Healthy Eating as Perceived by Thai Adolescents in Public Schools, Bangkok, Thailand
Keywords:
Healthy eating, Thailand, adolescents, perspectiveAbstract
Unhealthy food consumption during adolescence increases the risk of non-communicable diseases and can decrease quality of life in adulthood. This study employed a qualitative descriptive design to describe the meaning of healthy eating from the perspectives of adolescents enrolled in secondary public schools in Bangkok and their food choices for healthy eating. Through purposive sampling, 30 participants participated in in-depth interviews. Data were analyzed using content analysis. Four themes emerged that reflect healthy eating as perceived by the Thai adolescents. The first theme was consciously following a healthy eating pattern by consuming more vegetables and fruits, drinking high calcium milk, avoiding foods high in fat, sugar, and sodium, as well as energy drinks and alcoholic beverages. A healthy “plate” included red meat, rice, fat, and vegetables, with no meal skipping. The second theme entailed avoiding foods perceived to be hazardous by consuming safe foods, including organic foods, while avoiding foods contaminated with toxins and chemicals, recycled cooking oils, and burnt foods. Balancing food intake and energy expenditure refers to proper food consumption in accordance with daily activities. The third theme was selecting foods based on nutrition labeling by reading, understanding, and making food choice decisions, including information on serving size, portion size, ingredients, and expiration date. The fourth theme was food as health promoting by obtaining necessary nutrients from healthy foods. Results suggest approaches to develop guidelines for Thai adolescents in urban public schools that include food based dietary patterns, food ingredients, and reading food labels for healthy eating.
References
Wu XY, Zhuang LH, Li W, Guo HW, Zhang JH, Zhao YK, Hu JW, Gao QQ, Luo S, Ohinmaa A, Veugelers PJ. The influence of diet quality and dietary behavior on health-related quality of life in the general population of children and adolescents: a systematic review and meta-analysis. Qual Life Res. 2019; 28(8):1989-2015.
Micali N, Ploubidis G, De Stavola B, Simonoff E, Treasure J. Frequency and patterns of eating disorder symptoms in early adolescence. J Adolesc Health. 2014; 54(5):574-81.
Bronfenbrenner U. Ecological models of human development. International Encyclopedia of Education. 1994; 3:1643-47.
Banna JC, Buchthal OV, Delormier T, Creed-Kanashiro HM, Penny ME. Influences on eating: a qualitative study of adolescents in a periurban area in Lima, Peru. BMC Public Health. 2016; 15;16:40.
Araújo J, Teixeira J, Gaio AR, Lopes C, Ramos E. Dietary patterns among 13-y-old Portuguese adolescents. Nutrition. 2015; 31(1):148-54.
Ochola S, Masibo PK. Dietary intake of schoolchildren and adolescents in developing countries. Ann Nutr Metab. 2014; 64 Suppl 2:24-40.
Harris JL, Heard A, Schwartz MB. Older but still vulnerable: All children need protection from unhealthy food marketing: Yale Rudd Center for food policy and Obesity; 2014 Available from: www. YaleRuddCenter.org.
World Health Organization. Obesity and overweight fact sheet. Geneva (Switzerland): World Health Organization, 2016.
Nonboonyawat T, Pusanasuwannasri W, Chanrat N, Wongthanavimok N, Tubngern D, Panutrakul P, et al. Prevalence and associates of obesity and overweight among school-age children in a rural community of Thailand. Korean J Pediatr. 2019; 62(5):179-86.
Rerksuppaphol L, Rerksuppaphol S. Prevalence of metabolic syndrome in Thai children: A cross-sectional Study. J Clin Diagn Res. 2014; 8(4):PC04-7.
GBD 2017 Diet Collaborators. Health effects of dietary risks in 195 countries, 1990-2017: a systematic analysis for the global burden of disease study 2017. Lancet. 2019; 393(10184):1958-1972.
O'Neil CE, Keast DR, Nicklas TA, Fulgoni VL 3rd. Out-of-hand nut consumption is associated with improved nutrient intake and health risk markers in US children and adults: National Health and Nutrition Examination Survey 1999-2004. Nutr Res. 2012; 32(3):185-94.
Mellendick K, Shanahan L, Wideman L, Calkins S, Keane S, Lovelady C. Diets rich in fruits and vegetables are associated with lower cardiovascular disease risk in adolescents. Nutrients. 2018; 10(2):136.
Donin AS, Nightingale CM, Owen CG, Rudnicka AR, Perkin MR, Jebb SA, Stephen AM, Sattar N, Cook DG, Whincup PH. Regular breakfast consumption and type 2 diabetes risk markers in 9- to 10-year-old children in the child heart and health study in England (CHASE): a cross-sectional analysis. PLoS Med. 2014; 11(9):e1001703.
Funtikova AN, Navarro E, Bawaked RA, Fíto M, Schröder H. Impact of diet on cardiometabolic health in children and adolescents. Nutr J. 2015; 14:118.
