Dr Aisling Daly

Introduction
Eating behaviours vary by sex, age and BMI status, and different eating behaviour styles are associated with varying dietary intakes(1). This study aims to determine factors associated with the eating behaviours of Irish teens, using data from the recent National Teens’ Food Consumption Survey II (NTFSII 2019/20, n=428, M/F: 212/216)(2).

Methods
The Three Factor Eating Questionnaire (TFEQ-r18) contains 18 items, making up 3 scales: Cognitive Restraint (CR, 6 items), Emotional Eating (EE, 3 items), Uncontrolled Eating (UE, 9 items)(3). Converted scores range from 0-100, indicating the proportional contribution of each eating behaviour style, and are calculated using the equation S-L/Rs x100 (S=sum of scale scores, L=lowest possible score, Rs=possible score range)(3). 

Descriptive statistics, independent samples t-tests and Pearson correlations were run to test associations between the three TFEQ-r18 scales and age, sex, BMI, Physical Activity (PA), weight perception and dietary variables, including total daily energy intake (kcal) and daily fat, protein and carbohydrate intakes (as % Total Energy).

Results
Mean(SD) scores among the whole group were CR=28.25(17.62), EE=25.03(27.77), UE=38.84(18.73). Females scored higher than males on CR (32.20(18,85), 24.97(15.64)) and EE (34.51(29.84), 15.20(21.13), both P

Conclusion
The predominant eating behaviour style for Irish teens is UE, which is eating more than intended based on hunger, sensory factors, or being physically near food. In general, levels of CR and EE are lower in this Irish teen cohort, but both restrained and emotional eating are higher in girls, those with a higher BMI, with a negative weight perception, and with lower energy intakes. Teens with a higher BMI show higher levels of CR and EE, but the direction of causality is unclear – does BMI change the eating behaviour or does the eating behaviour increase BMI? However, the associations between weight perception, dietary intake and eating behaviour styles suggest that, independent of measured BMI, teens who perceive their weight to be too high may be more likely to change their eating and activity habits because of this. This information could help inform healthy eating messages to teens based on motivating factors for diet habits, getting the balance right to prevent both overeating and disordered eating habits.

Introduction
During adolescence, teens start making their own food choices, and while health and nutrition are important, practical and social concerns also play an influential role(1). The present study aims to determine factors that may influence the food choices of Irish teens, using data from the Food Choice Questionnaire (FCQ)(2) in the National Teens’ Food Consumption Survey II (NTFSII 2019/20, n=428, M/F: 212/216)(3).

Methods
The FCQ contains 36 items and assesses the level of importance placed on different motives when making food choices(2). Principal Component Analysis, reliability testing, Pearson correlations and independent samples t-test analyses were run to determine the key motivations for food choice and their association with age, sex, BMI, Physical Activity (PA), Screen Time (ST), weight perception, daily energy intake (kcal) and daily fat, protein and carbohydrate intakes (as %Total Energy).

Results
Eight motivating factors were identified for Irish teens’ food choices, in order of importance: Sensory Appeal (SA), Price & Availability (P&A), Health & Natural Content (HNC), Familiarity, Ease of Preparation (EoP), Mood, Weight Control (WC), and Ethical Concerns (EC). Girls placed more importance than boys on HNC (r=0.16), WC (r=0.21), Mood (r=0.21), and EC (r=0.20, all P​​​​​​​
Conclusion
Health and practical aspects to food choice are important for teens, but taste remains a key influence. However, food choice motivations vary between the sexes and by age, BMI status and weight perception, where girls were more motivated by health, weight control, mood and ethical concern than boys, and older teens were more influenced by mood and ease of preparation than younger teens. Both those classified as overweight and those who perceived they were overweight were motivated more by weight control and mood for their food choices, whereas those who perceived their weight to be correct placed more importance on health and natural content. Those motivated by weight control had lower energy and higher protein intakes, and those motivated by the health and natural content of food had more health promoting behaviours with higher PA and lower ST, and higher protein intakes. Understanding the motivations of teens’ food choice can help understand why they struggle to meet dietary recommendations, and help to develop more effective health promotion messages.

The aim of this research was to investigate the attitudes, behaviours and influences surrounding food choices and eating behaviours among Irish teens. Qualitative methods were used to gain a deeper understanding from the teens’ perspective, based on their lived experiences around food.

Six semi-structured focus group discussions were completed with Irish secondary school-going teens in Transition Year, aged 15–17 years (n = 47). Participants came from both single-sex and mixed schools in Dublin and Wexford, and included both males and females. Due to Covid-19 restrictions, five focus groups were conducted via video call. Discussion topics were introduced using a vignette format, with the content based on key eating behaviour styles identified in the literature: restrained, emotional, uncontrolled eating(Reference Karlsson, Persson and Sjostrom1) & variety seeking tendencies(Reference Van Trijp and Steenkamp2). Focus groups were moderated by the first author and attended by a research assistant, who took detailed notes. Data coding was managed using NVivo software (V12) and analysis was completed following the six phases of reflexive Thematic Analysis, as outlined by Braun and Clarke(Reference Braun and Clarke3).

Three themes relating to teen food choices and their eating behaviours were generated: 1) the importance of enjoying food and the eating occasion, 2) the role of the food environment, and 3) social concerns around health and appearance. Of overwhelming importance was the enjoyment factor from food, in terms of both taste and the overall experience of the eating occasion. The food environment includes food availability at school, at home and the social environment and concerns around food and eating with peers. Concerns for physical and social appearance, as well as price, convenience and familiarity with the food were factors involved in food choices, but the priority for all teens was to enjoy the food and the occasion around eating. Health was mentioned as a factor, but more in relation to the perception of health and what was socially acceptable, where eating certain foods could be perceived as being “healthy/good” or “unhealthy/bad”. Teens described concerns about social judgement associated with certain foods, rather than concerns about their impact on the teen's physical health. In general, the participants in this research had a strong understanding of nutrition and the social pressures linked with food and body image, but did not feel that they themselves fall victim to peer judgement or pressure from social media directly.

The thoughts involved when making food choices encompass a wide range of factors for teens, and decisions regarding what to eat are linked to the individual priorities of the teen themselves and are highly context specific and fluid. Taste and enjoyment are highly important, but concerns for the social acceptability of certain foods can play an important and often conflicting role.