Original Article doi:10.31674/mjn.2022.v13i04.

001

Food Access and Fast-Food Consumption Behaviour among

Health Sciences Students at Uitm Puncak Alam
Roslinda Isa*, Noor Adni Mohd Adam, Siti Anissha Ahmad Subari, Siti Suraya Nordin, Rosuzeita Fauzi

Universiti Teknologi MARA, Selangor, Shah Alam 40450, Malaysia

*Corresponding Author's Email: [email protected]

ABSTRACT

Background: Fast foods can be seen convenient to people who lives a busy lifestyle. Nevertheless,
uncontrolled consumption of fast food can lead to obesity. About 84% of Malaysian students consumed fast
food and often unable to meet recommended nutrient intake due to snacking habits and skipping meals.
Objective: To identify food access and fast-food consumption behaviour among Health Sciences students at
UiTM Puncak Alam. Methods: This cross-sectional study was done among Health Sciences students at
UiTM Puncak Alam. The questionnaire was adapted from 'Fast Food Consumption and Obesity'. A total 267
from Year 2 and Year 3 was participated. The questionnaire consists of 27 questions including demographic
data, food access and fast-food consumption behaviour. Results: Majority of the students have problem in
transportation for food access and consumed fast food many times per month. However, the study finding
showed no relationship between transportation problem, fast food consumption behaviour and BMI.
Conclusion: With the advance in technology food can be order online and can be delivered by the restaurant.
Therefore, there was no relationship between transportation problem and fast-food consumption behaviour.
Future research should focus on effect of fast-food consumption behaviour on students' academic
performance and health related quality of life.
Keywords: Fast Food; Food Access; Consumption Behavior; Body Mass Index

INTRODUCTION particular tend to have a high frequency of eating out and

were likely to pick fast food when they eat out.
Malaysia is undergoing a rapid process of
modernisation. Through the 9th Malaysia plan, the Alizadeh & Ghabili (2008), showed students tended
government has taken the initiative to promote and to skip their meals, especially breakfast and frequently
encourage Western fast-food franchises, as one of many consumed fast food. Gan et al., (2011), reported that
efforts to boost the country's economy (Abdullah et al., many students frequently skipped breakfast skipped at
2017). Ali & Abdullah (2012), state that the new living least one meal daily. Javaid & Munir (2018) found that
environment and changes of lifestyles have resulted in a students who skip breakfast showed disruptive and
new arrangement in eating, which was not the case two distracting behaviour in the classroom.
decades ago. As a result of lifestyle changes in
metropolitan cities, the habit of fast food consumption Driskell et al., (2006) and Gan et al., (2011) reported
has developed (Abdullah et al., 2017). that university students tend to eat fast food at least once
weekly. Living in college also restrict students from
Habib et al., (2011) reported that 84% of Malaysian cooking, thus increase the frequency of them ordering
students' consumed fast food. Gan et al., 2011), found food online given the fact that fast foods usually quick
that university students are often unable to meet the and always ready-to-go, many students opted for fast
recommended nutrient intakes. Snacking habits of high food rather than nutritious food. Student dietary intake
fat and calorie foods, tending to skip breakfast and they changed during college years resulting in increased
consume lots of fast food regularly. Bipasha & Goon consumption of fast food (Alfawaz, 2012; Fraser et al.,
(2014) also reported that university students, in 2010).
Received 2 July 2021; Received in revised form 14 July 2021; Accepted 21 October 2021

