Seasonality was shown to have an effect on food availability and accessibility, increasing the risk of food insecurity and causing poor diet quality and malnutrition. Therefore, this study aimed to determine seasonal effects on household food security status, diet quality, and nutritional status of urban poor adolescents in Malaysia. A cohort study was conducted among 164 adolescents aged 10-17 from 12 People Housing Programme in Kuala Lumpur, Malaysia during the Northeast (November 2021 till March 2022) and Southwest (June 2022 till September 2022) monsoon. Household food security status was measured using the 18-item USDA Household Food Security Survey Module. Dietary intake was determined using a two-days 24-h dietary recall and translated into Standardized Malaysian Healthy Eating Index (S-MHEI). Anthropometric and haemoglobin level measurements were performed to determine nutritional status. Seasonality was found to have a significant effect on overall diet quality (p = 0.021), food groups such as fish (p < 0.001), meat/poultry/eggs (p = 0.003), and legumes/nuts (p < 0.001), and fat nutrient (p = 0.037) as well as anaemia status (p = 0.020) after controlling the confounders. Although food security did not vary with seasons, seasonality affected the consumption of certain food groups as well as anaemia status for urban poor adolescents. Seasonally sensitive nutrition initiatives should be developed to ensure diet adherence to recommendations, ultimately enhancing the diet quality of urban poor adolescents.
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