Article Type: Research Article Article Citation: Suraksha Subedi, Suvash Nayaju, Sweta Subedi, Astha Acharya, and Ashok
Pandey. (2020). KNOWLEDGE AND PRACTICE ON JUNK FOOD CONSUMPTION AMONG
HIGHER LEVEL STUDENTS AT SELECTED EDUCATIONAL INSTITUTIONS OF KATHMANDU, NEPAL.
International Journal of Research -GRANTHAALAYAH, 8(12), 306-314. https://doi.org/10.29121/granthaalayah.v8.i12.2020.2872 Received Date: 20 November 2020
Accepted Date: 31 December 2020
Keywords: Educational
Institutions Junk Food Influencing
Factors Knowledge Practice Students Background: Junk food is a term for food that is of
little nutritional value and often high in fat, sugar, salt, and calories. Junk
food can have a detrimental effect on levels of energy and mental well-being.
Consumption of large quantities of junk food is associated with a drastic
reduction in the consumption of nutritious foods such as milk, fruits and vegetables. High revenues, rapid urbanization,
free home delivery, mouthwatering commercials and foreign cuisines have led to
growing trend in the consumption of junk food. Purpose: The aim of this study was to assess the
level of knowledge, prevalence, practice and influencing factors of junk food
consumption among students of educational institutions of Kathmandu, Nepal. Methods: A Descriptive cross-sectional study was
conducted. Total 367 participants were selected from educational institutions
of Kathmandu using simple random sampling technique. Data were collected using
Semi-structured Questionnaire by self-administered method. Findings: Around half (45.2%) of the respondent had
poor level of knowledge, and only 19.1% of respondents had adequate knowledge
regarding harmful effects of junk food consumption. All of the
respondents had practice of junk food consumption. Research implications:
The outcome of this study
provides detailed understanding of not only knowledge, prevalence
and practice of junk food consumption among students but also the reasons and
influencing factors for students to consume junk food regardless of their knowledge
on harmful effect and complications of junk food consumption. Practical
Implications: The findings
of this paper seeks to urge the concerned authorities to admit the fact that,
the course with small topic regarding effects of junk food consumption alone
cannot minimize the practice of junk food consumption among students, banning
the advertisement which encourage the students to consume junk food is very
crucial and to conduct the awareness programme
regarding harmful effect of junk food consumption among all level of students through media and
course work is necessary to prevent malnourishment and complications of junk food
among students. Originality: This is the first survey regarding knowledge
and practice on junk food consumption among students of educational
institutions, and the area (educational institutions) were selected to collect
the data from the students of various background (age, education level,
ethnicity etc.) at same time, so that the results can be generalized among
students. 1. INTRODUCTION"Junk food"
generally refers to foods that contribute lots of calories but are of limited
nutritional value. Junk foods are usually commercially prepared and
packaged, like candy bars, chips, snack cakes, cheese puffs, and cookies. With
worldwide marketing and advertisement in 21st century "junk food" has
gone global. It can be seen almost everywhere in grocery and convenience stores,
fast-food restaurants, on television usually looking very appealing. (Magee, 2007). Junk food
contain
substantial amounts of trans fat, added sugars, salt and are high in energy but
contribute only few micronutrients to the diet (Rangan et al., 2008; “This Is
Your Body on Fast Food - The Washington Post,” 2018). Consumption
of poor-quality diet including junk food is associated to a higher risk of
obesity, heart disease and stroke, digestive issues, diabetes, cancer, and
early death (“This Is Your
Body on Fast Food - The Washington Post,” 2018). Adolescents
are nutritionally vulnerable considering their soaring nutritional requirements
for growth, eating habits and their susceptibility to environmental influences (World Health
Organization, 2005). As working
parents do not have much time for preparing the meals to their children, very
few school and university students carry with them homemade food, and most of
the students remain with no alternative option except taking junk food (Das, n.d.; “Junk Food Affects
Students’ Health-374929,” 2019). It is more likely that students who eat extra junk food may
suffer from health issues. Junk food can have a detrimental effect on levels of
energy and mental well-being and also keeps adolescents at higher risk of
chronic diseases (“Junk Food Affects Students’
Health-374929,” 2019; World Health Organization, 2005). Adolescent
Nutrition Survey in Nepal, 2014 reveals that 71 percent of male adolescents and
59 percent of female adolescents were
undernourished, and majority of adolescents
(94 %) reported that they usually eat junk or processed food (Aryal et al., 2016). Consumption
of large quantities of junk food is associated with a drastic reduction in the
consumption of nutritious foods such as milk, fruits and vegetables (Laxer & Janssen, 2014). High revenues, rapid urbanization,
