Directory UMM :Data Elmu:jurnal:N:Nutrition And Food Science:Vol99.Issue5.1999:
Food choices of 9-17year olds in Northern
Ireland ± influences and
challenges
Jennifer Warwick
Heather McIlveen and
Christopher Strugnell
The authors
Jennifer Warwick is based at the University of Ulster,
Northern Ireland Centre for Diet and Health, Coleraine,
County Londonderry, Northern Ireland.
Heather McIlveen and Christopher Strugnell are at
the Faculty of Business and Management, University of
Ulster at Jordanstown, Newtownabbey, Co. Antrim,
Northern Ireland.
Keywords
Food, Young people, Health, Nutrition,
Consumer behaviour
Abstract
Few studies have concentrated on the food choices of
young people and the potential influences, yet the food
choices established in these early years can determine the
diet and quality of health in later life. This study
investigates the diet and food choices of 9-17-year olds in
Northern Ireland and considers the potential effects of
age, gender and socio-economic grouping. A range of
research methods was implemented including observations, questionnaires and diet based case studies. The
observations, in five schools, indicated the types of foods
being chosen whilst the questionnaires further investigated this initial information along with other factors, to
obtain more detailed data. A total of 764 questionnaires
were administered to young people and 516 to parents to
facilitate comparison. In-depth diet based case studies
also took place evaluating the diets of 14 young people.
The research indicated that this group have a diet which
continues to cause concern.
Nutrition & Food Science
Number 5 . September/October 1999 . pp. 229±236
# MCB University Press . ISSN 0034-6659
Introduction
Many models have been developed to explain
food choice behaviour (Yudkin, 1956; Pilgrim, 1957; Khan, 1981; Randall and Sanjur,
1981; Krondl and Lau, 1982; Booth and
Shepherd, 1988; Furst et al., 1996) but little
research has focused upon young people. The
food choices and eating patterns of this group
have raised concern among those aiming to
promote a healthier lifestyle for the next
millennium. In Northern Ireland deaths from
coronary heart disease (CHD), in particular,
are of major concern. The Province has the
second highest rate of heart disease in the
world and in 1992, 4,313 people died due to
CHD.
It is during adolescence that many eating
habits are established which may be difficult
or even impossible to alter in later life (Davis,
1991). This has important implications for
future health and as the National Forum for
Coronary Heart Disease Prevention (1994)
states ``... the typical unhealthy diet increases
the risk of a variety of health problems both in
childhood and in later life ... Consequently,
healthy eating habits should be started early''.
Thus it is important to examine the factors
which influence the food choice decisions of
young people, in order to encourage them to
make healthier food choices.
Factors influencing food choice
decisions
``The diet of any individual, whether child,
adult or adolescent, is the result of the
intermeshing of a range of factors, many of
which are complex and conflicting'' (Shepherd and Dennison, 1996). This complexity
increases when the focus is placed on young
people, who are at a stage of development
described as ``turbulent'' and characterised by
major physical and psychological changes
(Woodward, 1986). The development of food
choice models has, in part, helped to highlight
the various influences but has not provided a
sufficient level of explanation or application
(Shepherd and Sparks, 1994).
Social factors influence food choice and
eating habits and the family remains the major
This study was supported by a distinction award
from the Department of Education for Northern
Ireland.
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Jennifer Warwick, Heather McIlveen and Christopher Strugnell
agency of socialisation from infancy to adolescence (Giddens, 1993). Sociologists have
stated that ``food is not simply a biological but
also a social phenomenon'' (Murcott, 1997)
highlighting the impact of social factors.
Rozin (1996) believes that early experiences
shape and determine later preferences and
Casey and Rozin (1989) indicate that ``there
is something to be learned from parents about
the establishment of likes and dislikes''.
Contento et al. (1993) found the mother to be
an important influence on the types of foods
chosen and ultimately, the food consumed
within the household. It is recognised that
from the ages of five to eight parental
influence has the most important effect on
food choice, in spite of a growing awareness of
other influences. As a child develops, other
influences come into action which can reverse, modify or alter the behaviour
established in the home.
Many parents feel that school marks a time
when their child becomes more independent
and their influence decreases, due to increased contact with peer groups. Duncker
(1938), as cited in Birch et al. (1980), found
that peer relations tended to result in an
expanded range of food preferences. Birch
(1980) also investigated the influence of peers
on pre-schoolers and their preferences for
vegetables and concluded that peers had a
positive influence on the acceptance of certain
vegetables. However, conflict between research exists and Williams et al. (1993) found
few relationships between adolescent food
choices and those of their peers, in a study in
Tasmania.
In addition to family and peers, culture also
affects food choice, ``What food we buy,
where we buy it and how we consume it is
ultimately connected with the culture in
which we have been brought up'' (Bareham,
1995). Curry (1984) assessed the influence of
culture on the diets of 521 young people
between 11 and 16 from the UK (n = 149),
New Zealand (n = 107) and the USA
(n = 265). It was concluded that culture had
an impact on diet and that the British culture
had infiltrated into New Zealand and the
USA due to historical connections. However,
teenagers may rebel against cultural norms in
an attempt to be different and also become
exposed to other factors which may exert a
stronger influence over food choice decisions.
Socio-economic status is also thought to
have an effect on food choice. Higher income
groups are considered to eat more of the foods
classified as part of a healthy diet. However,
McKenzie (1974) recognises that ``prosperity
creates problems in terms of diet and food
choice'' basically due to the dangers of
developing ``self induced'' diseases. Shepherd
et al. (1996) found that lower income groups
have less to spend on food which has a
negative impact on healthy eating practices.
Data collected from Newcastle upon Tyne
also indicated that higher socio-economic
groups consume more fruit and vegetables
(Gerhardy et al., 1995).
Psychological behaviour, involving people's
beliefs and attitudes, also affects food choice.
