Students and Healthy Eating: The Behavior–Intention Gap in an Unhealthy Food Environment

Background and objectives: Our food environment has a large influence on what we eat. The food environment around five schools in 'Education Boulevard' in the city of 's-Hertogenbosch (The Netherlands) is not healthy. Approximately 30 food outlets are present, and over 90% of the food products these outlets offer fall outside of the Dutch nutritional guidelines for healthy products (wheel of five). The aim of this study was to investigate the eating behavior of students in this food environment and to study the potential difference between what students say they consume at or around school (survey) and their actual food buying behavior (observations). Methods: This study was conducted in two steps: 1. A total of 251 students of the 'Education Boulevard' (≥16 years) filled in a survey which asked the following: what do they eat at or around school and where do they buy/get these foods? 2. Based on the survey, the five most popular food outlets were identified. At these five food outlets, the buying behavior of 267 students were observed: what did they actually buy? Results: The top three products that the students said they buy in the survey were as follows: 1. breads/sandwiches (16% of all indicated products), 2. salads (14%), and 3. sandwich toppings (14%). Our observations, however, show different results. The top three bought foods were as follows: 1. (fried) snacks (27% of total bought products), 2. breads/sandwiches (26%), and 3. sugar-sweetened beverages (12%). Salads, which were mentioned in the survey as the second most frequently bought food, were actually only bought by 3 out of the 267 observed students. Of the 448 products that the students actually bought (based on the observations), 94% did not fit within the Dutch wheel of five for healthy products. Discussion: This study demonstrates that students' food buying behavior is in line with the food on offer (>90% outside the wheel five) and underlines the need for interventions in the food environment. This study also highlights the intention–behavior gap, showing that what students say they do and what they actually do is not in line. Therefore, a survey is not the best method to study food buying behavior.