The food environment through the eyes of adolescents: exploring socioecological factors and opportunities for healthy and sustainable food choices.

backgroundAlthough it is evident that current food environments do not facilitate healthy and sustainable diets, it is still largely unknown how adolescents navigate their food environments during the school week. This study explored how adolescents, in rural and urban areas, interact with their food environment, the factors influencing this interaction and the opportunities they perceive to get healthy and sustainable food.

methodsA mixed-methods study was conducted among 305 adolescents, aged 12-16, of which 54% identified as female, 43% as male, and 3% as non-binary or other. Adolescents from 13 classes at four Dutch secondary schools in rural and urban areas participated. Participants completed a questionnaire and a food environment mapping assignment. Next, 50 focus groups were conducted with 5-8 participants each. Questionnaire and assignment data were analysed using descriptive statistics. Focus groups were analysed inductively, through a thematic analysis, to identify socioecological factors influencing adolescents' interaction with their environment.

resultsOf all food outlets, adolescents marked their home (n = 305), the supermarket (n = 268), and the school canteen (n = 194) as the most visited locations to obtain food during a school week. The home was perceived as a safe and pleasant place to eat, as well as a place where healthy and sustainable food is available and consumed. In out-of-home settings, adolescents perceived more freedom to make their own choices and fewer adolescents indicated that they obtain healthy and sustainable food themselves. Focus groups revealed 18 factors underlying adolescents' food choices in their environment, including the need for autonomy, the social function of food among peers, the influence of caregivers, the importance of a diverse and appealing food offer, and the price of food. Differences between rural and urban areas were mainly found in the presence and use of fast-food outlets and delivery services.

conclusionsWhile navigating the food offer in their homes, schools and other food outlets, adolescents balance more healthy and sustainable food choices at home with more autonomous, but less healthy and less sustainable, choices outside of their homes. To support adolescents in making more healthy and sustainable choices, environments in and around schools should be designed to promote healthy and sustainable options that are affordable, while also facilitating a social mealtime and giving adolescents space to express autonomy in their food choices.