For example, people develop various beliefs
about food, which may direct behaviour and
alter their diets. Similarly, Bareham (1995)
states that ``attitudes shape behaviour''
whereby a favourable attitude may encourage
a product to be consumed. However, he
maintains that ``attitudes are also shaped by
behaviour'', for example, where a ``mistake
purchase'' could result in the development of
a favourable attitude.
In addition physiological needs influence
food choices. Demands for nutrients such as
protein, calcium, iron and zinc are relatively
high (NDC, 1995) due to the rapid ``growth
spurt'' which occurs during this period,
although many young people fail to choose
the correct foods to meet these requirements.
However, the diets of teenagers and children
in the UK are usually high in fat and sugar.
This study examined the food choices of
children and teenagers between nine and 17
in Northern Ireland and the factors affecting
their food choice decisions and eating habits.
Methodology
A variety of research methods were implemented. Observation was carried out in five
schools, during lunch breaks in school cafeterias and lunchrooms, to give an indication
of the types of foods being chosen. The
schools were selected according to location
and educational ability (secondary schools in
Northern Ireland are segregated according to
academic attainment at the age of 11) to
include a range of socio-economic groupings.
The observation was mainly non-participant
although selected students were approached if
their choice of food was considered to be
worthy of further investigation, for example,
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Jennifer Warwick, Heather McIlveen and Christopher Strugnell
exceptionally high in fat and/or sugar. This
observation led to a more detailed study using
a questionnaire.
Questionnaires were distributed in ten
schools throughout Northern Ireland (both
rural and urban communities) to further
investigate food choices, adopting the same
selection criteria as before. The schools were
all co-educational with four primary schools
(ages 9-11) and six secondary schools (ages
11-17) taking part. A pilot study was carried
out to ensure that the wording of the
questions was correct and appropriate for
children. A range of questions were asked
(Warwick et al., 1997) which were mainly in
closed format, defined as ``questions in which
a number of alternative answers are given''
(Wilson and McClean, 1994), in an attempt
to focus the child and reduce the risk of
misinterpretation. A questionnaire was also
distributed to parents containing similar
questions to enable a comparison of responses
and to assess whether parents were aware of
their children's food choices and eating
habits. Following the pilot study, 764 questionnaires were completed by young people
with 516 parents responding, giving a response rate of 67.5 per cent. The results were
analysed by the Statistical Programme for
Social Sciences (SPSS) for Windows and the
chi-square test (w2) used to analyse the
association between the test variables.
The quality of young people's diets was
further assessed via in-depth case studies on
14 young people between nine and 17 years of
age. The candidates were members of youth
organisations in two different areas of
Northern Ireland, an inner urban area in
Belfast and a rural community approximately
20 miles west of Belfast. These two areas
represented various socio-economic groupings and facilitated comparisons. Each of the
candidates had to record their diet, including
all snacks, for one week, on five separate
occasions, during a one-year period. As the
aim was to consider the types of foods being
chosen and not the nutritional wellbeing of
each individual, food intakes were not
weighed. However, as the programme progressed the candidates were requested to
indicate the cooking methods used and to
provide more detail concerning the types of
food or drink consumed, for example, whole
or semi-skimmed milk. The programme
involved a training week to eradicate any
possible problems and to ensure that the
young people understood the procedure. On
completion of the training the candidates then
had the option of leaving the case study
programme.
Results and discussion
Observation
The observation highlighted the popularity of
foods such as French-fried potatoes (chips),
hamburgers, hot-dogs, potato crisps, confectionery and carbonated drinks. It was noted
that younger males, in particular, were more
inclined to choose chips as part of their lunch,
whereas older females tended to be more
``health conscious''. One 11-year-old boy
observed selected a portion of chips, one
doughnut, one Mars bar and a carbonated
(fizzy) orange drink. When approached the
child revealed that this was his choice of
school lunch every day. The observations also
indicated that the educational ability of the
child, broadly differentiated by the type of
school, had little influence on choices made.
These trends were further substantiated by
the questionnaire.
Questionnaires
Age
In total 764 children completed the questionnaire with all ages (9-17 years) being
represented. These were classified into three
categories: 9-11-year olds, 12-14-year olds
and 15-17-year olds to enable cross-tabulation using SPSS. Overall, the results indicated
that age did have a significant association with
food choice and eating habits. The 12 to 14year olds and the 15 to 17-year olds were
more inclined to eat school meals with 59.0
per cent and 50.6 per cent respectively
compared to 27.4 per cent of 9 to 11-year olds
(p < 0.001). The trend was reversed when the
consumption of packed lunches was viewed.
This can be partly explained by the introduction of the cash cafeteria system into
secondary schools (11+ years) whilst the
traditional set school meal remains in primary
schools. The cash cafeteria system undoubtedly provides a wider choice for the child as
they are allowed to select the items that are
preferred from a range of foods.
The effect of this choice was again evident
when the options for lunch were analysed.
44.9 per cent of 12 to 14-year olds and 37.0
per cent of 15 to 17-year olds chose chips
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Jennifer Warwick, Heather McIlveen and Christopher Strugnell
compared to only 16.4 per cent of nine to 11year olds (p < 0.001). In addition to this, the
percentage opting for a piece of fruit for lunch
was greater among the younger group at 26.5
per cent (p < 0.001). This group are still at
the stage where food consumption, at lunch
times, can be influenced by either parental or
educational control; thus overall food choices
appeared to be healthier. However, it must be
noted that the crisp and confectionery consumption was also slightly higher among this
group. In general terms lunch-time choices
among 9 to 17-year olds were a cause for
concern due to the low percentages choosing
the healthier options such as baked potatoes
(3.0 per cent), fruit (14.5 per cent) and salads
(3.8 per cent) compared to chips (34.8 per
cent), confectionery (25.9 per cent) and
crisps (18.5 per cent).
