THE STATUS OF FISH IN MALAYSIAN DIETS AND
POTENTIAL BARRIERS TO INCREASING CONSUMPTION OF FARMED SPECIES

Ee Von Goh

Thesis submitted to the University of Nottingham Malaysia Campus for the degree of Doctor of Philosophy
2018

Abstract………………………………………………………………………………………………………………………………………….i Dedications and Acknowledgements……………………………………………………………………………………………..ii List of Tables…………………………………………………………………………………………………………………………………iii List of Figures…………………………………………………………………………………………………………………………………v List of Abbreviations.…………………………………………………………………………………………………………………….vi

Chapter 1: Introduction

1.1 The Concept of Sustainable Diet for Human Health…………………………………………………………1
1.1.1 Indicators for Sustainable Consumption…………………………………………………………..3
1.2 The Importance of Fish in the Livelihood of Malaysian ……………………………………………………5 1.3 Fish Consumption Pattern in Malaysia………………………………............................................... 8 1.4 Fish Purchasing Behaviour of Malaysian…………………………………………………………………………. 9 1.5 Status of Malaysian Fishery Industry……………………………………………………………………………. 12
1.5.1 Marine Capture Fisheries……………………………………………………………………………… 12 1.5.2 Aquaculture……………………………………………………………………………………………………13 1.5.3 Post-Harvest Utilisation………………………………………………………………………………… 14 1.5.4 Assessing the Sustainability of Fishery Production……………………………………….. 15 1.5.5 The (Un)Sustainability of The Wild Fish Supply……………………………………………… 16 1.5.6 General Perceptions of Fish Farming and Farmed Fish……………………………………20
1.6 Stakeholders’ Roles in Fish Sustainability……………………………………………………………………… 23 1.7 Addressing Issues of Sustainability in the Aquaculture Sector………………………………………. 25 1.8 Thesis Outline………………………………………………………………………………………………………………. 26

Chapter 2: Research Methodology and Design

2.1 Introduction…………………………………………………………………………………………………………………. 27 2.2 Research Problem and Approach…………………………………………………………………………………. 27 2.3 Research Questions and Operational Definitions…………………………………………………………. 30 2.4 Study Design………………………………………………………………………………………………………………… 31
2.4.1 (R1) What is the fish-eating habit in Malaysia?................................................. 31
2.4.1.1 Selecting Tool for Dietary Assessment…………………………………………… 33
2.4.1.1.1 Dietary (or Food) Records……………………………………………… 33 2.4.1.1.2 Dietary History (Burke Diet History)………………………………. 34 2.4.1.1.3 Twenty-four Hour Recall Method……………………………………35 2.4.1.1.4 Food Frequency Questionnaire……………………………………….35
2.4.1.2 Adaptation of the FFQ…………………………………………………………………… 37 2.4.1.3 Validity of Food Frequency Questionnaires Measuring Fish Intake…39
2.4.2 (R2) Is Their Fish Consumption Habit Sustainable? ………………………………………..40 2.4.3 (R3) What are The Barriers and Opportunities for Expansion of The Aquaculture
Market?..................................................................................................... 41
2.4.4 (R4) What is The Fish Purchasing Behaviour in Malaysia?................................ 43 2.4.5 (R5) What are The Public Perceptions of Farmed Fish?.................................... 45
2.5 Selection of the Study Area………………………………………………………………………………………….. 45 2.6 Ethical Consideration……………………………………………………………………………………………………. 47 2.7 The Layout of the Thesis………………………………………………………………………………………………. 50

Chapter 3: The Nutrition and Health Transition in Malaysia

3.1 Introduction…………………………………………………………………………………………………………………. 51 3.2 Methods ……………………………………………………………………………………………………………………… 51
3.2.1 Demographics and Socio-economic Data……………………………………………………… 51 3.2.2 Food and Health Data…………………………………………………………………………………… 52
3.2.2.1 Food Balance Sheets (FBS) – 1980 to 2013……………………………………. 52 3.2.2.2 Malaysian Adult Nutrition Survey (MANS) - 2003 & 2014……………… 53 3.2.2.3 National Health and Morbidity Survey (NHMS) – 1986 to 2015…….. 54
3.3 Results…………………………………………………………………………………………………………………………. 55
3.3.1 Demographic Transition……………………………………………………………………………….. 55 3.3.2 Economic and Social Transition…………………………………………………………………….. 55 3.3.3 Food Consumption Changes…………………………………………………………………………. 58 3.3.4 Household Food Insecurity in Malaysia…………………………………………………………. 64 3.3.5 Changes in Nutrient Intake…………………………………………………………………………... 65 3.3.6 Prevalence of Selected NCD and NCD Risk Factors………………………………………… 66
3.3.6.1 Prevalence of Diabetes…………………………………………………………………. 67 3.3.6.2 Prevalence of Hypertension……………………………………………………………68 3.3.6.3 Hypercholesterolemia…………………………………………………………………….68
3.3.7 Malnutrition…………………………………………………………………………………………………. 69 3.3.8 Causes of Death……………………………………………………………………………………………. 70
3.4 Discussion……………………………………………………………………………………………………………………. 71 3.5 Conclusion……………………………………………………………………………………………………………………. 74

