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NATIONAL HEALTH AND

MORBIDITY SURVEY (NHMS) 2017:


Key Findings from the Adolescent
Health and Nutrition Surveys

Infographic Booklet
April 2018
© 2018 Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia,
Kuala Lumpur.

Perpustakaan Negara Malaysia Cataloguing-in-Publication Data

National Health and Morbidity Survey (NHMS) 2017 (NMRR-16-698-30042)


Adolescent Health and Nutrition Survey; Infographic Booklet

ISBN 978-983-2387-76-3

MOH/S/IKU/108.18(BOT)

Disclaimer:

The views expressed in this infographic booklet are those of the authors alone and do not necessarily represent
the opinions of the other investigators participating in the survey, nor the view or policy of the Ministry of Health.

Produced and Distributed by:

National Health and Morbidity Survey 2017: Adolescent Health and Nutrition Survey
Institute for Public Health
National Institutes of Health
Ministry of Health Malaysia
Jalan Bangsar, 50590 Kuala Lumpur
Federal Territories of Kuala Lumpur, Malaysia
Tel: +603-2297-9400
Fax: +603-2282-3114

Any enquiries or comments on this infographic booklet should be directed to:

National Health and Morbidity Survey 2017: Adolescent Health and Nutrition Survey
Institute for Public Health
National Institutes of Health
Ministry of Health Malaysia
Jalan Bangsar, 50590 Kuala Lumpur
Federal Territories of Kuala Lumpur, Malaysia
Tel: +603-2297-9400
Fax: +603-2282-3114

Published by the Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia.

Reviewers:

Dr Tahir Aris
Director, Institute for Public Health, MOH

Dr Nik Rubiah Nik Abd Rashid


Chief Senior Assistant Director, Family Health Development Division, MOH

Mr Mohd Ariff Ikram bin Ariffin


Communication Strategic Officer, Corporate Communication Unit, MOH

Dr Ihsan bin Ismail


Head of Program Evaluation Unit, Education Planning and Research Division, MOE

Design and layout:

Dr LeeAnn Tan
Medical Officer, Institute for Public Health, MOH

Mr Naziran Hasni
Public Relations Officer, Institute for Public Health, MOH
KEY FINDINGS
List of Infographics

Internet use and addiction among Malaysian adolescents


S. Maria Awaluddin, Normala Ibrahim, Chan Ying Ying, Rimah Melati Abd. Ghani, Amal Shamsudin, Wan Salwina Wan Ismail,
Norharlina Bahar, Saidatul Norbaya Buang, Nik Rubiah Nik Abd. Rashid
01
02
Teenagers and illicit drugs in Malaysia
Hasimah Ismail, Wan Shakira Rodzlan Hasani, Nur Liana Ab. Majid, Muhammad Fadhli Mohd Yusoff, Rushidi Ramly, Hamizatul
Akmal Abd Hamid, Norli Abdul Jabbar, Jane Ling Miaw Yn, Halizah Mat Rifin, Tania Gayle Robert, Thamil Arasu Saminathan,
Ahzairin Bin Ahmad, Tahir Aris

Bullying victimisation among adolescents in Malaysia


LeeAnn Tan, Rajini Sooryanarayana, Shubash Shander Ganapathy, Mohd Hazrin Hasim, Thamil Arasu Saminathan, Mohd Fuad
Mohd Anuar, Fazila Haryati Ahmad, Azriman Rosman
03
04
Pattern of current cigarette use among Form 1 to Form 5
students in Malaysia
Muhammad Fadhli Mohd Yusoff, Jane Ling Miaw Yn, Tee Guat Hiong, Noraryana Hassan, Nizam Baharom, Wan Shakira Rodzlan
Hasani, Ahzairin Ahmad, Tania Gayle Robert Lourdes, Halizah Mat Rifin, Hamizatul Akmal Abd Hamid, Aiman Abdul Ghani,
Hasimah Ismail, Thamil Arasu Saminathan, Nur Liana Ab Majid

Alcohol use among adolescents


Halizah Mat Rifin, Tania Gayle Robert Lourdes, Nur Liana Ab Majid, Hamizatul Akmal Abd Hamid, Wan Shakira Rodzlan Hasani,
Jane Ling Miaw Yn, Thamil Arasu Saminathan, Hasimah Ismail, Ahzairin Ahmad, Muhammad Fadhli Mohd Yusoff
05
Sex & teens: What is going on in Malaysia?
Noor Aliza Lodz, Noraida Mohamad Kasim, Maisarah Omar, S. Maria Awaluddin, Mohd Hatta Abdul Mutalip, Noor Ani Ahmad
06
07
Safe sex: What was used?
Noraida Mohamad Kasim, Noor Aliza Lodz, Maisarah Omar, S. Maria Awaluddin, Mohd Hazrin Hashim, Mohd Hatta Abdul
Mutalib, Noor Ani Ahmad

