Data from the FGDs are presented below as themes related to diet and physical activity.
Theme 1: Adolescents' Food Choices And Food Habits
In terms of food intake and habits, both adolescents and caregivers admitted that adolescents regularly consume and, often, prefer fast foods to home-cooked food mainly because they liked the taste.
‘…it will be nice, it will be tasty’ (FGD 4, 10–12 years, girl)
However, the major part of adolescents’ diet consisted of home-cooked, traditional, and staple foods such as ‘rice bhath’ (a spicy rice dish), ‘bisi bele bhath’ (a mixed dish of rice and lentils), ‘chapathi’ (unleavened whole-wheat flat bread), ‘uppittu’ (a savoury semolina dish), ‘poori’ (deep fried wheat bread), and rice with ‘sambar’ (a spicy lentil curry). When asked what types of foods they considered were healthy, almost all of them spoke about eating home-cooked food in order to maintain good health.
‘Should eat more home food’ (FGD 6, 15–17 years, boy),
‘Everything made at home is healthy and things eaten outside are unhealthy’ (FGD 5, 10–12 years, girl)
There were also health risks associated with eating foods prepared outside the home, such as,
‘…what they say is it’s made with some kind of oil kind of thing. It’s not butter 100% cream when you buy it from shops, it’s not….that’s why they say it’s unhealthy’ (FGD 4, mother),
‘...they say that some chemicals have been added to the [instant] noodles….they say it’s not good for health’ (FGD 1, mother)
‘If you eat outside you’ll get food poisoning’ (FGD 5, 10–12 years, girl)
Fruit, vegetables, green leafy vegetables, meat, eggs, and local staple dishes such as ‘anna saaru’ (rice with sambar) were repeatedly named by participants as being essential for health.
‘Should eat egg’ (FGD 6, 15–17 years, boy)
‘Should eat rice with ‘sambar’, and ‘muddhe’ (millet dumpling)’ (FGD 4, 10–12 years, girl)
They were not only aware of which foods were nutritious, but were able to elaborate why.
‘In fruits and vegetables there will be more vitamins and it is good for health.’ (FGD 5, 15–17 years, girl)
Participants in all FGDs were of the opinion that their diets were generally well balanced.
‘As far as I’m concerned I feel that we are eating well….We are vegetarians basically so I think they [adolescents] are having a balanced diet according to me with protein, carbohydrates…uh…umm vegetables and all that.’ (FGD 3, mother)
‘I feel that I am eating healthily’ (FGD 6, 15–17 years, boy)
A few individuals suggested that there could be room for small improvements.
‘Uhh…because whenever I used to think about whatever I used to eat I thought maybe I should keep it a little less because I was eating a lot’ (FGD 2, 10–12 years, girl)
Theme 2: Physical Activity Habits Of Adolescents
Subtheme 1- Types of physical activity
When adolescents were asked what types of physical activity they take part in, the most common answer was games, which included hide and seek, running and catching, skipping rope, ‘kho kho’ (a team sport involving running and tagging), ‘stone and iron’ and ‘shurrup current’ (a modified form of running and catching). A few girls said that they played organized sports such as basketball and table tennis, and that they cycled, swam, and sometimes danced with their friends. Adolescent boys reported taking part in a variety of sports and games such as cricket, football, ‘kabbadi’ (a physical team sport), tennis and badminton. Adolescents also said they exercised at school in the form of Physical Education and karate, and some also said they did yoga and jogging. Parents of adolescents similarly reported that their children participated in a variety of sports and games.
‘Extracurricular activities in the school like tennis she goes for tennis in the school….after come back she plays normal games’ (FGD 3, mother)
Opportunities for unplanned physical activity included household and other chores for both boys and girls. Girls said they helped with sweeping, cleaning, tidying, and sometimes worked in the garden to plant and water. In contrast, boys reported that they did odd jobs for the family business or helped at home with chores which involve lifting and carrying.
‘Sweeping, home cleaning, and cleaning vessels.’ (FGD 6, 15–17 years, girl)
Subtheme 2- Motivators to being physically active
Adolescents were asked why they took part in different physical activities and the majority explained that it was enjoyable, and that they felt good and happy when they did so.
‘I enjoy like almost every game. Ya, I feel very good playing.’ (FGD 2, 10–12 years, girl)
‘When we play we feel kind of happy.’ (FGD 6, 15–17 years, girl)
Other motivators to engage in games and sports and be physically active in general included an opportunity to spend time with friends,
‘While playing games, we can spend more time with friends.’ (FGD 5, 15–17 years, boy)
meet new people,
‘It’s just fun like that too most of the time when I keep on meeting people and all that…’ (FGD 2, 10–12 years, girl)
gain fitness and better physical appearance,
‘While playing basketball people can become more tall’ (FGD 2, 10–12 years, boy)
and be in better mental, emotional, and physical health.
