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Improving Adolescent Dietary Behaviour

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A special issue of Nutrients (ISSN 2072-6643).

Deadline for manuscript submissions: closed (28 June 2019) | Viewed by 66700

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Special Issue Editor

Dr. Charlotte Evans

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Guest Editor

University of Leeds, Leeds, United Kingdom
Interests: improving diet quality and dietary behaviour of children and adolescents; Evaluations of interventions and policies in young people; Systematic reviews and meta-analyses of interventions and observational studies to improve health and diet quality

Special Issue Information

Dear Colleagues,

There is increasing recognition that improving dietary behaviour in adolescents requires different approaches compared to programmes aimed at children. Despite evidence that adolescents generally consume a poor quality diet compared to other age groups there is less published research from young people. Many current nutrition policies focus solely on younger age groups despite a need for improving diets of adolescents.

This Special Issue of Nutrients, entitled "Improving adolescent dietary behaviour” aims to bring together high quality evidence to be used by researchers, policy makers and health professionals to improve diet in adolescents. We welcome the submission of manuscripts describing either original qualitative or quantitative research or systematic reviews and meta-analyses in adolescents (we use the World Health Organization definition of adolescent; age 10-19 years).

Potential topics may include, but are not limited to:

Interventions, including randomised, non-randomised and pilot controlled trials and pre and post studies, that evaluate programmes to improve food and/or nutrient intake in adolescents
Observational studies such as longitudinal studies investigating associations between environmental factors and dietary behaviour in adolescents
Cross-sectional studies investigating determinants of poor diet and factors influencing food choice in adolescents
Qualitative studies exploring factors influencing dietary behaviour in adolescents
Methodological studies exploring the use of innovative methods in evaluation of diet quality in adolescents.
Systematic reviews and meta-analysis of adolescent studies with dietary behaviour outcomes.

Dr. Charlotte Evans
Guest Editor

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

Adolescent
Nutrition
Diet
Dietary behaviour
Food choice
Food environment
intervention
trial
policy

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Published Papers (12 papers)

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Editorial

Jump to: Research, Review

4 pages, 177 KiB

Open AccessEditorial

Next Steps for Interventions Targeting Adolescent Dietary Behaviour

by Charlotte E. L. Evans

Nutrients 2020, 12(1), 190; https://doi.org/10.3390/nu12010190 - 9 Jan 2020

Cited by 6 | Viewed by 3198

Abstract

Adolescents in many countries consume poor quality diets that include high intakes of sugary drinks and fast food and low intakes of vegetables. The aims of this Special Issue on adolescent dietary behaviour were to identify methods and approaches for successful interventions to improve diet quality in this age group and identify at risk subgroups that need particular attention. In total, 11 manuscripts were published in this Special Issue—three qualitative studies which included a systematic review, five cross-sectional studies and three quantitative evaluations of interventions. This Editorial discusses the contribution of the studies and provides suggestions to improve the success of future interventions in adolescents. It is important that adolescents are involved in the design of interventions to improve social and cultural acceptability and relevance. Interventions targeting schools or communities framed within a larger food system such as issues around climate change and the carbon footprint of food may improve engagement. Furthermore, targeting adolescents in areas of lower deprivation is a priority where diet quality is particularly poor. Potentially successful interventions also include environmental policies that impact on the cost and marketing of food and drinks, although evaluations of these were not included in this issue. Full article

(This article belongs to the Special Issue Improving Adolescent Dietary Behaviour)

Research

Jump to: Editorial, Review

12 pages, 260 KiB

Open AccessArticle

The ‘Voice’ of Key Stakeholders in a School Food and Drink Intervention in Two Secondary Schools in NE England: Findings from a Feasibility Study

by Lorraine McSweeney, Jen Bradley, Ashley J. Adamson and Suzanne Spence

Nutrients 2019, 11(11), 2746; https://doi.org/10.3390/nu11112746 - 12 Nov 2019

Cited by 10 | Viewed by 3296

Abstract

Background: Overweight/obesity affects one-third of UK 11–15-year olds. Individually focussed interventions alone have limited effectiveness. Food choice architecture approaches increase the visibility and convenience of foods to facilitate the choice of ‘healthier’ foods and reduce ‘unhealthy’ foods. This qualitative component of a School Food Architecture (SFA) study aimed to determine the perceptions of pupils and staff in relation to school food provision and their perceptions of the intervention. Methods: Pupil focus groups and staff one-to-one interviews. Topic guides were developed from literature and in consultation with a Young Person’s Advisory Group. Thematic analysis was applied. Results: Focus group (n = 4) themes included: dining hall practices, determinants of choice, and aspects of health. Interview themes (n = 8) included: catering practices, health awareness, education, and knowledge of intervention. Pupils liked to purchase hand-held, quick to purchase foods potentially limiting the access to fruits and vegetables. Pupils were aware of ‘healthier’ food choices but would choose other options if available. Conclusions: Schools provide a daily school meal for large numbers of pupils, with time and dining environment constraints. Pupils consume 35–40% of their daily energy intake at school, therefore interventions enabling healthier eating in school are essential, including making healthier choices readily available and accessible. Full article

