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This study assessed nutritional status among Thai children using anthropometry, dietary intakes and micronutrient status. Cross-sectional survey with multi-stage cluster sampling. Body weight and height were measured in all children. Dietary intakes were assessed using 24-h dietary recall. Biochemical assessment was performed in one-third of the children. The study was conducted in Thailand's four geographical regions and Bangkok. 3478 Thai children aged 0·5-12·9 years. Stunting showed a downward trend by age group and was most prevalent among infants and toddlers. Overweight and obesity showed a significant upward trend by age group, location and sex and were highest among children aged 7-12·9 years. Risks of inadequate micronutrient intakes (Ca, Fe, Zn, vitamins A, C and D) were high (53·2-93·6 %). Prevalence of Zn and mild vitamin A deficiencies were low; vitamin D and B deficiencies were nil. Vitamin D insufficiency was significantly higher in the urban area and among girls. Anaemia was very high in infants and toddlers (56·6 and 35·2 %) but showed a significant downward trend by age group. There was an overall high prevalence of Fe deficiency (25 %) . Fe deficiency anaemia (4·2 %) among children aged 4-12·9 years old. The high prevalence of stunting and anaemia among children aged 0·5-3·9 years and overweight and obesity among children aged 7-12·9 years requires continued attention. While prevalence of biochemical micronutrient deficiencies was not high (except for Fe), high prevalence of dietary inadequacies for several micronutrients warrants further in-depth investigations.

The South East Asian Nutrition Survey II Indonesia aimed to provide up-to-date data on dietary intake, nutritional and biochemical status of children aged 0·5-12 years in Indonesia 2019-2020. Multistage cluster sampling, stratified by geographical location. Out of forty-six targeted districts in Indonesia, the study only covered twenty-one districts/cities in Java and Sumatera islands, Indonesia due to COVID-19 pandemic. A total of 2475 children aged 0·5-12 years were included. The growth (weight-for-age, height-for-age, weight-for-height and BMI-for-age) of Indonesian pre-school- and school-aged children was below the WHO standards. The prevalence of stunting in Java and Sumatera islands was 20·6 and 33·4 % in urban and rural areas, respectively. Stunting was higher in the 1·0-3·9-year age group, boys and rural areas. Overall, 9-12 percent of all children were overweight -obese, with 23·7 % of urban 7-12-year-olds having the highest prevalence.Anaemia was 22·8 % in < 5-year-old and highest in < 1-year-old children. Fe, Zn, vitamins A and D insufficiency was observed in 20·3 %, 11·9 %, 1·9 % and 27·1 % of the children. Dietary intakes of energy, fibre, Ca, Fe, Zn, vitamins A, B , C and vitamin D below the Indonesian RDA were prevalent and observed in more than half of the children. High stunting, increasing trends of overweight/ obesity, anaemia, serum vitamin D insufficiency, inadequate energy and micronutrient intake in children highlighted the triple burden of malnutrition in Java and Sumatera, Indonesia's most populous regions in 2019-2020, shortly before COVID-19 pandemic era.

Introduction: Stunting is associated with poor nutritional intake during early childhood. This study evaluated the effect of a daily intake of 510 mL of an oral nutritional supplement for 180 days on linear growth among children with stunting and at-risk of stunting aged 12–36 months. Methods: A community-based, single-arm intervention was conducted among 91 children in Kelantan, Malaysia. The children at enrolment had height-for-age Z-scores (HAZs) between <−1.0 SD and >−3 SD based on WHO Growth Standards. Anthropometric measurements were collected at baseline (T0), 90 days (T90; mid-intervention), and 180 days (T180; post-intervention). Nutrient intake was assessed using 24 h dietary recalls, and compliance was monitored via returned empty sachets. Results: The mean age of the children at baseline was 26.7 ± 6.6 months (range, 12.9–36.0 months), with 37 (41%) being stunted and 54 (59%) at risk of stunting. After intervention, the linear growth (height-for-age Z-score) was significantly improved over time (p < 0.001) in both stunted and at-risk children. A significant time-by-group interaction (p = 0.014) indicated differential effects between the stunted and at-risk groups. Post hoc analysis showed HAZ improvements from baseline (T0) to 180 days in stunted and at-risk groups (p < 0.001), with the stunted group demonstrating a greater mean change in HAZ compared with the at-risk group. The number of stunted children declined by 37.8% (p = 0.003). Nutrient intakes of protein, vitamin D, vitamin C, vitamin B-complex, calcium, phosphorus, magnesium, and iron improved significantly. Conclusions: A daily intake of 510 mL of oral nutrition supplement improved linear growth and nutrient intake. These findings support the potential of targeted supplementation in addressing child growth faltering and micronutrient inadequacies.

