indian journal of science and technology, vol 11(4), doi

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Indian Journal of Science and Technology, Vol 11(4), DOI: 10.17485/ijst/2018/v11i4/109848, January 2018ISSN (Print) : 0974-6846

ISSN (Online) : 0974-5645

Household Food and Nutrient Intake of Semai Aborigines of Peninsular Malaysia

Anto Cordelia Tanislaus Antony Dhanapal1, M. Sylvia Subapriya2 and Hnin Pwint Aung1

1Department of Chemical Science, University Tunku Abdul Rahman, Kampar, Perak, Malaysia; [email protected], [email protected], [email protected]

2Department of Food Science and Nutrition, Avinashilingam Institute for Home Science and Higher Education for Women, Coimbatore - 641043, Tamil Nadu, India; [email protected]

Keywords: Food Pattern, Nutrient Intake, Malaysia, Orang Asli, Semai

AbstractBackground: Malaysia is experiencing nutrition transition currently whereby the spectrum of nutrition is shifting from malnutrition towards overweight and obesity. The indigenous population of Malaysia continues to be in a state of poverty which apparently affects their food and nutrient intake. Methods: A total of 462 households with 2367 inhabitants irrespective of age and physiologic group were selected from 40 village zones spread along seven districts of Perak by population proportion to size sampling. The demographic, socio-economic, educational status and availability of physical amenities were collected through a pre-tested questionnaire. Food and nutrient intake was assessed by twenty-four-hour recall method on all members of households. All results were presented as mean values and percentages. Results: 71% of the families live below Poverty Level Incomes. Only 34% of men and 31% of women had received formal education. The Semai aborigines could meet only 70% of their energy needs. Cereals and pulses (92.5% of RNI) formed the major dietaries. Insufficient intake of green leafy vegetables (<50% of RNI), fruits (30% of RNI) and dairy products (15% of RNI) marked poor dietary diversity. Less than 50% of mean intake were recorded for vitamin A (14%), riboflavin (33.51%), iron (41%) and iodine (49%). Inadequate education, fewer employment, poor sanitary conditions, poor choices and unavailability of nutrient rich foods are the major factors that contribute to poor dietary diversity. The intervention and supplementation programs have not reached the marginalized community alike especially those residing in interior of forest fringes. Application: Nutrition education and empowerment in terms of education and employment can revert the current situation.

1. IntroductionThe “Orang Asli” is the earliest inhabitants of Peninsular Malaysia. Their origins can be traced back to China and Tibet, dating about 5000 years ago, with migration routes through the mainland of Southeast Asia followed by eventual settlement in Peninsular Malaysia and the Indonesian archipelago1. The name ‘Orang Asli’ is a native Malay term which transliterates as original people or first people. It is a collective term used for the 18 sub-ethnic native groups classified under Semang (Negrito), Senoi and Aboriginal Malay (Proto Malay).

Senoi is the largest group of Orang Asli in Peninsular Malaysia who are mainly distributed from the middle to northern part of Peninsular Malaysia (ref). The history of the Senoi people dates back to the second wave of migra-tion about 8,000 years ago from the mountainous areas of Cambodia and Vietnam2. Senoi share similar physical characteristics of the Mongoloids and speak the dialects of Khmer. Some believe that Senoi are the descendants of Australoids from Australia and Veddoid from South India3. The Senoi are divided into six sub-groups for administrative purposes comprising of the Semai, Temiar, Che Wong, Jah Hut, Semoq Beri and Mah Meri. Among

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the six sub-groups, only the Semai and Temiar people traditionally inhabit settlements in the Malaysian state of Perak. Further, only the Semai occupy larger areas of the geographic terrain of Perak, ranging from central parts of the state to the areas further south along its boundary with the state of Selangor. Malaysia has stood out with tremendous growth in industrialization and urbaniza-tion over the past three decades which also has had an impact on the nutrition and health status of its popula-tion. This unleashes the fact that Malaysia is in a state of nutrition transition which is typical to that of a transi-tional society where old problems continue to persist with emerging new ones. Chronic nutrient inadequacy mani-fested by protein-energy malnutrition among children, chronic energy deficiency in adults, and iron deficiency in children and females are the old problems that pre-vail along with excess consumption of calories and lack of physical activity leading to overweight, which serves as a precursor for chronic diseases such as diabetes and cardiovascular diseases. The Orang Asli communities are not spared from this nutrition transition, but unfor-tunately, studies pertaining to the nutritional status of the Semai people have been relatively few. The only past report which presents results of nutritional status of the Semai has been given in the article4. Malnutrition among Semai Children” published in 1988. This article portrays the nutritional status of Semai Orang Asli children, who are aged 18 years and below, in Perak.

