RESUMO
@# Introduction: The prevalence of child undernutrition and micronutrient deficiencies are higher in the Orang Asli (OA) than the general Malaysian population. The World Health Organization recommends the use of multiple micronutrient supplement (MMS) that is a blend of micronutrients in powder form that can be sprinkled onto foods for home fortification to prevent undernutrition among children. This pilot study aimed to assess the feasibility of using MMS among OA children. Methods: A total of 25 OA children (14 boys and 11 girls) aged 6-31 months (mean±SD = 15.7±7.2 months) in Negeri Sembilan were given three sachets of MMS weekly for 5 weeks. Caregivers were instructed to add MMS to three types of food from the same food group per week varying with a different food group weekly. Written instruction for using MMS in simple language was given prior to the supplementation. Caregivers were interviewed for information on socio-demographics, compliance, acceptance, preference and adverse effect of MMS. Results: A high level of compliance was observed (85%). All caregivers reported that the instructions for use were easy to read. No noticeable changes to the foods mixed with MMS were observed and no adverse effects were reported. Conclusion: This study demonstrated feasibility of the use of MMS for future trials among OA children. The easy to read information that comes with the MMS, frequent monitoring of MMS use and support to caregivers were required to ensure compliance. Cultural feeding practices and financial constraints may limit the types of food that can be mixed with MMS.
RESUMO
Introduction: Carotenoid-rich red palm oil (RPO)-based snacks have been provided to children in impoverished communities to improve their vitamin A status. The non-availabilty of information on the acceptability of RPO-based snacks by Malaysian aborigines (Orang Asli) children forms the basis of this study. Methods: Twenty-one Orang Asli children, majority of whom had normal body mass index for age (BMI-for-age) and aged 4.73 ± 0.92 years in Sungai Tekir, Negeri Sembilan were provided with three freshly-prepared snacks (springroll, curry puff or doughnut) each containing one teaspoon or 5 ml of RPO per serving, on separate mornings. On the fourth morning, one serving each of all 3 different snacks was provided together on a plate to every child for consumption and preference for the snacks recorded. The children’s habitual vitamin A intakes were assessed by a semi-quantitative food frequency questionnaire (FFQ) and carotenoid retention tests for the prepared snacks were performed by column chromatography. Results: Fifty-four percent of the children did not meet their RNI for vitamin A. Based on acceptance criterion of consuming at least one-half serving of the snacks provided, springroll and curry puff recorded 100% acceptability while doughnut had 82% acceptability. Preference of snack was in the order, springroll (47%)> doughtnut (35%)> curry puff (18%), but a Ztest test for proportions showed no statistical significance. Carotenoid retention tests showed great variation between snacks namely, doughnut (100%) >springroll (84%)>curry puff (45%). Conclusion: The overall findings indicate that the RPO-based snacks are highly acceptable and can be used to improve the dietary intake of provitamin A carotenoids of Malaysian Orang Asli children.
RESUMO
Objectives: There is a lack of current published information on health and nutritional status of Orang Asli children. A study was conducted to assess breastfeeding practices, dietary intake and growth status of Orang Asli children in Sepang and Carey Island, Selangor.Methods: A total of 173 children(88 Temuan and 85 Mah Meri) from 137 households were measured for body weight and height. Information on breastfeeding practices and dietary intake was obtained from their mothers. Results:Most of the mothers (98.9%) breastfed their infants with a high proportion (86.8%) initiating breastfeeding within one hour after delivery.About 53% of the mothers reported discarding colostrum due to various reasons including the perception that colostrum in undesirable and can produce ill-health. Although many of these mothers (58.3%) discarded colostrum on their own initiative, about 25% of them reported that they were advised by health professionals. Among mothers who had stopped breastfeeding at the time of the study (n=48), the mean duration of breastfeeding was 12.1 ± 8.9 months. About 33% of the mothers stopped breastfeeding before their infants were 6 months old and only 31% breastfed their children for more than 1 year. The percentages of significantly underweight, stunted and wasted were 48.9%, 5.2.2% and 4.3% respectively for children aged 1-3 years, whereas among children aged 4-6 years old, 35.8%, 50.6% and 1.3% were underweight, stunted and wasted, respectively. A higher proportion of Mah Meri than Temuan children in both age groups were significantly underweight, stunted and wasted. Despite the adequate intake of energy and most nutrients,the Orang Asli children had insufficient mean number of servings for all food groups-grain and cereals, fruits, vegetables, meat and fish, and milk and dairy products. Conclusion: In this study, undernutrition is a major health and nutrition problem among the Orang Asli children. The problem could be due to many factors that include poor infant and child feeding practices. Concerted efforts by various government and non government agencies are essential to improve the health and nutrition of Orang Asli.