Getting to Know About the Dietary Choices of Adolescents Living Around the World

Adolescence: Living at the Threshold between Restriction & the Liberty to Choose

The Image Aptly Portrays the Food Choices of Teenagers

Adolescence is an age where every teenager seems to be on a knife-edge and one cannot agree more on this point of view! It’s around puberty that girls and boys experience maximum growth with evident body changes happening in each of them. Besides physical growth, teens also evolve into mature individuals starting to form their own views and ideas. They start making judgements on our way of handling stuffs, comment on people’s appearance (fat or thin, beautiful and ugly and likewise), don’t extend an invitation to our advices and recommendations and feel like they have reached a stage where they are big enough to take decisions on their own. This decision-making idea has proved to be a costly affair in various domains of their life and one of them is certainly food habits. Many teenagers have brought about drastic changes to their lifestyles that include more unhealthy food choices, eating out frequently, absence of activity and late-night snacking all of which increase the adolescent’s nutritional risk over time. Having a teen in your household? I am sure you have been vigorously nodding your head to every sentence that’s written here!
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Terrible Nutritional Choices Taken During the Vulnerable Stage of Life
The period between 10 and 19 years of age is a vulnerable period where health-related behaviors that influence critical chronic degenerative diseases start and the food kids eat during this period are strong factors that determine their present and future health. Unfortunately, with the advent of processed foods and fast food restaurants, the diet quality of adolescents has sharply taken a dip and evidences too support this notion. There has been an increase in intake of energy-dense foods, aerated beverages and salty snacks while the consumption of fruits, veggies and whole grains has decreased paving way for obesity/overweight to be a major public health concern worldwide. Most of the teenager’s dietary choices are due to some distorted perception adopted by them. For instance, a study on adolescent girls found that these kids associated consumption of fast food with pleasure, independence and friends while consumption of healthy food was associated with parents and being at home.

Environmental factors including family, friends and society have a strong influence on these children’s ideologies, weight gain and eating habits during their transition from adolescence to adulthood. Nurturing kids with disciplined eating patterns and activity schedules right from younger years is crucial for setting the stage for a healthier adolescence and adulthood. For this, parents should not only emphasize on the need to eat right but also lead the way being a role model for their child. Habits and behaviors form by adolescence and when dietary behaviors are formed these are established through adulthood staying for a lifetime. The prevalence of unhealthy lifestyle patterns hence increases the risk of chronic health diseases such as obesity that impede well-being.
United States was the first country to popularize the fast food culture during the 1970s and now has become the largest fast food industry in the world. We have numerous reports on developed countries such as USA, UK and Australia that clearly emphasize the fact that adolescents in these places do not meet the required dietary guidelines as they display overconsumption of energy-dense foods and underconsumption of fruits and vegetables. But we have limited evidence on developing countries such as India and Africa. Still, existing research shows that adolescent’s food consumption varies according to gender and females, in general, display healthier dietary patterns than males. Australian girls consumed more fruits compared to boys while boys drank more carbonated beverages. Likewise, British girls preferred to eat more fruits and vegetables compared to boys while boys chose nutrient-poor foods comparatively. Researchers expect similar dietary habits from adolescents residing in developing countries as well and some of the studies are elaborated here.

Food Consumption Pattern in Indian Adolescents
A 15-page questionnaire with questions pertaining to meal consumption pattern, vegetarianism, food and beverage intake, snacking practices, home food environment, curriculum, consumerism, school canteen, acquisition of food skills and family characteristics was included in the dietary and lifestyle questionnaire (DALQ). The study included 356 boys and 670 girls who were between 14 and 15 years of age while most others were around 16 years of age. Nine food groups were chosen and with excluding water, among the other eight food groups energy-dense snacks was the commonly consumed food group. The other groups in descending order of food intake include cereals, energy-dense beverages, vegetables, fruits, milk and milk products, non-vegetarian food products and pulses and legumes. Adolescents generally consumed around 10.54 servings of water daily.