In a country like Malaysia, which witness’s rapid economic growth, they are still in a stage of nutrition tran-sition where the spectrum of nutrition shifts from under nutrition to overweight and obesity. While the developed countries are concerned on childhood overweight and obesity, the incidence of underweight, stunting, wasting and micronutrient deficiencies are still common among the developing and least developed countries and espe-cially among the indigenous community5. The emerging trend of overweight and persistent underweight is also on the rise as reported in the National Health and Morbidity Survey6. The prevalence of stunting is at (13.4%) while underweight accounts for 16.1% and overweight or obe-sity at 6.1% in children below 18 years.

Children from low-socio economic group are har-nessed by poor intake of diets which puts them at risk for macro and micronutrient insufficiencies such as pro-tein and calorie malnutrition (PEM), calcium, vitamin A, folate and a host of B vitamins7, foods that are low in qual-ity, high in sodium and deficient in fruits and vegetables8. Low income status is associated with less diverse diet and

lack of compliance with food based dietary guidelines9. Nutritional studies pertaining to food and nutrient intake among Semai aborigines at household level are very lim-ited and hence the need to assess their dietary intakes was initiated to strengthen the baseline information and understand their current state of living.

2. Methodology

2.1 Selection of Study Area and LocationPerak is the second largest state among the 13 states of Peninsular Malaysia and also ranks second in terms of Orang Asli population (32%) next only to Pahang (36%). The Semai Orang Asli tribes are distributed in seven dis-tricts from a total of ten districts in Perak state. For the purpose of getting representative samples, households from all the seven districts were included for the study. The districts include Hulu Perak, Hilir Perak, Kinta, Kuala Kangsar, Batang Padang, Perak Tengah and Kampar. Figure 1 depicts map of Perak region and the districts selected in Perak state.

Figure 1. Selection of districts in Perak. (Source: [https://commons.wikimedia.org/wiki/Filepercent3ADistricts_in_Perak.svg)This is only the district map and the district chosen is high-lighted with the tribal stickman figure

2.1 Study Design and Sampling ProcedureThis is a cross sectional; population based epidemiologi-cal study carried out on Semai aborigines, dwelling in tribal habitat for nearly three months prior to the study and until the study period August 2012 – July 2014.

Indian Journal of Science and Technology 3Vol 11 (4) | January 2018 | www.indjst.org

Anto Cordelia Tanislaus Antony Dhanapal, M. Sylvia Subapriya and Hnin Pwint Aung

The sample size of the study population was calculated using the formula proposed by Daniel WW (1999)10 for the estimation of a population proportion with a specified relative precision (25) as follows:

[ ]2

2

1Z P Pn

d−

=

Where n is the required sample size, Z is the statistic corresponding to level of confidence, P is expected preva-lence and d is precision (corresponding to effect size).

Assuming the overall nutritional insufficiency to be 40% as reported11 among the Orang Asli population and using a Confidence Interval (CI) of 95%, relative preci-sion of 10% and design effect of 2, the estimated sample size was 383 households. With an increment of 20% from the minimum required sample, a total of 462 households were covered for the study.

The assessment was done on seven districts and each district is considered as a primary stratum and the sec-ondary stratum is formed by the villages or village zones (urban and interior) formed within the primary stratum. Probability Proportion to Size (PPS) was used to select the 40 village zones using the latest comprehensive list of all villages obtained from Department of Orang Asli Development (Jabatan Kemajuan Orang Asli Malaysia (JAKOA), Perak. The Secondary Sampling Unit (SSU) was the Households (HHs) within each selected village zones. The number of sample allocated for each district, urban and interior was done proportionally to the popu-lation size. A bigger number of samples were allocated to the districts with a bigger population size such as Batang Padang, Kinta and Perak Tengah whereas less number of samples was selected from the districts with smaller population size such as Hulu Perak, Hilir Perak and Kuala Kangsar. The sample size for each stratum was reviewed and the sample size in some strata at district level had been inflated to ensure the number met minimum require-ment for the analysis. All members within the selected households (N = 2367) and all eligible respondents in the households irrespective of age and physiologic group were included in the study. Hospitalized persons, persons suffering from illness like HIV, cancer and chronic ill-nesses were excluded from the study.