The popularity of carbonated drinks was
evident from the questionnaire, especially
among the 15 to 17-year olds (64.8 per cent,
p < 0.001). A trend was also noted in the
decreasing consumption of pure orange and
milk among this group which is perhaps
worrying, especially in relation to vitamin C
and calcium intakes respectively. Figure 1
indicates the consumption of carbonated
drinks, pure orange and milk among the three
age categories.
Snacking was also prevalent among all age
groups with significant associations evident in
relation to snacking choices and the different
age groups, as indicated in Table I. The 9 to 11
year olds appear to consume a wider variety of
snacks and may, for example, consume two to
three choices together, as one snack. Overall,
the total percentage indicated the popularity of
crisps, chocolate and sweets as snack selections
in comparison to fruit. These findings are in
line with previous research indicating the
sustained popularity of high fat and/or sugar
snacks (McGuffin, 1983; Collings, 1994).
Young people are inclined to miss breakfast
(Webster, 1995), with Bartlett (1993) suggesting 58 per cent of young people leave the
house in the morning without eating. The
questionnaire indicated that the figure for
Northern Ireland was lower at 32 per cent.
However, the trend of adolescents being the
most likely to miss breakfast was substantiated with 79.6 per cent of 9 to 11-year olds,
65.9 per cent of 12 to 14-year olds and 56.8
per cent of 15 to 17-year olds eating breakfast
(p < 0.001). This trend was also related to
snacking on the way to school with 15.7 per
cent of 12 to 14 and 11.1 per cent of 15 to 17year olds most likely to eat as they travelled to
school (p < 0.01).
Given these results age does appear to be
significantly associated with food choices.
Table I Age and its association with snack choices
Age
Crisps
per cent
9-11
72.1
12-14
70.7
15-17
61.1
Significance
p < 0.05
level
Total
per cent
69.1
Snack choices
Fruit
Chocolate/sweets Biscuits/cakes
per cent
per cent
per cent
62.8
39.9
50.0
63.3
57.2
67.3
p < 0.001
48.8
p < 0.05
61.1
Figure 1 Consumption of carbonated drinks, pure orange juice and milk among 9 to 11, 12 to 14 and 15 to
17-year olds
232
41.6
33.2
30.2
35.1
Food choices of 9-17-year olds in Northern Ireland
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Number 5 . September/October 1999 . 229±236
Jennifer Warwick, Heather McIlveen and Christopher Strugnell
The 12 to 14-year olds were the group who
were most likely to eat chips and least likely to
consume fruit. However, it is difficult to
conclude which group is most at risk of an
``unhealthy'' diet, as each group revealed
worrying trends. It can, however, be concluded that 9 to 17-year olds in Northern
Ireland must review their food choices and in
particular reduce confectionery and potato
crisp consumption and increase fruit intake.
Gender
The research confirmed that females generally have a slightly ``healthier'' diet than
males, consuming more salads (5 per cent
compared to 2.5 per cent (p < 0.05)), more
fruit (15.2 per cent compared to 13.8 per
cent) and less confectionery and carbonated
drinks. However, the associations between
gender and food choices were not as significant as those between age and food choices.
The investigation into age revealed that
milk consumption was low and it was further
confirmed as being lower among females with
only 4.4 per cent drinking milk compared to
7.9 per cent of males. Although this result was
not significant it is still of importance due to
the risk of osteoporosis in females in later life
(NDC, 1992) which has been linked to low
intakes of calcium in earlier years. Consumption of breakfast was significantly
associated with gender; 58.7 per cent of
females in comparison to 78.5 per cent of
males consume breakfast; therefore it can be
concluded that older females are more likely
to miss breakfast. Figure 2 highlights breakfast consumption when both age and gender
are taken into consideration. It can be noted
that consumption decreases with age in both
genders but more so with females (p < 0.001).
Socio-economic grouping
To determine the socio-economic grouping
the occupations of the parents were requested
and were classified according to the RegistrarGeneral's Five-Point Occupational Scale
(Foxall, 1986; Bareham, 1995). The children
with parents in the lower socio-economic
groupings (unskilled workers and the unemployed) were more likely to eat school meals
with 62.5 per cent and 52.9 per cent
respectively (p < 0.01). There were significant
associations between socio-economic grouping and the consumption of chips and fruit.
The children with parents in professional
positions (higher socio-economic groupings)
consumed less chips (22.8 per cent) than
children with unemployed parents (40.2 per
cent), (p < 0.05). Similarly, the trend was
reversed when fruit consumption was investigated with 25 per cent of the children in the
higher group eating fruit compared to only
8.9 per cent of the children in the lower group
(p < 0.01). These trends are in line with
previous research indicating that higher socioeconomic groups eat more foods which could
be classified as being part of a healthier diet
(Gerhardy et al., 1995).
Parental questionnaire
The questionnaire administered to the parents was used as a comparison for the results
received from the children. It was interesting
to note the following differences:
.
More parents than children identified
fruit as being consumed (29.5 per cent
parents compared to 14.5 per cent
children (p < 0.001)).
.
More parents than children stated that
breakfast was eaten (75.8 per cent
Figure 2 Breakfast consumption among males and females of different ages
233
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Jennifer Warwick, Heather McIlveen and Christopher Strugnell
.
.
.
compared to 68.1 per cent (p < 0.05)).
Fewer parents than children admitted to
confectionery consumption (68 per cent
compared to 74.1 per cent (p < 0.05)).
Fewer parents than children stated that
snacking occurred on the way to school
(4.1 per cent compared to 12.7 per cent
(p < 0.001)).
Fewer parents than children identified the
consumption of chips as part of an
evening meal (30.2 per cent compared to
38.1 per cent (p < 0.001)).
