Research reportPeer influence on snacking behavior in adolescence☆
Introduction
Obesity is a complex and often chronic health problem resulting from the interaction of metabolic, genetic, environmental, and psychological factors (Wadden & Stunkard, 2004). Overweight often develops early in life and tracks into adulthood (Daniels, 2006), causing a serious burden during and beyond childhood (Lobstein & Jackson-Leach, 2006). Adolescence, with its rapid changes in body composition (Daniels et al., 2005) and food habits, coinciding with the transition from the direct home influence to the peer-related environment (Von Post-Skagegard et al., 2002), is likely to be a particularly vulnerable period in the onset of obesity.
Ecological models examine the problem of obesity by regarding both the individual disorder and the abnormal environment (Egger and Swinburn, 1997, Giskes et al., 2007). Easily available unhealthy food is an important representative of the so called physical ‘obesogenic’ environment (Cohen, 2008, Kipke et al., 2007, Martens et al., 2005, Zenk and Powell, 2008). Schools play an important role in the consumption of unhealthy food among adolescents. Availability of snacks at school has been associated with unhealthier food habits of secondary school pupils, and changing the canteen policy, e.g. by decreasing portion sizes, influenced energy balance in a favorable way (Cullen and Thompson, 2005, Cullen et al., 2000).
Besides the physical school environment that supplies food, we propose that also the social environment plays a role in determining unhealthy food intake among adolescents. During adolescence, children spend increasingly more time with friends, and their need to belong to a group and to be accepted by peers is higher than during other periods in life (Coleman, 1980). Social learning theory specifies that peers may influence each other by observing, modeling, and imitating behavior of important individuals in their environment (Bandura, 1986). Group norm setting is also a powerful mechanism in determining an individual's behavior (Coleman & Lal, 1994). Prospective research suggested that peers influence each other in a wide range of health behaviors, e.g., smoking (Gritz et al., 2003), alcohol consumption (Urberg, Degirmencioglu, & Pilgrim, 1997), and disordered eating (Zalta & Keel, 2006). Social networks have also been found relevant for the spreading of obesity in adults (Christakis & Fowler, 2007). The cross-sectional design of the current study cannot disentangle influence processes from selection processes such as similar adolescents choosing each other as friends. However, this is the first study to examine similarities in snack and soft drink consumption within friendship groups. To establish this relationship is an important first step before examining the precise causal mechanisms.
Adolescents’ snacking behavior is not only expected to depend on aspects of the physical and social environment, but also on personal characteristics (Kremers et al., 2006). Consumption of unhealthy food is more frequent in boys (Bauer et al., 2009, Von Bothmer and Fridlund, 2005) and in lower educated (Van der Horst et al., 2007) and overweight children (Hill et al., 2008, Kubik et al., 2005). The aim of the present study was to examine the association of adolescents’ snack and soft drink consumption with snack and soft drink consumption in friendship groups (social environment), the availability of snacks at school (physical environment), and personal characteristics. The investigation of the possible influence of the school environment was preliminary considering the design of our study. Our hypothesis was that the consumption in friendship groups, availability of snacks and soft drinks at school, and personal characteristics are associated with individual snack and soft drink consumption.
Section snippets
Population and design
This cross-sectional study was part of a larger survey called ‘Mental Health and Health Habits’. This longitudinal cohort study in adolescents that covers three years, examines the associations between psychosocial factors and health behavior such as food intake, smoking, and alcohol use (Larsen, Otten, & Engels, 2009). Participants were recruited from seven randomly selected secondary schools in suburban (N = 3) and urban (N = 4) areas from three regions in the Netherlands. Two schools were
Description of the sample
Of the original sample of 1330, 749 adolescents with complete data on all variables were part of a friendship group. This sample showed no difference with the non-friendship group sample with respect to age, zBMI, and snack consumption. The friendship group sample, as compared to the non-friendship group sample, included more girls (53% and 46%, respectively) and had a higher education level (4.7 versus 4.4). The education of 749 adolescents belonging to a friendship group was for 15%
Discussion
Individual snack and soft drink consumption was high when peers proximate to the adolescent had a high consumption combined with readily availability within schools of snacks in the canteen and soft drinks in the vending machines. Individual and peer snack consumption was particularly strongly associated in boys, adolescents with lower education levels, and normal weight adolescents.
