Exploring the Influence of Food Consumption on Schoolchildren’s Food Choices using A Gamified Choice Experiment in Greater Beirut, Lebanon

Abstract

Background: Children’s food choices are risk factors for the development of several non-communicable diseases (NCDs). In Lebanon, socio-economic crises have led to a shift in dietary patterns towards more processed and unhealthy foods, increasing the risk of NCDs among children. Thus, the objectives of this project were to examine how different food consumption exposures, classified into the 4 NOVA classifications (unprocessed food, processed culinary ingredients, processed food, and ultra-processed food), influence food choices among Lebanese children after the crises, as well as identifying the determinants of food choices after the crises in Lebanon.

Methodologies: The study used secondary data taken from the SCALE study, which was a cross-sectional study conducted with a stratified random sample of primary schools in Greater Beirut, and children were randomly selected from grades 4-5-6 in each school. Data were collected through different methods, including structured questionnaires and discrete choice experiments (DCE) to assess children’s food choices. Additionally, wearable cameras were used specifically to capture the real food consumption exposure of grade 6 children at home and on their way to school.

Results: Out of the 47 selected schools, a total of 2,125 children were included in this project, from which 176 were selected for the study. The study revealed significant associations between exposure to unprocessed foods and healthier food choices, with children exposed to three or more unprocessed items having higher odds of selecting more healthy and moderately healthy foods (OR = 2.93, p < 0.05, 95%CI (1.26, 6.83) for healthy choices; OR = 1.83, p < 0.05, 95%CI (1.11, 3.01) for moderately healthy choices). Eating meals at home, gender, eating in front of the TV/screen, and spending more time on the TV and the computer were identified to be significant determinants of children’s food choices.

Conclusions: The findings underscore the importance of promoting exposure to healthier food consumption both at home and on the way to school. Moreover, they highlight the necessity for public health policies aimed at enhancing children’s exposure to unprocessed food options. Future research is needed for a better understanding of the factors affecting children’s food choices.