Food insecurity exists whenever people are not able to access sufficient food at all times for an active and healthy life. This study used the Radimer/Cornell hunger and food insecurity instrument to assess food insecurity and to determine the risk factors and consequences of food insecurity among low-income households in Kuala Lumpur. One hundred and thirty-seven Malay pre-school children (4-6 years old) from Taman Sang Kancil were measured for their weights and heights. Questionnaires were used to collect food security and socioeconomic information on the households. The findings indicated that 34.3% of the households were food secure, while 65.7% experienced some kind of food insecurity, (27.7% households were food insecure, 10.9% individuals were food insecure and 27.0% fell into the child hunger category). The prevalence of underweight, stunting and wasting were 44.5%, 36.5% and 30.7% respectively. The prevalence of high weight-for-height (overweight) was 13.1%. Based on multinomial logistic regression, larger household size (OR=1.418; p<0.01) and lower educational level of mothers (OR=0.749; p<0.01) and fathers (OR=0.802; p<0.05) were found to be significant risk factors for food insecurity. The study, however, did not find any significant difference in children's nutritional status according to household food security levels. It is recommended that for the Malaysian population, the Radimer/Cornell hunger and food insecurity instrument should be modified and further validated with various ethnic groups in a variety of settings. The validation should include the appropriateness of the statements to the target grounds and their different risk factors and outcomes of food insecurity.
This report is a part of a multi-centre study in Asia on the problem of dual forms of malnutrition in the same households. In Malaysia, the prevalence of underweight and stunting persist among young children from poor rural areas. Overweight in adults, especially women from poor rural areas has been reported in recent years. Thus, this study was undertaken in order to assess the presence of the dual burden of underweight child-overweight mother pairs in a poor rural community. Out of 140 Malay households identified to have at least one child aged 1-6 years and mother aged above 20 years, 52.1% of the mothers were overweight, 15.7% of the children were underweight, 27.1% stunted and 5% wasted. Socio-economic background and food intake frequency data were collected from 54 underweight child/overweight mother pairs (UW/OW) and 41 normal weight child/normal weight mother pairs (NW/NW). Compared with the overweight mothers, a higher percentage of the normal weight mothers had received secondary education, were employed and with a higher household monthly income, although these differences were not significant. Patterns of food intake of the mothers and children appeared to have more similarities than differences between the UW/OW and NW/NW groups. Quantitative dietary intakes for 2 days using 24-hr recall and physical activity energy expenditure over the same period were assessed in a sub-group of UW/OW and NW/NW mothers and children. The NW/NW children showed significantly higher intake of total calories, fat and riboflavin than the UW/OW counterparts. Mean energy and nutrient intake of mothers from both groups were not significantly different, although the NW/NW mothers showed higher intake adequacy for total calories and most nutrients. While most of the mothers from both groups reported having no chronic illnesses, about half of the children in both groups had infections, especially gastrointestinal infections, over a 2-week period. Energy expenditure from physical activity for both UW/OW and NW/NW mothers and children did not differ significantly. This study confirmed inadequate intake of total energy and nutrients as the major factor for underweight in Malay children from rural areas. However, assessing intake and physical activity by interview methods were not sensitive enough to overcome perceived problems of under-reporting of energy intake and over-estimation of energy expenditure, especially by overweight subjects. Further investigations on a larger sample are necessary to understand the family dynamics leading to the double burden of malnutrition within the same household.
Food insecurity is a worldwide problem and has been shown to contribute to poor health and nutritional outcomes. In Malaysia, poor dietary intake, overweight and obesity, diabetes mellitus, and hypercholesterolaemia have been reported to be more prevalent in females compared to males and in Indians compared to other ethnic groups. A cross-sectional study was designed to investigate the relationship between food insecurity and health and nutritional status among 169 Indian women (19-49 years old, non-pregnant, and non-lactating) from randomly-selected palm-plantation households in Negeri Sembilan, Malaysia. Subjects were interviewed for socioeconomic and demographic data, and information on household food security and dietary intake. They were examined for weight, height, waist-circumference, blood pressure and lipids, and plasma glucose levels. For analysis of data, descriptive statistics, ANOVA, and logistic regression were used. Majority (85.2%) of the households showed food insecurity as assessed using the Radimer/Cornell Hunger and Food Insecurity Instrument. The food-secure women had significantly higher mean years of education and lower mean number of children than food-insecure groups (p<0.05). There was a significant decrease in the mean household income and income per capita as food insecurity worsened (p<0.05). Women who reported food security had significantly higher mean diet diversity score (11.60±4.13) than child hunger (9.23±3.36). The group of subjects with higher intake of meat/fish/poultry/legumes (crude odds ratio [OR]=0.53, confidence interval [CI]=0.29-0.95) and higher diet diversity score (crude OR=0.87, CI=0.78-0.97) was more likely to have < 3 health risks. Diet diversity score remained a significant protective factor against heath risks even after adjusting for other variables. The present study showed that food insecurity is indirectly associated with poor health and nutritional status. Therefore, appropriate community-based interventions should be designed and implemented to address the problems of food insecurity and possible health and nutritional outcomes.