A mounting crisis? Adolescent suicidal behaviour


Muslimah Yusof, Noor Ani Ahmad, Muhammad Aznudin Abd Razak, Fazly Azry Abdul Aziz, Rasidah Jamaluddin, Chan Ying
Ying, Noraida Mohamad Kasim, Nor’ain Abd Wahab, Nik Adilah Shahein, Rajini Sooryanarayana, Nurashikin Ibrahim
08
09
Care for adolescents: Peer and family support
Norzawati Yoep, Eida Nurhadzira Muhammad, Mohd. Amierul Fikri Mahmud, Faizul Akmal Abdul Rahim, Faizah Paiwai, S Maria
Awaluddin, Nur Azna Mahmud, Noor Aliza Lodz

10
Truancy among Malaysian adolescents
Faizah Paiwai, Nur Azna Mahmud, Norzawati Yeop, Mohd Amierul Fikri Mahmud, Faizul Akmal Abdul Rahim
Physical attacks and fights
Mohd Hazrin Hasim, Rajini Sooryanarayana, Shubash Shander Ganapathy, Thamil Arasu Saminathan, Mohd Fuad Mohd Anuar,
Fazila Haryati Ahmad, Azriman Rosman, LeeAnn Tan
11
Physical and verbal abuse at home among teenagers
Thamil Arasu Saminathan, Mohd Hazrin Hasim, Rajini Sooryanarayana, Shubash Shander Ganapathy, Mohd Fuad Mohd Anuar,
Fazila Haryati Ahmad, Azriman Rosman, LeeAnn Tan 12
Unintentional injury among Malaysian adolescents
Nazirah Alias, Chandrika Jeevananthan, Rajini Sooryanarayana, Shubash Shander Ganapathy, Thamil Arasu Saminathan, Mohd
Fuad Mohd Anuar, Fazila Haryati Ahmad, Azriman Rosman, LeeAnn Tan
13
Meal skipping behaviour among Malaysian adolescents
Mohamad Hasnan Ahmad, Ling Swee Nian, Nur Ili Mohamad Tarmizi, Ainan Nasrina Ismail, Mahenderan Appukutty, Rusidah
Selamat, Ruhaya Salleh 14
Dietary supplement consumption among adolescents in Malaysia
Fatimah Othman, Sam Azura Ahmad, Syafinaz Mohd Sallehuddin, Mohamad Ihsan Tahir, Safiah Mohd Yusof, Nur Azna Mahmud
15
16
Alarming facts on carbonated soft drinks consumption
among Malaysian adolescents
Syafinaz Mohd Sallehuddin, Rashidah Ambak, Ruhaya Salleh, Mohamad Hasnan Ahmad, Nur Shahida Abdul Aziz, Nor Azian
Mohd Zaki, Fatimah Othman, Azli Baharudin, Cheong Siew Man, Lalitha a/p Palaniveloo

17
Accuracy of body weight perception among adolescents
in Malaysia
Nur Shahida Abdul Aziz, Safiah Md Yusof, Rohana Yaakof, Ruby Zainureen, Norlida Zulkafly, Ruhaya Salleh, Noor Ani Ahmad

Do adolescents in Malaysia read food labels?


Ruhaya Salleh, Mohamad Hasnan Ahmad, Azli Baharudin, Cheong Siew Man, Ruzita Abd Talib, Lai Wai Kent, Noor ul-Aziha
Lalitha Palaniveloo, Rashidah Ambak, Hazizi Abu Saad, Shubash Shander a/l Ganapathy. 18
Physical activity among Malaysian adolescents
Nor Azian Mohd Zaki, Hazizi Abu Saad, Shahrulnaz Norhazli Nazri, Azahadi Omar, Ruhaya Salleh
19
20
Dietary patterns and heavy meals after dinner among
adolescents in Malaysia
Cheong Siew Man, Azli Baharudin, Ruhaya Salleh, Fatimah Othman, Mohamad Hasnan Ahmad, Nur Shahida Abdul Aziz,
Rashidah Ambak, Rusidah Selamat

