Urban School Nutrition: Student and Teacher Perspectives on Creating a Healthier Food Environment
Abstract
Changes in lifestyle and eating habits can affect food choices for adolescents, impacting their nutritional intake. Schools are pivotal in shaping healthy eating behaviors. This qualitative study explores the perspectives of secondary school students and teachers on strategies to improve the healthy food environment in an urban school. Two focus group discussions with students and one with teachers, along with one in-depth interview with the school principal, were conducted at a junior high school in Makassar city. The audio recordings were transcribed and analyzed thematically to identify key themes. Students appeared to be aware of the importance of healthy eating habits; however, they lacked a full understanding of which healthier choices to make. Focus group discussions and interviews revealed that all groups recognize the importance of promoting healthier choices through regulation, education, and accessible nutritious foods. The study highlights actionable strategies for implementing school-based interventions to foster sustainable healthy eating behaviors.
Full text article
References
1. Devine L. D., Hill A. J., Gallagher A. M. Improving Adolescents’ Dietary Behaviours in The School-Setting: Challenges and Opportunities. Proceedings of the Nutrition Society. 2023;82(2):172–185.
https://doi.org/10.1017/S0029665123002197
2. Chaudhary A., Sudzina F., Mikkelsen B. E. Promoting Healthy Eating Among Young People A Review of the Evidence of The Impact of School-Based Interventions. Nutrients. 2020;12(9):1–34. https://doi.org/10.3390/nu12092894
3. WHO. Obesity and Overweight. World Health Organization; 2025. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
4. UNICEF. Undernourished and Overlooked: A Global Nutrition Crisis in Adolescent Girls and Women. United Nations Children's Fund; 2023. https://www.unicef.org/reports/undernourished-overlooked-nutrition-crisis
5. Muonde M., Olorunsogo T. O., Ogugua J. O., Maduka C. P., Omotayo O. Global Nutrition Challenges: A Public Health Review of Dietary Risks and Interventions. World Journal of Advanced Research and Reviews. 2024;21(1):1467–1478. https://doi.org/10.30574/wjarr.2024.21.1.0177
6. Baltag V., Sidaner E., Bundy D., Guthold R., Nwachukwu C., Engesveen K., et al. Realising the Potential of Schools to Improve Adolescent Nutrition. BMJ. 2022; 379:e067678. https://doi.org/10.1136/bmj-2021-067678
7. Daly A. N., O’Sullivan E. J., Kearney J. M. Considerations for Health and Food Choice in Adolescents. Proceedings of the Nutrition Society. 2022;81(1):75–86. https://doi.org/10.1017/S0029665121003827
8. Fadila J. Hubungan Konsumsi Ultra Processed Food Terhadap Kejadian Berat Badan Lebih pada Remaja di SMPN 3 Makassar. (Thesis). Makassar; Fakultas Kesehatan Masyarakat Universitas Hasanuddin; 2022. https://repository.unhas.ac.id/id/eprint/18087/
9. Keane A, Willetts A, Godin L. Adolescents’ Perceptions of Healthy and Unhealthy Food: The Role of Food Additives and Naturalness. Journal of Public Health (Bangkok). 2015; 37(2):213–219.
10. Lachat C., Nago E., Verstraeten R., Roberfroid D., Van Camp J., Kolsteren P. Eating Out of Home and Its Association with Dietary Intake: A Systematic Review of The Evidence. Obesity Reviews. 2012;13(4):329–46. https://doi.org/10.1111/j.1467-789X.2011.00953.x
11. Worsley A. Nutrition Knowledge and Food Consumption: Can Nutrition Knowledge Change Food Behaviour? Asia Pacific Journal of Clinical Nutrition. 2002;11(S3):S579–S585. https://doi.org/10.1046/j.1440-6047.11.supp3.7.x
12. Iyassu A., Laillou A., Tilahun K., Workneh F., Mogues S., Chitekwe S., Baye K. The Influence of Adolescents’ Nutrition Knowledge and School Food Environment on Adolescents’ Dietary Behaviors in Urban Ethiopia: A Qualitative Study. Maternal & Child Nutrition. 2024;20(S5):e13527. https://doi.org/10.1111/mcn.13527
13. Van Ansem W. J., Schrijvers C. T., Rodenburg G., Van de Mheen D., Van de Goor I. A. School Food Environments and The Dietary Choices of Adolescents: The Role of Food Availability. J Sch Health. 2013;83(7):521–9.
