The promotion of good nutrition is high on the health policy agenda in the UK. Young people are a particularly important group, as poor eating habits established during teenage years may be maintained into adulthood, creating a number of cardiovascular and other health-related problems later in life. Putting policy into practice means developing and implementing effective interventions for, and with young people. An important step in this process involves examining what we can learn from existing research. Our objectives were to provide practitioners, policy-makers and researchers with a summary of evidence to help them develop, implement and evaluate interventions for promoting physical activity among young people. We had a particular focus on young people at greatest risk for poor nutrition from socially excluded groups and upon interventions targeting ‘structural’ or ‘environmental’ barriers to healthy eating (e.g. access to healthy foods).
Exhaustive searches were undertaken of multiple sources to identify relevant studies. The methodological quality and findings of studies meeting specific inclusion criteria were assessed using standardised tools. Two types of study were included: international studies evaluating the effectiveness of interventions, and UK studies examining young people’s own views about healthy eating and how it might be promoted. A total of 30 studies met our inclusion criteria: 8 examined young people’s views and 22 were potentially rigorous evaluations of the effectiveness of interventions.
Several multi-component interventions complementing classroom activities with school-wide initiatives as well as involving parents were found to have positive effects. There is stronger evidence for effectiveness among young women compared to young men. Although attitudes towards healthy eating were generally positive, personal preferences for ‘fast foods’ on grounds of taste tended to dominate food choice. Young people particularly valued the ability to choose what they eat. Healthy foods were predominantly associated with parents/adults and the home, while ‘fast food’ was associated with pleasure, friendship and social environments. Factors inhibiting their ability to eat healthily included poor availability of healthy meals at school, healthy foods sometimes being expensive, and wide availability of, and personal preferences for ‘fast foods’. Ideas for promoting nutrition included the provision of information on nutritional content of school meals (for young women particularly), and better food labelling.
A comparison across study types identified effective interventions that have addressed barriers that young people identify such as increasing the availability of healthy foods in the school canteen and involving parents and the home environment. Interventions delivered by peers or teachers were effective despite young people not rating these groups as important sources of information about nutrition. Major gaps were the lack of effective interventions which addressed concerns such as the high cost of healthy foods, a taste preference for ‘fast foods’, or lack of ‘will power’ to avoid ‘fast foods’.
This report should be cited as: Shepherd J, Harden A, Rees R, Brunton G, Garcia J, Oliver S, Oakley A (2001) Young people and healthy eating: a systematic review of research on barriers and facilitators. London: EPPI Centre, Social Science Research Unit, Institute of Education, University of London.