Groceries shopping practices and diet quality among Malaysian

Nur Islami Mohd Fahmi Teng*, Maziana binti Mat Zin and Nurhazimah binti Zakaria

Department of Nutrition and Dietetics, Faculty of Health Sciences, Universiti Teknologi MARA, 42300 Bandar Puncak Alam, Selangor, Malaysia

*Corresponding Author:
Nur Islami Mohd Fahmi Teng
Department of Nutrition and Dietetics, Faculty of Health Sciences
Universiti Teknologi MARA, 42300 Bandar Puncak Alam, Selangor, Malaysia
Tel:
+603-3258-4540
Fax: +603-3258-4599
E-mail: [email protected]
 

Abstract

Objective: Poor nutritional status had been associated with the diet quality and grocery shopping practices. Besides, the socioeconomic status influenced their behaviors toward grocery shopping practices. The aims of this study are i) to determine the association between diet quality and grocery shopping practices among supermarket adult consumers ii) to determine the risk factors that affect the grocery shopping practices among supermarket adult consumers.

Design: A set of questionnaires regarded on demographic data, and groceries shopping practices were administered.

Setting: This is a cross sectional study, conducted in Klang Valley, Malaysia.

Subjects: A total of 118 volunteered consumers between aged 20 to 64 years old were studied.

Results: This study showed that more than half of consumers categorized as regular shoppers (56.8%), while the remaining as recommended shoppers (43.2%). There was a poor positive (r = 0.233) and significant (p<0.05) correlation between diet quality and grocery shopping practices. Consumers that practiced recommended grocery shopping had better fruit (mean = 1.3, SD = 0.96, with p = 0.004) and vegetable (mean = 1.4, SD = 0.6, with p = 0.025) serving per day. Most of the consumers with poor diet quality come with secondary education (51.4%) (Crude OR [cOR]): 0.43; 95% CI: 0.19, 0.99), and low household income (47.7%) (cOR: 0.34; 95% CI: 0.15, 0.75).

Conclusions: Sociodemographic and diet quality may influence the groceries shopping practice. The findings of this study are useful to determine the potential groups for nutrition intervention programs in order to combat the health inequity among adults.

Keywords

Groceries shopping, Diet quality, Healthy eating index

Introduction and Background

Rapid growing of socioeconomic in the country for the past years led to significant changes of lifestyles among the communities. The sustained economic growth in Malaysia had resulted in a definite innovation in the food, which gave impact to the nutrition and health issues. One of the factors that lead to the obesity and overweight nowadays is poor quality in eating pattern due to lack of purchasing and consumption of fruits and vegetables [1].

Groceries’ shopping is one of the important factors that may affect the diet quality of an individual. This is due the rapid evolving of supermarkets that offers junk foods and processed foods. This expansion and diffusion of supermarket not only influence the producers but also the consumers due to the price and availability of the processed, packages and dried foods [2]. Most of these foods that are available in supermarket nowadays are high in sodium, sugar and fat content in which one of the element that contribute to the risk factor of non-communicable chronic disease as well as obesity. Several studies had investigated the expansion of supermarkets and their effect on small farmers and food retailing [3]. There was also studies by Balsevich, Berdegué, Flores, Mainville, and Reardon that analysed the relationship between the evolutions of supermarkets and consumer preferences as well as food safety [4]. However, there was a big research gap on the implication of grocery shopping practices towards eating pattern among adult consumers in the urban population.

Thus, the aim of this study is to determine the association of grocery shopping practices and diet quality among supermarket adult consumer. Besides, it is also important to highlight the risk factors that affect the grocery shopping practices.

Methodology

Subjects: A total of 118 adult consumers, aged between 20 to 64 years old were consented in this cross sectional study. We used purposive sampling technique, where we excluded those with physical and mental disability, terminally ill disease and those who spent money for business purpose related to foods. Participants were recruited from the hypermarket and residential area around Klang Valley. This study was approved by the Research Ethical Committee of Universiti Teknologi MARA.