These differences may be explained by:
(1) the parent wishing to perceive that their
child's diet is healthier than it really is; or
(2) a lack of knowledge concerning what their
child actually eats.
It is important to note that the age group in
question are at a stage of development where
they may desire greater independence and
resist parental control; thus the second
explanation is both possible and understandable.
Case studies
The observation and questionnaires raised
concern as to the types of foods being chosen
by young people and ultimately the quality of
their diet during these years. The case studies
investigated the diets of 14 young people in
greater depth, and highlighted the differences
between the two locations. Tables II and III
illustrate the diets of two of the candidates,
recorded over a two-day period. Both were
nine year old females with candidate 1 living
in a rural area approximately 20 miles north
west of Belfast and candidate 2 from an inner
city district in a lower class area of Belfast.
Candidate 2's diet indicated a lack of fruit and
vegetables, apart from peas, and a limited
fibre intake. This pattern was in fact consistent across the study. In contrast candidate 1
had a variety of fruit, vegetables, cereals and
wholemeal bread included in her diet, again a
trend which was noted throughout the study.
Although the example given would suggest
that candidate 1 was vegetarian, the remaining diet sheets indicated otherwise. Also a
difference in the consumption of confectionery was noted with candidate 2 consuming a
considerable quantity of sweets and having a
bottle/can of Coca-Cola every day. In comparison to candidate 1's diet the diet of
candidate 3 (Table IV), a nine-year-old male
from the same area, highlighted the differences between male and female diets, as
indicated in previous results. Although the
form lacked detail on occasions, the candidate
was interviewed informally and he admitted
to eating a vast amount of snack foods,
especially confectionery and very little fruit.
An interesting finding was observed when a
15-year old female (candidate 4) from the
rural district was investigated. Table V highlights her diet which was low in fruit and
vegetables and high in fat and sugar products.
This diet was not consistent with the other
female diets recorded in the rural area but it
was revealed that the child had only recently
moved to the area and was originally from an
inner city area ± an observation perhaps
worthy of further investigation.
Conclusion
In the light of previous research and considering the amount of information now
Table II Candidate 1 diet recall
Day
Breakfast
Break
Lunch
Tea/dinner
Supper
Snacks
Monday
Fruit and
fibre cereal
Chocolate
biscuit
Wholemeal bread
with peanut
butter. Grapes and
apple juice
Two potato
waffles, two
vegetable fingers,
garden peas,
tomato and
lettuce
One apple
Two slices of
wholemeal
toast. A small
dish of
ice-cream. One
packet of crisps
Tuesday
Fruit and
fibre cereal
Mint square
Wholemeal bread
with peanut
butter. Grapes
and an orange.
Apple juice
Home-made
lentil burgers
with carrots,
peas and
boiled potato
234
Two slices of
wholemeal toast.
One piece of
coffee cake and
one packet of
soft mints
Food choices of 9-17-year olds in Northern Ireland
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Number 5 . September/October 1999 . 229±236
Jennifer Warwick, Heather McIlveen and Christopher Strugnell
Table III Candidate 2 diet recall
Day
Breakfast
Break
Lunch
Tea/dinner
Supper
Snacks
Monday
Nesquick and
a cup of tea
Chip stick crisps
and a bottle of
Coca-Cola
Mashed
potato, beans
and sausage
Soup and a
cup of tea
Chocolate
biscuit
Taz, Milky Way
rolls and bonbon sweets
Tuesday
Nesquick and
a cup of tea
Chip stick crisps
and a bottle
of Coca-Cola
Mashed potato,
meat balls and
cabbage
Stew and a
cup of tea
Bread and
jam
Toffee bar
and a packet of
sweets
Supper
Table IV Candidate 3 diet recall
Day
Breakfast
Break
Lunch
Tea/dinner
Monday
Toast, Frosties
cereal and
pure orange
juice
A packet of
Rolos, a Milky
Way and a
can of
Coca-Cola
Cheese sandwiches,
a packet of
crisps and diluting
orange
Baked potato,
cheese and baked
beans
Tuesday
Toast, Frosties
cereal and
pure orange
juice
A packet of
crisps and a
can of
Coca-Cola
Cheese on toast
and a jam doughnut
An Ulster fry ±
sausage, egg,
bacon and potato
bread
Snacks
Two packets of
polo mints, one
packet of butter
ball sweets,
two packets of
crisps and a can
of Coca-Cola
Two fig
rolls
A Mars bar
and a packet
of Opal Fruits
Table V Candidate 4 diet recall
Day
Breakfast
Break
Lunch
Tea/dinner
Monday
Tuesday
One packet
of crisps
One ham roll,
one packet of
crisps, one
chocolate bar
and a can of
Lilt
available on healthy eating, it is disappointing
to note that the diet of the younger generation
is still a cause for concern. The poor diet of
many young people today has implications for
the health status of the adult population in the
twenty-first century, especially as future
health is often established in the early years of
life. It would appear that the general population has received sufficient information on
diet and how to establish healthy food choices
but this seems to have had little long term
impact. The young people surveyed did reveal
a knowledge of healthy eating practices but
Supper
Snacks
Chicken strips in
batter with
garlic dip and
battered
mushrooms.
A bottle of Lilt
One bar of
chocolate and
three chocolate
biscuits
1/4 of a pizza
with ham and
mushroom
topping
Screwball ice-cream,
two packets of
crisps, one lolly pop
and one packet
of polo sweets
still failed to put this knowledge into practice.
Many factors influence food choice and the
age, gender and socio-economic grouping of
the child all have an effect. Hunton (1994)
highlights that healthy eating has to be sold as
a ``fun ticket and not a health ticket'' which
may have a more positive influence on food
choice among young people. If a reduction in
health-related diseases is to occur and food
choices are to improve, change is necessary
but facilitating this change remains a
challenge. Young people have to start now to
make the right food choices for lifelong health.
