There are more obese people in Malaysia than in other Southeast Asia countries¹, based on a report released June 7, 2017 by the Asia Roundtable on Food Innovation for Improved Nutrition (ARoFIIN) – a public-private a partnership set up to tackle issues related to obesity, malnutrition and non-communicable diseases (NCD’s).
Commissioned by ARoFIIN and produced by The Economist Intelligence Unit (EIU), the report is the first to carry out a detailed analysis on the economic impact of obesity in ASEAN. Entitled “Tackling obesity in ASEAN – Prevalence, impact, and guidance on interventions”, the report calls for more concerted efforts by health authorities to tackle the problem of obesity to avoid strains on healthcare systems.
Impact and economic cost of obesity
Among the six countries studied in the report, Malaysia has the highest obesity and overweight prevalence at 13.3% and 38.5% respectively. In 2016, the condition also cost the nation some US$1 billion to US$2 billion, equivalent to around 10% to 19% of Malaysia’s healthcare spending. This makes the country the second highest spender in ASEAN for obesity-related problems. On an absolute-costs basis, Indonesia is more affected by obesity at US$2 billion to US$4 billion (8% to 16% of national healthcare spending), while Singapore is third highest at US$0.4 billion to US1 billion (equivalent to between 3% to 10% of national healthcare spending).
Apart from costs, obesity-related problems have far-reaching implications. Based on the Report, obesity reduces productive years by a weighted average of between four and nine years across the six countries. Malaysia has the largest number of productive years lost due to obesity among females at between seven and 12 years, as well as the second highest number of years lost due to obesity among males, at between six and 11 years.
As obesity increases the risk of non-communicable diseases (NCD)², the country continues to bear a heavy burden, with NCD accounting for nearly three out of four deaths. A high proportion of adults suffer from undiagnosed diabetes and hypertension.
Lack of awareness, insufficient exercise and poor dietary choices are the culprits
Key obesity drivers in Malaysia include the lack of exercise, low dietary quality, cultural factors and lack of awareness on obesity. The Malaysian Adult Nutrition Study reported that only a third of the adult population had ever exercised, while only 14% had performed adequate levels of exercise.
The Malaysian National Health and Morbidity Survey also found that 92.5% of adults aged 18 and above consume less than five portions of fruit and vegetables a day. Cultural factors such as Malaysians’ love for food and their strong culture of entertaining guests with food also contribute to the obesity problem.
Dr Tee E. Siong, President of the Nutrition Society of Malaysia, has also argued that an increasing emphasis on academic excellence has resulted in additional hours of tuition and academic work among children, to the detriment of physical education. More critically, the lack of awareness and the general view held by most Malaysians that obesity is a cosmetic rather than health issue further amplifies the problem as many fail to see the link between obesity and NCDs.
Among the more effective interventions highlighted in the Report, low glycaemic , low calorie, low fat and low carbohydrate diets, as well as regular exercise, have shown to be the most promising in reducing obesity at both the individual and population levels. Interventions that can target both diets and exercise will be more effective than interventions targeting one or the other. Recent initiatives in Malaysia targeted at improving dietary quality include its eighth annual Nutrition Month, aimed at promoting environmentally sustainable healthy eating to achieve overall wellness, where its National Heart Institute unveiled a programme including cooking classes. The country also launched its National Plan of Action on Nutrition Malaysia III, covering 2016 to 2025, to promote healthier eating habits among Malaysians.
The Report also suggested that local governments should identify specific problem areas where they can step in with initiatives to increase the level of physical activity.
Within the industry, global food manufacturers have also been continuously innovating to offer affordable and healthier food products with fortified minerals, and lower salt, sugar and fat content. Going forward, ARoFIIN hopes to extend its reach by working closely with the small and medium enterprises in Southeast Asia to do the same.
The way forward
Dr Simon Baptist, EIU’s Chief Economist who led the Report, noted that data on obesity prevalence in the region is uneven and often absent across the ASEAN region. This constrains policy-making, which can in turn lead to certain untargeted programmes or interventions. “This study is the first time such a detailed analysis on the impact of obesity has been carried out. We hope it will help deepen the understanding of Southeast Asia’s obesity threat,” said Dr Baptist.
The Report shows that obesity rates vary widely, depending on ethnic, genetic, regional and economic differences and underscores the need for carefully tailored obesity prevention strategies, rather than a one-size-fits-all approach. Dr Baptist added, “This Report aims to be a guide for policymakers, health organisations and the industry as they tackle the rising threat of obesity in the region together. Taking time to identify at-risk communities can enable the development of smarter policies and more targeted interventions, and tackling obesity can help to free up resources in national healthcare systems and channel them to other areas that deserve attention.”
The Asia Roundtable on Food Innovation for Improved Nutrition (ARoFIIN) was set up in 2015 to leverage public-private partnership, to bring together experts from government, academia, industry and civil society sectors across Asia, in order to initiate and sustain regional, multi-stakeholder dialogue on the role of food innovation in tackling obesity and chronic disease in the region. This partnership works with the goal of fostering a conducive forum to support the dissemination of science-based information on the causes and drivers of obesity and chronic disease, as well as improve clarity on the barriers and enablers for food innovation and research and development in the region. ARoFIIN leverages effective public-private partnerships and stimulates scalable, cost-effective and multi-stakeholder strategies that drive food innovation and positive change in consumer behaviour.
ARoFIIN is convened by the Health Promotion Board (HPB), Agency for Science, Technology and Research (A*STAR), the Singapore Institute for Clinical Sciences (SICS) and Food Industry Asia (FIA).
¹ Covers six Southeast Asia countries, namely Singapore, Malaysia, Indonesia, Thailand, the Philippines and Vietnam
² NCDs include type 2 diabetes, cancer, cardiovascular diseases and stroke