14. Mama Chabi S., Fanou-Fogny N., Nago Koukoubou E., Deforche B., Van Lippevelde W. Factors Explaining Adolescent Girls’ Eating Habits in Urban Benin: A Qualitative Study. Adolescents. 2022;2(2):205–219. https://doi.org/10.3390/adolescents2020017
15. Florence M. D., Asbridge M., Veugelers P. J. Diet Quality and Academic Performance. Journal of School Health. 2008;78(4):209–215. https://doi.org/10.1111/j.1746-1561.2008.00288.x
16. Rasmussen M., Krølner R., Klepp K. I., Lytle L., Brug J., Bere E., Due P. Determinants of Fruit and Vegetable Consumption Among Children and Adolescents: A Review of The Literature. Part I: Quantitative Studies. International Journal of Behavioral Nutrition and Physical Activity. 2006;3(22):1–19. https://doi.org/10.1186/1479-5868-3-22
17. Kundu S., Khan M. S. I, Bakchi J., Sayeed A., Al Banna M. H., Begum M. R., Hassan M. N. Sources of Nutrition Information and Nutritional Knowledge Among School-Going Adolescents in Bangladesh. Public Health in Practice. 2020;1(March):1–5. https://doi.org/10.1016/j.puhip.2020.100030
18. Egg S., Wakolbinger M., Reisser A., Schätzer M., Wild B., Rust P. Relationship Between Nutrition Knowledge, Education and Other Determinants of Food Intake and Lifestyle Habits Among Adolescents from Urban and Rural Secondary Schools in Tyrol, Western Austria. Public Health Nutrition. 2020;23 (17):3136–3147. https://doi.org/10.1017/S1368980020000488
19. Story M, Neumark-Sztainer D, French S. Individual and Environmental Influences on Adolescent Eating Behavior. Journal of the American Dietetic Association. 2002;102(3): S40–S51. https://doi.org/10.1016/S0002-8223(02)90421-9
20. Contento I. R. Nutrition Education: Linking Research, Theory, and Practice. 2008;17 (1):176–179. https://pubmed.ncbi.nlm.nih.gov/18296331/
21. WHO. Report of The Commission on Ending Childhood Obesity: Implementation Plan: Executive Summary. World Health Organization; 2017. https://iris.who.int/handle/10665/259349
22. Rocha L. L, Cordeiro N. G., Jardim M. Z., Kurihayashi A. Y, Gentil P. C, Russo G. C, et al. Do Brazilian Regulatory Measures Promote Sustainable and Healthy Eating in The School Food Environment? BMC Public Health. 2023;23(2166):1–9. https://doi.org/10.1186/s12889-023-17111-7
23. O’Brien K. M., Barnes C., Yoong S., Campbell E., Wyse R., Delaney T., et al. School-Based Nutrition Interventions in Children Aged 6 to 18 Years: An Umbrella Review of Systematic Reviews. Nutrients. 2021;13 (11):1–31. https://doi.org/10.3390/nu13114113
24. Barnes C., Mccrabb S., Stacey F., Nathan N., Yoong S. L., Grady A., et al. Improving Implementation of School-Based Healthy Eating and Physical Activity Policies, Practices, and Programs: A Systematic Review. Translational Behavioral Medicine. 2021;11(7):1365–1410. https://doi.org/10.1093/tbm/ibab037
25. Langford R., Bonell C. P., Jones H. E, Pouliou T., Murphy S. M., Waters E., et al. The WHO Health Promoting School Framework for Improving The Health and Well-Being of Students and Their Academic Achievement. Cochrane Database of Systematic Reviews. 2014;4(CD008958). https://doi.org/10.1002/14651858.CD008958.pub2
26. Swinburn B. A., Sacks G., Hall K. D., McPherson K., Finegood D. T., Moodie M. L., et al. The global obesity pandemic: Shaped by Global Drivers and Local Environments. Lancet. 2011;378(9793):804–814. http://dx.doi.org/10.1016/S0140-6736(11)60813-1
27. Nørnberg T., Houlby L., Jørgensen L., et al. Do We Know How to Nudge? A Review of The Use of Behavioral Nudges in The School Food Environment. Int J Behav Nutr Phys Act. 2016;13(1):77.