free home delivery, mouthwatering
commercials and foreign cuisines have led to growing trend in the consumption
of junk food (Mandoura et
al., 2017). Some evidence even marks junk
foods as being as addictive as alcohol and drugs (“This Is Your
Body on Fast Food - The Washington Post,” 2018). The
important contributing factors to junk food consumption are nuclear family,
working mother, socioeconomic status, and easy access to the fast-food shop,
food taste and quick service in the shop (Das, n.d.). In the last three
decades, junk food intake among teenagers has increased by fivefold. This is
because of its good taste, easy access, affordable cost, variety of choices,
taste (Stuckler
et al., 2012). A rise in
the intake of junk food is a global phenomenon with the prevalence rate of
around 70% (Rouhani et
al., 2012; WHO, 2003). Among all age groups and particularly in young adults, it
is considered an emerging major public health problem (Bauer et al.,
2009; Rouhani et al., 2012). Food
Institute’s analysis of data from the Bureau of Labor Statistics depicted that
millennials alone spend 45
percent of
their budget’s food dollars on eating out. The average American family now spends half their food budget on restaurant food, in contrast to
past 40 years. In 1977, only 38 percent of family food budgets were spent
eating outside the home. An occasional consumption of fast food won’t hurt,
whilst a habit of eating out could have detrimental health effects (Pietrangelo, 2018). In
context of Nepal, junk food and its health impacts is an burning issue and poor
nutritional value of junk food is in lime light which supports that poor
nutritional value in children's diet can undermine the strength that children
need for studying, interacting with family, participating in sports and games,
making friends, or simply feeling good about themselves (Kaushik et
al., 2011; Resource Centre for Primary Health Care, 2013). In the absence of sound policies, strategies
and strict labelling criteria, nutritionally void products claim to be enriched
with vitamins, calcium, minerals, and iron, whilst ignoring the fact they are
laden with artificial colors, preservatives, emulsifiers and flavors, excess
amount of salt, sugar and unhealthy fats. On the other
hand, for decades most industrialized and developed countries have been raising
the debate and confining the junk food manufacturers and fast-food companies.
Similarly, growing public health concern and awareness in the public has also
forced them to use more wholesome raw materials. However, self-regulation by
the advertising industry is not working (Sherpa,
2018). School-going
kids who consume junk food were found to have half of their calories from
high-sugar, high-salt and high-fat snacks in contrast to those who consumed
them in less quantities (Nepali
Sansar, 2019). Junk food contains sweeting agents,
preservatives, added color and in top of that alluring advertisements makes
children addicted to
such foods and they deny eating homemade
foods and skip their meal. However, these foods do not have sufficient
nutritive value to fulfill their dietary needs and at time when good nutrition
is of utmost priority in children for their proper growth between the ages of
6-12 years, junk foods do not have sufficient nutritive value to fulfill their
dietary needs. (Ashakiran
& Deepthi, 2012; Neupane, 2014). 2. METHODS2.1. DATA SOURCEThis
study entitled “Knowledge and practice on junk food consumption among higher
level students at selected educational institutions of Kathmandu, Nepal” was
basically based on quantitative method for primary data collection and analysis
of those collected data was done using different descriptive statistics methods
obtained from educational institutions using semi-structured questionnaire as
the tool for data collection. 2.2. STUDY DESIGN AND SETTINGA
descriptive cross-sectional study was conducted among 367 randomly selected
students at educational institutions (Collins and Glossa Prep) of Kathmandu,
Nepal. Data was collected using semi-structured questionnaire by
self-administered method. The filled questionnaires were checked for
correctness and completeness and coded serially. The collected data was entered
into Epi-data 3.0 and data analysis was carried out in SPSS version 22. 2.3. DATA ANALYSISDescriptive
statistics (frequency and percentage) was used to describe demographic data,
knowledge, prevalence, practice and influencing factors for junk food
consumption. A correlation analysis was performed to quantify the strength of
association between the level of knowledge and selected socio – demographic
variables of respondents. 2.4. INCLUSION CRITERIAStudents
taking preparation classes in Collins and Glossa Prep Institutions
(Institutions located at Putalisadak, Kathmandu where
students take preparation classes for GRE, IELTS, SAT etc.) were under
inclusion criteria. 3. RESULTS3.1. SOCIO-DEMOGRAPHIC CHARACTERISTICSNearly
half (42.5%) of the respondents were of the age group 15 to 20 years. Around
half (52.0 %) of the respondents were female, majority of the respondents were
from nuclear family. Two third of the respondents (69.2%) were Hindu, around
half of the respondents were Brahman. Majority of the respondent’s father
(39.5%) had higher secondary level of education whereas least (4.4%) were uneducated.