21
Dietary intake among Malaysian adolescents
Lalitha Palaniveloo, Noor Hasnani Ismail, Chin Kim Ling, Ruhaya Salleh, Rusidah Selamat, Mohd Azahadi Omar, Mohamad
Hasnan Ahmad

22
State of adolescents’ mental health in Malaysia
Mohamad Aznuddin Abd Razak, Fazly Azry Abd Aziz, Rasidah Jamaluddin, Noor Ani Ahmad, S Maria Awaluddin, Muslimah
Yusof, Nurashikin Ibrahim, Sherina Mohd Sidik
National Health and Morbidity Survey 2017 Overview Report

In 2018, there are about

5.5M 02
The objectives of this study were to identify health
risk behaviors and protective factors among
secondary school students, and to determine
adolescents nutrition-related components among adolescents

in Malaysia. in Malaysia.

More than half of them are in schools. Adolescents


There were three major scopes in this survey:
are valuable assets to the country as they will
• Adolescent Health Survey (AHS)
become future leaders who will continue to drive
• Adolescent Mental Health (DASS-21)
and sustain the development of the nation. They
• Adolescent Nutrition Survey (ANS)
are perceived as the healthiest population group
however they do have their own set of unique
problems and healthcare needs.

Nationwide school-based surveys were conducted


among adolescents in Malaysia were in 1996,
2012, and most recently in 2017 - the findings of
which are presented in this booklet.

Methodology

National school Multistage stratified Cross-sectional


sampling frame cluster sampling design study design

www.nmrr.gov.my
MARCH MAY

2017 TO
2017

Data collection from Registered with


26 March to 3 May 2017 NMRR-16-698-30042

36 teams for data collection; Validated


4 teams each for Sabah and Sarawak; questionnaires used
2 teams per state in Peninsular Individual and parental
consents obtained before
Malaysia and the Federal Territories
conducting the surveys

www.iku.gov.my
National Health and Morbidity Survey 2017 Overview Report

AHS & DASS ANS


Target population
13-17 10-17
years years

1. Face-to-face interview for


Anonymous Instruments habitual food intake , dietary
self-administrated intake and nutritional status
questionnaire with
scannable answer 2. Anonymous
sheet self-administrated
questionnaire with scannable
answer sheet

Study sample
212 secondary schools
212 secondary schools and
were randomly selected 99 primary schools
were randomly selected
(30,496 students) (40,087 students)

Response rate

89.2% 89.5%

Distribution of Schools for Adolescent Health and Nutrition Survey, 2017

www.iku.gov.my
National Health and Morbidity Survey 2017 Key Findings

01 Internet use and addiction among


Malaysian adolescents

6 in 7 secondary school adolescents were


active internet users in Malaysia
Why should we worry
about adolescents
engaging excessively

2 in 7 secondary school adolescents were


addicted to the internet in Malaysia
in online activities?

Excessive online
gaming, gambling,
shopping, chatting
Viewing pornographic
Bumiputera websites
Sabah Internet addiction*
Strangers online, data
Bumiputera
31% was highest among
insecurity
Sarawak adolescents of
29% Cyber-bullying
Chinese ethnicity
environments
Chinese
Malay 34%
28%
30% 28% * Internet addiction among
adolescents was measured
Indian male female using Malay Version Internet
24%
addiction Test
Chong Guan, Ng, et al.

Prevalence of internet addiction by form


Devices used by
38%
The prevalence of internet addicts:
internet addiction
seemed to increase
18%
with age, rising up to
38% among Form 5
students 94%
Form 1 Form 2 Form 3 Form 4 Form 5
Smartphones

Prevalence of internet addiction by state


Computers,
Pr evalence (%)
15.0 40.0
62% laptops, or
notebooks

WP Kuala Lumpur and


WP Putrajaya had the
highest rates of internet
addiction among all states 31%
Tablet devices

Source: Adolescent Health Survey, NHMS 2017


www.iku.gov.my
National Health and Morbidity Survey 2017 Key Findings

02 Teenagers and illicit drugs


in Malaysia

3.4%
Definition of
Drug use:

Taking of heroin,
morphine, glue,
amphetamine or 1 in 25 Are current drug users
methamphetamines secondary school students in Malaysia
(ecstasy, syabu, ice), claimed to have ever used drugs.
marijuana/ganja
(except prescribed
medicine).

