KUALA LUMPUR, July 2 — Malaysia is often seen as a food heaven thanks to its splendid array of gastronomic variety made available round the clock at 24-hour eateries in every neighbourhood.

This delightful perk, however, is partly responsible for the growing waistline of most Malaysian adults.

Key findings from the National Health and Morbidity Survey 2023 by the Health Ministry say Malaysians are getting fatter.

The trend in overweight and obesity among adults in Malaysia from 2011 to 2023 has grown from 44.5 to 54.4 per cent.

That’s a 10 per cent increase in about a decade.

The data also shows that growth has increased even more in recent years.

Based on the data, one in two Malaysian adults is overweight or obese, which is one of the main contributing factors to the ever-growing number of people living with non-communicable diseases (NCDs) in Malaysia.

But what is the root cause of this unhealthy trend among Malaysians?

Our lifestyle and food choices are the main culprits

According to family medicine specialist Assoc Prof Dr Verna Lee Kar Mun, Malaysia is a food heaven and many people tend to eat out most days, at least one meal daily.

"We have at least three major food choices, namely Malay, Indian and Chinese food, and then not forgetting the very established addictive western fast-food chains, and more recently the Asian food cultures - Thai, Japanese, Korean, Taiwan, Arabic, Vietnam, etc.

"If not all, most of these restaurants serve highly refined carbo, high fat, high salt, and ultra-processed food. We are spoiled by choices,” said Dr Lee, who is also with IMU University.

According to her, the unhealthy eating habits may differ for people from different socio-economic class.

"As for the lower socioeconomic group of B40 Malaysians, their staple diets are mainly rice, curry and eggs, with very few vegetables/fruits, and maybe chicken/fish once a week.

"But they eat a lot of rice and flour.”

Apart from food, Dr Lee said most Malaysians have a sedentary lifestyle which is a contributing factor to obesity.

"We sit a lot and hardly move. Exercise is rare among Malaysians.

"Many of my patients say they do not have time to exercise and for those living in low-cost flats, there is no proper venue to encourage physical activity.”

According to her, obesity can also be an inherited gene from parent to child, while some children may also watch what adults eat and pick up the habits from them.

"If parents are obese, most of the time, their kids are obese too.”

The culprit for NCDs

While obesity on its own is classified as a non-communicable disease (NCD), it can lead to many other deadly NCDs and complications such as diabetes, high cholesterol and hypertension.

According to upper gastrointestinal and bariatric surgeon Dr Yeap Chee Loong, obesity is a significant risk factor for chronic diseases such as diabetes, cardiovascular diseases, respiratory illnesses, liver problems and certain cancers.

"It also poses mental health risks such as depression and low self-esteem.

"Higher illness and absenteeism rates due to obesity-related health issues also reduce workforce productivity," said Dr Yeap who is attached to Gleneagles Hospital Kuala Lumpur.

Based on the NHMS 2023 primary report by the Health Ministry, about 2.3 million or approximately 10 per cent of Malaysian adults live with three NCDs.

The top four prevalent NCDs amongst Malaysian adults were obesity (54.4 per cent), high cholesterol (33.3 per cent), hypertension (29.2 per cent) and diabetes (15.6 per cent).

What needs to be done?

According to Dr Lee, leading a healthy lifestyle should start with oneself.

When it comes to eating, she said it’s all about moderation.

"The MOH’s healthy plate quarter which includes a quarter of complex carbo, half portion protein and five-colours vegetables and fruits with very little fat and salt concept is a good way to start in all three meals namely; breakfast, lunch and dinner for all age groups including young children.

"Start from every home, then schools, universities, and workplaces.”

To fix the sedentary lifestyle, she said everyone can start by walking.

"At home, switch screen time to walk time, and at schools, schedule a 30-min physical activity/walking session daily in the timetable for all, including the teachers.

"Being a role model to the next generation is the most powerful tool — make exercise an essential living activity just like we eat, sleep, and pray every day.”

Dr Lee said adults can start making a habit out of walking from home to train/bus stations, from car parks to office/institutions, from office/institutions to lunch places, use the stairs and find any opportunity to walk.

"When people start to feel the endorphin effects of exercise, they will be addicted for more.”

A holistic approach

According to Dr Yeap, awareness campaigns alone may not solve the obesity prevalence in the country and it needs a comprehensive approach.

He said the government should look into policy interventions such as implementing taxes on sugar-sweetened beverages and unhealthy food to reduce the consumption of unhealthy food.

"Providing subsidies for healthier food options, such as fruits and vegetables, can also make them more affordable.

"There should also be enforced regulations on food advertising, particularly targeting children.”

Dr Lee, on the other hand, said more research and data are also needed to prove what works for Malaysians.

"Our food culture is very different from other countries in the Asia region, therefore, we need to use the current data and innovate healthy eating habits just for Malaysians.”

She said most diet data from the US and European countries may not be suitable and applicable to our culture and lifestyle.

"We need to create a healthy Malaysian menu that all Malaysians eat daily with a very low risk of getting obese or overweight.

"It should incorporate the flavour and culture of the three major ethnic groups.”