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 FOOD ACCESS AND FAST-FOOD CONSUMPTION BEHAVIOUR AMONG STUDENTS

Excessive consumption of fast food is often Instrument

associated with increased risk of non-communicable The questionnaire was adapted from the research of
diseases, including diabetes and hypertension. Fast food is Fast Food Consumption and Obesity (Abdullah et al.,
typically high in fat, sodium, and sugar but low in fibre 2015). The questionnaires consisted of three parts, which
and deficient in essential micronutrients (Cheong et al., were part A on demographic data, part B on food access
2019). Moreover, fast food tends to be consumed in large and part C on fast food consumption. Part A consisted of
amounts and accompanied by carbonated beverages that seven items which were gender, year of study, course
may result in excessive calorie intake and afterwards programs, weight, height, Body Mass Index (BMI) and
increase the risk of overweight and obesity (Cheong et al., transportation problems of respondents. Part B was food
2019). Radzi et al., (2019) found that obesity is associated access questionnaire which consists of 7 questions.
with a higher risk of developing cardiovascular disease, Question 1, 2, 4 and 5 used multiple-choice questions by
metabolic syndrome and type II diabetes. The high choosing only one answer appropriately. For question 3,
amount of fat in fast food and lack of physical activities respondents need to answer all questions by ticking in the
can rise to unhealthy and excessive weight (Abdullah et provided table. Question 6 and 7 were using Likert scale
al., 2015). questions. Part C was on fast food consumption behavior,
Over-nutrition can lead to overweight and obesity consists of 14 questions regarding fast food consumption
(WHO, 2012). Based on the National Health and and the reason why students visit fast food restaurants.
Morbidity Survey, (2015) classifications, the national Question 1 to 13 were using dichotomous questions
prevalence of overweight was 33.4%, and the prevalence (Yes/No) while question 14 using Likert scale (usually,
of obesity was 30.6%. Thus, this study was done to sometimes, never/rarely). Pilot study was done, and the
identify food access and fast-food consumption behaviour Cronbach’s alpha was found to highly reliable (a: 0.754).
among Health Sciences students at UiTM Puncak Alam. Data Collection
METHODOLOGY Data was collected once ethical approval from UiTM
Study Design ethic committee, from December 2019 until February
2020. The researchers approached second and third-year
A cross-sectional design was use in this study. health sciences students to answer questionnaires during
Study Location their learning and lectures in faculty. The information
about the objectives of the study was given. Then,
This study was conducted at the Faculty of Health informed consent and questionnaires had been given to
Sciences in UiTM Selangor Puncak Alam Campus at respondents once they agree to participate. The time
Bandar Puncak Alam, Selangor. allocated for respondents to answer the questionnaires
Sample was around 15 to 20 minutes. Questionnaires were
collected immediately after respondents finished
Non-random probability sampling design which is answering.
used in this study is purposive convenience sampling. The
inclusion criteria were Year 2 and Year 3 full- time degree Data Analysis
students from Faculty of Health Sciences. Exclusion Statistical Packages the Social Sciences (SPSS)
criteria students who were among first and fourth-year full version 25 was used to analyse the data. Descriptive
time and part time degree, diploma and non-health statistical analysis was used for determining results of
science students and in medical or study leave. demographic data. Descriptive analysis also used to
Sample Size Calculation identify food access and fast food consumption behaviour
among Health Sciences students at UiTM Puncak Alam.
A sample size was calculated from the population of Pearson Chi-Square was used to find the relationship
868 Year 2 and Year 3 full-time degree students by using between transportation problem with fast food
formula (Krejcie & Morgan, 1970) and considered consumption behaviour and relationship between fast
adequate based on “rule of thumb” with 5% margin of food consumption behaviour with BMI.
error, 95% confidence interval (CI), 50% population
proportion and 868 of the population size. Finally, the Ethical Approval
sample required for this study was 267. Approval from the UiTM Ethic Committee was

