Adolescent food frequency and socio-economic status in a private urban and peri-urban school in Hilton, KwaZulu-Natal

Objective: The objective of the study was to make a comparative analysis of the dietary preferences of adolescents attending an urban versus a peri-urban school in KwaZulu-Natal, in order to investigate the association between socio-economic status and food frequency.Design: The design was a cross-sectional descriptive survey.Setting: The setting was an urban and peri-urban high school in Hilton, KwaZulu-Natal.Subjects: One hundred and eleven grade 9-11 learners from a peri-urban school, and 98 grade 9-11 learners from an urban school, volunteered to participate.Outcome measures: A non-quantified food frequency questionnaire was used to assess food frequency. A socio-demographic questionnaire developed for the purpose of this study was utilised to collect information on parental education, employment status and household or accommodation data. A Household Food Insecurity Access Scale  questionnaire was used to determine the household food insecurity of the learners.Results: The findings indicated that there was a higher preference for globalised foods (high in fat and sugar), particularly fast food, by learners from the peri-urban school (p-value < 0.01). These learners were also more likely to consume locally available, high-fat snacks (p-value < 0.01). Grade 10 urban school learners consumed more red meat and processed meats than their peri-urban school counterparts (p-value < 0.01). Negative correlations were observed between parental education and employment status (particularly of the mothers) and fast food consumption in  adolescents (p-value < 0.01).Conclusion: A high frequency of globalised or energy-dense food intake was associated with low socio-economic status. Although healthy eating habits were generally poor in urban and peri-urban adolescents, food sources varied, possibly owing to cost and availability. The importance of a diverse diet and the inclusion of a wider range of affordable, nutrient-rich foods should be promoted in the school setting, and also to parents, particularly those of a lower socio-economic status