Nutrition Research and Practice (Nutr Res Pract) 2013;7(2):132-138
pISSN 1976-1457 eISSN 2005-6168
Assessing the children’s views on foods and consumption of selected food groups:
outcome from focus group approach
Sharifah Intan Zainun Sharif Ishak1, Shamarina Shohaimi1§ and Mirnalini Kandiah2
1Department of Biology, Faculty of Science, University Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia
2Department of Food Science and Nutrition, Faculty of Applied Sciences, UCSI University, Malaysia
The food choices in childhood have high a probability of being carried through into their adulthood life, which then contributes to the risk of
many non-communicable diseases. Therefore, there is a need to gather some information about children’s views on foods which may influence
their food choices for planning a related dietary intervention or programme. This paper aimed to explore the views of children on foods and the
types of foods which are usually consumed by children under four food groups (snacks, fast foods, cereals and cereal products; and milk and dairy
products) by using focus group discussions. A total of 33 school children aged 7-9 years old from Selangor and Kuala Lumpur participated in
the focus groups. Focus groups were audio-taped, transcribed and analyzed according to the listed themes. The outcomes show that the children
usually consumed snacks such as white bread with spread or as a sandwich, local cakes, fruits such as papaya, mango and watermelon, biscuits
or cookies, tea, chocolate drink and instant noodles. Their choices of fast foods included pizza, burgers, French fries and fried chicken. For cereal
products, they usually consumed rice, bread and ready-to-eat cereals. Finally, their choices of dairy products included milk, cheese and yogurt.
The reasons for the food liking were taste, nutritional value and the characteristics of food. The outcome of this study may provide additional
information on the food choices among Malaysian children, especially in urban areas with regard to the food groups which have shown to have
a relationship with the risk of childhood obesity.
Key Words: Diet, child, obesity, Malaysia, focus groups
Childhood obesity is one of many public health concerns
nowadays as it has been identified to increase the risk of getting
other diseases in adulthood, including cardiovascular disease,
type 2 diabetes, hypertension and some cancers . The
prevalence of overweight and obesity among children is
increasing in many countries around the world, including
Malaysia. Also, the prevalence of overweight and obesity in
primary school children increased significantly from 2002 to
2008. Furthermore, the prevalence of overweight children
increased from 11.0% in 2002 to 12.8% in 2008. The same trend
was shown in the prevalence of obesity where the prevalence
increased from 9.7% in 2002 to 13.7% in 2008 . A number
of studies also demonstrated that the prevalence of overweight
and obesity among urban school children was higher than that
compared to rural school children [3,4].
The relationship between certain food groups and childhood
obesity was studied extensively and it has been well-established.
Snacks and fast foods consumption has been identified in
contributing to the development of childhood obesity . Previous
studies suggested that dietary fibre may help protect against
childhood obesity as dietary fibre affects food intake, digestion
and absorption of nutrients and carbohydrate metabolism .
Cereal and cereal products are sources of dietary fibre as well
as fruits, vegetables, legumes and other whole-grain products.
Besides dietary fibre, several studies also suggest that dairy
products may have favourable effects on body weight in children
[7,8] and adults [9,10]. As the food groups above have potential
effects on children’s health, it is important for public health and
education professionals to identify what types of foods in the
food groups are actually consumed by children in order to
develop interventions to encourage them to make better food
choices and reduce the risk for chronic diseases.
Children’s food choice is crucial as it becomes one of the
determinants of their food intake, which then influence their
nutritional status in terms of their development, growth and
health. Their food choices in the early stage of life have a high
This study was supported by a grant from the Ministry of Higher Education of Malaysia under the Fundamental Research Grant Scheme (FRGS) (Project No.:
§Corresponding Author: Shamarina Shohaimi, Tel. 603-8946-6637, Fax. 603-8656-7454, Email. email@example.com
Received: May 20, 2012, Revised: February 7, 2013, Accepted: February 8, 2013
ⓒ2013 The Korean Nutrition Society and the Korean Society of Community Nutrition
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/)
which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Sharifah Intan Zainun Sharif Ishak et al.