(This article belongs to the Special Issue Improving Adolescent Dietary Behaviour)

16 pages, 1542 KiB

Open AccessArticle

Factors Influencing British Adolescents’ Intake of Whole Grains: A Pilot Feasibility Study Using SenseCam Assisted Interviews

by Maya Kamar, Charlotte Evans and Siobhan Hugh-Jones

Nutrients 2019, 11(11), 2620; https://doi.org/10.3390/nu11112620 - 1 Nov 2019

Cited by 14 | Viewed by 3727

Abstract

High whole grain intake is beneficial for health. However, adolescents consume low levels of whole grain and the understanding of the underpinning reasons for this is poor. Using a visual, participatory method, we carried out a pilot feasibility study to elicit in-depth accounts of young people’s whole grain consumption that were sensitive to their dietary, familial and social context. Furthermore, we explored barriers and suggested facilitators to whole grain intake and assessed the feasibility of using SenseCam to engage adolescents in research. Eight British adolescents (aged 11 to 16 years) wore a SenseCam device which auto-captured images every twenty seconds for three consecutive days. Participants then completed traditional 24-hour dietary recalls followed by in-depth interviews based on day three SenseCam images. Interview data were subjected to thematic analysis. Findings revealed that low adolescent whole grain intake was often due to difficulty in identifying whole grain products and their health benefits; and because of poor availability in and outside of the home. The images also captured the influence of parents and online media on adolescent daily life and choices. Low motivation to consume whole grains, a common explanation for poor diet quality, was rarely mentioned. Participants proposed that adolescent whole grain consumption could be increased by raising awareness through online media, improved sensory appeal, increased availability and variety, and tailoring of products for young people. SenseCam was effective in engaging young people in dietary research and capturing data relevant to dietary choices, which is useful for future research. Full article

(This article belongs to the Special Issue Improving Adolescent Dietary Behaviour)

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13 pages, 729 KiB

Open AccessArticle

Mapping and Predicting Patterns of Chinese Adolescents’ Food Preferences

by Shaojing Sun, Jinbo He and Xitao Fan

Nutrients 2019, 11(9), 2124; https://doi.org/10.3390/nu11092124 - 6 Sep 2019

Cited by 22 | Viewed by 4650

Abstract

This study aimed to examine the patterns of, as well as the predictors for, Chinese adolescents’ food preferences. Using the national data of the China Health and Nutrition Survey (CHNS), we analyzed the data of 697 adolescents in the age range of 12 to 17 years. Latent class analysis revealed four types of food preferences: varied diet (37.09%, n = 254), avoiding vegetables (19.69%, n = 131), low appetite (7.56%, n = 50), and healthy diet (35.66%, n = 222). Major predictors for food preferences included demographic variables (e.g., gender, urban versus rural residence), nutrition knowledge, preference for activities, and social attitudes. Results did not show any significant differences in BMI z-scores among the four latent classes. However, there were significant differences in the number of sleeping hours among the classes. Full article

(This article belongs to the Special Issue Improving Adolescent Dietary Behaviour)

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22 pages, 1392 KiB

Open AccessFeature PaperArticle

Healthy Planet, Healthy Youth: A Food Systems Education and Promotion Intervention to Improve Adolescent Diet Quality and Reduce Food Waste

by Melissa Pflugh Prescott, Xanna Burg, Jessica Jarick Metcalfe, Alexander E. Lipka, Cameron Herritt and Leslie Cunningham-Sabo

