The assessment of a new community dietetic approach for changing the eating habits of young adolescents living in less affluent areas of Liverpool
Liverpool has some of the highest rates of preventable disease in the UK. Obesity levels in young people are increasing and diet and decreased activity levels are implicated in its progression. The eating habits of young people are far from ideal and there is a need to develop initiatives that can bring about positive changes in lifestyle. The aims of this research were firstly, to assess the eating habits, factors affecting food choice and the motivations for change in young people, and using the data collected, to design and pilot a questionnaire to facilitate the development of a nutrition intervention. Studies assessed the validity and reliability of a self-administered Food Intake Questionnaire (FIQ). Results suggested that the FIQ had face validity and reliability, being able to detect a change in eating habits of ± 10% in a sample of 100 children over a three-month period. A validity study showed that the FIQ had criterion validity for sugary (r = .34) and fatty foods (r = .21) intake, when compared to a three-day diary and interview method. Six hundred and ninety seven schoolchildren aged 11-13 years completed the FIQ and children with 'good' and 'poor' diets were selected to take part in separate focus group interviews. The focus group data described a food culture in which young people classified their foods as 'Junk" and "parental" foods as "proper" food. Definitions of dieting were elaborate, and including various strategies such as "cutting down" and "going on a health week". The data also suggested that health was a poor motivator of change and that school nutrition interventions based on physical activity and "well being" factors would be more effective in facilitating change than a medical, disease oriented approach. A combined questionnaire was designed to evaluate factors affecting intake (as identified by the focus groups). It was piloted in a separate school. The results showed the most frequently reported foods included sweets, crisps, fizzy drinks and chocolate. Discriminant analysis of the BCQ identified five factors able to separate diet groups at the extremes of the distribution (good and poor diets). These included: perception of health, influence of peers, and school activities. In conclusion, two tools have been developed to enable the eating habits of children, and the influences upon them, to be evaluated. In addition using these tools to gain an understanding of the cultural influences that affect eating habits enabled a nutrition intervention more relevant to the cultural imperatives of adolescents to be planned.