Association of food environment with diet quality and Body Mass Index (BMI) of school-going adolescents in Nepal

BACKGROUND: Adolescents are being more vulnerable to non-communicable diseases (NCDs). A healthy food environment is crucial in maintaining a healthy diet and achieving better health outcomes. This study aimed to determine how certain features of home food environment affect diet quality and Body Mass Index (BMI) of school-going adolescents.

METHODS: We conducted a cross-sectional analytical study among 678 school-going adolescents aged 15-19 years in Budanilkantha municipality of Kathmandu, Nepal. We assessed home availability of food items in the past day, walking time needed to reach nearest shops from home, parental modeling, and parenting style. Furthermore, we assessed diet quality using a Diet Quality Questionnaire as Global Dietary Recommendations (GDR) Score and measured height and weight of participants to calculate BMI. We used multiple regression models to analyze data, all statistical analyses were performed using STATA-14.

RESULTS: Of 678 participants, 51.92% were males, and mean age was 15.56 years. Those who had to walk > 20 minutes to reach nearest vegetable shop had an average 1.44 point lower GDR Score (95% CI: -2.08, -0.19) than those with vegetable shops at their home. Those who had processed meat at home in the past day had 1.61 points lower GDR Score (95% CI: -1.95, -1.28), those with fruits and vegetables had 0.74 points lower GDR Score (95% CI: 0.48, 1.00) as compared to those who didn't have. Participants who had starchy staple available had a BMI score lower by 5.59 kg/m2 on average (95% CI: - 10.78, - 0.40), and when two participants whose parental modeling scores differed by a unit were compared, the one with a higher score had on an average 0.19 kg/m2 greater BMI (95% CI: 0.01, 0.37).

CONCLUSION: This study highlights impact of home food environment on diet quality and BMI among adolescents in urban Nepal. Availability of healthy foods positively affects diet quality, while unhealthy items negatively influences it. Future research should explore wider food environmental factors and intervention strategies to improve adolescents' diet quality.