Gaps in nutrition knowledge and barriers to eating healthy among low-income, school-going adolescent girls in Delhi

Aim This study assessed the nutrition awareness, attitude and practices of adolescent girls in Delhi and focussed on identifying gaps in knowledge and barriers to healthy eating. Subject and method A total of 250 adolescent girls (13-15 years old) belonging to low-income families were selected from four government-run schools in four districts of Delhi in 2016-2017. The cross-sectional study involved assessing the girl's nutrition knowledge, attitude and practices and frequency of food consumption using a pretested questionnaire. Focus group discussions held with teachers, parents and the girls themselves helped to shed light on reasons for not adopting healthy food choices. Results Nearly three quarters (72%) of girls skipped one or more meals every day. About 34% of girls stated it was not necessary to consume fruit and vegetables on a daily basis. Around 51% of girls had not consumed green leafy vegetables in the past week. Only 40% ate fruit daily and 58% substituted meals with snacks on a regular basis. 'Not feeling hungry' and 'disliking the taste of healthy foods' were identified as major barriers to eating a healthy diet. Only 18% of girls knew that a lack of iron in the diet could cause anaemia. A significant but weak correlation between nutrition knowledge and attitude was observed (r = 0.258; p < 0.05). There was no significant relationship between nutrition knowledge and practices (p > 0.05). Teachers were of the opinion that the school curriculum provided enough background about health and nutrition. However, the low scores of the girls (6.892 +/- 3.24) did not reflect this. Parents believed their children did not have healthy eating habits and expected schools to provide the necessary information. Conclusion Innovative behaviour change strategies are needed to inculcate healthy eating habits with the engagement of parents and teachers. School curriculums need to be modified to impart not only appropriate nutrition knowledge but also motivation for behaviour change.