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Healthfulness of the Food Environment in Putrajaya, Malaysia: Implications for Public Health Action

Noor, N. F. M.; Mokhtar, S. A. b.; Minhat, H. S.; Ahmad, S. A.; Mokhtar, Z. A.

2025-11-17 public and global health
10.1101/2025.11.16.25340357 medRxiv
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IntroductionThe prevalence of overweight and obesity in Malaysia has reached unprecedented level, with Putrajaya recording among the highest rates. Despite this, limited attention has been given to understanding the local food environment, which plays a crucial role in shaping dietary behaviours. This observational study aimed to assess the healthfulness of food establishments in Putrajaya and provide insights into their implications for public health. MethodsA total of 745 food establishments, including 80 food stores and 665 eateries, were systematically identified, geocoded using Google Maps, and validated through cross-referencing with supplementary sources. Each establishment was assessed using the Nutrition Environment Measures in Stores (NEMS-S) and Nutrition Environment Measures in Restaurants (NEMS-R) instruments. capturing the availability, quality, pricing, and promotion of healthier food options. NEMS scores were computed and compared across establishment types. Descriptive statistics and spatial mapping were used to summarize and illustrate patterns of food environment healthfulness. ResultsHealthy food items such as whole-wheat bread, low-sugar cereal, and healthier beverages were more commonly available, whereas fruits and vegetables remained limited across stores. Supermarkets recorded the highest overall NEMS-S scores, followed by fresh markets and grocery shops, while convenience stores performed poorest. Among eateries, healthier menu options such as vegetable dishes, healthy entrees, and 100% fruit juice were more readily accessible as compared to fruits, whole-grain bread, and brown rice. 24-hour restaurants scored the highest NEMS-R scores, whereas fast-food outlets presented the greatest barriers to healthy eating. Spatial analysis revealed pronounced disparities, with healthier outlets clustering in northern precincts, while less healthy environments were more widely dispersed throughout the city. ConclusionThe study highlights notable disparities in the availability of healthy food options across Putrajaya. Strengthening policies and initiatives that foster healthier retail and dining environments is essential to promote nutritious eating and mitigate obesity risks in this planned urban community.

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