When adolescents were asked about healthy eating, the answers were clear. Adolescents shared knowledge they had acquired over the years. Responses alluded to concepts such as health, healthy foods, physical activity and water consumption. When asked about their knowledge of healthy versus unhealthy foods, they were easily assigned into one of the three profiles.
The majority group (profile 1) had a minor interest in healthy eating; however, they preferred the consumption of junk food, but considered making changes to their habits.
The intermediate group (profile 2) were those who cared about their diet. This group reported the importance of consumption of healthier foods than profile 1. Female adolescents stated it was important to "eat in moderation" (eighth grade female) and that they were "careful not to overeat" (eighth grade female). On the other hand, males mentioned sports as a primary factor for a healthy life. An example was the opinion of one student: "Exercising ... makes you not want to eat junk ... you just can´t" (seventh grade male).
... I do a lot of exercise ... in my house we don´t eat a lot of fried food and if we eat sweets it´s like once a month ... "(eighth grade female).
Among the minority group (profile 3), unhealthy foods were preferred. Profile 3 did not demonstrate any interest in making a change and were indifferent about personal eating habits (Table 2).
¨ ... I eat healthy when I´m with my grandma and my mom…when I´m with my brother we only eat junk food ... "(seventh grade female)
"... Most of the time I eat junk food. I hardly ever eat healthy [food]..." (Seventh grade male)
The self-evaluation by adolescents of their diet did not differ by sex. However, females were more severe with themselves with an average of 4.4, on a scale of 1 to 7, while males had an average of 5.0.
"... a 3 because sometimes when I'm with my mom I eat fruit with yogurt or milk with banana, but when I'm with my dad I eat junk food ... ¨ (sixth grade female).
“... about a 5 because I eat a lot of bread ... and I do not eat a lot of vegetables” (seventh grade male).
Adolescent diet reflected behaviors far from those recommended in the dietary guidelines for the Chilean population (21). For foods such as dairy, fruits, vegetables and fish, frequency of consumption was lower than the daily recommendation, with an average dairy consumption between 1-2 servings, eaten primarily at breakfast or snack, 3 servings of fruit and vegetables a day; and 1 serving of fish per week. On the other hand, adolescents exceeded recommended consumption of sugary drinks and bread, consuming 0.5 to 1.0 liter of sugar-sweetened beverages and 2 to 3 units of bread. Participant comments focused on the feeling of satiety and taste for these foods. The majority of participants consumed sweet or salty snacks every day. Water consumption reported to be approximately a half liter per day.
"There is always soda in my house. I can drink up to 3 liters ... they buy diet [soda] but I don´t like it, it grosses me out "(eighth grade female).
Adolescents report that they like to cook, however, they reported cooking foods with quick preparations, like rice, pasta, sandwiches, burgers and fries, among others, and showed little interest and ability to prepare more complex foods.
“When I'm hungry I cook pasta, fries, rice or sausage” (seventh grade female)
“The only thing I know cooking is pasta, egg or hamburger” (Eighth grade female)
Participants explained their eating habits, considering their daily meal times offered at school (Table 3).
In Profiles 1 and 2 most of the adolescents reported eating breakfast at home. However, they felt that their breakfast choices were unhealthy, as they sought the fastest alternative, which was usually a hot drink (tea or milk) and bread. The most frequent barrier to a healthy breakfast was time, with participants stating that they were unable to prepare something more elaborate.
Both Profiles 1 and 2 ate lunch at school, but some in Profile 1 ate again at home after school. They reported not liking the school lunch because it was low in salt. Thus, most participants had the habit of bringing their own salt to improve the taste.
In Profile 3 they did not eat breakfast and lunch at school.
"I do not eat breakfast because I get up very late and I do not like to eat early" (sixth grade female).
With regard to tea time (called “once” in Chile) the three profiles are very similar. Adolescents reported that this was the time when the family ate together with bread being an important part of this meal.
"At tea time, I eat bread with egg or butter" (seventh grade female).
On weekends, the majority of adolescents said that their eating habits changed for the worse, in comparison to during the week, as result of increased junk food consumption. Adolescents stated that on the weekend they go out to eat with their families to places like the mall food court, where they mostly ate burgers, pizzas, and grilled chicken with fries, hot dogs, Chinese food and other “junk” food. On the other hand, a group reported eating healthy and unhealthy foods. The minority group stated that their diet improved on the weekend because there was more time to cook, thus improving access to “homemade” foods, and an increased consumption of vegetables in salads.
Considering the stage of development and importance of the peer group, adolescents were consulted about the foods they normally ate when they attended meetings with their friends. They answered that their food was not healthy, without any difference by sex with a preference for pizza, soft drinks, hot dog, hamburgers and snacks, among others. When asked if their friends influenced their food choices, the answer of the majority of the group was that their peers influenced their choices. However, some of them recognized that the final decision was their own responsibility.
The taste of high-calorie food (they considered "junk" food to taste good) and the sensation of satiety were mentioned by teens as barriers to healthy eating.
"Because they are better" (eighth grade male)
"Because they fill you up more" (eighth grade male)
They also considered that unhealthy foods are a "vice" and when they start eating they cannot stop (addictive factor). They reported being aware of this situation but were not willing to change their behavior. They considered that these factors were the biggest barriers to eating healthy.
"Once you eat you cannot stop" (male, seventh grade)
"It's that yummy things are not healthy" (female, eighth grade)
Another barrier was that the lunch offered by the school cafeteria was low in salt.
“The lunch that they have here doesn´t have enough salt, for that reason lots of us bring our own” (female, sixth grade)
Use of Technology: All students had access to technology through mobile phones, tablets or computers. The most used social networks were (in order) Facebook, Whatsapp, Youtube and Instagram. Adolescents were asked if they would use technology for food education with some examples, such as messages with dish recipes and other. Answers varied, with students noting that their interest in the use of technology for food education would depend on the content, such as a personalized program with information like weight and height, for a self-assessment of nutritional status or the benefits of engaging in various sports. (Table 4).