The voice of young people is important in promoting healthy eating habits among adolescents

Good health and nutrition go beyond knowing what to eat. We must make a conscious choice to eat well and have the means and opportunities to access healthy food options. Poor food choices—of items of low quality and nutritional value—and their harmful consequences affect people of all ages and communities. However, low income communities and those with limited awareness about prioritising healthy eating, are especially vulnerable. A 2022 Unicef report shows that two thirds of children aged under 5 years (around 475 million) in low and middle income countries experience food poverty, lacking access to a nutritious and diverse diet.1

Young people, particularly girls from communities and backgrounds like ours in Lakhwal, a suburban locality of Islamabad where access to facilities is limited, face multiple challenges to good health and nutrition. They are constrained by gender norms, financial limitations, a lack of information about healthy eating, and an environment where unhealthy food is both conveniently available and inexpensive. All of these factors contribute to making younger girls more vulnerable to unhealthy food. As the BMJ Collection on Tackling the Triple Burden Of Adolescent Girls’ Malnutrition shows (https://www.bmj.com/collections/nourishing-south-asia), these barriers not only make it harder for adolescent girls to prioritise healthy eating and have good nutrition, they can also have long term effects on their overall health and wellbeing.

As young girls working to promote and consume healthier nutrition options daily, we witness how limited awareness about the importance of healthy eating, together with insufficient finances for better food options, contributes to a culture of unhealthy eating in our area. If policy makers are serious about improving adolescent girls’ health and nutrition in communities like ours, they will have to begin by tackling the root causes.

For many adolescent girls, eating healthily is not just a matter of choice but a challenge shaped by gender norms. For example, the young girls in our community generally have lots of household responsibilities that restrict their time and energy to focus on their own health. Boys’ nutrition and education is often prioritised, and although women are typically responsible for preparing family meals, they often have the least access to nutrition education and resources to make informed, healthier choices.

The food environment we live in further complicates the matter by making it difficult to eat well. Even when adolescent girls know what is healthy, financial constraints and an increasing presence of cheap, processed foods leave them with little control over their diet. Unhealthy eating is not just a matter of personal preference but often a reflection of the limited choices we have. Street vendors sell bakery items and other sugary and colourful foods that are attractive to children but lay the foundations of unhealthy eating habits. Items such as greasy fries, processed food, and sugary drinks are easily accessible in small local shops called dhaabaas, making them the most affordable food options. In our communities, access to fresh produce is limited not just by cost but also by a lack of awareness about healthier alternatives.

It is important to have a structured approach to tackle these challenges. In our community one possible solution could be the formation of a food council including young girls, health professionals, and policy makers. This council would provide the space to work collaboratively to promote healthier food environments. This type of model has been used in other countries, including the United States, where food policy councils bring together diverse stakeholders to assess and improve local food systems, fostering community engagement and policy development. Food councils can work in collaboration with local education authorities to provide education to adolescents at their schools, particularly on nutritious and affordable meal planning. The councils can advocate for healthier canteens at school and push the government to implement regulations on selling processed foods. They can work collectively with local vendors to encourage the sale of healthier food options. They can also propose and inform policy makers on practical ways to make healthier food more accessible and affordable to all.

A food council can amplify adolescent voices like ours and help to overcome the health and nutrition challenges young girls in our community face. We also need policies that drive actions to promote better food environments and prioritise nutrition education and awareness. The BMJ collection emphasises the importance of implementing gender responsive strategies and enforcing policies to improve adolescent girls’ nutrition.