Our results indicate that adolescents’ consumption of unhealthy snacks was influenced by a broad range of factors, including taste, lack of a sense of urgency for personal health, peer pressure and parental influence, easy access to unhealthy snacks, limited availability and high price of healthy snacks, inadequate knowledge, appeal of snacks, habit, and media advertisements.
Adolescents in our study were well informed of the negative health consequences of unhealthy snacks but were less likely to practice eating healthy snacks. Nevertheless, they emphasized that when information about negative health consequences of unhealthy foods/snacks are delivered by “important others,” it motivates them to eat less of them. This finding reemphasizes the notion that knowledge at some level is a logical prerequisite for the adoption of healthy behaviors, but acquisition of knowledge by itself does not seem adequate to assure behavioral change (32
). Based on Mirmiran et al, despite the acceptable level of knowledge in Tehrani adolescents, only 25% of boys and 15% of girls had good nutritional practices (33
). Therefore, focusing only on delivering information and increasing adolescents’ knowledge about the short and long-term benefits of a healthy diet may not be an appropriate or sufficient strategy for this age group (34
). Adolescents often do not think of a healthy diet as a priority or a matter to be concerned with (35
). However, female adolescents mostly avoid use of unhealthy snacks/food to control their weight, or to gain a socially acceptable body size (36
), and to ward off undesirable comments for their weight (37
There are several studies devoted to understanding the role of peers in determining food choices (37
). The results of this study also points to the impact that friends and peers seemingly have on snack choices among participants. With no exception, there was an undivided belief among participants that friends and peers have power to influence their snacking choices. This persuading role of friends and peers is deeply rooted in the Iranian culture around eating that heavily emphasizes the sharing of food. In Iranian culture, it is considered rude if a person who is eating food does not offer it to others who are around him or her, particularly friends and regardless of the amount of food (i.e. whether there is enough to share). Offering food to others named as “ta’arof” is a routine practice that is mandated by the culture. According to this cultural phenomenon, one offers something, particularly food, out of politeness to another person and on the receiving end, refusing what has been offered is considered out of politeness, whether or not he/she wants it. An adolescent who takes snacks to school or any peer gathering knows that it will be offered to friends and therefore will be inclined to choose a type of snack that will gain everybody’s approval and even further, will be praised. This is done to avoid negative judgment from friends regarding one’s snacking choices.
Regardless of specific factors associated with the participants’ culture, similar to previous research, our findings show that adolescents tend to be sensitive to the way their peers view them when it comes to eating. This supports the argument that peers have an important role in adolescents’ social life. In our study, adolescents noted that when they are with their friends and peers, they eat more unhealthy snacks because it is the norm. Herman and colleagues argue that in the absence of clear eating guidelines, people use the behavior of others as a sign of ‘appropriate’ eating behavior (40
). As noted by Monge-Rojas, the practices followed by the majority are considered “normal,” whereas the practices that are individually defined are considered “weird” (34
) Since eating behaviors are learned actions, and parents are a primary source of socialization, they play an important role in children’s eating habits. In our study, parents are reported as influencing factors in adolescents’ snacking choices. Iranian cultural principles put a great deal of emphasis on care and feeding ways of children. This responsibility particularly is assigned to mothers. In other hand, cultural norms expect children to obey their parents’ instructions (23
). Adolescents believed that parents can directly impose changes in their eating habits by setting eating rules and purchasing only snacks and foods they consider healthy. They also can indirectly make changes in the eating habits of their children by making changes in their own eating habits. Previous studies have investigated the effects of parental food choices, purchasing behaviors, and family food environments on various (un) healthy eating behaviors (41
). A vast majority of these studies showed the positive impact of healthy family food environment and parental control on adolescent healthy eating behaviors. However, Stevenson noted that although parental supervision may translate into less consumption of unhealthy food by their children in the short-term, it may impede adolescents’ self efficacy (45
). Adolescents may rebel against too much parental control and adapt unhealthy diets as a way to show their autonomy.
Another important finding of this study that warrants further discussion has to do with the strong opinion and judgment that participants had placed on the packaging of snack products. To the view of our participants, look, color, and packaging quality of a snack are all important criteria for choosing them. It is important to note that snacking is a new phenomenon in Iran and is heavily advertised by using Western styles of packaging in order to attract consumers. Commercial snacks that are offered to kids in Iran are often wrapped in colorful packages and have an attractive appearance.
In this study most participants claimed they were more or less in control of their diet, however, factors such as easy access to junk foods, personal taste preferences, and social pressure by the media lowered their behavioral control. This result is somewhat similar to previous studies. For example in the systematic review by Shepherd and colleagues, barriers to healthy eating included poor school meal provision, ease of access to unhealthy snacks/foods, relative cheapness of unhealthy snacks/foods, and personal taste preferences for fast foods (46
). However, family support, availability, and accessibility of healthy foods, desire to look good, and will power were reported to be facilitators (46
Our study had a number of limitations that need to be addressed. In this study, only the views of students were assessed. Obtaining views of parents and school staff might have improved the understanding of the issue. The study was only conducted among female adolescents and focused on their attitude, motivation, and self-control on unhealthy snacking. Therefore, the results may be generalizable only to females but not necessarily to male adolescents. Another limitation of this study has to do with the possibility that some adolescents in this study might have given socially desirable responses instead of discussing their own views. This especially happens when issues are discussed in-group settings. Despite the limitations, results obtained in this study can be used to improve our understanding of issues involved in unhealthy snacking behavior among female adolescents in Iran and similar societies. In summary, the implications of this formative research are threefold: First, socio-cultural and psychological variables can have profound influences on female adolescents’ unhealthy eating behaviors. Hence, interventions aimed at improving adolescents’ nutrition, especially reducing snack consumption, are likely to be more effective if these factors are taken into account. Second, educational messages should be tailored based on Iranian’s deep cultural beliefs regarding food sharing and the power of Western style commercialization and advertisement of healthy snacks. Finally, it seems that besides interventions that focus on environmental changes such as increasing availability of healthy snacks, interventions with female adolescents should also address the following areas: applying persuasive messages to promote adolescents’ internal locus of control; linking dietary behaviors to physical appearance; and training skills such as how to resist peer /media pressures as well as strategies for making informed decisions.