Cross-sectional study on behavioural determinants associated with sugary foods and beverages and their correlates with body mass index among adolescents in Nagarjun municipality, Nepal

Abstract

Objectives: This study was conducted to determine the status of and factors associated with behavioural determinants (knowledge, attitude and practice) of sugary foods and beverages among adolescents in Kathmandu, Nepal.

Design: Cross-sectional study.

Setting: The study was done at educational institutions located in Nagarjun municipality, Kathmandu, Nepal.

Participants: In this study, 768 adolescents from grades 8, 9 and 10 were selected using a multistage random sampling technique.

Primary and secondary outcome measures: Knowledge regarding sugary foods and beverages was assessed using 9 questions, attitude was measured through 13 Likert scale statements and consumption was assessed using 9 questions through a semi-structured questionnaire. Body mass index (BMI) was calculated based on anthropometric measurements. Pearson's χ² test and logistic regression were used to assess factors associated with those behavioural determinants, along with their correlates with BMI. A p value of <0.05 was considered statistically significant.

Result: Adequate level of knowledge was found among 84.11% (95% CI: 81.52% to 86.70%) of the adolescents. Awareness of the health risks and inclination to adopt healthier behaviours was seen among 60% of the adolescents (95% CI: 56.55% to 63.49%). The percentage of adolescents consuming sugary foods and beverage items was 84.50% (95% CI: 81.94% to 87.07%). The odds of having adequate knowledge among respondents was twice (adjusted OR (AOR)=2.05, 95% CI: 1.12 to 3.76) more likely for those who were living with their parents. Female adolescents (AOR=2.51, 95% CI: 1.61 to 3.89), whose mothers are homemakers (AOR=1.99, 95% CI: 1.04 to 3.58) and fathers are engaged in foreign employment (AOR=2.09, 95% CI: 1.04 to 4.21), were more likely to consume sugary items. Prevalence of overweight and obesity was seen among 6.38% (95% CI: 4.64% to 8.11%) of respondents. Consumption was seen to be significant to the model overweight/obesity versus normal (OR=11.95 (95% CI: 1.61 to 88.42)).

Conclusion: Adequate knowledge alone was insufficient for influencing food selection and choices. Family-indulged interventions can be useful as familial factors seem to be impacting behavioural characteristics. Sugary foods and beverages consumption was linked to being overweight/obese, highlighting the importance of dietary discipline in reducing this risk.

Keywords: Adolescent; Behaviour; Body Mass Index.

Figure 1. Attitude towards sugary foods and beverages alongside its effects. This is the radar plot illustrating the responses from adolescents regarding their attitudes towards sugary foods and beverages across multiple dimensions. The data were collected through a Likert scale questionnaire. Each dimension was normalised and plotted along the axes of the radar chart, with higher values indicating stronger agreement or higher frequency. The shaded area represents the aggregate attitudes, where larger coverage on the radar plot corresponds to more positive attitudes or higher consumption of sugary foods and beverages. The concentric circles represent intervals of normalised scores from 0 (centre) to 1 (outer edge), indicating the relative strength of responses across dimensions.