Comparison of Nutritional Knowledge, Attitudes and Practices between Urban and Rural Secondary School Students: A Cross-Sectional Study in Sabah, East Malaysia

Abstract

Nutritional knowledge, attitudes and practice (KAP) may guide healthy meal choices. Here, nutritional KAP was compared across school students in Sabah based on locality and gender. A cross-sectional survey of students aged 15–19 years was conducted using multistage sampling. Nutritional KAP was measured via questionnaire. Anthropometric measures of weight and height were taken in person to calculate body mass index (BMI). Among the 994 participants, 80% were urban and 60% were female (mean age 16.5 ± 0.6 yr). Most were of Kadazan-Dusun (23%) ethnicity. Measured height for age Z score (HAZ) and BMI for age Z score (BAZ) differed between urban and rural students (−1.2 ± 0.8 versus −1.5 ± 0.7 for HAZ; p < 0.001; 0.2 ± 1.4 versus −0.1 ± 1.3; p = 0.02, respectively). No difference in nutritional knowledge was found, although urban students prioritized having a healthy/balanced diet (59.55% versus 48.50%, p = 0.03) and ate daily breakfast (57.4% versus 10.2%, p < 0.001) compared to rural. Females scored higher on nutritional knowledge than males (18.9 ± 2.8 vs. 18.1 ± 3.4, respectively, p = 0.0001), yet males selected more healthy/balanced foods (63.3% versus 53.3%, p = 0.041). The gap remains between nutritional KAP and translating this to healthy eating among adolescents, related to locality and gender.

Knowledge of calories and its influencing factors: evidence from a fast-growing developing country

“…This finding contradicted the evidence from previous studies, which showed no significant relationship between urbanization and nutrition knowledge (Steyn et al. , 2000; Jeinie et al. , 2021).…”

“…As compared to individuals in highurbanization states, those in low-urbanization states were less likely to have knowledge of the definition of calories, whereas those in middle-urbanization states were more likely to have knowledge of the effect of calories on body weight. This finding contradicted the evidence from previous studies, which showed no significant relationship between urbanization and nutrition knowledge (Steyn et al, 2000;Jeinie et al, 2021). It can be concluded that while health information is widely available in urban areas, residents in high-urbanization states may not always have good caloric knowledge.…”

“…However, Steyn et al (2000) employed South African data and found no significant rural-urban variations in nutrition knowledge among university students. Consistent with this finding, Jeinie et al (2021) found that students in urban and rural areas had similar nutrition knowledge scores.…”

Healthy Diet-Related Knowledge, Attitude, and Practice (KAP) and Related Socio-Demographic Characteristics among Middle-Aged and Older Adults: A Cross-Sectional Survey in Southwest China

“…The KAP theoretical model is frequently utilized in investigations and studies concerning diet behavior changes and public health issues [ 32 ]. Based on the fundamental principles of KAP theory, enhancing knowledge can bring about changes in attitudes and behaviors, consequently alleviating the burden of diseases [ 33 , 34 ]. Previous research has extensively examined the correlation between diet and health status among older adults [ 35 ].…”

Relationship between Early Initiation Breastfeeding, Exclusive Breastfeeding, Complementary Feeding, and Nutritional Education with Nutritional Status of Children under Three years

“…The present study found no link between the history of nutrition education on breastfeeding and complementary feeding and the nutritional status of children in the Sumbang District. Nutrition education, on the other hand, is critical for boosting mothers' knowledge and awareness of feeding methods (36)(37). Inconsistent results could be attributed to a lack of data on nutrition education quality and delivery.…”