17%
Initiated drug use at
2.4%
Ever used
2.8%
Ever used
age 7 years or amphetamines or marijuana
younger methamphetamines

Trends in Illicit Drug Use


4.3% Ever used drugs
3.4% Currently using
drugs
1.7%
1.5%
2012 2014

Source of getting drugs (%)

Some other way 6.1

Family 4.4

Friend 11.4

Stole 14.0

Gave someone else money 13.3


to buy it for me
Bought them from someone 25.9

Source: Adolescent Health Survey, NHMS 2017


www.iku.gov.my
National Health and Morbidity Survey 2017 Key Findings

03 Bullying victimisation among adolescents in Malaysia

1 in 6
Boys were bullied more than girls,
most frequently among those of
Indian ethnicity

adolescents was a recent


victim of bullying*
* defined as being on the receiving end of “bad and unpleasant”
actions, such as “teasing a lot in an unpleasant way”, or being
19% vs
14%
“left out of things on purpose”

Prevalence of bullying by state

Pr evalence (%)
10.0 25.0

Pahang r ecor ded t he


highes t pr evalence of
being bullied at leas t once
in t he pas t 30 days among
s econdar y s chool s t udent s
(22 %)

Kelant an r ecor ded t he


lowes t pr evalence of being
bullied at leas t once in t he
pas t 30 days among
s econdar y s chool s t udent s
(12.5 %)

Prevalence of bullying by form

Bullying was experienced most among those in Form 1,


and decreased with age. The most common form of
bullying was ‘being made fun of because of
23%
how body or face looks’ (16%)
19%

15%
13%
10%

Form 1 Form 2 Form 3 Form 4 Form 5

Source: Adolescent Health Survey, NHMS 2017


www.iku.gov.my
National Health and Morbidity Survey 2017 Key Findings

04 Pattern of current cigarette use among Form 1


to Form 5 students in Malaysia

1 in 10 smokes 22% 5%

Prevalence of current Prevalence of current


cigarette smoking by form cigarette smoking by ethnicity

15.3%
14.3% 14.1%
12.8% 12.6% 22.2% 19.8% 17.9%

Bumiputera Bumiputera Other


Sarawak Sabah

15.0% 14.1% 7.0%

Indian Malay Chinese


Form 1 Form 2 Form 3 Form 4 Form 5

Prevalence of current cigarette smoking by state

Prevalence in Current Cigarette Smoking (%)


5.0 20.0
Wilayahrecorded
WP Labuan Persekutuan
the
Labuan
highest recordedin
prevalence the
highest
current prevalence
cigarette smoking in
current cigarette smoking
(19.2%) (19.2%)

W[Putrajaya
WP Putrajayarecorded
recordedthe
the
lowest prevalence
prevalencein
in
current cigarette
current cigarettesmoking
smoking
(7.8%)
(7.8 %)

Source: Adolescent Health Survey, NHMS 2017


www.iku.gov.my
National Health and Morbidity Survey 2017 Key Findings

05 Alcohol use among adolescents

DEFINITIONS

Ever drinkers:
Those who had a
history of alcohol
About 1 in 10 students are current drinkers consumption in their
life time.

Current drinkers:
Those who had at least a
“drink” of alcohol in the
reported past 30 days
drunkenness
Drunkenness:
had their first alcoholic When someone
demonstrates signs such
beverage before the
as staggering when
age of 14 years walking, not being able to
speak right and throwing
up after consuming
alcohol in a lifetime.

About 1 in 5 students ever consumed alcohol

Sources of obtaining alcohol


Q: How did you
obtain the alcohol?
38%
27%
17%
9% 8%
2%
Family Store Friends I gave someone Some Stole
else money to other way
buy for me

Source: Adolescent Health Survey, NHMS 2017


www.iku.gov.my
National Health and Morbidity Survey 2017 Key Findings

06 Sex & teens: What is going on in Malaysia?

35%
Among surveyed 13-17-year-olds,

7.3%
27%
Ever had sex before
had already age 14 years old
had sex.

21%
Prevalence of ever having had sex by form
11%
9.3% Were having multiple
6.9% 7.3% 6.9% sexual partners
6.1%

6%
Remove Form 2
Class/
Form 3 Form 4 Form 5
5%
Form 1 Are currently still
having sex

The prevalence of ever having had sex was


highest in Pahang, and lowest in WP Kuala Lumpur

9.5% 4.3%

Source: Adolescent Health Survey, NHMS 2017


www.iku.gov.my
National Health and Morbidity Survey 2017 Key Findings

07 Safe sex: What was used?


Among those surveyed who had 9 in 100
ever had sex, only

12%
boys
said they
16 in 100
used girls
condoms
used condoms when they had sex

21% 17% 16%


of the students of remove of the rural
who used class / Form 1 students used
condoms were students used condom
Indian condoms

