Assessing Dietary Supplement Use, Health Status Perception, and Mediterranean Diet Adherence Among Young Adults: A Cross-sectional Study

Main Article Content

Khang Jin Cheah
Yazan Ranneh
Xin Hui Hup
Chin Xuan Tan

Abstract

Introduction: Dietary supplement (DS) consumption has significantly increased, particularly post-COVID-19. However, the prevalence and determinants of DS intake among university students in Perak, Malaysia, remain underexplored. This study aimed to assess DS consumption, alongside knowledge, attitudes, and practices (KAP), and its association with perceived health status and Mediterranean diet adherence. Methodology: A cross-sectional study was conducted among students at Universiti Tunku Abdul Rahman (UTAR), Perak Campus. A validated questionnaire collected data on DS consumption patterns. Chi-square tests were used to examine differences between DS users and non-users across categorical sociodemographic variables. Logistic regression identified predictors of DS use, including knowledge, awareness of the Mediterranean diet, and perceived health status. Results: Among 278 respondents (25.9% male, 74.1% female), 38.8% reported DS use, with Vitamin C, fish oil, and Vitamin B complex being the most consumed. Poor knowledge (44.2%) and negative attitudes (61.2%) towards DS were common, regardless of usage. High-risk behaviours were exhibited by 50.9% of users. Significant associations were found between DS consumption and knowledge (p= 0.003) as well as Mediterranean diet awareness (p= 0.016), though no associations with gender, attitude, year of study, or education level were observed. Conclusion: Educational interventions are necessary to improve students' knowledge and awareness of DS, promoting safer consumption practices. Despite some awareness, the prevalence of high-risk behaviours highlights the need for professional guidance and monitoring.

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Khang Jin Cheah, Yazan Ranneh, Xin Hui Hup, & Chin Xuan Tan. (2025). Assessing Dietary Supplement Use, Health Status Perception, and Mediterranean Diet Adherence Among Young Adults: A Cross-sectional Study. Malaysian Journal of Medicine and Health Sciences, 21(6), 1382.1 –1382.13. https://doi.org/10.47836/mjmhs.v21.i6.1382
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References

Dwyer JT, Coates PM, Smith MJ. Dietary Supplements: Regulatory Challenges and Research Resources. Nutrients. 2018;10(1):41. doi: https://doi.org/10.3390/nu10010041.

Singh S, Razak MA, Sangam SR, Viswanath B, Begum PS, Rajagopal S. Chapter 2 - The Impact of Functional Food and Nutraceuticals in Health. In: Holban AM, Grumezescu AM, editors. Therapeutic Foods. Academic Press; 2018. p. 23-47.

Jun SA-O, Cowan AE, Tooze JA, Gahche JJ, Dwyer JT, Eicher-Miller HA-O, et al. Dietary Supplement Use among U.S. Children by Family Income, Food Security Level, and Nutrition Assistance Program Participation Status in 2011⁻2014. Nutrients. 2018;10(9):1212. doi: https://doi.org/10.3390/nu10091212.

(IPH) IfPH. The National Health and Morbidity Survey 2014: Malaysian Adult Nutrition Survey. 2015;Vol. 1: Methodology and General Findings:108 pages.

Wahab MSA, Hamdi H, Ali AA, Karuppannan M, Zulkifli MH, Maniam S, et al. The use of herbal and dietary supplements for COVID-19 prevention: A survey among the public in a Malaysian suburban town. Journal of Herbal Medicine. 2023;39:100650. doi: https://doi.org/10.1016/j.hermed.2023.100650.

Mohammed AH, Hassan BAR, Blebil A, Dujaili J, Wayyes AM, Abdulhamid OA, et al. Evaluating knowledge, habits, and beliefs regarding dietary supplements as a protective measure against COVID-19 in Malaysia and Iraq: A postsecond wave cross-sectional analysis. Health Science Reports. 2024;7(2):e1865. doi: https://doi.org/10.1002/hsr2.1865.

Naqvi AA, Ahmad R, Zehra F, Yousuf R, Kachela B, Nehal Nadir M. Dietary Supplement Use Among Students of Pharmacy Colleges in the City of Karachi, Pakistan: Prevalence, Opinions, and Attitudes. Journal of Dietary Supplements. 2019;16(2):166-78. doi: 10.1080/19390211.2018.1443191.

El Khoury D, Hansen J, Tabakos M, Spriet L, Brauer P. Dietary Supplement Use among Non-athlete Students at a Canadian University: A Pilot-Survey. Nutrients. 2020;12(8):2284. doi: https://doi.org/10.3390/nu12082284.

Islam MA, Al-karasneh AF, Rizvi M, Nisa ZU, Albakheet AM, Alshagawi MA, et al. Prevalence, reasons, and determinants of dietary supplements use among undergraduate female students of health and non-health colleges in a Saudi public university. PLOS ONE. 2021;16(3):e0247295. doi: 10.1371/journal.pone.0247295.

