PETALING JAYA: An expert has warned that stunting – a silent crisis that begins in the womb and strikes hardest in the first 1,000 days – leaves lifelong scars that school-based feeding programmes alone are powerless to reverse.
Although school menus are designed by licensed dietitians and typically include rice, vegetables, protein and milk, the meals also serve as a nutritional safety net for children from low-income households, whose diets may lack essential nutrients at home.
Universiti Teknologi Mara Faculty of Applied Sciences senior lecturer Dr Azizah Othman said existing school meal programmes, while beneficial, are not sufficient to fully address stunting among pupils.
“By this age, stunting has often already occurred, so nutritional interventions that begin only at school-going age are usually too late to reverse the physical and cognitive impacts.
“Stunted growth has long been considered permanent after the age of two, but new research shows partial recovery is possible even after the age of five with proper diet and healthcare,” she said.
Azizah stressed that although early intervention remains the most effective strategy, efforts after age five can still significantly improve a child’s health and development, underscoring the need for continued support for stunted children at all ages.
She explained that while full height restoration to genetic potential becomes less likely with age, targeted interventions, such as nutrient-rich supplements, infection control and a healthier diet, can promote catch-up growth in muscle mass, organ function and cognitive performance.
“Parents and teachers can spot early signs of stunted growth by monitoring physical development and daily behaviours. A consistently modest height gain for age, reflected in static growth charts or clothing that is not quickly outgrown, is a key red flag.
“A child who avoids nutritious food, eats slowly, falls sick often, tires easily during play or appears smaller than peers may be showing signs of poor growth,” she added.
While low weight-for-age is not always a direct indicator, Azizah noted that persistent underweight combined with developmental delays, such as late motor milestones, should raise concern.
She said poor growth is primarily caused by prolonged protein deficiency, which disrupts cell development and hormone production, along with shortages of essential nutrients such as iron (for brain function and oxygen flow), zinc (for DNA and immune health), and calcium or vitamin D (for bone development).
“These deficiencies often occur together, creating a cycle where poor nutrition reduces appetite and absorption, while frequent infections, worsened by a weakened immune system, further drain nutrients.
“To prevent these gaps from becoming permanent, it is vital to bridge them with diverse diets, supplements and effective infection control,” she said.
Azizah acknowledged that Malaysia has introduced several measures to combat stunting, led by the Health and Education Ministries under the National Plan of Action for Nutrition of Malaysia 2016 to 2025, which adopts a life-course approach to improving national nutrition.
Initiatives such as the Rancangan Makanan Tambahan programme provide nutritious meals to primary school pupils from low-income families, while nationwide nutrition education and health campaigns aim to raise awareness.
“However, despite these efforts, stunting remains a pressing concern, particularly in rural and underserved communities.
“Strengthening inter-agency collaboration, prioritising early-life nutrition and addressing social determinants such as poverty and education will be key to achieving lasting progress,” she said.
In March, the Education Ministry reported that more than 90,000 pupils aged between 10 and 12 were affected by stunted growth last year, based on findings from the National Physical Fitness Standard and Body Mass Index analysis.
