Not just forgetfulness: dementia, a silent epidemic
KUALA LUMPUR : Dementia often begins subtly – a forgotten name, a repeated story, a misplaced item.
But contrary to widespread belief, this condition is not just about old-age forgetfulness – in Malaysia, it is a silent epidemic, driven by an ageing population and widespread chronic illnesses like diabetes and high blood pressure.
With nearly 16% of the population being age 60 and above, studies suggest that over 200,000 Malaysians are living with dementia. Soberingly, this figure is likely underestimated because of low awareness and limited screening.
Globally, dementia affects more than 55 million people, and the World Health Organization predicts this number will reach 78 million by 2030.
'When someone can no longer perform the tasks they once managed easily, such as cooking or holding a conversation, that's when we begin to suspect it could be dementia,' said consultant neurologist Dr Mohamad Imran Idris.
'The hallmark of dementia isn't just forgetfulness; it is when thinking skills interfere with daily life – language, judgement, even recognising familiar faces. That is when it is time to get help.'
Dr Mohamad Imran Idris.
Imran also clarified the difference between dementia and Alzheimer's disease, explaining that the latter is just one type of dementia.
'Dementia is an umbrella term. Alzheimer's is the most well-known, but in Malaysia, vascular dementia – caused by impaired blood flow to the brain, often after a stroke or due to chronic illnesses – is also very common,' he said.
According to Imran, conditions such as hypertension, high cholesterol and diabetes are key contributors to vascular dementia.
Notably, the doctor stressed that dementia is no longer an old person's disease. 'It's not just grandma or grandpa anymore. We've seen people in their 40s and even 30s developing early signs after strokes or years of unmanaged chronic illness.'
While there is no cure for dementia, the good news is, certain medicines can slow its progression. Additionally, screening tools, from digital cognitive assessments to blood tests that detect early brain changes, are becoming more accessible, Imran said.
Individuals both young and old should invest early in their future cognitive health. (Envato Elements pic)
In the meantime, it's important for everyone to keep their brain healthy and engaged. While diet and exercise are known brain boosters, socialising also plays a powerful role.
'Talking with friends, engaging in conversation – these spontaneous, unpredictable interactions challenge the brain and help preserve cognitive function,' Imran added.
Ultimately, those in their 40s and 50s should start thinking seriously about their brain health, on top of controlling their blood pressure, staying socially engaged, sleeping well, and eating a balanced diet.
'These aren't just good habits – they're investments in your future cognitive health. If we care for our hearts to avoid a heart attack, we should do the same for our brains,' he concluded.
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Malay Mail
5 hours ago
- Malay Mail
Rebuilding Malaysia's house of care by using AI in RMK13 — David Chang and Sean Thum
AUGUST 2 — Malaysia is rebuilding our national house of care, and this time, we must do it right. After decades of wear and tear, our health systems need structural repair. The 13th Malaysia Plan, or RMK13, unveiled by Prime Minister Anwar Ibrahim, gives us the blueprint. It outlines a vision for a stronger, fairer, and more resilient Malaysia. Artificial intelligence is one of the tools that can help us get there. RMK13 rests on three pillars. First, raising the floor, so no one is left behind. Second, raising the ceiling, to push Malaysia into high-growth and high-value industries. Third, strengthening the foundations that hold everything together, through better governance and more responsive institutions. Nowhere is this transformation more urgent than in healthcare. Our clinics are overcrowded. Healthcare workers are stretched. Rural communities still face gaps in access. At the same time, our healthcare workers are carrying enormous pressure, often without the tools or support they need. If healthcare is the room in which the rakyat most often encounters the state, then it must be livable, accessible, and built to last. Raising the floor in health means improving services for the rakyat. Everyone, from elderly to children, from rural to urban, deserves reliable and timely care. It also means protecting the well-being of those who provide that care. AI can help achieve both. Artificial intelligence is not a replacement for doctors or nurses, but it can help ease their load. For example, natural language tools can write patient notes or summarise medical histories. This gives health workers more time to focus on patients. AI can also help screen for diseases early. Malaysia's own Dr Mata system already uses AI to detect diabetic eye disease in thousands of patients. These tools bring care closer to where people live. A nurse in a rural clinic, equipped with a simple tablet and an AI app, can