Dietary Behaviours and Association with Nutritional Status Among Malaysian School-Based Adolescents: Findings from Adolescent Health Survey 2022.

Background/objective: This study determined the prevalence of dietary behaviours and examined their relationship with nutritional status among Malaysian school-based adolescents. Methods: Data from 33,523 adolescents who participated in the Adolescent Health Survey (AHS 2022) were analysed. Multiple logistic regression was employed to assess associations between dietary behaviours and nutritional status, adjusting for potential confounders. Results: Our findings demonstrated a double burden of malnutrition, with 6.8% stunting, 8.3% thinness, and 30.5% overweight/obese. High prevalence of inadequate daily intake of fruit and vegetables (FV) (83.9%) and insufficient daily dairy consumption (62.7%) was observed. Approximately one-third of adolescents reported frequent fast-food consumption (i.e., at least one day per week) (35.4%) and daily intake of carbonated soft drinks (32.4%). Daily carbonated soft drink consumption was associated with higher odds of overweight/obesity (aOR:1.11; 95% CI:1.04-1.20), highlighting the need to prioritise the public health strategies aimed at reducing sugar intake. Conversely, inadequate FV intake (aOR:0.88; 95% CI:0.81-0.95) and frequent fast-food consumption (aOR:0.87; 95% CI:0.82-0.94) were associated with lower odds of overweight/obesity, while insufficient daily dairy intake was associated with lower odds of thinness (aOR:0.83; 95% CI:0.73-0.94). These negative associations should be interpreted cautiously due to possible reverse causality and reporting bias. Conclusions: The findings highlight the importance of strengthening nutrition education and the food environment among Malaysian adolescents.