Over the past six months, we have discussed how to care for an ageing population. We debated pensions, long-term care, caregiver support, age-friendly communities, elder rights and institutional care
Indeed, all these are important. But perhaps we have overlooked the most fundamental question: how do we ensure Malaysians reach old age healthier in the first place?
Healthy ageing does not begin at 60 or 65 years old. It begins during childhood, continues through adulthood, and is shaped every day by the choices we make, the environments we live in, and the policies our leaders prioritise
The foundations of healthy ageing are laid long before the first grey hair appears. Nutrition during pregnancy influences fetal development. Early childhood shapes brain development, bone health and lifelong eating habits
School years establish patterns of physical activity, sleep and emotional resilience. Adolescence influences smoking, alcohol use, and mental well-being
The World Health Organization (WHO) defines healthy ageing not merely as the absence of disease but as the process of developing and maintaining the functional ability that enables well-being in older age
This framework rests on three interrelated components: maintaining intrinsic capacity, preserving functional ability, and creating supportive physical and social environments
Intrinsic capacity refers to the physical and mental capacities a person possesses —strength, mobility, cognition, psychological well-being, sensory function, and vitality
Functional ability reflects whether people can continue doing what matters to them: meeting daily needs, remaining mobile, maintaining relationships, continuing to learn, making decisions and contributing to society
Equally important is the environment — homes, neighbourhoods, workplaces, transport systems and communities — that either enables or limits these abilities
Intrinsic capacity does not suddenly appear in old age. It is built gradually from conception through childhood and adolescence
Children who receive adequate nutrition, opportunities for physical activity, emotional security and quality education are more likely to enter adulthood with stronger physical, cognitive and psychological reserves. These reserves become the foundation that helps people remain resilient as they age
These three components – intrinsic capacity, functional ability, and supportive physical and social environments – remind us that healthy ageing is never solely an individual’s responsibility. It is equally a societal responsibility
Malaysia’s demographic transition therefore requires more than preparing hospitals and nursing homes. It requires a whole-of-society commitment to creating healthier lives decades before people become old
This perspective reflects what <a href="https://healthylife7.com/obesity-driven-ckm-syndrome-a-growing-public-health-threat-warns-american-heart-association/" title="Obesity-Driven CKM Syndrome A Growing Public Health Threat, Warns American Heart Association”>public health experts describe as the life-course approach to healthy ageing. Health is not determined by a single event or one stage of life, but by the cumulative effect of biological, behavioural, social and environmental influences from before birth through older age
Healthy ageing is therefore not a programme for older adults — it is the lifelong outcome of healthy living across every stage of life
This aspiration is also entirely consistent with the United Nation’s Sustainable Development Goals. Good health and well-being (SDG 3), reducing inequalities (SDG 10), sustainable cities (SDG 11), decent work (SDG 8) and partnerships (SDG 17) all converge towards one common objective — allowing people to remain healthy, productive and independent throughout life
Unfortunately, our health system continues to devote far greater attention and re
Despite decades of healthy lifestyle campaigns, smoking cessation initiatives, nutrition education, and physical activity promotion, non-communicable diseases (NCDs) continue to rise
Diabetes, obesity, hypertension and cardiovascular diseases remain among Malaysia’s greatest health challenges. Many of the behaviours responsible for chronic disease are not adopted in middle age. They begin much earlier
Food preferences, attitudes towards exercise, sleep habits, emotional coping, screen use and even health beliefs are largely formed during childhood and reinforced by family, schools and communities
Prevention therefore begins not when disease appears, but when healthy habits are first established. Adolescence represents another critical opportunity. During these formative years, lifelong habits involving smoking, vaping, alcohol consumption, physical activity, nutrition, sleep, and mental health are often established
Investing in young people may yield health dividends that continue for the next five or six decades
Knowledge alone has proven insufficient. Behaviour is far more complicated than information. This is where behavioural insights have become increasingly important
Research around the world has shown that people often know what they should do but struggle to translate knowledge into consistent action. Decisions are influenced by convenience, social norms, habits, emotions, financial constraints and the environments surrounding them
Instead of blaming individuals for poor lifestyle choices, behavioural science encourages us to redesign environments that make healthier choices easier:
- Safe walking paths encourage exercise.
- Affordable healthy food encourages better diets.
- Smoke-free public spaces reduce tobacco use.
- Simple food labelling helps consumers make informed choices.