Prevalence of using (a) condoms and (b) other forms of birth control by state

Pr evalence of Condom Us e (%)


Pr evalence of Condom Us e (%)
(a) 0.0 25.0
(b) 8.0 15.0
Kelant an r ecor ded t he
highes t pr evalence f or t he
Kelant an r ecor ded t he us age of bir t h cont r ol
highes t pr evalence f or 14.9
22.2 t ools ot her t han condom
condom us e among among M alays ian
M alays ian s t udent s s t udent s (14.9%)
(22.2%)

J ohor r ecor ded t he Lowes t


pr evalence f or us age of
3.2
Put r ajaya r ecor ded t he bir t h cont r ol t ools ot her
lowes t pr evalence f or 8.1 t han condom among
condom us e among M alays ian s t udent s (8.1%)
M alays ian s t udent s (3.2%)

Among those surveyed who had 12 in 100


ever had sex, only boys

10%
said they 7 in 100
used other girls
forms of
birth control used other forms of birth control

Source: Adolescent Health Survey, NHMS 2017


www.iku.gov.my
National Health and Morbidity Survey 2017 Key Findings

08 Adolescent suicidal behaviour: A mounting crisis?


Suicidal behaviour encompasses suicidal ideation, plan and/or attempt

Girls Boys Suicidal behaviour 2012 & 2017


Suicidal 10.8% 9.1%
ideation 10.0% (Ideation)
7.9% 7.3% (Plan)
6.8% 6.9% (Attempt)
Suicidal plan 7.8% 6.8% 6.4%

Suicidal attempt 6.9% 7.0%


2012 2017

Indian Chinese Others Bumiputera Sarawak Bumiputera Sabah Malay

19.3% 17% 17.9% 13.7% 10.1% 10.7% 13.8% 10.1% 9.4% 10.8% 7.4% 9.4% 10.1% 7.5% 6.1% 7.8% 5.4% 4.6%

Suicidal behaviour was highest among


Form 1 students Ideation Ideation
10.9% 8.8%
Urban Rural
Plan Plan
Suicidal Suicidal Suicidal 7.9% 6.6%

ideation plan attempt Attempt Attempt

11.2% 9.0% 10.1% 6.7% 7.2%

13.2%
Suicidal ideation
9.5%
Suicidal plan
9.3%
Suicidal attempt
highest in highest in highest in
WP Kuala Lumpur Selangor Perak

Source: Adolescent Health Survey, NHMS 2017


www.iku.gov.my
National Health and Morbidity Survey 2017 Key Findings

09 Care for adolescents: Peer and family support

Less than half


of adolescents
perceived that their
Only 1 in 7
parents knew what adolescents
they were doing in perceived that their
their free time parents check their
homework

Only
1 in 3
adolescents
perceived that
their parents
understood
their problems

2012
vs Less than
2017 half
of adolescents had peer
support at school

Prevalence (%) of protective factors among


adolescents (2012 and 2017)

Parents knew what they were doing in their free time

Parents understood their problems

Parents checked their homework

Had peer support at school

0.0 20.0 40.0 60.0 80.0

2017 2012

Source: Adolescent Health Survey, NHMS 2017


www.iku.gov.my
National Health and Morbidity Survey 2017 Key Findings

10 Truancy among Malaysian adolescents

Definition of
Truancy:

Missed class or school


without permission for Rural Urban Boys Girls
at least one day in the
past 30 days 32.6% 27.6% 32.6% 27.6%

FORM 1 26.6%

FORM 2 27.8%

FORM 3 27.5%

FORM 4 34.5%

FORM 5 30.8%

Malay Indian
29% 33% Truancy rates were
highest among students
of ‘Other’* ethnicities,
Chinese
Others Bumiputera followed by Bumiputera
28%
37% Sabah
35% Sabah and Indian

Bumiputera *other ethnic groups in


Sarawak Malaysia apart from the
23% major ethnicities

Prevalence of Truancy by State


Pr evalence (%)
20.0 36.0

Ter engganu dis played t he National prevalence = 29.4%


highes t pr evalence of
t r uancy among s econdar y
s chool s t udent s in t he pas t
one mont h at 35.9%

Source: Adolescent Health Survey, NHMS 2017


www.iku.gov.my
National Health and Morbidity Survey 2017 Key Findings

11 Physical attacks and fights


Had been physically attacked:

25.5% 20.6%
Kedah National prevalence = 25.3%
rural 21.6%
PulauPinang
21.8%
kelantan
19.2%
Terengganu
27.4%
Perak

