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Research The Alcohol & Public Health Research Unit has conducted a number of studies in the area of food policy, advertising and patterns of consumption. Influences on Teenage Food Choices
Televised Food Advertising to Children Influences on Teenage Food Choices This project, funded by the NZ Health Research Council, was directed at identifying factors influencing the food intake and related behaviour of young New Zealanders aged 13-16, to inform policy and programme development. There were three components to the project to focus separately on Pakeha, Maori and Samoan teenagers. The aim of this project was to develop a research-based understanding of factors influencing food intake by young New Zealanders of different socio-economic status and household composition, and to inform policy and programme development with the ultimate goal of improving the nutritional behaviour and well-being of New Zealanders. The study of Pakeha teenagers began with a review of the international literature. Through a networking process, Pakeha researchers identified a sample of 20 Auckland families with a Pakeha teenager was selected to reflect different socio-economic status and household composition. In late 1994 and early 1995 separate face-to-face interviews were conducted with the ten male and ten female teenagers and with the caregiver who was their household's principal shopper. The teenager also completed a computer questionnaire. The topics covered included availability, family influences, economic and advertising influences and nutritional knowledge, as well as the individual teenager's eating patterns. Researchers: Summary of Findings of the Pakeha Study A large number of personal, family, social and environmental factors influence adolescents' food choice and eating habits. The research explored four main areas: family and household influences; economic, availability and advertising influences; influence of perceptions and knowledge about food and health, and the adolescents' eating patterns. Many of the sample's responses relating to 'unhealthful' food groups (sweet snacks and soft drinks, packet chips and takeaways) were different from those relating to the 'healthful' groups (dairy products, vegetables, fruit, pasta/rice, breakfast cereals, breads and meat). The finding are summarised in the following sections:
Family and household influences The family was the major influence on what the teenagers ate. Family eating patterns had changed in many families from the previous generation towards more variety and a change in the 'healthfulness' of the food eaten (either towards more 'healthful' or 'less healthful'). Parents were still providing nearly all the food resources for the adolescents, but parents were perceived to have more influence on what the teenagers ate at home than what they ate elsewhere. Individual family members influenced the teenagers in different ways. Most families had some rules or guidelines about eating times, frequency of eating, eating place, or eating certain foods. In some families where parents had separated, rules and guidelines depended on which parent the teenager was with. Separation of parents had a major economic impact on some families and this led to a significant change in the availability of food at home. The availability of foods at home which were 'healthful' or 'less healthful' limited the teenagers' food choices. They had some influence on what was bought for the household through asking for certain foods and through parents taking the adolescents' preferences and needs into account. These Pakeha teenagers had a limited role in preparing and cooking food for the family, and a limited knowledge of how to do so. Economic, availability and advertising influences Price was an important influence on foods purchased by both teenagers and parents. The types of food low income families could buy was limited by price more than was the case for middle and high income families. Middle and high income families also took price into account when buying food, although convenience and saving time were more important. Parents' concepts of the 'value for money' of foods was a combination of price, nutritional value and eating for pleasure. A few of the parents agreed that having an teenage child was a strain on the household food budget, although most said their teenager was getting the food they needed. However, they were not always getting as much variety as the parents would like. Availability of foods at home had some influence on what foods teenagers bought with their own money. For example, fruit was readily available at home, adolescents tended not to purchase fruit for themselves. Adults did not consider accessibility (eg. transport, location of shops and their opening hours) to be a problem when purchasing food for the family. However, the easy accessibility of foods at shops had an influence on teenagers purchasing some foods, particularly from the 'less healthful' groups. Advertising was perceived by both teenagers and adults to have some influence on the teenagers' food consumption patterns and the adults' purchases. Adults were particularly influenced by advertising for 'special offers'. Adolescents liked some television advertisements because the food looked attractive or tempting and the ads were 'cool', humorous, far-fetched, had catchy tunes, made them aware of the food or made them feel hungry. Perceptions and knowledge about food and health Perceptions of the relationship