Healthy defaults in schools — including nutritious meals, regular physical activity and health literacy — can quietly reshape behaviour without coercion and may be among the most powerful public health interventions available
Government policies therefore matter enormously. However, policies alone are still insufficient
People often require sustained support to transform good intentions into lasting habits. This is where health coaching deserves greater attention in Malaysia
Health coaches do not replace doctors, nurses, dietitians, physiotherapists or psychologists. Instead, they complement existing health care teams by helping individuals translate medical advice into realistic daily action
Doctors may recommend weight reduction. Dietitians may prescribe healthier eating plans. Physiotherapists may develop exercise programmes
Health coaches are behaviour change specialists who help people stay motivated, overcome barriers, solve everyday problems and remain accountable throughout the journey
Lifestyle modification is rarely achieved during a single clinic consultation lasting ten or fifteen minutes. Sustainable behaviour change requires continuous encouragement, regular follow-up and personalised support
Health care increasingly recognises that success depends not only on clinical expertise but also on empowering people to take ownership of their own health
One of the often-overlooked “superpowers” of health coaches is their ability to hold space for clients throughout this journey
Rather than simply providing advice, health coaches create a safe, non-judgemental environment where individuals can explore their challenges, celebrate small victories, overcome setbacks, and build confidence in their own ability to change
By listening deeply, asking thoughtful questions, and remaining consistently present, health coaches support clients as they navigate the physical, emotional, and practical complexities of changing lifelong habits.
This ongoing partnership fosters accountability, resilience, and self-efficacy, enabling transformation that extends beyond improved health behaviours to greater well-being and quality of life
Parents and caregivers are among a child’s earliest health coaches. Children learn by watching what adults eat, how active they are, how they cope with stress and whether healthy living is viewed as enjoyable or burdensome
Family meals, shared physical activity and positive role modelling often have far greater influence than health education delivered in classrooms
Nutrition provides another excellent example. Many Malaysians still perceive healthy food as expensive, bland or restrictive. The growing discipline of culinary medicine challenges this misconception
By combining nutrition science with practical cooking skills, culinary medicine demonstrates that healthy meals can also be affordable, culturally acceptable, enjoyable and delicious.
Rather than prescribing diets people cannot sustain, culinary medicine teaches families how to prepare appealing meals using healthier ingredients without sacrificing taste or cultural preferences
After all, lasting behaviour change is rarely built on deprivation or restriction. When people feel they must constantly give up the foods they love, adherence inevitably declines
Sustainable success comes from creating healthier ways of eating that people genuinely enjoy and can maintain for life. Healthy eating should become a pleasurable lifestyle — not a punishment
As children become adults, the workplace becomes another powerful environment shaping lifelong health behaviours. Most adults spend a large proportion of their lives at work. Employers therefore have enormous influence over health behaviours
Corporate wellness should no longer be viewed as an employee benefit but as a strategic investment. Healthy employees are generally more productive, experience fewer sick days, demonstrate higher morale and contribute to organisational resilience
Workplaces that encourage physical activity, mental well-being, healthy food choices, smoking cessation, preventive health screening and flexible work arrangements are investing directly in their own productivity
However, meaningful workplace wellness requires more than occasional health talks, annual screenings or one-off wellness campaigns. Organisations need to redesign the workplace itself — its policies, physical environment, organisational culture, leadership practices and daily work routines — so that the healthy choice becomes the easy and natural choice
Government agencies and the private sector should work together to make workplace wellness a national movement rather than isolated programmes
Perhaps equally important is how health care professionals communicate. Patients rarely change behaviour simply because they receive instructions
People respond far better to respectful, empathetic and honest conversations that recognise individual circumstances, fears and motivations
Effective communication is not merely delivering health information. It is listening carefully, asking meaningful questions, building trust and empowering patients to discover their own motivation for change
Sometimes, a sincere conversation changes lives more effectively than another prescription
Malaysia now stands at an important crossroads. Our rapidly ageing population should not only encourage us to build more hospitals and care homes. It should motivate us to build healthier lives
Healthy ageing requires governments willing to place prevention at the centre of national development
It requires employers who recognise that employee well-being drives productivity, communities that make healthy choices easier, and health care professionals who become partners rather than simply providers
Most importantly, it requires every Malaysian to recognise that while health care services can treat illness, no health care system can substitute for the daily decisions each of us makes about how we live
The health shift that Malaysia needs is not simply a shift within the Ministry of Health (MOH). It is a shift in mindset across the entire nation. Because healthy ageing is not created in hospitals
Healthy ageing is not something we begin preparing for after retirement. It is built across the life course — from the womb, to the classroom, to the workplace, to the community, and ultimately into older age — one healthy decision at a time
Because healthy ageing truly begins in childhood, and every opportunity we create for healthier children today becomes an investment in healthier older Malaysians tomorrow
Jessica See is the founder of Health Coach International and Culinary Medicine Academy, while Dr Zarihah Zain is a public health physician who retired from the Ministry of Health in 2012 and is now a part-time lecturer in community medicine and medical ethics
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.