Chapter 3: Malaysian Fish Consumption Habits and Its Sustainability

4.1 Introduction…………………………………………………………………………………………………………………. 75 4.2 Methods………………………………………………………………………………………………………………………. 76
4.2.1 Study Design…………………………………………………………………………………………………. 76 4.2.2 Study Subjects………………………………………………………………………………………………. 76 4.2.3 Development Process of the FFQ………………………………………………………………….. 77 4.2.4 Validation of FFQ………………………………………………………………………………………….. 78 4.2.5 Misreporting of Energy and Nutrient Intake…………………………………………………. 78
4.2.5.1 Determinants of Misreporting………………………………………………………. 79 4.2.5.2 Methods Used to Identify Mis-reporters ………………………………………. 79 4.2.5.3 Reporting of Data in Consideration of Mis-reporters………………………80
4.2.6 FFQ Analysis…………………………………………………………………………………………………. 81 4.2.7 Statistical Analysis………………………………………………………………………………………… 82
4.3 Results…………………………………………………………………………………………………………………………. 82
4.3.1 Subjects Characteristics……………………………………………………………………………….. 82 4.3.2 Energy Intake……………………………………………………………………………………………….. 86 4.3.3 Macronutrients Intake………………………………………………………………………………….. 88
4.3.3.1 Carbohydrates Intake…………………………………………….......................... 88 4.3.3.2 Protein Intake……………………………………………………………………………….. 89 4.3.3.3 Fat Intake……………………………………………………………………………………… 94
4.4 Discussion……………………………………………………………………………………………………………………. 95 4.5 Conclusion…………………………………………………………………………………………………………………… 99

Chapter 5: Opportunities and Barriers to the Expansion of the Aquaculture Industry

5.1 Introduction……………………………………………………………………….101 5.2 Methods…………………………………………………………………………..103

5.2.1 Questionnaire for Wholesalers…………………………………………...103 5.2.2 Questionnaire for Aquaculturists…………………………………………104 5.2.3 Administration and Analysis of the Questionnaire………………………...104

5.3 Results…………………………………………………………………………….106

5.3.1 Wholesalers’ Profile……………………………………………………...106
5.3.1.2 Best Selling Seafood Species……………………………………106 5.3.1.3 Purchasing Channel……………………………………………107 5.3.1.4 Barriers and Opportunities of Market Expansion………………..108 5.3.1.5 Wholesalers’ Perceived End-Users’ Attitude about Aquaculture

Products………………………………………………………109

5.3.2 Aquaculturists’ Profile……………………………………………………111
5.3.2.1 Farmed Seafood Species……………………………………….111 5.3.2.2 Distribution Channels of Farmed Fishes…………………………111 5.3.2.3 Aquaculturists’ Perceived Barriers and Opportunities of Market

Expansion……………………………………………………..112

5.3.2.4 Aquaculturists’ Perceived End-Users’ Attitude about Aquaculture

Products………………………………………………………114
5.4 Discussion…………………………………………………………………………115 5.5 Conclusion………………………………………………………………………...118

Chapter 6: Fish Purchasing Behaviours: Perception of Farmed Fish versus Scientific Evidence

6.1 Introduction……………………………………………………………………….119 6.2 Methods…………………………………………………………………………..120
6.2.1 Study Subjects…………………………………………………………...120 6.2.2 Study Design…………………………………………………………….120