between food and health had a major effect on what the teenagers chose to eat and what their parents chose to make available to them. However, for some food groups, in some contexts, other factors such as taste overrode these health considerations. Most of the foods the teenagers wanted to eat more of were 'healthful', although about a quarter wanted to eat more of the 'less healthful' foods. Parents wanted their children to eat more from the 'healthful' food groups. Parents' perceptions of the reasons for their teenager not eating as much of the 'healthful' groups as the parent would like were that they did not like these foods, preferred others or the food was not easy to prepare. This contrasted with the views of the teenagers who said lack of availability of these foods at home and school, family rules and cost were the main reasons they did not eat as much as they would like. Half the teenagers believed that eating different foods would make a difference to their health and about half did not. Most knew which foods were 'good for you' or 'not so good for you'. The teenagers' knowledge of the health effects of foods classified as 'not so good for you' was greater than for foods that were 'good for you'. For instance, none of them mentioned the protective effects of foods containing anti-oxidants (such as fruit and vegetables) against cancer. Adolescents and parents had a similar concept of a 'balanced meal' - a combination of protein, carbohydrate and vegetables, with no dessert or drink. Information on food packages was the main way the teenagers said they could tell if an item was 'good for them' or not. Parents looked at food labels so they could avoid 'unhealthful' food components (such as fat and sugar) rather than so they could purchase foods with 'healthful' components such as vitamins and minerals. Most of the teenagers' nutritional knowledge came from family, mainly mothers, and from school. Some were learning about nutrition through involvement in sport and exercise. However, food available at sports venues was often of the 'less healthful' type. The foods most commonly purchased by the teenagers (other than at school) were from the 'less healthful' food groups, whereas food purchased at school was from both the 'less healthful' and 'healthful' categories. Teenage Eating Patterns Most of the teenagers ate at least six times a day. All except two ate breakfast, which was usually cereal, milk, and/or bread (eg. toast). At school about three quarters ate a morning snack, mainly packet chips, fruit, cakes/biscuits and filled rolls. All the teenagers ate lunch at school. Filled rolls, sandwiches, fruit, cakes/biscuits, packet chips, and meat pies were most commonly eaten. Nearly all teenagers ate a snack after school, mainly cakes/biscuits, fruit, bread rolls or sandwiches, packet chips and savoury biscuits. A few of the teenagers ate from only the 'less healthful' food groups on some eating occasions, rather than eating a mixture of 'healthful' and 'less healthful' food. All but two of the teenagers had a meal between 5pm and 8pm. A variety of meals were eaten, some kind combination of meat/carbohydrate/vegetable being most typical. About half ate some kind of dessert. About two thirds of the teenagers had a snack after 8pm, usually cakes, sweet biscuits or fruit. Nearly all the teenagers ate fruit and vegetables each day, with an average of two servings of vegetables and two to three servings of fruit. Girls in the sample ate more fruit and vegetables than the boys. Sweet snacks and fruit were the most common food groups eaten as snacks at home. Fruit was much more commonly eaten as a snack at home than vegetables. Fruit was perceived to taste good, be available and be 'healthful'. Vegetables were seen as difficult to prepare, not snack foods and not tasty. Most of the teenagers washed or wiped fruit and vegetables before eating them as a snack. Some parents had a positive perception of their children's eating patterns, saying they had good appetites, ate in a healthy way, or were flexible. Other parents thought their children ate in an erratic way, were fussy, ate 'too much rubbish', were greedy or ate food that was too expensive. Parents said that the teenagers ate a greater quantity of food and had more snacks than other members of their family. A few of the parents said they were losing control of what their children ate. This was seen as a natural developmental process by some parents, although a few saw it as a problem. Many of the parents stated that their children had changed their eating patterns in the previous year, eating more 'healthful' food, greater quantities, or wishing to become vegetarian. About half the teenagers had asked their parents in the previous year to buy new food or drink such as fruit, salad foods and sweet snacks. Most parents said they had made changes in the previous year of the types of food they bought for teenagers, mainly buying more 'healthful' food. Fruit and Vegetables as Pakeha Adolescent Food Choices The consumption of fruit and vegetables has been shown by nutritionists to have preventative effects with regard to cardiovascular disease and cancer, and recent health promotions in New Zealand have emphasised the need to eat 'five plus' a day. As part of a wider study of the eating habits of New Zealand adolescents, particular attention was given to factors affecting their consumption of and attitudes towards fruit and vegetables by Pakeha teenagers. This component of the study examined the interaction