Nutrients 2019, 11(8), 1869; https://doi.org/10.3390/nu11081869 - 11 Aug 2019

Cited by 57 | Viewed by 11130

Abstract

Emerging evidence suggests a link between young people’s interest in alternative food production practices and dietary quality. The primary purpose of this study was to examine the impact of a student-driven sustainable food systems education and promotion intervention on adolescent school lunch selection, consumption, and waste behaviors. Sixth grade science teachers at two middle schools (n = 268 students) implemented a standards-based curriculum on sustainable food systems, addressing the environmental impacts of food choices and food waste. The cumulating curriculum activity required the 6th grade students to share their food systems knowledge with their 7th and 8th grade counterparts (n = 426) through a cafeteria promotional campaign to discourage food waste. School-wide monthly plate waste assessments were used to evaluate changes in vegetable consumption and overall plate waste using a previously validated digital photography method. At baseline, the intervention students consumed significantly less vegetables relative to the control group (47.1% and 71.8% of vegetables selected, respectively (p = 0.006). This disparity was eliminated after the intervention with the intervention group consuming 69.4% and the control consuming 68.1% of selected vegetables (p = 0.848). At five months follow up, the intervention group wasted significantly less salad bar vegetables compared to the control group (24.2 g and 50.1 g respectively (p = 0.029). These findings suggest that food systems education can be used to promote improved dietary behaviors among adolescent youth. Full article

(This article belongs to the Special Issue Improving Adolescent Dietary Behaviour)

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12 pages, 1095 KiB

Open AccessArticle

Examining the Efficacy of a ‘Feasible’ Nudge Intervention to Increase the Purchase of Vegetables by First Year University Students (17–19 Years of Age) in British Columbia: A Pilot Study

by Matheus Mistura, Nicole Fetterly, Ryan E. Rhodes, Dona Tomlin and Patti-Jean Naylor

Nutrients 2019, 11(8), 1786; https://doi.org/10.3390/nu11081786 - 2 Aug 2019

Cited by 12 | Viewed by 5060

Abstract

In the transition from high school to university, vegetable consumption tends to deteriorate, potentially influencing immediate and longer-term health outcomes. Nudges, manipulation of the environment to influence choice, have emerged as important to behavior change goals. This quasi-experimental pilot study examined the impact of a contextually feasible evidence-informed nudge intervention on food purchasing behavior of older adolescents (1st year students) in a university residence cafeteria in British Columbia, Canada. A co-design process with students and staff identified a student relevant and operationally feasible nudge intervention; a placement nudge, fresh vegetables at the hot food table, combined with a sensory and cognitive nudge, signage encouraging vegetable purchase). Using a 12-week single-case A-B-A-B design, observations of the proportion of vegetables purchased were used to assess intervention efficacy. Data analysis included visual trend inspection, central tendency measures, data overlap, variability and latency. Visual trend inspection showed a positive trend when nudges were in place, which was more apparent with female purchases and during the first intervention (B) phase. However, further analysis showed lack of baseline stability, high variability across phases and overlapping data, limiting efficacy conclusions. Menu choices, staff encouragement, term timing and student finances are other potential influences. Further ‘real world’ nudge research is needed. Full article

(This article belongs to the Special Issue Improving Adolescent Dietary Behaviour)

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15 pages, 2857 KiB

Open AccessArticle

Using Food Models to Enhance Sugar Literacy among Older Adolescents: Evaluation of a Brief Experiential Nutrition Education Intervention

by María Isabel Santaló, Sandra Gibbons and Patti-Jean Naylor

Nutrients 2019, 11(8), 1763; https://doi.org/10.3390/nu11081763 - 31 Jul 2019

Cited by 14 | Viewed by 7504

Abstract

Adolescent diets high in sugar are a public health concern. Sugar literacy interventions have changed intake but focused more on children, adults, and early adolescents and on sugar sweetened beverages rather than total sugar consumption. Food models are an efficacious experiential learning strategy with children. This study assessed the impact of two 45 min nutrition lessons using food models on adolescents’ sugar literacy. Classes (n = 16) were randomized to intervention or control with knowledge, label reading skills, intentions to limit sugar consumption measured at baseline and follow-up. Two hundred and three students aged 14 to 19 from six schools on Vancouver Island, BC, Canada participated in the study. Adolescents’ knowledge of added sugar in foods and beverages and servings per food group in a healthy diet was limited at baseline but improved significantly in the intervention condition (F(1, 201) = 104.84, p < 0.001) compared to controls. Intention to consume less added sugar increased significantly after intervention (F(1, 201) = 4.93, p = 0.03) as did label reading confidence (F(1, 200) = 14.94, p < 0.001). A brief experiential learning intervention using food models was efficacious for changing student’s knowledge about sugar guidelines and sugar in food, label reading confidence, and intention to change sugar consumption. Full article

(This article belongs to the Special Issue Improving Adolescent Dietary Behaviour)