2.2 Construct of Study Instruments The information pertaining to the socio economic data and demographic details such as age, sex, occupation,

annual income of the family, type of dwelling, environ-mental sanitation and literacy level of all individuals in the households were collected through a pre-tested and structured questionnaire. The questionnaire was designed in English and translated into Aslian language with the locals in the field set up. A twenty-four-hour recall record used12 and reproduced according to local Malaysian set-ting was used to evaluate the individual and household dietary intake per day. Information pertaining to the meal pattern, type of preparation, amount of raw food, cooked food and left over was recorded. Information pertaining to participation in supplementary food program or food basket program executed and under practice by Ministry of Health was also collected. The number of consumption units (members) partaking in the meal was also noted. The average intakes of different foods based on serving size at household levels and per consumption unit per day were calculated according to age/sex and physiological status. The average nutrient consumption was computed using the Food Composition Table13 and The Malaysian Dietary Guideline14. The intake of various foods and their nutri-ent composition were compared with the Recommended Nutrient Intakes for Malaysia (2005) as suggested by the National Coordinating Committee on Food and Nutrition (NCCFN), Ministry of Health Malaysia15.

2.3 Data AnalysisAll the information collected was entered into the data entry system (MS Excel 2010). Data analysis was done by exporting the raw data [in Comma-separated values (CSV) form] into SPSS version 17. The data were then checked and cleaned for missing entries. Most of the data are presented in mean and percentages.

2.4 Ethical Clearance and Informed ConsentThe research protocol and survey instruments were approved by the Ethical Research Committee of University Tunku Abdul Rahman (U/SERC/23/2014) and Avinashilingam Institute for Home Science and Higher Education for Women (AUW/IHEC-14-15/XPD-03) following a review process. Permission was also granted from JAKOA (Department of Orang Asli Affairs)16, Perak, Malaysia (JHEOA.PP.30.052 Jld.6(26) prior to data collec-tion. The study complied to the conditions as suggested by the Ethics Review Committee. No invasive techniques were used in data collection on the selected subjects.



An information sheet and a consent form were made available for every respondent. For minor or disabled, a sign consent was taken from the head of the family or guardian with a witness. For an illiterate respondent, a thumb print was also taken from the respondent with a literate person as a witness. For infants and young chil-dren, the consent was obtained from either the head of the family or from their mothers. The identity (names, IC number and addresses) was not recorded in the question-naire or information form. Confidentiality of the data was assured to all participants.

3. Results

3.1 Demographic Profile of Semai HouseholdsThe demographic information pertaining to the socio-economic and education background of the Semai Orang Asli is enumerated in Table 1.

Majority of the Orang Asli HHs (85.71%) covered were nuclear families and the average family size is 5.12 persons per family among the Semai communities, which is higher than the national population (4.3 persons) of Malaysia. 61% of the families were medium sized fami-lies with (5-7 persons) as against the national population, where 56% were small size households (less than 5 per-sons)17. Most of the Semai embrace Islam (38.96%) and Christianity (25.32%). Earlier, the religious beliefs of the Orang Asli were centered on the existence of spirits in animate objects – also termed as “Animism”. Due to the conversion by Islamic and Christian missionaries, major-ity of the tribes accepted conversion whereas a minority of them still remains as animists.

The Orang Asli continue to lag behind in their edu-cational status with 64.86% (n = 446) of household heads (men) and 68.76% of mothers (n = 462) being illiterates. Similar results of 66% illiteracy were also reported by Ministry of Education in 2009. Agriculture, fishing, ani-mal husbandry or forest related income category forms the main occupation (80%) among Semai men, as most of them inhabit the forest and forest-fringe areas. Small percentages were employed as waged laborers in oil palm estates (23%), rubber estates (17%) and other labors (19%). 63% of the mothers were housewives and only the remaining 37% did odd jobs in factories and farms. The traditional method of income generation is by hunting

animals and collecting forest produce like honey, resins, rambutans, durians and petai. The percentage of men and women employed in Public Sectors is less than 1% which widens the gap in their economic status. Figure 2 shows median and mean monthly household income of Orang Asli compared with Malaysian population.

