Neha Rathi

Introduction: The prevalence of overweight and obesity and the associated non-communicable diseases in young adulthood has increased significantly in the last decade. Urban Indian young adults fail to meet the recommended guidelines for healthy diet and physical activity. The aim of this qualitative study was to gain novel insights into the barriers and facilitators of a healthy lifestyle of Indian young adults residing in urban settings. Methods: Underpinned by the social constructivism paradigm, in-depth interviews were conducted with young adults (aged 21–30 years) who were recruited using purposive and snowball sampling techniques from eight metropolitan cities (New Delhi, Mumbai, Kolkata, Chennai, Ahmedabad, Pune, Hyderabad, Bengaluru). Interviews were audio recorded and transcribed verbatim. Transcripts were transferred to NVivo software for inductive thematic analysis. Results: A total of 79 young adults (41 males, 38 females) participated in the interviews. Five themes and their associated sub-themes were identified: (i) Perceptions of a healthy lifestyle (consuming a balanced diet, leading an active life, having adequate sleep); (ii) Facilitators of a healthy lifestyle (family support and upbringing, health promotion by celebrities and famous personalities, built environment, body image, intrinsic motivation); (iii) Barriers to a healthy lifestyle (time constraints, food environment challenges, peer pressure); (iv) Strategies adopted to maintain a healthy lifestyle (dietary management, engaging in exercise and other forms of physical activity, reducing screen time); and (v) Recommendations for prospective interventions (education and awareness about nutrition and health, creating healthy and hygienic food environments). Conclusion: The evidence emerging from this multisite inquiry offers first-hand information about the individual, social, and environmental level barriers and facilitators to the adoption of a healthy lifestyle among urban Indian young adults. Strategies and recommendations suggested during the interviews can be used to tailor prospective lifestyle interventions for encouraging the adoption of sustainable healthy lifestyle in young adults. Prospective interventions could focus on enhancing nutrition and health knowledge of young consumers and offering more healthy and hygienic food options in cafeterias of workplaces and educational institutions as well as other eateries.

Background and objectives: Urban Indian adolescents often practice unhealthy dietary behaviors such as meal skipping and snacking on high energy foods with low nutrient value. To promote healthy snacking behaviors among adolescents it is essential to explore the factors that may influence the consumption of healthy and unhealthy snacks among Indian adolescents.Materials and methods: Informed by the social constructivism framework, an exploratory-descriptive qualitative research approach was employed to obtain a richer understanding of the influences on urban Indian adolescents’ snacking behaviors. Using purposive sampling, adolescents aged 10–19 years were recruited from two government and two private schools in Varanasi city, Uttar Pradesh, India. Face-to-face interviews were conducted in Hindi/English, per the preference of the participants. The conversations were digitally recorded, transcribed verbatim, and translated to English (where necessary) for analysis. Themes were extracted using inductive coding.Results: A total of 62 adolescents (50% female; 76% private school pupils) with mean age 15.3 (SD: 1.86) years completed the interviews between November 2024 and February 2025. Ten themes emerged including: (i) Perceptions of a snack; (ii) liking for unhealthy snacks; (iii) consequences of snacking; (iv) snacking timing; (v) cost of snacks; (vi) parental rules around snacking; (vii) influence of peers; (viii) school food environment; (ix) neighborhood food environment; (x) food and beverage marketing.Conclusion: These findings show that multiple factors are likely to influence snacking behaviors in Indian adolescents, aligning with literature on adolescent snack consumption in international settings. Behavioral interventions should be designed to create enabling environments to encourage healthy snack consumption in adolescents by removing barriers at the individual, household, and societal levels.

Development of healthy food behaviors in childhood is significant for optimum growth and development of children as well as future health. However, many Indian children display unhealthy dietary habits including poor intakes of fruits and vegetables and excessive consumption of calorie-dense, nutrient-poor foods and sugar-sweetened beverages. Therefore, the factors that influence their daily diet need to be explored for developing future interventions and policies. In this light, the present inquiry was designed to examine the various influences on the food behaviors of Indian primary school children. Informed by the socio-ecological framework, this study used an exploratory qualitative research approach to conduct semi-structured interviews with 22 primary school children, 19 mothers, and 18 teachers residing in Varanasi, India. For children, the interviews were preceded by a drawing session where the interviewees were asked to draw their preferred and non-preferred food and beverage items. Interviews were carried out in English or Hindi and digitally recorded. Interviews were conducted until data saturation was achieved. Digital recordings were transcribed verbatim and translated to English (where necessary) for the purpose of thematic analysis. The transcripts were coded both deductively and inductively using the NVivo software program. Individual level influences included taste and nutritional knowledge. At the interpersonal level, the family food environment and peers emerged as key determinants. The physical environment also played a pivotal role in determining food behaviors, with the school food environment and food availability in the marketplace being significant. Lastly, at the societal level, television and internet advertisements were frequently cited as important determinants of children’s food behavior. The collective insights from the three stakeholder groups have the potential to inform public health nutrition policies and interventions targeting the different socio-ecological factors to encourage healthy eating in Indian primary school children.

