2025
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PublicationArticle Factors that influence snacking behaviors among urban Indian adolescents – a qualitative inquiry(Frontiers Media SA, 2025) Neha Rathi; Anthony F. Worsley; Meg M. BrueningBackground and objectives: Urban Indian adolescents often practice unhealthy dietary behaviors such as meal skipping and snacking on high energy foods with low nutrient value. To promote healthy snacking behaviors among adolescents it is essential to explore the factors that may influence the consumption of healthy and unhealthy snacks among Indian adolescents. Materials and methods: Informed by the social constructivism framework, an exploratory-descriptive qualitative research approach was employed to obtain a richer understanding of the influences on urban Indian adolescents’ snacking behaviors. Using purposive sampling, adolescents aged 10–19 years were recruited from two government and two private schools in Varanasi city, Uttar Pradesh, India. Face-to-face interviews were conducted in Hindi/English, per the preference of the participants. The conversations were digitally recorded, transcribed verbatim, and translated to English (where necessary) for analysis. Themes were extracted using inductive coding. Results: A total of 62 adolescents (50% female; 76% private school pupils) with mean age 15.3 (SD: 1.86) years completed the interviews between November 2024 and February 2025. Ten themes emerged including: (i) Perceptions of a snack; (ii) liking for unhealthy snacks; (iii) consequences of snacking; (iv) snacking timing; (v) cost of snacks; (vi) parental rules around snacking; (vii) influence of peers; (viii) school food environment; (ix) neighborhood food environment; (x) food and beverage marketing. Conclusion: These findings show that multiple factors are likely to influence snacking behaviors in Indian adolescents, aligning with literature on adolescent snack consumption in international settings. Behavioral interventions should be designed to create enabling environments to encourage healthy snack consumption in adolescents by removing barriers at the individual, household, and societal levels. © © 2025 Rathi, Worsley and Bruening.PublicationArticle Household dietary gatekeepers’ perceptions of home cooking and its associated factors: A qualitative inquiry from urban India(Academic Press, 2025) Neha Rathi; Bidya Singh; Mukta Singh; Anthony F. WorsleyThe high consumption of calorie-dense, nutrient-poor meals from out of home sources has been identified as a potential risk factor for the growing burden of obesity and diet-related chronic degenerative diseases among urban Indians. Consumption of home cooked meals is linked with positive dietary and health outcomes. However, little is known about the views of Indians regarding home cooking. Therefore, this investigation was designed to qualitatively explore urban Indian nutritional gatekeepers' perceptions of home cooking and the factors influencing it. The social constructivism theoretical framework was employed to inform this qualitative investigation. A purposive sample of 34 household dietary gatekeepers (28 women; 6 men) from the Kolkata metropolis participated in face-to-face/telephonic interviews. In-depth interviews were conducted in English/Hindi/Bengali (translated to English where necessary), digitally recorded and transcribed verbatim. Inductive thematic analysis was employed to code the transcripts in the NVivo software program. Emerging themes and sub-themes were: (i) Home cooking is a duty; (ii) Facilitators of home cooking (Home cooking is good for health; Home cooking is economical; Preservation of dietary heritage; Home cooking is a source of happiness); (iii) Barriers to home cooking (Paid employment outside the home; Health issues associated with ageing; Limited culinary skills); (iv) Transformation in home cooking; (v) Decline in home cooking; (vi) Acquisition of cooking skills; (vii) Cooking skills are a necessity. These themes have the potential to inform the creation and development of public health policies and interventions aimed at stimulating home cooking for positive dietary and health outcomes. Future research should focus on developing family-based and school-based cooking interventions to inculcate culinary skills in children and adolescents. In addition, government could levy tax on ultra-processed convenience foods to minimize their utilization as well as subsidize sales of raw food ingredients to encourage ‘cooking from scratch’ using fresh and basic food ingredients. © 2025 Elsevier LtdPublicationArticle What influences Indian primary school children’s food behaviors? - Perceptions of children, mothers and teachers(BioMed Central Ltd, 2025) Neha Rathi; Prarthana Tiwari; Manisha Kanwar; Anjali