Individual and Environmental Influences on Adolescent Eating Behaviors

https://doi.org/10.1016/S0002-8223(02)90421-9Get rights and content

Abstract

Food choices of adolescents are not consistent with the Dietary Guidelines for Americans. Food intakes tend to be low in fruits, vegetables, and calcium-rich foods and high in fat. Skipping meals is also a concern among adolescents, especially girls. Factors influencing eating behaviors of adolescents need to be better understood to develop effective nutrition interventions to change eating behaviors. This article presents a conceptual model based on social cognitive theory and an ecological perspective for understanding factors that influence adolescent eating behaviors and food choices. In this model, adolescent eating behavior is conceptualized as a function of individual and environmental influences. Four levels of influence are described: individual or intrapersonal influences (eg, psychosocial, biological); social environmental or interpersonal (eg, family and peers); physical environmental or community settings (eg, schools, fast food outlets, convenience stores); and macrosystem or societal (eg, mass media, marketing and advertising, social and cultural norms).

Section snippets

A Conceptual Framework for Understanding Adolescent Eating Behaviors

Conceptual models or theories are useful in understanding and explaining the dynamics of health behaviors, the processes for changing the behaviors, and the effects of external influences on the behaviors (13), (14). A common theme that runs throughout the various theoretical frameworks used to explain eating behavior is that multiple socioenvironmental and personal factors interact to influence individual behavioral patterns (13). Social cognitive theory (SCT) provides a particularly useful

Psychosocial

Food preferences Food preferences are formed as a result of the complex interactions of many factors in a person's environment, including early childhood experiences with food and eating, positive or negative conditioning, exposure, and genetics (eg, sensitivity to a bitter taste) (18). Self-reported food preferences have been found to be one of the strongest predictors of food choices (15), (19), (20), (21).

Taste and sensory perceptions of food Studies with adolescents and adults have shown

Family

The family is a major influence on adolescents’ eating behavior. The family mediates adolescents’ dietary patterns in 2 distinct ways: The family is a provider of food, and the family influences food attitudes, preferences, and values that affect lifetime eating habits. As they transition toward greater independence and autonomy, food habits of adolescents reflect the changing role of parental influence on food choices. The increase in dining out that occurs during adolescence is related to the

Physical Environmental Influences (Community Settings)

One third of all teen eating occasions take place outside the home (53). More than half (52%) of out-of-home eating occasions take place at school, followed by fast-food restaurants (16%), other locations (16%), and vending machines (6%) (53). Thus, the physical environment in the community has a large impact on adolescent eating, influencing access to and availability of foods and influencing perceived norms regarding eating behaviors.

Macrosystem Influences (Societal)

Macrosystem influences are more distal to the adolescent but have the potential to have a substantial effect on adolescents, their families, peers, and the community in which they live. Factors within the larger society—which can affect adolescent eating behavior—include the media, cultural norms, social norms, food production and distribution systems, and food accessibility and availability. For example, youth and families living on rural American Indian reservations or families living in

Future Research Directions

This review indicates that there are multiple interacting influences on adolescents’ eating behaviors and that the relationships between these factors are complex. Future research should examine how the multiple levels of the ecological model described in this paper influence adolescent eating behaviors. Development of effective nutrition interventions rests on identifying factors most predictive of adolescent eating behaviors, and the relative strengths of the individual and environmental

Implications for Interventions and Policies

This article proposes an ecological model for understanding individual and environmental factors that influence adolescent eating behaviors. The identification of predictive factors at multiple levels of influence is crucial because factors that are the most potent and amenable to change should form the foundation for planning interventions (97). The objective of health behavior programs is to change predictive factors that serve to support and reinforce the targeted behavior. Changing

Summary

This paper presents an ecological model to understand and explain the multiple and interacting influences on adolescent eating behaviors. An understanding of how the 4 levels of influence—individual, social environmental, physical environmental, and macrosystem—interact and affect adolescent eating behaviors is needed for the development of effective nutrition interventions. Interventions addressing factors at the different levels of influence, which complement and build upon each other, are

References (100)

  • D.C. Cusatis et al.

    Influences on adolescent eating behavior

    J Adolesc Health.

    (1996)
  • I. Contento et al.

    Research perspective on school-aged nutrition education

    J Nutr Educ.

    (1992)
  • M. Axelson et al.

    A meta-analysis of food and nutrition-related research

    J Nutr Educ.

    (1985)
  • A.M. Siega-Riz et al.

    Three squares or mostly snacks— what do teens really eat? A sociodemographic study of meal patterns

    J Adolesc Health.

    (1998)
  • S.A. French et al.

    Pricing strategy to promote fruit and vegetable purchase in high school cafeterias

    J Am Diet Assoc.

    (1997)
  • T.A. Nicklas et al.