perform eye scans, triage symptoms, or follow up with patients more effectively. This is what it means to use AI to raise the floor. We are not replacing human care, but extending its reach. Raising the ceiling means taking bold steps toward a more innovative healthcare system. Across the world, hospitals are using AI to detect heart conditions, spot tumours in scans, and even advise on treatments for rare diseases. These tools are not perfect. The author notes that Malaysia should become a place where medical innovation is both exported and accessible to our own people. . — AFP pic A homegrown health AI sector could also create new jobs and raise our global profile. Malaysia should become a place where medical innovation is both exported and accessible to our own people. The third pillar of RMK13 is good governance. In health, this means making systems that are efficient, transparent, and trusted. Right now, too many processes in our hospitals are slow or repetitive. Doctors spend hours on forms and paperwork. Patients are referred between departments with missing or incomplete records. AI can help streamline these tasks. It can automate basic documentation, manage patient flow, and support scheduling. These may seem like small improvements, but together they free up time, reduce mistakes, and make the system more responsive. One of the clearest priorities under RMK13 is building a single lifelong health record for each citizen. One person, one record. This is essential if AI tools are to work well. But it also improves care in general. With complete and accurate records, doctors can make faster, safer decisions. With better data, public health responses can be more targeted and effective. For this to work, we need strong data governance and clear safeguards. Health information is sensitive. Malaysians must trust that their records are safe, and that AI will be used to help, not harm. All of this depends on people. No technology can run itself. If we want AI to support healthcare, we must first support our healthcare workers. This includes fair pay, better career pathways, and continuous training. It also includes recognising and retaining the talent we already have. The 'Made by Malaysia' slogan is not just about products. It is about people. We cannot lead in AI or health if we continue to lose our best minds to burnout or emigration. Talent is our foundation. RMK13 gives us the chance to rebuild healthcare with purpose. Artificial intelligence is just one tool. But if we use it wisely, we can build a system that is more efficient, more humane, and more ready for the challenges ahead. This is our shared house. Let us build it so that no one is left waiting at the door. * This is the personal opinion of the writer or publication and does not necessarily represent the views of Malay Mail.
Sinar Daily
6 hours ago
- Sinar Daily
Obesity's toll on children's mental, emotional health
KUALA LUMPUR - "Do you want the 30 sen change or sweets?' a female vendor, who was selling homemade ice cream for 70 sen a stick, asked a schoolboy who handed her RM1. "Sweets,' replied the boy before walking away with his ice cream and sweets. Vendors selling candies, sweets, light snacks, fast food, ice cream and carbonated drinks are a common sight outside school gates. A random survey of several primary schools in Kuala Lumpur and Negeri Sembilan by Bernama recently found that the vendors turn up every school day without fail, with pupils scrambling to buy their favourite drink or snack as soon as school ends. At one school, one student was seen rushing to help his father sell carbonated drinks after school. These beverages, commonly known as air gas and sold at RM1 a cup, come in a variety of colours - red, green, purple, orange and black - and flavours. With a few ice cubes added, they become the perfect thirst quencher on a scorching hot day. But little do the children know the "hidden cost' of consuming the sugar-laden air gas almost on a daily basis. CONSUMING CARBONATED DRINKS DAILY According to a press release dated May 2019 by the United Nations Children's Fund (UNICEF) Malaysia, Malaysians' consumption of sugary drinks has increased dramatically over the past 15 years, in tandem with rising incomes. More than one-third (36 per cent) of students have sugary drinks at least once a day, and the average daily sugar intake for adolescents has increased from seven teaspoons in 2012 to 10 teaspoons in 2017, which is more than the recommended limit for adults. On average, Malaysians consume around three kilogrammes of sugar per year in the form of sugary drinks. UNICEF Malaysia also said taxation of sugary drinks has consistently been shown to reduce sugar consumption and improve health outcomes. For example, in the Philippines, sugar-sweetened beverage taxes have reduced consumption of sugary drinks by 8.7 percent, and a study found that they could prevent 24,000 premature deaths related to diabetes, stroke and heart diseases. In Malaysia's case, it introduced an excise duty on sugary drinks in Budget 2019 at 40 sen per litre, which was increased by 10 sen to 50 sen in