Sociodemographic indicators: Information on age, gender, level of education, and level of income was obtained. Education was stratified into secondary and tertiary education. Level of income was categorizes in the basis of low (<MYR 2300), moderate (MYR 2300-5600) and high (>MYR 5600) *[MYR 1 = USD 0.233 as on 6th January 2016]. We further categorized into the amount of money usually spent for groceries shopping (<MYR100 or >MYR100) and the frequency of groceries shopping (daily, >4times, weekly or fortnightly).

Assessment of groceries shopping practices: The practices of groceries shopping among participants were assessed using questionnaire adapted from Turrell, Blakely, Patterson, Oldenburg [5]. The practices were then categorized into ‘recommended’ and ‘regular’ shoppers group. “Recommended” was defined as those who mainly purchased healthy foods, in line with the Malaysia Dietary Guidelines [6]. Further, the factors that influenced the purchasing patterns were determined.

Assessment of eating pattern and diet quality: Diet History Questionnaire (DHQ) [7] was used to assess dietary patterns on participants. Participants’ were interviewed regarding the type of food eaten, portion size, cooking method as well as the frequency of each type of meals taken. Based from the DHQ, the diet quality was further determined using Healthy Eating Index [8]. In the present study, we categorized the index into eight components (Table 1). Each component was calculated based on the scoring given and calculations for each score were done proportionately. The possible score range from 0-100 where the lowest score reflect poor compliance with Malaysia Dietary Guidelines and vice versa. The scoring was categorised into three; score <51% as poor, 51-80% as moderate, >8-% as good.

Component Maximum point Standard for maximum score Standard of minimum score of zero
Whole grain 10 4-8 servings/day No whole grains
Fish 10 = 1 serving/day No seafood or plant proteins
Meat 10 ½ - 1 servings/day No protein foods
Dairy product 10 1-3 servings/day No dairy
Green and bans 10 ½ - 1 serving/day No dark green vegetables or beans and peas
Fruits 10 =2 servings/day No fruits
Vegetables 10 =3 servings/day No vegetables
Sodium 10 =2400 mg/day =4800mg/day

Table 1: Component and scoring criteria of Healthy Eating Index

Statistical analysis: Data was analyzed using Statistical Package for the Social Sciences (SPSS) version 21.0. The normality of data was tested using Kolmogrov Smirnov test. Pearson correlation, Chi Square test, T test, and simple linear regression test were applied. The significant level was set at p value less than 0.05.

Results

Demographic

A total of 118 participants involved in this study. Demographics characteristics was summarised as in Table 2. Majority of the subjects have tertiary education level, perform their groceries shopping in weekly basis, and spent more than MYR 100 for groceries shopping.

Variable   n (%)
Age 20-39 years 64 (54.2)
  40-64 years 54 (45.8)
Gender Male 50 (42.4)
  Female 68 (57.6)
Educational level Secondary 37 (31.4)
  Tertiary 81 (68.6)
Frequency of shopping Daily 8 (6.8)
  >4 times 29 (24.6)
  Weekly 44 (37.3)
  Fortnightly 37 (31.4)
Money spent for groceries shopping <MYR 100 50 (42.4)
  >MYR100 68 (57.6)

Table 2: Sociodemographic characteristics

The groceries shopping practice

More than half of the subjects was categorised as regular shoppers (Table 3). Analysis of the risk factors that affect the groceries shopping shows that secondary educational level had decrease odds to practice recommended grocery shopping by 57% than tertiary educational level. Those who spent per shopping more than RM 100 had 1 times the odds to practice recommended grocery shopping than those who spent less than RM 100 whilst those who had income less than RM 2300 had 66% decrease odds to practice recommended grocery shopping than who had income more than RM 2300 (Table 4).

