However, many children tend to be picky eaters and only consume foods they like, particularly fried and sugary items. Some even refuse to eat vegetables altogether.
These challenges become even greater during the months of Ramadan and Syawal, when an abundance of food options is available.
According to experts, if such eating patterns persist, children are at risk of developing various long-term health issues including iron deficiency anaemia (IDA), a condition caused by insufficient iron levels leading to a lack of red blood cells.
This, in turn, affects oxygen supply throughout the body, which can have serious consequences on a child’s growth, particularly in terms of brain development and learning abilities.
Experts say that IDA, which is also observed among pregnant women, is not a “minor problem that can be easily resolved”.
Based on the 2022 National Health and Morbidity Survey, anaemia prevalence remains high in Malaysia: nearly 46% of children below age five (or one in two), and two out of five pregnant women in Malaysia were reported to be affected by this condition.
Senior consultant paediatric endocrinologist Dr Muhammad Yazid Jalaludin describes IDA as a “silent pandemic”, mainly because it develops unnoticed. According to his research, one in three children in Malaysia is at risk of anaemia.
“The risk is higher among young children between six and 12 months old, and those underweight for their age, because their iron needs are greater than those of adults owing to their rapid physical and cognitive growth,” he said.
Yazid said while IDA can have a significant impact on an individual’s life, it often goes unnoticed due to subtle symptoms such as paleness, irritability, fatigue, increased heart rate, and angular cheilitis (inflammation of one or both corners of the mouth).
“In addition to affecting children’s physical growth and cognitive development, prolonged iron deficiency can also weaken the immune system, making them more susceptible to various illnesses.
“In pregnant women, IDA can lead to severe complications for both mother and baby, including premature birth and sudden infant death. IDA has also been associated with postpartum depression,” he said in a recent interview with Bernama.
Yazid, who was the lead researcher for the 2023 Iron Strong Danone Study involving 1,201 children under four years old at selected health clinics, noted that IDA occurs in children in both urban and rural areas.
“What concerns us is that unbalanced eating habits, including excessive intake of foods high in fat, sugar and salt, remain prevalent among the population, further exacerbating iron deficiency.
“Many foods sold, especially at Ramadan bazaars, contain little or no iron. Delicious, popular items such popiah and traditional kuih often lack sufficient iron content,” he said.
He added that the period from early Ramadan to Aidilfitri can be a high-risk time for developing IDA if food choices are not made wisely.
“Although IDA usually develops over a long term, prolonged iron deficiency can worsen an existing condition. In this context, food providers play a crucial role in offering nutritious and balanced meals.
“Use fresh, iron-rich ingredients such as leafy greens, red meat, chicken and fish. Reduce processed foods and offer more fresh fruits. For children’s beverages, choose plain water or milk and avoid sweetened drinks to support their healthy growth,” he advised.
To address IDA more effectively, Yazid suggested that the government should introduce mandatory periodic screening for children, particularly those aged under five, who are among the most vulnerable to anaemia.
Regular screenings can help detect the condition early, and allow parents and caregivers to take proactive steps to ensure their children receive adequate nutrients, he concluded.