Budget 2024. An additional 40 sen was added through Budget 2025, bringing the total excise duty to 90 sen per litre. The tax applies only to three categories of ready-to-drink sugary beverages manufactured locally or imported. According to the Ministry of Health Malaysia (MOH), the implementation of the sugar tax in 2019 has shown a reduction in the consumption of sugar-sweetened beverages among teenagers - from 36.9 percent (according to the National Health and Morbidity Survey [NHMS] 2017 findings) to 16.4 percent (data from a 2022 study to assess the impact and effectiveness of Malaysia's sugar-sweetened beverage tax). "Young people and the lower-income group (B40), who are the highest consumers and spend the most on sugary drinks, have benefited positively from this tax,' the ministry said. COMPLY WITH GUIDELINES? However, sugary beverages are not the only concern. Unhealthy eating habits among children are further reinforced by the widespread availability of fast food and processed snacks sold not only in shops but outside school gates as well. Despite regulations in place, vendors continue to operate near schools, offering children easy access to calorie-dense, low-nutrient options - often without their parents' knowledge. But are these vendors even allowed to operate outside schools? According to the Guidelines on the Ban on Sale of Food and Beverages Outside School Gates (2021 Edition) enforced by local authorities, food premises such as static, mobile and temporary hawkers are strictly prohibited from operating within 40 metres of the school perimeter. However, existing licensed static hawkers and stall operators are allowed to operate within the 40-metre boundary, but they are not allowed to sell food and drink items mentioned in the List of Prohibited Food and Beverages for Sale in Schools issued by the Ministry of Education Malaysia (MOE). Meanwhile, Mahani Mohd Baseri, senior assistant for student affairs at Sekolah Kebangsaan King George V, Seremban, Negeri Sembilan, said food and beverages sold by vendors operating outside the school compound do not come under the school's jurisdiction, noting that the responsibility lies with the local authority, in this case, the Seremban City Council. "As a school, we can issue directives for hawkers to stay 40 to 50 metres away from the school entrance, as outlined in the MOE guidelines. We also issue warning letters to hawkers who remain defiant,' she said, adding the school has also filed reports with the local authority concerned to address non-compliant hawkers. Mahani emphasised that all food items sold in school canteens comply with guidelines set by MOE. "School canteens are prohibited from selling snacks, fast food or processed food such as sausages and nuggets. We regularly monitor what is being sold in our canteen and we also maintain a self-inspection file with inspections done by canteen workers and overseen by teachers,' she said. A study titled 'Fast-Food Consumption among Children According to Shari'ah Perspective', published in July 2021, stated that fast food consumption among children is becoming increasingly worrying due to its association with unhealthy nutrition and long-term health effects. Children aged 12 to 15 years in Malaysia consume fast food twice a week on average. Different factors influence fast food intake, including a rise in advertising, the growing number of fast food restaurants and changing modern lifestyles, especially in terms of food choices. BIG BUT FEEL 'SMALL' Linking obesity to more than just the risk of developing noncommunicable diseases (NCDs), Dr Muhammad Yazid Jalaludin, Professor of Paediatrics at the Faculty of Medicine, Universiti Malaya, said obese children are also at high risk of experiencing emotional and mental health challenges. He said stress and depression are often silent struggles faced by many overweight and obese children. "They feel very 'small' despite their large body size. Usually, when obese children feel down, they turn to food and the cycle continues without solving the problem. "If stress and depression are identified (among obese cases), we begin treatment using psychological methods for therapy and motivation. However, if that fails, we would get psychiatrists involved and begin medical treatment to help them,' said Dr Muhammad Yazid, who is also a senior consultant paediatric endocrinologist at Universiti Malaya Medical Centre (UMMC) and UM Specialist Centre (UMSC). Sharing his experience treating an 11-year-old obese boy, he said the child was brought in by his grandfather because he was unable to undergo circumcision due to his excess body weight, which led to a condition called buried penis. A buried penis, which can occur due to several factors including obesity, aging or injuries that cause excess skin or fat to cover the penis, can make certain medical procedures difficult. "If a child has a buried penis, circumcision cannot be performed using laser or clamp methods due to the high risk of infection if the circumcision wound cannot be properly cleaned,' he said, adding his young patient was given a diet and physical activity