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Obesity and Dining Out: an Exploration of Dietary Trends in Urban Malaysia Sylvia S

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Obesity and Dining Out: an Exploration of Dietary Trends in Urban Malaysia Sylvia S University of South Florida Scholar Commons Graduate Theses and Dissertations Graduate School 3-28-2014 Obesity and dining out: An exploration of dietary trends in urban Malaysia Sylvia S. Lim University of South Florida, [email protected] Follow this and additional works at: https://scholarcommons.usf.edu/etd Part of the Public Health Commons, and the Social and Cultural Anthropology Commons Scholar Commons Citation Lim, Sylvia S., "Obesity and dining out: An exploration of dietary trends in urban Malaysia" (2014). Graduate Theses and Dissertations. https://scholarcommons.usf.edu/etd/5061 This Thesis is brought to you for free and open access by the Graduate School at Scholar Commons. It has been accepted for inclusion in Graduate Theses and Dissertations by an authorized administrator of Scholar Commons. For more information, please contact [email protected]. Obesity and Dining Out: An Exploration of Dietary Trends in Urban Malaysia by Sylvia Lim Siew Boon A thesis submitted in partial fulfillment of the requirements for the degree of Master of Arts Department of Anthropology with a concentration in Biocultural Medical Anthropology College of Arts and Sciences University of South Florida and Master of Public Health Department of Global Health with a concentration in Global Health Practice College of Public Health University of South Florida Major Professor: David Himmelgreen, Ph.D. Jaime Corvin, Ph.D. Daniel Lende, Ph.D. Date of Approval: March 28, 2014 Keywords: diet, urban, nutrition transition, Kuala Lumpur, biocultural anthropology Copyright © 2014, Sylvia Lim Siew Boon Dedication For my grandmother Lee Siu Eng: Your capacity to love and forgive humbles me. Your resourcefulness and strength amaze me. Thank you for the mee sua and memories. Acknowledgments I extend my immense gratitude to those who participated in this research. Thank you for sharing your stories and for reacquainting me with the city I grew up in. Your time, generosity, and patience are much appreciated. I wish to thank my advisor Dr. David Himmelgreen for his tremendous support, encouragement and guidance; my committee members Drs. Daniel Lende and Jaime Corvin for their valuable assistance and advice. Your offices were sanctuaries. I want to convey my gratitude to Drs. Wayne Westhoff, Boo Kwa, and Aurora Sanchez- Anguiano at the College of Public Health for their assistance in ensuring a smooth field experience. I am grateful to the faculty and staff at Universiti Sains Malaysia for contributing to this experience, especially Dr. Andrew Tan for being an excellent field supervisor, and Dr. Anwar Fazal for linking me with various organizations. I also want to acknowledge the staff at the Malaysian Ministry of Health and Institute of Public Health Malaysia for their help in securing key publications. I want to thank Ayeshah Syed for editing my research instruments and checking my translations; Chan May Hui, Kenneth Chan, Grace Chang, Muna Noor, Agnes Ong, Nadya Shahabuddin, Marina van Doorn-Hussain, and Yit Yuon Li for offering invaluable insights, rides, contacts and companionship; Allison Cantor, Isabella Chan, Gene Cowherd, James Kruczek, Nicole Lavick, Meredith Main, Charlotte Noble, MacKenzie Tewell, Jamee Thumm, and Dr. Christian Wells for their generosity and counsel. I am grateful for the support, love, and understanding from my mother Sheila, my father James, and my brother Samuel; the extended Lim clan; and Ginger Stefan. Last but not least, I want to express my deepest gratitude to my spouse Tony Stefan, a true model of patience and unconditional love. Without him, none of this would have been possible. This research was generously funded and supported by the University of South Florida College of Public Health, the Department of Anthropology, Universiti Sains Malaysia, and Sigma Xi, the Scientific Research Society. Table of Contents List of Tables ................................................................................................................................ iii List of Figures ............................................................................................................................... iv Abstract ...........................................................................................................................................v Chapter 1: Introduction ...................................................................................................................1 Purpose of research project .................................................................................................2 Summary of chapters ..........................................................................................................3 Chapter 2: Literature Review ..........................................................................................................5 Public health perspective ....................................................................................................5 Anthropological perspective: the biocultural framework ...................................................7 Globalization of food and the distribution of obesity risk ................................................11 Setting ..............................................................................................................................13 Brief history .....................................................................................................................14 Political/governing structure .............................................................................................15 Demographics ...................................................................................................................16 Economy and income ........................................................................................................17 Food/fuel policies and politics ..........................................................................................19 Prevalence of overweight/obesity and associated risks ....................................................21 National nutrition campaigns ............................................................................................22 Malaysian food consumption trends .................................................................................24 Street food consumption ...................................................................................................26 Chapter 3: Methods .......................................................................................................................29 Sampling ...........................................................................................................................31 Recruitment .......................................................................................................................31 Recruitment criteria ..........................................................................................................33 Data collection ...................................................................................................................33 Instrumentation and pilot ......................................................................................33 Phase 1: Consumers, subgroup 2 ..........................................................................37 Phase 2: Consumers, subgroup 1 ..........................................................................37 Phase 3: Street food vendors .................................................................................38 Ethical review processes and conduct ...............................................................................38 i Chapter 4: Analysis and Findings .................................................................................................41 Phase 1: Consumers, subgroup 2 ......................................................................................42 Demographic and descriptive analysis ..................................................................42 Correlations and logistic regression analyses .......................................................49 Phase 2: Consumers, subgroup 1 ......................................................................................56 Demographics and anthropometry data ................................................................56 Diet recall data ......................................................................................................58 Interview data ........................................................................................................61 Theme 1: Work .........................................................................................62 Theme 2: Dining behavior ........................................................................65 Theme 3: Food, nutrition, and health ........................................................67 Theme 4: Concepts of street food/dining options .....................................70 Phase 3: Food vendors ......................................................................................................78 Demographics and business models .....................................................................78 Doing business ......................................................................................................81 Diet and more ........................................................................................................82 Chapter 5: Discussion and Conclusion .........................................................................................84
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