6.2.3 Development of Questionnaire…………………………………………..122 6.2.4 Statistical Analysis……………………………………………………….125

6.3 Results…………………………………………………………………………….126

6.3.1 Frequency of Total Fish Consumption…………………………………….126 6.3.2 Preferences and Prevalence of Farmed Fish Consumption………………...126 6.3.3 Determinants at Point of Purchase……………………………………….127 6.3.4 Potential Factors and Barriers Influencing Decision to Buy Fish……………128 6.3.5 Objective and Subjective Knowledge about Fish…………………………..132 6.3.6 General Perceptions of Farmed versus Wild Fish………………………….132
6.3.6.1 Taste and Texture……………………………………………...133 6.3.6.2 Quality and Freshness………………………………………….134 6.3.6.3 Availability and Price Stability…………………………………..135 6.3.6.4 Health Benefits and Contaminant Content……………………...135 6.3.6.5 Consumers’ Appreciation………………………………………136

6.4 Discussion…………………………………………………………………………137

6.4.1 “Farmed fishes are not as fresh as the wild ones” ………………………...138 6.4.2 “The texture of farmed fishes is poorer than the wild ones” ………………141 6.4.3 “Farmed fishes have poorer flavour and odour than the wild ones” ……….143 6.4.4 “Farmed fishes are less nutritious compared to the wild ones” …………...146 6.4.5 “The level of contaminants is higher in farmed than wild fishes” ………….152

6.5 Conclusion………………………………………………………………………...156

Chapter 7: Discussion and Conclusion

7.1 Main Findings……………………………………………………………………..158

7.2 Revisiting Research Problem: Is farmed fish capable of replacing wild-caught fish in the

Malaysian diet? …………………………………………………………………...163

7.3 Implications and Perspectives for Stakeholders …………………………………….164
7.3.1 Improving the Monitoring and Surveillance of Fisheries Activities…………164 7.3.2 Reducing Reliance on Fish Meal as Fish Feed……………………………...165 7.3.3 Establishing Sustainable Dietary Guidelines……………………………….166 7.3.4 Relationship to Previous and Future Research …………………………....168

References Appendix

Appendix A – 24-hour Diet Recall Form Appendix B – 24-hour Dietary Recall Instruction Appendix C – Handout for 24-hour Dietary Recall Appendix D – Food Frequency Questionnaire Appendix E – Food Frequency Questionnaire Portion Sizes Handout Appendix F – Food Frequency Questionnaire Fish Photo Handout Appendix G – Malaysian Dietary Guideline (1) Appendix H – Malaysian Dietary Guideline (2) Appendix I – Latin Names of Commonly Consumed Fish in Malaysia Appendix J – Wholesaler Survey Questionnaire Appendix K – Aquaculturist Survey Questionnaire Appendix L – Consumer Survey Questionnaire Appendix M – Ethical Approval

ABSTRACT

The thesis took an interdisciplinary, problem-oriented approach to address the research problem: ’Is farmed fish capable of replacing wild-caught fish in the Malaysian diet?’ The main objectives of the project were to assess current fish consumption habits, evaluate the impacts of these on sustainability of fish stocks and determine whether aquacultured products could be a suitable substitution. A combination of data collection methods was used, namely dietary assessments, systematic literature review, market research interviews and surveys and analysis of electronic and paper-based official records. The review of the Malaysian food balance sheets showed a significant transition in diet over the last three decades, specifically with respect to an increase in animal protein by approximately 60% over this time, with fish as the major source of protein. To further explore the contribution of fish to the diet of Malaysians, and any ethnic and geographical differences in consumption, a food frequency questionnaire (FFQ) was developed to assess habitual dietary intakes within selected coastal, rural and urban populations across different cultural groups in Klang Valley. The FFQ provided a clearer picture of the quantities of fish consumed by Malaysians and enabled the characterisation of Malaysian fish consumers based on the types of fish species consumed for sustainability assessment purpose. The nutritional contribution of wild versus farmed fish was compared and contrasted. Results from this study, combined with detailed studies of perception of wild versus farmed fish by consumers, aquaculturists and wholesalers, provided a greater understanding of the factors that influence consumers’ fish buying and consumption habits. The key findings are discussed with respect to the sustainability of the current situation, potential for expanding the aquaculture sector to replace wild fish in the Malaysian diet and recommendations for future research and issues for policy makers involved in the expansion of the industry.

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DEDICATION AND ACKNOWLEDGEMENTS

I would like to thank all the people who contributed in some way to the work described in this thesis. First and foremost, I thank my supervisors, Dr Susan Azam-Ali, Dr Fiona McCullough and Dr Soma Mitra. During my tenure, they contributed to a rewarding graduate school experience by giving me intellectual freedom in my work, engaging me in new ideas, and demanding a high quality of work in all my endeavours.