To assess the nutritional status, growth parameters and lifestyle behaviours of children between 0·5 and 12 years in nationally representative samples in Malaysia, Indonesia, Thailand and Vietnam. A cross-sectional study was conducted in the four countries, between May 2019 and April 2021. Data collected can be categorised into four categories: (1) Growth - anthropometry, body composition, development disorder, (2) nutrient intake and dietary habits - 24-h dietary recall, child food habits, breast-feeding and complementary feeding, (3) socio-economic status - food insecurity and child health status/environmental and (4) lifestyle behaviours - physical activity patterns, fitness, sunlight exposure, sleep patterns, body image and behavioural problems. Blood samples were also collected for biochemical and metabolomic analyses. With the pandemic emerging during the study, a COVID-19 questionnaire was developed and implemented. Both rural and urban areas in Malaysia, Indonesia, Thailand and Vietnam. Children who were well, with no physical disability or serious infections/injuries and between the age of 0·5 and 12 years old, were recruited. The South East Asian Nutrition Surveys II recruited 13 933 children. Depending on the country, data collection from children was conducted in schools and commune health centres, or temples, or sub-district administrative organisations. The results will provide up-to-date insights into nutritional status and lifestyle behaviours of children in the four countries. Subsequently, these data will facilitate exploration of potential gaps in dietary intake among Southeast Asian children and enable local authorities to plan future nutrition and lifestyle intervention strategies.

This paper aims to report South East Asian Nutrition Surveys (SEANUTS) II Malaysia data on nutritional status, dietary intake and nutritional biomarkers of children aged 6 months to 12 years. Cross-sectional survey conducted in 2019-2020. Multistage cluster sampling conducted in Central, Northern, Southern and East Coast regions of Peninsular Malaysia. 2989 children aged 0·5-12·9 years. Prevalences of stunting, thinness, overweight and obesity among children aged 0·5-12·9 years were 8·9 %, 6·7 %, 9·2 % and 8·8 %, respectively. Among children below 5 years old, 11·4 % were underweight, 13·8 % had stunting and 6·2 % had wasting. Data on nutritional biomarkers showed that a small proportion of children aged 4-12 years had Fe (2·9 %) and vitamin A deficiencies (3·1 %). Prevalence of anaemia was distinctly different between children below 4 years old (40·3 %) and those aged 4 years and above (3·0 %). One-fourth of children (25·1 %) had vitamin D insufficiency, which was twice as prevalent in girls (35·2 % . boys: 15·6 %). The majority of children did not meet the recommended dietary intake for Ca (79·4 %) and vitamin D (94·8 %). Data from SEANUTS II Malaysia confirmed that triple burden of malnutrition coexist among children in Peninsular Malaysia, with higher prevalence of overnutrition than undernutrition. Anaemia is highly prevalent among children below 4 years old, while vitamin D insufficiency is more prevalent among girls. Low intakes of dietary Ca and vitamin D are also of concern. These findings provide policymakers with useful and evidence-based data to formulate strategies that address the nutritional issues of Malaysian children.

To describe the economic, lifestyle and nutritional impact of the COVID-19 pandemic on parents, guardians and children in Malaysia, Indonesia, Thailand and Vietnam. Data from the SEANUTS II cohort were used. Questionnaires, including a COVID-19 questionnaire, were used to study the impact of the pandemic on parents/guardians and their children with respect to work status, household expenditures and children's dietary intake and lifestyle behaviours. Data were collected in Malaysia, Indonesia, Thailand and Vietnam between May 2019 and April 2021. In total, 9203 children, aged 0·5-12·9 years, including their parents/guardians. Children and their families were significantly affected by the pandemic. Although the impact of lockdown measures on children's food intake has been relatively mild in all countries, food security was negatively impacted, especially in Indonesia. Surprisingly, in Malaysia, lockdown resulted in overall healthier dietary patterns with more basic food groups and less discretionary foods. Consumption of milk/dairy products, however, decreased. In the other countries, intake of most food groups did not change much during lockdown for households based on self-reporting. Only in rural Thailand, some marginal decreases in food intakes during lockdown persisted after lockdown. Physical activity of children, monthly household income and job security of the parents/guardians were negatively affected in all countries due to the pandemic. The COVID-19 pandemic has significantly impacted societies in South-East Asia. To counteract negative effects, economic measures should be combined with strategies to promote physical activity and eating nutrient-adequate diets to increase resilience of the population.