∙What is your favourite food?
∙Why do you like the food?
∙What is the food you do not like?
∙Why don’t you like the foods?
∙What is snack? Give an example.
∙What kinds of snacks do you usually consume?
∙What is fast food? Give an example.
∙What kind of fast foods do you usually consume?
∙What are cereal and cereal products? Give an example.
∙What kind of cereal and cereal products do you usually consume?
∙What are milk and dairy products?
∙What kind of dairy products do you usually consume?
Fig. 1. Questions for focus group discussions
probability to be carried through into adult life. The link between
the diet during childhood and health in adulthood has been
proven in many studies [11,12]. The diet during childhood
contributes to the risk of disease in adult life such as coronary
heart disease, cancer, stroke, hypertension and osteoporosis.
It is important to assess children’s views on foods which may
influence their food choices among children in Malaysia since
there are only a scarce number of studies related to children’s
food choices that have been reported in this country. Most of
the information of children’s food choices was reported from
the other countries outside Malaysia [13-17]. The information
may not be applicable for Malaysian children due to the diffe-
rences in eating patterns and food availability. Perhaps the types
of foods commonly consumed by Malaysian children are already
known, but not all of the food types have been documented.
In addition, by having documented information on the food
consumption of Malaysian children, it can be used as references
for planning the related intervention and development of a dietary
assessment method such as a food frequency questionnaire and
dietary assessment aid such as food photographs specifically for
There were several studies conducted to determine food
consumption among children using either a qualitative or quanti-
tative approach [13,17,18]. Qualitative research methodology has
been used extensively in health and nutrition research. A focus
group discussion is one type of qualitative methodology which
has been applied widely in nutrition research. There were studies
which applied focus group discussions to assess adolescents’
perceptions about factors influencing their food choices and
eating behaviour  as well as to explore the perceptions of
physical activity and healthy eating among children . This
research method is also applied in studies to explore children’s
perspective on their everyday consumption of meals and snacks
, and to explore the social and cultural influence on food
However, there is a limited number of studies published on
the application of focus group discussion in order to explore
children’s views on foods and to determine the foods usually
consumed by children especially in Malaysia. The present study
aimed to explore the children’s views on foods and the types
of foods which are usually consumed by the children under four
food groups (snacks, fast foods, cereals and cereal products; and
milk and dairy products) using qualitative methodology, specifically
focus group discussions. Focus group discussions can be an
effective method for obtaining data from special groups such as
children who may have low literacy skills as the participants
can use their own words in explaining and describing their views.
Moreover, the qualitative method is applicable for this study as
individual opinions are the main interest [23,24].
Subjects and Methods
Five focus groups were conducted involving children aged 7-9
years old, who were divided into 5-10 participants per group.
All the sessions were held at school during school hours. The
focus group was conducted by a facilitator and assisted by a
scribe who took field notes throughout the discussion. The
discussion was conducted in Malay language and followed the
procedures in the Facilitator’s Guides booklet which was
prepared by the research team. Before the discussion session
started, the facilitator and scribe introduced themselves to the
participants and started the ice-breaking session in which each
of the participants were asked to briefly introduce themselves.
Then, the session proceeded with the introduction to the study
where the facilitator briefly explained the aims of the focus group,
the rules in the focus group and the confidentiality of the outcome
from the focus group. The participants were also informed that
the discussion will be audio-taped for the purpose of data
analysis. After the introduction, the discussion session began by
asking semi-structured and open-ended questions. The questions
for the focus group are listed in Fig. 1. Each focus group took
about 75 minutes and was conducted by the same two researchers.
The study was approved by the Medical Research Ethics
Committee of Faculty of Medicine and Health Sciences,
Universiti Putra Malaysia, Malaysia.