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 FOOD ACCESS AND FAST-FOOD CONSUMPTION BEHAVIOUR AMONG STUDENTS

obtained on 3 Sept 2019 before the study started. service” and 8(3%) also reported that “students do not
Respondents were given written consent prior to the eat fruits and vegetables”.
commencement of the study. Question five was “It is easy to find fresh fruits and
RESULTS vegetables within community or neighbourhood.” 120
(44.9%) agreed to the statement while 54 (20.0%)
Demographic Data students were strongly agreed. For the last question
Table 1 show that majority of the respondents were “Often is transportation become a problem in getting
female students, 220 (82.5%). In term year of study, 167 fresh fruits and vegetables”, 79 (29.6%) of the
(62.5%) students from third year and 100 (37.5%) respondents reported it happened “sometimes” while 37
(13.9%) of the respondents reported that transportation
students from second year. Majority of students 167
“always” become a problem.
(62.5%) were having normal weight.
Fast food consumption behaviour of health science
Table 1: Frequency Distribution of Students’ students in UiTM Puncak Alam
Characteristics (n=267)
First question was on “Frequency eating fast food”,
Characteristic Frequencies Percent (%) majority of the respondents 148(55.4%) consumed fast
Demographic food multiple times per month. Question two was on
Gender
“Main reason why respondents prefer fast food”, 99
Male 47 17.6 (37.1%) of respondents chose fast foods because it was
Female 220 82.4 convenient and 80 (31.0%) picked taste of the food as
Year of Study reason. Other than that, cost of the food 29 (10.9%),
Year 2 100 37.5 sociability 37 (13.9%) and fast food outlets conveniently
Year 3 167 62.5 located 22 (8.2%). Question three was on “Usual time
BMI eat fast food”, 83 (31.1%) respondents eat during dinner,
Underweight 38 14.2 while 76 (28.5%) respondents eat during lunch.
Normal 167 62.5
Overweight 53 19.9
Question four was on “type of fast food preference”,
Obese 9 3.4 majority of the respondents 148 (55.4%) preferred to
Do you have Transportation Problems?
have meal package that sold in fast food outlets. The rest
of respondents picked individual item or ‘a la carte’ 60
Has problem 159 59.6 (22.5%), different item from the various menu 56
No problems 108 40.4
(21.0%) and other type of order 3 (1.1%). Question five
was on “order super-size” with majority of respondents
Food access among Health Sciences students at
194 (72.7%) did not order the super-size menu,
UiTM Puncak Alam
meanwhile 57 (21.3%) of the respondents would have
This study found that 115 (43.1%) of respondents super-size. Question six was question on “eat in the
were “taking 2 serves of vegetables every day”. restaurant or take out” 133 (49.8%) of the respondents
However, 19 (7.1%) respondents who “don’t eat preferred to take-outs and 115 (43.1%) of the respondents
vegetables”. Second question was on “Serves of fruits prefer to dine-in. Question seven was on “Where do you
you usually eat every day”, majority of respondents 172 usually eat your take-out” 100 (37.5%) eat at home, 23
(64.4%) reported that take “Less than 1 serve”. Question (8.6%) of the respondents eat in the car and 10 (3.7%)
three was on “Choose places to shop for fresh fruits and choose other places. Question eight was “Go to fast food
vegetables” 115 (43.1%) of the respondents preferred to restaurant with?”, 95 (35.6%) of the respondents go with
shop for fresh fruits and vegetables within their friends (10.5%) and 4 (1.5%) go alone. Question nine
community. While 28 (10.5%) of the respondents “did was on “Is the type of nutritional information available at
not buy fresh fruits and vegetables”. Question four was the fast-food restaurants you usually go to?” majority of
on “Main reason does not buy fresh fruits and vegetables the respondents 147 (55.1%) reported present, while 64
within community or neighbourhood” 49 (18.4%) of the (24.0%) of the respondents reported never noticed.
respondents reported that those stores had poor quality Question ten was on “Ever read nutritional information”
fruits and vegetables. Meanwhile, 8(3%) of the only 107 (40.1%) of the respondents read. Question 11
respondents reported that “stores having poor quality was on “Nutritional information help to decide” only 47