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236
Ireland ± influences and
challenges
Jennifer Warwick
Heather McIlveen and
Christopher Strugnell
The authors
Jennifer Warwick is based at the University of Ulster,
Northern Ireland Centre for Diet and Health, Coleraine,
County Londonderry, Northern Ireland.
Heather McIlveen and Christopher Strugnell are at
the Faculty of Business and Management, University of
Ulster at Jordanstown, Newtownabbey, Co. Antrim,
Northern Ireland.
Keywords
Food, Young people, Health, Nutrition,
Consumer behaviour
Abstract
Few studies have concentrated on the food choices of
young people and the potential influences, yet the food
choices established in these early years can determine the
diet and quality of health in later life. This study
investigates the diet and food choices of 9-17-year olds in
Northern Ireland and considers the potential effects of
age, gender and socio-economic grouping. A range of
research methods was implemented including observations, questionnaires and diet based case studies. The
observations, in five schools, indicated the types of foods
being chosen whilst the questionnaires further investigated this initial information along with other factors, to
obtain more detailed data. A total of 764 questionnaires
were administered to young people and 516 to parents to
facilitate comparison. In-depth diet based case studies
also took place evaluating the diets of 14 young people.
The research indicated that this group have a diet which
continues to cause concern.
Nutrition & Food Science
Number 5 . September/October 1999 . pp. 229±236
# MCB University Press . ISSN 0034-6659
Introduction
Many models have been developed to explain
food choice behaviour (Yudkin, 1956; Pilgrim, 1957; Khan, 1981; Randall and Sanjur,
1981; Krondl and Lau, 1982; Booth and
Shepherd, 1988; Furst et al., 1996) but little
research has focused upon young people. The
food choices and eating patterns of this group
have raised concern among those aiming to
promote a healthier lifestyle for the next
millennium. In Northern Ireland deaths from
coronary heart disease (CHD), in particular,
are of major concern. The Province has the
second highest rate of heart disease in the
world and in 1992, 4,313 people died due to
CHD.
It is during adolescence that many eating
habits are established which may be difficult
or even impossible to alter in later life (Davis,
1991). This has important implications for
future health and as the National Forum for
Coronary Heart Disease Prevention (1994)
states ``... the typical unhealthy diet increases
the risk of a variety of health problems both in
childhood and in later life ... Consequently,
healthy eating habits should be started early''.
Thus it is important to examine the factors
which influence the food choice decisions of
young people, in order to encourage them to
make healthier food choices.
Factors influencing food choice
decisions
``The diet of any individual, whether child,
adult or adolescent, is the result of the
intermeshing of a range of factors, many of
which are complex and conflicting'' (Shepherd and Dennison, 1996). This complexity
increases when the focus is placed on young
people, who are at a stage of development
described as ``turbulent'' and characterised by
major physical and psychological changes
(Woodward, 1986). The development of food
choice models has, in part, helped to highlight
the various influences but has not provided a
sufficient level of explanation or application
(Shepherd and Sparks, 1994).
Social factors influence food choice and
eating habits and the family remains the major
This study was supported by a distinction award
from the Department of Education for Northern
Ireland.
229
Food choices of 9-17-year olds in Northern Ireland
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Jennifer Warwick, Heather McIlveen and Christopher Strugnell
agency of socialisation from infancy to adolescence (Giddens, 1993). Sociologists have
stated that ``food is not simply a biological but
also a social phenomenon'' (Murcott, 1997)
highlighting the impact of social factors.
Rozin (1996) believes that early experiences
shape and determine later preferences and
Casey and Rozin (1989) indicate that ``there
is something to be learned from parents about
the establishment of likes and dislikes''.
Contento et al. (1993) found the mother to be
an important influence on the types of foods
chosen and ultimately, the food consumed
within the household. It is recognised that
from the ages of five to eight parental
influence has the most important effect on
food choice, in spite of a growing awareness of
other influences. As a child develops, other
influences come into action which can reverse, modify or alter the behaviour
established in the home.
Many parents feel that school marks a time
when their child becomes more independent
and their influence decreases, due to increased contact with peer groups. Duncker
(1938), as cited in Birch et al. (1980), found
that peer relations tended to result in an
expanded range of food preferences. Birch
(1980) also investigated the influence of peers
on pre-schoolers and their preferences for
vegetables and concluded that peers had a
positive influence on the acceptance of certain
vegetables. However, conflict between research exists and Williams et al. (1993) found
few relationships between adolescent food
choices and those of their peers, in a study in
Tasmania.
In addition to family and peers, culture also
affects food choice, ``What food we buy,
where we buy it and how we consume it is
ultimately connected with the culture in
which we have been brought up'' (Bareham,
1995). Curry (1984) assessed the influence of
culture on the diets of 521 young people
between 11 and 16 from the UK (n = 149),
New Zealand (n = 107) and the USA
(n = 265). It was concluded that culture had
an impact on diet and that the British culture
had infiltrated into New Zealand and the
USA due to historical connections. However,
teenagers may rebel against cultural norms in
an attempt to be different and also become
exposed to other factors which may exert a
stronger influence over food choice decisions.
Socio-economic status is also thought to
have an effect on food choice. Higher income
groups are considered to eat more of the foods
classified as part of a healthy diet. However,
McKenzie (1974) recognises that ``prosperity
creates problems in terms of diet and food
choice'' basically due to the dangers of
developing ``self induced'' diseases. Shepherd
et al. (1996) found that lower income groups
have less to spend on food which has a
negative impact on healthy eating practices.
Data collected from Newcastle upon Tyne
also indicated that higher socio-economic
groups consume more fruit and vegetables
(Gerhardy et al., 1995).
Psychological behaviour, involving people's
beliefs and attitudes, also affects food choice.