Likewise, majority of the respondent’s mother (28.9%) also had higher secondary
level of education and minority (12.0%) were illiterate. Highest number of
respondent’s father (49.6%) were engaged in service and the highest number of
respondent’s mother were house manager (40.1%). Majority
of the respondents (45.5%) got information regarding junk food from internet
whereas minority (4.10%) from friends. Likewise, majority of the respondents
(36.8%) lived with their parents whereas minority of the respondents (6.5%) lived
with their friends.
Table 1: Level of knowledge of the respondents (n=367)
Around
half (45.2%) of respondents had poor level of knowledge, and only 19.1% of
respondents had adequate knowledge regarding harmful effects of junk food
consumption. (Table 1) 3.2. PREVALENCE OF JUNK FOOD CONSUMPTIONAll of
the respondents (367) consume junk food. This data clearly shows that all of the students consumed junk food regardless of their
knowledge regarding harmful effect of junk food consumption. Table 2: Practice of junk food consumptions of the respondents (n=367)
Half of
the respondent’s family member consumed junk food on daily basis, more than
half of the respondent (60.8%) consumed junk food as an alternative to
breakfast sometime, likewise more than half of the respondents (66.2%) goes
outside from home for dinner sometimes. Nutritional
information displayed on package influenced to buy junk food for around half of
the respondents (47.7%), moreover, around half of the respondents (48.2%) did
not check expiry date while purchasing junk food. Majority (71.1%) of
respondents did not check proper packing while consuming junk food and almost all of the respondents did not check nutrient levels in the
junk food. (Table 2) Table 3: Factors associated for junk food consumption (n=367)
Majority
(30.2%) of the respondent's reason for consuming junk food was easily
availability of junk food, likewise majority of respondents (27.5%) favorite
junk foods were Chatpate, Panipuri,
chips etc. Almost half of the respondent’s (40.1%) place for consuming junk
food frequently was street food stall. Also instantly prepared junk food was
available sometimes for more than half of the respondents (72.5%). (Table 3) 3.3. TIME OF JUNK FOOD CONSUMPTION AMONG RESPONDENTSWhile travelling majority of the respondents(
44.4%) always consumed junk food, while studying majority of the
respondents(36.2%) mostly consumed junk food, while staying alone majority of
the respondents (43.1%) often consumed junk food, while staying with friends
majority of the respondents (55.0%) sometimes consumed junk food, while staying
with family majority of the respondents (73.8%) sometimes consumed junk food,
and on special occasion majority of the respondents( 58.0%) sometimes consumed
junk food. 3.4. PERSONAL VIEW ON INFLUENCING FACTORS FOR JUNK FOOD CONSUMPTION AMONG RESPONDENTSMain influencing factors for junk food on
personal view were junk foods being more delicious than home-cooked foods
(54.5%), quick to prepare and buy (58.9%), energetic (66.5%). Because of the
good taste of junk food many students were influenced to consume junk food. 3.5. SOCIAL FACTORS RELATED TO INFLUENCING FACTORS FOR JUNK FOOD CONSUMPTION AMONG RESPONDENTSMain influencing factors for junk food
consumption on social factors were to spend time with friends and to socialize
and entertain (44.7%), extensive advertisements on fast foods (42.2%).