Žeželj SP, Tomljanović A, Jovanović GK, Krešić G, Peloza OC, Dragaš-Zubalj N, et al. Prevalence, Knowledge and Attitudes Concerning Dietary Supplements among a Student Population in Croatia. International Journal of Environmental Research and Public Health. 2018;15(6):1058. doi: 10.3390/ijerph15061058.

Bjelica A, Aleksić S, Goločorbin-Kon S, Sazdanić D, Torović L, Cvejić J. Internet Marketing of Cardioprotective Dietary Supplements. The Journal of Alternative and Complementary Medicine. 2020;26(3):204-11. doi: 10.1089/acm.2019.0128.

Dong W, Sun Z, Bai R. Prevalence of and Factors Associated With Nutritional Supplement Use Among Older Chinese Adults: A Nationwide Cross-Sectional Study in China. Frontiers in Public Health. 2022;10. doi: https://doi.org/10.3389/fpubh.2022.822087

Walrand S. Dietary supplement intake among the elderly: hazards and benefits. Current Opinion in Clinical Nutrition & Metabolic Care. 2018;21(6):465-70. doi: 10.1097/MCO.0000000000000512.

Alowais MA, Selim MAE. Knowledge, attitude, and practices regarding dietary supplements in Saudi Arabia. Journal of Family Medicine and Primary Care. 2019;8(2):365-72. doi: https://doi.org/10.4103/jfmpc.jfmpc_430_18.

Kobayashi E, Sato Y, Umegaki K, Chiba T. The Prevalence of Dietary Supplement Use among College Students: A Nationwide Survey in Japan. Nutrients. 2017;9(11):1250. doi: https://doi.org/10.3390/nu9111250.

Djaoudene O, Romano A, Bradai YD, Zebiri F, Ouchene A, Yousfi Y, et al. A Global Overview of Dietary Supplements: Regulation, Market Trends, Usage during the COVID-19 Pandemic, and Health Effects. Nutrients. 2023;15(15):3320. doi: https://doi.org/10.3390/nu15153320.

Kim D, Ji I, Ng’ombe JN, Han K, Vitale J. Do Dietary Supplements Improve Perceived Health Well-Being? Evidence from Korea. International Journal of Environmental Research and Public Health. 2021 doi: 10.3390/ijerph18031306.

Lieberman HR, Marriott BP, Williams C, Judelson DA, Glickman EL, Geiselman PJ, et al. Patterns of dietary supplement use among college students. Clinical Nutrition. 2015;34(5):976-85. doi: https://doi.org/10.1016/j.clnu.2014.10.010.

Huong C, Chua, J. L., Ng, R. Y., Panse, D. K., Misra, S., & Sumera, A. . Knowledge, attitude and practices (KAP) towards anaemia among female university students in Malaysia: A cross-sectional survey. Malaysian Journal of Nutrition. 2022;28(2):203-15. doi: https://doi.org/10.31246/mjn-2021-0067.

Mohd Radzi SNA, Abdul Razak RNH, Nik Hassan NF. Dietary Supplements: A Survey Use, Attitudes and Knowledge Among IIUM Kuantan Students. International Journal of Care Scholars 2021;4(Supp1):40-7. doi: 10.31436/ijcs.v4iSupp1.186.

Guasch-Ferré M, Willett WC. The Mediterranean diet and health: a comprehensive overview. Journal of Internal Medicine. 2021;290(3):549-66. doi: https://doi.org/10.1111/joim.13333.

Pourhoseingholi MA, Vahedi M, Rahimzadeh M. Sample size calculation in medical studies. Gastroenterology and hepatology from bed to bench. 2013;6(1):14-7.

Tareq MA, Emi UH, Banna MHA, Rezyona H, Seidu A-A, Abid MT, et al. Prevalence and factors associated with dietary supplement use among Bangladeshi public university students: A cross-sectional study. PLOS ONE. 2022;17(10):e0276343. doi: 10.1371/journal.pone.0276343.

World Health Organization (WHO). Obesity: Preventing and managing the global epidemic. Report of a WHO consultation. World Health Organization technical report series; 2000. p. i-253.

Omron: Instruction Manual: Body Composition Monitor Model HDF-375 Karada Scan. https://www.manualslib.com/manual/799747/Omron-Karadascan-Hbf-375.html?page=33#manual (n.d.). Accessed.

Elsahoryi NA, Odeh MM, Jadayil SA, McGrattan AM, Hammad FJ, Al-Maseimi OD, et al. Prevalence of dietary supplement use and knowledge, attitudes, practice (KAP) and associated factors in student population: A cross-sectional study. Heliyon. 2023;9(4):e14736. doi: https://doi.org/10.1016/j.heliyon.2023.e14736.

Tavakol M, Dennick R. Making sense of Cronbach's alpha. Journal of Medical Education. 2011(2):53-5. doi: https://doi.org/10.5116/ijme.4dfb.8dfd.

Taber KS. The Use of Cronbach’s Alpha When Developing and Reporting Research Instruments in Science Education. Research in Science Education. 2018;48(6):1273-96. doi: 10.1007/s11165-016-9602-2.