plan, which he followed strictly. Eventually, the boy lost weight and was able to undergo circumcision like other children. "His grandfather came back to see me and cried. This shows how excess weight and obesity can impact not only the child emotionally but also family members who worry deeply about their condition,' he said. Pointing to a study he carried out with his team of researchers, the findings of which were published in January this year, Dr Muhammad Yazid said 22,816 primary and secondary schoolchildren from selected government schools in Kuala Lumpur, Selangor and Negeri Sembilan were screened, and 29.4 percent of primary schoolchildren and 26.8 percent of secondary students were found to be overweight and obese. He said the findings reflected the urgency for effective intervention, leading to the development of the 'My Body is Fit and Fabulous at School' (MyBFF@school) programme, funded by MOH. "MyBFF@school is a school-based intervention programme developed to tackle childhood obesity in Malaysia. It combines physical activities, nutritional education and psychological support to help schoolchildren adopt healthier lifestyles. "The programme includes structured games, health talks and motivational sessions aimed at improving both physical fitness and mental well-being,' he said. WHEN JOKES BECOME TRAUMATIC Meanwhile, child psychologist Dr Noor Aishah Rosli, who is also managing director of CPC International, said there are obese children who feel ashamed and stressed about their body size and lack self-confidence. Hence, they avoid socialising and isolate themselves. She said this eventually makes them feel left out and affects their emotional and mental state, which can ultimately impact their academic performance. "The most common psychological effect experienced by obese children is their sensitivity about their physical appearance, including what they wear, because society generally perceives fat and obese people as unattractive. They are also afraid to socialise for fear of being bullied, either verbally or physically, which worsens their emotional state. "We often see, not just in schools, that children with larger body sizes are made fun of, whether intentionally or otherwise, through body shaming and other means. I once handled a case of a 10-year-old girl who refused to go to school because her friends called her 'elephant' due to her obesity. "It was heartbreaking. She had just transferred to a new school and was trying to adjust. Other children laughed at her and didn't want to befriend her. She felt stressed and cried every time she came home from school. So, through mental therapy, we helped her to develop a more positive mindset to deal with the situation,' she said. WHAT CHILDREN NEED MOST Dr Noor Aishah added that early signs of mental health problems among obese children include depression, changes in sleep patterns, irregular appetite, irritability, increased sensitivity and being easily offended even over small matters. According to her, weight-loss programmes are particularly challenging for obese children aged seven to 12 who are still in the "fun' stage of eating, compared to teenagers aged 16 to 18 who are already motivated to look good, stay fit and be free from obesity. "Another challenge is the pressure from family members who often make sarcastic comments or jokes about a child's body. Some obese children starve themselves for up to two days because they are stressed and believe they can lose weight quickly, but that won't happen because losing weight healthily takes time. "I've also treated obese children who had difficulty sleeping or suffered from insomnia, prediabetes and high blood pressure. With these conditions, it's hard for them to enjoy school activities like sports and cocurricular activities,' she said. SWEET, CHEAP, DANGEROUS Commenting on the wide availability of unhealthy snacks, Consumers Association of Penang (CAP) education officer N.V. Subbarow said hundreds of snack and drink products are sold in the market today, with many imported from neighbouring countries and specifically designed to attract children. These items, especially confections and colourful beverages, are often sold for as low as 60 to 70 sen, making them even cheaper and more appealing than local products. He noted that the packaging and bright, rainbow-like colours are deliberately designed to catch children's attention, while the products themselves contain high levels of sugar and little to no nutritional value. "This is a serious concern. Parents have told us their children are rejecting vegetables and fruits in favour of these sugary treats. Some kids won't even drink plain water anymore - they only want coloured drinks with high sugar content,' he said. Subbarow called for immediate regulatory intervention to halt the import and widespread sale of such products, especially near schools and in supermarkets, mini markets and night markets. "If this continues unchecked, these highly processed products will flood the market. Without regulation, our children will develop serious health risks at a very young age and we