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UNlVERSITI MALAYSIA SABAH
BORANG PENGESAHAN STATUS TESIS WOMEN FRaU
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, engaku membenarkan tesis (LPSI Satjanal Doktor Falsafah) ini di sirnpan di Perpustakaan Universiti Malaysia Sabah lengan syarat-syarat kegunaan seperti berikut: _
I . Tesis adalah hakmilik Universiti Malaysia Sabah. 2. Perpustakaan Universiti Malaysia Sabah dibenarkan membuat salinan untuk tujuan pengajian sahaja. 3. Perpustakaan dibenarkan membuat salinan tesis ini sebagai bahan pertukaran antara institusi pengajian tinggi. 4. ** Sila tandakan ( / )
SULIT
TERHAD
/"" TIDAK TERHAD
(Mengandungi maklumat yang berdarjah keselamatan atau kepentingan Malaysia seperti yang termaktub di dalam AKTA RAHSIA RASMI 1972)
(Mengandungi maklurnat TERHAD yang telah ditentukakan oleh organisasilbadan di man~ penyelidikan dijalankan)
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l' A. TAN: * Potong yang tidak berkenaan_ * Jika tesis ini SULIT atau TERHAD, sila lampiran surat daripada pihak berkuasalorgansasi
berkenaan dengan menyatakan sekali sebab dan tempoh tesis ini perlu dikelaskan sebagai SULIT danTERHAD.
* Tesis dimaksudkan sebagai tesis bagi Ijazah Doktor Falsafah dan Sarjana secara penyelidikan, atau disertasi bagi pengajian secara kerja kursus dan penyelidikan, atau Laporan Projek Srujana Muda (LPSM).
NUTRIENT INTAKES OF WOMEN FROM LOW INCOME HOUSEHOLDS IN
KAMPUNG TEBOBON, KOTA KINABALU, SABAH
DORA LIYANA BT ABD LATAF
THESIS SUBMITTED IN PARTIAL FULFILLMENT FOR BACHELOR OF FOOD
SCIENCE WITH HONOURS (FOOD SCIENCE AND NUTRITION)
SCHOOL OF FOOD SCIENCE AND NUTRITION
UNIVERSITI MALAYSIA SABAH
2010
DECLARATION
I hereby declare that the material in this thesis is my own except for quotations, excerpts, summaries and references, which have been duly acknowledged.
17th MAY 2010
DORA LIYANA BT ABD LA TAF
HN2006-2349
ii
DECLARED BY
SUPERVISOR
(DR. YASMIN BENG HOUI 001)
EXAMINER 1
( DATIN RUGAYAH ISSA)
EXAMINER 2
( PUAN SHALAWATI @ SALWA BT IBRAHIM)
DEAN ~. (ASSOC. PROF. DR. MOHO ISMAIL ABDULLAH)
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ACKNOWLEDGEMENT
I would like to thank the Jawatankuasa Ketua Kampung (JKK) Kampung Tebobon and respondents in Kampung Tebobon for their participation in this study. My deepest appreciation goes to my supervisor, Dr Yasmin Doi Beng Houi for all her advice, guidance and support that led to the completion of this thesis.
I would also like to thank the lecturers of School of Food Science and Nutrition, Universiti Malaysia Sabah for their guidance and knowledge sharing throughout my four years studying there. My appreciation also goes to my friends who have helped me throughout my final year project.
Last but not least, I am grateful to my parents for their love, encouragement and strong belief in me throughout my life especially during the four years I am away from them. Thank you.