The average household income per month of the Orang Asli households was RM 645 and average per capita income was RM 139. Based on the Poverty Level Income set by the Economic Transformation Program 201419 as poor (average household income per month below RM 760 and hardcore poor (average household income per month less than RM 460), 59% of the Orang Asli house-holds exist in a state of poverty and 12% of the families remain as hardcore poor. On an average, 71% of the fami-lies live below Poverty Level Incomes (PLI). Though there is a steep decrease in the incidence of poverty at national level over time from 49.3% in 1970 to 1.7% in 201219, the Orang Asli continues to remain as impoverished and eco-nomically marginalized.

Figure 2. Median and mean monthly household income (RM) of Orang Asli compared with Malaysian population.

Table 1. Demographic profile of Semai households (n = 462)

Family Type (n = 462) n %Nuclear 396 85.71Extended Nuclear 42 9.09Joint 24 5.19Family size (n = 462)1-4 people 156 33.775-7 people 283 61.26> 7 23 4.98



Religion (n = 462)Islam 180 38.96Bahai 41 8.87Buddhist 17 3.68Christian 117 25.32Animist 107 23.16Education of HH Head (N = 446)No formal education 299 64.86Primary 83 18Secondary 74 16.05Tertiary 7 1.52Education of Mother (N = 462)No formal education 317 68.76Primary 91 19.74Secondary 52 11.28Tertiary 4 0.87Occupation of HH Head (N = 446)Agricultural. Laborer 21 4.55

Fishing 39 8.44

Hunter gatherers 53 11.47

Other Laborers 88 19.05

Bamboo Factory 41 8.87

Oil palm laborer 107 23.16

Rubber Tappers 78 16.88

Others 35 7.58

Occupation of Mother (N = 462)Agricultural. Laborer 21 4.55

Hunter gatherers 56 3.90

Other Laborer 69 23.18

Bamboo Factory 29 6.28

Housewife 292 63.20

Income of Households (n = 462)HH income (RM) 645.15±

202.9Income per capita (RM) 139.6

±69.09Classification based on Poverty Level Income (ETP, 2012)*Poor 274 59.31Hard core poor 56 12.12

* ETP – Economic Transformation Program, Malaysia (2012)

3.2 Physical Facilities of Semai HouseholdsThe Government of Malaysia in its initiation to shift the Orang Asli inhabited in the interiors of jungle to the main land implemented National Housing Scheme namely Program Pembangunan Rakyat Term skin (PPRT) which is Hardcore Poor Development Program and Program Bantuan Rumah (PBR) which is Housing Assistance Program (Table 2). Houses with basic amenities are con-structed and distributed to the Orang Asli which is not availed by the Semai aborigines as most of them did not prefer to rehabilitate and was reluctant to shift from their current habitat. The current study, recorded just 4% and 14% of beneficiaries under these two housing assistance programs respectively. The rest of the households (82%) continue to dwell in houses built on their own with indig-enous building materials (25%), the traditional bamboo or wooden houses (28%), semi wooden houses (19%) and a less (10%) residing in stone houses. Pipe and tank water (47%) are the predominant water source on the Semai households. For those who are dwelling near the riverside (26%), river water is the source of drinking water. While 19% of the households were supplied with drinking water from Perak Water Board, 7 % still rely on well water for drinking and cooking purposes. Less than 1% use treated water for drinking purposes. Around 92% of households use Liquefied Petroleum Gas (LPG) as their major fuel source and the remaining households still practice tradi-tional method of cooking with firewood (8%). 75% of the households receive power supply from Tenega National Berhad (TNB) and some of the villages use solar energy as the main source for electricity. Only 26% of the house-holds had separate kitchen whereas the remaining 76% shared the kitchen with living room or outside. Sanitary latrines are present in only 23% of the households in which 8% do not use them.

3.3 Food and Nutrient Intake of Semai HouseholdsThe mean consumption of food from all food groups (Serving Size/Consumption Unit/Day and individual nutrients as percent Recommended Nutrient Intake of Malaysia is tabulated (Tables 3 and 4). In general, cereals and tubers especially rice and tapioca formed the major dietaries of the subjects surveyed for dietary status. They formed the bulk of nutrients meeting 92.5% of RNI. Rice is the staple food of Malaysia and is consumed at least a minimum of two frequencies every day. Tapioca and



yam are the other alternatives when there is no accessi-bility or availability to rice. The other grains and cereals like wheat, corn and barley are used occasionally in lesser amounts. The inclusion of pulses and legumes in a Semai meal is less than the recommended intake of one serving per day. Soybean is taken in the form of soy milk followed by groundnuts. Peas, lentils, beans, chickpeas and various types of dhal but are eaten in very less amounts. Soymilk are readily available, comes in easy convenience packs and cheaper which accounts for the high consumption particularly among these groups. Pulses and dried beans are not cooked as it takes longer time for cooking and is quite expensive compared to rice and other cereals.