I would like to thank colleagues, friends and family who supported me during the difficult times throughout my doctoral studies.

To my dear mother who faced her too early death bravely…I miss you mum. I wish you were here to witness the completion of my PhD degree.

This work was (financially) supported by Crops For the Future (CFF) and the University of
Nottingham Malaysia Campus (UNMC) through the CFF-UNMC Doctoral Training Partnership scholarship scheme.

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List of Tables

1. The quantity of marine fishes landed in Malaysia from year 2009 to 2014………………………….13 2. The quantity of aquacultured fishes produced in Malaysia from year 2009 to 2014…………….14 3. Typology of individual dietary survey methods………………………………………………………………….. 33 4. Sustainability indicators and their respective sources of information………………………………….40 5. The research questions behind each chapter………………………………………………………………………50 6. Daily per caput dietary energy supply (kcals) by products over the 34-year period…………….58 7. Daily per caput supply of animal and vegetal products in terms of protein over the 34-year period………………………………………………………………………………………………………………………………….62
8. Daily per caput supply of animal and vegetal products in terms of fats over the 34-year period, 1980 – 2013……………………………………………………………………………………………………………63
9. The prevalence of selected risk factors of NCD in adults of 18 years and above …………………66 10. Prevalence of diabetes 18 years old and above…………………………………………………………………..67 11. Prevalence of diabetes 30 years old and above……………………………………………………………………67 12. Prevalence of hypertension 18 years old and above……………………………………………………………68 13. Prevalence of hypertension 30 years old and above……………………………………………………………68 14. Prevalence of hypercholesterolemia 18 years old and above………………………………………………69 15. Prevalence of hypercholesterolemia 30 years old and above………………………………………………69 16. Five major causes of mortality, 1995 – 2014………………………………………………………………………..70 17. Classification of body weight in adults according to BMI……………………………………………………..80 18. Socio-demographic characteristics of subjects of current study vs Department of Statistics
(DoS) Malaysia (2016)………………………………………………………………………………………………………….83
19. Mean BMI of subjects of current study vs MANS 2003 & 2014……………………………………………84 20. Prevalence of different weight status among subjects of different ethnicities in current study vs MANS 2003 & 2014…………………………………………………………………………………………………………85
21. The distribution of energy intake of subjects of current study before exclusion of misreporters vs MANS 2014………………………………………………………………………………………………………86
22. The distribution of energy intake of (kcal/d) subjects of current study after exclusion of misreporters……………………………………………………………………………………………………………………………..87
23. The Mean ± SD intake of Carbohydrates of Subjects of Current Study…………………………………88 24. The Mean ± SD intake of Total Protein and Animal Protein of Subjects of Current Study…….89

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25. The Percentage Contribution of Different Sources of Animal Protein Intake of Subjects of
Current Study………………………………………………………………………………………………………………………90
26. Popularity of top 15 fish and products by prevalence and weight from FFQ of current study…………………………………………………………………………………………………………………………………..91
27. Annual Per Capita Weight (g) of Top 15 Most Consumed Seafood across Different
Geographical Locations in Current Study…………………………………………………………………………….92
28. The distribution of percentage of farmed fish out of the total amount of fish consumed by subjects of current study…………………………………………………………………………………………………….93
29. The Mean ± SD intake of Total Fat, SFA, MUFA and PUFA of Subjects of Current Study………94 30. SWOT analysis as proposed by DoF representatives at 2009 Regional workshop………………102 31. The % figures indicate the percentage of all wholesalers who included that species in their list of Top 5 best selling species in the past year……………………………………………………………….106
32. Export Destinations of Farmed Fish…………………………………………………………………………………..112 33. Consumers’ characteristics………………………………………………………………………………………………..121 34. List of Farmed Fish Species Commonly Available in Klang Valley……………………………………….122 35. Prevalence of different types of fish consumers across different geographical locations….126 36. Fish origin preference across different geographical locations………………………………………….127 37. Self-reported past purchase of farmed fish and/or seafood across different geographical location……………………………………………………………………………………………………………………………..127
38. Mean Likert-scale scores and standard deviations of determinant factors at point of purchase across different ethnic groups & geographical locations………………………….…………129

39. Mean Likert-scale scores and standard deviations of motivating factors of fish purchase across different ethnic groups & geographical locations…………………………………………………..130