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ABSTRACT
The objective of this study was to determine the nutrient intakes of women from low income households in Kampung Tebobon, Kota Kinabalu, Sabah. Studies were carried out on 28 women from low income households aged 18 to 59 years old. The respondents were interviewed and measured for socio-demographic, dietary intake, nutritional status and food security. Food intake records using 3 day-24 hour dietary recall, body mass index (8M!) and body fat composition measurements were obtained. Food security which may influence nutrient intakes and nutritional status was also studied using the Radimer/Cornell hunger and food insecurity instrument. Mean energy intake was 1255.0 ± 388.7 kcaljd, compared to 1580 ± 53 kcaljd for Sabahan Bumiputera women as reported from the MANS study (Mirnalini et aI., 2008). Mean contribution of energy from protein, fat and carbohydrate was 11%, 21.7% and 29.4% respectively. As for vitamins and minerals, more than 60% of respondents did not meet RNI for calcium, iron, thiamin, riboflavin, niacin and vitamin C. There was a significant correlation between level of food security and calcium, iron, thiamine and niacin intakes (p<0.05). Most of the women, 48.1% were categorised in the normal BMI range, but 8MI was not associated to food security. Majority of the households (85.7%) reported to be in some degree of food insecurity (household insecure 25%, individual insecure 53.6% and child hunger 7.1%). There is a need for improving the quality of the nutrient intakes of this group to prevent nutrient defiCiencies and their consequences. Further studies should be carried out using biochemical markers of nutritional status to validate dietary intake reports.
v
ABSTRAK
PENGAMBILAN NUTRIEN WANITA DARI ISIRUMAH BERPENDAPATN RENDAH DI KAMPUNG TEBOBON, KOTA KINABALU, SABAH
Objektif utama kajian ini adalah untuk menentukan pengambilan nutrien wanita dari isirumah berpendaptan rendah di Kampung Tebobon, Kota Kinabalu, Sabah. Kajian dijalankan ke atas 28 orang wanita dari isirumah berpendapatan rendah yang berumur di antara 18 hingga 59 tahun. Responden ditemuramah mengenai sosio-demografi, pengambilan makanan, tahap pemakanan dan jaminan kedapatan makanan. Rekod pengambilan makanan menggunakan 3 hari-peringatan diet 24 jam, indeks jisim tubuh (DT) dan pengukuran komposisi lemak badan diambil. Jaminan kedapatan makanan yang mungkin mempengaruhi pengambilan nutrien dan tahap pemakanan juga dikaji dengan menggunakan instrumen Radimer/Cornell. Purata pengambilan tenaga adalah 1255. 0 ~ 388.7 kkal sehari berbanding dengan 1580 ~ 53 kkal sehari untuk wanita Bumiputera Sabah sebagaimana yang telah dilaporkan dalam kajian MANS (Mirnalini et al., 2008). Purata tenaga daripada protein lemak dan karbohidrat adalah masing-masing 11%, 21.7% dan 29.4%. Bagi mikronutrien pula, lebih daripada 60% responden tidak mencapai RNI Malaysia untuk kalsium, zat bes~ thiamin riboflavin, niasin dan vitamin C Terdapat perkaitan di antara pengambilan kalsium, zat bes~ thiamin dan niasin dan jaminan kedapatan makanan (p<0.05). Kebanyakan wanita, 48.1% dikategorikan mempunyai DT dalam julat norma~ akan tetap/~ DT tidak dapat dikaitkan dengan jaminan kedapatan makanan. Majoriti isirumah (85.7%) dilaporkan berada dalam beberapa darjah tiada jaminan kedapatan makanan (peringkat isirumah 25%, individu 53.6% dan kebuluran kanak-kanak 7.1%). Adalah menjadi satu keper/uan untuk meningkatkan kualiti pengambilan nutrien kumpulan ini bagi menghalang kekurangan nutrien dan kesan-kesannya. Kajian pada masa hadapan perlu dijalankan dengan menggunakan ujian biokimia tahap pemakanan untuk mengesahkan laporn pengambilan diet.