Fruits and vegetables are primary sources of vitamins and minerals that may alleviate the risk of chronic illnesses. However, Indian adolescents consume inadequate amounts of fruits and vegetables, with less than 10% meeting recommendations. Micronutrient deficiencies are a major public health problem in India. For example, the prevalence of iron-deficiency anemia and Vitamin A deficiency in adolescents is 28.5% and 14.4%, respectively. To promote fruit and vegetable consumption among Indian adolescents, we need to identify the factors which may influence the consumption. The aim of this qualitative inquiry was to explore perceived influences of fruit and vegetable consumption among Indian adolescents. Using purposive sampling, adolescents aged 10–19 years were recruited from two public and two private (independent) schools in Varanasi, India. Face-to-face interviews along with the ‘draw and tell’ technique were used for data collection. Interviews were conducted in English as well as in Hindi depending on the preferences of the adolescents. The conversations were digitally recorded and transcribed verbatim. The transcribed data were subjected to thematic analysis. Data were coded inductively, and themes were extracted using NVivo software program. A total of 58 adolescents (53% female; 74% urban) with mean age 13.6 years completed the interviews. Nine major themes and associated sub-themes emerged, including: (i) Sensory properties (i.e., taste, color, flavor, texture); (ii) Health and immunity; (iii) Allergy; (iv) Home food environment (i.e., influence of mothers, availability and accessibility of fruits and vegetables); (v) Cost; (vi) Food preparation; (vii) Influence of peers; (viii) School food environment; (ix) Proclivity for energy-dense, nutrient-poor foods and beverages. The emerging themes and sub-themes show that multiple factors are likely to affect fruit and vegetable consumption in adolescents, aligning with literature on adolescent fruit and vegetable consumption in international settings. Behavioral interventions should be designed to create enabling environments to encourage fruit and vegetable consumption in Indian adolescents by removing barriers at the individual, household, and community levels, thereby reducing the enduring prevalence of micronutrient deficiencies.

[This corrects the article DOI: 10.1017/jns.2024.4.].

High prevalence of anaemia is a severe public health problem in several low- and middle-income countries like India. A qualitative inquiry was designed to understand the perceptions of adolescents regarding anaemia and anaemia prevention measures. Convenience sampling was employed to recruit 39 adolescents (19 girls; 20 boys) from Tikari, India. Interviews were carried out in the local language, audio-recorded and transcribed verbatim. Hemoglobin concentration was also assessed from a single drop of capillary blood using the HemoCue, and the participants were asked to share their Science/Biology and Home Science textbooks. Interview data was analysed thematically. Descriptive statistics were used to examine the distributions of the hemoglobin data while textbooks were analysed using content analysis to verify the coverage of anaemia and anaemia-related matter. Seven themes were identified: (i) Poor understanding of the term anaemia; (ii) Minimal discussion about anaemia in classroom; (iii) Limited knowledge about symptoms of anaemia; (iv) Limited awareness about prevention and cure of anaemia; (v) Perception of iron folic acid and deworming tablets among students; (vi) Lack of contribution of health workers in the prevention of anaemia; (vii) No knowledge of ‘Anemia free India’ programme. More than half of the sample had anaemia (16.7% mild anaemia, 33.3% moderate anaemia, 2.8% severe anaemia). Content analysis revealed that there was limited discussion about anaemia in both Home Science and Science textbooks. Behavioural interventions should focus on inculcating healthy culinary and dietary practices and addressing the gaps in knowledge and understanding of anaemia and its prevention among adolescents.

Background: Indian adolescents exhibit unhealthy food behaviours and inactive lifestyles which increase their risk of developing obesity and associated negative health consequences. The family food environment represents a vital setting to nurture healthy lifestyle behaviours in adolescents, with parents influencing their adolescents’ dietary and physical activity behaviours. Yet, much of the existing evidence exploring parental influences predominantly focuses on mothers while fathers’ engagement in instilling healthy dietary and physical activity behaviours is understudied, more so in the context of developing economies like India. Therefore, this qualitative study was designed to understand Indian fathers’ views on instilling healthy behaviours in their children.Methods: Convenience sampling along with snowball sampling techniques were employed to recruit fathers of adolescents aged 10–19 years from Kolkata city, India. Informed by the research aim and review of literature, an interview guide was developed and pre-tested. Interviews were carried out either in person or virtually (Zoom/telephone) in English/Hindi/Bengali as per the preference of the participants. All interactions were audio recorded, transcribed verbatim, and translated to English for the purpose of data analysis. The transcripts were analysed thematically using NVivo software program. Themes were identified using both inductive and deductive approaches.Results: A total 36 fathers participated in the interviews. Seven main themes were identified: (i) Involvement of fathers in adolescent upbringing (i.e. engagement in meal preparation, food shopping, educational activities, physical activity); (ii) Family food environment (i.e. setting food rules, having meals with children, making food available); (iii) Challenges to instilling healthy behaviours in adolescents (i.e. adolescents’ sedentary lifestyle and liking for unhealthy foods); (iv) Barriers to routine involvement in adolescent upbringing (i.e. time constraints due to paid employment, poor socio-economic status); (v) Adolescent nutrition education: (vi) Dual burden of malnutrition (i.e. awareness of malnutrition, no knowledge about government-led health programs for adolescents); (vii) Paternal knowledge.Conclusions: The emerging themes reveal that Indian fathers played a crucial role in instilling healthy dietary and physical activity behaviour in their adolescents through various parenting practices such as purchasing nutritious food, enforcing food rules, disseminating nutrition-related knowledge, and encouraging adolescents to participate in moderate-to-vigorous intensity outdoor sports. This provides strong support for the inclusion of fathers in sustainable family-focused lifestyle interventions to maximise the nurturing care required by adolescents as well as assist in normalising the representation of fathers in health and welfare policies designed for adolescents.