are already seeing it happen,' he warned. He also urged MOH and other authorities to regularly organise nationwide health campaigns, not just in the media but also in schools, employing visual materials like posters and streamers to educate both children and parents about the dangers of sugar-heavy diets and childhood obesity. As Malaysia tackles the childhood obesity crisis, experts emphasise that it is not just about managing weight, it is also about protecting a child's self-worth. Many of these children tend to isolate themselves, carrying deep emotional wounds from being teased and shamed by others. Beyond healthier eating habits and lifestyle changes, they also need empathy, understanding and the chance to be accepted for who they truly are, not just how they look. Next week (Monday): In the final part of this series, Bernama seeks feedback from experts and the Ministry of Health Malaysia regarding the immediate actions and measures taken to address the issue of childhood obesity in the country, including from the perspective of regulations and specific legislation. (This story was produced under the "Communicating Noncommunicable Diseases' Media Fellowship by Probe Media Foundation Inc. [PMFI], Reporting ASEAN [RA] and World Health Organization [WHO]. The views and opinions expressed in this piece are not necessarily those of PMFI, RA and WHO.) - BERNAMA
Sinar Daily
7 hours ago
- Sinar Daily
Too young, too heavy: Malaysia's rising childhood obesity crisis
KUALA LUMPUR - Like any other teenager, Muhammad Mikhael Qaiser Mohd Yuzaini longs to participate in sports and physical activities. But the 14-year-old tires easily, neither can he stand for extended periods or handle physically demanding tasks. The main reason: his weight. As of early March this year, he weighed in at 103 kilogrammes (kg), a figure considered obese for his height of 168 centimetres (cm). According to the World Health Organisation (WHO), Malaysia has one of the highest childhood obesity rates in Southeast Asia. - Photo illustrated by Sinar Daily "I'm truly determined to lose weight this year because I want to live a healthier and more active life,' declared Muhammad Mikhael Qaiser, who is fondly known as Mikhael and is currently undergoing treatment to reduce his weight. Childhood obesity has become a global health crisis, with poor dietary habits and sedentary lifestyles, fuelled by screen time and lack of physical activity, contributing to this "epidemic'. According to the World Health Organisation (WHO), Malaysia has one of the highest childhood obesity rates in Southeast Asia. Childhood obesity in Malaysia has been on a steady rise over the past 15 years, with over 30 percent of children aged five to 17 classified as overweight or obese in 2022. (Under the United Nations Convention on the Rights of the Child and Malaysia's Child Act 2001, a child is defined as anyone under the age of 18.) Meanwhile, a study titled 'Prevalence of Childhood Overweight and Obesity in Malaysia: A Systematic Review and Meta-analysis' published in November 2024, found that the prevalence of childhood overweight, obesity and excess weight in Malaysia almost doubled over a 26-year period from 1996 to 2022. According to WHO, in 2022, 37 million children under the age of five were overweight; and over 390 million children and adolescents aged five to 19 years were overweight, including 160 million who were living with obesity. Overweight is a condition of excessive fat deposits in the body, while obesity is a chronic complex disease defined by excessive fat deposits that can impair health. Obesity can lead to increased risk of type 2 diabetes and heart disease. It can also affect bone health and reproduction, and increase the risk of certain cancers. Obesity influences the quality of living, such as sleeping or moving. The diagnosis of overweight and obesity is made by measuring people's weight and height and by calculating the body mass index (BMI): weight (kg)/height² (m²). The body mass index is a surrogate marker of fatness and additional measurements, such as waist circumference, can help the diagnosis of obesity. The BMI categories for defining obesity vary by age and gender in infants, children and adolescents. STRUGGLES OF A TEENAGER In 2021, when Mikhael was 11 years old and weighed 70 kg, he was offered the opportunity to participate in a study conducted by paediatric specialists at Universiti Malaya Medical Centre (UMMC) to address his obesity issue. His parents were informed that as part of the study, Mikhael had a 50 percent chance of receiving either an actual weight loss medication or a placebo. Wanting to help their only child shed his excess weight, Mikhael's parents agreed to let him join the study. Over the course of the four-year programme, Mikhael received injection-based treatment. But by the time the programme ended, his weight did not decrease. Instead, it continued to rise, reaching 103 kg by early Ramadan (March) this year. (It was later confirmed that Mikhael had been placed in the placebo group, meaning he did not receive the actual medication throughout the study period. This