Factors Associated With Knowledge, Attitudes, and Practices Regarding Functional Foods Among the Adult Population: A Cross-Sectional Survey in Bangladesh

Abstract

Background and aims: Functional foods (FF) may contribute to achieving both longer and healthier life expectancy. However, knowledge, attitudes, and practices (KAP) regarding FF remain unexplored in Bangladesh. Therefore, this study assessed KAP levels and their socio-demographic predictors among Bangladeshi adults. Methods: A cross-sectional survey was conducted among 966 adults in Bangladesh (May 2023-June 2023) using face-to-face interviews through structured questionnaire. Knowledge (12 dichotomous items, total 0-12 score), attitudes (10 items on a 3-point Likert scale, total 0-20 score), and practices (12 items on a 4-point Likert scale, total 0-36 score) were assessed, with cut-offs of < 6, < 10, and < 18 classified as poor, and ≥ 6, ≥ 10, and ≥ 18 classified as good, respectively. Group differences were analyzed using t tests and ANOVA, and sociodemographic predictors were identified through multiple linear regression with adjusted model. Results: Finding shows that the majority of participants had poor knowledge (75.3%) and poor practices (65.3%), though attitudes were overwhelmingly positive (90.1%). Lower knowledge score was associated with being a housewife (β = -2.7; p = 0.011) and poor health (β = -1.4; p = 0.039), while higher education (β = 1.5; p = 0.025), and higher monthly FF expenditure (> 1000 BDT; β = 2.3; p < 0.001) predicted higher knowledge. Positive attitudes were associated with female gender (β = 2.5; p = 0.002), good health (β = 1.6, p = 0.002), regular exercise at least 30 min (β = 2.9; p < 0.001), and chronic disease (β = 1.4; p = 0.011), while urban residence predicted lower attitudes (β = -1.9; p < 0.001). Higher practices were linked to higher income (> 10,000 BDT; β = 1.7; p = 0.033), regular exercise at least 30 min (β = 1.8; p = 0.011), chronic disease (β = 1.6; p = 0.033), and higher FF expenditure (β = 3.7; p < 0.001). Conclusions: Knowledge and practices regarding FF were generally low among Bangladeshi adults, despite predominantly positive attitudes. Education, gender, income, health status, and exercise mostly influence the KAP, highlighting implications for public health strategies, nutrition education programs, and future policy development related to FF consumption in Bangladesh.