Dietary behavior of school-going adolescents in Bhutan: Findings from the global school-based student health survey in 2016

• Published in: Nutrition (Burbank, Los Angeles County, Calif.) Los Angeles County, Calif.), 2021-10, Vol.90, p.111290-111290, Article 111290
• Main Authors: Choeda, Tshering, Jeyashree, Kathiresan, Kathirvel, Soundappan, Dorji, Thinley, Dorjee, Kinley, Tenzin, Karma, Thinley, Sangay, Tenzin, Tashi, Gurung, Mongal Singh
• Format: Article
• Language: English
• Subjects: Adolescents; Age; Behavior; Beverages; Carbonated beverages; Carbonation; Child development; Children & youth; Confidence intervals; Eating behavior; Education; Fast food; Food; Food intake; Fruits; Health care; Health risks; Health surveys; Healthy diet; High-protein diet; Human nutrition; Malnutrition; Non-communicable disease; Nutrition; Nutrition research; Obesity; Overnutrition; Overweight; Polls & surveys; Population; Prevention; Private schools; Proteins; Questionnaires; Risk analysis; Risk factors; Risk taking; Schools; Social isolation; Statistical analysis; Students; Suicidal ideation; Sustainable development; Teenagers; Tobacco; Undernutrition; Underweight; Vegetables
• ISSN: 0899-9007; 1873-1244
• DOI: 10.1016/j.nut.2021.111290

Bhutan is experiencing a dual burden of undernutrition and overnutrition among adolescents. Understanding dietary behavior is vital to designing evidence-based interventions to improve adolescent nutrition and prevent non-communicable diseases in adults. The aim of this study was to assess the pattern of dietary behavior and associated sociodemographic, behavioral, and metabolic risk factors among school-going adolescents in Bhutan. The Bhutan Global School-based Student Health Survey 2016 studied students in grades 7 to 11 (N = 7576), sampled from 50 schools, randomly selected based on probability proportional to enrollment size, using a standardized self-administered questionnaire. Consumption of adequate fruits and vegetables (each at least twice daily, or a combination of at least five times daily), high-protein food at least twice weekly) in the past 30 d, no fast food in the past week, and no carbonated/sweetened drinks in the past 30 d were studied. Weighted prevalence of dietary behaviors and adjusted prevalence ratio (95% confidence interval) for factors associated with them were calculated. Of 5809 students from 13 to 17 y of age comprising 3255 (56%) girls and 3184 (54.8%) day students, 1166 (20.1%) were underweight, 1655 (28.5%) were tobacco users, and 1349 (23.2%) were alcohol users. Adequate fruit and vegetable intake, high protein consumption, not consuming fast foods and carbonated beverages were reported by 29.6%, 31.8%, 9.6%, and 14.9%, respectively. Being a day student, sex, and not reporting health risk behaviors were significantly associated with any healthy dietary behavior. Healthy eating behavior was low among Bhutanese adolescents. Policies influencing availability, affordability, and acceptability of healthy diets through peer-led, school- and community-based interventions are required to promote adolescent health and prevent non-communicable diseases. •The prevalence of healthy dietary behavior was low among adolescents assessed based on self-report of four major eating behaviors.•High-protein food consumption was more prevalent among day students than boarding students.•Fewer boarding students reported consumption of fast food and carbonated drinks than day students.•Standardized menus to meet the calorie and nutrient requirements of the adolescents can be used across the country for boarding students.•Revised taxation policies are recommended to inflate prices of unhealthy food choices, thus discouraging their consumption.