Drivers and solutions to unhealthy food consumption by adolescents in urban slums, Kenya: a qualitative participatory study
Abstract Objective: To explore the perceptions, drivers and potential solutions to the consumption of unhealthy, ultra-processed foods (UPF) and foods high in fat, salt and sugar (HFSS) and their contribution to the double burden of malnutrition among adolescents living in urban slums, Kenya. De...
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2025-01-01
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| Series: | Public Health Nutrition |
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| Online Access: | https://www.cambridge.org/core/product/identifier/S1368980025000400/type/journal_article |
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| author | Milkah N Wanjohi Elizabeth Wambui Kimani-Murage Michelle Holdsworth Rebecca Pradeilles Calistus Wilunda Gershim Asiki Kerstin Klipstein-Grobusch |
| author_facet | Milkah N Wanjohi Elizabeth Wambui Kimani-Murage Michelle Holdsworth Rebecca Pradeilles Calistus Wilunda Gershim Asiki Kerstin Klipstein-Grobusch |
| author_sort | Milkah N Wanjohi |
| collection | DOAJ |
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Abstract
Objective:
To explore the perceptions, drivers and potential solutions to the consumption of unhealthy, ultra-processed foods (UPF) and foods high in fat, salt and sugar (HFSS) and their contribution to the double burden of malnutrition among adolescents living in urban slums, Kenya.
Design:
Qualitative participatory research, through Photovoice, group discussions and community dialogues. Inductive, thematic analysis was undertaken.
Setting:
Three major slums, Nairobi.
Participants:
Adolescents 10–19 years (n 102: 51 boys, 51 girls) and adults (n 62).
Results:
UPF/HFSS consumption emerged as a predominant theme on foods commonly consumed by adolescents, and the causes of undernutrition and overweight/obesity. Adolescents described UPF/HFSS as junk, oily, sugary or foods with chemicals and associated UPF/HFSS consumption with undernutrition, obesity and non-communicable diseases. They perceived UPF/HFSS as modern, urban, classy and appealing to young people and minimally processed foods as boring and primitive, for older people, and those in rural areas. Individual-level drivers of UPF/HFSS consumption were organoleptic attributes (taste/aroma), body size/shape, illicit drug use, convenience and adolescents’ autonomy. Social environment drivers were peer pressure and social status/aspirations. Physical environment drivers were UPF/HFSS availability and accessibility in the slums. Education on healthy eating and the adverse effects of consuming UPF/HFSS, through existing structures (youth groups, school, community health strategy), was proposed as a potential solution to UPF/HFSS consumption.
Conclusion:
UPF/HFSS were perceived as associated with poor nutrition and health, yet were preferred over unprocessed/minimally processed foods. Interventions to promote healthy diets beyond raising awareness are important, while addressing the underlying perceptions and drivers of UPF/HFSS consumption at the individual level and in the social and physical food environments.