40. Mean Likert-scale scores and standard deviations of motivating factors of fish purchase across different ethnic groups& geographical locations ……………………………………………………131
41. Prevalence of different responses towards multiple statements assessing objective knowledge…………………………………………………………………………………………………………………………132
42. Prevalence of consumers with different perceptions towards farmed versus wild fish……..133 43. Content of total fat, Omega 3 fatty acid and EPA+DPA in popularly consumed fishes in
Malaysia….………………………………………………………………………………………………………………………..150

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List of Figures

1. Value of export and import of fishery commodities, 2001 – 2014……………………………………….19 2. Stakeholder Roles in Seafood Sustainability………………………………………………………………………. 23 3. CFF Research Value Chain……………………………………………………………………………………………………25 4. Summary of process flow and exchange of findings between methods………………………………32 5. Map of Malaysia………………………………………………………………………………………………………………….45 6. Location of data collection for consumer surveys……………………………………………………………….47 7. Malaysia GDP from 1960 to 2016………………………………………………………………………………………..56 8. Average percentage of contribution of daily per caput dietary energy supply (kcals) by products based on FBS 1980 – 1984 …………………………………………………………………………………..60
9. Average percentage of contribution of daily per caput dietary energy supply (kcals) by products based on FBS 2010 – 2013 …………………………………………………………………………………..60
10. Average percentage of contribution of daily per caput protein supply (g) by animal products based on FBS 1980 – 1984…………………..………………………………………………………………………………61
11. Average percentage of contribution of daily per caput protein supply (g) by animal products based on FBS 2010 – 2013…………………………………………………………………………………………………..61
12. Percentage contribution of macronutrients to daily energy intake in MANS 2003 and 2014 13. Prevalence of purchasing stock from various sources………………………………………………………….65 14. Distribution channels of wholesalers…………………………………………………………………………………107 15. Wholesalers’ perceived barriers to the expansion of aquaculture industry……………………….108 16. Wholesalers’ perceived opportunities for market expansion…………………………………………….109 17. Wholesalers’ perceived end-users’ attitude about aquaculture products…………………………110 18. Distribution Channels of Farmed Fishes.……………………………………………………………………………111 19. Aquaculturists’ perceived barriers to the expansion of aquaculture industry……………………113 20. Aquaculturists’ perceived opportunities of market expansion…………………………………………..114 21. Aquaculturists’ perceived end-users’ attitude about aquaculture products…………………..… 115

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List of Abbreviations

24HR AHA ALA
24-Hour Recall American Heart Association alpha-Linolenic acid
AMCS ASEAN BDA BMI
Australian Marine Conservation Society Association of Southeast Asian Nations British Dietetic Association Body Mass Index
BMR CAP
Basal Metabolic Rate Consumers Association of Penang Crops for The Future Research Centre Coronary Heart Disease
CFFRC CHD CPG CVD DHA DLW DoFM DoSM DPA EE
Clinical Practice Guidelines Cardiovascular Disease Docosahexaenoic acid Doubly Labeled Water Department of Fisheries Malaysia Department of Statistics Malaysia Docosapentaenoic acid Energy Expenditure

• EFA
• Essential Fatty Acid

• EI
• Energy Intake

• EPA
• Eicosapentaenoic acid

• EPU
• Economy Planning Unit

FAO FBS
Food and Agriculture Organization Food Balance Sheet
FDAM FFQ
Fisheries Development Authority of Malaysia Food Frequency Questionnaire

• Gross domestic product
• GDP

• HBS
• Household Budget Survey

• High Density Lipoprotein
• HDL

HUFA ICD
Highly unsaturated fatty acids International Classification of Diseases

• Individual dietary survey
• IDS

IUCN IUU
International Union for Conservation of Nature Illegal, unreported and unregulated

• Low Density Lipoprotein
• LDL

MANS MSC MUFA NCD
Malaysia Adult Nutrition Survey Marine Stewardship Council Monounsaturated Fatty Acid Non-Communicable Disease National Coordinating Committee on Food and Nutrition
NCFFN vi
NEP NGO NHMS PUFA RNI
New Economic Policy Non-governmental organizations National Health & Morbidity Survey Polyunsaturated fatty acids Recommended Nutrient Intakes

• Standard Deviation
• SD

• SDG
• Sustainable Development Goal

SEAFDEC Southeast Asian Fisheries Development Center

• SFA
• Saturated Fatty Acid

SPSS TEE
Statistical Package for the Social Sciences Total Energy Expenditure World Health Organization World Wildlife Fund
WHO WWF