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TABLE OF CONTENTS
TITLE
DECLARATION
DECLARED BY
ACKNOWLEDGEMENT
ABSTRACT
ABSTRAK
TABLE OF CONTENTS
LIST OF TABLES
LIST OF FIGURES
LIST OF APPENDIX
LIST OF ABBREVIATIONS
CHAPTER 1: INTRODUCTION
1.1 :Objectives
1.2: Hypothesis
CHAPTER 2: LITERATURE REVIEW
2.1: Food security
2.2: Food price and food expenditure
2.3: Food selection
2.3.1: Food selection in developed countries
2.3.2: Food selection in developing countries
2.4: Poverty Line Income (PLI)
2.5: Dietary method
2.6: Food security and nutrient intakes
vii
ii
iii
iv
v
vi
vii
x
xii
xiii
xiv
1
2
2
3
3
5
6
8
9
9
10
11
2.7: Low socio-economic status and nutrient intakes 15
2.8: Nutritional assessment 20
2.9: Misreporting of energy 24
CHAPTER 3: METHODOLOGY 26
3.1: Research location 26
3.2: Selection of respondents 26
3.3: Sampling technique and sample size 26
3.4: Pilot study 27
3.5: Data collection 27
3.5.1: Household socio-economic data 28
3.5.2: Food intake 28
3.5.3: Anthropometric measurements and body composition 29
3.5.4: Statistical analysis 31
CHAPTER 4: RESULTS AND DISCUSSION 32
4.1: Socio-economic data 32
4.2: Nutrient intake 34
4.2.1: Intake of energy and macronutrients 34
4.2.2: Adequacy of energy and macronutrients intake 38
4.2.3: Intake of micronutrients 39
4.2.4: Adequacy of micronutrient intakes 44
4.2.5: Comparison with the average Sabahan Bumiputera 47 women's nutrient intakes
4.3: Nutritional status 48
4.3.1: Body mass index (BMI) 49
4.3.2: Body fat composition 52
4.3.3: Under-reporting of energy 55
viii
4.4: Food security
4.4.1: Food security and nutrient intakes
4.4.2: Food security and nutritional status
CHAPTER 5: CONCLUSION
5.1: Conclusion
5.2: Limitation and suggestion
5.3: Statement of key findings
REFERENCE
APPENDIX A
APPENDIX B
APPENDIXC
APPENDIXD
APPENDIX E
APPENDIX F
APPENDIXG
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59
59
62
62
63
64
65
73
74
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LIST OF TABLES
Table 2.1: Malaysia GINI coefficient from year 1997-2007 6
Table 2.2: Malaysia poverty line income for year 2002-2008 10
Table 2.3: Nutrient intake of food secure and food insecure respondents 11
Table 2.4: Distribution of nutrient intake relative to RDA for food secure and 12 food insecure respondents
Table 2.5: Nutrient intake of women according to food security status 14
Table 2.6: Food consumption surveys amongst various communities in 16 Malaysia
Table 2.7: Percentage of respondents with energy and nutrient intakes lower 17 than the national average (n=199)
Table 2.8: Median intake of energy, carbohydrate, protein and fat in Sabah 17 and by Sabah Bumiputera
Table 2.9: Median micronutrient intakes of Sabah and Sabah Bumiputera 19
Table 2.10: Nutritional status among children from urban and rural 22 communities in Malaysia
Table 2.11: Predictive BMR equation from Malaysian adults 25
Table 3.1: Classification used to classify individuals by severity of food 28 insecurity
Table 3.2: Body fat range for men and women 18 years of age and older 30
Table 3.3: The classification of body weight in adults according to BMI 30
Table 4.1: Socio-economic data of women in Kampung Tebobon 33
Table 4.2: Macronutrient intakes of respondents by socio-economic 35 characteristics
Table 4.3: Correlation coefficient values of energy and macronutrients with 36 selected characteristics
Table 4.4: Comparison of energy and macronutrient intakes of the present 37 study with other communities in Malaysia
x
Table 4.5: Micronutrient intakes of respondents by socio-economic 41 characteristics
Table 4.6: Correlation coefficient values of energy and macronutrients with 43 selected socio-economic characteristics
Table 4.7: Comparison of RNI achieved in the present study with past 46 literatures
Table 4.8: The average nutrient intakes in Kampung Tebobon compared to 47 the MANS 2003 study
Table 4.9: Physical characteristics of respondents in Kampung Tebobon 50
Table 4.10: BM! of respondents by socio-economic groups 51
