Abstract
OBJECTIVES: This study builds upon our previous MyNutriLifeCOVID-19 online survey conducted during Malaysia’s second national lockdown (MCO 2.0), by exploring a broader range of nutritional and lifestyle behaviours and their association with risks of underweight, overweight and obesity among Malaysian adults. DESIGN: Cross-sectional study. SETTING: The MyNutriLifeCOVID-19 was a nationwide survey conducted in all five regions (Central Zone, Northern Zone, Southern Zone, East-coast Zone and East-Malaysia) in Malaysia. PARTICIPANTS: A total of 1182 Malaysian adults participated in the online survey between March and May 2021. OUTCOME MEASURES: Self-reported body weight status, nutritional and lifestyle behaviours, including dietary practices, physical activity, perceived stress, and sleep quality were ascertained using a validated questionnaire. RESULTS: Approximately one-third of the Malaysian adults (36.8%) were either overweight or obese, with 8.63% underweight. Despite widespread intentions to manage weight, only 30% engaged in regular exercise. Poor sleep and unhealthy dietary behaviours, characterised by high sugar intake and low consumption of fruits and vegetables, were prevalent among the respondents. The hierarchical multinomial regression analysis revealed underweight was attributed to being single, experiencing high stress and insufficient exercise. Conversely, overweight and obesity were linked to being male, older, Malay ethnicity, lunch skipping, poor adherence to healthy eating concept, had disordered eating and frequent consumption of roasted foods. CONCLUSION: The present study revealed significant weight-related challenges faced by Malaysians during the national lockdown. Despite efforts at weight management, insufficient physical activity, poor sleep quality, and unhealthy dietary behaviours persisted. These findings underscore the complex interplay of sociodemographic, lifestyle, and dietary factors in shaping weight outcomes among Malaysian adults, emphasised the importance of addressing sociodemographic, lifestyle, and dietary factors in comprehensive public health strategies, as it highlighted multifaceted risk factors for both underweight and overweight/obesity. There is a need for targeted interventions addressing diverse risk profiles to promote healthier lifestyles and combat the growing burden of obesity-related health issues. The findings of this study offer crucial insights into the enduring consequences of the COVID-19 pandemic on Malaysian health behaviours. As the world grapples with the increasing threat of communicable diseases, understanding the long-term impacts of such events on lifestyle and health outcomes is imperative. Our research underscores the need for comprehensive public health interventions that address not only the immediate health challenges but also the lasting psychological and behavioural effects of crises. By investing in resilient health systems and promoting healthy lifestyles, we can better prepare for future pandemics and mitigate their devastating consequences. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-025-23699-9.