Patel; Mukta Singh; Kalpna Gupta; Anthony F. WorsleyBackground: Development of healthy food behaviors in childhood is significant for optimum growth and development of children as well as future health. However, many Indian children display unhealthy dietary habits including poor intakes of fruits and vegetables and excessive consumption of calorie-dense, nutrient-poor foods and sugar-sweetened beverages. Therefore, the factors that influence their daily diet need to be explored for developing future interventions and policies. In this light, the present inquiry was designed to examine the various influences on the food behaviors of Indian primary school children. Methods: Informed by the socio-ecological framework, this study used an exploratory qualitative research approach to conduct semi-structured interviews with 22 primary school children, 19 mothers, and 18 teachers residing in Varanasi, India. For children, the interviews were preceded by a drawing session where the interviewees were asked to draw their preferred and non-preferred food and beverage items. Interviews were carried out in English or Hindi and digitally recorded. Interviews were conducted until data saturation was achieved. Digital recordings were transcribed verbatim and translated to English (where necessary) for the purpose of thematic analysis. The transcripts were coded both deductively and inductively using the NVivo software program. Results: Individual level influences included taste and nutritional knowledge. At the interpersonal level, the family food environment and peers emerged as key determinants. The physical environment also played a pivotal role in determining food behaviors, with the school food environment and food availability in the marketplace being significant. Lastly, at the societal level, television and internet advertisements were frequently cited as important determinants of children’s food behavior. Conclusions: The collective insights from the three stakeholder groups have the potential to inform public health nutrition policies and interventions targeting the different socio-ecological factors to encourage healthy eating in Indian primary school children. © The Author(s) 2025.PublicationArticle Perceived influences of fruit and vegetable consumption among Indian adolescents – A qualitative inquiry(BioMed Central Ltd, 2025) Neha Rathi; Anthony F. Worsley; Meg M. BrueningBackground: Fruits and vegetables are primary sources of vitamins and minerals that may alleviate the risk of chronic illnesses. However, Indian adolescents consume inadequate amounts of fruits and vegetables, with less than 10% meeting recommendations. Micronutrient deficiencies are a major public health problem in India. For example, the prevalence of iron-deficiency anemia and Vitamin A deficiency in adolescents is 28.5% and 14.4%, respectively. To promote fruit and vegetable consumption among Indian adolescents, we need to identify the factors which may influence the consumption. The aim of this qualitative inquiry was to explore perceived influences of fruit and vegetable consumption among Indian adolescents. Methods: Using purposive sampling, adolescents aged 10–19 years were recruited from two public and two private (independent) schools in Varanasi, India. Face-to-face interviews along with the ‘draw and tell’ technique were used for data collection. Interviews were conducted in English as well as in Hindi depending on the preferences of the adolescents. The conversations were digitally recorded and transcribed verbatim. The transcribed data were subjected to thematic analysis. Data were coded inductively, and themes were extracted using NVivo software program. Results: A total of 58 adolescents (53% female; 74% urban) with mean age 13.6 years completed the interviews. Nine major themes and associated sub-themes emerged, including: (i) Sensory properties (i.e., taste, color, flavor, texture); (ii) Health and immunity; (iii) Allergy; (iv) Home food environment (i.e., influence of mothers, availability and accessibility of fruits and vegetables); (v) Cost; (vi) Food preparation; (vii) Influence of peers; (viii) School food environment; (ix) Proclivity for energy-dense, nutrient-poor foods and beverages. Conclusions: The emerging themes and sub-themes show that multiple factors are likely to affect fruit and vegetable consumption in adolescents, aligning with literature on adolescent fruit and vegetable consumption in international settings. Behavioral interventions should be designed to create enabling environments to encourage fruit and vegetable consumption in Indian adolescents by removing barriers at the individual, household, and community levels, thereby reducing the enduring prevalence of micronutrient deficiencies. © The Author(s) 2025.