Sociocultural Influences on Dietary Practices and Physical Activity Behaviors of Rural Adolescents—A Qualitative Exploration

Abstract

In the aftermath of nutrition transition and ever-increasing sedentarism, adolescents globally are exposed to negative health consequences. Diverse sociocultural influences play a critical role in their adoption of unhealthy dietary practices and suboptimal physical activity behaviors. Context-specific understandings of how these sociocultural influences shape adolescents’ dietary and physical activity patterns in a rural, resource-limited setting remained elusive. Aiming to address the gap, this qualitative study explored adolescents’ and mothers’ perception of broader sociocultural aspects that sculpt the food choices, eating habits and physical activity behaviors of adolescents in Matlab, Bangladesh. Six digitally-recorded focus group discussions were transcribed verbatim, translated into English and analyzed thematically. Marked taste-driven dietary preference of adolescents and its prioritization within family by the mothers, popularity of street foods, better understanding of the importance of food hygiene and safety contrasting with narrow perception of balance and diversity in diet, peer influence along with deficient school and community food environment, internalization and rigidity of gender norms were found to be exerting major influence. The findings highlighted key targets for community-based nutrition interventions and endorsed thorough consideration of socio-cultural factors in formulating strategies to promote healthful eating and physical activity behaviors among the adolescents.

Exploring Rural Adolescents’ Dietary Diversity and Its Socioeconomic Correlates: A Cross-Sectional Study from Matlab, Bangladesh

“…Additionally, wealthier households may opt for using their additional income to purchase non-staple foods. Corroborating that, mothers in our qualitative study conducted in Matlab emphasized the role of the high cost of meat, eggs, milk, and certain fruits in narrowing down their options for diversifying adolescents' diet [33].…”

“…Gendered consumption pattern was also noted for meat, eggs, and dairy as well as legumes, nuts, and seeds: girls consumed these less. Adolescent boys in Matlab spend more time outdoors than girls, playing or engaging in strenuous activities during cultivation and harvesting seasons [33]. This could underlie intra-household inequality in food allocation that gives boys differential access [53,54] to foods perceived as capable of delivering more energy or giving bodily strength (e.g., meat, eggs, and milk).…”

“…It is often postulated that schooling may equip adolescents with better understanding of what constitutes a healthy diet. However, Matlab presents a context where the school and community food environment is dominated by street food vendors selling inexpensive, nutrient-poor foods-mostly deep-fried or highly processed-that primarily attract adolescents [33]. There is no school meal program running in Matlab either.…”

“…Mother/guardian-adolescent dyads were interviewed at their residences with a pre-tested, structured questionnaire containing pre-coded questions. Insights from previous follow-ups and qualitative study undertaken at the initial phase of the 15-year follow-up [33] guided questionnaire preparation and context-specific adaptation of standard instruments. The interviewers received comprehensive training on questionnaire survey techniques and data collection using tablet computer devices.…”

“…In our adapted version, we separated "Fish" from "Meat, poultry, and fish" to avoid masking of the plausibly lower consumption of meat by an anticipated higher consumption of fish. Whereas families in Matlab mostly buy meat from the market [33], fish remains more accessible due to its abundant natural availability in Matlab. Having fish in the same food group with meat and poultry may, therefore, obscure affordability issues and potential association with socioeconomic status.…”