Kim H, Kim, H., & Byun, B. . Predictors of Pain, Perceived Health Status, Nutritional Risk, Social Support and Self-Transcendence on Depression Among Lower Income Senior Citizens. Indian Journal of Science and Technology. 2015;8(1):1-11. doi: 10.17485/ijst/2015/v8iS1/59099.

Ruggeri S, Buonocore P, Amoriello T. New Validated Short Questionnaire for the Evaluation of the Adherence of Mediterranean Diet and Nutritional Sustainability in All Adult Population Groups. LID - 10.3390/nu14235177 [doi] LID - 5177. Nutrients. 2022;14(23):5177. doi: https://doi.org/10.3390/nu14235177.

Hosmer DW, Lemeshow, S., & Sturdivant, R.X. Applied Logistic Regression. : John Wiley & Sons, Inc. ; 2013.

Hair JF, Black, W. C., Babin, B. J., Anderson, R. E., & Tatham, R. L. Multivariate Data Analysis. 7th ed. ed. New York: Pearson; 2010.

Choi J. The Association Between Health Conditions, Consciousness, Involvement, and Knowledge and Dietary Supplement Intake among University Students in South Korea. International Journal of Environmental Research and Public Health. 2019;16(20):4028. doi: 10.3390/ijerph16204028.

AlTarrah D, ElSamra Z, Daher W, AlKhas A, Alzafiri L. A cross-sectional study of self-reported dietary supplement use, associated factors, and adverse events among young adults in Kuwait. Journal of Health, Population and Nutrition. 2024;43(1):117. doi: 10.1186/s41043-024-00611-6.

AlTamimi JZ. Awareness of the Consumption of Dietary Supplements among Students in a University in Saudi Arabia. Journal of Nutrition and Metabolism. 2019;2019(1):4641768. doi: https://doi.org/10.1155/2019/4641768.

Pu B, Zhang L, Tang Z, Qiu Y. The Relationship between Health Consciousness and Home-Based Exercise in China during the COVID-19 Pandemic. International Journal of Environmental Research and Public Health. 2020;17(16):5693. doi: https://doi.org/10.3390/ijerph17165693

Mamun AA, Hayat N, Zainol NR. Healthy Eating Determinants: A Study among Malaysian Young Adults. Foods. 2020;9(8):974. doi: 10.3390/foods9080974.

Wang Y, Neilson LC, Ji S. Why and how do consumers use dietary supplements? A systematic review and thematic analysis. Health Promotion International. 2023;38(1):daac197. doi: 10.1093/heapro/daac197.

Delikanlı Akbay G, Karakullukçu E. Nutritional health, supplement and herbal product use, and Mediterranean diet evaluation among Turkish university students. Mediterranean Journal of Nutrition and Metabolism. 2024;17(4):335-47. doi: 10.1177/1973798X241289324.

Filipa A, Ana H, Luís Filipe G, Alexandra Marques P, Amélia B, Ana C, et al. Mediterranean diet adherence and nutritional literacy: an observational cross-sectional study of the reality of university students in a COVID-19 pandemic context. BMJ Nutrition, Prevention & Health. 2023;6(2). doi: 10.1136/bmjnph-2023-000659.

Almoraie N, Alothmani N, Alomari W, Al-Amoudi A. Addressing nutritional issues and eating behaviours among university students: A narrative review. Nutrition research reviews. 2024:1-45. doi: 10.1017/S0954422424000088.

Cheah KJ, Chua PL. Knowledge, Attitude, and Practice of Sugar-Sweetened Beverage (SSB) Among University Students in Klang Valley, Malaysia. Malaysian Journal of Medicine and Health Sciences. 2023;19(6):186-93. doi: 10.47836/mjmhs.19.6.25.

Sicinska E, Madej D, Szmidt MK, Januszko O, Kaluza J. Dietary Supplement Use in Relation to Socio-Demographic and Lifestyle Factors, including Adherence to Mediterranean-Style Diet in University Students. Nutrients. 2022 doi: 10.3390/nu14132745.

Ronis MJJ, Pedersen KB, Watt J. Adverse Effects of Nutraceuticals and Dietary Supplements. Annual review of pharmacology and toxicology. 2018;58:583-601. doi: https://doi.org/10.1146/annurev-pharmtox-010617-052844.

Lwakatare M, Mlimbila J. Dietary Supplement Use and Associated Factors Among Adults Working in Urban Settings in Tanzania: A Cross-Sectional Study. Health Services Insights. 2023;16:11786329231170752. doi: 10.1177/11786329231170752.

` Alqrache A, Mostafa M, Ghabrah O, Ghabrah Z, Kamal N, Ghabrah T, et al. Knowledge and Patterns of Dietary Supplement Use among Students Attending King Abdulaziz University in Saudi Arabia: A Cross-Sectional Study. Inquiry : A Journal of medical care organization, provision and financing. 2021;58:469580211020882. doi: https://doi.org/10.1177/00469580211020882.

Chan YM, Ab Rahim I, Khaw WF, Jawahir S. Factors Associated With Dietary Supplements Purchase Among Adults In Malaysia: Findings From A Nationwide Survey. Malaysian Journal of Public Health Medicine. 2024;24(1):67-74.