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Human nutrition

Evaluation of nutritional energy requirements for Malaysia - Mohd. Ismail Noor

Human nutritional requirements have been reviewed periodically and assessed by various national and international agencies. The 1981 consultation on energy and protein requirements commissioned by FAO, WHO, and the UNU dealt specifically with the latest information available for deriving estimates of the energy and protein requirements of children and adults [1]. After a series of further meetings and discussions, it was agreed that FAO would undertake responsibility for preparing a manual designed to help economists and planners in dealing with the problems of food supply at a national or regional level and to assist nutritionists and others who want to examine the basis of energy requirements [2].

Several important variables must be assessed in order to provide energy-requirement values for any given population, namely, the total population size and its age structure, body weights of children and adults, basal metabolic rates (BMR), physical activity levels and the energy cost of different activities, and the number of pregnant women each year. Most countries, including Malaysia, do not have all of the needed information. In the absence of nutritional survey data at the national level, this paper describes the current status of energy-requirement estimates based on limited studies.

Population size and policy

A recent survey estimated the population of Malaysia in 1988 at 16.98 million [3]. The distribution of the population according to rural or urban residence and according to ethnic group is shown in table 1. About 62% of the total population live in rural areas and the remainder in urban localities (gazetted areas with a population of 10,000 or more). About 61% of the total population are Malays, 30% Chinese, and 9/O Indians and others.

Body weight

Actual body-weight measurements are essential for calculating BMR and total energy requirements. Bodyweight data collected from several local studies [4, 5] are presented in table 2, together with the index to growth curves for Malaysia [2]. There are indications of higher body weight values in adolescents than the index values. This only emphasizes the importance of representative studies to confirm trends in body-weight changes.

A comprehensive survey on nutrition status in rural poverty villages was conducted by the Institute for Medical Research between 1979 and 1983 [6] (table 3). Several other recent studies have reported similar findings in rural villages and urban slums. Although Malaysian children are ahead of children in Bangladesh, India, Nepal, and Indonesia in growth, with present trends it could take more than a decade of uninterrupted prosperity for them to catch up with their Japanese or even Singapore counterparts [7]. About two-thirds of the total population of Malaysia live in rural areas. The high prevalence of stunted children and underweight adults in a supposedly healthy population, compared with available standards, has serious implications for estimates of energy requirements.

Dietary energy availability versus requirements

The trend in the energy availability of the national food supply from 1961 to 1984 is shown in table 4, compared with the national average requirement as recommended by FAO [8] (2,230 kcal) and the value derived using calculations based on James and Schofield [2] (2,030 kcal; see table 5). There appears to be a gradually increasing surplus of calories available per capita per day from 9.3% in 1961-1963 to 20.5% in 19831985 using the FAO figure of 2,230 kcal, and an even greater surplus, ranging from 20.1% to 32.0%, if one adopts the figure of 2,030 kcal derived by James and Schofield's method [2].


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