Eating Behaviour of Adolescent Schoolgirls in Malang, East Java: A Qualitative Study
Eating Behaviour of Adolescent Schoolgirls in Malang, East Java: A Qualitative Study
Eating Behaviour of Adolescent Schoolgirls in Malang, East Java: A Qualitative Study
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ABSTRACT
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*Corresponding author: Mulia Sondari
Directorate of Processed Food Registration, National Agency of Drug and Food Control
Ministry of Health Republic of Indonesia, Jl. Percetakan Negara No 23, Jakarta, Indonesia.
Tel: +6289687554782, Fax : +62-21 4245267; Email: [email protected]
S88 Sondari M, Brouwer I & Februhartanty J
Table 1. Sample questions for adolescent The mothers of the adolescent girls
girls (aged 15-18 years) that fulfilled the
No. Sample questions inclusion criteria above were selected for
1. Tell me about your daily eating
triangulation. The school staff members
routine during weekdays and who were selected were employed at
weekends? one of the selected schools and were
2. What kinds of food do you like to willing to participate on the day of data
eat? Why do you like them? collection.
3. What does a healthy eating mean to Purposive sampling was used to
you? recruit mother and girl (daughter) pairs
4. Tell us about the places in your for the interviews. Participants were
neighbourhood where you can get selected from two of the most highly
food. populated sub-districts in Malang,
5. What do you think about the food namely Kedungkandang (43,666
available in your school? households) and Sukun (45,666
households) (Central Bureau of Statistic
Participants Indonesia, 2013). The screening process
Our study focused on adolescent girls involved visiting the homes of the girls
aged 15-18 years, from low-income and asking them and their mothers about
families who were enrolled in a public the household income and expenditure.
high school or public vocational school
Participants for the FGD were
in Malang. The girls who were selected
selected from the three public schools
were mostly of low SES and attended
public schools which charged school that were willing to participate in the
fees that were reasonably affordable to study. At each school, the staff selected
them. In addition, the SES level was 10-20 female students who received
determined based on demographic school fee subsidy. The researcher
information gained during the screening then invited the selected students to
process and their monthly household complete a demographic information
income range IDR 700,000–2,000,000 form to screen the parental income so
IDR (US$47.51–135.75) which was as to ensure it met the requirements
categorized as C and D classes based on for low socioeconomic level. Out of the
Nielsen’s classification in 2010 (Table 2). 45 adolescent girls from three schools,
The girls were excluded from selection 25 were eligible. A total of 19 girls were
if they had difficulty in communicating, included in the FGDs as the rest were
mental illness and/or learning disability.
and which were healthy foods such as (iii) Price of the food
vegetables, tofu and tempeh. Most of the girls indicated that they
often preferred foods that were cheaper
(ii) Food preferences and easy to buy even though they are
The adolescent girls stated that the not healthy.
taste of food was the most important
factor that influenced their decisions “Unhealthy food, like bakso, is cheap,
on the choice of foods. Overall, the girls and the bakso seller is easy to find
were enthusiastic when talking about near the house” (Girl 4–Interview)
savory, sweet or spicy foods. On the
other hand, vegetables were associated “I don’t have enough pocket money,
with unpleasant and negative taste so most of the time I only buy snacks
experiences. at school” (Girl 6-Interview)
“Taste of the food is important. I like “The food sold by street vendors or
savory food because it’s tasty” (Girl– school canteen is cheaper than that
FGD 2) sold in the mall. This is because the
facilities to make the food are not
“I like eating snacks because it tastes good and the ingredients are cheaper”
good” (Girl-FGD 3) (Girl–FGD 2)
“Vegetables? I don’t eat it very
School staff believed that the girls
much because it’s tasteless” (Girl 4–
preferred tasty and cheap foods over
Interview)
healthy food.
“I don’t like cabbage because it’s
“They will consider taste and price for
bitter” (Girl 2-Interview)
food choice. The canteen in this school
sells cheap meals like bakso. They’re
Mothers and school staff also reported
likely to buy this kind of food instead
that taste preferences influenced the
of healthy food” (School staff 2)
girls when making food choices. Mothers
understood that healthy foods such as
Theme 2: Environmental influences
vegetables were good for their children
(i) School and neighbourhood
and which were often available at home.
But they often compromised with their The availability and accessibility of
children and did not put pressure on fast foods and local foods in the school
them to eat vegetables. canteen and the neighbourhood, such
as from street vendors or casual shops,
“It’s hard to tell my daughter to eat was the most frequent reason expressed
vegetables. She said vegetables are by the adolescent girls for deciding on
not tasty” (Mother 6) their food choices.
“If I force her to eat vegetables, she “I often buy savory snacks and cold
won’t eat the food at all. So, I let her sweet drinks at the school canteen”
eat what she wants” (Mother 1) (Girl 2–Interview)
“Mostly the students only consider the “I like eating bakso but sometimes
taste of the food without considering I didn’t eat bakso in a week, if the
whether it is healthy or not” (School bakso seller in the canteen was
staff 1) away” (Girl 7-Interview)
Qualitative study on adolescents’ eating behaviours in Malang, Indonesia S93
“We want to eat fruits, but there’s no said anything to discourage the girls
fruit seller in the school canteen, not from doing so. Instead, mothers tended
even a fresh juice seller” (Girl-FGD 1) to accept the food choices of their
daughters.