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| format | Article |
| id | doaj-art-4e4f0cc3d26c4a759da6783be8660a63 |
| institution | Kabale University |
| issn | 1368-9800 1475-2727 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | Public Health Nutrition |
| spelling | doaj-art-4e4f0cc3d26c4a759da6783be8660a632025-08-20T04:02:27ZengCambridge University PressPublic Health Nutrition1368-98001475-27272025-01-012810.1017/S1368980025000400Drivers and solutions to unhealthy food consumption by adolescents in urban slums, Kenya: a qualitative participatory studyMilkah N Wanjohi0https://orcid.org/0000-0003-4289-4762Elizabeth Wambui Kimani-Murage1Michelle Holdsworth2https://orcid.org/0000-0001-6028-885XRebecca Pradeilles3https://orcid.org/0000-0003-0334-3714Calistus Wilunda4Gershim Asiki5Kerstin Klipstein-Grobusch6Julius Global Health, Department of Global Public Health and Bioethics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands Nutrition and Food Systems Unit, African Population and Health Research Center, Nairobi, KenyaNutrition and Food Systems Unit, African Population and Health Research Center, Nairobi, KenyaMontpellier Interdisciplinary Centre on Sustainable Agri-Food Systems (UMR MoISA), University of Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institute Agro, IRD, Montpellier, FranceMontpellier Interdisciplinary Centre on Sustainable Agri-Food Systems (UMR MoISA), University of Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institute Agro, IRD, Montpellier, FranceNutrition and Food Systems Unit, African Population and Health Research Center, Nairobi, KenyaChronic Disease Management Unit, African Population and Health Research Center, Nairobi, KenyaJulius Global Health, Department of Global Public Health and Bioethics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa Abstract Objective: To explore the perceptions, drivers and potential solutions to the consumption of unhealthy, ultra-processed foods (UPF) and foods high in fat, salt and sugar (HFSS) and their contribution to the double burden of malnutrition among adolescents living in urban slums, Kenya. Design: Qualitative participatory research, through Photovoice, group discussions and community dialogues. Inductive, thematic analysis was undertaken. Setting: Three major slums, Nairobi. Participants: Adolescents 10–19 years (n 102: 51 boys, 51 girls) and adults (n 62). Results: UPF/HFSS consumption emerged as a predominant theme on foods commonly consumed by adolescents, and the causes of undernutrition and overweight/obesity. Adolescents described UPF/HFSS as junk, oily, sugary or foods with chemicals and associated UPF/HFSS consumption with undernutrition, obesity and non-communicable diseases. They perceived UPF/HFSS as modern, urban, classy and appealing to young people and minimally processed foods as boring and primitive, for older people, and those in rural areas. Individual-level drivers of UPF/HFSS consumption were organoleptic attributes (taste/aroma), body size/shape, illicit drug use, convenience and adolescents’ autonomy. Social environment drivers were peer pressure and social status/aspirations. Physical environment drivers were UPF/HFSS availability and accessibility in the slums. Education on healthy eating and the adverse effects of consuming UPF/HFSS, through existing structures (youth groups, school, community health strategy), was proposed as a potential solution to UPF/HFSS consumption. Conclusion: UPF/HFSS were perceived as associated with poor nutrition and health, yet were preferred over unprocessed/minimally processed foods. Interventions to promote healthy diets beyond raising awareness are important, while addressing the underlying perceptions and drivers of UPF/HFSS consumption at the individual level and in the social and physical food environments. https://www.cambridge.org/core/product/identifier/S1368980025000400/type/journal_articleUltra-processed foodsAdolescentUnhealthy foodDietary behavioursUrbanPhotovoiceParticipatory researchSub-Saharan Africa |
| spellingShingle | Milkah N Wanjohi Elizabeth Wambui Kimani-Murage Michelle Holdsworth Rebecca Pradeilles Calistus Wilunda Gershim Asiki Kerstin Klipstein-Grobusch Drivers and solutions to unhealthy food consumption by adolescents in urban slums, Kenya: a qualitative participatory study Public Health Nutrition Ultra-processed foods Adolescent Unhealthy food Dietary behaviours Urban Photovoice Participatory research Sub-Saharan Africa |
| title | Drivers and solutions to unhealthy food consumption by adolescents in urban slums, Kenya: a qualitative participatory study |
| title_full | Drivers and solutions to unhealthy food consumption by adolescents in urban slums, Kenya: a qualitative participatory study |
| title_fullStr | Drivers and solutions to unhealthy food consumption by adolescents in urban slums, Kenya: a qualitative participatory study |
| title_full_unstemmed | Drivers and solutions to unhealthy food consumption by adolescents in urban slums, Kenya: a qualitative participatory study |
| title_short | Drivers and solutions to unhealthy food consumption by adolescents in urban slums, Kenya: a qualitative participatory study |
| title_sort | drivers and solutions to unhealthy food consumption by adolescents in urban slums kenya a qualitative participatory study |
| topic | Ultra-processed foods Adolescent Unhealthy food Dietary behaviours Urban Photovoice Participatory research Sub-Saharan Africa |
| url | https://www.cambridge.org/core/product/identifier/S1368980025000400/type/journal_article |
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