between 20 New Zealand Pakeha teenagers and the parent most involved in food purchase and preparation to identify factors affecting teenagers' consumption of fruit and vegetables, as well as purchases of fruit as a snack away from home. Although the teenagers believed fruit and vegetables were 'good for you', consumption was affected by the degree of independence or parental control in different eating situations, and the teenagers' perceptions of the desirability of different foods. A number of health promotion strategies were suggested by this study. Researchers: Influences on the Eating Patterns and Food Choices of Samoan Teenagers in Auckland This component of the project was undertaken by Samoan researchers over 1995 and 1996. Through networking, 20 Samoan families with a 13-16 year old teenager were selected to reflect a range of socio-economic circumstances, religions, family types and geographic location within Auckland. Face-to-face interviews with the teenagers were in English. Face to face interviews were conducted with the mother (or in a few iinstances the aunt or grandmother); 17 in Samoan and 3 in English. The topics covered included meal definitions and perceptions about food, responses to advertising, preferences and attitudes to fruit and vegetables, availability at home and at school, cooking, household rules and cultural influences. Researchers: Nite Fuamatu, Rita Thetadig, Sally Casswell The food balance sheets are a data source for identifying trends in food supply in New Zealand and for international comparisons which can contribute to planning and monitoring the effects of public health policy. Since the 1930s information has been collected on the amount of food produced, imported, exported and wasted in New Zealand. The Alcohol & Public Health Research Unit used time series analysis for the first time to examine changes over the 22 consecutive years for which data was available. Three perspectives were taken. Firstly, each of the eleven food groups in the balance sheet was considered as a time series of kilograms of food available per person per year. Secondly, the trends in total energy available in the food supply and also the percentage contribution of each of the eleven groups to total energy were examined. Finally, the food groups of the food balance sheet were assembled to approximate the four groups of the New Zealand dietary guidelines (cereals; fruit and vegetables; milk and dairy; and meats, fish, eggs, nuts or pulses). The variability of the data prevented the detection of long term trends in some of these series. There appears to be evidence that there has been no significant change in the amount of fruit and vegetables available for consumption during this period. However because total weight of food available per person and also total energy appear to have been declining over the same period, the relative energy contribution of fruit and vegetables to the nation's food supply has been increasing. This increase is due to increases in fruit supply. Researchers The Alcohol & Public Health Research Unit conducted some preliminary work on pesticide residues in food. This involved a literature review and some informal interviews with a number of key people working in the area of pesticides in New Zealand. The review explored differences between scientific and public perceptions of health risks of pesticide residues in food. In New Zealand a large number of pesticides are registered for use and the public has some long-term exposure to certain residues in food and water. Scientific evidence shows that direct exposure to some pesticides can cause health effects. However, the public health effects of pesticide residues in food and water are uncertain, partly because current epidemiological and toxicological techniques are not well-equipped to investigate the effects of long-term, low dose exposure. From the results of several surveys in New Zealand and overseas, it appears that a significant proportion of the New Zealand public believe that pesticide residues in food are a health risk. This contrast between the scientific uncertainty and the public perception provides a tension for public health policy-making in this area. Some countries have chosen to implement pesticide reduction policies, whereas in New Zealand policies vary across different agricultural and horticultural sectors. Researchers: Caroline Maskill, Max Harré, Sally Casswell Community Gardening:A Literature Review In 1994, the Alcohol & Public Health Research Unit was contracted by Te Hotu Manawa Maori to undertake a literature review on community gardening. The objective was to summarise and assess the national and international literature on community fruit and vegetable gardens as a resource for those interested in community food gardens, the ideas behind them and what they involve in social and practical terms. The literature sighted was of three main types: 'how to' manuals, news reports of specific projects, and material locating community gardens in a broader social context, for example, in relation to urban poverty. Much of the practical literature is from the United States and does not always fit well with the New Zealand situation. The literature rarely locates community gardening within the contest of general gardening practices or diverse cultural attitudes to gardening or land. It fails to explore group dynamics among those involved. There is little discussion of the potential of community gardens for health promotion or community development, although