Advertisement and modernization have increased the junk food consumer in recent
years. 3.6. FAMILY FACTORS RELATED TO INFLUENCING FACTORS FOR JUNK FOOD CONSUMPTION AMONG RESPONDENTSMain influencing factors on family factors were
junk foods being cheap and convenient (40.9%), parents’ interest in fast food
(57.8%), reluctance to carry home-cooked food to school or other places (100%),
preparing food at home on a regular basis (51.8%), high cost of eating
traditional food out of home (51.8%). 3.7. ASSOCIATION OF LEVEL OF KNOWLEDGE WITH SELECTED SOCIO-DEMOGRAPHIC VARIABLES OF RESPONDENTSThere was significant association of
respondent’s gender, ethnicity, type of family, father’s education, mother’s
education, father’s occupation, mother’s occupation with level of knowledge on
junk food consumption. 4. DISCUSSIONThis
study showed that around half (45.2%) of respondents had poor level of
knowledge, and only minority of respondents (19.1%) had adequate level of
knowledge which is in contrast with the study done by Prabhu Priya, Sumit Kumar et. al on "A study to assess the knowledge
and practice of junk food consumption among pre university students in Udupi,
Taluk, Karnataka India" (2018), which revealed that more than one quarter
(31.87%) of the participants had insufficient knowledge, less than half (41.88
%) of the participants had moderate knowledge, and 26.25 % of the participants
had ample knowledge of the impact of consumption of fast food (Khongrangjem
et al., 2018). In the
study done by Lt Col Mercy Antony, Lt Col R K Bhatti et.al on "Junk Food
Consumption and Knowledge about its Ill Effects among Teenagers: A Descriptive
Study" (2013), showed that 7.21% adolescents had really good knowledge and
46.15% adolescents had an average understanding of the adverse effects of junk
food which is in contrast to the finding of present study where nearly half of
the adolescents (45.2%) had poor knowledge and few -respondents (19.1%) had
adequate knowledge regarding the effects of junk food consumption. (Col et al., 2013). This
study provided that all of the respondents consumed junk food which is almost
similar with the study done by Habib Arif et.al on
Prevalence, Determinants and Consequences of Fast-Food Consumption among
college students in Abha-Aseirthe, which depicted
that point prevalence of fast food consumption of the undergraduate applied
medical student was 89% (Habib et al.,
2016). In a
study done by Najila Mandoura
(2017) on "Factors Associated with Consuming Junk Food among Saudi Adults
in Jeddah City", showed that the deliciousness of the local foods make one
to consume the junk foods which was similar to this
study where more than half of the participants (54.5%) consumed junk foods as
it was more delicious than the home-made foods. Moreover, the reason for
preferring the junk food was to save time which was close to our study where
14.2% of the participants preferred junk foods as it saves time. Also, soft
drinks were the most commonly used beverages in that study which is similar to
this study in which 31.1 % of the participants consumed soft drinks as their
favorite junk food (Mandoura et
al., 2017). In the study done by Banik
R on "Fast food consumption and obesity among urban college going
adolescents in Bangladesh (2019) it was reported that, majority of the
participants (35.9%) consumed fast foods with friends which was slightly similar to this study where more than half of the
participants (55%) consumed junk food while staying with friends. More than one
quarter of the participants (26.8%) consumed fast food for breakfast whereas
this study depicted that more than half of the participants (60.8%) consumed
junk food as an alternative to breakfast (Banik et al., 2020). In the
study done by Pahari S et.al (2020) on "Perception and factors influencing
junk food consumption among school children of Pokhara", it was
highlighted that 6.8% of the respondents showed various reasons for junk food
consumption such as easy availability, cheaper products in the market whereas
in this study 16.3% of the participants showed easily
availability of the junk food as a reason for junk food consumption. Moreover,
the study indicated that there was a statistical association between the gender
of the students and the preferred choice of junk food while the findings of
this study showed significant association of level of knowledge with gender and
type of family of the respondents. Furthermore, advertisement was found to be
one of the major influencing factors (13.6%) for junk food consumption among
children while nearly half of the participants (42.2%) also found advertisement
as the influencing factor in this study (Pahari &
Baral, 2020). In the study done by H. Ansari et.al on "Fast food