Participants for the focus group were recruited from two
primary schools in the urban area of Selangor and Kuala Lumpur,
Malaysia. The schools were drawn randomly from a list of urban
schools in Selangor and Kuala Lumpur which were obtained from
the website of the Department of Education from both states,
respectively. The parents of eighty children in Year 1 to Year
3 (7-9 years old) in both schools were given a letter informing
them about the study and asked their permission to allow their
children to participate in the focus group discussion. From the
total parents invited, 37 consents were obtained (46%). A total
of 33 children participated in the focus group and the remaining
4 children were not present on the day the focus group was
Food choices of Malaysian children
Characteristics of respondentsFrequency Percentage
Sex of children
Age of children (yrs)
Table 1. Characteristics of respondents by sex, age and ethnicity (n = 33)
Reasons of food liking Example of response
Taste of the foods
(n = 21, 63.6%)
∙“I like pizza because it’s tasty”
(8 years old boy)
∙Question: “Why don’t you like chocolate?
“Because it’s too sweet” (8 years old boy)
“I don’t like chocolate... it’s too bitter for me”
(10 years old girl)
∙“Orange is so sour... I don’t like it..”
(7 years old boy)
(n = 11, 33.3%)
∙“I like spinach. Spinach can provide nutrient”
(8 years old boy)
∙“I like vegetable and bread because both are
nutritious” (9 years old boy)
∙Question: “Why you don’t like sweets?”
“It can cause tooth ache” (7 years old girl)
“It is not a nutritious food” (7 years old boy)
Characteristics of the
(n = 5, 15.2%)
∙“I like nugget because it’s crispy” (8 years old girl)
∙“Ayam masak merah (chicken cooked with chilli
paste) smell delicious... that’s why I like it..”
(8 years old girl)
∙Question: “Why you don’t like to eat fish?”
“Fish has a lot of bones” (9 years old girl)
Table 2. Reasons of food liking among interviewed children and the number
of children responded to the respective reasons
Food groups Example of response
∙“Everyday I eat doughnut at the school canteen..”
(7 years old boy)
∙“I take fruits such as papaya as my snack...at least
3 times in a week...” (7 years old girl)
∙“French fries and fried chicken, the fast foods I
usually eat... I can easily buy it from fast food
restaurant or school canteen.” (7 years old boy)
Cereals products with
∙“I frequently eat ready-to-eat cereals with milk...
anytime, not only for breakfast...” (7 years old boy)
Table 3. Types of snacks, fast foods, cereal products and dairy products
consumed among interviewed children
conducted. The characteristics of participants by sex, age and
ethnicity are shown in Table 1.
Analysis of the data was based on the questions asked during
the focus groups. Focus groups were audio-taped with prior
consent from the participants and transcribed while referring to
the field notes which were taken by the scribe. The audiotapes
were then listened to again in order to identify responses for
every question. After the analysis process was completed, the
outcomes were organized into themes based on the response from
participants as below:
• Favourite and non-favourite food
• Reasons of food liking
• Consumption of snacks, fast foods, cereals and cereal
products and dairy products
• Knowledge about snacks, fast foods, cereals and cereal
products and dairy products
Favourite and non-favourite food
Most of the interviewed children (n = 20, 60.6%) like to eat
cereal and cereal products. The children like to eat various types
of rice for example white rice or in combination with other dishes
such as chicken, fish and vegetables like water spinach, carrot,
spinach, long bean, cucumber and cabbage. The other types of
rice were nasi lemak (rice cooked with coconut milk served with
anchovy, chilli paste and boiled egg), chicken rice (rice served
with steamed or fried chicken and chicken soup) and fried rice.
Their favourite cereal products were ready-to-eat cereals with
milk, fried kuehteow, fried vermicelli, white bread and instant
noodles. Furthermore, they also like to eat fast foods including
nuggets, fried chicken, pizza and burgers. Some types of fruits
such as apple, mango and also salad (mixture of fruits and
vegetables) were also popular among the children. On the other
hand, some of the children dislike ice cream, chocolate, sweets,
fish, fruits such as oranges, papaya, bananas, water melon and
rose apples and also vegetables such as pumpkin and cucumber.