discussion of why gardens are established signals some of these benefits. However, the literature does provide insights into the nature and history of community gardens, how to go about establishing one, common problems and suggestions for evaluation. Researchers: Rachael Trotman, Carla Spinola Establishing community interest Assess the needs and interests of people in the community before the garden is planned. This is essential and can be done through surveys and/or consultation such as public meetings, interviews, and groups discussions. Consultation with people experienced in setting up a garden is also useful. While interest in community gardens is increasing, the demand for plot in this country is not very high. Because farming is prevalent and urban family plots are large enough for individual gardens, access to land and fresh produce is relatively easy. It is important that potential participants share needs, see gardens as important, demonstrate a sense of commitment and are willing and able to contribute a reasonable amount of time to working cooperatively in the garden. Community gardening is general defined as an urban phenomenon, meeting the needs of city dwellers. It is rural community garden is contemplated, consideration should be given to issue relevant to a rural setting, such as travel distances. Consider the purpose There are many reasons why gardens are established and they lend themselves to multiple opportunities. These should be considered and the purpose for a particular garden clarified at the outset. Consider the cultural context There are different issues around cultural conceptions of land and gardening which have implications for a community garden. For example, it may be a means through which traditional gardening methods are revived or particular foods made available. Interviews with key informants are necessary to access Maori conceptions of community gardening since the literature focuses on Western cultural contexts. Establish goals and objectives The first, and most important, step in planning a garden is to establish clear goals and objectives that are achievable and shared by the participants. Decide on the nature and type of garden The purpose of the garden and the specific objectives that are set will determine the type of garden that is established. This includes reaching agreement on the philosophy and method of gardening that is adopted and which is appropriate for the users. For example, the selection of a single communal plot worked by a collective or family, individual plots, or a combination. Document the process Reasons given for doing this include:
The process can be documented in a diary or in minutes from meetings, demonstrating where and how the garden has developed. Facilitate on-going feedback Feedback about the project, for example, though meetings, social events or newsletters, is identified as necessary to maintain the interest of gardeners. Also regular feedback from participants, using questionnaires or discussions, can establish whether or not the garden is meeting their needs. In so doing, objectives, timetables, resources etc. can be adjusted appropriately. Report on outcomes How is the garden working? Has the garden met the objectives. For example, if a desired outcome is to increase a community's access to fresh fruit and vegetables, then this must be the aim of the garden and the focus of an evaluation. It can be detailed in progress reports or newsletters, or discussed at meetings. A study was completed in early 1997, which involved four components which examined: the exposure of 9 to 17 year olds to televised food advertising; their responses to specific advertisements; the content of the advertisements; and the nature of the regulations controlling food advertising in other countries. Exposure to food advertising: Market research company data was collected using 'people-meters' that record when people are viewing television. A sample week of television during hours children were more likely to be viewing was also recorded and analysed. This identified the extent to which 9 to 17 year olds were being exposed to and were viewing food advertisements, and the nutritional value of the foods that were being predominantly advertised. A paper based on this research has been submitted for publication. Response to specific advertisements: Sixteen focus groups with 11-12 and 14-15 year olds were undertaken to gain an understanding of how they were responding to seven food advertisements they were shown. Findings from this and the content analysis (see below) have been included in a paper which has been submitted for publication. Content analysis: Five experts in media and communication studies were questioned on the content of 13 advertisements and the content of another 75 was examined by the researcher. Certain themes were more associated with different types of food groups. Broadcasting regulations: Information was obtained from 19 countries. It was common for most countries to have a section relating to advertising to children, but most, including New Zealand, did not have specific codes relating to the advertising of food to children. The implications of the overseas codes for the New Zealand context were discussed, along with issues relating to interpretation and enforcement. This research has relevance for the development of healthy public policy in relation to children and teenage nutrition. Researchers: Kay Hammond, Allan Wyllie, Sally Casswell.
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