Table 4.11: Body fat percentage of respondents by socio-economic groups 53
Table 4.12: Types of energy reporters according to energy intake, BM! and 56 body fat percentage
Table 4.13: Socio-economic characteristics according to food security status 58
Table 4.14: Nutrient intake of food secure and food insecure respondents 60
Table 4.15: Physical characteristics of respondents according to food security 61 status
xi
LIST OF FIGURES
Figure 4.1: Energy and macronutrients achieved by respondents in Kampung 38
Tebobon
Figure 4.2: Micronutrients achieved by respondents in Kampung Tebobon 44
Figure 4.3: Distribution of BM! and body fat percentage of respondents in 54 Kampung Tebobon
xii
LIST OF APPENDIX
Appendix A Gantt Chart 73
Appendix B Consent and information form 74
Appendix C Part A (I) - Socio-demography 77
Appendix D Part A (11)- Food security 79
Appendix E Part B - 24 hour diet recall 81
Appendix F Part C - Anthropometric and body fat measurements 82
Appendix G Abstract for poster presentation 83
xiii
BMI
BMR
CPI
FAO
MANS
MOH
PLI
RDA
RM
RNI
WHO
LIST OF ABBREVIATIONS
Body Mass Index
Basal Metabolic Rate
Consumer Price Index
Food and Agriculture Organisation
Malaysian Adult Nutrition Survey
Ministry of Health Malaysia
Poverty line Income
Recommended Daily Allowance
Ringgit Malaysia
Recommended Nutrient Intake for Malaysia
World Health Organisation
xiv
CHAPTER 1
INTRODUCTION
Socio-economic development in Malaysia has caused the increased availability of
food products and changes to lifestyle leading to shifts in dietary practices and
food preferences which affect the health-disease pattern in the community. Socio
economic status is one of the most powerful predictors of health status and
mortality worldwide (MOH, 2005).
According to the National Nutrition Policy of Malaysia, Malaysia bears
malnutrition problems which are micronutrient deficiency including iron deficiency
and iodine deficiency disorders (IDD) among young children, women of
childbearing age and the elderly. Nutrient deficiency can lead to poor cognitive
development and academic performance in children and also reduce work capacity
and productivity among adults (MOH, 2005).
Food security is defined in the World Food Summit of 1996 as existing
when all people at all times have access to suffiCient, safe, nutritious food to
maintain healthy and active life. The concept is that it includes both physical and
economic access to food that meets people's dietary needs as well as their food
preferences (WHO, 2009). Food security is assessed in several degrees which are
food secure, household insecure, individual or adult insecure and child hunger.
Child hunger occurs when both adults and child do not have access to food or they
do not have sufficient food to eat (Radimer, 2002).
There are indications that the food security at the household level remains
a problem among the poor. Households' food insecurity which leads to malnutrition
is often reflected in a household with low monthly income, low income per capita,
low educational level, unemployment among adult household members, single
female-headed households and other factors (Zalilah and Ang, 2001). The Poverty
Line Income (PU) set by the Malaysian government for a five-member household
in Sabah is RM960 (DSW, 2008).
The present study is an investigation on the nutrient intakes of women
from low income households in Kampung Tebobon, Kota Kinabalu. The findings
were compared to the findings from Malaysian Adults Nutrition Survey (MANS)
2003 (Mirnalini et al., 2008) and Recommended Nutrient Intake for Malaysia (RNI)
(NCCFN, 2005).
1.1 Objectives
The objectives of this study are:
i. to evaluate the extent to which the nutrient intakes of women from
low income households in Kampung Tebobon vary from the MANS
2003 findings and RNI Malaysia.
ii. to determine the nutritional status of women from low income
households in Kampung Tebobon using anthropometric
measurements and body fat composition.
iii. to determine the association between household food security and
nutrient intakes of low income households.