“I like eating burgers” (Girl
4-Interview). “Where do you buy it?” “She used to like vegetables, but now
(Interviewer) “From the street vendors she doesn’t. Maybe because now she
near my home” (Girl 4-Interview) often buys varieties of food that are
sold by the street vendors” (Mother 9)
“She used to like vegetables, but
now she doesn’t. Maybe it is because “I don’t think they are eating healthy
she now often buys varieties of food food at school. They mostly eat bakso,
that are sold by the street vendors” I guess. But, at home, they eat food
(Mother 9) that is healthy because I prepare
vegetables, fish, tofu and tempeh”
Some girls commented on the school (Mother 5)
rules about food restrictions in the
canteen, which prohibit spicy foods and DISCUSSION
certain local fast foods. A school staff The findings of this study appear to be
member confirmed that there were some aligned with some of the influences on
rules about foods at school but that they healthy eating that are described in the
were limited to spicy foods and foods SCT (Bandura, 1998). Using the SCT as a
with unpermitted colorants. guide, the influences on the eating habits
of adolescent girls were considered as (i)
(ii) Family individual factors (such as knowledge
All the girls reported that mothers often and awareness, food preferences and
warned them not to eat unhealthy foods. food price) and (ii) environmental factors
Unfortunately, the rules were often (family, school and neighbourhood).
prohibited only spicy foods. Our study found that most adolescent
girls had some knowledge about healthy
“Mom told me not to eat spicy foods, eating and were aware of its benefits.
but I still eat it at school. Sometimes However, their eating behavior did not
I followed her rule, but sometimes I reflect their awareness. They often
disobeyed it” (Girl 5–Interview) skipped breakfast and showed a personal
preference for unhealthy food, such
“Mom told me not to eat too much as fast foods and local, nutrient-poor
spicy food and instant noodles” (Girl- foods. It would appear that knowledge
FGD 3) of healthy eating and its benefits are
not related to healthier eating practices
“Sometimes I eat spicy foods at school (Rathi, Riddell & Worsley, 2017).
or when my mom is working” (Girl The girls frequently reported that the
4-Interview) taste of the food was an important factor
affecting their choice of food. This may,
“I prohibit her eating food with chilli in part, explain the fact that they give
sauce; I told her that it’s not good for priority to short-term considerations
her health” (Mother 8) of eating behaviour, such as pleasure,
rather than long-term outcomes, such
The mothers were aware that the girls as prevention of disease. Other studies
often bought fast foods or poor-nutrient have shown that factors such as taste,
foods from the school canteen or street texture and the appearance of food
vendors, but there were none of them
S94 Sondari M, Brouwer I & Februhartanty J
were more important than knowledge important role in influencing the food
of healthy eating among adolescents behaviour consumption of their children
(Fitzgerald et al., 2010). (Pearson, Ball & Crawford, 2012). The
The main reason given by the girls for mothers in this study recognised that
their preference for fast foods and local their daughters practised unhealthy
foods is that they were affordable and eating habits. However, both girls and
readily accessible. The girls mentioned their mothers did not mention any
several times that unhealthy foods, strict rules regarding eating practices,
i.e. fast foods, nutrient-poor foods, beyond warnings not to consume spicy
and foods sold by street vendors, were foods. The mothers believed that it was
cheaper than healthy foods. The girls difficult to expect their children to eat
in the present study came from low healthily if they (the parents) did not do
SES households and had limited pocket so themselves.
money for purchasing food. Therefore, Based on the SCT, socio-
cost was a determinant in choosing environmental factors, such as parental
food. This is in line with other studies and societal support, can influence
on students from low income families the food intake behavior seen among
who chose foods based on convenience adolescents (Salvy et al., 2011; Story,
and affordability (Maulida et al., 2016). Neumark-Sztainer & French, 2002).
A study among Chinese adolescents Parental knowledge has been associated
similarly reported that unhealthy foods with healthy eating habits in children
were cheaper and popular among them (Grosso et al., 2012; Ansem et al., 2014).
(Chan et al., 2016). Nevertheless, the role of mothers may be
The SCT describes the importance limited only to the provision of healthy
of socio-environmental factors in food at home. Mothers in this study
influencing eating behaviours (Bandura, stated that the healthy food they usually
1998). The lack of school rules and ease prepared were simple dishes such as
of availability of food were revealed as fish, vegetable, tofu and tempeh.
key factors that influenced the eating This study only examined adolescent
behaviours of the girls in this study. girls from Malang and thus our findings
Mothers of the girls and school staff may not apply to all adolescent girls in
members expressed concerns about Java Province, much less throughout
their easy access to fast foods and Indonesia.
local nutrient-poor foods in the school
canteens. Some schools had no rules CONCLUSION
to restrict unhealthy foods. The school
A sample of adolescent girls from low
staff members confirmed that the school
SES in Malang, Indonesia showed some
rules were guided by food hygiene and
knowledge about healthy eating but
safety rather than nutritional quality.
did not show healthy eating practices,
Other qualitative studies have also
in skipping breakfast and consuming
reported that the availability of food at
fast food and nutrient-poor foods.
schools was a factor that influenced the
The factors influencing the adolescent
food consumption habits of adolescents
girls’ eating behaviours were driven
(Naidoo et al., 2017; Verstraeten et al.,
by individual preferences as well as
2014). As school meals can contribute
by the environmental factors. Future
30-40% of daily calorie intake of
interventions should not only target
students (Osowski et al., 2015; Nathan
adolescents, but also schools, the
et al., 2016), it is imperative for schools
community and their family members
to promote healthy food consumption
as well. School breakfast and healthy
(Bevans et al., 2012).
school canteen programmes, nutrition
Parents, especially mothers, play an
Qualitative study on adolescents’ eating behaviours in Malang, Indonesia S95