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 FOOD ACCESS AND FAST-FOOD CONSUMPTION BEHAVIOUR AMONG STUDENTS

(17.6%) of the respondents’ reported “sometimes”. respondents 115 (43.1%), consumed two servings of
Question 12 was on “Likely to order healthy meals” vegetables followed by 106 (39.7%) respondents who
majority of the respondents 143 (53.6%) reported eat less than one serving every day. This showed that
“Somewhat likely”. Last question “Distance resident more than half of the respondents consumed less
from fast food restaurant” majority of the respondents vegetables per day. This trend also could be seen in fruits
186 (69.7%) reported that 0-5km. consumption where 172 (64.4%) of respondents eat less
than one serving per day. Similar with Gan et al., (2011),
Relationship between trsanportation problems and
who reported that 143 (47.7%) universities students in
fast food consumption
Malaysia consumed only one serving of vegetable every
Table 2 showed the relationship between day. Bernardo et al., (2017) also reported that the intake
transportation problem and fast food consumption. The of vegetables and fruits among university students were
result showed that there was no significant relationship rather low than the recommended serving per day. The
between transportation problems and frequency of fast World Health Organisation (WHO, 2005) recommended
food consumption as p-value >0.05 which p=0.080. adults to consume at least 400 gm or equivalent to five
servings of vegetables and fruits daily to reduce the risk
Table 2: Relationship between Food Access and Fast of chronic diseases.
Food Consumption (N=267)
Variables Transportation, N (%)
The main reason for not buying fresh fruits and
problem vegetables for 49 (18.4%) respondents in this study were
X²(df) p value
Has No due to the poor quality of fruits and vegetables. On top of
problem problem that, 39 (14.6%) respondents reported a high price as the
Frequency of fast-food 5.050 (2) *0.080 second reason not to buy fresh vegetables and fruits.
consumption
Per week 25 (9.4%) 29 (10.9%) Since respondents in this study were university students,
Per month 92 (34.5%) 56 (21.0%) money problems can be the reason for respondents to not
Less than once per month 42 (15.7%) 23 (8.6%) buy fruits. Similar with Pulz et al., (2017), statement that
Total 159 (59.6%) 108 (40.4%)
*chi square test
healthy food was expensive, and the access was difficult,
making it hard for live a healthy lifestyle.
Relationship between fast food consumption
behavior with Body Mass Index (BMI). Access to sources of food, students may need a
medium of transportation such as public bus, cars, and
Table 3 showed there was no significant association motorbike. Among 267 respondents, 79 (29.6%) of them
between fast food consumption behaviour among Health reported that sometimes it was difficult to find
Sciences students with BMI as p-value >0.05 which transportations. Living in college require respondents to
p=0.715. follow the bus schedule, so they cannot go out to find
fresh fruits.
Table 3: Relationship between BMI with Frequency of
Health Sciences Students Consumed Fast Food (n=267) Fast food consumption behaviour among Health
Sciences students UiTM Puncak Alam
Characteristics BMI, N (%)
X2(df) p-value The results of this study revealed that more than half
Underwe Normal Overweight
ight of the respondents 148 (55.4%) eat fast foods every
Frequency of 2.106 (4) *0.716 month. Similar with previous study in Malaysia, where
visiting fast
food restaurant: most of the respondents aged 24 or younger consumed
Per week 9 (3.4) 34 (12.7) 11 (4.1) fast food monthly (Abdullah et al., 2015; Mat et al.,
Per month 20 (7.5) 96 (36.0) 32 (12.0) 2016). Moreover, Gan et al., (2011), stated that 52.4%
Less once than 9 (3.4) 37 (13.9) 19 (7.1)
per month
and 38.4% of female and male students respectively eat
Total 38 (14.2) 167 (62.5) 62 (23.2) at a fast food restaurant at least one to three times
*chi square test monthly.
DISCUSSION There were a lot of reasons that affected fast food
consumption. In this study, about 99 (37.1%) of
Food access among Health Sciences students at
respondents chose convenience as the main reason to eat
UiTM Puncak Alam
fast food. Dunn et al., (2011), reported that convenience
The finding from this study showed that most of the influenced the respondents the most. Similar with