1.2 Hypothesis
The nutrient intakes of women from low income households in Kampung Tebobon
are lower than the RNI Malaysia and MANS 2003 findings.
2
CHAPTER 2
LITERATURE REVIEW
2.1 Food security
Food poverty and hunger exist in the developed countries as well as developing
countries and the most rapid increase in chronic hunger experienced in recent
years occurred between 2003 and 2007 (FAD, 2008). WHO (2009) defined food
security as existing when all people at all times have access to sufficient, safe,
nutritious food to maintain healthy and active life. There are three important
aspects of food security which are food availability, food quality and safety and
food processing capabilities (Tee and Cavalli-Sforza, 1993). The most important
component of food security is food availability to the communities.
Radimer et al. (1992) has developed RadimerjCornell hunger and food
insecurity instrument to assess household hunger and food insecurity in the United
States. It categorises the households into four categories which are food secure,
household food insecurity, individual food insecurity and child hunger. The usage
of this instrument is limited to within the low income households' population.
National surveys in United States, Australia, Canada and New Zealand have
measured food security. Currently, there is no national survey to measure food
security in the Malaysian population. However, there are studies on food security
done on rural and low income households in Malaysia using the Radimer/Cornell
hunger and food insecurity instrument (Zalilah and Ang, 2001; Zalilah and Tham,
2002; Zalilah and Khor, 2005). From past studies, the use of this instrument has
been validated to be used in the Malaysian population.
RadimerjCornell hunger and food security instrument was used to identify
hunger and food insecurity at two levels which are individual and household levels.
At the individual and household levels, four dimensions (quantity, quality,
psychological acceptability and social acceptability) need to be measured to
identify food insecurity. At the individual level, these measures are adequacy of
energy intake, adequacy of nutrient intake, feelings of deprivation or restricted
choice, and normal meal patterns. At the household level, they are related to
household stores, quality and safety of available foods, anxiety about food
supplies, and sources of food (Radimer, 2002).
Food insecurity status of households, determined using the RadimerjCornell
measures, was significantly associated with the quantity of household food
supplies, frequency of consumption of fruits and vegetables and associated
nutrients (Kendall et aI., 1996). These relationships indicate that in the rural
population the RadimerjCornell measures capture information about household
food supplies and the quality of diets, and may be useful indicators of dietary
differences in groups at risk of food insecurity. Households' food insecurity which
lead to malnutrition is often reflected in a household with low monthly income, low
income per capita, low educational level, unemployment among adult household
members, single female-headed households and other factors (Kennedy and Peters,
1992). This is supported by studies done in developed countries where household
income has been found to influence household food security which households
with lower incomes are at risk for food insecurity (Johnson and Rogers, 1993;
Kendall et al., 1995; Olson, et al., 1997).
Zalilah and Khor's (2005) study in Sabak Bernam, Selangor, showed that
the risk factors for food insecurity are lower years of education, household income
and income per capita, more children and mothers as housewives. In contrast,
Zalilah and Ang's (2001) study in Kuala Lumpur showed that household income,
income per capita, income of fathers and income of mothers are not risk factors for
food insecurity. The difference in findings may be because households in the
Kuala Lumpur study did not report the actual situation of their household food
security due to embarrassment in discussing the matter with outsiders (Zalilah and
Ang, 2001).
4
2.2 Food price and food expenditure
Food prices have increased for the past years due to the increase in oil price in the
world market. According to the FAD (2009), food price index had an increment of
9% in year 2006, 24% in 2007 and 51% in year 2008. High food prices are
driving millions of people into food insecurity which worsens the conditions for
many who were already food insecure. Food price increases gave most impact on
the poorest, landless and female-headed households (FAD, 2008) . The cost of
achieving and maintaining food security is important and can be revealed through
an analysis of the proportions of either income or expenditure allocated for food.