Table 2. Physical facilities of Semai households

Type of HouseProgram Pembangunan Rakyat Termiskin (PPRT)*

20 4.33

Program Bantuan Rumah (PBR)**

63 13.64

Own house 379 82.03Built using indigenous materials

117 25.32

Bamboo/wooden house 129 27.92Stone house 48 10.39Semi wooden 88 19.05Source of Drinking waterLembaga Air Perak (Perak Water Board)

88 19.05

Pipe/Tank water 217 46.97River water 120 25.97Well water 33 7.14Treated water 1 0.22Source of Cooking FuelLiquefied Petroleum Gas (LPG)

424 91.77

Firewood 38 8.23Biogas 0 0Kerosene 0 0Source of ElectricityNo electricity 7 1.52Tenaga National Berhad (Electricity Board)

345 74.68

Solar 107 23.16Generator 3 0.65

Presence of Separate KitchenPresent 121 26.19Absent 341 73.81Presence of Sanitary LatrinePresent 66 14.29Absent 357 77.27Present but not in use 39 8.24

* Hardcore poor development program,** Housing assistance program

The mean intake of green leafy vegetables and other vegetables is less than 50% of the recommendation (3 servings per day). Tapioca shoots, sweet potato leaves, kangkong (water spinach/water convolvulus or swamp cabbage) are the prime green leafy vegetables and petai (Parkia speciosa or bitter beans) is being consumed reg-ularly. The consumption of GLVs is better compared to those residing in close proximity to towns. Long beans and petai were the regular vegetables in their menu. Vegetables like carrots, beans, cauliflower, broccoli and other vegetables are seldom included in their menu as they are expensive and mostly sold in super markets and hyper markets. Similarly, only 30.5% of the study popu-lation met the daily requirements for fruits which is set at two servings per day. The commonest fruits consumed were hill banana, durians and rambutans which they collect from the forests and are seasonal fruits. Apples, oranges, grapes, watermelon were less likely consumed by the Semai tribes as these are made available only in supermarkets and are unaffordable for these marginalized community to be consumed on daily basis.

Nearly, 55% of the Semai tribes include fish in their daily meals. Rivers serve as their main fishing source. While anchovies (IKANBILIS) and marine fishes are pre-ferred by the rural people, chicken, eggs and mutton are consumed more among the urban people. The Orang Asli consumes less of meat from other sources. Consumption of milk and milk products was poor and only 15% could meet their daily requirements of RNI while the others either consumed less or none at all. The Semai tribe has a misconception that condensed milk is a reliable milk source today for more than three decades. They use them to make coffee and tea and also diluted creamer or con-densed milk was administered as formula milk for young children as observed during dietary survey. Table 4 clearly



underlines the fact that the Semai Orang Asli individuals did not meet the RNI for any nutrient except for sodium (147%) which is more than the recommended intake. They were able to obtain 80% and more of the require-ments for thiamin and niacin while energy, protein and folate could meet only 60% of a day’s requirement. They could meet half the recommended allowances for calcium and vitamin C whereas iron, riboflavin and vitamin A and iodine were present only at levels less than 50%. Only 70% of the energy needs are met by the Semai aborigi-nes. Carbohydrates form the prime energy source (76%) which is mainly obtained from rice and cassava while fish

form their major protein source and fat comes from other flesh foods, sweetened condensed milk and cooking oils. This is in line with the findings of the MANS, 200820 and also reinstate the fact that the Orang Asli had the least consumption for the proximate principles as compared to the national and general population. Figure 3 is the mean consumption of energy source per day. The dietary diversity among the Orang Asli is poor whereby not all food groups are included in their meal every day. They lack fruits, vegetables, pulses, milk and dairy products in their diet. This can be attributed to the cost of these prod-ucts in the market and most of them are solely available

Table 3. Average household consumption of foods based on 2000 calorie diet of RNI (Serving size/CU/day) Total No. of Households n = 462