28. Ronto R., Carins J., Ball L., Pendergast D, Harris N. Adolescents’ Views on High School Food Environments. Health Promotion Journal of Australia. 2021;32(3):458–466. https://doi.org/10.1002/hpja.384
29. Octawijaya I. H., Wariki W. M. V, Hori A., Ichikawa M. Food Environment of Junior High Schools in Tomohon City, Indonesia. Indonesian Journal of Public Health. 2022;17 (3):377–384. https://doi.org/10.20473/ijph.v17i3.2022.377-384
30. Coady O. R., Styles S. E., Smith C. Barriers and Enablers to Providing Healthy Food and Beverages in New Zealand Secondary School Canteens. Health Promotion International. 2025;40(1):daaf011. https://doi.org/10.1093/heapro/daaf011
31. da Silva M. B., Pinheiro K. C., Rockenbach G., Hinnig P. D., de Pinho M. G., de Souza L. D., et al. Association Between the Food Environment Around Schools and Food Consumption of Adolescents in Large and Small Municipalities in Southern Brazil. International Journal of Environmental Research and Public Health. 2024;21(11): 1524. https://doi.org/10.3390/ijerph21111524
32. Wang Y., Lobstein T. Worldwide Trends in Childhood Overweight and Obesity. International Journal of Pediatric Obesity. 2006;1(1):11–25. https://doi.org/10.1080/17477160600586747
33. Mekonnen Kifle M, Terragni L., Morseth M. Teachers’ Perception of Their Students’ Dietary Habits in Addis Ababa, Ethiopia: A Qualitative Study. BMC Nutrition. 2024; 10(141). https://doi.org/10.1186/s40795-024-00946-7
34. Almughamisi M, O’Keeffe M, Harding S. Adolescent Obesity Prevention in Saudi Arabia: Co-identifying Actionable Priorities for Interventions. Frontiers Public Health. 2022;10:1–11. https://doi.org/10.3389/fpubh.2022.863765
35. Pérez-Rodrigo C., Aranceta J. School-based Nutrition Education: Lessons Learned and New Perspectives. Public Health Nutrition. 2001;4(1a):131–139. https://doi.org/10.1079/PHN2000108
36. Story M, Kaphingst KM, Robinson-O’Brien R, Glanz K. Creating Healthy Food and Eating Environments: Policy and Environmental Approaches. Annual Review of Public Health. 2008;29:253–272. https://doi.org/10.1146/annurev.publhealth.29.020907.090926
37. WHO. 1998. Global School Health Initiative: Health-Promoting Schools. World Health Organization; 1998. https://www.who.int/health-topics/health-promoting-schools#tab=tab_1
38. FAO. School-based Food and Nutrition Education. Rome: Food and Agriculture Organization of The United Nations; 2020. https://openknowledge.fao.org/server/api/core/bitstreams/be2fc797-d10d-44fc-9e62-618190756f26/content
Authors
Copyright (c) 2025 by author
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Atribusi-NonKomersial-BerbagiSerupa 4.0 Internasional License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Copyright encompasses rights to reproduce and deliver the article in all form and media, including reprints, photographs, microfilms and any other similar reproductions, as well as translations. The reproduction of any part of this journal, its storage in databases and its transmission by any form or media, such as electronic, electrostatic and mechanical copies, photocopies, recordings, magnetic media, etc.
All articles published Open Access are free for everyone to read and download. Under the CC-BY-NC-SA license, authors retain ownership of the copyright for their article, but authors grant others permission to use the content of publications in Media Kesehatan Masyarakat Indonesia Universitas Hasanuddin in whole or in part provided that the original work is properly cited. Users (redistributors) of Media Kesehatan Masyarakat Indonesia Universitas Hasanuddin are required to cite the original source, including the author's names, Media Kesehatan Masyarakat Indonesia Universitas Hasanuddin as the initial source of publication, year of publication, and volume number.
Media Kesehatan Masyarakat Indonesia Universitas Hasanuddin is licensed under Creative Commons Atribusi-NonKomersial-BerbagiSerupa 4.0 Internasional.