consumption and overweight/obesity prevalence in students and its association
with general and abdominal obesity" (Sep, 2018)
pinpointed that overall,
72.4 percent consumed fast food. These students have consumed at least one kind
of fast food. The most popular form of fast-food
consumption was burger (44.4 %),
pizza (39.7%), and fried chicken (13.8%), respectively. However, in the present
study it was depicted that 100% of the higher level students consumed junk food
and chatpate, panipuri,
chips were the favorite junk food consumed by students. (Mohammadbeigi
et al., 2018). A study
done by Vinay Gopal (January,2012) on “Student’s perspective on junk foods
" showed that 44% of the participants do not take junk food as an
alternative to breakfast which was in contrast to this
study where 60.8% of the participants consume junk food as an alternative to
breakfast. Also, the reason for consuming junk food was changing lifestyle by
14.2% of the participants while 8.7% of the participants chose changing
lifestyle as the reason for consuming junk food in this study. Moreover, 16.2%
of the participants check the label of the junk food whereas in this study very
few participants (6.5%) check the label of the junk food (Gopal et al.,
2012). A study
done by Sapkota SD (May-August, 2017) on Junk Food
Consumption among Secondary Level Students, Chitwan highlighted that 90.1% of
the participants consumed junk food as it tastes better while in this study
22.6% participants consumed junk food as it gives the new taste. In addition,
less than half (15.5%) of the participants consumed junk food due to the
influence of TV advertisement similarly this study showed that, 24.3% of the
participants consumed junk food because of TV advertisements. Also, more than
one quarter (35.9%) of the participants frequently consumed chat pate than
other junk foods uniformly, this study showed that more than one quarter of the
participants (27.5%) consumed chatpate, panipuri, chips . (Sapkota &
Neupane, 2017). 5. CONCLUSION AND POLICY IMPLICATIONSNepal has no strict policies or advertising
standards to regulate outlandish health claims made by manufacturers of
packaged foods, fizzy drinks and franchised fast-food
outlets. Public awareness of the health impact of sugar consumption is growing
in the West with books like Case Against Sugar, but there are
no such campaign in Nepal. Regardless of knowledge on harmful effects of junk
food consumption, students are consuming it, because of time constraint, easy
availability of junk food, advertisement etc. So along with awareness program
more effective program and policies should be implemented to stop the practice
of junk food consumption, and visual program regarding harmful effect of junk
food consumption should also be encouraged through television or internet. 6. DIRECTIONS FOR FUTURE RESEARCHVarious cross-sectional studies have been
conducted regarding knowledge and practice of junk food consumption as shown in
this study, but comparative studies can be done on this topic to assess the
health and nutritional status among students who consume and do not consume
junk food. Also, longitudinal studies can be done to assess the growth and
development of children and adults who has the history of regular junk food
consumption. 7. EXPECTED OUTCOMESThis study examined the knowledge, prevalence
and contributing factors for junk food consumption among secondary level
students. The findings of this study will be useful for the future researchers
to fulfil the existing gap and will act as a ladder for those working in the
field of health and nutrition. Ultimately, it will aid in the development of
interventions and programs accordingly as per need at the policy level. 7.1. ETHICAL CONSIDERATIONThe study was conducted after the
ethical permission from department of Sociology and Anthropology, Ratna Rajyalaxmi Campus, Tribhvan University. Similarly, written permission was
taken from the concerned Educational Institutions of Kathmandu (Collins
Institution and Glossa Prep Institution), before the survey, purpose of the study was clarified to each participants
and beforehand consent was taken from them. Those who refused to provide
consent were not influenced by any means to participate in the study.
Confidentiality and anonymity were emphasized and maintained and collected data
was used only for this research purpose without any modification. SOURCES OF FUNDINGThis research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. CONFLICT OF INTERESTThe authors have declared that no competing interests exist. ACKNOWLEDGMENTThe authors would like to
express our gratefulness to Ratna Rajya Laxmi Campus,
head of selected institutions as well as all the participants for providing
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