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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Main Authors: Milkah N Wanjohi, Elizabeth Wambui Kimani-Murage, Michelle Holdsworth, Rebecca Pradeilles, Calistus Wilunda, Gershim Asiki, Kerstin Klipstein-Grobusch
Format: Article
Language:English
Published: Cambridge University Press 2025-01-01
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
description 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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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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