Exploring protein quantity and quality in Malaysian diets

From the Drewnowski research group, Public Health Sciences Division

Global dietary patterns present a paradox shaped by economic, cultural, and health-related factors. In many developing regions, economic growth leads to a shift from traditional plant-based diets to increased consumption of animal proteins—particularly meat. This transition is fueled by rising income, urbanization, globalization, and cultural perceptions associated with meat consumption, often seen as a symbol of wealth and a well-rounded diet. On the flip side, countries such as the United States are witnessing a growing trend towards plant-based diets. This shift is motivated by concerns for health, the environment, and ethical considerations regarding animal rights. Such divergent dietary trends underscore the complexity of global food consumption patterns, where economic development and health and environmental awareness create contrasting shifts in dietary habits.

A recent study conducted by the Socio-Cultural Research in Protein Transition (SCRiPT) team and featured in the Asia-Pacific Journal of Public Health provides a detailed examination of the protein consumption patterns in Malaysia. In this research, Dr. Drewnowski and his colleagues evaluated the quantity and diversity of protein sources, focusing on how these vary across different socio-demographic groups within the Malaysian population. The Fred Hutchinson Cancer Center has been at the forefront of developing new methods of dietary intake assessment, including the pivotal food frequency questionnaire for the Women's Health Initiative. Additionally, the Center has led the way in establishing brief dietary screeners targeting specific food groups. In this project, Dr. Drewnowski and his team concentrated on evaluating dietary protein sources amidst a backdrop of evolving dietary patterns and the ongoing nutrition transition in Malaysia.

Estimates of total protein intake in g/day from the protein diversity indicator (PDI) (a) and estimates of total protein intake in g/day from PDI by food group (b).
Estimates of total protein intake in g/day from the protein diversity indicator (PDI) (a) and estimates of total protein intake in g/day from PDI by food group (b). Image provided by Dr. Drewnowski.

The study employed a stratified random sampling methodology, drawing from the Malaysian Adult Nutrition Survey. It included more than 1600 Malaysian adults from various regions of the country, ensuring a mix that represented different urbanization levels, genders, ages, and ethnicities. Data were collected by the Protein Diversity Indicator (PDI) and were compared to data obtained from a single 24-hour dietary recall completed by the same study participants. The 29-item PDI is a new questionnaire designed to assess protein diversity and quality in food in the past day or night, which is less resource-intensive than conventional dietary intake assessment methods such as diet histories and 24-hour recalls that involve participants listing all foods and drinks consumed in the previous 24 hours or a more extended period.

Overall, the study revealed interesting patterns in protein consumption in Malaysia. The average protein intake was found to be 75.2 g/day from the 24-hour dietary recall and 74.9 g/day from the PDI, indicating general adequacy in protein consumption. Protein intakes varied across socio-demographic lines, with higher intake associated with males, high- income, high-education, and Chinese ethnicity. The composition of protein sources in the diet was widely distributed, with meat and poultry contributing 36.2%, fish accounting for 8.8%, eggs and dairy making up 16.0%, and plant-based proteins forming 39.0%. The analysis highlighted a trend where the consumption of animal-based proteins was notably higher among the younger, more educated, affluent demographics, as well as among single individuals residing in urban areas. Conversely, the consumption of traditional Malaysian staples, like fish and rice was more associated with rural settings and lower socio-economic status. This shift in dietary patterns is attributed to the rapid modernization in Southeast Asia and the increased availability of fast foods.

In conclusion, the study demonstrates that short dietary assessment instruments like the PDI can effectively assess protein nutrition and amino acid adequacy across various population subgroups in low- and middle-income countries. The PDI can be adapted for other countries in Southeast Asia to serve a broader global health purpose. Such adaptations and future trials will be crucial for validating its use in different cultural contexts and among populations with varying levels of nutrition.

Dr. Drewnowski's latest research investigates the protein consumption patterns on the global scale and the phenomenon of peak meat consumption. His team is examining whether the trajectory of future dietary habits can be predicted based on fundamental laws of economics. The goal is to achieve affordable nutrient density for all. Can this be done without relying on animal proteins and fortified processed options?


This study received support from Ajinomoto Co. Japan. The study was conducted in collaboration with research teams at Taylor's University in Kuala Lumpur, Malaysia, and SEAMEO in Jakarta, Indonesia.

Fred Hutch/UW/Seattle Children’s Cancer Consortium member Dr. Adam Drewnowski contributed to this work.

Drewnowski, A., Monsivais, P., Mognard, E., Ismail Noor, M., Karim, N., Laporte, C., Alem, Y., & Poulain, J. P. (2024). A Short Dietary Assessment Instrument to Evaluate Protein Quality and the Diversity of Protein Sources in Malaysian Diets. Asia-Pacific journal of public health, 10105395231219049. Advance online publication.