Peer-reviewed article
Prevalence and factors associated with undernutrition among preschoolers in low-income urban households in Malaysia.
Abdul Wahid AH, Abdul Manaf Z, Hamzaid NH, Abdul Hamid H, Sutan R ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined undernutrition among preschool children aged 4-6 years from low-income urban households in Kuala Lumpur, Malaysia. Researchers measured 326 children and found that 34.7% were undernourished, with underweight being most common at 29.8%. The strongest risk factors were maternal underweight, chronic disease in the child, and older child age, while socioeconomic factors like income and parental education were not significantly associated with undernutrition. The findings suggest that biological and family factors, rather than poverty alone, drive undernutrition in this urban setting.
Key points
- Undernutrition prevalence was 34.7% among preschoolers; underweight (29.8%), stunting (16.0%), and wasting (12.0%) were identified
- Maternal underweight showed the strongest association with child undernutrition (aOR 13.40)
- Chronic disease in the child was significantly associated with undernutrition (aOR 3.49)
- Parental income and education level were not significant factors, contrary to typical socioeconomic patterns
- Higher parental involvement in feeding was unexpectedly associated with increased odds of undernutrition
Limitations
This is a cross-sectional survey that identifies associations but cannot establish causation or explain the counterintuitive finding that higher parental feeding involvement was associated with more undernutrition. The study is limited to one city in Malaysia and may not be generalisable to other urban or rural settings.
Abstract
Undernutrition remains a persistent public health concern, particularly among preschool-aged children, despite significant economic progress in Malaysia. This study aimed to determine the prevalence of undernutrition and identify its associated factors among preschoolers from low-income urban families. A cross-sectional survey was conducted from April to August 2025 among 326 children aged 4-6 years attending government subsidised preschools in Kuala Lumpur, the capital city of Malaysia. Anthropometric measurements including weight, height, Body Mass Index (BMI), mid-arm circumference (MUAC) were taken, and mothers completed a structured questionnaire covering sociodemographic characteristics, child health history, and the Malaysian Comprehensive Feeding Practices Questionnaire (CFPQ-M). Undernutrition was defined as the presence of underweight, stunting, or wasting that complied to WHO standards. Multivariate binary logistic regression performed to identify factors associated with undernutrition. The prevalence of undernutrition was 34.7% with underweight, stunting, and wasting recorded at 29.8%, 16.0%, and 12.0%, respectively. Factors associated with undernutrition included child age ≥ 60 months (adjusted odds ratio [aOR] = 2.42; 95% CI 1.17-5.00), low birth weight (aOR = 0.24; 95% CI 0.11-0.53), presence of chronic disease (aOR = 3.49; 95% CI 1.08-11.36), and maternal underweight (aOR = 13.40; 95% CI 1.13-159.38). Higher parental involvement in feeding (aOR = 1.31; 95% CI 1.07-1.61) and lower restriction for weight control (aOR = 0.92; 95% CI 0.87-0.97) were also associated with increased odds of undernutrition, whereas socioeconomic variables such as parental income and education level were not significant. Undernutrition among preschoolers from urban low-income households in Kuala Lumpur remains prevalent and was more consistently associated with biological and familial factors, including intergenerational influences, than with socioeconomic characteristics within this study population. These findings highlight the importance of integrated interventions focusing on maternal nutrition, early growth monitoring, and evidence-based caregiver feeding support to reduce intergenerational undernutrition risk.