Spatial distribution of healthy food options: an evaluation of the food environment in Putrajaya

Introduction: The prevalence of overweight and obesity in Malaysia has reached historically high levels, with particularly high rates observed in Putrajaya, the administrative capital of the country. Despite this, limited attention has been given to the role of the local food environment in shaping dietary behaviours within the Putrajaya community. This study aimed to assess the healthfulness and spatial configuration of the food environment in Putrajaya. Methods: This observational study evaluated the food environment in Putrajaya, Malaysia, using the Nutrition Environment Measures Survey for Stores (NEMS-S) and Restaurants (NEMS-R). All food stores and eateries were assessed for the healthy food options. Kernel Density Estimation was applied to examine spatial clustering patterns of relatively healthy and unhealthy food environments. Results: A total of 80 food stores and 665 eateries were assessed. Supermarkets achieved the highest NEMS-S scores, with a median total score of 27.0 (IQR: 19.0), driven primarily by availability sub-scores (20.0; IQR: 14.0) rather than price incentives (3.0; IQR: 3.0). Although 80.5% of stores stocked whole-wheat bread, only 6.5% offered lean meat options, and price favouring healthier alternatives scores were consistently low across all store types (range: 2.0-3.5). For restaurants, aggregate NEMS-R scores indicated limited healthfulness across outlet types, with 24-hour restaurants recording the highest median score (5.0; IQR: 1.0). While 87.3% of eateries provided at least one healthy main dish, only 0.5% offered low-fat milk. Facilitators supporting healthy choices were absent across outlets (median:0.0), and barriers to healthy eating sub-scores were negligible (median:0.0), indicating limited structural support within the restaurant food environment to promote healthier choices. Spatial analysis identified clustering of healthy food environments in Precincts 1, 14, 15, and 16. However, density mapping demonstrated substantial spatial overlap and adjacency between healthy and unhealthy food environment clusters, indicating that healthier food access is embedded within a broader obesogenic environment. Conclusion: The findings indicate the presence of food swamp–like conditions in Putrajaya, characterised by the dominance and spatial salience of unhealthy food environments despite apparent outlet diversity. Targeted policy, community-based, and urban planning interventions are warranted to improve the healthfulness of food environments in Putrajaya.

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