KUALA LUMPUR, May 27 — The key findings from the newly-released National Health and Morbidity Survey 2023 by the Health Ministry once again tells of the worrying public health situation among Malaysians.

It’s never enough to talk about non-communicable diseases known as NCDs, and it appears that there is an endemic of diabetes, hypertension, high cholesterol and obesity in the country.

According to the data, almost 2.3 million adults in Malaysia live with three NCDs.

Based on Statista, Malaysia has an approximate 23 million adult population, which means one in 10 adults live with three NCDs.

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Apart from diabetes which affects one in six Malaysians, 7.5 million adults live with high cholesterols while one in three have hypertension.

Malaysian adults are also getting fatter with a rising obesity rate at 54.4 per cent.

The survey found that the trend in overweight and obesity among adults in Malaysia rose 10 per cent in a decade.

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Tip of the iceberg

Looking at the data, consultant public health physician Dr Feisul Idzwan Mustapha said the findings look concerning with the high, and rising prevalence of NCDs and their risk factors in Malaysia.

“These conditions, including high cholesterol and hypertension, are major risk factors for cardiovascular diseases, which are among the leading causes of morbidity and mortality.”

He said the high prevalence of these conditions indicate a substantial burden on the national health system, as they often lead to chronic complications requiring long-term management and treatment.

“This not only affects the quality of life of the individuals but also increases healthcare costs and the demand for medical services,” said Dr Feisul, who is also Perak State Health Department director of public health.

Sharing similar views, consultant endocrinologist at Prince Court Medical Centre Dr Malathi Karupiah said the high prevalence of multiple chronic conditions in a significant portion of the population suggests widespread health issues.

“High cholesterol is a major risk factor for cardiovascular diseases, indicating that a large number of people are at increased risk for heart attacks and strokes.

“Meanwhile, hypertension, or high blood pressure, can lead to serious health complications like heart disease, stroke, and kidney failure if not managed properly.”

According to Dr Malathi, such a high prevalence of NCDs among Malaysians may lead to a potential public health crisis for the country.

A billion ringgit burden

Dr Feisul said the financial burden of managing NCDs is substantial.

“While exact figures vary, it is estimated that the cost of treating NCDs in Malaysia runs into billions of ringgit annually.

“This includes direct costs such as hospital admissions, medications, and medical procedures, as well as indirect costs related to loss of productivity and long-term disability.”

He said the rising prevalence of NCDs undoubtedly puts more pressure on the healthcare system, necessitating increased funding, resources, and infrastructure to manage these chronic conditions.

“It also highlights the need for a more robust preventive approach to reduce the incidence of NCDs and alleviate the economic strain on the healthcare system.”

Dr Malathi, on the other hand, said the increased number of patients requiring frequent and longer hospital stays due to complications from NCD will put a strain on hospitals’ capacities, affecting the system's ability to respond to other medical needs efficiently.

"This trend would also increase the demand for healthcare professionals, potentially leading to workforce shortages or the need for additional training for existing staff.”

A vicious cycle in the making

According to Dr Feisul, obesity is a major risk factor for several NCDs, including diabetes, hypertension, and cardiovascular diseases.

“With an obesity rate of 54.4 per cent, a significant proportion of the population is at increased risk for these conditions.

“Obesity contributes to the development of insulin resistance, dyslipidemia, and hypertension, all of which are critical pathways leading to NCDs.”

Therefore, he said, addressing obesity is paramount in the efforts to reduce the prevalence of NCDs.”

Dr Malathi also pointed to obesity as the main culprit for Type 2 diabetes, cardiovascular diseases, cancers as well as joint and musculoskeletal disorders.

“The excess weight can lead to conditions like osteoarthritis due to the increased load on joints.

“Additionally, obesity is associated with a higher risk of several types of cancer, including breast, colon, and endometrial cancers.”

What to do?

Despite numerous awareness campaigns and intervention efforts by the Health Ministry over the years, the numbers seem to be on an upward trend.

Dr Feisul said while awareness campaigns are vital, comprehensive policy and regulatory measures and interventions would be crucial in tackling NCDs.

“Policies that promote healthy environments, such as regulating the marketing of unhealthy foods, especially towards children; implementing taxes on drinks and food high in salt, sugar and fats; and ensuring access to nutritious food options, are essential.

“Additionally, enhancing urban planning to create more opportunities for physical activity and improving healthcare services to support early detection and management of NCDs are important strategies.”

Asked if limiting operating hours of 24-hour eateries such as mamaks and fast-food chains would be effective in tackling the issue, Dr Feisul said such a proposal may be positive for behavioural change.

“The proposal to limit the operating hours of 24-hour eateries, including mamaks and fast-food chains, could potentially contribute to reducing the incidence of unhealthy eating behaviours, especially among children, particularly late-night snacking on high-calorie, low-nutrient foods.

“However, this measure should be part of a broader, multifaceted approach that includes education, community support, and accessible healthy food options.”

He said addressing the underlying determinants of unhealthy eating habits and creating a supportive environment for healthy choices will be more effective in the long run.

Dr Malathi also agreed that limiting the operating hours of 24-hour eateries could help curb unhealthy eating habits such as late-night snacking on high-calorie, low-nutrient foods.

“By reducing access to unhealthy food options during late hours, it may encourage people to adopt healthier eating patterns.”

She said another measure to consider would be to implement stricter regulations on the marketing and availability of unhealthy food and beverages, such as sugary drinks and high-fat snacks.

“We also need to implement nutrition and physical activity programmes in schools to encourage healthy habits from a young age, which can have long-term benefits in preventing NCDs.”