Childhood obesity is related to low physical activity level and a sedentary lifestyle. The aim of this study was to assess the physical activity level and sedentary behaviour of Malaysian children aged 7 to 12 years and to examine their association with body mass index (BMI), BMI-for-age Z-score (BAZ), body fatness (%BF) and waist circumference (WC). A total of 1736 children, representing all ethnic groups were recruited from six regions of Malaysia. Anthropometric measurements included body weight, height and waist circumference. Body fat percentage (%BF) was assessed using bioelectrical impedance. Physical activity was assessed by a physical activity questionnaire (PAQ) in all children and by pedometers in a subsample (n = 514). PAQ score and pedometer step counts were negatively associated with BMI, BAZ, %BF and WC after adjusting for covariates. Screen time was positively associated with BAZ and WC. However, other sedentary activities were not significantly related with any anthropometric indicators. Strategies to promote active living among children in Malaysia should focus not only on increasing physical activity but also emphasise reduction in sedentary behaviours.

Socioeconomic factors and nutritional status have been associated with childhood cognitive development. However, previous Malaysian studies had been conducted with small populations and had inconsistent results. Thus, this present study aims to determine the association between socioeconomic and nutritional status with cognitive performance in a nationally representative sample of Malaysian children. A total of 2406 Malaysian children aged 5 to 12 years, who had participated in the South East Asian Nutrition Surveys (SEANUTS), were included in this study. Cognitive performance [non-verbal intelligence quotient (IQ)] was measured using Raven’s Progressive Matrices, while socioeconomic characteristics were determined using parent-report questionnaires. Body mass index (BMI) was calculated using measured weight and height, while BMI-for-age Z-score (BAZ) and height-for-age Z-score (HAZ) were determined using WHO 2007 growth reference. Overall, about a third (35.0%) of the children had above average non-verbal IQ (high average: 110–119; superior: ≥120 and above), while only 12.2% were categorized as having low/borderline IQ (< 80). Children with severe obesity (BAZ > 3SD), children from very low household income families and children whose parents had only up to primary level education had the highest prevalence of low/borderline non-verbal IQ, compared to their non-obese and higher socioeconomic counterparts. Parental lack of education was associated with low/borderline/below average IQ [paternal, OR = 2.38 (95%CI 1.22, 4.62); maternal, OR = 2.64 (95%CI 1.32, 5.30)]. Children from the lowest income group were twice as likely to have low/borderline/below average IQ [OR = 2.01 (95%CI 1.16, 3.49)]. Children with severe obesity were twice as likely to have poor non-verbal IQ than children with normal BMI [OR = 2.28 (95%CI 1.23, 4.24)]. Children from disadvantaged backgrounds (that is those from very low income families and those whose parents had primary education or lower) and children with severe obesity are more likely to have poor non-verbal IQ. Further studies to investigate the social and environmental factors linked to cognitive performance will provide deeper insights into the measures that can be taken to improve the cognitive performance of Malaysian children.

This study aimed to assess fruit and vegetable intake patterns and their associations with sociodemographic characteristics, anthropometric status and nutrient intake profiles among Malaysian children aged 1–6 years. Using the Malaysian dataset of South East Asian Nutrition Surveys (SEANUTS Malaysia), a total of 1307 children aged 1–6 years with complete datasets were included in this analysis. Dietary intake was assessed using age-specific, validated food frequency questionnaires. On average, Malaysian children consumed 0.91 and 1.07 servings of fruits and vegetables per day, respectively. Less than one-fifth of the children achieved the daily recommended servings of fruits (11.7%) and vegetables (15.8%). Fruit intake was associated with age, parental educational level and geographical region, and vegetable intake was associated with ethnicity and geographical region. There was little evidence of an association between fruit and vegetable intake and children’s anthropometric status, but an adequate intake of fruits and vegetables contributed significantly and differently to children’s micronutrient intake. Future nutrition interventions should focus on addressing the sociodemographic determinants and be tailored to the needs of the low consumers to more effectively promote and encourage the adequate intake of fruit and vegetables among young children.

A daily balance of physical activities, sedentary behaviors and sleep are important for maintaining the health of young children. The aim of this study is to explore the association between 24-h movement behavior of Malaysian children aged 4 to 6 years with weight status. A total of 230 preschoolers were recruited from 22 kindergartens in Kuala Lumpur. Physical activity was assessed by Actical accelerometer while screen time and sleep duration were proxy-reported by parents. Children spent on average 5.5 ± 1.3 h on total physical activity (including 1.0 ± 0.4 h of moderate- vigorous physical activity), 3.0 ± 1.6 h on screen activities and 9.5 ± 1.3 h sleeping daily. The proportion of children who complied with physical activity and sleep guidelines were 48.7% and 55.2%, respectively. About 25.2% of children met screen time recommendation. Only 6.5% of children met all three age-specific physical activity, screen time and sleep guidelines. Children who met any two guidelines were less likely to be overweight or obesity compared to those who did not meet any of the guidelines (OR: 0.276; 95% CI: 0.080–0.950). In conclusion, Malaysian preschoolers have low compliance to movement behavior guidelines, especially in meeting screen time recommendations. Compliance to movement behavior guidelines was associated with lower odds of overweight and obesity.

The present study aimed to report the prevalence of anaemia and iron deficiency (ID) and to explore the associations among socio-demographic characteristics, nutritional status and inflammation status in the occurrence of anaemia and ID in a nationally representative sample of Malaysian primary schoolchildren. Using data from the South East Asian Nutrition Surveys (SEANUTS), 544 Malaysian children aged 7 to 12 years were included in this secondary analysis. Blood samples were drawn for haemoglobin and serum ferritin analysis while C-reactive protein (CRP) and α-1-acid glycoprotein (AGP) were measured to detect inflammation. Prevalence of anaemia and ID were 4.0% and 5.2%, respectively. There were significantly more anaemic indigenous bumiputra children (9.9%) than Chinese children (0.6%). Correction for inflammation did not change the prevalence of ID. More overweight/obese children than thin/normal weight children were found to have elevated acute phase protein (APP). Children with elevated inflammatory markers had significantly higher ferritin level than children without inflammation. Periodic health assessments of anaemia and ID at the population level to monitor and clarify the epidemiology of health problems are required to inform public health policies and strategies.