For example, people develop various beliefs
about food, which may direct behaviour and
alter their diets. Similarly, Bareham (1995)
states that ``attitudes shape behaviour''
whereby a favourable attitude may encourage
a product to be consumed. However, he
maintains that ``attitudes are also shaped by
behaviour'', for example, where a ``mistake
purchase'' could result in the development of
a favourable attitude.
In addition physiological needs influence
food choices. Demands for nutrients such as
protein, calcium, iron and zinc are relatively
high (NDC, 1995) due to the rapid ``growth
spurt'' which occurs during this period,
although many young people fail to choose
the correct foods to meet these requirements.
However, the diets of teenagers and children
in the UK are usually high in fat and sugar.
This study examined the food choices of
children and teenagers between nine and 17
in Northern Ireland and the factors affecting
their food choice decisions and eating habits.
Methodology
A variety of research methods were implemented. Observation was carried out in five
schools, during lunch breaks in school cafeterias and lunchrooms, to give an indication
of the types of foods being chosen. The
schools were selected according to location
and educational ability (secondary schools in
Northern Ireland are segregated according to
academic attainment at the age of 11) to
include a range of socio-economic groupings.
The observation was mainly non-participant
although selected students were approached if
their choice of food was considered to be
worthy of further investigation, for example,
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Jennifer Warwick, Heather McIlveen and Christopher Strugnell
exceptionally high in fat and/or sugar. This
observation led to a more detailed study using
a questionnaire.
Questionnaires were distributed in ten
schools throughout Northern Ireland (both
rural and urban communities) to further
investigate food choices, adopting the same
selection criteria as before. The schools were
all co-educational with four primary schools
(ages 9-11) and six secondary schools (ages
11-17) taking part. A pilot study was carried
out to ensure that the wording of the
questions was correct and appropriate for
children. A range of questions were asked
(Warwick et al., 1997) which were mainly in
closed format, defined as ``questions in which
a number of alternative answers are given''
(Wilson and McClean, 1994), in an attempt
to focus the child and reduce the risk of
misinterpretation. A questionnaire was also
distributed to parents containing similar
questions to enable a comparison of responses
and to assess whether parents were aware of
their children's food choices and eating
habits. Following the pilot study, 764 questionnaires were completed by young people
with 516 parents responding, giving a response rate of 67.5 per cent. The results were
analysed by the Statistical Programme for
Social Sciences (SPSS) for Windows and the
chi-square test (w2) used to analyse the
association between the test variables.
The quality of young people's diets was
further assessed via in-depth case studies on
14 young people between nine and 17 years of
age. The candidates were members of youth
organisations in two different areas of
Northern Ireland, an inner urban area in
Belfast and a rural community approximately
20 miles west of Belfast. These two areas
represented various socio-economic groupings and facilitated comparisons. Each of the
candidates had to record their diet, including
all snacks, for one week, on five separate
occasions, during a one-year period. As the
aim was to consider the types of foods being
chosen and not the nutritional wellbeing of
each individual, food intakes were not
weighed. However, as the programme progressed the candidates were requested to
indicate the cooking methods used and to
provide more detail concerning the types of
food or drink consumed, for example, whole
or semi-skimmed milk. The programme
involved a training week to eradicate any
possible problems and to ensure that the
young people understood the procedure. On
completion of the training the candidates then
had the option of leaving the case study
programme.
Results and discussion
Observation
The observation highlighted the popularity of
foods such as French-fried potatoes (chips),
hamburgers, hot-dogs, potato crisps, confectionery and carbonated drinks. It was noted
that younger males, in particular, were more
inclined to choose chips as part of their lunch,
whereas older females tended to be more
``health conscious''. One 11-year-old boy
observed selected a portion of chips, one
doughnut, one Mars bar and a carbonated
(fizzy) orange drink. When approached the
child revealed that this was his choice of
school lunch every day. The observations also
indicated that the educational ability of the
child, broadly differentiated by the type of
school, had little influence on choices made.
These trends were further substantiated by
the questionnaire.
Questionnaires
Age
In total 764 children completed the questionnaire with all ages (9-17 years) being
represented. These were classified into three
categories: 9-11-year olds, 12-14-year olds
and 15-17-year olds to enable cross-tabulation using SPSS. Overall, the results indicated
that age did have a significant association with
food choice and eating habits. The 12 to 14year olds and the 15 to 17-year olds were
more inclined to eat school meals with 59.0
per cent and 50.6 per cent respectively
compared to 27.4 per cent of 9 to 11-year olds
(p < 0.001). The trend was reversed when the
consumption of packed lunches was viewed.
This can be partly explained by the introduction of the cash cafeteria system into
secondary schools (11+ years) whilst the
traditional set school meal remains in primary
schools. The cash cafeteria system undoubtedly provides a wider choice for the child as
they are allowed to select the items that are
preferred from a range of foods.
The effect of this choice was again evident
when the options for lunch were analysed.
44.9 per cent of 12 to 14-year olds and 37.0
per cent of 15 to 17-year olds chose chips
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Jennifer Warwick, Heather McIlveen and Christopher Strugnell
compared to only 16.4 per cent of nine to 11year olds (p < 0.001). In addition to this, the
percentage opting for a piece of fruit for lunch
was greater among the younger group at 26.5
per cent (p < 0.001). This group are still at
the stage where food consumption, at lunch
times, can be influenced by either parental or
educational control; thus overall food choices
appeared to be healthier. However, it must be
noted that the crisp and confectionery consumption was also slightly higher among this
group. In general terms lunch-time choices
among 9 to 17-year olds were a cause for
concern due to the low percentages choosing
the healthier options such as baked potatoes
(3.0 per cent), fruit (14.5 per cent) and salads
(3.8 per cent) compared to chips (34.8 per
cent), confectionery (25.9 per cent) and
crisps (18.5 per cent).