‘Mind will become free.’ (FGD 6, 15–17 years, girl)
Subtheme 3- Challenges to being physically active
Despite both adolescents and parents reporting that adolescents take part in a variety of physical activities on a regular basis, it was clear that significant barriers existed that prevented or made it difficult for adolescents to do so. Adolescents reported a variety of reasons why they do not take part in physical activity such as not having company, lacking the confidence to take part in sports, parents preventing boys from playing outside for fear of getting injured, and girls being pressured to do housework instead. It was also reported that older (15–17 years) girls felt uncomfortable around boys their age and avoided playing games and sports in their presence, specifically, in a shared space such as a public playground. However, the most salient barriers that emerged were the pressure of school work and the lure of digital devices.
Subtheme 3a- School work and its influence on physical activity
When asked what challenges adolescents faced when wanting to take part in physical activity many of the participants said that school work took precedence in their lives.
‘Studies stop us from playing.’ (FGD 6, 15–17 years, boy)
Some adolescents said that their parents want them to focus on studies rather than playing.
‘Ma’am for example we will be wanting to go out and play. But Mother will tell us to stay in and study. We’ll want so much to play…when we see other children playing we’ll also want to play. But in some families they won’t allow the children to go out and play.’ (FGD 4, 10–12 years, girl)
They also admitted to themselves recognizing the need to focus on school work and that there is so much that needs to be done, which doesn’t leave much time for games and sports.
‘And also to do writing…there will be so much to write, right? I too will want to go out and play but won’t be able to.’ (FGD 4, 10–12 years, girl)
Adolescents also reported seeing others in their age group prioritising school work over physical activity.
‘They’ll be only focused on their studies’. (FGD 6, 15–17 years, girl)
School work commitments included homework, assignments, and preparation for exams. Parents also reported that adolescents are burdened with school work to the extent that they have had them taken out of activities such as dance classes in order to prioritise education, which they felt to be necessary.
‘Children are not getting time for the other activities, they will always be with studies and I don’t see her watching movies also nor browsing. Always she will be busy in the studies only’ (FGD 1, mother)
However, one mother recognized the importance of the right balance of activity and school work and lamented the fact the teenagers neither have recreational activities as part of their school/college curriculum, nor do they have time after school, which was a very different experience compared to hers as a student.
‘They have the studies also. In our time and all, only particular timings we had….8 to 5 college means, 8 to 5 everyday we’ll be there. After 5 o’clock [our] mind used to be free…away from the studies.’ (FGD 1, mother)
The same parent also complained that adolescents in the present time have to spend even their Sundays on education-related exercises.
‘Even Sunday also they are keeping the college.’ (FGD 1, mother)
Subtheme 3b- Screen time and its influence on physical activity
When asked how adolescents spend their free time, the majority said that they either watch TV or spend time on their mobile phones, opining that it is even an addiction for some.
‘When my sister, ok, she got food poisoning for the fifth time so she was admitted to the hospital. That’s when she got extremely addicted to computer, she could not come out and she…like whenever I went there she hardly used to play with me. She always took the computer and just kept on seeing and seeing and seeing and seeing.’ (FGD 2, 10–12 years, girl)
Adolescents said that because of this, some don’t even come out of their houses, which was seen as being a problem.
‘There’s a guy….that fool that he always keeps on playing video games. He never comes out.’ (FGD 2, 10–12 years, boy)
Some recognized that watching TV had both advantages and disadvantages, the good being that it could be a source of entertainment and the bad being the possibility of getting addicted to it and preventing them from being physically active.
‘Good and bad in many ways. Depending on what perspective we take….Maybe for your entertainment…for your entertainment and joy. The bad…the bad perspective might be you get too addicted you keep on seeing it very often.’ (FGD 2, 10–12 years, girl)
A few adolescents admitted that given a choice they would spend time watching TV or play games on their mobile phones to pass the time rather than go out and play. Some parents likewise said that their children preferred to watch TV rather than play.
‘She…if I allow her she would love to sit in front of TV’ (FGD 3, mother)
Caregivers explained that TV and other electronic devices are a major attraction which prevent adolescents from engaging in social activities including playing and being outdoors. They also recognized the effect of digital distractions on adolescent concerns with increased body weight and body image and shape, being clear about the consequences of eating but not exercising.
‘Physical activities they don’t have. Morning they will get up, first they will see the mobile, then they will go have bath and go to the college. After the college they will come and they will sit and they will see the mobile. They don’t have any physical activity. They fill their stomach but don’t spend their energy on any physical activity’ (FGD 1, mother)
It was also noted that while it’s a reality that adolescents these days are over burdened with school work, they are still able to find the time to use their mobile phones either to play games or use social media.
‘They have time for chatting with the friends on mobile’ (FGD 1, mother)
They stressed the fact that digital gadgets have taken precedence in the lives of these young men and women, that they no longer socialize like they used to before mobile phones (especially smart phones) became so easily accessible.