In this study, more than half of respondents had meals regularly and 40.2% had meals of at least three times per day. This finding was comparatively lower than that reported by a Chinese study in which 83.6% of university students consumed regular meals, with 79% of them took at least three times per day [17
]. Another study reported that 61.4% of Lebanese university students had regular meals daily[14
Regular breakfast consumption among medical students is important for sufficient energy intake to overcome fatigue due to busy (daily) learning schedule [20
]. In this study, less than half of respondents (43.9%) had breakfast daily. This finding was higher in comparison to a previous study [14
] which found that 31.8% of study population had breakfast daily. However, some studies from Malaysia found higher rates of daily breakfast consumption among Malay undergraduate students in Selangor (75.6%) [21
] and female adolescents in Pahang (52.6%) [5
The frequent consumption of snacks and light meals is a recognizable aspect of teenage food behavior [22
]. Surprisingly, our study found that only 42.4% of respondents had snacking at least three times per week. This finding was comparatively lower than previous studies from different countries, which found greater proportion of Syrian adolescents (53.0%) and Lebanon students (53.2%) [14
] consumed snacks regularly.
The majority of respondents in our study consumed vegetables and legumes frequently (81.8%). This finding was high in comparison to previous studies from China (47.9%) [17
] and Bahrain (26.3%) [22
]. However, one study from Malaysia found that only 19% of university students consumed vegetables more than three times per week [11
]. Our study also found that 48.5% of respondents consumed fruits at least three times per week. Similar finding was reported by Yahia et al.,(2008) [14
]. It was reported that low intake of fruits and vegetables is associated with several chronic diseases at adulthood [24
]. Our study disclosed that majority of medical students were aware of this health risk.
The typical university student diet is usually high in fat [25
]. Students often select fast food due to its palatability, availability and convenience [14
]. Surprisingly, our study found that only 21.2% of respondents consumed fast food often. Chin and Nasir, (2009) [5
] reported that only 4.7% of respondents visited fast food restaurants frequently. In contrast, Moy et al., (2009) [12
] reported that 60-70% of primary school students were fond of fast food. However, our study also found that majority of respondents (73.5%) consumed fried food at least twice a week or more, which was in line with that found by a previous study [14
Most of the respondents in this study (81.8%) had meals with their family or friends. This is comparatively higher to that found by a previous study in which 42.7% of university students had meals with their families or peers [14
Smoking and alcohol consumption were significantly associated with eating habit in this study. Similar findings were reported among Chinese university students [17
]. Our study also found a significant association between age and eating habits.
Attending a university or college can be a stressful experience for many college students [26
]. Previous studies found that behavioral consequences of stress may affect eating habits [27
]. People living in a stressful society tend to eat more as a way of coping with stress [26
]. A possible new innovation in this study was the association between eating habits and psychosocial factors among Malaysian medical students; eating habits score in this study was significantly lower among those who answered ‘yes’ on the following statements: “eat because of feeling lonely”, “eat until stomach hurts”, “eat because of feeling upset or nervous” and “eat because of feeling bored”. Kagan & Squires, (1984) [16
] suggested that uncontrolled eating patterns among college students could be due to compulsive eating behaviors. With the paradigm shift towards industrialization and cultural change globally, information on healthy diet has become scarce in many developing and developed nations. The most vulnerable group, being university students, have adopted unhealthy eating behaviors due to reduced availability, affordability and accessibility of healthy diet in university campuses and surrounding food outlets. This study exhibited multi-factorial causes affecting eating habits among Malaysian university students. Understanding the contexts of such multi-factorial causes may help healthy food promotional activities by parents, university authorities, food providers and health promotion officers. Results of this study may help to create a foundation for possible interventional programs on healthy eating habits promotions. Blended with different socio-cultural and psychological attributes across different regions, a unified healthy eating policy should be drafted, being potentially amalgamated and practiced in all regions including developing and developed nations.