Groceries shopping practices n %
Regular 67 56.8
Recommended 51 43.2

Table 3: Groceries shopping practices

Risk Factor Crude OR (95%CI) p value
Age      
20-39 1.05 (0.51, 2.18) 0.899
40-64 1.00    
Gender      
Male 0.82 (0.44, 1.92) 0.819
Female 1.00    
Ethnicity      
Malay 0.65 (0.06, 7.37) 0.728
Others 1.00    
Educational level      
Secondary 0.43 (0.19, 0.99) 0.048
Tertiary 1.00    
Household income      
<RM 2300 0.34 (0.15, 0.75) 0.008
>RM 2300 1.00    
Money spend      
<100 0.44 (0.21, 0.95) 0.036
>100 1.00    

Table 4: Risk factors of groceries shopping practice

Further, we analysed the factors that may affect groceries shopping practices. As expected, concern about body weight was the significant factors that affected groceries shopping practices (p<0.05). In this case, a total of 60.6% subjects in recommended shoppers category concerns about their body weight as compared to only 39.4% from regular group. In contrast, price was the most important factors that influence the regular shoppers’ category (not significant) (Table 5).

Grocery shopping practices
  Regular Recommended p value
  n (%) n (%)  
Concerns about health n (%)     0.541
Yes  75 (63.6) 41 (54.7) 34 (45.3)  
No     43 (36.4) 26 (60.5) 17 (39.5)  
The Price n (%)     0.502
Yes  98 (83.1) 57 (58.2) 41 (41.8)  
No     20 (16.9) 10 (50.0) 10 (50.0)  
Your own taste preference n (%)      
Yes 61 (50.8) 36 (58.3) 25 (41.7) 0.621
No  57 (48.3) 31 (54.4) 26 (45.6)  
Partners’ taste preference n (%)     0.353
Yes  59 (50.0) 31 (52.5) 28 (47.5)  
No     59 (50.0) 36 (61.0) 23 (39.0)  
Children’s taste preference n (%)     0.126
Yes  53 (44.9) 26 (49.1) 27 (50.9)  
No   65 (55.1) 41 (63.1) 24 (36.9)  
Concerns about body weight n (%)     0.018
Yes  33 (28.0) 13 (39.4) 20 (60.6)  
No   85 (72.0) 54 (63.5) 31 (36.5)  
Suitability for young children n (%)     0.995
Yes  44 (37.3) 25 (56.8) 19 (43.2)  
No     74 (62.7) 42 (56.8) 32 (43.2)  
Out of habit n (%)      
Yes   26 (22.0) 15 (57.7) 11 (42.3) 0.915
No     92 (78.0) 52 (56.5) 40 (43.5)  
Availability n (%)     0.860
Yes  20 (16.9) 11 (55.0) 9 (45.0)  
No     98 (83.1) 56 (57.1) 42 (42.9)  
Taste preference of other adult n (%)     0.385
Yes  30 (25.4) 15 (50.0) 15 (50.0)  
No     88 (74.6) 52 (59.1) 36 (40.9)  

Table 5: Factors affecting groceries shopping

Diet quality

Table 6 summarised the diet quality based on shopping practices category. Consumers that practiced recommended grocery shopping had better fruits and vegetables serving per day (p<0.05) and high HEI score (p<0.05) as compared to regular shopping practices. However, total HEI score revealed that none of the subjects have good diet quality. More than half was categorise having moderate diet quality (Figure 1 and Table 7). Further, we analysed the association between shopping practices and diet quality. There was a poor positive (r = 0.233) and significant (p<0.05) correlation between eating pattern and grocery shopping practices as shown in Figure 2.