The popularity of carbonated drinks was
evident from the questionnaire, especially
among the 15 to 17-year olds (64.8 per cent,
p < 0.001). A trend was also noted in the
decreasing consumption of pure orange and
milk among this group which is perhaps
worrying, especially in relation to vitamin C
and calcium intakes respectively. Figure 1
indicates the consumption of carbonated
drinks, pure orange and milk among the three
age categories.
Snacking was also prevalent among all age
groups with significant associations evident in
relation to snacking choices and the different
age groups, as indicated in Table I. The 9 to 11
year olds appear to consume a wider variety of
snacks and may, for example, consume two to
three choices together, as one snack. Overall,
the total percentage indicated the popularity of
crisps, chocolate and sweets as snack selections
in comparison to fruit. These findings are in
line with previous research indicating the
sustained popularity of high fat and/or sugar
snacks (McGuffin, 1983; Collings, 1994).
Young people are inclined to miss breakfast
(Webster, 1995), with Bartlett (1993) suggesting 58 per cent of young people leave the
house in the morning without eating. The
questionnaire indicated that the figure for
Northern Ireland was lower at 32 per cent.
However, the trend of adolescents being the
most likely to miss breakfast was substantiated with 79.6 per cent of 9 to 11-year olds,
65.9 per cent of 12 to 14-year olds and 56.8
per cent of 15 to 17-year olds eating breakfast
(p < 0.001). This trend was also related to
snacking on the way to school with 15.7 per
cent of 12 to 14 and 11.1 per cent of 15 to 17year olds most likely to eat as they travelled to
school (p < 0.01).
Given these results age does appear to be
significantly associated with food choices.
Table I Age and its association with snack choices
Age
Crisps
per cent
9-11
72.1
12-14
70.7
15-17
61.1
Significance
p < 0.05
level
Total
per cent
69.1
Snack choices
Fruit
Chocolate/sweets Biscuits/cakes
per cent
per cent
per cent
62.8
39.9
50.0
63.3
57.2
67.3
p < 0.001
48.8
p < 0.05
61.1
Figure 1 Consumption of carbonated drinks, pure orange juice and milk among 9 to 11, 12 to 14 and 15 to
17-year olds
232
41.6
33.2
30.2
35.1
Food choices of 9-17-year olds in Northern Ireland
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Jennifer Warwick, Heather McIlveen and Christopher Strugnell
The 12 to 14-year olds were the group who
were most likely to eat chips and least likely to
consume fruit. However, it is difficult to
conclude which group is most at risk of an
``unhealthy'' diet, as each group revealed
worrying trends. It can, however, be concluded that 9 to 17-year olds in Northern
Ireland must review their food choices and in
particular reduce confectionery and potato
crisp consumption and increase fruit intake.
Gender
The research confirmed that females generally have a slightly ``healthier'' diet than
males, consuming more salads (5 per cent
compared to 2.5 per cent (p < 0.05)), more
fruit (15.2 per cent compared to 13.8 per
cent) and less confectionery and carbonated
drinks. However, the associations between
gender and food choices were not as significant as those between age and food choices.
The investigation into age revealed that
milk consumption was low and it was further
confirmed as being lower among females with
only 4.4 per cent drinking milk compared to
7.9 per cent of males. Although this result was
not significant it is still of importance due to
the risk of osteoporosis in females in later life
(NDC, 1992) which has been linked to low
intakes of calcium in earlier years. Consumption of breakfast was significantly
associated with gender; 58.7 per cent of
females in comparison to 78.5 per cent of
males consume breakfast; therefore it can be
concluded that older females are more likely
to miss breakfast. Figure 2 highlights breakfast consumption when both age and gender
are taken into consideration. It can be noted
that consumption decreases with age in both
genders but more so with females (p < 0.001).
Socio-economic grouping
To determine the socio-economic grouping
the occupations of the parents were requested
and were classified according to the RegistrarGeneral's Five-Point Occupational Scale
(Foxall, 1986; Bareham, 1995). The children
with parents in the lower socio-economic
groupings (unskilled workers and the unemployed) were more likely to eat school meals
with 62.5 per cent and 52.9 per cent
respectively (p < 0.01). There were significant
associations between socio-economic grouping and the consumption of chips and fruit.
The children with parents in professional
positions (higher socio-economic groupings)
consumed less chips (22.8 per cent) than
children with unemployed parents (40.2 per
cent), (p < 0.05). Similarly, the trend was
reversed when fruit consumption was investigated with 25 per cent of the children in the
higher group eating fruit compared to only
8.9 per cent of the children in the lower group
(p < 0.01). These trends are in line with
previous research indicating that higher socioeconomic groups eat more foods which could
be classified as being part of a healthier diet
(Gerhardy et al., 1995).
Parental questionnaire
The questionnaire administered to the parents was used as a comparison for the results
received from the children. It was interesting
to note the following differences:
.
More parents than children identified
fruit as being consumed (29.5 per cent
parents compared to 14.5 per cent
children (p < 0.001)).
.
More parents than children stated that
breakfast was eaten (75.8 per cent
Figure 2 Breakfast consumption among males and females of different ages
233
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Jennifer Warwick, Heather McIlveen and Christopher Strugnell
.
.
.
compared to 68.1 per cent (p < 0.05)).
Fewer parents than children admitted to
confectionery consumption (68 per cent
compared to 74.1 per cent (p < 0.05)).
Fewer parents than children stated that
snacking occurred on the way to school
(4.1 per cent compared to 12.7 per cent
(p < 0.001)).
Fewer parents than children identified the
consumption of chips as part of an
evening meal (30.2 per cent compared to
38.1 per cent (p < 0.001)).
These differences may be explained by:
(1) the parent wishing to perceive that their
child's diet is healthier than it really is; or
(2) a lack of knowledge concerning what their
child actually eats.
