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balanced diet is essential for children to ensure they receive all the necessary nutrients for physical and mental development.
However, many children tend to be picky eaters and only consume foods they like, particularly fried and sugary foods. Some even refuse to eat vegetables altogether, and parents give in to their demands to avoid tantrums. These challenges become even greater during the months of Ramadan and Syawal when an abundance of food options is available.
According to experts, if such eating patterns persist, children are at risk of developing various long-term health issues, including iron deficiency anaemia (IDA), a condition caused by insufficient iron levels leading to a lack of red blood cells.
A deficiency of red blood cells affects oxygen supply throughout the body, which can have serious consequences on a child’s growth and development, particularly brain development and learning abilities.
IDA is also observed among pregnant women and experts say this is not a “minor problem that can be easily resolved”.
Based on data from the 2022 National Health and Morbidity Survey, anaemia prevalence remains high in Malaysia, with nearly 46 percent of (or one in two) children aged under five and two out of five pregnant women in Malaysia reported to be affected by this condition.
‘SILENT PANDEMIC’
Universiti Malaya (UM) professor and senior consultant paediatric endocrinologist Dr Muhammad Yazid Jalaludin describes IDA as a ‘silent pandemic’ mainly because it develops unnoticed, adding that his research found that one in three children in Malaysia is at risk of anaemia.
“The risk is higher among young children (six-12 months old) and those underweight for their age because their iron needs are greater than those of adults due to their rapid physical and cognitive growth,” he said.
Dr Muhammad Yazid Jamaluddin
Dr Muhammad Yazid said IDA can have a significant impact on an individual’s life but often goes unnoticed due to its subtle symptoms, including paleness, irritability, fatigue, increased heart rate and angular cheilitis (inflammation of one or both corners of the mouth).
“In addition to affecting children’s physical growth and cognitive development, prolonged iron deficiency can also weaken the immune system, making them more susceptible to various illnesses.
“For pregnant women, IDA can lead to more severe complications for both the mother and the baby, including premature birth and sudden infant death. IDA has also been associated with postpartum depression,” he said in a recent interview with Bernama.
Dr Muhammad Yazid, who was the lead researcher for the 2023 Iron Strong Danone Study involving 1,201 children under four years old at selected health clinics, noted that IDA occurs in children in both urban and rural areas.
“What concerns us is that unbalanced eating habits, including excessive intake of foods high in fat, sugar and salt, remain prevalent among the population, further exacerbating iron deficiency.
“Many foods sold, especially at Ramadan bazaars, contain little or no iron. Delicious, popular items such popiah and traditional kuih often lack sufficient iron content,” he said.
He added that the period from early Ramadan to Aidilfitri can be a high-risk time for developing IDA if food choices are not made wisely.
“Although IDA usually develops over a long term, prolonged iron deficiency can worsen an existing condition.
“In this context, food providers play a crucial role in offering nutritious and balanced meals. Use fresh, iron-rich ingredients such as leafy greens, red meat, chicken and fish. Reduce processed foods and offer more fresh fruits. For children’s beverages, choose plain water or milk and avoid sweetened drinks to support their healthy growth,” he advised.
MANDATORY SCREENING
To address IDA more effectively, Dr Muhammad Yazid suggested that the government introduce mandatory periodic anaemia screening for children, particularly those aged under five.
He said this age group is among the most vulnerable to anaemia, adding regular screenings can help detect anaemia early and allow parents and caregivers to take proactive steps to ensure their children receive adequate nutrients.
The importance of awareness of a balanced diet in dealing with the problem of iron deficiency anemia.
“Early detection is key to tackling this issue because if left untreated, anaemia can lead to serious complications that may affect a child’s immunity and academic performance in the future.
“This approach could also help reduce long-term risks associated with iron deficiency. Early detection allows for appropriate nutritional interventions to ensure children’s health is well-maintained,” he added.
AWARENESS, EDUCATION
Meanwhile, Angie Low, director of SEA Medical & Nutritional Science Hub at Danone, an international food company, said research conducted by the company in collaboration with UM and Ministry of Health researchers has highlighted the importance of awareness about balanced nutrition in addressing IDA.
“Awareness of proper nutrition provides parents with the essential knowledge to ensure their children receive sufficient iron,” she said, adding that among the initiatives taken include the introduction of an online questionnaire that allows parents to evaluate their children’s iron intake.
Food providers play an important role by offering nutritious and balanced meals such as green vegetables and red meat.
Developed by Danone in collaboration with paediatric and nutrition experts, this tool provides clear and detailed guidance on the types and amounts of iron-rich foods that should be included in children’s daily diets.
“Other initiatives include various nutritional awareness programmes aimed at providing parents with accurate information on the importance of iron in children’s diets. These programmes also focus on selecting healthier food options to help reduce the risk of IDA in children,” she explained.
She is confident that greater awareness of balanced nutrition will help parents make better decisions in choosing foods that offer optimal health benefits for their children.
Low added the company is also engaged in a strategic partnership with Malaysia’s Social Welfare Department to conduct anaemia screenings at childcare centres registered under the department as an early measure to identify this often-overlooked health issue.
“This initiative is more than just a health programme – it’s a symbol of hope in ensuring that children from underprivileged families receive the attention and care they need.
“Easy access to these health screenings allows parents to gain valuable insights into their children’s health status and take preventive action before it is too late.
“Awareness programmes like this not only protect the younger generation’s health but also strengthen public understanding of the role of balanced nutrition in preventing IDA,” she added.