On the other hand, developing countries, especially the poorest, face difficult
choices between maintaining macroeconomic stability and putting in place policies
and programme to deal with the negative impact of high food and fuel prices on
their people.
Rising food prices lead to decreased access to food in low socio-economic
households. This happens in low income households with a large number of
members. Food sharing occurs and hence, the amount of food taken per person is
reduced. However, if food prices rise at the same time as household income,
access to food may be unchanged. When households have limited or no access to
food, the households falls into household food insecurity category. In Malaysia,
the price of rice and other essential food items are being regulated and strictly
enforced. Thus, food price in Malaysia generally do not suffer great fluctuations
except for fish, fruits and vegetables (Tee and Cavalli-Sforza, 1993). Evidence
shows that there exist a relationship between food prices and nutrient intakes
(ACC/SCN, 1992).
The household level consequences of food price crisis are felt by low
income food-deficit countries (UFDCs) where a 50% rise in staple food price
causes a 21% increase in total food expenditure. In a high income country, this
rise in prices causes a 6% rise in retail food expenditure with income expenditure
on food rising from 10 to 11% (Shrimpton et a/., 2009).
5
Income distribution in Malaysian households can be assessed using the
inequality aspect. The inequality aspect or GINI coefficient shows how dispersed a
given income distribution is. The United Nations GINI coefficient 2007 for Malaysia
is 37.9, which is better compared to 46.2 in year 2004 (Table 2.1). A value of 0
represents absolute equality and a value of 100 absolute inequality. The income
distribution gives the income amount in real Malaysian Ringgit for households at
each percentile of the per capita income distribution (UNDP, 2009).
The Malaysian Household Expenditure Survey 2004/2005 found that
households in Malaysia spent almost 20% of their monthly expenditure on food
and non-alcoholic beverages in 2004/2005 compared to 23% in 1998/1999. The
survey showed that the urban households spent on average RM2285 per month for
household expenditure (food and other essentials) compared to RM1301 for the
rural households (DSM, 2009b). On average, rural households spent 1.8 times
lower than urban households.
High food prices may have long-term effects on human development as
households, in their effort to deal with rising food bills, either reduce the quantity
and quality of food consumed, cut expenditure on health and education or sell
productive assets. Children, pregnant women and lactating mothers are at highest
risk.
Table 2.1: Malaysia GINI coefficient from year 1997-2007
Year 1997 2004 2007
GINI coefficient 49.2 46.2 37.9
Source: UNDP (2009)
2.3 Food selection
When food price increase, poor and food insecure households face a significant
risk of food consumption falling below a critical level with regards to health and
survival. The existence of such a level can be considered to imply discontinuous
6
preferences because malnutrition and in the worst case starvation is a state any
household will avoid at any cost (L0vendal et al., 2007).
Price change has been shown to differentially influence purchase of
different food items especially among low income groups (Epstein et al./ 2007).
When there is an increase in food price, each individual will look into some safety
measures to reduce or minimise the impact of food price increases. One of the
strategies that can be taken is to reduce the intake of varieties of food, especially
expensive foods such as meat, fish, fruits and dairy products. The intake of staple
food such as rice does not change but there may be an increase in the intake of
cheaper foods. The frequency and portion size are also reduced as a step to
minimize the effect of the increase in food prices (Shrimpton et al., 2009).
Unlike the higher income households, the lower income households
experience constraints on food purchasing. Glanville and McIntyre's (2009) study
showed that the quality of beverage intake by members of low-income households
fluctuates in accordance with financial resources available to purchase foods. The
purchasing of milk is highest at the time of the month when they had the most
money to spend. Mothers' beverage intake is compromised by the degree of food
insecurity the family experiences. Darmon et al. (2002) and Schrijvers et al. (1999)
showed that material and economic constraints influences food selection and
therefore diet quality. Dowler (1997) previously identified insufficient food storage
space and avoidance of food wastage as factors reinforcing unhealthy eating in low
income families. Dietary quality assessed by a global index has been shown to
decline when less money is spent on food.