Reasons of food liking
There were several reasons why they like and dislike certain
foods. One of the reasons was the taste of the foods. Some of
them (n = 11, 33.3%) like or dislike the food because of their
knowledge that the foods are nutritious and good for their health
or the foods are not nutritious and can cause illness. Furthermore,
the other reason for liking a particular food is the characteristics
of the foods such as crispiness and smell. The examples of
responses for the reasons of liking a particular food are shown
in Table 2.
Consumption of snacks, fast foods, cereals and cereal products
and dairy products
The children usually consumed snacks between breakfast and
lunch and between lunch and dinner. Between breakfast and
lunch, they consumed white bread with peanut butter, kaya
Sharifah Intan Zainun Sharif Ishak et al.
Food groups Example of response
∙“For me, all foods can be snacks..” (7 years old girl)
∙“Snacks are all about junk food..” (9 years old girl)
∙Question: “What is fast food?”
“Fast food is the food that can cause illness”
(8 years old girl)
“It’s the food that contains fat” (8 year old boy)
“It’s the unhealthy food” (8 year old girl)
Cereal and cereal
∙“Cereals are the nutritious foods..like breakfast
cereals..Koko Crunch and Honey Star, which I eat
every morning” (7 years old boy)
Milk and dairy products ∙“I know what dairy products is...it’s like milk and ice
cream..” (7 years old boy)
Table 4. Knowledge about snacks, fast foods, cereals and cereal products and
dairy products among interviewed children
(spread made from coconut) and sardines as sandwiches, local
cakes, such as karipap (curry puff) and local doughnut and fruits
such as papaya, mango and watermelon. The types of foods they
consumed between lunch and dinner were biscuits or cookies,
tea, chocolate drink and instant noodle. For fast foods, the
children usually consumed pizza, burgers, French fries and fried
chicken. The types of cereal and cereal products which they
frequently consumed were rice, bread and ready-to-eat cereals
such as Koko Crunch, Honey Star and cornflakes. The children
also frequently consumed milk and other dairy products like
cheese and yogurt with various flavours such as strawberry, grape
and mango. The examples of responses for the types of snacks,
fast foods, cereal products and dairy products consumed among
interviewed children are shown in Table 3.
Knowledge about snacks, fast foods, cereals and cereal products
and dairy products
When the children were asked about the definition of a snack,
they had no idea what a snack is. Some of them think that all
snacks are unhealthy, but the fact is snacks can be healthy and
unhealthy depending on the choice of food. They listed keropok
(local crisp made of shrimp/ fish and rice flour), instant noodles,
potato chips and junk food as examples of snacks. For fast foods,
children aged 7 years old cannot give the definition of fast food
and gave wrong examples of fast food such as fruits and
vegetables. On the other hand, older children gave some ideas
about what fast food is. When they were asked about cereal and
cereal products, most of them did not know what cereal and cereal
products are. Only one gave an opinion about cereals. After
explaining the definition of cereal and cereal products to them,
they were able to give several examples of cereal brands such
as Koko Crunch, Honey Star and Nestum. Finally, for milk and
dairy products, most of the children do not know what a dairy
product is. Only one gave an opinion. The examples of responses
for the knowledge about snacks, fast foods, cereal products and
dairy products among interviewed children are shown in Table 4.
In this study, we found that most of the children like food
because of the taste. The other reasons are because the food is
nutritious and the attractive characteristics of the food such as
a nice smell and the foods texture, for example the crispiness.
Previous studies have shown that the taste of food emerged as
a major limiting factor related to consumption  and children’s
liking of the taste of a product has been identified as the most
important determinant of children’s food choice [26-28]. Besides
taste, the appearance, the smell and the way the food is prepared
or served contribute to the most important influence on food
choice among adolescents .