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18 pages, 2227 KiB

Open AccessArticle

Non-Milk Extrinsic Sugars Intake and Food and Nutrient Consumption Patterns among Adolescents in the UK National Diet and Nutrition Survey, Years 2008–16

by Heidi T. Lai, Jayne Hutchinson and Charlotte E. L. Evans

Nutrients 2019, 11(7), 1621; https://doi.org/10.3390/nu11071621 - 17 Jul 2019

Cited by 7 | Viewed by 4573

Abstract

The revised guidelines from the Department of Health (DoH) in the UK state that mean population intakes of free sugars should be below 5% of the total energy (TE) consumption of the British population. However, very few studies have assessed the impact of this recommendation on diet quality in the UK. We explored the dietary patterns and intakes of micronutrients of British adolescents with low intakes of non-milk extrinsic sugars (NMES) (similar to free sugars but not equal, with slight differences in the categorisation of fruit sugars from dried, stewed or canned fruit and smoothies), using the National Diet and Nutrition Survey Rolling Programme, years 1–8 (NDNS RP). The sample included 2587 adolescents aged 11–18 years. Four percent (112) of adolescents reported consuming 5% or lower NMES as a proportion of TE. The odds of being categorised as a low-sugar consumer in adolescents (≤5% TE from NMES) were significantly lower with higher intakes of sweetened drinks, fruit juice, cakes, biscuits, sugar and sweet spreads, chocolate confectionery and sugar confectionery, and significantly higher with higher intakes of pasta and rice, wholemeal and brown bread, and fish. Across the five categories of NMES intakes, micronutrient intakes were lowest for those consuming either ≤5% TE or more than 20% TE from NMES, and optimal for those consuming between 10–15% of energy from NMES. These findings confirm the difficulties of meeting the free sugars recommended intake for adolescents. Care needs to be taken to ensure that an adequate consumption of micronutrients is achieved in those adhering to the revised guidelines on free sugars. Full article

(This article belongs to the Special Issue Improving Adolescent Dietary Behaviour)

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16 pages, 427 KiB

Open AccessArticle

Nutritional Behaviors of Polish Adolescents: Results of the Wise Nutrition—Healthy Generation Project

by Joanna Myszkowska-Ryciak, Anna Harton, Ewa Lange, Wacław Laskowski and Danuta Gajewska

Nutrients 2019, 11(7), 1592; https://doi.org/10.3390/nu11071592 - 13 Jul 2019

Cited by 18 | Viewed by 5087

Abstract

Background: Recognition of the dominant dietary behaviors with respect to gender and specific age groups can be helpful in the development of targeted and effective nutritional education. The purpose of the study was to analyze the prevalence of the selected eating behaviors (favorable: Consuming breakfasts, fruit, vegetables, milk and milk beverages, whole grain bread and fish; adverse: Regular consumption of sweets, sugared soft drinks and fast-foods) among Polish adolescents. Methods: Data on the nutritional behaviors were collected using a questionnaire. Body mass status was assessed based on weight and height measurements. Results: 14,044 students aged 13–19 years old from 207 schools participated in the study. Significant differences were found in the nutritional behaviors depending on age, gender and nutritional status. Favorable nutritional behaviors corresponded with each other, the same relationship was observed for adverse behaviors. The frequency of the majority of healthy eating behaviors decreased with age, whereas the incidence of adverse dietary behaviors increased with age. Underweight adolescents more often consumed sugared soft drinks, sweets and fast food compared to their peers with normal and excessive body mass. Conclusions: A significant proportion of adolescents showed unhealthy nutritional behaviors. Showing changes in the incidence of nutritional behaviors depending on age, gender and body weight status, we provide data that can inform the development of dietary interventions tailored to promote specific food groups among adolescents on different stages of development to improve their diet quality. Full article

(This article belongs to the Special Issue Improving Adolescent Dietary Behaviour)

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15 pages, 261 KiB

Open AccessArticle

Food Consumption in Adolescents and Young Adults: Age-Specific Socio-Economic and Cultural Disparities (Belgian Food Consumption Survey 2014)