Deesamer S, Piaseu N, Maneesriwongul W, Orathai P, Schepp KG. Development and psychometric testing of the Thai-nutrition literacy assessment tool for adolescents. Pacific Rim Int J Nurs Res. 2020; 24(1):5-19.
Miles MB, Huberman AM, Saldana J. Qualitative Data Analysis: A Methods Sourcebook. 3 ed. California: SAGE; 2014.
Zhang Y, Wildemuth BM. Qualitative analysis of content. 2017. In: Applications of social research methods to questions in information and library science [Internet]. California: Libraries. 2nd. [318-29]. Available from: https://books.google.co.th/books?hl=th&lr=&id=uv98DQAAQBAJ&oi=fnd&pg=PA318&dq=related:5Ro4IZNraQImUM:scholar.google.com/&ots=VUNNF8N5hn&sig=imx5AUdRGvJnN6Jo0V_DKYMROwE&redir_esc=y#v=onepage&q&f=false.
Elo S, Kaariainen M, Kanste O, Polkki T, Utriainen K, Kyngas H. Qualitative content analysis: A focus on trustworthiness. SAGE journals. 2104; 1-10.
Silva DC, Frazão Ida S, Osório MM, Vasconcelos MG. Perception of adolescents on healthy eating. Cien Saude Colet. 2015; 20(11):3299-308.
Ward E. Addressing nutritional gaps with multivitamin and mineral supplements. Nutr J. 2014; 13(1):72.
Pedersen TP, Meilstrup C, Holstein BE, Rasmussen M. Fruit and vegetable intake is associated with frequency of breakfast, lunch and evening meal: cross-sectional study of 11-, 13-, and 15-year-olds. Int J Behav Nutr Phys Act. 2012; 9:9.
Rodrigues PRM, Luiz RR, Monteiro LS, Ferreira MG, Gonçalves-Silva RMV, Pereira RA. Adolescents' unhealthy eating habits are associated with meal skipping. Nutrition. 2017; 42:114-120.e1.
Boeing H, Bechthold A, Bub A, Ellinger S, Haller D, Kroke A, et al. Critical review: vegetables and fruit in the prevention of chronic diseases. Eur. J. Nutr. 2012; 51(6):637-63.
Amao I. Health benefits of fruits and vegetables: Review from Sub-Saharan Africa. 2018. Available from: http://dx.doi.org/10.5772/intechopen.74472.
Conner TS, Brookie KL, Carr AC, Mainvil LA, Vissers MC. Let them eat fruit! The effect of fruit and vegetable consumption on psychological well-being in young adults: A randomized controlled trial. PloS one. 2017; 12(2):e0171206.
Al-Otaibi H. Factors influencing fruit and vegetable intake in adolescents. In: Ostojic SM, editor. Human health and nutrition: New research. New York: Nova Science 2015. p.183-200.
Kakinami L, Houle-Johnson SA, Demissie Z, Santosa S, Fulton JE. Meeting fruit and vegetable consumption and physical activity recommendations among adolescents intending to lose weight. Prev Med Rep. 2018; 13:11-5.
Ma Z, Hample D. Modeling Parental Influence on Teenagers' food consumption: an analysis using the Family Life, Activity, Sun, Health, and Eating (FLASHE) Survey. J Nutr Educ Behav. 2018; 50(10):1005-1014.
Yadav B, Kaur M. Knowledge regarding health hazards of junk food and its prevention among adolescents. J Nurs Res. 2019; 1(2):57-64.
Iqbal MP. Trans fatty acids - A risk factor for cardiovascular disease. Pak J Med Sci. 2014; 30(1):194-7.
Rather IA, Koh WY, Paek WK, Lim J. The sources of chemical contaminants in food and their health implications. Front Pharmacol. 2017; 8:830.
Butler A. Nitrites and nitrates in the human diet: Carcinogens or beneficial hypotensive agents? J Ethnopharmacol. 2015; 167:105-7.
Ouhtit A, Al-Sharbati M, Gupta I, Al-Farsi Y. Potato chips and childhood: what does the science say? An unrecognized threat? Nutrition. 2014; 30(10):1110-2.
Haidar A, Carey FR, Ranjit N, Archer N, Hoelscher D. Self-reported use of nutrition labels to make food choices is associated with healthier dietary behaviours in adolescents. Public Health Nutr. 2017; 20(13):2329-2339.
Miller LM, Cassady DL. The effects of nutrition knowledge on food label use. A review of the literature. Appetite. 2015; 92:207-16.
Jun S, Cowan AE, Tooze JA, Gahche JJ, Dwyer JT, Eicher-Miller HA, Bhadra A, Guenther PM, Potischman N, Dodd KW, Bailey RL. Dietary supplement use among u.s. children by family income, food security level, and nutrition assistance program participation status in 2011-2014. Nutrients. 2018; 10(9):1212.
Vandevijvere S, Barquera S, Caceres G, Corvalán C, Karupaiah T, Kroker-Lobos M, et al. An 11-country study to benchmark the implementation of recommended nutrition policies by national governments using the Healthy Food Environment Policy Index, 2015-2018. Obes Rev. 2019; 20(Suppl 2): 57-66.
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