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 FOOD ACCESS AND FAST-FOOD CONSUMPTION BEHAVIOUR AMONG STUDENTS

Prabhu and Narayan (2015), students choose fast food that accessibility to fast food outlet also depends on the
because of quick service and convenience. This may be mobility factors such as car and other public transport
because of students’ busy lifestyles and the prohibition services. Caspi et al., (2012) stated that though
to cook in the residential college areas. Thus, food accessibility was a component, the availability of public
delivery was the most convenient way to sort out the services has been legally recognised as part of food
issue. Habib et al., (2011) stated that the convenience of access.
the restaurants and easily accessibility were prime
criteria for students to choose fast foods outlets. In this study there was no relationship between
Onurlubaş & Yilmaz (2013), found a similar outcome transportation problems with fast food consumption
that accessibility, service speed, menu variety and behaviour among Health science students at UiTM
availability of special products play a significant role Puncak Alam. The reason can be as most of the fast food
towards youngsters. restaurant provides delivery services. Abdullah et al.,
(2015), reported that most of the fast food franchise
The second common reason was the taste of food. provides delivery services to the accommodation area of
Habib et al., (2011) also reported that taste of food, the students; thus, this kind of facilities made fast food
safety and the rapidity of preparation were the main easy to access. Since majority of respondents in this
factors for choosing a certain fast food restaurant. study have internet access so it is easier for them to make
Anderson et al., (2012), also found that among 64% of online order. Even though they don’t have transport but
the respondents who eat fast food at least once per month still can ask for delivery services through apps like grab
agree that fast food outlet was quick and convenient, food, food panda and others.
16% chose taste of the food.
Relationship between fast food consumption
In this study setting Faculty Health Sciences, Puncak behaviour with Body Mass Index (BMI) among Health
Alam was surround with fast food restaurants such as Sciences students at UiTM Puncak Alam.
McDonald's, Kentucky Fried Chicken (KFC) and Pizza
The result showed that majority of Health Science
Hut which were available nearby within 0-5 kilometre
students in Year 2 and 3 have an average normal BMI.
(km) from the campus and residential college.
Moreover, in this study, 36.0% of the respondents with
According to Abraham et al., (2018), the place of study
normal BMI went to a fast food restaurant every month.
was located in an area with a variety of fast food options Besides, respondents were among the group who
making it easier or more likely for them to consume fast frequently consume fast foods compared to other groups
food. Bernsdorf et al., (2017) stated that there was such as obese. From that, it indicates that there was no
relation between fast food accessibility and intake. The relation (p=0.715) between upper BMI and fast food
possibility increased when fast food outlet was near to consumption.
the accommodation area because it was easier to access.
Likewise, the consumption decreased when the distance A study by Fournier et al., (2016) which was done in
increased (up to four km). However, this was not a Malaysia, also showed a similar result, where 9.8% and
problem for people who have transportations (Bernsdorf 9.5% of the participants are underweight and obese
et al., 2017). An increasing number of fast food outlets respectively, and another 58.7% have normal weight.
also made them easy to access within a short distance Similarly, the results reported no relationship between
(Habib et al., 2011). BMI and frequency of eating out (p=0.5037).
The relationship between transportation problems These results seem to be contradicted by a study by
and fast food consumption behaviour among Health Al-Otaibi & Basuny (2015), among female university
Sciences students at UiTM Puncak Alam students in Saudi Arabia. There was a relationship
between BMI and the frequency of students visiting fast
This study reported that for majority of the food franchises (p=0.05). About 56% of the students visit
respondents transportations become problem since fast food twice or more per week are overweight /obese.
students who stayed in hostel were not allowed to bring
their own transport. Dhillon et al., (2019), reported that Another thing to consider is the sample population in
limited transportation options for out-of-campus both studies study. This study population is from Health
grocery stores and food joints were also perceived as and Sciences Faculty, which made them conscious of
barrier to food access. Bernsdorf et al., (2017), reported their own BMI and food consumption.

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 FOOD ACCESS AND FAST-FOOD CONSUMPTION BEHAVIOUR AMONG STUDENTS

CONCLUSION obesity. Future research should focus more on the long-

term effect of fast food consumption behaviour on
Availability of transportation influences respondents students’ academic performance and health related
accesses to fresh foods. Fast food consumption quality of life.
behaviour of the students was influenced by several
factors such as the taste of the food, and location of fast Conflict of Interest
food restaurant. There was no relationship between
transportation problem and fast food consumption The authors declare that there is no conflict of
behaviour, due to advance in technology food can be interests.
ordered online and can be delivered by the restaurant. ACKNOWLEDGEMENT
Lastly, there was no significant relationship between fast
food consumption behaviour and BMI since health The authors would like to thank all participating
science students were much aware about the effect of students, lecturers, and faculty administrators involved.

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