Introduction
Maintaining a healthy diet is more complex than a matter of personal choice. While the notion that one can be healthy if one chooses to be is valid, as individuals can make healthy choices by being informed and disciplined consumers, it overlooks a bigger factor that shapes our eating behaviours, one that consumers have little power over—the food environment.
Food environment refers to the everyday setting where we access foods and decide what to eat. It can vary according to location, lifestyle and occupation. The food environment plays an important role in influencing the food we can access, the type of food we eat and, consequently, our nutritional status.
A healthy food environment is one that allows—or even prompts—people to make food choices that contribute to their health and well-being. For example, suppose you are surrounded by a food environment where healthy options are readily available and more affordable than unhealthy choices. In that case, you are more likely to make healthier choices.
In contrast, if you are surrounded by a food environment that is dominated by fast food restaurants and convenience stores, you are more likely to purchase fast foods and unhealthy snacks.
The state of the food environment in Malaysia
Worryingly, an examination of Malaysia’s food environment based on the available data and research evidence paints a grim picture. The current food environment in the country does not make healthy food choices easy. Instead, it makes unhealthy food choices more desirable.
This is due to several factors, ranging from the high availability, accessibility and desirability of unhealthy foods to the unaffordability of healthier and more nutritious options.
The growing availability and accessibility of unhealthy food
Over the past decades, Malaysia’s reliance on imports for food supply has grown significantly, and so has the import of highly processed, energy-dense, and high-fat, sugar or salt foods. In fact, the import rate of these foods has been rising faster than that of healthier foods.
The consumption of food that is high in energy, fat, sugar or salt is commonly associated with obesity and non-communicable diseases (NCDs) such as diabetes, high cholesterol and heart diseases, which many Malaysians are already struggling with.
On the other hand, our national supply of fruits and vegetables, from both local production and import, is insufficient for the entire population to meet the recommended daily intake. It is, therefore, not surprising when national surveys consistently show that Malaysians do not consume adequate fruits and vegetables.
The increased use of online food delivery services, which gained popularity during the pandemic, also poses additional challenges for Malaysians to eat healthily.
While consumers enjoy greater convenience and wider choices when buying food online, they may also be exposed to more unhealthy options. The convenience of having food delivered to the doorstep may also promote excessive consumption and a sedentary lifestyle, further increasing the health risk of our population.
Health concerns over the increased usage of online food delivery services are not without reason. For instance, fast food such as fried chicken and burgers and sugary drinks like bubble tea, milk tea and teh tarik are commonly ordered or searched on Grab, a leading food delivery platform in Malaysia. Sweetened or carbonated beverages—major sources of sugar consumed by Malaysians—are frequently purchased as teatime and supper snacks.
Widespread unhealthy food advertising adds to the challenges
Besides accessibility and affordability, marketing and advertising are other significant factors in the food environment that significantly influence our food preferences.
There is strong evidence showing that unhealthy foods such as sweetened beverages, ice cream, fast food and snacks are advertised at a higher rate than healthy foods on TV and YouTube, platforms many schoolchildren use for educational content. Even more concerning, these advertisements tend to target children through higher advertising rates during school holidays and children’s peak viewing time.
Exposure to unhealthy food advertisements, especially those that use promotional characters, has been shown to influence children’s food preferences, purchase requests and actual consumption patterns. For example, children who are exposed to fast food advertisements are more likely to favour fast food than those who are not.
Adolescents and young adults, too, are at risk of being exposed to and influenced by pervasive food advertising on websites, social media apps and online games, which are currently unregulated. Digital advertising can be more persuasive than conventional advertising on broadcast media like TV and radio as it can be personalised and targeted through data analytics, algorithms and creative techniques such as the engagement of social media influencers.
Healthy diets are getting more costly
From 2017 to 2022, the cost of a healthy diet in Malaysia has risen by 26%. Fruit accounts for the biggest portion of the healthy diet cost (29%), followed by animal-sourced food (e.g. meat, fish, seafood and eggs) and vegetables. Expectedly, fruits are the food group that most Malaysians, especially the low-income group, do not consume sufficiently, suggesting that the higher cost of fruits relative to other food items may pose as a significant barrier to healthy eating.
The rising cost of a healthy diet, coupled with stagnating wage growth, will lead to more people, particularly those living in poverty or with low income, struggling to afford nutritious food. This is because the lower income groups are already dedicating a larger portion of their disposable income to food compared to those with higher income, making them more vulnerable to food price increases. To stay within their food budget, lower-income families may prioritise energy-abundant or filling foods like starchy foods and protein over micronutrient-rich foods like fruits.
While one can argue that meals prepared at home can be both nutritious and affordable, it fails to consider the hidden costs of home-cooked meals, such as time and energy costs. For people facing time constraints due to significant time spent working, commuting and fulfilling care responsibilities daily, meal preparation can become a burden. For those with low income or living in rental units, kitchen equipment and storage facilities may be limited, restricting their ability to cook at home or prepare meals in bulk.
Building an environment conducive to healthier choices
When unhealthy foods are more accessible, affordable and, with the effects of advertising, also more desirable and convenient than healthier options, it is no wonder that people consume them in excess.
It is high time we move away from emphasising individual willpower and focus more on the broader social and environmental factors that drive food choices, which can be addressed through effective policies.
In light of Malaysia's unhealthy food environment, simply promoting healthy food intake or discouraging people from consuming unhealthy food will not suffice. Ensuring that healthier choices are similarly, if not more, available, affordable, and accessible is equally important.
In preparation for the upcoming National Plan of Action for Nutrition of Malaysia (NPANM IV), the Nutrition Division of the Ministry of Health is encouraging the public and stakeholders to submit their feedback and nutritional aspirations via the Aspirasi Pemakanan Rakyat (ASPERA) initiative. This is an opportunity for us to collectively shape the policies that will impact our health and nutrition.
