Food Environment in and Around Schools and Colleges of Delhi and National Capital Region (NCR) in India

Abstract

Background: Food policies and the environment in and around educational institutes have the potential to influence food practices, eating patterns, and behaviours of children. Methods: A mixed-methods, cross-sectional study was implemented to examine the existing food policies, food environment determinants, and food choices of school (9 schools; Private=6, Public=3) and college (n=4) going students from Delhi and National Capital Region (NCR), India. Data was collected from school (n=253) and college (n=57) students, parents of school students (n=190), teachers (n=12, schools=9, colleges=3), canteen operators of private schools (n=6) and colleges (n=4) using focus group discussions, in-depth interviews, surveys and structured observations (in and around schools and colleges). Results: A variety of food and beverage options were available in and around educational institutes but the majority of these options were unhealthy i.e. high in fat, salt, and sugar, despite restrictions. The available healthy foods and beverages in the canteens as well as outside through vendors were priced higher compared to unhealthy options. During lunchtime, twelve vendors were seen around six schools (3 private and 3 public). The density of these vendors increased at the time of dispersal (n=37) with a higher number of outside private schools (n=27) compared to public schools (n=10). Around colleges, vendors (n=14) were seen throughout the day. The students from all private schools (n=6) and colleges (n=2) were exposed to the high fat, salt, and sugar food advertisements (n=10), whereas, no advertisements were observed around public schools. Private school students are more vulnerable compared to public schools due to the availability of canteen with unhealthier options, the higher density of vendors outside school, higher exposure to unhealthy food advertisements, the higher purchasing power of students to eat outside food, and the non-availability of any school meals programme.Conclusion: The current food environment in and around educational institutes is conducive to establish and sustain unhealthy eating behaviours. It is imperative to ensure the availability of healthy food in and around their educational institutes to improve their health and wellbeing. Therefore, emphasise the need to address this challenge through regular monitoring and surveillance of the recently introduced FSSAI regulation 2020, to ensure its compliance and appropriate enforcement strategies.

A Direct Assessment of the External Domain of Food Environments in the National Capital Region of India

“…A few studies have been conducted in India for assessment of the food environment. Three of these studies assessed the food environment surrounding private schools and colleges (Rathi et al, 2016(Rathi et al, , 2017Bassi et al, 2020). Another two assessed the opinions of adolescents toward different categories of foods (Maxfield et al, 2016;Rathi et al, 2018) and the effect of the rural food environment and access to food on their nutritional status (Ganpule-Rao et al, 2020).…”

“…Since Turner et al's systematic review was conducted, four additional studies on food environments in India have been published (Li et al, 2019;Bassi et al, 2020;Ganpule-Rao et al, 2020;Surendran et al, 2020). A cross-sectional study of adolescents in rural Pune found that those living in villages with the highest density of food vendors had a higher body mass index (BMI), waist circumference, and percent body fat (Ganpule-Rao et al, 2020).…”

“…A qualitative study in that same population found that affordability and availability were the most important drivers of fruit and vegetable intake (Surendran et al, 2020). Finally, a study in Delhi found that there is a greater density of unhealthy food vendors outside private schools and colleges compared to public schools and that marketing of foods high in fat, sugar, and salt is more common around private schools compared to public schools (Bassi et al, 2020).…”