Hidden hunger: How dairy can help tackle the triple burden of malnutrition among South East Asian children

Children drinking milk in school
Children drinking milk in school (Getty Images)

South East Asian children are facing the triple burden of malnutrition – undernutrition, overnutrition, and micronutrient deficiencies, with the latter, known as ‘hidden hunger’, emerging as an alarming trend.

This is according to new data from the South East Asian Nutrition Surveys (SEANUTS II), which aims to provide up-to-date information on the nutritional status, dietary intake, and lifestyle behaviours of children in the South East Asian region.

SEANUTS II was built on the 2012 study SEANUTS I. Both were funded by dairy giant Friesland Campina.

Teams from universities in Indonesia, Malaysia, Thailand, and Vietnam were responsible for study design and data collection. Around 14,000 children aged between six months to 12 years were recruited for SEANUTS II.

Overall, SEANUTS II shows that malnutrition – specifically stunting and anaemia – still exists in South East Asia, particularly among younger children. However, among older children, there is a higher prevalence of overweight and obesity – indicators of overnutrition.

Crucially, most children do not meet the average needs of micronutrients, especially calcium and vitamin D, which are important for growth and development of bones. Furthermore, vitamin D is required for supporting the immune system.

These findings point to a need for targeted nutritional interventions, which involves incorporating dairy to improve the nutritional profile of South East Asian children.

“We see real opportunities in this multi-stakeholder approach because we’re really encouraged by the fact that more governments are seeing dairy as an essential part of growing up healthy,” said Corine Tap, President Asia at Friesland Campina.

Accessible nutrition through collaborations

Tap highlighted a three-pronged strategy to address malnutrition – collaboration, accessibility, and education.

The first involves collaborations with governments and NGOs.

“This is mainly through school programmes, where we help make available nutritious dairy products. We work with the ministries of education and health because schools are an important platform for [disseminating] nutritional information.

“While working with governments to address nutrient deficiencies at the country level, we collaborate with NGOs and private sectors to conduct education campaigns at the community level,” said Tap.

This encourages multi-stakeholder collaboration, ensuring overall support and that governments prioritise nutrition in their policies.

For example, school programmes targeted at growth stunting are key initiatives of newly elected President Prabowo Subianto in Indonesia.

“We are one of the pilot partners in Indonesia’s school milk and school meal programmes, where the free lunch for schoolchildren includes one carton of milk. The pilot data will help to scale these programmes up on a larger scale to the rest of the country,” said Tap.

This leads to the next point of driving affordability and accessibility.

“Most of these products are fortified with appropriate nutrients that can be tailored to meet the dietary needs of specific populations. They come in various sizes at the right price points to ensure affordability. And to be accessible, we aim to be present in the many shops that parents buy from,” said Tap.

Pack sizes are varied to cater for different needs, such as a one-litre pack for family breakfasts, and smaller packs for children, which could be 100–110 ml or 215–225 ml for larger children and young adults.

Thirdly, Tap advocates a “systematic grassroots approach” to drive education campaigns that explain the benefits of milk consumption, as well as initiatives to help scale up milk production, improving food security within the country.

“We systematically reach out to communities, including schools and healthcare centres, through our brands and local teams.

“We also help farmers by setting up cooperatives so that they can work together and receive help on how to ensure good quality and quantity of milk,” said Tap.

Other dairy initiatives include one in Malaysia, where 78,000 children benefited from school programmes, through which Friesland Campina provides 21 million cartoons of milk a year.

In Thailand, the firm donated one million cartons of omega-fortified dairy products to vulnerable children through its One Million Smiles campaign.

For Vietnam, the firm promotes access to dairy through its Dutch Lady brand. It is also working with the government to improve labelling clarity, helping parents and caregivers choose the right products for their children.

In the Philippines, the firm offers nutrient-dense solutions through its Alaska brand, which include small milk packs that fit within daily budgets of low-income families.

There is also a culinary range for Filipino dishes that use milk. This provides an additional way through which children can access the required nutrients.

In essence, the goal is to build on SEANUTS II insights and fine-tune formulations for specific countries that have differing needs.

‘Alarming’ statistics

SEANUTS II revealed that more than 70 percent of children in South East Asia lack calcium, and more than 80 percent lack vitamin D.

Additionally, 24–40 percent of children younger than four years old were found to be anaemic, which can impact cognitive development, physical growth, and immunity.

The results also showed that in Indonesia, 15% of children aged 7–12 are overweight or obese, compared to 30–32% in Malaysia, Thailand, and Vietnam.

There was also a clear divide between rural and urban children.

“We see more overweight issues in urban areas, while stunting is more prevalent in the rural regions.

“However, micronutrient deficiency is across the board. Governments have focused a lot on stunting or overweight and obesity, but hidden hunger is a rising, alarming concern – a child may appear healthy but suffer from critical nutrient deficiencies affecting growth,” said Tap, who attributed these phenomena to affordability issues, dietary habits, and knowledge gaps.

Economic barriers, exacerbated by COVID-19 and post-pandemic inflation, have made nutritious foods like dairy less accessible, even for the middle class.

Furthermore, starchy meals are staple in these regions – rice and noodles, for example, are low in protein and micronutrients, with milk rarely included.

Many parents and caregivers also remain unaware of the nutritional gaps in their children’s diets.

To address these issues, the firm is working closely with these countries from its development centre based in Singapore.

“We’re doing this through collaboration, expanding school programmes, community-based initiatives, and leveraging data. This data, for us as a community and an industry, can guide policies and regulations.

“The goal is to see improvements in the next SEANUTS study, rather than flatlining or decline. With this data, we can work together to move forward and hopefully achieve meaningful progress in the next study,” concluded Tap.