explained why there was no significant change in his weight despite the structured programme). This concerned his parents, prompting them to refer Mikhael back to the Paediatric Obesity Clinic at UMMC, which has been operating since 2006, for further treatment in hopes that he could eventually reach a healthy weight of around 65 to 70 kg. Starting in April, Mikhael has been advised to take an oral medication, Metformin 500 mg, once daily, and after two weeks, two pills per day to help improve insulin efficiency. He is also required to meet with a doctor every three months for follow-up treatments. Meanwhile, his father Mohd Yuzaini Abu Bakar, 48, who resides with his family in Taman Medan in Petaling Jaya, Selangor, said Mikhael had been cute and chubby since infancy. He said Mikhael loved milk and could finish eight big bottles of formula milk per day until the age of three. Mohd Yuzaini, a medical laboratory technologist at UMMC, said he and his wife began consulting a paediatrician when their son was four years old due to concerns about his rapid weight gain. Since both parents work at UMMC, they were more exposed to health issues and found it easier to access medical support. On Mikhael's eating habits, Mohd Yuzaini said he loves to eat and is not picky about food. "Whether it's home-cooked or food bought outside, he's fine with it, even trendy or viral food and drinks. There was a time when, every time we went out, he insisted on getting a drink from a popular coffee chain, even though we knew it was high in sugar. As parents, sometimes we just couldn't say no to him,' he said. Mohd Yuzaini said on their way to work every morning, they would drop Mikhael off at the babysitter's house before he went to school. "At the babysitter's, he would usually buy nasi lemak or fried noodles from a nearby shop for breakfast… his favourite. "At school, during recess, he would eat nasi lemak or fried noodles again. After school, he would return to the babysitter's house and get ready to go to the religious school (tahfiz school) in the afternoon. His mother would usually pack lunch for him with extra portions, just in case he got hungry later. "At the tahfiz school, food is also provided, and it's common for people to donate meals there. After school ends at around 7 pm, we would all have dinner together,' he said, adding snacks like biscuits and chocolates as well as bread, fruits and instant noodles were readily available at home in case Mikhael got hungry at night. HIDDEN GENETIC RISKS Sharing that Mikhael's obesity is likely not solely due to his diet, Mohd Yuzaini said it may be influenced by genetic factors although no medical tests have been carried out to confirm this. "Many members of my family, including me, have obesity issues,' he said, adding his weight once peaked at 165 kg (his height is 176 cm). "In the past, I used to be active in rugby. When we're involved in sports, we eat and stay active, so we are able to keep our weight under control. But later on, I stopped playing rugby and focused on my job… I became physically less active and started to gain weight.' Mohd Yuzaini, who has six siblings and is the eldest, said his immediate younger sibling passed away due to heart disease caused by obesity. "Another two siblings are also obese, with one of them having had a leg amputated due to diabetes,' he said, adding that in 2007, he decided to undergo bariatric surgery after his doctor warned he would eventually develop diabetes, hypertension and heart disease if he did not undergo the procedure. Mohd Yuzaini experienced weight loss after the surgery and two years later, his weight dropped to 107 kg from 165 kg. "Since then, I've been maintaining my weight and if it increases, it's only slightly. Thankfully, my previous borderline blood pressure (readings) and sugar levels have stabilised,' he said. Commenting on the treatment Mikhael is currently receiving, Mohd Yuzaini said it combines the expertise of three clinics - paediatrics, sports medicine and dietetics - and is administered by the Paediatric Obesity Clinic at UMMC. Doctors at the sports medicine clinic gave several exercise recommendations for Mikhael, such as walking up and down the stairs for 30 minutes daily and using a portable pedal exerciser that can be used anytime and anywhere. Said his father: "We tried it (exercises) during the fasting month (this year) and, thankfully, after the festive season, we saw his weight drop by three kg. "We'll continue with the suggested approach, combining (intermittent) fasting with exercise… we're aiming for Mikhael's weight to drop to 90 kg by the end of this year.' FAMILY DIET CHANGES Mohd Yuzaini said he and his wife Zaliza Mat Som, 58, have also started controlling their son's diet. "We've implemented a kind of intermittent fasting for him… he skips breakfast as advised by the doctor and he is allowed to eat during break time at school. "For his lunch and dinner, we've reduced his portions - he is allowed just a fistful of rice (low glycemic index). We've also cut down on oily and fatty foods, while adding more vegetables and fruits (to