Cereals, grains and tubers

Pulses and legumes

Green leafy and other vegetables

Fruits Fish Other flesh foods

Milk and Milk produts

Mean 5.55 0.75 1.25 0.61 0.45 0.74 0.46

STD 1.27 0.44 0.82 0.80 0.61 0.66 0.52

RNI 6 serving 1 serving 3 servings 2 servigs 1 serving 1 serving 3 servings

% Deficit

7.5 25 58.33 69.50 55 26 84.67

% intake 92.5 75 41.67 30.50 45 74 15.33

Table 4. Percent intake of RNI for nutrient per consumption unit per day

Nutrients Mean STD RNI % Deficit % Intake

Energy (kcal) 1704.97 243.71 2440 30.12 69.88

Protein (g) 35.98 3.93 60 40.03 59.97

Calcium (mg) 219.68 77.42 400 45.08 54.92

Iron (mg) 11.39 1.15 28 59.30 40.70

Vitamin A (mg)

83.46 85.88 600 86.09 13.91

Thiamin (mg) 1.01 0.40 1.2 16.03 83.97

Riboflavin (mg)

0.44 0.11 1.3 66.49 33.51

Niacin (mg) 13.01 1.85 16 18.72 81.28

Vitamin C (mg)

36.70 11.15 70 47.58 52.42

Folate (mg) 245.91 61.56 400 38.52 61.48

Iodine (µg) 107.59 7.58 124 50.73 49.27

Sodium (mg) 2210.60 528.24 1500 147.37 147.37



in the hypermarkets. Many of them did not have access to these shops due to transport facilities and feels it is too expensive for them to buy. This has resulted in poor dietary diversity which ultimately leads to micronutrient deficiencies.

Figure 3. Percent consumption of macronutrient source per day.

4. DiscussionIn spite of the initiatives taken up by the Ministry of Education, Malaysia to improve the educational status of the Orang Asli, most of them turn out to be illiter-ates. Restructuring of Orang Asli education program was initiated and carried out to provide them with equal edu-cational opportunities, integrate them with the advanced section of the population and protect their traditional beliefs. Low socio-economic status and less proximity to the local and rural schools are the main factors that con-tribute to the poor educational status. After taking over the schools of indigenous communities from JAKOA, the Education Ministry of Malaysia is striving hard to improve the educational status of Orang Asli children, to bring down the school drop-out rates and streamlining them with their national counterparts.

The income level of Orang Asli is ten times less than the mean average income of the overall Malaysian popu-lation, which reiterates that Orang Asli are economically weaker section of the entire population. There exists a wide gap between the economic status of the National Population and the indigenous population in poverty ratio. Similar results have been reported in earlier stud-

ies on Orang Asli in Malaysia21–23. Same trends in poverty among the tribes have also been reported by NNMB Report 2012 for tribes in India. More employment oppor-tunities in government and public sectors could help uplift this economically weaker community.

Fruits and vegetables are a host of vitamins, minerals, dietary fiber phytonutrients and antioxidants. However, the consumption of fruit by Malaysian adults was always considered as pleasurable snack24. Less preference is given to the procurement of fruits in their food budget. The fruits form their menu only during seasons available. A study on national population revealed that 29% and 8% of the population bought fruits on a weekend basis and fewer than that respectively. Similar pattern of poor con-sumption of fruits is also evident among the tribes in India (NNMB, 2012)12. Poor intake of green leafy and other vegetables (33%) on daily basis are also evident among their national counterparts as reported by25. The Malaysian Adult Nutrition Survey, 2003 also uncloak the fact that fruits and vegetables consumption is low among Malaysian26. According to the report by27, 78% of adults worldwide consumed less than the minimum recom-mended of five daily servings of fruits and vegetables per day. The transition in nutrition has only resulted in fewer intakes of green leafy and other vegetables due to its high cost and unavailability to the Semai population which also contributes to micronutrient deficiencies among this indigenous group.

Fish forms the primary protein source of protein among the Orang Asli communities in general28–30. Malaysians consume at least 56.5 kg of fish per person each year are ranked top among the world’s top fish con-sumers31. This statistic was way above the world average of below 20 kg per capita and even surpasses Japan. On average, Malaysian households spend about RM100 a month to buy fish32. The difference between national population and the Semai Orang Asli is that the former goes in for marine fishes whereas the Orang Asli con-sumes small fishes from the river. Fish forms the major food consumed among the meat, fish and poultry group in the Food Guide Pyramid which is their prime source of protein. The findings from the Malaysian Adult Nutrition survey also confirm that most Malaysians include fish in their daily meals33.