Characteristic Grocery shopping practices   p value
(mean ± SD) Regular Recommended  
  (mean ± SD) (mean ± SD)  
Grain      
Serving/day (5.9 ± 1.9) 6.0 ± 1.9 5.8 ± 1.7 0.571
HEI score (7.1 ± 1.9) 7.2 ± 1.9 7.01 ± 1.9 0.575
Meat      
Serving/day (1.5 ± 0.8) 1.5 ± 0.9 1.4 ± 0.7 0.546
HEI score (8.9 ± 2.2) 8.8 ± 2.4 9.0 ± 2.03 0.628
Fish      
Serving/day (0.9 ± 0.6) 0.8 ± 0.6 1.0 ± 0.6 0.215
HEI score (6.8 ± 3.5) 6.5 ± 3.7 7.2 ± 3.3 0.261
Legume      
Serving/day (0.3 ± 0.5) 0.3 ± 0.5 0.3 ± 0.5 0.994
HEI score (2.2 ± 3.5) 2.3 ± 3.6 2.2 ± 3.4 0.882
Fruits      
Serving/day (1.1 ± 0.9) 0.9 ± 0.8 1.3 ± 0.96 0.004
HEI score (5.0 ± 3.4) 4.1 ± 3.3 6.1 ± 3.3 0.002
Vegetable      
Serving/day (1.3 ± 0.7) 1.1 ± 0.7 1.4 ± 0.6 0.025
HEI score (4.2 ± 2.3) 3.8 ± 2.4 4.8 ±1.95 0.028
Dairy      
Serving/day (0.3 ± 0.5) 0.3 ± 0.6 0.3 ± 0.5 0.953
HEI score (0.9 ± 1.7) 0.9 ± 1.9 0.9 ± 1.6 0.954
Sodium      
Serving/day  (2598 ± 1003) 2549 ± 957 2663 ± 1068 0.545
HEI score (7.6 ± 3.2) 7.7 ± 2.96 7.4 ± 3.5 0.545

Table 6: Analysis of Diet Quality

Grocery shopping practices
  Regular, n(%) Recommended, n(%) p value
Poor 33 (49.3) 17 (33.3) 0.083
Moderate 34 (50.7) 34 (66.7)  
Good 0 0  

Table 7: Correlation between diet quality and groceries shopping practices

internalmedicine-HEI-score

Figure 1: Total HEI score

internalmedicine-diet-quality

Figure 2: Association between diet quality and groceries shopping practices

Discussion

Malaysia, is a county that has developed from agriculture based economy to manufacture industry [9]. This rapid change in economy subsequently affects the diet quality and eating pattern, especially among urban resident area. The rapid changes in the urbanisation and industrial food products contribute to the changes of food consumption in Malaysia as well as ‘westernised’ eating pattern [10]. Further, growing numbers of large supermarket with variety of local and imported groceries may affect the consumers’ choice and affect their diet quality.

There are many factors that can affect the grocery shopping practices among adult. Given in this study, higher education, better income and extra money spend in groceries shopping were the factors leading to better groceries choice. Higher education level may influence healthy practices as they are considered to have better knowledge about healthy eating [11]. They are also more likely to use nutritional labels during purchasing [12]. On the other hand, those with low education are more likely to have low income, rarely use nutritional label [13] and have higher tendency to purchased unhealthy foods together with low intake of fruit and vegetables. Nutritious foods also appears to be expensive than unhealthy food [14-16]. However, it is still unclear whether the healthy foods are really more expensive than less healthy foods when the price is as count per calorie [17]. Therefore, an education towards healthy foods purchase may be a potential intervention towards the low income population.

It can also be concluded that concern about body weight is the factor that makes people bought healthy groceries. However, the limitation in this study is that we did not measure our subjects’ body mass index, hence could not relate whether our subjects were concern about their current BMI (body mass index) or about getting overweight. Higher BMI often associated with unhealthy groceries shopping [18], and it is known that bad eating habit is well correlate with high BMI and chronic diseases. The recommended group was also found to have better intake of vegetables and fruits. Previous studies have concluded that the intake of these food groups was better in high income group [19-20]. Those with low income may found that both fruits and vegetables are expensive [21] and rather spent for their staple food.

Conclusion

To conclude, eating pattern was correlate positively with grocery shopping practice. People who practice better eating habit may perform groceries shopping wisely [22]. There is a need to conduct a larger scale of study with longer duration.

Conflict of Interest

There is no conflict of interest.

Acknowledgment

We thank Universiti Teknologi MARA for financial support via Lestari Grant, 600-IRMI/DANA 5/3 LESTARI (0094/2016).

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