28.5%
27.7% Pahang
25.2% 19.3% 31.4% 30.0%
Selangor
WP Kuala Lumpur
urban 28.7%
24.6%
N. Sembilan
WP Putrajaya
21.9%
Melaka 26.1%
Johor
27.7%
WP Labuan 27.2%
Sabah

35.3% 24.1% 24.6%


24.1%
Sarawak

23.5% Had been involved in a


Perlis
21.0%
Kedah
physical fight:
21.2%
kelantan
22.7% National prevalence = 24.9%
Pulau Pinang 21.2%
Terengganu
26.7%
Perak
27.9% 25.7%
28.1% Pahang
28.2%
Selangor rural
WP Kuala Lumpur 24.6%
24.7% N. Sembilan
WP Putrajaya
22.4%
Melaka
21.3% 24.2%
Johor
urban 17.9% 32.0%
26.0%
WP Labuan
27.2%
Sabah

25.5%
Sarawak
36.2% 23.6% 22.0%

Source: Adolescent Health Survey, NHMS 2017


www.iku.gov.my
National Health and Morbidity Survey 2017 Key Findings

12 Physical and verbal abuse at home among teenagers

1 in 10 teenagers
are physically abused

4 in 10 teenagers
are verbally abused

13% 11% 49%


37%

Boys suffer more physical abuse Girls suffer more verbal abuse

Abuse among teenagers by form (%)

45.1
42.8 43.6 42.7
42.0
The incidence of
physical abuse is
low and reduces as
18.1
14.3 teenagers grow but
10.3
verbal abuse is high
9.1
6.8

and remains
Form 1 Form 2 Form 3 Form 4 Form 5
constant with age
Physical abuse Verbal Abuse

Source: Adolescent Health Survey, NHMS 2017


www.iku.gov.my
National Health and Morbidity Survey 2017 Key Findings

13 Unintentional injury among


Malaysian adolescents

30%
Unintentional
22% injury:
Cut / Stab Wound
A serious injury in
36% 14% the past 12 months
Broken bone / Dislocated joint which makes the
7% student miss at least
had been seriously Concussion, Head/Neck Injury, one full day of usual
injured in the past Knocked out activity (such as
12 months 24% 3% school, sports or a
Bad burn job) OR requires
treatment by a
doctor or medical
Prevalence of recent serious injury by state personnel

Pr evalence (%)
Per lis r ecor ded t he
25.0 35.0
highes t pr evalence r at e
f or s er ious head injur y
among s econday s chool
s t udent s (34.1 %)

Penang r ecor ded t he


lowes t pr evalence r at e f or
s er ious head injur y among
s econday s chool s t udent s
(25.2 %)

Prevalence of recent serious injury by form


36%
32%
28% 28%
26%

Serious injuries
occured most
frequently in
Form 1, reducing
slightly with age

FORM 1 FORM 2 FORM 3 FORM 4 FORM 5

Falls (35%) were the most common


cause of unintentional injuries
sustained among adolescents

Source: Adolescent Health Survey, NHMS 2017


www.iku.gov.my
National Health and Morbidity Survey 2017 Key Findings

14 Meal skipping behaviour among


Malaysian adolescents
Trend of main meal intake (%) among Malaysian Adolescents
DEFINITIONS
56%
53%
Breakfast: 48% 48%

Malaysian school-based
30%
First food consumed 28% Student Health Survey, 2012

after waking from Adolescent Nutrition Survey, 2017

sleep (6am-8am) Breakfast Lunch Dinner

Lunch: In 2017, approximately:


Foods consumed
between 11am to 3pm 7 in 10 adolescents 5 in 10 adolescents
skipped breakfast skipped lunch regularly
regularly
Dinner:
Foods consumed 5 in 10 adolescents
between 6pm to 10pm skipped dinner regularly

74% 32%
of obese adolescents adolescents skipped breakfast
skipped breakfast because they “had no time”

44% 9%
adolescents skipped adolescents skipped breakfast
breakfast because because “no food was available”
they had “no appetite”

Breakfast +
3% Lunch
Take 2 m
y ain
da me Breakfast +
na al 4%
si s
Dinner
27
l

in
ea

ad
m

%
ay
in

19% Lunch +
ma

Dinner
18
Take 3

Proportion of
main meal
intake
ay s

4% Breakfast
%
31

ad

% 24
Lunch
No

in
ma

ls
ea
in

ea Dinner 7% Lunch
m
m

ls a in
in
ad e 1m
ay Tak
13%
Dinner

Source: Adolescent Nutrition Survey, NHMS 2017


www.iku.gov.my
National Health and Morbidity Survey 2017 Key Findings

15 Dietary supplement consumption among


adolescents in Malaysia

Every 2 in 5 and 1 in 3
of adolescents consumed
01
vitamin/mineral and food
supplements respectively

