title: Unhealthy diet practice and symptoms of stress and depression among adolescents in Pasir Gudang, Malaysia.
abstract: Missing main meals and an unhealthy snacking pattern can lead to poor diet quality and consequently to the presence of chronic diseases among which mental disorder is no exception. Since there is little research on diet, skipping meals and psychological status in Asian countries, this study tries to determine eating behaviour and predicting symptoms of stress and depression of adolescents in Pasir Gudang, Malaysia.
  
  
  
  A cross-sectional study was conducted among Form 1 secondary school-going adolescents (n 1565, response rate: 90%) in southern Malaysia from April to May 2013. A self-administered structured and validated questionnaire (socio-demographic, eating behaviour questionnaire, and depression, anxiety and stress scales (DASS-21)) was used for data collection.
  
  
  
  Among respondents, 803 (51.3%) were female, 1125 were Malay (71.9%) with a mean age of 13.7 (SD=0.8) years. Logistic regression analysis indicated that students who were underweight (OR=3.07, 95% CI 1.21, 7.76), obese (OR=2.64, 95% CI 1.01, 6.87), used to eat out of home (OR=1.37, 95% CI 1.28, 2.13), eat dinner (>4 days/week) (OR=1.59, 95% CI 1.04, 2.43) were more likely to have depression or stress symptoms. Moreover, participants with 4-7 days/week eating breakfast (OR=0.88, 95% CI 0.21, 0.89) were less likely to be at mild/moderate stress.
  
  
  
  Findings underscore the effect of unhealthy eating practices among adolescents on mental health. Targeted education should be implemented to improve psychological well-being.
authors.affiliation: Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, University Putra Malaysia, Malaysia.
authors.forename: Esra
authors.initials: E
authors.lastname: Tajik
authors.affiliation: Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Malaysia. Electronic address: latiffah.latiff@gmail.com.
authors.forename: Abd Latiff
authors.initials: AL
authors.lastname: Latiffah
authors.affiliation: Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Malaysia.
authors.forename: Hamidin
authors.initials: H
authors.lastname: Awang
authors.affiliation: Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, University Putra Malaysia, Malaysia.
authors.forename: Adznam
authors.initials: A
authors.lastname: Siti Nur'Asyura
authors.affiliation: Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, University Putra Malaysia, Malaysia.
authors.forename: Yit Siew
authors.initials: YS
authors.lastname: Chin
authors.affiliation: Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Malaysia.
authors.forename: Abu Bakar
authors.initials: AB
authors.lastname: Azrin Shah
authors.affiliation: Department of Medical, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Malaysia.
authors.forename: Chai Hsia
authors.initials: CH
authors.lastname: Patricia Koh
authors.affiliation: Department of Medical, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Malaysia.
authors.forename: Che Ghazali
authors.initials: CG
authors.lastname: Mohd Izudin Hariz
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology*; D003866:Depressive Disorder / Q000209:etiology; D004032:Diet; D005247:Feeding Behavior; D005260:Female; D015438:Health Behavior; D006801:Humans; D016015:Logistic Models; D008296:Malaysia; D008297:Male; D062407:Meals; D009765:Obesity / Q000150:complications / Q000523:psychology; D012574:Schools; D062410:Snacks; D013315:Stress, Psychological / Q000209:etiology*; D013334:Students; D011795:Surveys and Questionnaires; D013851:Thinness / Q000150:complications / Q000523:psychology
keywords: Adolescents; Depression symptoms; Meal skipping; Snacking; Stress symptoms