    Impact of breakfast consumption on nutritional adequacy of the diets of young adults in Bogalusa, LouisianaEthnic and gender contrasts

    J Am Diet Assoc.

    (1998)
  • S. Barr

    Dieting attitudes and behavior in urban high school studentsImplications for calcium intake

    J Adolesc Health.

    (1995)
  • D. Neumark-Sztainer et al.

    Weight-control behaviors among adults and adolescentsAssociations with dietary intake

    Prev Med.

    (2000)
  • D. Neumark-Sztainer et al.

    Dieting and binge eating among adolescentsWhat do they really mean?

    J Am Diet Assoc.

    (1998)
  • M. Nichter et al.

    Dieting and “watching” behaviors among adolescent femalesReport of a multimethod study

    J Adolesc Health.

    (1995)
  • D. Neumark-Sztainer et al.

    Correlates of inadequate consumption of dairy products among adolescents

    J Nutr Educ.

    (1997)
  • I.R. Contento et al.

    Food choice among adolescentsPopulation segmentation by motivations

    J Nutr Educ,

    (1988)
  • R.K. Johnson et al.

    Effects of maternal employment on family food consumption patterns and children's diets

    J Nutr Educ.

    (1993)
  • D. Neumark-Sztainer et al.

    Correlates of inadequate fruit and vegetable consumption among adolescents

    Prev Med.

    (1996)
  • G. Feunekes et al.

    Food choice and fat intake of adolescents and adultsAssociations of intakes within social networks

    Prev Med.

    (1998)
  • M. Story et al.

    Availability of foods in high schoolsIs there cause for concern?

    J Am Diet Assoc.

    (1996)
  • L. Harnack et al.

    Availability of a la carte food items in junior and senior high schoolsA needs assessment

    J Am Diet Assoc.

    (2000)
  • C.L. Perry

    The tobacco industry and underage youth smokingTobacco industry documents from the Minnesota litigation

    Arch Pediatr Adolesc Med.

    (1999)
  • K. Kotz et al.

    Food advertisements during children's Saturday morning television programmingAre they consistent with dietary recommendations?

    J Am Diet Assoc.

    (1994)
  • A.E. Field et al.

    Exposure to the mass media and weight concerns among girls

    Pediatrics.

    (1999)
  • M. Story

    Nutritional requirements during adolescence

  • L. Jeep

    Centers for Disease Control and Prevention. Guidelines for school health programs to promote lifelong healthy eating

    MMWR.

    (1996)
  • L. Lytle et al.

    Covariance of adolescent health behaviorsThe class of 1989 study

    Health Educ Res: Theory Prac.

    (1995)
  • J. Burghardt et al.

    The School Nutrition Dietary Assessment StudySchool Food Service, Meals Offered, and Dietary Intakes

    (1993)
  • J.F. Morton et al.

    Changes in children's total fat intakes and their food group sources of fat, 1989–91 versus 1994–95Implications for diet quality

    Fam Econ Nutr Rev.

    (1998)
  • Food Guide PyramidA Guide to Daily Food Choices

    (2000)
  • K. Munoz et al.

    Food intakes of U.S. children and adolescents compared with recommendations

    Pediatrics.

    (1997)
  • M. Story et al.

    Promoting healthy eating and physical activity in adolescents

    Arch Pediatr Adolesc Med.

    (1999)
  • L.A. Lytle et al.

    How do children's eating patterns and food choice change over time? Results from a cohort study

    Am J Health Promot.

    (2000)
  • K. Glanz et al.

    Theory at a GlanceA Guide for Health Promotion and Practice

    (1995)
  • K. Glanz et al.

    Health Behavior and Health Education

    (1997)
  • T. Baranowski et al.

    How individuals, environments, and health behavior interactSocial cognitive theory

  • U. Bronfenbrenner

    The Ecology of Human DevelopmentExperiments by Nature and Design

    (1979)
  • K.R. McLeroy et al.

    An ecological perspective on health promotion programs

    Health Educ Q.

    (1988)
  • L. Birch

    Development of food preferences

    Annu Rev Nutr.

    (1999)
  • L. Birch et al.

    Development of eating behaviors among children and adolescents

    Pediatrics.

    (1998)
  • S. Barr

    Associations of social and demographic variables with calcium intakes in high school students

    J Am Diet Assoc.

    (1994)
  • S. French et al.

    Cognitive and demographic correlates of low fat vending snack choices among adolescents and adults

    J Am Diet Assoc.

    (1999)
  • D. Gracey et al.

    Nutritional knowledge, beliefs and behaviours in teenage school students

    Health Educ Res: Theory Prac.

    (1996)
  • B.H. Lin et al.

    The Diets of America's ChildrenInfluences of Dining out, Household Characteristics, and Nutrition Knowledge

    (1996)
  • Cited by (1097)

    View all citing articles on Scopus
    View full text