Dietary Patterns and Associated Factors Among Adolescents in Malaysia: Findings from Adolescent Nutrition Survey 2017

Abstract

Balanced diet in the early stages of life plays a role in optimum growth and maintains good health status of adolescents. Dietary habits that are established during adolescence will sustain till adulthood. Therefore, this present study aims to identify the dietary patterns and to determine factors associated with dietary patterns in terms of socio-demographic characteristics, locality of schools, ethnicity, eating habits, self-perceived weight status, and food label reading habit among adolescents in Malaysia. Data from the Adolescent Nutrition Survey (ANS) 2017 was used for the present study. ANS is a population representative school-based cross-sectional study among school-going adolescents from primary four to secondary five from schools in 13 states and three federal territories registered under the Ministry of Education Malaysia. A self-administrated questionnaire was used to collect information on socio-demographic characteristics, locality of schools, ethnicity, eating habits, self-perceived weight status, and food label reading habit. A pre-tested face-to-face food frequency questionnaire (FFQ) was used to collect information on food group intake frequency. Dietary patterns were identified by using exploratory factor analysis and associated factors, using complex sample general linear model (GLM) analysis. All statistical analyses were carried out at 95% confidence interval or p-value < 0.05. The dietary patterns identified are healthy, unhealthy, and alternative proteins. The healthy dietary pattern was significantly associated with the types of school and ethnicity. The unhealthy dietary pattern was significantly associated with the locality of schools, ethnicity, frequency of snacks intake per week, frequency of eating out per week, self-perceived weight status, and food label reading habit. Significant associations were found between alternative proteins dietary pattern and locality of schools, ethnicity, and types of school. This study found that there is a disparity of dietary patterns between different ethnicity, locality of schools, and types of school. We recommend strategies of specifying ethnicity and geographical area to improve dietary patterns of adolescents in Malaysia.

Psychological distress and unhealthy dietary behaviours among adolescents aged 12–15 years in nine South-East Asian countries: a secondary analysis of the Global School-Based Health Survey data

“…However, since the overall frequencies of fruit and vegetable consumption were low, consumption in all countries was likely below the minimum recommended amount (at least 400 grams) by the World Health Organization (WHO). Previous studies from this region have reported that a significant proportion of adolescents do not consume adequate quantities of fruits and vegetable, but the results are not directly comparable because of different definitions and measures (22)(23)(24)(25). A previous global study reported that compared to other WHO regions, the mean daily consumption of fruit among adolescents from South and East Asia was higher, whereas the mean daily consumption of fruits was lower (9).…”

“…Therefore, it is important to quantify potential sex differences in the burdens of psychological distress and unhealthy dietary behaviours. While some previous studies investigated the prevalence of mental health problems (19)(20)(21) and unhealthy dietary habits (22)(23)(24)(25) in adolescents residing in South-East Asian countries, they were limited by non-representative and smaller samples, and differences in variable definitions and analytic approaches made cross-country comparisons difficult. Moreover, to the best of our knowledge, no study examined the potential association between psychological distress and unhealthy dietary practices among adolescents from South-East Asian region.…”

Facilitators and Barriers to Implementing Healthy School Canteen Intervention among Malaysian Adolescents: A Qualitative Study

“…The foods sold in the school contribute up to 50% of the students’ daily calories intake. Abundant low-nutrition, energy-dense foods sold in the school can easily be the reason for malnutrition among school children [ 5 , 14 ]. Despite the guide on healthy canteens by the Ministry of Education, one-third of the food sold are the processed foods, still being sold in the school canteen, with limited availability of fruits, vegetables and milk [ 36 ].…”

“…Obese adolescents consume more energy-dense diets that are high in sugar, oil, fat, and processed foods compared with adolescents who have a normal body mass index [4,5].…”

“…Obese adolescents consume more energy-dense diets that are high in sugar, oil, fat, and processed foods compared with adolescents who have a normal body mass index [ 4 , 5 ]. Particularly, male adolescents tend to have poor dietary intake high in sugar and salt with low consumption of fruits, vegetables and dairy products, and higher energy and macronutrient intake than female adolescents [ 6 , 7 , 8 ].…”