Exploring the impact of COVID-19 movement control orders on eating habits and physical activity in low-resource urban settings in Malaysia

BACKGROUND: The COVID-19 pandemic led Malaysia to introduce movement control orders (MCOs). While MCOs were intended to slow the spread of COVID-19, the effects of such measures on the noncommunicable disease (NCD) risk factors have not been fully explored. This exploratory study aimed to understand the effect of the MCO on the eating habits and physical activity levels of the urban poor in Malaysia as well as potential health promotion interventions during the COVID-19 pandemic.

METHODS: This rapid assessment used a mixed-method approach in three low-cost public flats in Kuala Lumpur targeting the B40, which is the bottom 40% of the economic spectrum. A total of 95 community members participated in a quantitative phone survey, while 21 respondents participated in a qualitative phone survey, including 12 community members and nine community health volunteers (CHVs).

RESULTS: The movement restriction imposed during the MCO significantly reduced the frequency and duration of respondents' physical activity. At the same time, respondents reported significantly increased consumption of home-cooked meals. More than half of respondents reduced their consumption of packaged snack foods (53.7%), street desserts (54.7%), fast food (50.5%), soft drinks (50.5%), and 3-in-1 or instant drinks (50.5%) due to limited access during the MCO. B40 communities were receptive to potential interventions to encourage healthier eating and physical activity leveraging digital approaches under the 'new normal'. Reported concerns included internet accessibility and affordability, functionality, and digital literacy.

CONCLUSION: The COVID-19 pandemic requires innovation to address diseases and risk factors at the community level. While movement restrictions reduced physical activity, they created opportunities for low-income individuals to have greater control over their diet, enabling them to adopt healthier eating habits. Lifestyle changes experienced by vulnerable populations provide an opportunity for creative and technology-enabled interventions to promote healthy eating and exercise.