02 School children aged


10-12 years old were
the top consumers of
dietary supplements

WP Putrajaya showed
the highest prevalence 03
of dietary supplement
users

BMI
Thin adolescents
04 consumed higher dietary
supplements compared
to other BMI status

The most consumed


dietary supplements
were vitamin C and
05
honey

The main reason for taking


06 dietary supplements was
due to parents advice

Source: Adolescent Nutrition Survey, NHMS 2017


www.iku.gov.my
National Health and Morbidity Survey 2017 Key Findings

16 Alarming facts on carbonated soft drinks


consumption among Malaysian adolescents

Rural

41%
Adolescents living in rural areas
Urban

34% 1 in 3 36%
of Malaysian students
consumed carbonated soft drinks more had carbonated soft
frequently than their urban counterparts drinks at least once daily

32%
Boys Girls

40% 32% Upper secondary


school level
Male adolescents consumed carbonated
soft drinks more frequently than girls

Intake of carbonated soft drinks by ethnicity 40%


Lower secondary
63.6%
school level
48.2% 47.4% 43.6%

Lower secondary
school students
consumed carbonated
soft drinks more
Bumi Bumi
Others
Sabah
Indian frequently
Sarawak

Prevalence of carbonated soft drinks intake by state

Pr evalence (%)
20.0 60.0

Source: Adolescent Health Survey, NHMS 2017


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National Health and Morbidity Survey 2017 Key Findings

17 Accuracy of body weight perception


among adolescents in Malaysia

50%
of adolescents with

NORMAL DEFINITION
body weight, correctly perceived their weight to be normal

Urban Rural Primary Secondary


Body weight
perception
51% 49%
50% 52% Body weight
50% 47%
perception refers to
the personal
evaluation of one’s
weight as

70%
of adolescents with “underweight” or
“normal weight” or
THIN “overweight”,
body weight, correctly perceived their weight to be thin irrespective of actual
body mass index (BMI)
Urban Rural Primary Secondary

68% 71%
69% 71% 66% 72%

44%
of adolescents with

OVERWEIGHT
body weight, correctly perceived their weight to be overweight

Urban Rural Primary Secondary

35% 52%
46% 41% 28% 55%

14%
of adolescents with

OBESE
body weight, correctly perceived their weight to be obese

Urban Rural Primary Secondary

11% 17%
15% 12% 9% 17%

Source: Adolescent Nutrition Survey, NHMS 2017


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National Health and Morbidity Survey 2017 Key Findings

18 Do adolescents in Malaysia
read food labels?
DEFINITIONS

Always: 33%
always
Reads food labels every
time when buying or
receiving food/drinks

Sometimes:
51%
Occasionally or once in sometimes
a while reads food 16%
never
labels when buying or
receiving food/drink
Reasons for not reading food labels:
Never:
Not interesting 38
Does not read food
Do not understand 19.2
labels at all
Time constraint 17.7

Did not know the importance 14.4

Small font 12.4

Already aware 11.8

Type of macronutrient
Type of information read from food labels
noted from labels (%):

78.6% 28.7% Food


ingredients
Expiry date
Total
42 34
energy
Total 17.3% 24.8% Nutrition
facts
carbo- 33 40 Nutrition claims Nutrition Facts
hydrate Serving Size
Servings Per Container

Amount Per Serving


...g

Calories .... Calories from Fat ...


% Daily Value*

Total Fat ...g ...%

Total fat 33 49
Saturated Fat ...g ...%
Trans Fat ...g
Cholestrol ...mg ...%
Sodium ...mg ...%
Total Carbohydrate ...g ...%
Dietary Fiber ...g ...%
Sugars ...g
Protein ...g

Vitamin A ...%

Total
Vitamin C ...%

18.2%
...%

Storage
Calcium

25 18
Iron ...%
*Percent Daily Values are based on a 2,000 calorie diet.

protein
Your Daily Values may be higer or lower depending on your

instructions
calorie needs.

