Panel Session Presentation Slides

1. Panel Discussion:
Obesity, diabetes & other non-
communicable diseases
Venue : Victory Room, Mercu UEM
Date : 5th September 2019

2. Obesity, diabetes & other non-
communicable diseases
Tan Zhai Gen
for Wan Manan Wan Muda, Jomo KS and Tan Zhai Gen
5th September 2019

3. KhazanahResearchInstitute
Dietary risks contribute most to
death and disability
Sources: IHME, 2018
+ The crisis of obesity, diabetes & other NCDs: the crisis and how to prevent it

4. KhazanahResearchInstitute
Obesity (BMI-for-age) among Malaysians aged <18
years
Obesity among adults aged ≥18 years
Sources: NHMS 2006, 2011, 2015 Sources: NHMS 1996, 2006, 2011, 2015
Overweight & obesity in Malaysia
+ The crisis of obesity, diabetes & other NCDs: the crisis and how to prevent it
5.4 6.1
11.9
0.0
2.0
4.0
6.0
8.0
10.0
12.0
14.0
NHMS 2006 NHMS 2011 NHMS 2015
Prevalence(%)
Obesity
16.6
29.1 29.4 30
4.5
14
15.1
17.7
0.0
5.0
10.0
15.0
20.0
25.0
30.0
35.0
NHMS 1996 NHMS 2006 NHMS 2011 NHMS 2015
Prevalence(%)
Overweight Obesity
[1] As noted earlier, there are different BMI thresholds at different ages for children to be considered overweight or obese.
• Malaysia is the 2nd fattest country in ASEAN
(after Brunei) & 6th in the Asia Pacific
2 x
4 x
2 x

5. KhazanahResearchInstitute
Obesity in Malaysia
+ The crisis of obesity, diabetes & other NCDs: the crisis and how to prevent it
• Highest among Chinese, 5-9 years old, urban
areas, Kuala Lumpur, males
Children and adolescents <18
Adults >18
• Highest among Indians, 55-59 years old,
urban areas, Putrajaya, females
Income group
• Highest number of obese: RM2000-3000
• Highest share of obese: RM9000-10,000

6. KhazanahResearchInstitute
Trends in prevalence of total diabetes mellitus (known and undiagnosed), known diabetes
mellitus, undiagnosed diabetes mellitus and impaired fasting glucose (IFG), 1996-2015
Source: NHMS 1996, 2006, 2011, 2015
Diabetes in Malaysia
+ The crisis of obesity, diabetes & other NCDs: the crisis and how to prevent it
6.9
11.6
15.2
17.5
7
7.2
8.3
4.3
8
9.2
4.2
4.9 4.7
0
2
4
6
8
10
12
14
16
18
20
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
Prevalence(%)
Year
Total diabetes Known Undiagnosed IFG
• Number more than doubled in < 20 years
1
2

7. KhazanahResearchInstitute
Prevalence of selected NCDs
Source: NHMS 2006, 2011, 2015
Other NCDs in Malaysia
+ The crisis of obesity, diabetes & other NCDs: the crisis and how to prevent it
• Hypercholesterolemia doubled in 10 years, while
hypertension declined by 2 percentage points
11.6%
17.5%
32.2%
30.3%
20.7%
47.7%
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
2006 2011 2015
Diabetes Hypertension Hypercholesterolemia

8. KhazanahResearchInstitute
Other NCDs in Malaysia
+ The crisis of obesity, diabetes & other NCDs: the crisis and how to prevent it
• Colorectal cancer is among most prevalent in the population
• Link between cancer and diet is variable and hard to prove, but
research suggests links between cancer and diets.
14.6
14.4
6.6
6.4
5.6
5.5
4.2
3.9
2.9
2.7
0 5 10 15 20
Colorectal
Trachea, Bronchus, Lung
Prostate
Nasopharynx
Liver
Lymphoma
Leukaemia
Stomach
Bladder
Other Skin
Age-Standardized Rate (ASR)
31.1
11.1
7.6
6.0
5.9
3.8
3.8
3.4
2.9
2.6
0 5 10 15 20 25 30 35
Breast
Colorectal
Cervix Uteri
Trachea, Bronchus, Lung
Ovary
Corpus Uteri
Lymphoma
Leukaemia
Thyroid
Stomach
Age-Standardized Rate (ASR)
Ten most frequent cancers among males
in Malaysia per 100,000 people, 2007-11
Ten most frequent cancers among females
in Malaysia per 100,000 people, 2007-11
Source: Omar & Tamin, 2011

9. KhazanahResearchInstitute
What is driving the crisis?
+ The crisis of obesity, diabetes & other NCDs: the crisis and how to prevent it
• Increased food intake:
Increase in daily intake per capita?
33% increased fat intake since 1960s
80% increased sugar intake since 60s
• Increased sedentary lifestyle:
33.5% of adults not physically active
74.4% waking hours spent on
sedentary activity
• Genetic factors, medical illness,
globalization, convenience food spreads

10. KhazanahResearchInstitute
Impacts
+ The crisis of obesity, diabetes & other NCDs: the crisis and how to prevent it
• Health impact:
Diet-related NCDs, obstructive sleep apnea
Increased stress level
• Economic impact:
Increased injuries and disability, reduced
productivity
• Social impact:
Psychological and social wellbeing affected
Dissatisfied ‘body image’

12. KhazanahResearchInstitute
Current nutrition strategy inadequate
+ The crisis of obesity, diabetes & other NCDs: the crisis and how to prevent it
• Soft policies ineffective in
discouraging unhealthy (e.g.,
processed) food consumption
• Policy measures ignored
underlying drivers of obesity,
e.g., food, social, health & living
environments
• Food policy not fully harmonized
with agriculture policy

13. KhazanahResearchInstitute
National Nutrition Strategy Proposals
+ The crisis of obesity, diabetes & other NCDs: the crisis and how to prevent it
• Ensure food supply chain enables
healthy diets
• Ensuring more household resources,
income managed by women tends to
improve household nutrition
• Improve nutrition education in schools
• Improve public nutrition information
• Ban food, beverage advertising for kids
• Regulate food sales in school canteens

14. Thank You

15. KhazanahResearchInstitute
Determinants of obesity
+ The crisis of obesity, diabetes & other NCDs: the crisis and how to prevent it

16. Improving nutrition interventions

17. Commercialisation
Greater dependence on markets
Communities lose control of
food systems
Increasing food processing
diminishes quality, nutrition
Packaged foods in public
programmes 17

18. KhazanahResearchInstitute
Upcoming Discussion Session
• 1st of October, Tuesday, 10am – 12pm:
Tackling micronutrient deficiencies
+ The crisis of obesity, diabetes & other NCDs: the crisis and how to prevent it