Logically, nurses were thought to practice healthy lifestyle by having a good MTB. However, in this study 42.9% of the nurses were found to have poor MTB which reflected that they did not practice what they had learn throughout their services. This finding is almost the same in comparison to a study that was carried out by Muhammad et al. among nurses in Malaysia with almost similar sociodemographic distribution but working in hospital setting . Muhammad et al. (2014) in their study found 53% of the nurses perceived that they had poor eating by taking meal not at regular time (47%), skipping breakfast (49%), less frequent snacking (60%), favour in fried food (89%) and did not drink water as per recommended (90%) . This pattern of MTB of the nurses is expected as they were working in rotating shift and at the busiest wards (medical and surgical) with a high turnover of patient.
In this study, we found that most of the respondents skipped their meal (breakfast lunch or dinner), and they were mostly likely to skip dinner (44.7%) and breakfast (40%) throughout their working day. This was coherent to the finding by Coomarasamy et al. (2014) in their study among 1086 staff nurses in Malaysia who attended International Nursing Day and Seminar in 2012. These nurses were working at various public or private institution. They found a total of 37.2% of the nurses skip at least one meal per day. This show that, skipping meal was not only a problem among nurses working in hospital but also at other setting as well.
In a study conducted in India , they found that 40% of nurses skipped their lunch and other meals. These results contradict with our findings. However, our study was carried out in health clinic setting with a different workload and working hours which may be a factor to better compliant to lunch compared to hospital nurses with rotating shift . The trend of skipping breakfast and dinner among respondents needs to be prevented as it may increase the risk for overweight and obesity [18,19.20.21].
Abnormal body weights have become a great concern among nurses in Malaysia. More than half of our respondents had body mass index more than 25kg/m2 and 27.1% of the respondents were obese. These figures were higher when compared to the findings of previous studies where 18% to 23.5% of the respondents were found to be obese [5,6,21]. However, in our study the association between abnormal body weight and MTB was not statistically significant association.
Our research showed that eating home cooked foods for breakfast and dinner have significant association with a good MTB. A large cohort study found that taking frequent home cook foods was associated with better quality meals in terms of higher vegetable and fruitcontents . In addition to that, healthy fruit juice intake was found to be higher among those who take home cooked foods . Those who prepared less home cooked foods have significant association with eating fast foods and quick service foods . Fast food and quick service foods are usually having high salt amount which sometimes exceed the daily recommended amount even with one meal .
Having companies when taking lunch was found to influence MTB, as found in this study. A person’s MTB would be changed with whom they took their meal which also known as ‘modelling’ in order to adapt with the social norm [26,27]. In modelling, someone’s MTB was affected by adjusting of the amount of the food intake due to the appropriateness based on the occasion . Even though many people do not acknowledge that eating companion would affect their MTB compared to the self- factors such as hunger or type of food, however, study found that social cues did affect someone’s MTB as in social model .