his diet),' he added, stressing that dieting is important because Mikhael's current weight puts him at risk for prediabetes. Mohd Yuzaini also said that through changes in his family's eating patterns and by exercising regularly, even his wife has experienced weight loss. "We want to support Mikhael in achieving his ideal weight, so we too have to make changes towards a healthier lifestyle,' he said. Mohd Yuzaini, meanwhile, suggested that health programmes involving nutritionists, fitness trainers and counsellors be conducted more frequently in schools for students as well as their parents, so they are better informed on how to tackle obesity while also raising awareness about obesity-related diseases. "Parents should also be informed of their children's (physical) condition, especially when their schools conduct certain tests like the 'Ujian Standard Kecergasan Fizikal Kebangsaan Untuk Murid Sekolah Malaysia' (SEGAK), which can indirectly help prevent obesity among students,' he added. SEGAK is a mandatory physical fitness test conducted twice a year in all government schools in Malaysia, designed to measure students' physical fitness levels based on health indicators. PARENTS MUST LEAD While Mikhael's family is doing their part, experts say the real change must start at home - and with consistent parental support. Sharing his views, fitness coach Kevin Zahri, popularly known as 'Cikgu Fitness Malaysia', said parents must become role models for their children, not just in terms of behaviour but also lifestyle, personal health and nutrition, and should always practice the principles of 'lead by example' and 'walk the talk'. According to him, being overweight or obese at a young age not only affects physical health but can also impact a child's emotions, self-confidence and mental well-being. "A sedentary and inactive lifestyle is easily carried over into adulthood and difficult to change. Therefore, parents need to help children set boundaries for screen time and video games, and ensure that they are consistently involved in physical activities. "Physical activity or recreational time should not be treated as a 'special occasion' but rather made part of a child's daily routine to nurture their mental, emotional and physical development from an early age,' he said. Touching on his '30-Day Health Challenge' online programme, held monthly throughout the year, Kevin said the response has been very encouraging, with many families participating to support children who struggle with excess weight and obesity. "Many parents initially wanted to enrol only their overweight children in the programme, but I encouraged them to join as a family. This is to prevent the child from feeling ashamed, stressed or having low self-esteem. "It turned out that my approach not only makes the programme more enjoyable for the whole family but they also get to lead a healthier lifestyle. With the 'fit family' concept, it becomes more meaningful as they spend quality time together and support each other,' he said, adding parents should not rely solely on doctors or schools to look into their children's health. Kevin added that while supplements can be used, for example by athletes or to make up for certain nutrient deficiencies, they are not a substitute for real food because what is more important is making healthy food choices to maintain good health. "My daughter is a national tennis player, while my son goes for football training four times a week. They both take supplements, including multivitamins, to support their growth and cover any nutritional gap. "As parents, we must take responsibility in leading our own 'circle of influence', which is our family. Start small, like doing physical activities together every Saturday, such as walking, playing badminton or pickleball,' he said, adding that more information about his programme is available at In conclusion, Mikhael's experience underscores the complex web of factors that contribute to childhood obesity - from possible genetic predisposition and family lifestyle to eating habits and emotional influences. His journey also reflects the harsh reality faced by many Malaysian children whose health is silently shaped by daily routines, social norms and limited physical activity. His story is not unique but rather a wake-up call. If childhood obesity continues to be overlooked or normalised, the long-term consequences on health, well-being and national productivity could be severe. Early intervention, family support and stronger public awareness are crucial to change the narrative - one child, one household at a time. Tomorrow: From type 2 diabetes to fatty liver and sleep apnoea, part two explores the risks of non-communicable diseases (NCDs) in children due to obesity, and highlights the importance of early treatment and public awareness. (This story was produced under the "Communicating Noncommunicable Diseases' Media Fellowship by Probe Media Foundation Inc [PMFI], Reporting ASEAN [RA] and World Health Organization [WHO]. The views and opinions expressed in this piece are not necessarily those of PMFI, RA and WHO.) - BERNAMA
