Abstract
BACKGROUND: Adolescence is a key period for public health interventions due to rapid physical, emotional, and intellectual development. Food environments greatly influence adolescents' food choices and diets and, consequently, their overall health. We aimed to understand adolescents' perceptions regarding factors influencing their food environment and to identify opportunities for accelerating actions to promote healthier food environments. METHODS: We developed and disseminated a survey using U-Report, a social messaging tool by UNICEF, targeting adolescents aged 10-19 years. This U-poll-based survey was available online in 12 Indian languages from June to November 2022. Following the lifting of COVID-19 restrictions, the survey was also administered offline. RESULTS: Responses were received from 143,878 adolescents across 36 states of India. More than half of the adolescents surveyed (67.6%) reported that food advertisements influence their food choices. Nearly 72.6% of participants reported reading food labels, and 62.8% reported that it is very important to simplify the nutrient information available on food packs. About 30.7% of adolescents indicated that they can't eat healthy foods due to higher prices (expensive/costly), while 15.3% reported that they don't eat healthy foods as they do not find them tasty. CONCLUSION: The study highlights multiple factors influencing adolescents' food choices in India, and underscores the importance of creating supportive food environments. The findings suggest potential areas for intervention such as improving accessibility, affordability, and appeal of healthy foods. Future efforts should explore comprehensive strategies for strengthening policies and guidelines around healthy food environments, while further research is needed to assess the effectiveness of such interventions.