FINANCIAL HARDSHIP AND DIETARY ADHERENCE DURING COVID-19 PANDEMIC
DOI:
https://doi.org/10.37268/mjphm/vol.23/no.1/art.1802Keywords:
Dietary adherence, healthy diet recommendation, financial hardship, covid-19, pandemicAbstract
The COVID-19 pandemic affected the global economy resulting in financial hardship due to declining wages or job losses. A decreased income influences food expenditure and accessibility affecting dietary adherence to healthy recommendations. Thus, this study aimed to investigate the association between financial hardship and dietary adherence among Malaysian working adults during the pandemic. Individuals aged 18 to 59 years (N=163) who experienced financial hardship during the pandemic participated in this cross-sectional study. The data were collected through an online survey. The reported number of servings consumed by the respondents for nine food groups was compared with the recommendations by the Malaysian Dietary Guidelines 2020 and Malaysian Food Pyramid 2020 using one-sample t-test to measure dietary adherence. The association between the financial hardship categories (?25%, 26-50%, 51-75%, and 76-100% of monthly household income reduction rate during the pandemic) and dietary adherence status was assessed using the chi-squared test. The respondents consumed significantly lower number of servings of vegetables, fruits, cereals, fish, legumes, milk and milk products, and fat/oils, compared to recommendations (all p<0.001) whereas their sugar intake was significantly higher than recommended (p=0.041). These indicate dietary non-adherence. However, no association between financial hardship and dietary adherence was detected among adults who were financially affected during the COVID-19 pandemic in this study. In conclusion, most Malaysian adults who reportedly experienced financial hardship during the COVID-19 pandemic demonstrated non-adherence to healthy dietary recommendations. However, whether this was influenced by financial difficulties faced during the pandemic is inconclusive and warrants further investigation.
References
Tan T, Carvalho M, Sivanandam H, Rahim R. Nearly 100,000 Malaysians have lost jobs since start of MCO, says HR ministry. TheStar Newspaper. 9 Dec 2020. Retrieved from https://www.thestar.com.my/news/nation/2020/12/09 (Accessed 5 June 2022)
Department of Statistics Malaysia. Household Income Estimated and Incidence of Poverty Report, Malaysia. 2020. Retrieved from https://www.dosm.gov.my (Accessed 1 June 2022)
Department of Statistics Malaysia. Household Income & Basic Amenities Survey Report 2019. 2021. Retrieved from https://www.dosm.gov.my (Accessed 5 June 2022)
World Health Organization. Adherence: Defining Adherence. 2003. Retrieved from https://www.who.int/chp/knowledge/publications/adherence_Section1.pdf (Accessed 25 May 2022)
Ministry of Health Malaysia. Malaysian Dietary Guidelines 2020. 2020. Retrieved from https://nutrition.moh.gov.my/MDG2020/mobile/index.html#p=1 (Accessed 24 May 2022)
Ministry of Health Malaysia. Piramid Makanan Malaysia 2020 – Mendidik Rakyat Mengambil Makanan dengan Betul. 2020. Retrieved from https://www2.moh.gov.my/index.php/pages/view/2725 (Accessed 24 May 2022)
Shahar S, Jan Mohamed HJ, de los Reyes F & Amarra SA. Adherence of Malaysian Adults’ Energy and Macronutrient Intakes to National Recommendations: A Review and Meta-Analysis. Nutrients. 2018; 10(11):1584-1611.
Lewis M, Lee AJ. Affording health during the COVID-19 pandemic and associated economic downturn. Aust N Z J Public Health. 2020; 44(6):519–520.
Blakely T, Ni Mhurchu C, Jiang Y, et al. Do effects of price discounts and nutrition education on food purchases vary by ethnicity, income and education? Results from a randomized, controlled trial. J Epidemiol Community Health. 2011; 65(10):902.
Nazri NS, Vanoh D, Leng SK (2021). Malnutrition, low diet quality and its risk factors among older adults with low socio-economic status: A scoping review. Nutr Res Rev. 2021; 34(1):107–116.
La Mantia C. Diet quality in relation to income, education, and food insecurity among Canadian adults. 2020. Retrieved from https://tspace.library.utoronto.ca (Accessed 26 May 2022)
Al Mamun A, Hayat N, Zainol NRB. Healthy eating determinants: A study among Malaysian young adults. Foods. 2020; 9(8):974
French SA, Tangney CC, Crane MM, Wang Y, Appelhans BM. Nutrition quality of food purchases varies by household income: the SHoPPER study. BMC Public Health. 2019; 19(1):231.
Karupaiah T, Swee WC, Liew SY, Ng BK, Chinna K. Dietary health behaviors of women living in high rise dwellings: a case study of an urban community in Malaysia. J Community Health. 2013; 38(1):163-171.
Yusoff MSB. ABC of content validation and content validity index calculation. Education in Medicine Journal. 2019; 11(2):49–54.
Bland JM, Altman DG. Statistics notes: Cronbach’s alpha. BMJ. 1997; 314:572
Streiner DL. Starting at the beginning: an introduction to coefficient alpha and internal consistency. J Pers Assess. 2003; 80(1):99-103.
Institute for Public Health (IPH). National Health and Morbidity Survey 2014: Malaysian Adult Nutrition Survey (MANS) Vol. II: Survey Findings. 2014. Retrieved from https://iku.moh.gov.my (Accessed 26 May 2022)
Litton MM, Beavers AW. The Relationship between Food Security Status and Fruit and Vegetable Intake during the COVID-19 Pandemic. Nutrients. 2021; 13(3):712.
Ramadas A, Tham SM, Lalani SA, Shyam S. Diet quality of Malaysians across lifespan: A scoping review of evidence in a multi-ethnic population. Nutrients. 2021; 13(4):1380
Nik Mustapha NH, Abd Rashid NK, Nasir A. Household Income and Expenditure Relationships: A Simultaneous Equation Approach. Chinese Business Review. 2011; 10(6):395-405.
Picchioni F, Goulao LF, Roberfroid D. The impact of COVID-19 on diet quality, food security and nutrition in low and middle income countries: A systematic review of the evidence. Clin Nutr. 2022; 41(12):2955-2964.