Results
It was observed that a majority of the adolescents did not consume food from all eight food groups, almost two-thirds (59%) did not consume pulses and legumes, more than 50% refrained from eating non-vegetarian items such as fish, meat and chicken, 45% did not eat fruits, 30% did not eat vegetables and 36% did not consume milk and milk products. Visible gender difference in the consumption of these 8 food groups were visible. While girls consumed more of veggies, fruits, cereals and non-vegetarian food products compared to boys it was also seen that male kids consumed more of milk and milk products and energy-dense beverages. Energy-dense snacks, pulses and legumes did not display evident differences in consumption portion between boys and girls. The present study is a clear evidence that more than 75% of adolescents consumed three or more servings of energy-dense snacks and 50% of participants consumed 3 or more servings of energy-dense beverages. While this study happened in Kolkata, another study in New Delhi showed that more than a quarter (32%) of secondary school kids consumed fast foods such as pizzas, burgers and fried foods three and more times every week. Despite being the largest producer of milk, the study showed that almost two-fifth of participants did not consume recommended dairy servings that nourish the body with energy, protein and micronutrients. Also, girls in the study ate healthier than boys reflecting the worldwide ideology that females ate healthier than males. This could be attributed to the weight-consciousness of the female population and also to the male population which often feels that eating greens, surviving on salads and healthy food was not a display of masculinity.

A global survey on adolescents residing in Southeast Asian countries such as India, Indonesia, Myanmar, Thailand and Sri Lanka suggested that nearly 28% of participants reported consuming fruits less than once daily. Indian adolescents display unhealthy dietary patterns and until this trend changes we cannot expect to see remarkable changes in obesity/overweight rates in the Indian population.
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Food Patters of Saudi Arabian Adolescents
A cross-sectional study was conducted on girls aged between 13 and 29 years and their body measurements were taken at the start of the study. Of the 196 participants involved in the study, 64.8% of them were adolescents aged between 13 and 18 years while the rest were adults. Results showed that more than 95% of them ate fast food at restaurants with 52.8% adolescent girls and 60.9% young adult girls consuming fast food once per week. 25.2% adolescent girls and 20.3% young adult girls consumed fast food twice or more per week. Common fast foods included beef or chicken burgers (70.4%), pizzas (32.7%) and French fries (29.6%). Most of the participants chose small or medium portion sizes and it was only 17.9% participants who went for large portion sizes. 89% adolescents and 75% adult girls consumed carbonated soft drinks along with their fast food meal while consumption of coffee, tea, sweetened fruit drinks and energy drinks were a rare combination with fast food. While adolescents mostly consumed fast food for taste, adult females consumed it for the sake of convenience. It was a surprising to find that a majority of these girls did not know the nutritional value of these fast foods or were totally ignorant of the concept of nutrition value.

Cohort Study on Malaysian Adolescents
The study on Malaysian students included 1361 adolescent girls and boys aged around 13 years. A 7-day dietary intake history regarding information on food and drink consumption at breakfast, mid-morning snack, lunch, tea, dinner and supper were noted by reputed dietitians. Height, weight and body mass index measurements were calculated at the start of the study. Among the total number of participants involved in the study 1290 of them completed a dietary interview. Of the lot, almost 65% were females. Study results showed that male adolescents consumed more energy (carbs, protein, fats and saturated fats), macronutrients and sugars compared to females. Females consumed more of vitamin D compared to their male counterparts but had inadequate consumption of iron. Both males and females had decreased intake of energy, vitamin D and calcium but showed optimal intake of proteins and fats.

All these studies are a clear indication that adolescents anywhere around the world are not consuming a well-balanced meal that’s rich in nutrients. Most of the teenagers are inclined towards processed foods consumption quoting different reasons which also exists as the cause behind the obesity epidemic. Parents, teachers and the society must come together in helping children change their attitude towards food, help them choose more of vegetables, fruits and pulses to eat daily and make them realize the importance of a healthy diet in one’s life.

References
Food Consumption Patterns of Adolescents Aged 14-16 Years in Kolkata: https://nutritionj.biomedcentral.com/articles/10.1186/s12937-017-0272-3
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Trends of Fast Food Consumption Among Adolescent & Young Adult Saudi Girls Living in Riyadh: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4366480/
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Dietary Intake Among Adolescents in a Middle-income Country: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0155447

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