Source: Adolescent Nutrition Survey, NHMS 2017


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National Health and Morbidity Survey 2017 Key Findings

19 Malaysian adolescents: How active are they?

About 45% of Malaysian students


are physically active

Primary school students Prevalence of physical Boys are more active


are more active than activity among urban than girls
secondary school and rural school children
students was similar

57.0% Rural Boys


Primary
school
46.4% 54.1%
37.3% Urban Girls
Secondary
school
43.2% 35.2%
Prevalence of physically active adolescents according to body weight status

43 .4% 44 .9% 43 .5% 44 .7%

Thinness Normal Overweight Obese

Screen time more than 2 hours over weekends and on schooling days

Active students
57.0%

43.0%

54.4%

45.6%

Inactive students

*Screen time refers to the time spent


on watching television, playing video
games and using the computer or
Schooling days Weekends surfing the internet

Source: Adolescent Nutrition Survey, NHMS 2017


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National Health and Morbidity Survey 2017 Key Findings

20 Dietary patterns and heavy meals after dinner


among adolescents in Malaysia

adolescents ate inadequate

1 in 3 cereals/ grains/ tubers/


related products daily 1 in 2 adolescents ate inadequate
legumes daily

4 in 5 adolescents ate inadequate


fish daily 1 in 4 adolescents ate excessive
poultry & meat & eggs daily

2 in 3 adolescents ate inadequate


fruits daily 3 in 4 adolescents ate inadequate
milk & dairy product

23 in 25
adolescents ate inadequate vegetables daily

Demographic breakdown of respondents who


eat heavy meals after dinner on a daily basis

Primary Secondary
National
prevalence of
6.9% 6.1%
adolescents
having heavy
meals after
dinner* Rural Urban

6.4% Daily (7 days)


6.5% 6.3%
70.4% 1-6 days
23.2% DId not take

*Meals taken after 10pm, consisting of ‘heavy food’ or high Girls Boys
calorie food such as nasi lemak, roti canai, fried noodles,
burger, fried chicken and etc. It does not include light snacks 5.1% 7.6%
for example 2 biscuits and/or one glass of milk.

Source: Adolescent Nutrition Survey, NHMS 2017


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National Health and Morbidity Survey 2017 Key Findings

21 Dietary intake among adolescents

Adolescents are
Dietary intake:
Median energy getting the
1848 intake per day of recommended Daily eating patterns
kcal adolescents in composition* of of an individual
nutrients from including the
Malaysia quantities and the
their diet
calories consumed
as well as the intake
of macronutrients
(nutrients that is

15% 52%
required in large
amounts) and
micronutrients
(nutrients that is
required in small
amounts)

Carbohydrate

Fat
*Recommended
Protein
Nutrient Intake
33% (RNI) 2017:

Median energy by ethnicity Carbohydrate:


50-65%
Malay 1855 kcal
Protein:
Chinese 1806 kcal
10-20%
Indian 1583 kcal

Bumiputera Sabah 1934 kcal Fat:


Bumiputera Sarawak 1899 kcal
25-35%

Others 2102 kcal

40.7g Sugar intake in


29.5g adolescents
increased 1.4x
from 2012 to
2017

2012 2017

Source: Adolescent Nutrition Survey, NHMS 2017


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National Health and Morbidity Survey 2017 Key Findings

22 State of Adolescents’ Mental Health in Malaysia


(Based on DASS-21 scoring)

1 depressed
in 5
2 in 5
anxious 1in 10
stressed

17.7% 18.9% 42.3% 37.1% 10.3% 8.9%


Malay Chinese Indian
47%
39% 36% 33%
21%
16% 15%
10%
9%

Bumipu tera Bumiputera


Sabah Sarawak Other
47% 44%
40%
22% 22%
17%
11%
13% 10%

Speedometer colour legend: Depression Anxiety Stress

Prevalence of depression, anxiety, and stress by state

Depress ion Anxiety Stres s


46 .8
42 .4 43 .2
40 .4 40 .4 41 .2
38 .1 38 .1 38 .7 39 .5
3 7.0 36 .8 37 .2 37 .6 36 .1
34 .8
Prevalence (%)

2 1.0 22 .6 21 .9 21 .3 20 .7
16 .4 18 .8 18 .8 17 .9 18 .5
14 .6 1 6.0 15 .4 16 15 .4
13 .1 12 .5 12 .3 12 .1
10 .4 11 11 .4
9 .3 8 .5 8 .2 9 .2 8 .5 8 .3
6 .3 7.0 6 .6 7 .6

Source: Adolescent Mental Health (DASS-21), NHMS 2017


www.iku.gov.my
INSTITUTE FOR PUBLIC HEALTH

National Institutes of Health


Ministry of Health, Malaysia
Jalan Bangsar
50590 Kuala Lumpur

www.iku.gov.my