It is important to note that the age group in
question are at a stage of development where
they may desire greater independence and
resist parental control; thus the second
explanation is both possible and understandable.
Case studies
The observation and questionnaires raised
concern as to the types of foods being chosen
by young people and ultimately the quality of
their diet during these years. The case studies
investigated the diets of 14 young people in
greater depth, and highlighted the differences
between the two locations. Tables II and III
illustrate the diets of two of the candidates,
recorded over a two-day period. Both were
nine year old females with candidate 1 living
in a rural area approximately 20 miles north
west of Belfast and candidate 2 from an inner
city district in a lower class area of Belfast.
Candidate 2's diet indicated a lack of fruit and
vegetables, apart from peas, and a limited
fibre intake. This pattern was in fact consistent across the study. In contrast candidate 1
had a variety of fruit, vegetables, cereals and
wholemeal bread included in her diet, again a
trend which was noted throughout the study.
Although the example given would suggest
that candidate 1 was vegetarian, the remaining diet sheets indicated otherwise. Also a
difference in the consumption of confectionery was noted with candidate 2 consuming a
considerable quantity of sweets and having a
bottle/can of Coca-Cola every day. In comparison to candidate 1's diet the diet of
candidate 3 (Table IV), a nine-year-old male
from the same area, highlighted the differences between male and female diets, as
indicated in previous results. Although the
form lacked detail on occasions, the candidate
was interviewed informally and he admitted
to eating a vast amount of snack foods,
especially confectionery and very little fruit.
An interesting finding was observed when a
15-year old female (candidate 4) from the
rural district was investigated. Table V highlights her diet which was low in fruit and
vegetables and high in fat and sugar products.
This diet was not consistent with the other
female diets recorded in the rural area but it
was revealed that the child had only recently
moved to the area and was originally from an
inner city area ± an observation perhaps
worthy of further investigation.
Conclusion
In the light of previous research and considering the amount of information now
Table II Candidate 1 diet recall
Day
Breakfast
Break
Lunch
Tea/dinner
Supper
Snacks
Monday
Fruit and
fibre cereal
Chocolate
biscuit
Wholemeal bread
with peanut
butter. Grapes and
apple juice
Two potato
waffles, two
vegetable fingers,
garden peas,
tomato and
lettuce
One apple
Two slices of
wholemeal
toast. A small
dish of
ice-cream. One
packet of crisps
Tuesday
Fruit and
fibre cereal
Mint square
Wholemeal bread
with peanut
butter. Grapes
and an orange.
Apple juice
Home-made
lentil burgers
with carrots,
peas and
boiled potato
234
Two slices of
wholemeal toast.
One piece of
coffee cake and
one packet of
soft mints
Food choices of 9-17-year olds in Northern Ireland
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Jennifer Warwick, Heather McIlveen and Christopher Strugnell
Table III Candidate 2 diet recall
Day
Breakfast
Break
Lunch
Tea/dinner
Supper
Snacks
Monday
Nesquick and
a cup of tea
Chip stick crisps
and a bottle of
Coca-Cola
Mashed
potato, beans
and sausage
Soup and a
cup of tea
Chocolate
biscuit
Taz, Milky Way
rolls and bonbon sweets
Tuesday
Nesquick and
a cup of tea
Chip stick crisps
and a bottle
of Coca-Cola
Mashed potato,
meat balls and
cabbage
Stew and a
cup of tea
Bread and
jam
Toffee bar
and a packet of
sweets
Supper
Table IV Candidate 3 diet recall
Day
Breakfast
Break
Lunch
Tea/dinner
Monday
Toast, Frosties
cereal and
pure orange
juice
A packet of
Rolos, a Milky
Way and a
can of
Coca-Cola
Cheese sandwiches,
a packet of
crisps and diluting
orange
Baked potato,
cheese and baked
beans
Tuesday
Toast, Frosties
cereal and
pure orange
juice
A packet of
crisps and a
can of
Coca-Cola
Cheese on toast
and a jam doughnut
An Ulster fry ±
sausage, egg,
bacon and potato
bread
Snacks
Two packets of
polo mints, one
packet of butter
ball sweets,
two packets of
crisps and a can
of Coca-Cola
Two fig
rolls
A Mars bar
and a packet
of Opal Fruits
Table V Candidate 4 diet recall
Day
Breakfast
Break
Lunch
Tea/dinner
Monday
Tuesday
One packet
of crisps
One ham roll,
one packet of
crisps, one
chocolate bar
and a can of
Lilt
available on healthy eating, it is disappointing
to note that the diet of the younger generation
is still a cause for concern. The poor diet of
many young people today has implications for
the health status of the adult population in the
twenty-first century, especially as future
health is often established in the early years of
life. It would appear that the general population has received sufficient information on
diet and how to establish healthy food choices
but this seems to have had little long term
impact. The young people surveyed did reveal
a knowledge of healthy eating practices but
Supper
Snacks
Chicken strips in
batter with
garlic dip and
battered
mushrooms.
A bottle of Lilt
One bar of
chocolate and
three chocolate
biscuits
1/4 of a pizza
with ham and
mushroom
topping
Screwball ice-cream,
two packets of
crisps, one lolly pop
and one packet
of polo sweets
still failed to put this knowledge into practice.
Many factors influence food choice and the
age, gender and socio-economic grouping of
the child all have an effect. Hunton (1994)
highlights that healthy eating has to be sold as
a ``fun ticket and not a health ticket'' which
may have a more positive influence on food
choice among young people. If a reduction in
health-related diseases is to occur and food
choices are to improve, change is necessary
but facilitating this change remains a
challenge. Young people have to start now to
make the right food choices for lifelong health.
235
Food choices of 9-17-year olds in Northern Ireland
Nutrition & Food Science
Number 5 . September/October 1999 . 229±236
Jennifer Warwick, Heather McIlveen and Christopher Strugnell
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