamalar K, Zalilah MS, Neng AA. Nutritional status of Orang Asli (Che Wong tribe) adults in Krau Wildlife Reserve, Pahang. Mal J Nutr. 2010;16(1):55–68.
25.
Chua EY, Zalilah MS, Chin YS, Norhasmah S. Dietary diversity is associated with nutritional status of Orang Asli children in Krau Wildlife Reserve, Pahang. Mal J Nutr. 2012;18(1):1–13.
26.
Osman A, Tan TT, Sakinah O, Khalid BAK, Wu LL, Ng ML. Prevalence of NIDDM and impaired glucose tolerance in aborigines and Malays in Malaysia and their relationship to sociodemographic, health, and nutritional factors. Diabetes Care. 1993;16(1):68–75. doi:10.​2337/​diacare.​16.​1.​68.CrossRef
27.
Wan Nazaimoon WM, Suraiami M. Prevalence of diabetes, impaired fasting glucose and metabolic syndrome among female Orang Asli community in Peninsular Malaysia. Int J Diab Dev Ctries. 2010;30:118–22. doi:10.​4103/​0973-3930.​66503.CrossRef
28.
Phipps ME, Chan KKL, Naidu R, Mohamad NW, Hoh BP, Quek KF, et al. Cardio-metabolic health risks in indigenous populations of Southeast Asia and the influence of urbanization. BMC Public Health. 2015;15:47.CrossRefPubMedPubMedCentral
29.
Department of Wildlife and National Parks Peninsular Malaysia (PERHILITAN). Krau Wildlife Reserve, Pahang. Peninsular Malaysia: Department of Wildlife and National Parks Peninsular Malaysia; 2012. http://​www.​wildlife.​gov.​my Accessed 28 Jun 2012.
30.
Department of Orang Asli Affairs (JAKOA). Household distribution of Orang Asli in Krau Wildlife Reserve, Pahang. Malaysia, Pahang: Department of Orang Asli Affairs; 2011-2012.
31.
WHO. Physical status: the use and interpretation of anthropometry. WHO Technical Report Series. Geneva, Switzerland: World Health Organization (WHO); 1995.
32.
WHO Multicentre Growth Reference Study Group. WHO child growth standards: length/height-for-age, weight-for-age, weight-for-length and body mass index-for-age: Methods and Development. Geneva: WHO; 2006.
33.
Doak C, Adair L, Bentley M, Fengying Z, Popkin BM. Overweight and underweight coexist within households in Brazil, China and Russia. Public Health Nutr. 2002;5:215–21.PubMed
34.
Varela-Silva MI, Dickinson F, Wilson H, Azcorra H, Griffiths PL, Bogin B. The nutritional dual-burden in developing countries – how is it assessed and what are the health implications? Coll Antropol. 2012;1:39–45.
35.
The Economic Planning Unit. Tenth Malaysia plan 2011-2015. Putrajaya, Malaysia: The Economic Planning Unit, Prime Minister’s Department; 2010.
36.
37.
Caballero B. A nutrition paradox – underweight and obesity in developing countries. N Eng J Med. 2005;14:1514–6.CrossRef
38.
Fadli AR, Adzrool Idzwan I, Kamarudzaman MI, Mustaffa Halabi HA. The impact of Che Wong tribe resettlement through image representation: the documentation of Che Wong tribe at Kuala Gandah, Lanchang Pahang Malaysia. IPEDR. 2012;51:40.
39.
Khor GL. Resettlement and nutritional implications: the case of Orang Asli in regroupment schemes. Pertanika J Soc Sci & Hum. 1994;2(2):123–32.
40.
Sawaya AL, Robert S. Stunting and future risk of obesity: principal of physiological mechanism. Cadernos Saude Publica. 2003;19 Suppl 1:S21–8.CrossRef
41.
Bouzitou DNG, Fayomi B, Delisle H. Child malnutrition and maternal overweight in the same households in poor urban areas of Benin. Sante. 2005;15:263–70.
42.
Khor GL, Sharif ZM. Dual forms of malnutrition in the same households in Malaysia – a case study among Malay rural households. Asia Pac J Clin Nutr. 2003;12:427–37.PubMed
43.
Raphael D, Delisle H. Households with undernourished children and overweight mothers: Is this a concern for Haiti? Ecol Food Nutr. 2005;44:147–65.CrossRef
44.
Darmon N, Drewnowski A. Does social class predict diet quality? Am J Clin Nutr. 2008;87:1107–17.PubMed
45.
Wamani H, Astrøm AN, Peterson S, Tumwine JT, Tylleskär T. Boys are more stunted than girls in Sub-Saharan Africa: a meta-analysis of 16 demographic and health surveys. BMC Pediatr. 2007;7:17.CrossRefPubMedPubMedCentral
46.
Dancer D, Rammohan A, Smith MD. Infant mortality and child nutrition in Bangladesh. Health Econ. 2008;17(9):1015–35.CrossRefPubMed
47.
United Nations Children’s Fund. Tracking progress on child and maternal nutrition. New York, NY: UNICEF; 2009.
48.
Angeles-Agdeppa I, Lana RD, Barba CVC. A case study on dual forms of malnutrition among selected households in District 1, Tondo, Manila. Asia Pac J Clin Nutr. 2003;12:438–46.PubMed
49.
Beydoun MA, Wang Y. Do nutrition knowledge and beliefs modify the association of socio-economic factors and diet-quality among US adults? Prev Med. 2008;46:145–5.CrossRefPubMed
50.
Barker DJP, Osmond C, Forsen TJ, Kajantie E, Eriksson JG. Trajectories of growth among children who have coronary events as adults. N Eng J Med. 2005;353:1802–9. doi:10.​1056/​NEJMoa044160.CrossRef
51.
Ramachandran P. Maternal & child nutrition: new dimensions of dual nutrition burden. Indian J Med Res. 2009;130:575–8.PubMed
Metadata
Title
Double-burden of malnutrition among the indigenous peoples (Orang Asli) of Peninsular Malaysia
Authors
C. Y. Wong
M. S. Zalilah
E. Y. Chua
S. Norhasmah
Y. S. Chin
A. Siti Nur’Asyura
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2015
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-015-2058-x

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