Chandigarh teens cut junk food, reduce over 1,000+ unwanted calories in their daily diet: Why this PGI study is significant

While junk food consumption fell, students did not significantly increase fruit or home-cooked food intake, indicating that cutting unhealthy food is easier than building healthy habits. (Freepik file photo)

Can awareness sessions really work in changing teen eating patterns and wean them away from their greatest addiction, cookies, burgers, sodas and chips? These are all ultra-processed foods, which are energy-dense, have added sugars, fats, sodium and low essential nutrients. As they are linked to poor diet quality and heightened risks of obesity, diabetes, heart disease and all-cause mortality, a new study has shown that simple school-based behaviour programmes can dramatically reduce junk food consumption among adolescents.

The study was conducted by researchers from the Public Health Foundation of India (PHFI) and PGI Chandigarh. It has been published in BMJ Global Health. “We did this study because there is limited evidence on school-based interventions targeting reduction in consumption of ultra-processed foods in low- and middle-income countries (LMICs) like India. What we found is that after 11 intensive awareness sessions for adolescents across eight public schools in Chandigarh over six months, the students reduced their consumption of ultra-processed foods and chose healthy diets. Their daily calorie consumption fell from 3,500 calories per day to around 2,000 calories, all because they had cut out their junk food. We also had one educational session with their parents too,” says Dr Sandeep Kaur, lead author, assistant professor and public health researcher at PHFI, who has earlier worked at PGI, Chandigarh. She shares more details of her study.

What are key takeaways from the study?

This was a randomised controlled study on urban adolescents. When we began these awareness sessions in association with school authorities, each teen was consuming around 3,500 calories per day (teens need anything between 1,800 to 2,000 calories per day), most of it coming from ultra-processed foods. That was the baseline. At the end of the intervention, when the students had changed their dietary changes, they had cut down their ultra processed food consumption by almost 30 per cent and reduced their daily calorie count by 1,682 calories that were coming from them. This shows that simple interventions in early adolescence work. Their consumption of other processed foods also dropped, showing a conscious shift to healthy dietary choices.

India is seeing a rapid rise in childhood obesity, diabetes and heart-disease risk. This study shows that schools could become the frontline outpost for preventing future lifestyle diseases, using low-cost interventions like the awareness sessions we did and the canteen menu overhaul that some CBSE schools are also adopting.

The results are significant because our impact assessment was delayed by eight months because of Covid. Still, there was a calorie drop which proved that school level interventions are sustainable if we work with both teachers and parents.

What was the methodology used to change student eating behaviour?

We had everyday sessions, beginning with why and what they preferred in their diet, be it in colour, taste and preference. That’s how we found that they were having 8 to 9 g of salt per day (WHO recommends consumption to less than 5 g a day). We found that in home cooking, their family members were used to sprinkling salt out of habit rather than measuring the amount. So, we gave the children a measuring spoon set, and told them they could scoop out the daily quota of salt as recommended by WHO, put it in a bowl and use it throughout the day in the food prepared for them. We spoke to their mothers about following this drill while packing tiffins.

What needs to be done at the policy level?

There should be a uniform policy for regulating ultra processed foods. Front-of-Pack Warning Labels (FOPLs), featuring clear symbols like black octagons stating “High in Sugar/Salt/Fats,” based on WHO guidelines, should be made mandatory. A new colour coding system to stratify the calorie load of packaged foods coupled with public awareness campaigns and restricting unhealthy food marketing are needed.