饮食行为、食品购买以及对健康食品可及性和可负担性的看法：一项对马来西亚低收入成年人的横断面研究。
Dietary practices, food purchasing, and perceptions about healthy food availability and affordability: a cross-sectional study of low-income Malaysian adults.
机构信息
RTI International, Selangor, Malaysia.
Center for Global Noncommunicable Diseases, RTI International, Seattle, USA.
出版信息
BMC Public Health. 2022 Jan 28;22(1):192. doi: 10.1186/s12889-022-12598-y.
BACKGROUND
Malaysia has the highest rate of overweight and obesity among Asian countries. Obesity is increasing particularly among low-income populations. This study aimed to assess dietary practices among low-income adults in urban communities, including gender and ethnic variation, to inform the development of locally tailored, evidence-based interventions for health promotion.
METHODS
This cross-sectional study was conducted from August to December 2020. Stratified sampling was employed to recruit 2983 low-income adults from households in the bottom 40% of the economic spectrum (B40) at six public, low-cost housing flats in the Federal Territory of Kuala Lumpur, Malaysia. Face-to-face interviews were conducted using a structured questionnaire to understand dietary practices, perceptions of healthy food availability and affordability, and factors affecting food purchasing decisions.
RESULTS
A staggering 89.5% of B40 adults were found to not consume adequate daily amounts of fruits and vegetables. In addition, 68.1% reported consuming sugar-sweetened beverages at least once per week, including commercially packed ready-to-drink beverages, sugar-added self-prepared drinks, and premixed drinks. Intake was statistically significantly higher among men (71.7%), Malays (70.3%), and Indians (69.9%). Bread and other commercially baked goods were the most common processed foods, and 52.9% of respondents consumed it at least once per week. Majorities reported that healthy foods were moderately available and priced. The top three reported factors affecting food purchase choices were price (79.4%), availability (75%), and taste (73%).
CONCLUSIONS
Adults in low-cost housing communities have unhealthy dietary patterns with low intake of fruits and vegetables and high intake of ultra-processed foods and calorie-dense local foods, with variations across gender and ethnicity. The study highlighted the need for educating low-income families on diet-disease relationships and possibilities for inexpensive, healthy eating that rely on minimally processed fresh foods. Policymakers engaging the food industry are advised to consider how to increase the affordability and availability of healthy foods in low-income communities in urban areas.
背景
马来西亚是亚洲国家中超重和肥胖率最高的国家。肥胖尤其在低收入人群中不断增加。本研究旨在评估城市社区低收入成年人的饮食行为，包括性别和族裔差异，以为制定有针对性的、基于证据的健康促进干预措施提供信息。
方法
这是一项横断面研究，于 2020 年 8 月至 12 月进行。采用分层抽样法，从马来西亚吉隆坡联邦直辖区六个公共、低成本住房公寓中经济水平处于底层 40%（B40）的家庭中招募了 2983 名低收入成年人。使用结构化问卷进行面对面访谈，以了解饮食行为、对健康食品供应和可负担性的看法，以及影响食品购买决策的因素。
结果
令人震惊的是，B40 成年人中有 89.5%没有摄入足够的每日水果和蔬菜量。此外，68.1%的人报告每周至少饮用一次含糖饮料，包括商业包装的即饮饮料、加糖自制饮料和预混饮料。男性（71.7%）、马来人（70.3%）和印度人（69.9%）的摄入量统计上显著更高。面包和其他商业烘焙食品是最常见的加工食品，52.9%的受访者每周至少食用一次。大多数人报告说健康食品的供应和价格适中。报告影响食品购买选择的前三个因素是价格（79.4%）、供应（75%）和口味（73%）。
结论
低成本住房社区的成年人饮食模式不健康，水果和蔬菜摄入量低，超加工食品和高热量本地食品摄入量高，性别和族裔差异较大。该研究强调需要教育低收入家庭了解饮食与疾病的关系，以及依靠 minimally processed fresh foods 实现廉价、健康饮食的可能性。建议参与食品行业的政策制定者考虑如何提高城市低收入社区健康食品的可负担性和可获得性。
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