Several studies suggested that access of food may also be due to the
pricing inequalities between small local shops and large supermarkets that are only
accessible by transportation (caraher et aI., 1998; Travers, 1996). Food price in
small local shops are usually higher than the one sold in large supermarkets. In
the present study, small local shops can be found located nearby households in
Kampung Tebobon whereas large supermarkets (Giant Hypermart and Survey
Supermarket) are located outside Kampung Tebobon. Transportation is needed to
7
reach the large supermarkets. Households using public transportation may be
purchasing less food than households using private transportation due to inability
in carrying heavy weight and limited storage facilities. The Malaysian Household
Expenditure Survey 2004/2005 showed that the urban households spent on
average RM2285 per month for household expenditure (food and other essentials)
compared to RM1301 for the rural households (DSM, 2009b). On average, rural
households spent 1.8 times lower than urban households.
2.3.1 Food selection in developed countries
Healthy dietary habits and food purchasing are often related to educational level,
household's income, house ownership and current economic status (Lalluka et al.,
2007). In Western countries, quantities purchased from each of the five major
food groups were positively associated with income, with the strongest association
found for vegetables and fruit followed by meat and alternates (Ricciuto et aI.,
2006; Dowler, 2001).
When households decrease their food expenses, they will also decrease the
purchase of healthy food such as fresh fish and fruits. These foods are expensive
compared to food with high content of sugar and saturated fats (Drewnowski and
Specter, 2004). Energy dense food can satisfy hunger at the lowest cost. This
corresponds to Hulshof et al. (2003) study which found that men and women in
low socio-economic status groups consumed more potatoes, spreads and cooking
fats, meat and coffee than those in higher socio-economic status groups.
Ricciuto et al. (2006) pointed out that food choice is also affected by
education level. Households where the reference person had a university degree
purchased significantly more vegetables and fruit and less meat and alternatives
and other foods, relative to households with the lowest education level. In canada,
like most Western countries, a healthier habit resulted from higher educational
level is associated to higher consumption of vegetables and fruits and lower
consumption of meats. This is because vegetables and fruits are more expensive
than meats. However, the same does not apply in Malaysia where fruits and
vegetables are cheaper than meats.
8
2.3.2 Food selection in developing countries
Food expenditure data in the Philippines showed that there is decline in green and
leafy vegetables consumption because its price is more expensive than other types
of vegetables (Bouis, 1991). One of the coping strategies in Haiti when food price
increases is people may eat seeds instead of planting them. For the urban poor,
these coping foods may also go up in price (Shrimpton et al., 2009). In Malaysia,
the mean frequencies for daily intake of rice, leafy vegetables, marine fish, local
kuih and anchovy were significantly higher among the rural compared to the urban
adults. In contrast, urban dwellers consumed more chicken and eggs than the
rural (MOH, 2008c).
2.4 Poverty Line Income (PU)
Households' income influences the food choice and nutritional status of an
individual (Lalukka et al., 2007). Ragayah (2007) states that the poverty line
income (PU) is the level of income that is just sufficient to obtain the minimum
necessities of life or basic needs which includes both food and non-food items. A
household is considered poor if the household's income falls below that line, which
means it lacks the resources to meet the basic needs of its individual members
(Government of Malaysia, 2006). The PU for Malaysia was estimated based on
the minimum requirements of a model five-member household for three major
components which are food, clothing and footwear and other non-food items such
as rent, fuel and power; furniture and household equipment; medical care and
health expenses; transport and communications; and recreation, education and
cultural services.
Table 2.2 shows the Malaysian PLI. The PU for a household of 5.2 in
Sabah is RM960 (DSW, 2008). Income per capita of RM192 will be taken if there
are more than five members in the household. A household is considered hardcore
poor if its monthly household income is less than the food PU which is RM398,
RM503 and RM482 for Peninsular Malaysia, Sabah and Sarawak respectively
(Government of Malaysia, 2006).
9
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