Comparable to earlier studies on body image and disordered eating behavior (Hutchinson and Rapee, 2007, Paxton et
References (63)
- et al.
An informal school-based peer-led intervention for smoking prevention in adolescence (ASSIST). A cluster randomised trial
Lancet
(2008) - et al.
Effect of a la carte and snack bar foods at school on children's lunchtime intake of fruits and vegetables
Journal of the American Dietetic Association
(2000) - et al.
Texas school food policy changes related to middle school a la carte/snack bar foods. Potential savings in kilocalories
Journal of the American Dietetic Association
(2005) - et al.
Food choice and fat intake of adolescents and adults. Associations of intakes within social networks
Preventive Medicine
(1998) - et al.
Weight-for-stature compared with body mass index-for-age growth charts for the United States from the Centers for Disease Control and Prevention
American Journal of Clinical Nutrition
(2002) - et al.
Modeling of palatable food intake in female young adults. Effects of perceived body size
Appetite
(2008) - et al.
Do friends share similar body image and eating problems? The role of social networks and peer influences in early adolescence
Behaviour Research and Therapy
(2007) - et al.
Food and park environments. Neighborhood-level risks for childhood obesity in East Los Angeles
Journal of Adolescent Health
(2007) - et al.
Adolescent depressive symptoms and smoking behavior. The gender-specific role of weight concern and dieting
Journal of Psychosomatic Research
(2009) - et al.
Beverage intake improvement by high school students in Saskatchewan, Canada
Nutrition Research
(2008)
Intake of sugar-sweetened beverages and weight gain. A systematic review
The American Journal of Clinical Nutrition
Peer modeling influences girls’ snack intake
Journal of the American Dietetic Association
Mutual exposure or close peer relationships do not seem to foster increased similarity in food, music or television program preferences
Appetite
Effects of social contexts on overweight and normal-weight children's food intake
Physiology & Behavior
The presence of friends increases food intake in youth
The American Journal of Clinical Nutrition
Individual and environmental influences on adolescent eating behaviors
Journal of the American Dietetic Association
Differences between parents’ and adolescents’ perceptions of family food rules and availability
Journal of Nutrition Education and Behavior
The school food environment associations with adolescent soft drink and snack consumption
American Journal of Preventive Medicine
Energy Intake of Swedish Overweight and Obese Children Is Underestimated Using a Diet History Interview
Journal of Nutrition
US secondary schools and food outlets
Health Place
Multiple regression: testing and interpreting interactions
Social foundations of thought and action: a social cognitive theory
Socioenvironmental, personal and behavioural predictors of fast-food intake among adolescents
Public Health Nutrition
The spread of obesity in a large social network over 32 years
New England Journal of Medicine
Obesity and the built environment. Changes in environmental cues cause energy imbalances
International Journal of Obesity
Statistical power analysis for the behavioural sciences
Applied multiple regression/correlation analysis for the behavioral sciences
Friendship and the peer group in adolescence
The demand for effective norms
Age and gender differences in children's food preferences
British Journal of Nutrition
Cited by (129)
The prevalence of obesity among school-aged children in Vietnam: A systematic review and meta-analysis
2023, Human Nutrition and MetabolismExamining food intake similarities in adolescent best friend dyads using longitudinal Actor-Partner Interdependence Models
2022, AppetiteCitation Excerpt :First, previous studies on food intake have predominantly focused on socialization by friends and paid less attention to the selection of friends. In previous cross-sectional studies, it has been shown that adolescents' intake of energy-dense, nutrient-poor unhealthy snacks is associated with their friends' intake of these foods (e.g., Wouters et al., 2010). Based on these concurrent associations, it has often been suggested that a process of “socialization” occurs, where friends are perceived as behavioral referents inducing changes in adolescent behavior.
Climate change awareness of the young generation and its impact on their diet
2021, Cleaner and Responsible Consumption
- ☆
This study was financed by the Netherlands Organization for Scientific Research (NWO) Veni Grant 451-05-013. We thank Lieke Woelders for the observations at the schools, Theo van der Weegen, for analyzing the dataset with respect to the peer friendship groups and Ad Vermulst, for his advice on multilevel analysis.