The socio-ecological model as a framework for understanding junk food consumption among schoolchildren in Nepal.

Background: The consumption of industrially processed food, popularly known as junk food, is a growing public health concern worldwide, including in Nepal. Schoolchildren are a vulnerable group and they consume junk food at school.
Aim: The aim of this study was to examine multi-level determinants of junk food consumption among basic schoolchildren using the socio-ecological model as a framework.
Methods: A cross-sectional study was conducted among students ( n = 404), and a self-reported questionnaire was used to collect the data. The chi-square test and logistic regression were applied to analyse the results using SPSS version 26.
Results: Nearly half (47%) of the students reported that they consumed junk foods at snack time. Important variables for explaining junk food consumption were knowledge of food and nutrition-a micro-level determinant; sharing knowledge of food and nutrition with classmates at school-a meso-level determinant; grade of student-an exo-level determinant; and occupation of parents-a macro-level determinant. However, multivariate analysis found that knowledge of food and nutrition ( p < 0.05), and sharing knowledge of food and nutrition with classmates at school ( p < 0.05) were the significant predictors of junk food consumption.
Conclusions: Junk food consumption is common among basic-level students in the study schools. Multi-level determinants explain the factors associated with this behaviour, extending from micro to macro as the socio-ecological model asserts. This study points to the need for comprehensive school-based nutrition education that targets multiple levels of influence, focusing on active learning approaches to promote healthy dietary behaviour in students.