When it comes to fleshy foods, the Semai people eat fleshy foods only when they hunt animals and not all days. Most of the meat or flesh food is cooked in bam-boo or smoked. The fleshy foods are prepared as soups or



deep fried (GORENG). Condensed milk forms a place in everyday consumption of a Malaysian diet34. Condensed milk is inexpensive compared to cow’s milk and is avail-able in all local sundry shops. Also it is sweetened and does not require sugar when added. Though the gov-ernment distributes milk powders through Food Basket Assistance Program and through the Primary Health Centre to the pregnant, lactating and young children, these have not reached all corners alike especially those living in the remote forest peripheries. This leads to poor consumption of dairy products among the Orang Asli communities.

With regard to nutrients, thiamin, the Semai native people were able to meet more than 80% of their daily requirements through rice which is a staple food for Orang Asli. The other sources of thiamine include pork, other grains and legumes. Niacin, also called as vitamin B-3 is used by the body mainly as enzyme that helps to release energy from food. All protein rich foods contain an amino acid tryptophan which is a precursor to nia-cin and can be converted to niacin in the body. Fish is a good source of niacin which also is the predominant protein source among the Orang Asli and hence they were able to meet at least 80% of their niacin requirement. The next best source is from the wild mushrooms they col-lect from forest but depends on the availability especially during rainy seasons. Papaya is the cheapest source of vitamin A in the form of carotenoids in an Orang Asli meal. The other major source is from the long flexible bean called petai, which is popular among the Orang Asli. The poor intake of yellow and dark green leafy veg-etables have deprived them of vitamin A. Based on the report by35 from among the 15 East Asia and Pacific pri-ority countries, only Malaysia does not have vitamin A supplementation at national level, reckoning instead on food-based strategies. Foods fortified with vitamin A are available in Malaysia. The irony is that these foods are not affordable by the Orang Asli and hence this problem has to be treated as a public health issue to combat Vitamin A Deficiency (VAD) among the indigenous groups.

Malaysia has recorded a significant prevalence on Iron Deficiency (ID) and Iron Deficiency Anemia (IDA) among women of reproductive age and pregnant women36. Apparently, the Semai indigenous community also lack iron in their diet and were able to meet only 40% of RNI. Lack of animal source of iron and poor intake of green leafy vegetables and iron fortified flour are the main contributors for lack of iron and folates. Steps should be

taken to combat iron deficiency among the native tribes by educating them to include iron rich foods and provide them with knowledge on how to raise a kitchen garden in their backyard as every Orang Asli house has space to con-vert into a kitchen garden. Low cost recipes incorporating iron rich foods should be taught and stern measures have to be taken in the form of prophylaxis to alleviate iron deficiency. Folates on the other hand show comparatively higher intake (60%) than iron. The outstanding sources of folate in the Semai food are rice, potatoes and water spin-ach (Kangkong). Legumes, green leafy vegetables, animal liver which are best sources of folate, however are less frequently consumed by the Semai tribes. Based on the emerging new evidences on the demanding role of folate in health and disease, the current RNI is established with a 50% increment over the past recommendation for all age groups37. Unfortunately, most of the individuals espe-cially the vulnerable groups like women of reproductive age, pregnant and lactating women and the indigenous could not meet these recommendations solely from dietary intake due to poor bioavailability. The National Adult Nutrition Survey Malaysia, 200338 revealed that 90% of urban adults and 75.3% of rural adults consumed at least a portion of cereal flour foods. In line with that, the Ministries of Health as well as Trade and Consumer Affairs and UNICEF in collaboration with the Economic Planning Unit, undertook the Flour Fortification Initiative to introduce a policy to ensure that wheat flour processed in Malaysia is mandatorily fortified with iodine and folic acid to ensure availability of iron and folate39. However, the percentage of Orang Asli who buy these iron and folate fortified flour is very limited which calls for supple-mentation of iron and folate.

Vitamin C is required for enhancing the absorption of iron and folate. The Orang Asli managed to obtain only 52% of RNI for vitamin C through their diet. Cassava leaves, bamboo shoots and water spinach are the major foods that contribute to vitamin C in the indigenous diet. Since vitamin C is the least stable of all vitamins, the method of cooking, especially heat, exposure to oxygen, prolonged cooking, light and type of cookware (copper and iron) can destroy vitamin C in foods. The RNI, which suggest an average intake of five servings of fruits and vegetables per day, would suffice the daily requirements for vitamin C. Unfortunately; the Semai tribes did not fulfill this criterion and hence did not meet the require-ments. The mean consumption of calcium accounts to only 55% of the RNI among the Semai indigenous



group. This is considerably low due to poor intake of milk and dairy products which are good sources of calcium. Considerable amounts of calcium come from soymilk which is inexpensive and readily available. Cassava, bam-boo shoots and petai also contribute to dietary calcium but to a lesser extent.