Most of the interviewed children like to eat rice. In Malaysia,
rice is the staple food and is one of the main energy sources
for Malaysian people. It is usually consumed twice daily as lunch
and dinner, served and consumed in many ways of cooking with
a variety of dishes. This outcome is not surprising because the
liking for some foods or products can be increased after repeated
exposure and this is also shown in a previous study . Salad,
the mixture of various types of fruits and/or vegetables mixed
together with small amounts of condiments such as mayonnaise
is also one of their favourite foods. They informed that their
mother usually prepared salad at home. As we know, salad is
easy to prepare and this is the convenient way to prepare the
food for working parents.
The children also like ready-to-eat cereals, such as cornflakes
which is usually consumed during breakfast. They like to eat
fried kuehteow and fried vermicelli, which can be easily bought
from restaurants or hawker stalls. Some of the children also like
to eat fast foods such as instant noodles, nuggets, fried chicken,
pizza and burgers. The children still consumed the fast foods
despite acknowledging that it is unhealthy and is not good to
consume frequently. Only a few of them like to eat fruits such
as apples and mangos and vegetables such as water spinach,
carrots, spinach, long beans, cucumbers and cabbage. They like
to eat fruits and vegetables not only because of the taste but
also because they know that vegetables are nutritious and good
for their health. A previous study also showed this positive
outcome in which children were eating fruits and vegetables for
their general health or for specific nutrients or benefits .
For non-favourite food, interestingly, some children also dislike
some types of foods when they know that the food is not good
for their health for example chocolate, sweets and ice cream.
The children do not like sweets as they know it can cause tooth
aches. This shows that intervention can be carried out to decrease
the intake of non-healthy foods and increase the intake of healthy
foods by explaining to them the long-term benefits and
consequences of over-consuming such types of foods. This
outcome also shows that the children did not only choose or
avoid foods based on their contents, but they also consider it
based on their basic knowledge on the health-related effect of
consuming the foods. However, they do not like some types of
Food choices of Malaysian children
fruits such as oranges, papayas, bananas, watermelon and rose
apples. One interviewed child did not like fish because of the
characteristics of fish with lots of bones.
In this study, we defined snacks based on the time criterion.
Food considered as meals are the foods consumed between 8
and 10 am, between 12 and 2 pm, and between 6 to 8 pm. Any
food item consumed between the meals is considered to be a
snack . Snacking can be an important way to meet the energy
and nutrient needs of growing children or it can lead to excess
energy intake . Most of the children interviewed take
nutritious snacks. They usually consumed snacks between
breakfast and lunch in school during recess time at about 10
to 10.30 am. Some of them brought food from home such as
bread and sandwiches and some children buy them at the school
canteen for example fruits and local cakes.
For the children who attend the morning school session, they
usually consume snacks in the evening at home and vice versa.
They usually consume biscuits or cookies with tea or chocolate
drinks as evening snacks. The types of snacks which we found
in the study were quite similar to the previous findings  which
reported that the usually consumed snacks among children and
adolescents were keropok (local crisp made of shrimp or fish
and rice flour), biscuits and bread followed by some local cakes.
The children also think that all snacks are always unhealthy food,
but the fact is snacks can be nutritious or non-nutritious
depending on the types of food chosen. Snacks can be classified
based on food categories by their quality and composition. Snacks
are usually classified as high quality, for example an apple and
a glass of milk; or low or no quality, such as ice cream and
Western fast foods are very popular among the children
interviewed. They usually consume fast foods such as pizza,
burgers, French fries and fried chicken. The reason why they
can usually consume these foods is because the foods are easily
accessed either in the school or at home. French fries and fried
chicken for instance can be bought from the school canteen or
can be prepared at home using frozen processed fries and chicken.
Younger children did not have any idea about fast food, while
older children could give some idea about what fast food is.
However, all of them only have negative ideas about fast food
including how fast foods can cause bad effects to their health,
contains high fat and is unhealthy. This shows that they are quite
exposed to the fact that most of the fast foods are not good
for their health.
