Development and evaluation of healthy meal plan for public university students in Peninsular Malaysia

University students, aged 18-25, face essential decisions affecting their long-term well-being, employment, and healthcare costs. Despite previous findings of high food insecurity among university students, the relationship between financial status and food security in this group remains unclear. Previous study highlights that while meal plans can mitigate food insecurity, there has been limited exploration of meal planning specifically in Malaysia. Thus, this study aims to develop and evaluate the Malaysian Student Healthy Meal Plan (MySHMP) for public university students in Peninsular Malaysia. The development and evaluation of MySHMP occurred in three phases. Phase I involved a cross-sectional study assessing food insecurity among 427 undergraduate students using multistage random sampling. Data on socioeconomic status, financial health, nutrition knowledge, meal expenditures, and physical activity were collected through a questionnaire, with a 24-hour dietary recall providing insights into food intake. Phase II focused on developing MySHMP based on Phase I findings, determining calorie requirements from the Malaysian Recommended Nutrient Intakes (RNI), and converting these into serving sizes according to the latest Malaysian Dietary Guidelines (MDG, 2020). Phase III entailed evaluating MySHMP by comparing its serving sizes against the MDG and conducting content validation with four expert panels, who completed self-administered questionnaires. The scores were presented as a content validity index (CVI), assessing three components of MySHMP (serving size; menu set; nutrient content and price). Phase I revealed that 60.9% of respondents were food insecure. Logistic regression indicated that male respondents (p < 0.05) and financial problems (p < 0.001) significantly associated with food security status. Males were twice as likely to experience food insecurity (AOR = 1.773, 95% CI: 1.091–2.882), and those with significant financial problems had four times higher odds of food insecurity (OR = 3.951, 95% CI: 2.494–6.259). Meal expenditure was statistically higher for males (p < 0.05). Among females, low physical activity levels (LPAL) and high physical activity levels (HPAL) showed significant differences in daily meal expenditure (RM 12.00 ± 5.00 vs. RM 15.00 ± 6.75; χ2 = 8.27, p < 0.05). Therefore, MySHMP was developed for six groups based on gender and physical activity levels in Phase II. Phase III evaluations confirmed that MySHMP met recommended serving sizes for all food groups. Content validation showed relevance average proportion of 0.94 (CVI) among experts. The universal agreement was 0.75, leading to menu revisions to improve food variety. The daily cost of MySHMP, post-modification, ranged from RM 21.91 to RM 29.08, depending on gender and physical activity level. In conclusion, the prevalence of food insecurity among Malaysian public university students is alarmingly high. MySHMP, the first validated healthy meal plan in Malaysia, offers a structured approach to healthy eating and periodic updates needed to address food availability and costs. It aims to improve food security for students and individuals aged 18 to 25, emphasizing the need for better financial support and nutritional education. Cross-stakeholder collaborations, including ministries, university administrators, food service providers, health professionals, and students, are vital for promoting healthy eating habits among emerging adults in this demographic.

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