Association between neighbourhood food environment and dietary quality among adolescents in Kuala Lumpur, Malaysia

The neighbourhood food environment has been found to influence the dietary quality of adolescents. Therefore, this study aims to investigate the association between neighbourhood food environment and dietary quality among adolescents that come from low-income families in Kuala Lumpur. This cross-sectional study involves 184 adolescents from six public secondary schools in Kuala Lumpur. The online self-administered questionnaire through Google Forms was used to obtain information regarding adolescents' sociodemographic characteristics, dietary quality, and perceived availability, accessibility, and affordability of the neighbourhood food environment. Food stores and home addresses were geocoded using Google Earth. Geographic Information System (GIS) was used to identify the status of neighbourhood food environment, map the food stores and home addresses, and determine 1000m buffer zones around respondents' addresses. Associations between neighbourhood food environment statuses and dietary quality were examined using Pearson correlation, Chi-Square Test and Multivariable Linear Regression (MLR). The most reported response for dietary quality status is it ‘requires improvement’ (62.0 %), compared to having a ‘poor diet’ (23.9 %) and ‘good’ (14.1 %). The majority (60.3 %) resided in a healthy food environment, while the minority lived in food swamps (37.0 %) and food deserts (2.7 %). Although the majority of respondents perceived While a higher number of them perceived high food availability (76.6 %) and affordability (64.7 %) of healthy food stores in their neighbourhood, over half (51.7 %) reported low accessibility to these stores. About 33.2 % of them never use food delivery services, followed by at least once per month (31.5 %), once every two weeks (16.3 %), and once per week (19.0 %). Age (rs = −0.19), ethnicity (X2 = 5.75), fathers' educational level (rs = 0.15), non-fast-food restaurants (r = -0.16) and convenience stores (rs = -0.20) were significantly correlated with adolescents' dietary quality (p < 0.05). However, after adjustment for covariates, ethnicity (β = 0.180, t = 2.283, p = 0.020), father's educational level (β = 0.177, t = 2.113, p = 0.036) and monthly household income (β = −0.169, t = −2.160, p = 0.032) were identified as significantly associated with dietary quality. The dietary quality of urban poor adolescents in Kuala Lumpur requires further improvement in terms of awareness and intervention. Interventions should focus on increasing fathers' awareness of healthy food choices and addressing ethnic dietary. Enhancing nutrition education in schools may also help improve dietary habits among low-income urban adolescents.

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