Some of the children usually consumed fast foods at fast food
restaurants with their family during weekends. A previous study
has shown that around 60-70% of children consumed fast food
and local hawker food in a week . The consumption of fast
foods in children have to be controlled as the previous study
reported that those who consumed fast foods more than four times
a week were more likely to be overweight and obese (24%) than
those who consumed fast foods less than four times a week (20%)
in the sample of primary school children aged 9 to 10 years
old in Selangor, Malaysia .
Interviewed children also consumed cereals as their main meals
(breakfast, lunch and dinner) and snacks. They usually eat
ready-to-eat cereal during breakfast while rice is consumed
everyday during lunch and dinner. Maybe ready-to-eat cereals
are a popular choice of breakfast meals because they are fast
and easy to prepare and consumed in the morning. The
convenience of food has been identified as one of the most
important factors perceived as influencing food choices in
adolescents . In addition, the advantage of having cereals
for breakfast was reported in a study that showed children who
skipped breakfast or ate non-cereal breakfast foods had a
significantly higher mean body mass index and blood cholesterol
level than children who ate breakfast, especially ready-to-eat
cereals . This is because breakfast cereal is usually lower
in fat and higher in fibre than a non-cereal breakfast, therefore
this finding suggests that high-fibre and low-fat meals may help
protect against childhood obesity. As discussed previously, cereal
and cereal products such as rice and bread are one of the main
energy sources for Malaysian people. Besides, cereal is also an
important source of dietary fibre, along with fruits, vegetables,
legumes and other whole-grain products .
Milk and other dairy products are among the best natural
sources of calcium. Almost all of the children interviewed
consumed milk every day during breakfast and supper. Based
on a previous study, eating breakfast has a positive impact on
milk intake and increases calcium intake . Most of the
children interviewed consumed ready-to-eat cereals with milk as
their breakfast. This has been studied in the Bogalusa Heart
Study, whereby most of the 10-year-old children (96%) who
consumed ready-to-eat cereals also consumed an item from the
milk group . Only a small number of children said that they
usually consume cheese and yogurt.
There are some limitations in the present study. Firstly, this
study may not be generalized for all Malaysian children as the
study takes part in only urban areas of Selangor and Kuala
Lumpur with only 7-9 years old children and the proportion of
the participants are not divided according to the proportion of
Malaysian children. In future studies, it is recommended to
expand the framework to both urban and rural areas to obtain
a better understanding of the food intake of Malaysian children.
Finally, the interviewed children are quite young and this may
affect the reliability of their report. For future studies, it is
suggested to interview parents, children and also school canteen
operators to gather better information about the availability of
foods in the school and home environment and the children’s
food choices in both settings.
The present study shows that children’s preferences of food
depend on several factors such as the taste, nutritional value and
characteristics of the food. Therefore, in order to promote healthy
food to children the food manufacturer should produce healthy
foods with good taste and an attractive presentation which is
child-friendly. Also, parents and teachers should educate the
Sharifah Intan Zainun Sharif Ishak et al.
children about healthier food choices, as they might be interested
in the food after they know the nutritional value of the food.
Parents have an important role in providing healthy foods and
snacks for their children at home. Schools also have to provide
the best environment for promoting fruits as snacks. Furthermore,
it is very important to promote the intake of fruits and vegetables
as snacks because they do not only satisfy the appetite but are
also nutritious. The outcome of this study may provide additional
information on the children’s views on foods and the
consumption of selected food groups among Malaysian children,
especially in urban areas with regard to the food groups which
have shown to have a relationship with the risk of childhood
obesity. Moreover, the outcome from this study may be useful
for future research in planning a related intervention or health
programme in order to improve the eating habits of children.
The authors would like to convey appreciation to Wong Yoke
Wei and Abdul Hafiz Abdul Rahman for assistance in field work.
The authors gratefully acknowledge the Ministry of Education
of Malaysia, Department of Education of Selangor and Kuala
Lumpur and all the teachers and students who participated in
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