by Lucille Desbouys, Karin De Ridder, Manon Rouche and Katia Castetbon

Nutrients 2019, 11(7), 1520; https://doi.org/10.3390/nu11071520 - 4 Jul 2019

Cited by 39 | Viewed by 5734

Abstract

A key issue in nutritional public health policies is to take into account social disparities behind health inequalities. The transition from adolescence toward adulthood is a critical period regarding changes in health behaviors. This study aimed to determine how consumption of four emblematic food groups (two to favor and two to limit) differed according to socio-economic and cultural characteristics of adolescents and young adults living in Belgium. Two non-consecutive 24-h dietary recalls were carried out in a nationally representative sample of 10–39 year old subjects (n = 1505) included in the Belgian food consumption survey 2014. Weighted daily mean consumption of “fruits and vegetables”, “whole grain bread and cereals”, “refined starchy food”, and “sugary sweetened beverages” (SSB) was calculated and explored in multivariable linear regressions stratified into four age groups. After adjustment, 10–13 year old adolescents living in less educated households daily consumed lower amounts of “fruits and vegetables” (adjusted mean: 165.6 g/day (95% CI: 125.3–206.0)) and “whole grain bread and cereals” (40.4 g/day (22.9–58.0)), and higher amounts of SSB (309.7 g/day (131.3–488.1) than adolescents of same ages living in more educated households (220.2 g/day (179.8–260.7); 59.0 g/day (40.3–77.8); and 157.8 g/day (1.7–314.0), respectively). The same trends were observed in older groups, along with strong consumption disparities according to region of residency, country of birth, and occupation, with specificities according to age. Our findings suggest the need to better explore such disparities by stage of transition to adulthood, and to adapt nutritional health programs. Full article

(This article belongs to the Special Issue Improving Adolescent Dietary Behaviour)

16 pages, 683 KiB

Open AccessArticle

Intake of Sugar-Sweetened Beverages in Adolescents from Troms, Norway—The Tromsø Study: Fit Futures

by Guri Skeie, Vårin Sandvær and Guri Grimnes

Nutrients 2019, 11(2), 211; https://doi.org/10.3390/nu11020211 - 22 Jan 2019

Cited by 12 | Viewed by 4361

Abstract

High intake of sugar-sweetened beverages (SSB) has been associated with weight gain and chronic disease. The objective of this paper was to study the intake of SSB and characteristics associated with SSB intake in adolescents from Troms, Norway. We present results from a cross-sectional analysis from the Tromsø Study: Fit Futures, with 426 female and 444 male students aged 15–17 years (93% participation rate). Descriptive statistics and logistic regression analyses were performed. Among females, 31.8% drank at least one glass of SSB per day on average, compared to 61.0% among males. The adjusted OR (odds ratio) of daily SSB drinking for males vs. females was 3.74 (95% CI (confidence interval) 2.68–5.22). Other dietary habits such as eating snacks, drinking artificially sweetened beverages, fruit juice, and seldom eating breakfast were associated with higher odds for daily SSB drinking, as was daily snuffing. Weight class was not associated with daily SSB drinking. Students in vocational studies, particularly males tended to be more likely to be daily SSB drinkers. The prevalence of participants who on average were daily drinkers was higher than in national studies. We have identified several possible targets for interventions. Clustering of unhealthy behaviours and tendencies to socioeconomic differences are of particular concern. Full article

(This article belongs to the Special Issue Improving Adolescent Dietary Behaviour)

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Review

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18 pages, 585 KiB

Open AccessReview

Socio-Ecological Influences on Adolescent (Aged 10–17) Alcohol Use and Unhealthy Eating Behaviours: A Systematic Review and Synthesis of Qualitative Studies

by Stephanie Scott, Wafa Elamin, Emma L. Giles, Frances Hillier-Brown, Kate Byrnes, Natalie Connor, Dorothy Newbury-Birch and Louisa Ells

Nutrients 2019, 11(8), 1914; https://doi.org/10.3390/nu11081914 - 15 Aug 2019

Cited by 13 | Viewed by 7561

Abstract

Excess body weight and risky alcohol consumption are two of the greatest contributors to global disease. Alcohol use contributes directly and indirectly to weight gain. Health behaviours cluster in adolescence and track to adulthood. This review identified and synthesised qualitative research to provide insight into common underlying factors influencing alcohol use and unhealthy eating behaviours amongst young people aged 10–17. Sixty two studies met inclusion criteria. Twenty eight studies focused on alcohol; 34 focused on eating behaviours. Informed by principles of thematic analysis and meta-ethnography, analysis yielded five themes: (1) use of alcohol and unhealthy food to overcome personal problems; (2) unhealthy eating and alcohol use as fun experiences; (3) food, but not alcohol, choices are based on taste; (4) control and restraint; and (5) demonstrating identity through alcohol and food choices. Young people faced pressure, reinforced by industry, to eat and drink in very specific ways, with clear social consequences if their attitudes or behaviour were deemed unacceptable. No qualitative studies were identified with an explicit and concurrent focus on adolescent eating behaviours and alcohol consumption. Further exploratory work is needed to examine the links between food and alcohol in young people’s emotional, social and cultural lives. Full article

(This article belongs to the Special Issue Improving Adolescent Dietary Behaviour)

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