Socio-ecological factors influencing food choices and behaviours of Maltese primary school children

Abstract

This aim of this study was to explore the various influences on the food choices and behaviours of Maltese primary schoolchildren. Using an ecological framework and following sociological theory of consumption it sought to uncover any group differences in food perceptions, beliefs, preferences and intake, as well as identify any culture-cuisine orientations of foods consumed in different settings. A multi-method grounded approach was adopted, where results from each stage of the research informed the focus of subsequent stages. A culture-sensitive research tool was developed for exploring children's food consumption and preferences in ten different homebased and non-home-based settings. Data was collected via a large-scale survey with a stratified sample of 7-8-year-old children (N=1088) and their parents (N=932). Follow-up focus group interviews with children (N=16 groups) and telephone interviews with parents (N=30) were also conducted in order to obtain more detail on influences on food intake. Analysis based on gender, household level of schooling, school type, region and access to cable TV showed that Maltese children's overall food intake was fairly similar across groups, though some specific patterns did emerge. Girls seemed to prefer and consume 'lighter' more 'feminine' foods and boys 'heavier' more 'masculine' foods. Children attending independent (fee-paying) schools tended to exhibit more 'modern' food practices based on novel and processed foods. They also tended to eat weekday supper with their family less frequently than other groups. Children attending state schools tended to consume more meat-based meals, milk and traditional Maltese foods. Children from the rural island of Gozo seemed to place greater value on balance, quality and freshness of food and ate their weekday supper with their family more frequently. A pronounced Westernisation of Maltese children's diet was evident. Traditional Maltese foods were only predominant in home-based snacks. Grandparents emerged as having an important role in exposing children to traditional cuisine. Mothers' provision of food for children was based primarily on hedonic and health motives. Strategies used to promote consumption of healthy food included controlling availability, information-giving and being prescriptive rather than restrictive. In general, both children and parents acknowledged the value of school food rules, although attitudes differed with regard to extent of imposition. Parents also felt that TV food portrayal was a strong influence on their children's food requests, as was to a lesser extent modelling of food behaviours by peers. Children's knowledge of the health value of food was good, though a few misperceptions existed and certain food associations were barriers to intake. Taste, texture, convenience and healthfulness were key attributes which attracted children to food. Local health promotion initiatives and nutrition education interventions need to target the different influences on Maltese children's food intake functioning at the different ecological levels. These include the children's own food perceptions, beliefs and valuations, as well as the different routes of influence of the mottler, grandparents, the school and television.