Individuals burdened with socioeconomic disadvantages, including food insecurity, are often exposed to circumstances that may increase the likelihood of smoking, which may in turn affect the respiratory health of others in the household, particularly children. Yet, the role of these factors in perpetuating tobacco use within households remains underexplored. Therefore, this study attempts to determine the association between household food security and socioeconomic status with paternal smoking in Malaysia. This study utilised data from the South East Asian Nutrition Surveys (SEANUTS II) Malaysia, which involved 2,687 children aged 0.5–12.9 years, recruited through multistage cluster sampling. Although the study recruited children as participants, the present analysis draws on paternal and household information, including food security, socioeconomic status, and paternal smoking, as reported through parent/guardian-reported questionnaires. Multivariate binary logistic regression was used to determine factors associated with paternal smoking habits. Overall, forty-three percent of fathers were reported as smokers. Younger fathers (aged <30.0 years) had twice the odds of smoking [aOR: 2.032 (95%CI 1.301–3.173)] compared to their older counterparts (aged >49.9 years). Fathers from low socioeconomic status households, particularly, those with extremely low household income [aOR: 2.606 (95%CI 1.711–3.968)] and without formal education/completed primary education [aOR: 2.604 (95%CI 1.710–3.966)], had double the odds of smoking than their counterparts. Self-employed/other occupation fathers [aOR: 1.343 (95%CI 1.056–1.709)] and families from food-insecure households [aOR: 1.251 (95%CI 1.053–1.487)] were found to have higher odds of smoking. In conclusion, household food insecurity and socioeconomic status, including age, occupation, household income, and education level were significantly associated with paternal smoking status. Authorities should customise interventions to mitigate socioeconomic barriers and create equitable access to quit-smoking resources. This is important for lowering smoking prevalence and safeguarding children’s health.

Indonesia is currently facing the double burden of malnutrition. While undernutrition is still a major public health problem, the prevalence of overnutrition is increasing. The objective of the South East Asian Nutrition Survey (SEANUTS) was to provide up-to-date data on nutritional status, food consumption and biochemical parameters related to nutrition for children aged 0·5–12 years. The SEANUTS study in Indonesia was conducted in a nationwide representative sample of 7·211 children using multistage cluster sampling based on probability proportional to size, stratified for geographical location, in forty-eight out of 440 districts/cities. The results show that the growth (weight for age, height for age, weight for height and BMI for age) of Indonesian pre-school- and school-aged children is below the WHO standards. The older the children, the more the deviation from the WHO standard curves. Underweight was more prevalent in rural areas (28·9 v. 19·2 %) and overweight/obesity was observed to be more widespread in urban areas (5·6 v. 3·2 %). The prevalence varied with age groups and sexes. The overall prevalence of stunting was 25·2 and 39·2 % in urban and rural areas, respectively. The prevalence of anaemia was nearly 55 % in children aged 0·5–1·9 years and ranged from 10·6 to 15·5 % in children aged 2–12 years. Fe deficiency was observed in 4·1–8·8 % of the children. The percentage of children with dietary intakes of energy, protein, and vitamins A and C below the Indonesian RDA was high and differed across urban and rural areas and age groups.

SEANUTS II Vietnam aims to obtain an in-depth understanding of the nutritional status and nutrient intake of children between 0·5 and 11·9 years old. Cross-sectional survey. A multistage cluster systematic random sampling method was implemented in different regions in Vietnam: North Mountainous, Central Highlands, Red River Delta, North Central and Coastal Area, Southeast and Mekong River Delta. 4001 children between 6 months and 11·9 years of age. The prevalence of stunting and underweight was higher in rural than in urban children, whereas overweight and obese rates were higher in urban areas. 12·0 % of the children had anaemia and especially children 0·5–1 year old were affected (38·6 %). Low serum retinol was found in 6·2 % of children ≥ 4 years old. The prevalence of vitamin D insufficiency was 31·1 % while 60·8 % had low serum Zn. For nutrient intake, overall, 80·1 % of the children did not meet the estimated energy requirements. For Ca intake, ∼60 % of the younger children did not meet the RNI while it was 92·6 % in children >7 years old. For vitamin D intake, 95·0 % of the children did not meet recommended nutrient intakes. SEANUTS II Vietnam indicated that overnutrition was more prevalent than undernutrition in urban areas, while undernutrition was found more in rural areas. The high prevalence of low serum Zn, vitamin D insufficiency and the inadequate intakes of Ca and vitamin D are of concern. Nutrition strategies for Vietnamese children should consider three sides of malnutrition and focus on approaches for the prevention of malnutrition.

Background: Malnutrition among Southeast Asian children remains an issue. Previous studies have linked higher dairy consumption to improved nutrient intake. This study examines the impact of dairy consumption on food, energy, and nutrient intakes among 2- to 12-year-old Southeast Asian children. Methods: We analyzed data from the cross-sectional South East Asian Nutrition Surveys (SEANUTS) II, involving 10,299 children aged 2 to 12 years from Indonesia, Malaysia, Thailand, and Vietnam. Dietary intake was assessed using 24 h dietary recall. Results: Daily dairy consumption was generally low among children aged 2–12 years in Southeast Asia. The proportion meeting daily dairy recommendations was 24% in Indonesia, 17% in Malaysia, 23% in Thailand, and 8% in Vietnam. In younger children aged 2–3 years, this proportion was higher (20–55%), whereas in older children aged 7–12 years, it was lower (2.7–9.6%). In addition, high dairy intake was associated with lower consumption of extra foods, higher overall nutrient intake, and higher proportions of children meeting estimated energy requirements and recommended intakes for vitamins A, B2, B12, D, and calcium. Conclusions: Dairy consumption was associated with lower consumption of extra foods, and it enhanced nutrient intake among Southeast Asian children, indicating a beneficial impact on their diet.