The other best sources are small fishes with edible bones such as sardines and anchovies, which are com-mon among the Malaysians and Orang Asli alike40. The results of NHMS 201141 also reported a poor intake of calcium (44% of RNI) in the national adult population. Poor food choices and low dietary diversity are deemed justifiable for the poor intake. Similar results were among the Che-Wong tribes42. Poor purchasing power leads to poor dietary choices and inadequacy among low-socio economic groups43. Iodine Deficiency Disorder (IDD) is a common micronutrient deficiency in developing countries that results in impaired mental development and poor IQ. The results from the survey on National Iodine Deficiency Disorders carried out in 199644 declared that IDD was not a public health problem in Peninsular Malaysia. However, contradictory results were reported in subsequent stud-ies and by the State Health Department IDD monitoring program. 32% of goiter prevalence has been reported in a study done on Orang Asli women of reproductive age in Hulu Langat District, Kuala Lumpur45. Also, the IDD monitoring program launched by the Ministry of Health Malaysia revealed that the median urinary iodine (UI, in UG/L) in states such as Perak was 70.5 and Pahang was 90.9 respectively46,47. The present study also shows a defi-cient intake for iodine which accounts to less than 50% of RNI. Similar pattern is also observed in other ethnic groups of aborigines in Pahang state48. The proportion of households using iodized salt in Peninsular Malaysia was found to be very low [2.5% (95% CI: 1.5, 4.1%)]. The pres-ent study identifies the pressing need to address iodine deficiency. Though Water iodination was introduced in several states, including Perak46, IDD continued to be unabated. Universal Salt Iodization Program has had very little or no impacts on the indigenous community espe-cially those residing in interior forest fringes. The present situation warrant for immediate action and intervention to improve the iodine status of the aborigines.

Sodium is the only nutrient which exceeded the rec-ommended levels of RNI (147%). This is due to the fact the Orang Asli use soy sauce (KICAP) in most of their food preparations. Also dried fish or anchovies are processed using salt which is incorporated in most of the dishes as

it is cheap and affordable when compared to other pur-chasing foods. Apparently sodium is added while cooking rice, cassava or other foods as a seasoning. High sodium intake is also common among the national population49 though their source is mainly from consuming processed foods. Hence intervention in terms of nutrition education has to be given to reduce salt intake among these primi-tive tribes of Peninsular Malaysia.

Comparison of energy and nutrient intake with the Recommended Nutrient Intakes (RNIs) for Malaysians50

was used to appraise dietary adequacy. As for energy-yielding nutrients, adequacy was assumed to have achieved if the individual’s mean intake met, the mini-mum following requirements: 20-30 % of energy from total fat, 55% to 70% carbohydrate and 10-15 % pro-teins. The adult Orang Asli individuals did not meet the criteria for macro-nutrients whereby their mean energy from carbohydrates was greater than the recommended guidelines and protein and fats contribute less than the recommended levels. (Figure 3) Intake of starch foods and poor inclusion of food from all food groups has led to the marked deviation from the RNI.

5. ConclusionThe Semai community still exists in a state of poverty and nutrition transition has little or no impact on the indig-enous communities. The common food in the Semai is hill rice, tapioca root and shoots, bamboo shoots, petai leaves and small fishes. It is obvious that the diet lacks diversity especially pulses, legumes, yellow and green veg-etables and fruits. Food basket programs as well as the school lunch program are currently in practice to ensure a balanced diet for the children, but the program did not reach the interiors of the forest fringes.

The Semai population residing in the interiors of the forest fringes is found to be more inflicted as compared to those residing close to the mainland. The women illiteracy rate is playing significant role in the selection, preparation and choice of food. If these women are given proper nutrition, education along with empowerment, there is a scope of improvement in the nutritional status in the children as well as the adults.

6. AcknowledgementThe authors deeply acknowledge Avinashilingam Institute for Home Science and Higher Education for Women and



University Tunku Abdul Rahman for making the study possible. The services rendered by JAKOA in granting permission to conduct the study and helping with the list of villages is highly accorded. The authors are grateful to all the village heads and the study participants for their willingness and active participation.

7. Conflict of InterestThe authors do not show any conflict of interest.

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