Ultra-Processed Food Consumption Among University Students in Sabah, Malaysia: Evidence from a Knowledge, Attitude, and Practice Study

Abstract

Ultra-processed foods (UPFs) are industrially formulated food products that are widely consumed because of their convenience, availability, shelf stability and palatability. University students are a relevant population for UPF-related nutrition research because their food choices are shaped by time constraints, limited budgets, academic demands and campus food environments. This cross-sectional study assessed knowledge, attitudes and consumption practices related to UPFs among university students in Kota Kinabalu, Sabah. A total of 384 students from public and private universities participated in an online questionnaire survey conducted from September to November 2025. The questionnaire covered sociodemographic characteristics, UPF knowledge, attitudes towards UPFs and self-reported UPF consumption practices. Data were analyzed using descriptive statistics, independent samples t-test, one-way analysis of variance, chi-square or Fisher’s Exact Test where appropriate, and Spearman correlation, with statistical significance set at p<0.05. More than half of the respondents had high knowledge of UPFs (52.3%), while 54.4% showed a moderate attitude level and 66.4% reported high UPF consumption practices. Significant differences in knowledge scores were observed by gender, age, living arrangement, monthly allowance and education level. However, UPF consumption practices did not differ significantly by gender, age, living arrangement, monthly allowance or education level. Spearman correlation showed that attitude was moderately and significantly associated with practice (r=0.490, p<0.001), whereas knowledge was not significantly associated with attitude or practice. The findings suggest that knowledge alone may be insufficient to reduce UPF consumption among university students. Campus based nutrition strategies should address attitudes, convenience, food access and practical behaviour changes.